HISTORY OF SURGERY.doc

AST. Surgical Technology, 2E. Rothrock. Alexander’s Care of the Patient in Surgery,Delmar Learning 12E. Elsevier

CHAPTER 1ORIENTATION TO SURGICAL TECHNOLOGY

No Chapter on this Topic

HISTORY OF SURGERY 3 HISTORY AND EVOLUTION OF SURGICAL SUTURES (Ch. 6)

187

SURGERY TODAY 4Surgical Specialties 5HISTORY OF SURGICAL TECHNOLOGY

6

FIELD OF SURGICAL TECHNOLOGY 8 Working Conditions 8 Personal Characteristics 8Surgical Team Members 8Surgical Technology Education and Certification

10

THE SURGICAL TECHNOLOGISTAS A PROFESSIONAL

11

Professionalism 11Surgical Technologist’s Lifestyle 12Job Descriptions for the Surgical Technologist

13

Career Opportunities 13HEALTH CARE FACILITIES 14Hospital Organization 15Hospital Departments and Interdepartmental Communication

17

Financial Considerations and Reimbursement

19

Organizations Related to Hospitals, Health Care, and Surgical Services

20

CHAPTER 2STANDARDS OF CONDUCT


LEGAL ISSUES 23Definitions of General Legal Terms 23Definitions of Traditional Principles 24Torts 25Consent for Surgery: A Basic Right 27 Protecting Patients’ Rights (Ch.2) 23Documentation 29 Clinical Documentation (Ch. 2) 27Event/Incident Reports 30 Box 2-4. Incident Reports (ch.2) 28Advance Directives 30ETHICAL AND MORAL ISSUES 30Moral Principles 31Bioethics 31AHA Patient’s Bill of Rights 31 Legal and Ethical Mandates (Ch. 10) 297Elements of Ethical Decision Making 32Professional Codes of Conduct 34Surgical Conscience 34SCOPE OF PRACTICE 34Job Descriptions and Competencies 35Credentialing 36Accreditation 36Core Curricula for Surgical Technology and Surgical Assisting

36


Career Development 36Clinical Ladder Program 37RISK MANAGEMENT AND LIABILITY 38Medical Errors 38Safe Medical Device Act 39Malpractice Insurance 39

CHAPTER 3THE SURGICAL PATIENT.


THE STSR AND THE SURGICAL PATIENT

43

PHYSICAL, PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL NEEDS OF THE SURGICAL PATIENT

43

Understanding the Surgical Patient 44Causes of Surgical Intervention 44The Surgical Patient, a Human Being 44Prioritizing Needs-Maslow’s Hierachy 45Life Stage Development: Select Basic Concepts

46

Cultural and Religious Influences 49

CHAPTER 4SPECIAL POPULATIONS

CAPTER 29 PEDIATRIC SURGERYCHAPTER 30 GERIATRIC SURGERYCHAPTER 31 TRAUMA SURGERY

INTRODUCTION 57PEDIATRIC PATIENTS 57 PERIOPERAIVE NURSING

CONSIDERATIONS (Ch. 29)1211

Monitoring the Pediatric Patient 59Shock 60Fluids and Electrolytes 60Infection 61Metabolic and Nutritional Responses 61Trauma 61 Child Abuse (Ch. 29)

TRAUMA (Ch. 29)12121263

PATIENTS WITH OBESITY 62Review of Surgical Considerations 64Specific Considerations of Bariatric Surgery 64PATIENTS WITH DIABETES 64Complications Associated with Diabetes 65Care of the Patient with Diabetes in Surgery 66PREGNANT PATIENTS 66Considerations when Caring for Pregnant Patients

67

Anesthesia 67Intraoperative Considerations for the Surgical Technologist

67

IMMUNOCOMPROMISED PATIENTS 68Acquired Immunodeficiency Syndrome 68Considerations for the Surgical Team Members

68

PATIENTS WITH DISABILITIES 69GERIATRIC PATIENTS 69 CHAPTER 30 GERIATRIC SURGERY 1295TRAUMA PATIENTS 71 CHAPTER 31 TRAUMA SURGERY 1317


THE “GOLDEN HOUR” AND TRAUMA PATIENTS

71 CHAPTER 31 TRAUMA SURGERY 1317

KINEMATICS 71 Preliminary Evaluation: Mechanism of Injury (Ch. 31)

1319

Blunt Trauma 71 Preliminary Evaluation: Mechanism of Injury (Ch. 31)

1321

Penetrating Trauma 72 Preliminary Evaluation: Mechanism of Injury (Ch. 31)

1322

TRAUMA SCORING 72 Preliminary Evaluation: Mechanism of Injury (Ch. 31)

1323

CONSIDERATIONS FOR THE SURGICAL TECHNOLOGIST

72 Multiple Operative Procedures (Ch. 31) 1334

Preservation of Evidence 72 Evidence Preservation (Ch. 31) 1336Hypothermia 73 Hypothermia (Ch. 31) 1338Infection 73 Increased Risk for Infection (Ch. 31) 1334PREPARATION OF THE CASE 73 Procedure Preparation (Ch. 31) 1334

CHAPTER 5PHYSICAL ENVIRONMENT AND SAFETY STANDARDS

CHAPTER 2 PATIENT AND ENVIRONMENTAL SAFETYCHAPER 4 INFECTION PREVENTION AND CONTROLCHAPTER 3 SURGICAL MODALITIES

PHYSICAL DESIGN OF THE SURGERY DEPARTMENT

77 Physical Plant Design Elements (Ch.2) 18

Areas of the OR 78 Traffic Control (Ch. 4) 134Physical Components of the Operative Suite 79 Physical Plant Design Elements (Ch. 2)

ENGINEERING PRACTICES TO CONTROL INFECTION (Ch. 4)

18111

Substerile Area 83 Environment of Care (Ch. 4) 112Direct Support Services 83HAZARDS AND REGULATORY AGENCIES

85

SAFETY CONSIDERATIONS 86Air-Handling System 86 Heating, Ventilating, Air Conditioning

(Ch. 4)112

Surgical Lights 86Noise in the Operating Room 86Ergonomics and Safety Considerations 86Fire Hazards and Safety 87 Electrical and Fire Hazards (Ch. 2)

Fire Safety (Ch. 3)1980

Electrical Hazards 88 Electrical and Fire Hazards (Ch. 2) 19Ionizing Radiation 89 Radiation Safety (Ch. 2) 21BIOLOGICAL HAZARDS AND SAFETY CONSIDERATIONS

90

Universal Precautions 90 Universal Precautions (Ch. 4) 106Standard Precautions 90 Standard Precautions (Ch. 4) 108Laser and Electrosurgical Plume 93 Smoke Evacuation (Ch. 3) 82Latex Allergy 94 Latex Allergy (Ch. 2) 21CHEMICAL HAZARDS AND SAFETY CONSIDERATIONS

94

Waste Anesthetic Gases 94 OPERATING ROOM POLLUTION (Ch. 7)

250

Methyl Methacrylate 95 Polymethyl Methacrylate (Ch. 22) 840Formalin 95 Care and Handling of Specimens ( Ch. 4) 36


Ethylene Oxide 95 Ethylene Oxide (Ch. 4) 124Glutaraldehyde 95CHAPTER 6BIOMEDICAL SCIENCE


INTRODUCTION 99COMPUTERS 99Surgical Applications 99Hardware 100Software 103Word Processing 104Graphics 105Internet Basics 106ELECTRICITY 107Surgical Applications 107Basic Principles of Electricity 108PHYSICS 112Medical and Surgical Applications 112Mechanics 113Nuclear Physics 122Gravity 122SURGICAL ROBOTS 122Terminology 123Design 123 Robotics (Ch.3) 65Remote Manipulation 124Geometry 124Hearing and Vision 125Decontamination and Sterilization of Robotic Components

125

Clinical Applications 125THE OR OF THE FUTURE 125Surgical Planning and Rehearsal 125Surface-Based Registration 126ROLE OF THE SURGICAL TECHNOLOGIST

126

CHAPTER 7ASEPSIS AND STERILE TECHNIQUE

CHAPTER 4 INFECTION PREVENTION AND CONTROL

HISTORY OF STERILIZATION 130 CHAPTER 4 INFECTION PREVENTION AND CONTROL

97

BASIC TERMINOLOGY 131 Box 4-1. Definition of Terms 99PATHOGENS AND INFECTION 131 Microorganisms That Cause Infection 98Infection 131 Box 4-1. Definition of Terms 99Pathogens Associated with Surgical Site Infection

132 Microorganisms that Cause Infection 98

Methods of Transmission 135 CONTROLLING INFECTION IN THE PERIOPERATIVE ARENA

106

PRINCIPLES OF ASEPSIS 138 Surgical Aseptic Principles 131Principle 1: Sterile Field 138 Surgical Aseptic Principles 131Principle 2: Sterile Team Member Attire 139 Surgical Aseptic Principles 131Principle 3: Movement in and around Sterile Field

140 Surgical Aseptic Principles Traffic Control

131134

SURGICAL CONSCIENCE 140CLEANING, DISINFECTION, AND STERILIZATION

141 Operating Room Environmental Cleaning 151


Cleaning and Disinfection 142 Disinfection Presterilization ProcedureOperating Room Environmental Cleaning

127113151

Disinfectant and Disinfectant/Sterilant Agents

147 Types of Disinfectants Disinfection of Endscopes

127128

INSTRUMENT PREPARATION AND WRAPPING FOR STERILIZATION

151 Presterilization Procedure 113

Instruments 151 Presterilization Procedure 113Specific Procedural Trays 151Instrument Sets 151 Packaging and Sterilizer Loading 116PACKAGING FOR STERILIZATION AND STORAGE

152 Packaging and Sterilizer Loading 116

Performance Standards of Packaging Material

152 Packaging and Sterilizer Loading 116

Performance Characteristics 152 Packaging and Sterilizer Loading 116Types of Packaging Materials 153 Packaging and Sterilizer Loading 116General Principles of Packaging 155 Packaging and Sterilizer Loading 116Sterilization 158 Work Practices to Control Infection 112Requirements and Essential Factors 159 Work Practices to Control Infection 112Basic Components of a Steam Sterilizer 160 Work Practices to Control Infection 112GAS STERILIZATION 163 Chemical Sterilization 121Ethylene Oxide 163 Chemical Sterilization 123Alternative Gas Sterilization Methods 164 Chemical Sterilization 123LIQUID CHEMICAL STERILIZATION PROCESSES

165 Chemical Sterilization 124

IONIZING RADIATION 165METHODS OF MONITORING THE STERILIZATION PROCESS

165 Work Practices to Control Infection

119

Mechanical Methods of Monitoring the Sterilization Process


119

Chemical Methods of Monitoring the Sterilization Process


119

Biological Methods of Monitoring the Sterilization Process


119

Bowie-Dick Test 167 Work Practices to Control Infection

120

EVENT-RELATED STERILITY 167 Operating Room Environmental Cleaning 151Environmental Decontamination 168 Operating Room Environmental Cleaning 151Environmental Services 168 Operating Room Environmental Cleaning 151Case by Case 168 Operating Room Environmental Cleaning 151Daily 168 Operating Room Environmental Cleaning 151CHAPTER 8GENERAL PATIENT CARE AND SAFETY

FOUND THROUGHOUT UNIT 1 FOUNDATIONS FOR PRACTICE

PREOPERATIVE PATIENT ROUTINES 172 General Patient Safety Measures (Ch. 2)Admission of the Patient to the Operating Room (Ch.2)ASSESSMENT (Ch. 10)

2425

299Surgical Consent 173 Protecting Patient Rights (Ch. 2) 23Preoperative Education 175 ASSESSMENT (Ch. 10) 299Patient Possessions 175 Admission of the Patient to the Operating

Room (Ch.2)27

Evening/Morning before Surgery 176 Admission of the Patient to the Operating 25


Room (Ch.2)

Diet 177 Admission of the Patient to the Operating Room (Ch.2)

27

Makeup and Dress 177Call to Operating Room 177Family Visit 177Patient Identification 177 Admission of the Patient to the Operating

Room (Ch.2)25

Transportation 178 Implementation (Ch. 5) 172TRANSFER AND POSITIONING 179 Implementation (Ch. 5) 172BASIC POSITIONING FOR SURGERY 180Supine Position 181 Supine (Ch. 5) 176Trendelenburg Position 183 Trendelenburg (Ch. 5) 176Reverse Trendelenburg Position 184 Reverse Trendelenburg (Ch. 5) 177Fowler’s Position and Sitting Position 184 Semi-Fowler (Ch. 5)

Fowler (Ch. 5)180181

Lithotomy Position 185 Lithotomy (Ch. 5) 178Prone Position 186 Prone (Ch. 5) 181Kraske (Jackknife Position) 188 Jackknife (Ch. 5) 182Lateral Position 189 Lateral (Ch. 5) 183Kidney Position 190 Lateral Kidney (Ch. 5) 184Sim’s Position 191THERMOREGULATORY DEVICES 191 Maintainin Normotheria In The Surgical

Patient (Ch. 2)TERMPERATURE CONTROL (Ch. 7)

35

247VITAL SIGNS 192 PERIOPERATIVE MONITORING

(Ch. 7)225

Temperature 192 TEMPERATURE CONTROL (Ch. 7) 247Pulse 193 Pulse Oximetry (Ch. 7) 227Respiration 194 Capnography (Ch. 7) 228Blood Pressure 196URINARY CATHETERIZATION 199 Urethral and Ureteral Catheters (Ch. 7) 530Indications 200 Urethral and Ureteral Catheters (Ch. 7) 530Procedure 200 Urethral and Ureteral Catheters (Ch. 7) 530Considerations 200 Urethral and Ureteral Catheters (Ch. 7) 530SKIN PREPARATION 202 Patient Skin Disinfection and Preparation

Ch. 4)147

Skin Preparation Setup 203 Patient Skin Disinfection and Preparation Ch. 4)

147

Skin Marking 206HEMOSTASIS AND BLOOD REPLACEMENT

206 HEMOSTASIS (Ch. 6) 195

Factors Affecting Hemostasis 207Control of Bleeding during Surgery 207 HEMOSTASIS (Ch. 6) 195Mechanical Methods 207 HEMOSTASIS (Ch. 6) 195THERMAL HEMOSTASIS 209 HEMOSTASIS (Ch. 6) 195PHARMACOLOGICAL AGENTS 209Blood Loss 210 Estimating Blood Loss (Ch. 2) 33Blood Replacement 210 Handling Blood and Blood Products

(Ch. 2)34

Hemolytic Transfusion Reactions 211CARDIOPULMONARY RESUSCITATION

211 Cardiopulmonary Resuscitation (Ch. 2) 39


Cardiac Arrest in the Surgical Setting 212 Cardiopulmonary Resuscitation (Ch. 2) 39MALIGNANT HYPERTHERMIA 213 Malignant Hyperthermia (Ch. 2)

MALIGNANT HYPOTHERMIA (Ch. 10)

39247

Prevention 213 MALIGNANT HYPOTHERMIA (Ch. 10)

247

Treatment 213 MALIGNANT HYPOTHERMIA (Ch. 10)

247

EMERGENCY MEDICAL SERVICES 213INDICATIONS OF EMERGENCY SITUATIONS

214

OBJECTIVES AND PRIORITIES IN ERMERGENCY SITUATIONS

214

Syncope 214Convulsions/Seizures 215Hemolytic Transfusion Reactions 211Clinical Manifestations of Impending Cardiac Arrest

216

CHAPTER 9SURGICAL PHARMACOLOGY AND ANESTHESIA

CHAPTER 7 ANESTHESIA(Also Ch. 8 and 32)Pharmacology (medications) is found under specific surgeries.

PHARMACOLOGY 219Drug Sources 219Drug Forms 220Drug Nomenclature 220Route of Administration 221Drug Classifications 221Pharmacokinetics 221Pharmacodynamics 222DRUG-HANDLING TECHNIQUES 223Medication Identification 223Supplies for Medication Handling 225Transfer of a Medication to the Sterile Field 225Medications Commonly Used in the Operating Room

226

HISTORY OF MODERN ANESTHESIA 229 HISTORY OF ANESTHESIA 219METHODS AND TECHNIQUES OF ANESTHETIC ADMINISTRATION

231 PREOPERATIVE PREPARATION 222

GENERAL ANESTHESIA 231 GENERAL ANESTHESIA 230Depth of General Anesthesia 231 Levels of General Anesthesia 231Phases of General Anesthesia 232 Phases of General Anesthesia 231Advantages of General Anesthesia 232Risks and Complications Associated with General Anesthesia

232 Typical Sequence of General Anesthesia 239

Anesthetic Agents 235 Types of General Anesthesia 231Adjuncts to General Anesthesia 240 Levels of General Anesthesia 231Anesthesia Equipment 241 PERIOPERATIVE MONITORING

ANESTHETIC MACHINES AND ANESTHETIC GASESTEMPERATURE CONTROL

225228

247NERVE CONDUCTION BLOCKADE 244 TYPS OF ANESTHESIA ARE 225Nerve Conduction Blocking Agents 244


Topical Anesthesia 246Local Anesthesia 246 Local Anesthesia 245Regional Anesthesia 246 Regional Anesthesia 239NONTRADITIONAL ANESTHESIA OPTIONS

249 Perioperative Medical Hypnotherapy (Ch. 32)

1361

TEAM MEMBER ROLES DURING ANESTHESIA ADMINISTRATION

249

Preoperative Visits 250 PREOPERATIVE PREPARATION 222Preoperative Routine-All Types of Anesthesia

250 PREOPERATIVE PREPARATION 222

Postanesthesia Care 253 PERIANESHTESIA CONSIDERATIONS (Ch. 8)

253

CHAPTER 10INSTRUMENTATION, EQUIPMENT, AND SUPPLIES

CHAPTER 3 SURGICAL MODALITIESCHAPTER 6 SUTURES, NEEDLES AND INSTRUMENTSand Chapters 4, 9, 15, 22, 25, 32

INSTRUMENTATION 259 Composition of Surgical Instruments (Ch. 6)

205

Classifications 259 Instrument Catagories (Ch. 6) 206Instrument Care and Handling 264 Care and Handling of Instruments (Ch. 6) 215Types of Instrument Sets 265SPECIALTY EQUIPMENT 269Endoscopes 269 Endoscopes (Ch. 3)

Endoscopic Instrumentation (Ch. 6) 42211

Power Tools 270 Powered Surgical Instruments (Ch. 32) 840Lasers 270 Laser (Ch. 3) 69Microscopes 273 Operating Microscopes (Ch. 18) 676Video Monitors, Recorders, and Cameras 273 VIDEO TECHNOLOGY (Ch. 3) 57Fiber-optic Headlamps and Light Sources 274Irrigation/Aspiration Units 274 Hydrodissection and Irrigation (Ch. 3) 94Cryotherapy Units 274 CryoSurgery (Ch. 3) 95Insufflators 274 INSUFFLATIN (Ch. 3) 67Nerve Stimulators 274ACCESSORY EQUIPMENT 275Suction Systems 275Electrosurgical Unit 275 Electosurgery (Ch. 3) 87Lights 278Pneumatic Tourniquets 279 Pneumatic Tourniquets (Ch. 22) 835Sequential Compression Devices 280 Application of Sequential Compression

Devices (Ch. 12)404

SUPPLIES 280Drapes 280 Creating the Sterile Field with Surgical

Drapes (Ch. 4)148

Sterile Packs 282Sponges and Dressings 282 Dressings (Ch. 9) 292Catheters, Tubes, and Drains 285 Drains (Ch. 9)

Urethral and Ureteral Catheters (Ch. 15)Chest Drainage Systems (Ch. 25)

2955301054

Nonsuture Needles 288Irrigators and Syringes 289


CHAPTER 11WOUND HEALING, SUTURES, NEEDLES, AND STAPLING DEVICES

CHAPTER 6 SUTURES, NEEDLES AND INSTRUMENTSCHAPTER 9 WOUND HEALING, DRESSINGS, AND DRAINS

INTRODUCTION 292 CH. 9 WOUND HEALING, DRESSINGS, AND DRAINS

281

TYPES OF WOUNDS 292 ETIOLOGY OF WOUNDS (Ch. 9) 281Surgical Wound 292 WOUND CLASSIFICATION (Ch. 9) 287Traumatic Wound 293 WOUND CLASSIFICATION (Ch. 9) 287Chronic Wound 294INFLAMMATORY PROCESS 294TYPES OF WOUND HEALING 294 ETIOLOGY OF WOUNDS (Ch. 9)

TYPES OF WOUND CLOSURE281

First Intention (Primary Union) 294 Primary Intention (Ch.9) 281Phases of Wound Healing by First Intention 295 PHASES OF HEALING (Ch. 9) 282Second Intention (Granulation) 295 Second Intention (Granulation) (Ch. 9) 282Third Intention (Delayed Primary Closure) 295 Delayed Primary Closure, or Tertiary

Intention (Ch. 9)282

FACTORS INFLUENCING WOUND HEALING

295 FACTORS AFFECTING WOUND HEALING (Ch. 9)

285

COMPLICATIONS OF THE HEALING WOUND

296 FACTORS AFFECTING WOUND HEALING (Ch. 9)

285

Intraoperative Wound Care 297 ANTIMICROBIAL PROPHYLAXIS (Ch. 9)

288

Postoperative Wound Care 298 WOUND MANAGEMENT (Ch. 9)DRESSINGSDRAINS

291292295

SUTURE 298 CH. 6 SUTURES, NEEDLES AND INSTRUMENTS

187

History 298 HISTORY AND EVOLUTION OF SURGICAL SUTURES (Ch. 6)

187

Types of Suture Material 299 SUTURE MATERIALS (Ch. 6) 188Suture Sizes 300General Factors Affecting Choice of Suture 300 Selection of Suture (Ch. 6) 195Characteristics of Common Sutures 300 Characteristics of Suture Material (Ch. 6) 189Packaging of Suture 303 PACKAGING, STORAGE, AND

SELECTION OF SUTURES (Ch. 6)194

Ligatures 303 Methods of Ligating Vessels (Ch. 6) 195Ligating Methods 303 Methods of Ligating Vessels (Ch. 6) 195Suture for the Procedure 304 PERIOPERATIVE NURSING

CONSIDERATIONS (Ch. 6)202

Layer Closure 305Endoscopic Suture 307 Endoscopic Suturing(Ch. 6) 202Suturing Techniques 307 SUTURING METHODS (Ch. 6) 199Accessory Devices 309 SKIN TAPES (Ch. 60 196STAPLING DEVICES 310 SKIN STAPLES (Ch. 6) 196Types of Staplers 312 SKIN STAPLES (Ch. 6) 196Meshes or Fabrics 313NEEDLES 314 SURGICAL NEEDLES (Ch. 6) 196Needle Eye 314 Eye (Ch. 6) 196Needle Point 315 Body (Ch. 6) 198Needle Bodies 315 Body (Ch. 6) 198


CHAPTER 12 SURGICAL CASE MANAGEMENT

No chapter on this subject, but some topics are covered in various chapters.

INTRODUCTION 318Applied Theory 319 CONTROLLING INFECTION IN THE

PERIOPERATIVE ARENA (Ch. 4)106

PREOPERATIVE CASE MANAGEMENT 323Attire 323 Surgical Attire (Ch. 4) 134Preparing the OR 327 ASEPTIC PRACTICES TO CONTROL

INFECTION (Ch. 4)131

ORGANIZING THE BACK TABLE 341 Basic Table Set-Ups (Ch. 6) 214Organizing the Mayo Stand 346 Basic Table Set-Ups (Ch. 6) 215Assisting a Team Member 346 Assisted-Gowning Procedure (Ch. 4) 143Draping the Surgical Patient 346 Creating the Sterile Field with Surgical

Drapes (Ch. 4)148

Positioning of the Sterile Team Members and the Furniture

353

INTRAOPERATIVE CASE MANAGEMENT

353

General Principles 353 Sponge, Sharp, and Instrument Counts (Ch. 2)

36

Progression of the Surgical Procedure 361POSTOPERATIVE CASE MANAGEMENT

363

Preservation of the Sterile Field 363Drape Removal 363Gown and Glove Removal 364 Removing Soiled, Gown, Gloves, and

Mask (Ch. 4)146

Immediate Postoperative Care 364Patient Transfer and Transportation 364Breakdown of the Setup 365The Operating Room Cycle 365The Instrument Cycle 366

CHAPTER 13DIAGNOSTIC PROCEDURES

No specific chapter on this topic. Diagnostic procedures can be found in the Perioperative Nursing Considerations section under specific surgeries.

SOURCES OF PATIENT DATA 371History and Physical Examination 371Diagnostic Imaging 371Laboratory Reports 378Electrodiagnostic Studies 381Pulmonary Diagnosis 382Endoscopy 383Plethysmography and Phleborheography 383INDICATIONS FOR SURGERY 383


CHAPTER 14GENERAL SURGERY

CHAPTER 11 GASTROINTESTINAL SURGERYCHAPTER 12 SURGERY OF THE LIVER, BILIARY TRACT, AND SPLEENCHAPTER 13 REPAIR OF HERNIASCHAPTER 17 BREAST SURGERYCHAPTER 26 VASCULAR SURGERYCHAPTER 16 THYROID AND PARATHYROID SURGERY

ANATOMY 386 SURGICAL ANATOMY (Ch. 11)SURGICAL ANATOMY (Ch. 12)

329395

Abdominal Cavity: General Dimensions 386Surface Features 386Abdominal Musculature 387Peritoneum 387Retroperitoneum 388Alimentary Canal 388 SURGICAL ANATOMY (Ch. 11) 329Esophagus 388 SURGICAL ANATOMY (Ch. 11) 329Stomach 389 SURGICAL ANATOMY (Ch. 11) 329Small Intestine 390 SURGICAL ANATOMY (Ch. 11) 330Mesentery 391 SURGICAL ANATOMY (Ch. 11) 333Colon 391 SURGICAL ANATOMY (Ch. 11) 334Rectum 393 SURGICAL ANATOMY (Ch. 11) 335Anus 393 SURGICAL ANATOMY (Ch. 11) 335Omenta 394Pancreas 394 SURGICAL ANATOMY (Ch. 12) 399Spleen 395 SURGICAL ANATOMY (Ch. 12) 399Liver 395 SURGICAL ANATOMY (Ch. 12) 396Biliary Tract 396 SURGICAL ANATOMY (Ch. 12) 399GENERAL SURGERY INSTRUMENTATION

397

Major Set 397 IMPLEMENTATION (Ch. 11) 344Minor Set 397 IMPLEMENTATION (Ch. 11) 344Local Excision Instruments 399Biliary Instruments 399 Instrumentation (Ch. 12) 405Intestinal Instruments 400 IMPLEMENTATION (Ch. 11) 344Other General Instruments 400 IMPLEMENTATION (Ch. 11) 344ROOM SETUP 400POSITIONING 400 IMPLEMENTATION (Ch. 11)

Positioning the Patient (Ch. 12)344404

DRAPING 400 IMPLEMENTATION (Ch. 11)Draping the Patient (Ch. 12)

344405

INCISIONS 402 ABDOMINAL INCISIONS (Ch. 11) 350SURGERY OF THE ABDOMINAL WALL: HERNIAS

404 CH. 13 REPAIR OF HERNIAS 433

Specific Anatomic Features of the Groin Area

404 SURGICAL ANATOMY (Ch. 13) 433

Hernias 405Hernia Repair 405 SURGICAL INTERVENTIONS (Ch. 13) 442SURGERY OF THE ALIMENTARY CANAL

407

Surgery of the Esophagus 408 SURGERY OF THE ESOPHAGUS (Ch. 11)

359


Gastric Surgery 408Pathological Conditions of the Stomach 408 SURGERY OF THE STOMACH

(Ch. 11)363

Procedures Related to Gastric Secretion, Ulcers, and Neoplasm

416 SURGERY OF THE ESOPHAGUS (Ch. 11)

363

Procedures for Morbid Obesity 416 BARIATRIC SURGERY (Ch. 11) 374Surgery of the Small Bowel 416 SURGERY OF THE SMALL BOWEL

(Ch. 11)374

Appendectomy 420 Appendectomy (Ch. 11) 375Colon Surgery 425 SURGERY OF THE COLON

(Ch. 11)378

STOMAS 427Anorectal Surgery 427 SURGERY OF THE RECTUM

(Ch. 11)391

Hemorrhoid Ligation and Excision 430 Hemorroidectomy (Ch. 11) 391Surgery of the Liver and Biliary Tract 430 SURGERY OF THE BILIARY TRACT

(Ch. 12)SURGERY OF THE LIVER(Ch. 12)

407

423Common Bile Duct Exploration 439 Open Common Bile Duct Exploration

(Ch. 12)414

SURGERY OF THE PANCREAS AND SPLEEN

447 SURGERY OF THE PANCREAS (Ch. 12)SURGERY OF THE SPLEEN (Ch. 12)

418

430Select Pathology of the Pancreas 447Draining Pancreatic Cysts 448 Drainage or Excision of Pancreatic Cysts-

Open Method (Ch. 12)418

Pancreatic Resection 448Whipple Pancreaticoduodenectomy 448 Pancreaticoduodenectomy (Whipple

Procedure) (Ch. 12)420

Surgery of the Spleen 452 SURGERY OF THE SPLEEN (Ch. 12) 430VASCULAR AND OTHER PROCEDURES

454 CH. 26 VASCULAR SURGERY 1079

Varicose Veins 454 Varicose Vein Excision and Stripping(Ch. 26)

1113

Vascular Access Procedures 455Muscle and Nerve Biopsies 456Incision and Drainage 456Excision of Lesion 456Endoscopy 457 ENDOSCOPIC PROCEDURES (Ch.11) 357BREAST SURGERY 457 CH. 17 BREAST SURGERY 635Breast Anatomy 457 SURGICAL ANATOMY (Ch. 17) 635Breast and Axilla: Pathology and Diagnosis 457 BREAST CANCER (Ch. 17) 635Breast Surgery (Noncosmetic) 457 SURGICAL INTERVENTIONS (Ch. 1) 647SURGERY OF THE THYROID AND PARATHYROID

461 CH. 16 THYROID AND PARATHYROID SURGERY

619

Anatomy of the Thyroid and Parathyroid 461 SURGICAL ANATOMY (Ch. 16) 619Pathological Conditions of the Thyroid and Parathyroid Glands

461 PERIOPERATIVE URSING CONSIDERATIONS (Ch. 16)

623

Thyroidectomy 461 SURGICAL INTERVENTIONS (Ch. 16) 629TRACHEOTOMY 461 TRACHEOSTOMY (Ch. 21) 801Indications for a Tracheotomy 461 TRACHEOSTOMY (Ch. 21) 801Illustrative Procedure: Tracheotomy 467 TRACHEOSTOMY (Ch. 21) 801


CHAPTER 15OBSTETRIC AND GYNOCOLOGICAL SURGERY

CHAPTER 14 GYNECOLOGIC SURGERY AND CESAREAN BIRTH

INTRODUCTION TO OBSTETRIC AND GYNOCOLOGICAL SURGERY

478 CH. 14 GYNECOLOGIC SURGERY AND CESAREAN BIRTH

45

ANATOMY 478 SURGICAL ANATOMY 455The Pelvis 478 Bony Pelvis

Pelvic Floor459460

External Genitalia 481 Female External Genital Organs (Vulva) 455Vagina 481 Pelvic Cavity 458Uterus 482 Pelvic Cavity 455Fallopian Tubes 483 Pelvic Cavity 457Ovaries 483 Pelvic Cavity 457PREGNANCY-A SPECIAL CONDITION 485 ABDOMINAL SURGERY DURING

PREGNANCY513

Select Key Terms in Labor and Delivery 486Labor 486SPECIAL INSTRUMENTATION, DRUGS, EQUIPMENT, AND SUPPLIES IN OBSTETRIC AND GYNOCOLOGICAL SURGERY

487 Implementation 465

Instrumentation 487 Instrumentation 466 Drugs 487Equipment 494Supplies 494 Dressings, Drains, and Packing 468OR SETUP AND BASIC PATIENT POSITIONING AND DRAPING

494 PositioningPrepping

466468

SURGICAL PROCEDURES: OBSTETRICS AND FERTILITY RELATED

494 SURGICAL INTERVENTIONS 471

Pathology and Surgical Conditions: Obstetrics and Fertility Related

494

Vaginal Delivery 495Cesarean Section 497 Cesarean Birth 513Tubal Occlusion (Sterilization) Procedures 503 Tubal Ligation 508Tuboplasty 504 Microscopic Reconstructive Surgery of

the Fallopian Tube507

Laproscopic Resection of Unruptured Tubal Pregnancy

507 Ectopic Tubal Pregnancy 495

SURGICAL PROCEDURES: GYNECOLOGICAL PROCEDURES


Gynecological Pathology 510SURGICAL INTERVENTION OVERVIEW

510

Abdominal Incisions for Gynecological Surgery

510

Surgical Intervention: Laparoscopy 515 Laparoscopy 492Basic Colposcopy 518Hysteroscopy 518 Hysteroscopy 487Marsupialization of Bartholin’s Gland Cyst 521 Marsupialization of Bartholin’s Duct Cyst

or Abscess487

Simple Vulvectomy 521 Simple Vulvectomy 471Anterior and Posterior Repair (Colporrhaphy)

524 Plastic Reconstructive Repair of the Vagina (Anterior and Posterior Repair;

473


Colporrhaphy)Cervical Biopsy, Cryotherapy, Laser Treatment, LEEP, and Conization

533 Conization and Biopsy of the Cervix 484

Dilation and Curettage 535 Dilation of the Cervix and Curettage 480Myomectomy 538 Abdominal Myomectomy 500Total Abdominal Hysterectomy and Bilateral Salpingo-oophorectomy (TAH-BSO)

542 Total Abdominal Hysterectomy 498

Vaginal and Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

546 Vaginal HysterectomyLaparoscopic-Assisted Vaginal Hysterectomy

491497

Radical Cancer Surgery: Total Pelvic Exenteration

547 Pelvic Exenteration 503

CHAPTER 16OPHTHALMIC SURGERY

CHAPTER 18OPHTHALMIC SURGERY

ANATOMY OF THE EYE 554 SURGICAL ANATOMY 657Orbit 554 Bony Orbit 657Extrinsic Muscles 555 Muscles 659Lacrimal System 555 Lacrimal Apparatus 567Globe 556 Globe 659Cavities and Chambers of the Eye 558OPHTHALMIC SURGICAL PATHOLOGY

558

Glaucoma 558Cataract 558Small Retinal Detachment 558Large Retinal Detachment 558Vitreous Hemorrhage 558Proliferative Vitreoretinopathy (PVR) 559Traction Retinal Detachment 559Epiretinal Membarane 559Corneal Pathology 559Chalazion 559Pterygium 559Dacryocystitis 559Strabismus 559OPTHALMIC MEDICATIONS 560 Ophthalmic Pharmacology 669SPECIAL CONSIDERATIONS IN OPHTHALMIC SURGERY


Special Equipment 560 Ophthalmic Sutures 678Instruments 561 Instrumentation 675SURGICAL INTERVENTION 562 SURGICAL INTERVENTIONS 680Surgical Repair of Ptosis 562 Surgery for Unilateral or Bilateral Ptosis 683Iridectomy 563 Iridectomy 700Trabeculoplasty 563 Laser Trabeculoplasty 703Strabismus Correction: Recession/Resection

563

Adjustable Suture Surgery 566Scleral Buckle 567 Scleral Buckling 705Enucleation and Evisceration of the Eye (Traditional Approach)

571 EnucleationEvisceration

687689

Keratoplasty (Corneal Transplant) 573 (Corneal Transplant) Keratoplasty 692Cataract Extraction 577 Cataract Extraction 696Phacoemulsification 580 Cataract Extraction 697


Vitrectomy 580 VITRECTOMY 707

CHAPTER 17OTORHINOLARYNGOLOGIC SURGERY

CHAPTER 19 OTOLOGIC SURGERYCHAPTER20 RHINOLOGIC AND SINUS SURGERYCHAPTER 21 LARYNGLOGICAND HEAD AND NECK SURGERY

ANATOMY OF THE EAR 587 SURGICAL ANATOMY 717Outer Ear 587 External, Middle, and Inner Ear 717Middle Ear 588 External, Middle, and Inner Ear 717Inner Ear 588 External, Middle, and Inner Ear 717PATHOLOGY OF THE EAR 589Pathology Affecting the Outer Ear 589Pathology Affecting the Middle Ear 589Pathology Affecting the Inner Ear 590Diagnostic Procedures/Tests for the Ear 590 PERIOPERATIVE NURSING

CONSIDERATIONS721

PREOPERATIVE CONSIDERATIONS 591 Planning and Implementation 723SPECIAL INSTRUMENTS, SUPPLIES, DRUGS


EAR PROCEDURES 592 SURGICAL INTERVENTIONS 733Myringotomy 592 Myringotomy 733Myringoplasty/Tympanoplasty 596 Tympanoplasty 735Mastoidectomy 600 Mastoidectomy 736Stapedectomy 600 Stapedectomy 738Stapedotomy 600 Stapedotomy 740Cochlear Implants 601 Cochlear Implantation 745ANATOMY OF THE NOSE AND SINUSES

601 SURGICAL ANATOMY 751

External Nose 601 SURGICAL ANATOMY 751Internal Nose 601 SURGICAL ANATOMY 751Paranasal Sinuses 602 SURGICAL ANATOMY 751Blood Supply to the Nose 602 SURGICAL ANATOMY 751Olfaction 603 SURGICAL ANATOMY 751PATHOLOGY OF THE NOSE AND PARANASAL SINUSES

603

Rhinitis/Sinusitis 603Nasal Polyps 604Hypertrophied Turbinates 604Deviated Nasal Septum 604Septal Perforation 604Epistaxis 604DIAGNOSTIC PROCEDURES 605Direct Vision 605Mirror Examination 605Radiography 605PREOPERATIVE CONSIDERATIONS 605 Planning 756SPECIAL INSTRUMENTS, SUPPLIES, AND DRUGS


NASAL PROCEDURES 609 SURGICAL INTERVENTIONS 761Submucous Resection (SMR) 609 Septoplasty or Submucous Resection of

the Septum (SMR)761

Polypectomy 612 Nasal Polypectomy 776


Intranasal Antrostomy 612Removal of Foreign Body 612Internal Maxillary Artery Ligation 613Sinus Procedures 613 Sinus Surgery 766Caldwell-Luc 613 Caldwell-Luc with Radical Antrosomy 777Ethmoidectomy 615 Ethmoidectomy 776Sphenoidectomy 616 Sphenoidectomy 776Drainage of the Frontal Sinus 616 Frontal Sinus Trephination

Frontal Sinus Operation (External Approach)-Trephine nd Obliteration

774776

Sinus Endoscopy 616 Endoscopic Sinus Suargery 767ANATOMY OF THE UPPER AERODIGESTIVE TRACT

618 SURGICAL ANATOMY 781

Pharynx 618 Pharynx 781Larynx 620 Larynx and Associated Structures 782Trachea 621 Trachea 783Bronchi and Lungs 621 .Esophagus 621 SURGICAL ANATOMY (Ch. 11) 329PATHOLOGY AFFECTING THE UPPER AERODIGESTIVE TRACT

621

Pharyngitis 621Epiglottis 622Tonsillitis 622Sleep Apnea 623Laryngitis 623Polypoid Corditis or Vocal Cord Polyps 623Vocal Cord Nodules 623Vocal Cord Granulomas 623Laryngeal Neoplasms 624Tracheitis and Bronchitis 624Laryngotracheobronchitis (Croup) 624Foreign Bodies 624PATHOLOGY AFFECTING THE ESOPHAGUS

624

Esophagitis 624Ulceration of the Esophagus 624Neoplasms Affecting the Esophagus 624Foreign Bodies 625Zenker’s Diverticulum 625DIAGNOSTIC PROCEDURES/TESTS 625 Assesment 786Direct Visualization 625Indirect Visualization 625Laboratory Tests 625 Assesment 786Radiological Examinations 625 Assesment 786Videostroboscopy 626Polysomnography 626Multiple Sleep Latency Test (MSLT) 626PREOPERATIVE CONSIDERATIONS 626 Implementation 787SPECIAL INSTRUMENTS, SUPPLIES, DRUGS


AERODIGESTIVE TRACT PROCEDURES


Adenoidectomy 628 Tonsillectomy and Adenoidectomy (Ch. 29)

1250


Tonsillectomy 628 Tonsillectomy and Adenoidectomy (Ch. 29)

1250

Incision and Drainage of a Peritonsellar Abscess

631

Uvulopalatopharyngoplasty 631 UVULOPALATOPHARYNGOPLASTY 803Laryngoscopy 633 LARYNGOSCOPY 792Bronchoscopy 636 BRONCHOSCOPY 793Esophagoscopy 636 ESOPHAGOSCOPY 793Panendoscopy 636Radical Neck Dissection with Mandibulectomy

636 RADICAL NECK DISSECTION 793

CHAPTER 18ORAL AND MAXILLOFACIAL SURGERY

No chapter on this topic.

ANATOMY OF THE ORAL CAVITY 645Lips 645Teeth 645Palate 646Cheeks 646Tongue 646ANATOMY OF THE FACE AND CRANIUM

646

Orbit 647Facial Muscles and Innervation 647EMBRYOLOGICAL EVELOPMENT OF THE FACE

648

PATHOLOGY OF THE ORAL CAVITY 649Mouth 649Jaw Bones 649Mandibular Fractures 649Frontal Fractures 650Orbital Fractures 650Zygomatic Fractures 650Midfacial Fractures 651Craniofacial Deformities 651DIAGNOSTIC TESTS 651ORAL PROCEDURES: GENERAL CONSIDERATIONS

652

Tooth Extraction/Odontectomy 653Tooth Restoration 657Implantation 657MAXILLOFACIAL PROCEDURES: GENERAL CONSIDERATIONS

658

Graft Materials 658 BONE GRAFTING (Ch. 22) 851Repair of Mandibular/Maxillary Fractures 659 Reduction of Maxillary Fractures

(Ch. 24)1028

Application of Arch Bars 659 Reduction of Mandibular Fracture(Ch. 24)

1028

Wire Fixation 662 Reduction of Mandibular Fracture(Ch. 24)

1028

Plate and Screw Fixation of Mandibular Fracture

663

Frontal Fracture Repair 666Orbital Floor Fracture Repair 667 Repair of Fracture of the orbit (Blowout) 689


(Ch. 18)Reduction of Zygomatic Fractures 670 Reduction of Zygomatic Fractures

(Ch. 24)1029

Le Fort I Fracture Repair 671 Reduction of Maxillary Fractures(Ch. 24)

1028

Le Fort II and III Fracture Repair 675 Reduction of Maxillary Fractures(Ch. 24)

1028

Craniofacial Reconstruction 675Correction of Retrognathism or Prognathism

679

Temporomandibular Joint Procedures 682CHAPTER 19PLASTIC AND RECONSTRUCTIVE SURGERY

CHAPTER 24PLASTIC AND RECONSTRUCTIVE SURGERY

ANATOMY 685Skin and Underlying Structures 685Palate 687Nose 687Hand 687Breast 694SURGICAL PATHOLOGY 694Pathology Affecting the Skin 694Cleft Lip and Palate 696Pathology Affecting the Hand 697Pathology Affecting the Breast 701DIAGNOSTIC PROCEDURES AND TESTS

701

SPECIAL INSTRUMENTATION, SUPPLIES, DRUGS, AND EQUIPMENT

701 Special Mechanical Devices 1009

Nasal Set 701Dermatome 702 Dermatome 1008Mesh Graft Device 704 Skin Meshers 1009SURGICAL INTERVENTION 704 SURGICAL INTERVENTION 1015Rhytidectomy 704 Rhytidectomy (Facelift) 1034Blepharoplasty 706 Blepharoplasty 1033Suction Lipectomy 707 Liposuction 1036Abdominoplasty 708 Abdominoplasty 1036Skin Grafts 709 Replacement of Lost Tissue (Skin Graft) 1015Dermabrasion 713 Dermabrasion 1034Scar Revision 713 Scar Revision 1035Cheiloplasty and Palatoplasty 713 PLASTIC AND RECONSTRUCTIVE

SURGERY (Ch. 29)1255

Rhinoplasty 714 Rhinoplasty 1033Hand Surgery 716 MICROSURGICAL REPLANTATION 1038Mammoplasty 723 BREAST RECONSTRUCTION 1021

CHAPTER 20GENITOURINARY SURGERY

CHAPTER 15GENITOURINARY SURGERY

ANATOMY 732 SURGICAL ANATOMY 519Suprarenal Glands 732 Adrenal Glands 519Kidneys 732 Kidneys 519Ureters 735 Ureters 520Urinary Bladder 736 Urinary Bladder 520Male Reproductive System 737 Urethra 522


Prostate Gland and Male Reproductive Organs

524

PATHOLOGY AFFECTING THE ADRENAL GLANDS

739

Cushing’s Syndrome 739Adrenal Insufficiency (Addison’s Disease) 739Pheochromocytoma 739PATHOLOGY AFFECTING THE URINARY SYSTEM

739

Bladder Tumors 739Urinary Calculi 740Kidney Disorders 740PATHOLOGY AFFECTING THE MALE REPRODUCTIVE SYSTEM

743

Phimosis 743Hypospadias/Epispadias 743Benign Prostatic Hypertrophy 743Cancer of the Prostate 744Cryptorchidism 744Testicular Torsion 744Testicular Cancer 744Trauma to the Genitourinary System 745DIAGNOSTIC PROCEDURES/TESTS 745History and Physical 745 Assessment 523Laboratory Findings 745 Assessment 523Radiological Findings 751 Assessment 523Biopsy 751Endoscopy 751 DIAGNOSTIC AND ENDOSCOPIC

PROCEDURES (Ch. 15)536

SPECIAL EQUIPMENT, INSTRUMENTS, SUPPLIES, DRUGS


PREOPERATIVE AND INTRAOPERATIVE PREPARATION


Incisional Options 754SURGICAL PROCEDURES 757 SURGICAL INTERVENTONS 536Adrenalectomy 757 Adrenalectomy 616Nephrectomy 757 Nephrectomy 610Renal Transplant 762 Kidney Transplant 613Stone Removal 763 SURGERY OF THE URETERS AND

KIDNEY602

Cystostomy 764 Suprapubic Cystostomy 583Cystectomy/Ileal Conduit 766 Radical Cystectomy with Pelvic

Lymphadenectomy595

Procedures for Stress Incontinence Affecting Women

771 Vesicourethral Suspension (Marshall-Marcheti-Krantz)Transvaginal Bladder Neck SuspensionSuburethral SlingTVT Sling

587

588589591

Transurethral Endoscopy of the Genitourinary Tract

774 DIAGNOSTIC AND ENDOSCOPIC PROCEDURESTransurethral Ureteropyeloscopy

536

540Circumcision 776 Circumcision (Ch. 29) 1239Orchiectomy 778 Orchiectomy 555Orchiopexy 778 Orchiopexy (Ch. 29) 1247


Hydrocelectomy 781 Hydrocelectomy 551Varicocelectomy 781 Varicocelectomy 554Hypospadias Repair 782 Hypospadias Repair (Ch. 29) 1241Insertion of Inflatable Penile Prosthesis 782 Penile Implant 547Vasectomy 783 Vasectomy 552Vasovasostomy 784 Vasovasostomy 553Prostatectomy 784 Transurethral Resection of the Prostate

GlandSuprapubic Prostatectomy

560

564

CHAPTER 21ORTHOPEDIC SURGERY

CHAPTER 22ORTHOPEDIC SURGERY

BONE AND BONE TISSUE 792 Anatomic Structures 817Bone Tissue 792 Anatomic Structures 817Types of Bones 794 Anatomic Structures 819Types of Joints 794 Anatomic Structures 817Bone Growth and Bone Cells 797Intramembranous Bones 798Endochondral Bone 798Mineral Storage 798Factors That Affect Bone Growth 798Clinical and Bone Landmark Terms 798PATHOLOGY 798Types of Fractures 805Normal Bone Healing 805Pathological Bone Healing 806Diagnostic Terms and Procedures 808THE SKELETON 808 Anatomic Structures 817The Skull 808 Head (Ch. 23) 931Vertebral Column 811 Vertebrae 819Bones of the Thoracic Region 812Clavicles 812 Shoulder and Upper Extremity 819Scapula 812 Shoulder and Upper Extremity 819Pectoral Girdle 812 Shoulder and Upper Extremity 819Humerus 812 Shoulder and Upper Extremity 820Radius and Ulna 813 Shoulder and Upper Extremity 820Hand and Wrist 814 Wrist and Hand 820Pelvis 814 Pelvis, Hip and Femur 822Hip and Femur 814 Pelvis, Hip and Femur 822Tibia and Fibula 814 Knee, Tibia, and Fibula 822Ankle and Foot 816 Ankle and Foot 825EQUIPMENT 818 Implementation 828Positioning Devices 818 Positioning and Positioning Aids 830Pneumatic Tourniquets 819 Pneumatic Tourniquets 834Traction 819 Traction 835Lasers 819 Lasers 838Radiography 819 Radiographic Intervention 833Air Flow 820 Airflow Control 838Continuous Passive Range-of-Motion Machines

820 Postoperative Management 838

Transcutaneous Electrical Nerve Stimulation

820 ELECTRICAL STIMULATION 850

Electrical Stimulation of Bone 820 ELECTRICAL STIMULATION 850


Saws, Drills, and Reamers 820 Orthopedic Instrumentation 840Arthroscopic Equipment 820 ARTHROSCOPY 915SUPPLIES 821 Instruments and Accessory Items 839Implants 821 Implant Inventories 839Suture 821 Suture Material 840Methyl Methacrylate 821 Polymethyl Methacrylate 840Pharmacology 821 Medications 844PROCEDURES 822 SURGICAL INTERVENTIONS 850Bone Grafting 822 Bone Grafting 850Knee Arthroscopy 824 Arthroscopy Of The Knee 915Arthroscopic Repair of Meniscal Tear 827 Operative Arthroscopy 918Arthroscopic Anterior Cruciate Ligament Repair

Arthroscopic Anterior Cruciate Ligament Repair

918

Above-the-Knee AmputationEndoscopic Carpal Tunnel Release 832 Carpal Tunnel Release 871Colle’s Fracture 835 Correction of Colle’s Fracture with

External Fixation871

Metacarpal Phalangeal Joint Arthroplasty 840 Metacarpal Arthroplasty 913Triple Arthrodesis 840 Triple Arthrodesis 893Achilles Tendon Repair 841Bunionectomy 842 Bunionectomy 894Open Reduction-Internal Fixation (ORIF) of the Humerus

842 Open Reduction and Internal FixationFractures of the Humeral Shaft

858863

Shoulder Joint Arthroscopy 845 Arthroscopy of the Shoulder 921Acromioplasty 846Repair of the Rotator Cuff 846 Correction of Rotator Cuff Tear 861Internal Fixation of Femoral Shaft Fracture 851 Internal Fixation

Supracondylar Fractures of the Femur857885

Repair of Hip Fracture 852 Hip Fractures 874Total Hip Arthroplasty 852 Total Hip Replacement 902Total Knee Arthroplasty 859 Total Knee Replacement 902

CHAPTER 22CARDIOTHORACIC SURGERY

CHAPTER 25 THORACIC SURGERYCHAPTER 27 CARDIAC SURGERYCHAPTER 29 PEDIATRIC SURGERY

ANATOMY OF THE CHEST 864 SURGICAL ANATOMY (Ch. 25) 1043The Thorax 864 SURGICAL ANATOMY 1043The Trachea 866 Trachea (Ch. 21) 783The Bronchial Tree 866 SURGICAL ANATOMY 1045The Lungs 867 SURGICAL ANATOMY 1045ANATOMY AND PHYSIOLOGY OF THE HEART

868 SURGICAL ANATOMY (Ch. 27) 1117

Location of the Heart 868 SURGICAL ANATOMY 1117Coverings of the Heart 869 SURGICAL ANATOMY 1117The Heart Wall 869 SURGICAL ANATOMY 1117The Heart Chambers 869 SURGICAL ANATOMY 1117The Heart Valves 869 SURGICAL ANATOMY 1117Blood Flow Through the Heart 870 SURGICAL ANATOMY 1117Blood Supply for the Heart 871 SURGICAL ANATOMY 1117The Cardiac Cycle 871Cardiac Output 872Cardiac Conduction 872 SURGICAL ANATOMY 1117Anatomical Development of the Heart 872OPERATIVE PATHOLOGY 873


The Chest Wall 873The Mediastinum 873The Lungs 874Thoracic Trauma 875Thoracic Outlet Syndrome 877Thoracic Aortic Aneurysm 877Coronary Artery Disease 879Valvular Disease 881Cardiomyopathy 882Cardiac Dysrythmias 882Congenital Heart Defects 884DIAGNOSTIC PROCEDURES: THORAX 887 SURGICAL INTERVENTIONS(Ch. 25) 1058Bronchoscopy 887 Standard Bronchoscopy Using Rigid

BronchoscopeBronchoscopy Using Flexible Bronchoscope

1058

1062

Mediastinoscopy 887 Mediastinoscopy 1063Thoracoscopy 887 Thoracoscopy 1064Thoracentesis 889DIAGNOSTIC PROCEDURES: CARDIAC

889 Diagnostic Studies (Ch. 27) 1124

Radiological Studies 889 Diagnostic Studies 1124SURGICAL INTERVENTION: THORACIC

889 SURGICAL INTERVENTION (Ch. 25) 1058

Special Preoperative Considerations 889 PERIOPERATIVE NURSING CONSIDERATIONS

1047

Special Instrumentation, Supplies, Drugs, and Equipment


Patient Preparation 890 Implementation 1049Thoracoscopy 892 Thoracoscopy 1064Scalene/Supraclavicular Node Biopsy 895Thoracotomy for Upper Lobectomy 895 Thoracotomy 1065Thoracotomy for Right Pneumonectomy 899 Pneumonectomy 1066Thoracotomy for Wedge Resection or Segmentectomy

899 Segmental Resection 1069

Decortication of Lung 899 Decortication 1072SURGICAL INTERVENTION: CARDIAC (ADULT)

900 PERIOPERATIVE NURSING CONSIDERATIONS (Ch. 27)SURGICAL INTERVENTION (Ch. 27)

1121

1153Preoperative Considerations 900 PERIOPERATIVE NURSING

CONSIDERATIONS1121

Patient Preparation 901 PERIOPERATIVE NURSING CONSIDERATIONS

1142

Techniques of Cardiopulmonary Bypass 901 Cardiopulmonary Bypass ((CPB) 1145Mechanical Circulatory Assistance 904 Mechanical and Biological Circulatory

Assistance1176

Coronary Artery Bypass Grafting 905 SURGERY FOR CORANARY ARTERY DISEASE

1157

Aortic Valve Replacement 911 SURGERY FOR THE AORTIC VALVE 1170Mitral Valve Replacement 916 SURGERY FOR THE MITRL VALVE 1165Thoracic Aortic Aneurysmectomy 917 SURGERY FOR THE THORACIC

AORTA1171

Pericardiectomy/Pericardial Window 918 PERICARDIECTOMY 1156Heart Transplantation 919 Heart Transplantation 111


Permanent Pacemaker Insertion 920 Insertion of Permanent Pacemaker 1183Percutaneous Transluminal Coronary Angioplasty

921

SURGICAL INTERVENTION: CARDIAC (PEDIATRIC)

921 SURGERY FOR CONGENITAL HEART DISEASE (Ch. 29)

1266

Special Preoperative Preparation 922 PERIOPERATIVE NURSING CONSIDERATIONS

1211

Atrial Septal Defect 922 Surgery for Atrial Septal Defect 1267Ventricular Septal Defect 922 Surgery for Ventricular Septal Defect 1268Patent Ductus Arteriosus 923 Closure of Patent Ductus Arteriosus 1280Correction of Aortic Coarctation 924 Repair of Coactation of the Aorta 1282Procedure for Correction of Tetralogy of Fallot

924 Correction of Tetralogy of Fallot 1272

Procedure for Correction of Transposition of the Great Arteries

925 Operations for Correction of Transposition of the Great Arteries

1273

CHAPTER 23PERIPHERAL VASCULAR SURGERY

CHAPTER 26 VASCULAR SURGERY

PERIPHERAL VASCULAR SURGERY 928 VASCULAR SURGERY 1079SURGICAL ANATOMY 928 SURGICAL ANATOMY 1079Blood Vessels 928 SURGICAL ANATOMY 1079Blood Pressure 930 SURGICAL ANATOMY 1079The Arterial System 931 SURGICAL ANATOMY 1079The Venous System 933 SURGICAL ANATOMY 1079OPERATIVE PATHOLOGY AND DIAGNOSIS

934 ARTERIAL DISEASEVENOUS DISEASE

10801086

Arterial Embolism 935 Acute Arterial Insufficiency 1081Arteriosclerosis Obliterans 935 Chronic Arterial Insufficiency 1080Aneurysms of the Abdominal Aorta 936 Aneurysmal Disease 1083SURGICAL INTERVENTIONS 937 SURGICAL INTERVENTIONS 1097Peripheral Vessel Angioplasty 937 Precutaneous Transluminal Angioplasty 1101Bypass Grafting and Endarterectomy 939 Carotid Endarterectomy with Shunt 1109Features of Peripheral Vascular Procedure 940 PERIOPERATIVE NURSING

CONSIDERATIONS1086

Aortofemoral Bypass 943Abdominal Aortic Aneurysmectomy 947 Abdominal Aortic Aneurysm Resection 1097Femoropopliteal Bypass 950 Femoral -Popliteal Bypass 1102Femorofemoral Bypass 954 Femorofemoral Bypass 1102Axillofemoral Bypass 956Carotid Endarterectomy 959 Carotid Endarterectomy 1106CHAPTER 24NEUROSURGERY

CHAPTER 23NEUROSURGERY

SURGICAL ANATOMY 966 SURGICAL ANATOMY 931Divisions of the Nervous System 966 SURGICAL ANATOMY 931Cranium 966 Head 931Vertebral Column 973 Back 947Blood Supply 974 Blood Supply 938Cranial Nerves 974 Cranial Nerves 941Spinal Nerves 974 Peripheral Nerves 953NEUROSURGICAL PATHOLOGY 976Cervical Spine 976 Pathological lesions of the Spinal Cord

and Adjacent Structures951

Thoracic Spine 977 Pathological lesions of the Spinal Cord and Adjacent Structures

951

Lumbar Spine 978 Pathological lesions of the Spinal Cord 951


and Adjacent StructuresNeoplasms 979 Head 943Head Injury 980 Head 945Spinal Cord Injury 982 Pathological lesions of the Spinal Cord


Cerebrovascular Disease 982 Head 945Congenital Abnormalities 983 Head 945INFECTION 984Abscess 984 Pathological lesions of the Spinal Cord


Spinal Tumors 985 Pathological lesions of the Spinal Cord and Adjacent Structures

952

Peripheral Nerve Disorders 985NEUROSURGICAL PROCEDURES 986 PERIOPERATIVE NURSING

CONSIDERATIONSSURGICAL INTERVENTION

955

Special Instrumentation, Supplies, Drugs, and Equipment


Patient Preparation 990 Implementation 955Craniotomy 991 Craniotomy 971Craniectomy 1001 Craniectomy 980Ventriculoperitoneal and Ventriculoatrial Shunt

1005 Ventriculoperitoneal Shunt 970

Transphenoidal Hypophysectomy 1008 Transphenoidal Hypophysectomy 983Stereotactic Procedure 1011 Stereotactic Procedures 987Cranioplasty 1012 Cranioplasty 984Spinal Procedures 1012 BACK SURGERY 990Peripheral Nerve Procedure 1020 PERIPHERAL NERVE SURGERY 997ADVANCES IN NEUROSURGERY 1022 Intraoperative MRI 1022Three-Dimensional Reconstruction 1022Radiosurgery 1022Minimal Invasive Techniques 1022Stereotaxis 1022Intraoperative Ultrasound 1023Brain Mapping 1023Endoscopic Neurosurgery 1023Deep Brain Stimulation 1023

APPENDIX A: ANATOMY PLATES 1025APPENDIX B: COMMON PREFIXES AND SUFFIXES

1036

APPENDIX C: MEASUREMENTS 1039

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