CHAPTER 1



CHAPTER 1

ORIENTATION TO SURGICAL TECHNOLOGY | |CH.1 THE SURGICAL TECHNOLOGIST-PAST, PRESENT, AND FUTURE

CH. 4 ORGANIZATION OF THE OPERATING ROOM: PERSONNEL AND ENVIRONMENT | | |

|HISTORY OF SURGERY |3 |Historical Development (Ch. 1) |2 |

|SURGERY TODAY |4 | | |

|Surgical Specialties |5 | | |

|HISTORY OF SURGICAL TECHNOLOGY |6 |Historical Development (Ch. 1) |2 |

|FIELD OF SURGICAL TECHNOLOGY |8 |World War II to the Present (Ch. 1) |4 |

| Working Conditions |8 | | |

| Personal Characteristics |8 | | |

|Surgical Team Members |8 |Personnel (Ch. 4) |21 |

|Surgical Technology Education and Certification |10 |World War II to the Present (Ch. 1) |4 |

|THE SURGICAL TECHNOLOGISTAS A PROFESSIONAL |11 | | |

|Professionalism |11 | | |

|Surgical Technologist’s Lifestyle |12 | | |

|Job Descriptions for the Surgical Technologist |13 |Surgical Technologist (Ch. 4) |23 |

|Career Opportunities |13 | | |

|HEALTH CARE FACILITIES |14 | | |

|Hospital Organization |15 | | |

|Hospital Departments and Interdepartmental |17 | | |

|Communication | | | |

|Financial Considerations and Reimbursement |19 | | |

|Organizations Related to Hospitals, Health Care, and |20 | | |

|Surgical Services | | | |

| | | | |

|CHAPTER 2 | |CH. 3 SURGERY AND THE LAW | |

|STANDARDS OF CONDUCT | |CH. 2 SURGICAL CONSIENCE AND ETHICS IN THE OPERATING | |

| | |ROOM | |

|LEGAL ISSUES |23 |Why Know the Law? (Ch. 3) |11 |

|Definitions of General Legal Terms |23 |Key Terms (Ch. 3) |10 |

|Definitions of Traditional Principles |24 | | |

|Torts |25 |Intentional Torts (Ch. 3) |14 |

|Consent for Surgery: A Basic Right |27 |Informed Consent (Ch. 3) |14 |

|Documentation |29 |Documentation and Incident Reporting (Ch. 3) |15 |

|Event/Incident Reports |30 |Documentation and Incident Reporting (Ch. 3) |15 |

|Advance Directives |30 | | |

|ETHICAL AND MORAL ISSUES |30 |Surgical Ethics (Ch. 2) |7 |

|Moral Principles |31 | | |

|Bioethics |31 | | |

|AHA Patient’s Bill of Rights |31 | | |

|Elements of Ethical Decision Making |32 | | |

|Professional Codes of Conduct |34 | | |

|Surgical Conscience |34 |Surgical Conscience (Ch. 2) |6 |

|SCOPE OF PRACTICE |34 |Exceeding the Scope of Practice (Ch. 3) |11 |

|Job Descriptions and Competencies |35 | | |

|Credentialing |36 |The Role of the Association of Surgical Technologists |11 |

| | |(Ch. 3) | |

|Accreditation |36 |Accreditation (Ch. 1) |4 |

|Core Curricula for Surgical Technology and Surgical |36 | | |

|Assisting | | | |

|Career Development |36 | | |

|Clinical Ladder Program |37 | | |

|RISK MANAGEMENT AND LIABILITY |38 |Civil Liability (Ch. 3) |12 |

|Medical Errors |38 |Errors in the Operating Room (Ch. 3) |14 |

|Safe Medical Device Act |39 |Mechanical Failures (Ch. 3) |15 |

|Malpractice Insurance |39 |Insurance (Ch. 3) |15 |

| | | | |

|CHAPTER 3 | |CH. 17 COMMUNICATING WITH THE SURGICAL PATIENT | |

|THE SURGICAL PATIENT. | | | |

|THE STSR AND THE SURGICAL PATIENT |43 | | |

|PHYSICAL, PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL NEEDS OF|43 |Psychological Concerns of the Surgical Patient |222 |

|THE SURGICAL PATIENT | | | |

|Understanding the Surgical Patient |44 | | |

|Causes of Surgical Intervention |44 | | |

|The Surgical Patient, a Human Being |44 | | |

|Prioritizing Needs-Maslow’s Hierachy |45 | | |

|Life Stage Development: Select Basic Concepts |46 | | |

|Cultural and Religious Influences |49 |Cultural Influences |223 |

| | | | |

|CHAPTER 4 | |CH. 17 COMMUNICATING WITH THE SURGICAL PATIENT | |

|SPECIAL POPULATIONS | |CH. 5 MICROBIOLOGY OVERVIEW AND ACQUIRED | |

| | |IMMUNODEFICIENCY SYNDROME | |

|INTRODUCTION |57 | | |

|PEDIATRIC PATIENTS |57 |Special Needs of the Pediatric Patient |222 |

| | |(Ch. 17) | |

|Monitoring the Pediatric Patient |59 | | |

|Shock |60 | | |

|Fluids and Electrolytes |60 | | |

|Infection |61 | | |

|Metabolic and Nutritional Responses |61 | | |

|Trauma |61 | | |

|PATIENTS WITH OBESITY |62 | | |

|Review of Surgical Considerations |64 | | |

|Specific Considerations of Bariatric Surgery |64 | | |

|PATIENTS WITH DIABETES |64 | | |

|Complications Associated with Diabetes |65 | | |

|Care of the Patient with Diabetes in Surgery |66 | | |

|PREGNANT PATIENTS |66 | | |

|Considerations when Caring for Pregnant Patients |67 | | |

|Anesthesia |67 | | |

|Intraoperative Considerations for the Surgical |67 | | |

|Technologist | | | |

|IMMUNOCOMPROMISED PATIENTS |68 | | |

|Acquired Immunodeficiency Syndrome |68 |Acquired Immunodeficiency Syndrome (Ch. 5) |40 |

|Considerations for the Surgical Team Members |68 | | |

|PATIENTS WITH DISABILITIES |69 | | |

|GERIATRIC PATIENTS |69 |Special Needs of the Elderly Patient |223 |

| | |(Ch. 17) | |

|TRAUMA PATIENTS |71 | | |

|THE “GOLDEN HOUR” AND TRAUMA PATIENTS |71 | | |

|KINEMATICS |71 | | |

|Blunt Trauma |71 | | |

|Penetrating Trauma |72 | | |

|TRAUMA SCORING |72 | | |

|CONSIDERATIONS FOR THE SURGICAL TECHNOLOGIST |72 | | |

|Preservation of Evidence |72 | | |

|Hypothermia |73 | | |

|Infection |73 | | |

|PREPARATION OF THE CASE |73 | | |

| | | | |

|CHAPTER 5 | |CH. 4 ORGANIZATION OF THE OPERATING ROOM: PERSONNEL | |

|PHYSICAL ENVIRONMENT AND SAFETY STANDARDS | |AND ENVIRONMENT | |

| | |And various other chapters throughout the book. | |

|PHYSICAL DESIGN OF THE SURGERY DEPARTMENT |77 |Physical Layout (Ch. 4) |25 |

|Areas of the OR |78 |Physical Layout (Ch. 4) |25 |

|Physical Components of the Operative Suite |79 |The Operating Suites (Ch. 4) |27 |

|Substerile Area |83 |Substerile Rooms (Ch. 4) |27 |

|Direct Support Services |83 |Description and Functions of Areas in the Operating |26 |

| | |Room (Ch. 4) | |

|HAZARDS AND REGULATORY AGENCIES |85 | | |

|SAFETY CONSIDERATIONS |86 |The Operating Suites (Ch. 4) |27 |

|Air-Handling System |86 |The Operating Suites (Ch. 4) |28 |

|Surgical Lights |86 |The Operating Suites (Ch. 4) |28 |

|Noise in the Operating Room |86 | | |

|Ergonomics and Safety Considerations |86 | | |

|Fire Hazards and Safety |87 |Fire (Ch. 16) |219 |

|Electrical Hazards |88 |The Operating Suites (Ch. 4) |28 |

|Ionizing Radiation |89 | | |

|BIOLOGICAL HAZARDS AND SAFETY CONSIDERATIONS |90 |Universal Precautions (Ch. 8) |68 |

|Universal Precautions |90 |Universal Precautions (Ch. 8) |68 |

|Standard Precautions |90 | | |

|Laser and Electrosurgical Plume |93 | | |

|Latex Allergy |94 | | |

|CHEMICAL HAZARDS AND SAFETY CONSIDERATIONS |94 | | |

|Waste Anesthetic Gases |94 |Volatile Liquids and Gas (Ch. 9) |82 |

|Methyl Methacrylate |95 | | |

|Formalin |95 |Formaldehyde (Ch. 6) |47 |

|Ethylene Oxide |95 |Precautions and Hazards (Ch. 7) |59 |

|Glutaraldehyde |95 |Glutaraldehyde (Ch. 6) |47 |

|CHAPTER 6 | |No chapter(s) on this topic. | |

|BIOMEDICAL SCIENCE | | | |

|INTRODUCTION |99 | | |

|COMPUTERS |99 | | |

|Surgical Applications |99 | | |

|Hardware |100 | | |

|Software |103 | | |

|Word Processing |104 | | |

|Graphics |105 | | |

|Internet Basics |106 | | |

|ELECTRICITY |107 | | |

|Surgical Applications |107 | | |

|Basic Principles of Electricity |108 | | |

|PHYSICS |112 | | |

|Medical and Surgical Applications |112 | | |

|Mechanics |113 | | |

|Nuclear Physics |122 | | |

|Gravity |122 | | |

|SURGICAL ROBOTS |122 | | |

|Terminology |123 | | |

|Design |123 | | |

|Remote Manipulation |124 | | |

|Geometry |124 | | |

|Hearing and Vision |125 | | |

|Decontamination and Sterilization of Robotic Components|125 | | |

|Clinical Applications |125 | | |

|THE OR OF THE FUTURE |125 | | |

|Surgical Planning and Rehearsal |125 | | |

|Surface-Based Registration |126 | | |

|ROLE OF THE SURGICAL TECHNOLOGIST |126 | | |

| | | | |

|CHAPTER 7 | |CH. 5 MICROBIOLOGY OVERVIEW AND ACQUIRED | |

|ASEPSIS AND STERILE TECHNIQUE | |IMMUNODEFICIENCY SYNDROME | |

| | |CH. 6 DISINFECTION AND DECONTAMINATION | |

| | |CH. 7 STERILIZATION: STANDARDS AND PRACTICE | |

| | |CH. 8 ASEPTIC TECHNIQUES AND UNIVERSAL PRECAUTIONS IN | |

| | |THE OPERATING ROOM | |

|HISTORY OF STERILIZATION |130 | | |

|BASIC TERMINOLOGY |131 |Key Terms (Ch. 5) |30 |

|PATHOGENS AND INFECTION |131 |Pathogenic Microorganisms (Ch. 5) |38 |

|Infection |131 |The Process of Infection (Ch. 5) |35 |

|Pathogens Associated with Surgical Site Infection |132 |Pathogenic Microorganisms (Ch. 5) |38 |

|Methods of Transmission |135 |Disease Transmission (Ch. 5) |32 |

|PRINCIPLES OF ASEPSIS |138 |The Rules of Aseptic Technique (Ch. 8) |66 |

|Principle 1: Sterile Field |138 |The Rules of Aseptic Technique (Ch. 8) |66 |

|Principle 2: Sterile Team Member Attire |139 |The Rules of Aseptic Technique (Ch. 8) |66 |

|Principle 3: Movement in and around Sterile Field |140 |The Rules of Aseptic Technique (Ch. 8) |66 |

|SURGICAL CONSCIENCE |140 |Surgical Conscience (Ch. 2) |6 |

|CLEANING, DISINFECTION, AND STERILIZATION |141 |Part 1 Disinfection (Ch. 6) |44 |

|Cleaning and Disinfection |142 |Part 1 Disinfection (Ch. 6) |44 |

|Disinfectant and Disinfectant/Sterilant Agents |147 |Disinfectant Chemicals ( Ch. 6) |45 |

|INSTRUMENT PREPARATION AND WRAPPING FOR STERILIZATION |151 |Preparation of Items (Ch. 7) |57 |

|Instruments |151 |Preparation of Items (Ch. 7) |57 |

|Specific Procedural Trays |151 | | |

|Instrument Sets |151 | | |

|PACKAGING FOR STERILIZATION AND STORAGE |152 |Wrapping Goods for Sterilization (Ch. 7) |60 |

|Performance Standards of Packaging Material |152 |Wrapping Goods for Sterilization (Ch. 7) |60 |

|Performance Characteristics |152 | | |

|Types of Packaging Materials |153 |Wrapping Goods for Sterilization (Ch. 7) |60 |

|General Principles of Packaging |155 |Wrapping Goods for Sterilization (Ch. 7) |60 |

|Sterilization |158 |Steam Sterilization (Ch. 7) |53 |

|Requirements and Essential Factors |159 |Loading and Operation (Ch. 7) |55 |

|Basic Components of a Steam Sterilizer |160 |Steam Sterilization (Ch. 7) |53 |

|GAS STERILIZATION |163 |Ethylene Oxide (Gas) Sterilization (Ch. 7) |58 |

|Ethylene Oxide |163 |Ethylene Oxide (Gas) Sterilization (Ch. 7) |58 |

|Alternative Gas Sterilization Methods |164 |The Future of Ethylene Oxide Sterilization (Ch. 7) |59 |

|LIQUID CHEMICAL STERILIZATION PROCESSES |165 |Cold Chemical Sterilization (Ch. 7) |63 |

|IONIZING RADIATION |165 |Sterilization by Ionizing Radiation (Ch. 7) |60 |

|METHODS OF MONITORING THE STERILIZATION PROCESS |165 |Sterilization and Control Monitors (Ch. 7) |60 |

|Mechanical Methods of Monitoring the Sterilization |165 |Sterilization and Control Monitors (Ch. 7) |62 |

|Process | | | |

|Chemical Methods of Monitoring the Sterilization |166 |Sterilization and Control Monitors (Ch. 7) |62 |

|Process | | | |

|Biological Methods of Monitoring the Sterilization |166 |Sterilization and Control Monitors (Ch. 7) |62 |

|Process | | | |

|Bowie-Dick Test |167 |Sterilization and Control Monitors (Ch. 7) |62 |

|EVENT-RELATED STERILITY |167 |Storage and Handling of Sterile Supplies (Ch. 7) |62 |

|Environmental Decontamination |168 | | |

|Environmental Services |168 | | |

|Case by Case |168 |Decontamination of the Surgical Suite |48 |

| | |(Ch. 6) | |

|Daily |168 |Decontamination of Other Areas in the Operating Room |50 |

| | |(Ch. 6) | |

|CHAPTER 8 | |CH. 3 SURGERY AND THE LAW | |

|GENERAL PATIENT CARE AND SAFETY | |CH. 10 TRANSPORTING AND POSITIONING THE SURGICAL | |

| | |PATIENT | |

| | |CH. 11 PREPARATION OF THE SURGICAL SITE | |

| | |CH. 13 HEMOSTASIS | |

|PREOPERATIVE PATIENT ROUTINES |172 | | |

|Surgical Consent |173 |Informed Consent (Ch. 3) |14 |

|Preoperative Education |175 | | |

|Patient Possessions |175 |Patient Property (Ch. 3) |12 |

|Evening/Morning before Surgery |176 | | |

|Diet |177 | | |

|Makeup and Dress |177 | | |

|Call to Operating Room |177 | | |

|Family Visit |177 | | |

|Patient Identification |177 |Patient Identification, Side, and Site of Surgery (Ch.|13 |

| | |3) | |

|Transportation |178 |Transportation of the Conscious Patient (Ch. 10) |90 |

|TRANSFER AND POSITIONING |179 |Transfer and positioning of the Anesthetized Patient |91 |

| | |(Ch. 10) | |

|BASIC POSITIONING FOR SURGERY |180 |Transfer and positioning of the Anesthetized Patient |91 |

| | |(Ch. 10) | |

|Supine Position |181 |Supine (Dorsal Recumbent) (Ch. 10) |91 |

|Trendelenburg Position |183 |Trendelenburg (Ch. 10) |92 |

|Reverse Trendelenburg Position |184 |Reverse Trendelenburg (Ch. 10) |93 |

|Fowler’s Position and Sitting Position |184 |Fowler (Sitting) (Ch. 10) |96 |

|Lithotomy Position |185 |Lithotomy (Ch. 10) |95 |

|Prone Position |186 |Prone with Headrest (Ch. 10) |94 |

|Kraske (Jackknife Position) |188 |Kraske (Jackknife) (Ch. 10) |93 |

|Lateral Position |189 |Sim’s (Lateral) (Ch. 10) |96 |

|Kidney Position |190 | | |

|Sim’s Position |191 |Sim’s (Lateral) (Ch. 10) |96 |

|THERMOREGULATORY DEVICES |191 | | |

|VITAL SIGNS |192 | | |

|Temperature |192 | | |

|Pulse |193 | | |

|Respiration |194 | | |

|Blood Pressure |196 | | |

|URINARY CATHETERIZATION |199 |Special Equipment (Ch. 22) |399 |

|Indications |200 |Special Equipment (Ch. 22) |399 |

|Procedure |200 | | |

|Considerations |200 | | |

|SKIN PREPARATION |202 |Surgical Skin Prep (Ch. 11) |101 |

|Skin Preparation Setup |203 |Special Skin Prep Procedures (Ch. 11) |103 |

|Skin Marking |206 | | |

|HEMOSTASIS AND BLOOD REPLACEMENT |206 |Intro. Paragraph (Ch. 13) |138 |

|Factors Affecting Hemostasis |207 | | |

|Control of Bleeding during Surgery |207 | | |

|Mechanical Methods |207 |Sponges (Ch. 13) |140 |

| | |Tourniquet |142 |

| | |Ligation Clips and Hemostatic Clamps and Suture |143 |

| | |Ligatures | |

|THERMAL HEMOSTASIS |209 |Electrosurgery (Ch. 13) |138 |

|PHARMACOLOGICAL AGENTS |209 |Pharmaceutical Hemostatic Agents |142 |

| | |(Ch. 13) | |

|Blood Loss |210 | | |

|Blood Replacement |210 |Autotransfusion (Ch. 13) |144 |

|Hemolytic Transfusion Reactions |211 | | |

|CARDIOPULMONARY RESUSCITATION |211 | | |

|Cardiac Arrest in the Surgical Setting |212 |Cardiopulmonary Arrest (Ch. 16) |219 |

|MALIGNANT HYPERTHERMIA |213 |Malignant Hyperthermia (Ch. 16) |218 |

|Prevention |213 | | |

|Treatment |213 |Malignant Hyperthermia (Ch. 16) |218 |

|EMERGENCY MEDICAL SERVICES |213 | | |

|INDICATIONS OF EMERGENCY SITUATIONS |214 | | |

|OBJECTIVES AND PRIORITIES IN ERMERGENCY SITUATIONS |214 | | |

|Syncope |214 | | |

|Convulsions/Seizures |215 | | |

|Anaphalactic Reactions |211 | | |

|Clinical Manifestations of Impending Cardiac Arrest |216 | | |

| | | | |

|CHAPTER 9 | |CH. 9 ANESTHESIA | |

|SURGICAL PHARMACOLOGY AND ANESTHESIA | |CH. 14 SURGICAL PHARMACOLOGY | |

|PHARMACOLOGY |219 | | |

|Drug Sources |219 | | |

|Drug Forms |220 | | |

|Drug Nomenclature |220 | | |

|Route of Administration |221 | | |

|Drug Classifications |221 | | |

|Pharmacokinetics |221 | | |

|Pharmacodynamics |222 | | |

|DRUG-HANDLING TECHNIQUES |223 |Accepting Medications in Surgery (Ch. 14) |151 |

|Medication Identification |223 |Accepting Medications in Surgery (Ch. 14) |151 |

|Supplies for Medication Handling |225 |Accepting Medications in Surgery (Ch. 14) |151 |

|Transfer of a Medication to the Sterile Field |225 |Accepting Medications in Surgery (Ch. 14) |151 |

|Medications Commonly Used in the Operating Room |226 |Medications Used in Surgery (Ch. 14) |152 |

|HISTORY OF MODERN ANESTHESIA |229 | | |

|METHODS AND TECHNIQUES OF ANESTHETIC ADMINISTRATION |231 |Classification of Anesthesia (Ch. 9) |81 |

|GENERAL ANESTHESIA |231 |General Anesthesia (Ch. 9) |81 |

|Depth of General Anesthesia |231 |General Anesthesia (Ch. 9) |81 |

|Phases of General Anesthesia |232 |General Anesthesia (Ch. 9) |81 |

|Advantages of General Anesthesia |232 | | |

|Risks and Complications Associated with General |232 |Malignant Hyperthermia (Ch. 16) |218 |

|Anesthesia | |Cardiopulmonary Arrest |219 |

|Anesthetic Agents |235 |Volatile Liquids and Gas (Ch. 9) |82 |

| | |Intravenous and Intramuscular Injection |83 |

|Adjuncts to General Anesthesia |240 |Adjuncts to Anesthetic Agents (Ch. 9) |87 |

| | |Hypothermia and Hypotension (Ch. 13) |143 |

|Anesthesia Equipment |241 |Volatile Liquids and Gas (Ch. 9) |83 |

|NERVE CONDUCTION BLOCKADE |244 |Local or Conduction Anesthesia (Ch. 9) |85 |

|Nerve Conduction Blocking Agents |244 | | |

|Topical Anesthesia |246 |Topical Anesthesia (Ch. 9) |86 |

|Local Anesthesia |246 |Local Infiltration (Ch. 9) |85 |

|Regional Anesthesia |246 |Epidural Anesthesia and Caudal Anesthesia and Spinal |86 |

| | |Anesthesia (Ch. 9) | |

|NONTRADITIONAL ANESTHESIA OPTIONS |249 | | |

|TEAM MEMBER ROLES DURING ANESTHESIA ADMINISTRATION |249 | | |

|Preoperative Visits |250 | | |

|Preoperative Routine-All Types of Anesthesia |250 | | |

|Postanesthesia Care |253 | | |

|CHAPTER 10 | |Found in various chapters throughout the book. | |

|INSTRUMENTATION, EQUIPMENT, AND SUPPLIES | | | |

|INSTRUMENTATION |259 | | |

|Classifications |259 |Types of Instruments (Ch. 15) |158 |

|Instrument Care and Handling |264 |Care of Instruments (Ch. 15) |158 |

|Types of Instrument Sets |265 | | |

|SPECIALTY EQUIPMENT |269 | | |

|Endoscopes |269 |Fiberoptic Procedures (Ch. 19) |324 |

|Power Tools |270 |Power Equipment (Ch. 23) |429 |

|Lasers |270 |CH. 18 LASER TECHNOLOGY AND USE |228 |

|Microscopes |273 |The Operating Microscope (Ch. 27) |575 |

|Video Monitors, Recorders, and Cameras |273 |Video Camera System (Ch. 20) |329 |

|Fiber-optic Headlamps and Light Sources |274 |Fiberoptic Cable and Light Source (Ch. 20) |327 |

|Irrigation/Aspiration Units |274 | | |

|Cryotherapy Units |274 | | |

|Insufflators |274 |Exposure During the Surgical Procedure (Ch. 20) |331 |

|Nerve Stimulators |274 | | |

|ACCESSORY EQUIPMENT |275 | | |

|Suction Systems |275 | | |

|Electrosurgical Unit |275 |Electrosurgery (Ch. 13) |138 |

|Lights |278 |The Operating Suites (Ch. 4) |28 |

|Pneumatic Tourniquets |279 |Tourniquet (Ch. 13) |142 |

|Sequential Compression Devices |280 | | |

|SUPPLIES |280 | | |

|Drapes |280 |Draping Materials and Their Application (Ch. 11) |104 |

|Sterile Packs |282 | | |

|Sponges and Dressings |282 |Wound Dressings (Ch. 12) |131 |

| | |Sponges (Ch. 13) |140 |

|Catheters, Tubes, and Drains |285 |Wound Drains (Ch. 12) |134 |

|Nonsuture Needles |288 | | |

|Irrigators and Syringes |289 | | |

|CHAPTER 11 | |CH. 5 MICROBIOLOGY OVERVIEW AND ACQUIRED | |

|WOUND HEALING, SUTURES, NEEDLES, AND STAPLING DEVICES | |IMMUNODEFICIENCY SYNDROME | |

| | |CH. 12 WOUND CLOSURE | |

|INTRODUCTION |292 | | |

|TYPES OF WOUNDS |292 |Classification of Wounds (Ch. 5) |37 |

|Surgical Wound |292 |Surgical Wound Infection (Ch. 5) |37 |

|Traumatic Wound |293 | | |

|Chronic Wound |294 | | |

|INFLAMMATORY PROCESS |294 |Inflammatory Response (Ch. 5) |36 |

|TYPES OF WOUND HEALING |294 |Wound Healing Categories (Ch. 12) |135 |

|First Intention (Primary Union) |294 |Wound Healing Categories (Ch. 12) |135 |

|Phases of Wound Healing by First Intention |295 | | |

|Second Intention (Granulation) |295 |Wound Healing Categories (Ch. 12) |135 |

|Third Intention (Delayed Primary Closure) |295 |Wound Healing Categories (Ch. 12) |135 |

|FACTORS INFLUENCING WOUND HEALING |295 |Surgical Wound Infection (Ch. 5) |37 |

|COMPLICATIONS OF THE HEALING WOUND |296 | | |

|Intraoperative Wound Care |297 | | |

|Postoperative Wound Care |298 |Wound Dressings (Ch. 12) |131 |

| | |Wound Drains |134 |

|SUTURE |298 |Intro . Paragraphs (Ch. 12) |112 |

|History |298 | | |

|Types of Suture Material |299 |Types of Suture and Their Preparation |113 |

| | |(Ch. 12) | |

|Suture Sizes |300 |Suture Size (Ch. 12) |113 |

|General Factors Affecting Choice of Suture |300 |Types of Suture and Their Preparation |113 |

| | |(Ch. 12) | |

|Characteristics of Common Sutures |300 |Types of Suture and Their Preparation |113 |

| | |(Ch. 12) | |

|Packaging of Suture |303 |Suture Packaging (Ch. 12) |113 |

|Ligatures |303 |Suture Ligatures (Ch. 13) |143 |

|Ligating Methods |303 | | |

|Suture for the Procedure |304 |Preparing and Handling of Suture Materials (Ch. 12) |115 |

|Layer Closure |305 | | |

|Endoscopic Suture |307 | | |

|Suturing Techniques |307 |Methods of Suturing (Ch. 12) |307 |

|Accessory Devices |309 |Skin Tapes and Clips (Ch. 12) |120 |

|STAPLING DEVICES |310 |Surgical Stapling Instruments (Ch. 12) |120 |

|Types of Staplers |312 | | |

|Meshes or Fabrics |313 | | |

|NEEDLES |314 |Surgical Needles (Ch. 12) |115 |

|Needle Eye |314 |Needle Eyes (Ch. 12) |115 |

|Needle Point |315 |Needle Shafts and Points (Ch. 12) |115 |

|Needle Bodies |315 |Needle Shafts and Points (Ch. 12) |115 |

|CHAPTER 12 | |CH. 8 ASEPTIC TECHNIQUES AND UNIVERSAL PRECAUTIONS IN | |

|SURGICAL CASE MANAGEMENT | |THE OPERATING ROOM | |

| | |CH. 16 SURGICAL ROUTINES AND EMERGENCIES | |

| | |And various other chapters throughout the book. | |

|INTRODUCTION |318 |Surgical Technologist (Ch. 4) |23 |

|Applied Theory |319 |Preparation for the Day’s Work (Ch. 16) |212 |

| | |The Rules of Aseptic Technique (Ch. 8) |66 |

| | |Surgical Conscience (Ch. 2) |6 |

| | |Universal Precautions (Ch. 5) |40 |

|PREOPERATIVE CASE MANAGEMENT |323 | | |

|Attire |323 |Surgical Attire (Ch. 8) |67 |

|Preparing the OR |327 |Preparation for the Day’s Work (Ch. 16) |212 |

| | |CH. 8 ASEPTIC TECHNIQUES AND UNIVERSAL PRECAUTIONS IN |65 |

| | |THE OPERATING ROOM | |

|ORGANIZING THE BACK TABLE |341 |Table Set-Up (Ch. 16) |213 |

|Organizing the Mayo Stand |346 | | |

|Assisting a Team Member |346 |Gowning and Gloving the Surgeons and Draping the |214 |

| | |Patient (Ch. 16) | |

|Draping the Surgical Patient |346 |Draping (Ch. 11) |104 |

| | |Gowning and Gloving the Surgeons and Draping the |214 |

| | |Patient (Ch. 16) | |

|Positioning of the Sterile Team Members and the |353 |Gowning and Gloving the Surgeons and Draping the |214 |

|Furniture | |Patient (Ch. 16) | |

|INTRAOPERATIVE CASE MANAGEMENT |353 | | |

|General Principles |353 |Intraoperative Procedures (Ch. 16) |215 |

| | |Instrumentation |215 |

| | |Specimens |216 |

| | |Communication |217 |

| | |Completion of the Procedure-Final Count |217 |

|Progression of the Surgical Procedure |361 | | |

|POSTOPERATIVE CASE MANAGEMENT |363 | | |

|Preservation of the Sterile Field |363 | | |

|Drape Removal |363 | | |

|Gown and Glove Removal |364 | | |

|Immediate Postoperative Care |364 | | |

|Patient Transfer and Transportation |364 |Completion of the Procedure-Final Count |217 |

| | |(Ch. 16) | |

|Breakdown of the Setup |365 |Completion of the Procedure-Final Count |217 |

| | |(Ch. 16) | |

|The Operating Room Cycle |365 | | |

|The Instrument Cycle |366 |During Surgery and After Surgery (Ch. 15) |209 |

| | | | |

|CHAPTER 13 | |No chapter(s) on this topic. | |

|DIAGNOSTIC PROCEDURES | | | |

|SOURCES OF PATIENT DATA |371 | | |

|History and Physical Examination |371 | | |

|Diagnostic Imaging |371 | | |

|Laboratory Reports |378 | | |

|Electrodiagnostic Studies |381 | | |

|Pulmonary Diagnosis |382 | | |

|Endoscopy |383 | | |

|Plethysmography and Phleborheography |383 | | |

|INDICATIONS FOR SURGERY |383 | | |

|CHAPTER 14 | |CH. 19 GENERAL SURGERY | |

|GENERAL SURGERY | | | |

|ANATOMY |386 |Intro. Paragraphs |238 |

|Abdominal Cavity: General Dimensions |386 |Structures of the Abdominal Cavity |240 |

|Surface Features |386 | | |

|Abdominal Musculature |387 | | |

|Peritoneum |387 | | |

|Retroperitoneum |388 | | |

|Alimentary Canal |388 | | |

|Esophagus |388 |Esophagus |240 |

|Stomach |389 |Stomach |240 |

|Small Intestine |390 |Small Intestine |240 |

|Mesentery |391 |Small Intestine |240 |

|Colon |391 |Large Intestine |241 |

|Rectum |393 |Rectum |242 |

|Anus |393 | | |

|Omenta |394 | | |

|Pancreas |394 |Pancreas |242 |

|Spleen |395 |Spleen |246 |

|Liver |395 |Liver |242 |

|Biliary Tract |396 |Gallbladder |242 |

|GENERAL SURGERY INSTRUMENTATION |397 | | |

|Major Set |397 | | |

|Minor Set |397 | | |

|Local Excision Instruments |399 | | |

|Biliary Instruments |399 | | |

|Intestinal Instruments |400 | | |

|Other General Instruments |400 | | |

|ROOM SETUP |400 | | |

|POSITIONING |400 |Laparotomy |246 |

|DRAPING |400 |Laparotomy |246 |

|INCISIONS |402 |Abdominal Incisions |238 |

|SURGERY OF THE ABDOMINAL WALL: HERNIAS |404 | | |

|Specific Anatomic Features of the Groin Area |404 | | |

|Hernias |405 | | |

|Hernia Repair |405 |Hernia Repair |308 |

|SURGERY OF THE ALIMENTARY CANAL |407 | | |

|Surgery of the Esophagus |408 | | |

|Gastric Surgery |408 | | |

|Pathological Conditions of the Stomach |408 |Gastrostomy |249 |

|Procedures Related to Gastric Secretion, Ulcers, and |416 | | |

|Neoplasm | | | |

|Procedures for Morbid Obesity |416 |Gastric Bypass |275 |

|Surgery of the Small Bowel |416 |Anastomosis of the Small Intestine |252 |

|Appendectomy |420 |Appendectomy |263 |

|Colon Surgery |425 |Colon Resection and Anastomosis |256 |

|STOMAS |427 | | |

|Anorectal Surgery |427 |Excision of Anal Fistula |321 |

|Hemorrhoid Ligation and Excision |430 |Hemorrhoidectomy |319 |

|Surgery of the Liver and Biliary Tract |430 |Wedge Resection of the Liver |271 |

|Common Bile Duct Exploration |439 |Operative Cholangiography: Exploration of the Common |266 |

| | |Bile Duct | |

| | |Cholecystectomy |265 |

|SURGERY OF THE PANCREAS AND SPLEEN |447 | | |

|Select Pathology of the Pancreas |447 | | |

|Draining Pancreatic Cysts |448 | | |

|Pancreatic Resection |448 | | |

|Whipple Pancreaticoduodenectomy |448 |Pancreaticojejunostomy (Whipple’s Procedure) |271 |

|Surgery of the Spleen |452 |Splenectomy |269 |

|VASCULAR AND OTHER PROCEDURES |454 | | |

|Varicose Veins |454 |Internal Vein Stripping (Ch. 25) |541 |

|Vascular Access Procedures |455 | | |

|Muscle and Nerve Biopsies |456 | | |

|Incision and Drainage |456 | | |

|Excision of Lesion |456 | | |

|Endoscopy |457 |Fiberoptic Procedures |324 |

|BREAST SURGERY |457 | | |

|Breast Anatomy |457 | | |

|Breast and Axilla: Pathology and Diagnosis |457 | | |

|Breast Surgery (Noncosmetic) |457 |Breast Surgery |321 |

|SURGERY OF THE THYROID AND PARATHYROID |461 |Thyroid Surgery |322 |

|Anatomy of the Thyroid and Parathyroid |461 | | |

|Pathological Conditions of the Thyroid and Parathyroid |461 | | |

|Glands | | | |

|Thyroidectomy |461 |Thyroidectomy |322 |

|TRACHEOTOMY |461 |Tracheotomy (Ch. 24) |479 |

|Indications for a Tracheotomy |461 | | |

|Illustrative Procedure: Tracheotomy |467 | | |

|CHAPTER 15 | |CH. 21 OBSTETRIC AND GYNOCOLOGIC SURGERY | |

|OBSTETRIC AND GYNOCOLOGIC SURGERY | | | |

|INTRODUCTION TO OBSTETRIC AND GYNOCOLOGICAL SURGERY |478 |Intro. Paragraph |350 |

|ANATOMY |478 |Surgical Anatomy |350 |

|The Pelvis |478 | | |

|External Genitalia |481 |External Genitalia and Associated Structures | |

|Vagina |481 | | |

|Uterus |482 |Uterus |350 |

|Fallopian Tubes |483 |Fallopian Tubes |350 |

|Ovaries |483 |Ovaries |350 |

|PREGNANCY-A SPECIAL CONDITION |485 | | |

|Select Key Terms in Labor and Delivery |486 | | |

|Labor |486 | | |

|SPECIAL INSTRUMENTATION, DRUGS, EQUIPMENT, AND SUPPLIES|487 | | |

|IN OBSTETRIC AND GYNOCOLOGICAL SURGERY | | | |

|Instrumentation |487 | | |

| Drugs |487 | | |

|Equipment |494 | | |

|Supplies |494 | | |

|OR SETUP AND BASIC PATIENT POSITIONING AND DRAPING |494 | | |

|SURGICAL PROCEDURES: OBSTETRICS AND FERTILITY RELATED |494 | | |

|Pathology and Surgical Conditions: Obstetrics and |494 | | |

|Fertility Related | | | |

|Vaginal Delivery |495 | | |

|Cesarean Section |497 |Cesarean Section |362 |

|Tubal Occlusion (Sterilization) Procedures |503 |Tubal Ligation: Pomeroy and Irving Techniques |358 |

|Tuboplasty |504 | | |

|Laproscopic Resection of Unruptured Tubal Pregnancy |507 | | |

|SURGICAL PROCEDURES: GYNECOLOGICAL PROCEDURES |510 | | |

|Gynecological Pathology |510 | | |

|SURGICAL INTERVENTION OVERVIEW |510 | | |

|Abdominal Incisions for Gynecological Surgery |510 |Abdominal Procedures |355 |

|Surgical Intervention: Laparoscopy |515 | | |

|Basic Colposcopy |518 | | |

|Hysteroscopy |518 | | |

|Marsupialization of Bartholin’s Gland Cyst |521 |Excision of Cystic Bartholin’s Gland |366 |

|Simple Vulvectomy |521 |Simple Vulvectomy |370 |

|Anterior and Posterior Repair (Colporrhaphy) |524 |Repair of Cystocele and Rectocele (Anterior and |369 |

| | |Posterior Repair) | |

|Cervical Biopsy, Cryotherapy, Laser Treatment, LEEP, |533 |Conization of the Cervix |364 |

|and Conization | | | |

|Dilation and Curettage |535 |Dilation and Curettage |364 |

|Myomectomy |538 | | |

|Total Abdominal Hysterectomy and Bilateral |542 |Abdominal Hysterectomy |354 |

|Salpingo-oophorectomy (TAH-BSO) | |Salpingo-oophorectomy |356 |

|Vaginal and Laparoscopically Assisted Vaginal |546 |Vaginal Hysterectomy |374 |

|Hysterectomy (LAVH) | | | |

|Radical Cancer Surgery: Total Pelvic Exenteration |547 | | |

|CHAPTER 16 | |CH. 27 EYE SURGERY | |

|OPHTHALMIC SURGERY | | | |

|ANATOMY OF THE EYE |554 |Surgical Anatomy |572 |

|Orbit |554 |The Bony Orbit |572 |

|Extrinsic Muscles |555 |The Ocular Muscles |572 |

|Lacrimal System |555 |The Lacrimal Apparatus |573 |

|Globe |556 |External Layers of the Eyeball |573 |

|Cavities and Chambers of the Eye |558 |The Eye’s Chambers |575 |

|OPHTHALMIC SURGICAL PATHOLOGY |558 | | |

|Glaucoma |558 |Filtering Procedure for Glaucoma |597 |

|Cataract |558 |Intracapsular Cataract Extraction |590 |

|Small Retinal Detachment |558 |Retinal Detachment |597 |

|Large Retinal Detachment |558 | | |

|Vitreous Hemorrhage |558 | | |

|Proliferative Vitreoretinopathy (PVR) |559 | | |

|Traction Retinal Detachment |559 | | |

|Epiretinal Membarane |559 | | |

|Corneal Pathology |559 | | |

|Chalazion |559 | | |

|Pterygium |559 |Excision of Pterygium |578 |

|Dacryocystitis |559 |Dacryocystorhinostomy for Lacrimal Blockage |587 |

|Strabismus |559 |Muscle Surgery: Lateral Rectus Resection and Medial |584 |

| | |Rectus Recession | |

|OPTHALMIC MEDICATIONS |560 |Special Medications |577 |

|SPECIAL CONSIDERATIONS IN OPHTHALMIC SURGERY |560 | | |

|Special Equipment |560 |Special Equipment |575 |

|Instruments |561 |Ophthalmic Instruments |577 |

|SURGICAL INTERVENTION |562 |Surgical Procedures |577 |

|Surgical Repair of Ptosis |562 |External Levator Resection for Ptosis |581 |

|Iridectomy |563 |Filtering Procedure for Glaucoma |597 |

|Trabeculoplasty |563 | | |

|Strabismus Correction: Recession/Resection |563 |Muscle Surgery: Lateral Rectus Resection and Medial |584 |

| | |Rectus Recession | |

|Adjustable Suture Surgery |566 | | |

|Scleral Buckle |567 | | |

|Enucleation and Evisceration of the Eye (Traditional |571 |Enucleation |589 |

|Approach) | | | |

|Keratoplasty (Corneal Transplant) |573 |Corneal Transplant (Penetrating Keratoplasty) | |

|Cataract Extraction |577 |Intracapsular Cataract Extraction |590 |

|Phacoemulsification |580 |Related Procedure |592 |

|Vitrectomy |580 |Closed Vitrectomy |598 |

| | | | |

|CHAPTER 17 | |CH. 28 EAR, NOSE, THROAT, AND MOUTH SURGERY | |

|OTORHINOLARYNGOLOGIC SURGERY | | | |

|ANATOMY OF THE EAR |587 |Surgical Anatomy |600 |

|Outer Ear |587 |External Ear |600 |

|Middle Ear |588 |Middle Ear |600 |

|Inner Ear |588 |Inner Ear |600 |

|PATHOLOGY OF THE EAR |589 | | |

|Pathology Affecting the Outer Ear |589 | | |

|Pathology Affecting the Middle Ear |589 | | |

|Pathology Affecting the Inner Ear |590 | | |

|Diagnostic Procedures/Tests for the Ear |590 | | |

|PREOPERATIVE CONSIDERATIONS |591 |Surgical Procedures |608 |

|SPECIAL INSTRUMENTS, SUPPLIES, DRUGS |592 |Special Equipment |602 |

|EAR PROCEDURES |592 |Surgical Procedures |608 |

|Myringotomy |592 |Myringotomy with Insertion of Ear Tubes |608 |

|Myringoplasty/Tympanoplasty |596 |Tympanoplasty |613 |

|Mastoidectomy |600 |Radical Mastoidectomy |610 |

|Stapedectomy |600 |Stapedectomy |609 |

|Stapedotomy |600 | | |

|Cochlear Implants |601 |Cochlear Implantation |615 |

|ANATOMY OF THE NOSE AND SINUSES |601 |Surgical Anatomy |616 |

|External Nose |601 |External Nose |616 |

|Internal Nose |601 |External Nose |616 |

|Paranasal Sinuses |602 |Paranasal Sinuses |616 |

|Blood Supply to the Nose |602 | | |

|Olfaction |603 | | |

|PATHOLOGY OF THE NOSE AND PARANASAL SINUSES |603 | | |

|Rhinitis/Sinusitis |603 | | |

|Nasal Polyps |604 | | |

|Hypertrophied Turbinates |604 | | |

|Deviated Nasal Septum |604 | | |

|Septal Perforation |604 | | |

|Epistaxis |604 | | |

|DIAGNOSTIC PROCEDURES |605 | | |

|Direct Vision |605 | | |

|Mirror Examination |605 | | |

|Radiography |605 | | |

|PREOPERATIVE CONSIDERATIONS |605 | | |

|SPECIAL INSTRUMENTS, SUPPLIES, AND DRUGS |606 | | |

|NASAL PROCEDURES |609 |Surgical Procedures |620 |

|Submucous Resection (SMR) |609 |Nasal Septal Reconstruction |620 |

|Polypectomy |612 |Polypectomy |622 |

|Intranasal Antrostomy |612 | | |

|Removal of Foreign Body |612 | | |

|Internal Maxillary Artery Ligation |613 | | |

|Sinus Procedures |613 | | |

|Caldwell-Luc |613 |Caldwell-Luc Procedure |621 |

|Ethmoidectomy |615 | | |

|Sphenoidectomy |616 | | |

|Drainage of the Frontal Sinus |616 | | |

|Sinus Endoscopy |616 | | |

|ANATOMY OF THE UPPER AERODIGESTIVE TRACT |618 |Surgical Anatomy |616 |

|Pharynx |618 |Pharynx |616 |

|Larynx |620 |Larynx |616 |

|Trachea |621 |Trachea |619 |

|Bronchi and Lungs |621 |The Lungs and Associated Respiratory Structures (Ch. |469 |

| | |24) | |

|Esophagus |621 |Esophagus (Ch. 19) |240 |

|PATHOLOGY AFFECTING THE UPPER AERODIGESTIVE TRACT |621 | | |

|Pharyngitis |621 | | |

|Epiglottis |622 | | |

|Tonsillitis |622 | | |

|Sleep Apnea |623 | | |

|Laryngitis |623 | | |

|Polypoid Corditis or Vocal Cord Polyps |623 | | |

|Vocal Cord Nodules |623 | | |

|Vocal Cord Granulomas |623 | | |

|Laryngeal Neoplasms |624 | | |

|Tracheitis and Bronchitis |624 | | |

|Laryngotracheobronchitis (Croup) |624 | | |

|Foreign Bodies |624 | | |

|PATHOLOGY AFFECTING THE ESOPHAGUS |624 | | |

|Esophagitis |624 | | |

|Ulceration of the Esophagus |624 | | |

|Neoplasms Affecting the Esophagus |624 | | |

|Foreign Bodies |625 | | |

|Zenker’s Diverticulum |625 | | |

|DIAGNOSTIC PROCEDURES/TESTS |625 | | |

|Direct Visualization |625 | | |

|Indirect Visualization |625 | | |

|Laboratory Tests |625 | | |

|Radiological Examinations |625 | | |

|Videostroboscopy |626 | | |

|Polysomnography |626 | | |

|Multiple Sleep Latency Test (MSLT) |626 | | |

|PREOPERATIVE CONSIDERATIONS |626 | | |

|SPECIAL INSTRUMENTS, SUPPLIES, DRUGS |626 | | |

|AERODIGESTIVE TRACT PROCEDURES |628 | | |

|Adenoidectomy |628 |Tonsillectomy and Adenoidectomy |624 |

|Tonsillectomy |628 |Tonsillectomy and Adenoidectomy |624 |

|Incision and Drainage of a Peritonsellar Abscess |631 | | |

|Uvulopalatopharyngoplasty |631 | | |

|Laryngoscopy |633 |Laryngoscopy |622 |

|Bronchoscopy |636 | | |

|Esophagoscopy |636 | | |

|Panendoscopy |636 | | |

|Radical Neck Dissection with Mandibulectomy |636 |Radical Neck Dissection |624 |

|CHAPTER 18 | |CH. 28 EAR, NOSE, THROAT, AND MOUTH SURGERY | |

|ORAL AND MAXILLOFACIAL SURGERY | |CHAPTER 29 | |

| | |PLASTIC AND RECONSTRUCTIVE SURGERY | |

|ANATOMY OF THE ORAL CAVITY |645 |Surgical Anatomy |616 |

|Lips |645 |Lips |619 |

|Teeth |645 |Teeth |620 |

|Palate |646 | | |

|Cheeks |646 |Cheeks |619 |

|Tongue |646 |Tongue |619 |

|ANATOMY OF THE FACE AND CRANIUM |646 | | |

|Orbit |647 | | |

|Facial Muscles and Innervation |647 | | |

|EMBRYOLOGICAL EVELOPMENT OF THE FACE |648 | | |

|PATHOLOGY OF THE ORAL CAVITY |649 | | |

|Mouth |649 | | |

|Jaw Bones |649 | | |

|Mandibular Fractures |649 | | |

|Frontal Fractures |650 | | |

|Orbital Fractures |650 | | |

|Zygomatic Fractures |650 | | |

|Midfacial Fractures |651 | | |

|Craniofacial Deformities |651 | | |

|DIAGNOSTIC TESTS |651 | | |

|ORAL PROCEDURES: GENERAL CONSIDERATIONS |652 |Dental Procedures |626 |

|Tooth Extraction/Odontectomy |653 |Dental Extraction |626 |

|Tooth Restoration |657 | | |

|Implantation |657 | | |

|MAXILLOFACIAL PROCEDURES: GENERAL CONSIDERATIONS |658 | | |

|Graft Materials |658 | | |

|Repair of Mandibular/Maxillary Fractures |659 |Repair of Fractured Mandible (Ch. 29) |653 |

| | |Repair of Fractured Maxilla |653 |

|Application of Arch Bars |659 |Application of Arch Bars (Ch. 29) |651 |

|Wire Fixation |662 | | |

|Plate and Screw Fixation of Mandibular Fracture |663 | | |

|Frontal Fracture Repair |666 | | |

|Orbital Floor Fracture Repair |667 | | |

|Reduction of Zygomatic Fractures |670 |Repair of Fractured Zygoma (Ch. 29) |653 |

|Le Fort I Fracture Repair |671 | | |

|Le Fort II and III Fracture Repair |675 | | |

|Craniofacial Reconstruction |675 | | |

|Correction of Retrognathism or Prognathism |679 | | |

|Temporomandibular Joint Procedures |682 | | |

|CHAPTER 19 | |CHAPTER 29 | |

|PLASTIC AND RECONSTRUCTIVE SURGERY | |PLASTIC AND RECONSTRUCTIVE SURGERY | |

|ANATOMY |685 |Surgical Anatomy |629 |

|Skin and Underlying Structures |685 |Surgical Anatomy |629 |

|Palate |687 | | |

|Nose |687 | | |

|Hand |687 | | |

|Breast |694 | | |

|SURGICAL PATHOLOGY |694 | | |

|Pathology Affecting the Skin |694 | | |

|Cleft Lip and Palate |696 | | |

|Pathology Affecting the Hand |697 | | |

|Pathology Affecting the Breast |701 | | |

|DIAGNOSTIC PROCEDURES AND TESTS |701 | | |

|SPECIAL INSTRUMENTATION, SUPPLIES, DRUGS, AND EQUIPMENT|701 |Special Equipment and Materials |631 |

|Nasal Set |701 | | |

|Dermatome |702 | | |

|Mesh Graft Device |704 | | |

|SURGICAL INTERVENTION |704 |Surgical Procedures |631 |

|Rhytidectomy |704 |Rhytidectomy |634 |

|Blepharoplasty |706 |Blepharoplasty |641 |

|Suction Lipectomy |707 | | |

|Abdominoplasty |708 | | |

|Skin Grafts |709 |Skin Grafts |631 |

|Dermabrasion |713 |Dermabrasion |641 |

|Scar Revision |713 | | |

|Cheiloplasty and Palatoplasty |713 |Repair of Cleft Palate and Repair of Cleft Lip |651 |

|Rhinoplasty |714 |Rhinoplasty |644 |

|Hand Surgery |716 | | |

|Mammoplasty |723 |Reduction Mammoplasty and Augmentation Mammoplasty and|661 |

| | |Trans-Rectus Abdominus Myocutaneous Flap | |

| | | | |

|CHAPTER 20 | |CH. 22 UROGENITAL SURGERY | |

|GENITOURINARY SURGERY | | | |

|ANATOMY |732 |Surgical Anatomy |378 |

|Suprarenal Glands |732 |Adrenal Glands |378 |

|Kidneys |732 |Kidneys |378 |

|Ureters |735 |Ureter |378 |

|Urinary Bladder |736 |Urinary Bladder |381 |

|Male Reproductive System |737 |External Reproductive Organs of the Male |381 |

| | |Internal Reproductive Organs of the Male |382 |

|PATHOLOGY AFFECTING THE ADRENAL GLANDS |739 | | |

|Cushing’s Syndrome |739 | | |

|Adrenal Insufficiency (Addison’s Disease) |739 | | |

|Pheochromocytoma |739 | | |

|PATHOLOGY AFFECTING THE URINARY SYSTEM |739 | | |

|Bladder Tumors |739 | | |

|Urinary Calculi |740 | | |

|Kidney Disorders |740 | | |

|PATHOLOGY AFFECTING THE MALE REPRODUCTIVE SYSTEM |743 | | |

|Phimosis |743 | | |

|Hypospadias/Epispadias |743 | | |

|Benign Prostatic Hypertrophy |743 | | |

|Cancer of the Prostate |744 | | |

|Cryptorchidism |744 | | |

|Testicular Torsion |744 | | |

|Testicular Cancer |744 | | |

|Trauma to the Genitourinary System |745 | | |

|DIAGNOSTIC PROCEDURES/TESTS |745 |Diagnostic Procedures |404 |

|History and Physical |745 | | |

|Laboratory Findings |745 | | |

|Radiological Findings |751 | | |

|Biopsy |751 | | |

|Endoscopy |751 | | |

|SPECIAL EQUIPMENT, INSTRUMENTS, SUPPLIES, DRUGS |751 |Open Procedures |383 |

| | |Closed Procedures: Cytoscopy |399 |

|PREOPERATIVE AND INTRAOPERATIVE PREPARATION |752 |Duties of the Cytoscopic assistant |404 |

|Incisional Options |754 | | |

|SURGICAL PROCEDURES |757 | | |

|Adrenalectomy |757 | | |

|Nephrectomy |757 |Simple Nephrectomy |383 |

|Renal Transplant |762 |Kidney Transplantation |385 |

|Stone Removal |763 |Pyelolithotomy |387 |

|Cystostomy |764 |Suprapubic Cystostomy |389 |

|Cystectomy/Ileal Conduit |766 |Ileal Conduit |387 |

|Procedures for Stress Incontinence Affecting Women |771 |Vesicourethral Suspension (Marshall-Marchetti-Krantz |390 |

| | |Procedure) | |

|Transurethral Endoscopy of the Genitourinary Tract |774 |Closed Procedures: Cytoscopy |399 |

|Circumcision |776 |Circumcision |392 |

|Orchiectomy |778 |Simple Orchiectomy |394 |

|Orchiopexy |778 |Orchiopexy |397 |

|Hydrocelectomy |781 |Hydrocelectomy |398 |

|Varicocelectomy |781 | | |

|Hypospadias Repair |782 |Repair of Hypospadias |394 |

|Insertion of Inflatable Penile Prosthesis |782 |Insertion of a Penile Implant |394 |

|Vasectomy |783 |Vasectomy |398 |

|Vasovasostomy |784 | | |

|Prostatectomy |784 |Suprapubic Prostatectomy |390 |

| | |Retropubic Prostatectomy |391 |

| | | | |

|CHAPTER 21 | |CHAPTER 23 | |

|ORTHOPEDIC SURGERY | |ORTHOPEDIC SURGERY | |

|BONE AND BONE TISSUE |792 |Surgical Anatomy |412 |

|Bone Tissue |792 |Bone Tissue and membranes |412 |

|Types of Bones |794 |Classification of Bones |412 |

|Types of Joints |794 |The Articular System |420 |

|Bone Growth and Bone Cells |797 | | |

|Intramembranous Bones |798 | | |

|Endochondral Bone |798 | | |

|Mineral Storage |798 | | |

|Factors That Affect Bone Growth |798 | | |

|Clinical and Bone Landmark Terms |798 |Bone Landmarks |416 |

|PATHOLOGY |798 |Fractures |425 |

|Types of Fractures |805 |Classification of Fractures |425 |

|Normal Bone Healing |805 | | |

|Pathological Bone Healing |806 |Fracture Management |426 |

|Diagnostic Terms and Procedures |808 | | |

|THE SKELETON |808 |The Skeleton |412 |

|The Skull |808 |The Bones of the Body |416 |

|Vertebral Column |811 |The Bones of the Body |416 |

|Bones of the Thoracic Region |812 |The Bones of the Body |416 |

|Clavicles |812 |The Bones of the Body |416 |

|Scapula |812 |The Bones of the Body |416 |

|Pectoral Girdle |812 |The Bones of the Body |416 |

|Humerus |812 |The Bones of the Body |416 |

|Radius and Ulna |813 |The Bones of the Body |416 |

|Hand and Wrist |814 |The Bones of the Body |416 |

|Pelvis |814 |The Bones of the Body |416 |

|Hip and Femur |814 |The Bones of the Body |416 |

|Tibia and Fibula |814 |The Bones of the Body |416 |

|Ankle and Foot |816 |The Bones of the Body |416 |

|EQUIPMENT |818 |Orthopedic Equipment and Supplies |427 |

|Positioning Devices |818 |Orthopedic Table and Surgical Armboard |432 |

|Pneumatic Tourniquets |819 |Pneumatic Tourniquet |429 |

|Traction |819 | | |

|Lasers |819 | | |

|Radiography |819 | | |

|Air Flow |820 | | |

|Continuous Passive Range-of-Motion Machines |820 | | |

|Transcutaneous Electrical Nerve Stimulation |820 | | |

|Electrical Stimulation of Bone |820 | | |

|Saws, Drills, and Reamers |820 |Power Equipment |429 |

| | |Orthopedic Instruments |435 |

|Arthroscopic Equipment |820 |Arthroscopic Equipment |438 |

|SUPPLIES |821 |Orthopedic Equipment and Supplies |427 |

|Implants |821 |Orthopedic Instruments |432 |

|Suture |821 | | |

|Methyl Methacrylate |821 |Methyl Methacrylate Cement |429 |

|Pharmacology |821 | | |

|PROCEDURES |822 | | |

|Bone Grafting |822 | | |

|Knee Arthroscopy |824 |Arthroscopic Surgery |438 |

|Arthroscopic Repair of Meniscal Tear |827 |Arthroscopic Surgery |438 |

|Arthroscopic Anterior Cruciate Ligament Repair | |Arthroscopic Surgery |438 |

|Above-the-Knee Amputation | |Above-Knee Amputation (Ch. 25) |542 |

|Endoscopic Carpal Tunnel Release |832 |Open Procedures: Exposure and Description |442 |

|Colle’s Fracture |835 | | |

|Metacarpal Phalangeal Joint Arthroplasty |840 |Open Procedures: Exposure and Description |442 |

|Triple Arthrodesis |840 | | |

|Achilles Tendon Repair |841 | | |

|Bunionectomy |842 | | |

|Open Reduction-Internal Fixation (ORIF) of the Humerus |842 |Open Procedures: Exposure and Description |442 |

| Shoulder Joint Arthroscopy |845 |Arthroscopic Surgery |438 |

|Acromioplasty |846 | | |

|Repair of the Rotator Cuff |846 |Arthroscopic Surgery |438 |

|Internal Fixation of Femoral Shaft Fracture |851 |Open Procedures: Exposure and Description |442 |

|Repair of Hip Fracture |852 |Open Procedures: Exposure and Description |442 |

|Total Hip Arthroplasty |852 |Open Procedures: Exposure and Description |442 |

|Total Knee Arthroplasty |859 |Open Procedures: Exposure and Description |442 |

| | | | |

|CHAPTER 22 | |CHAPTER 24 | |

|CARDIOTHORACIC SURGERY | |CARDIOTHORACIC SURGERY | |

|ANATOMY OF THE CHEST |864 |Surgical Anatomy |467 |

|The Thorax |864 |The Thoracic Cavity |467 |

|The Trachea |866 |The Lungs and Associated Respiratory Structures |469 |

|The Bronchial Tree |866 |The Lungs and Associated Respiratory Structures |469 |

|The Lungs |867 |The Lungs and Associated Respiratory Structures |469 |

|ANATOMY AND PHYSIOLOGY OF THE HEART |868 | | |

|Location of the Heart |868 |The Heart |467 |

|Coverings of the Heart |869 |The Heart |467 |

|The Heart Wall |869 |The Heart |467 |

|The Heart Chambers |869 |The Heart |467 |

|The Heart Valves |869 |The Heart |467 |

|Blood Flow Through the Heart |870 |The Heart |467 |

|Blood Supply for the Heart |871 |The Heart |467 |

|The Cardiac Cycle |871 |The Heart |469 |

|Cardiac Output |872 | | |

|Cardiac Conduction |872 | | |

|Anatomical Development of the Heart |872 | | |

|OPERATIVE PATHOLOGY |873 | | |

|The Chest Wall |873 | | |

|The Mediastinum |873 | | |

|The Lungs |874 | | |

|Thoracic Trauma |875 | | |

|Thoracic Outlet Syndrome |877 | | |

|Thoracic Aortic Aneurysm |877 | | |

|Coronary Artery Disease |879 | | |

|Valvular Disease |881 | | |

|Cardiomyopathy |882 | | |

|Cardiac Dysrythmias |882 | | |

|Congenital Heart Defects |884 | | |

|DIAGNOSTIC PROCEDURES: THORAX |887 | | |

|Bronchoscopy |887 |Bronchoscopy |476 |

|Mediastinoscopy |887 |Mediastinoscopy |478 |

|Thoracoscopy |887 | | |

|Thoracentesis |889 | | |

|DIAGNOSTIC PROCEDURES: CARDIAC |889 | | |

|Radiological Studies |889 | | |

|SURGICAL INTERVENTION: THORACIC |889 | | |

|Special Preoperative Considerations |889 | | |

|Special Instrumentation, Supplies, Drugs, and Equipment|889 | | |

|Patient Preparation |890 | | |

|Thoracoscopy |892 | | |

|Scalene/Supraclavicular Node Biopsy |895 | | |

|Thoracotomy for Upper Lobectomy |895 |Lobectomy |484 |

|Thoracotomy for Right Pneumonectomy |899 |Pneumonectomy |485 |

|Thoracotomy for Wedge Resection or Segmentectomy |899 |Lung Biopsy |483 |

|Decortication of Lung |899 | | |

|SURGICAL INTERVENTION: CARDIAC (ADULT) |900 | | |

|Preoperative Considerations |900 | | |

|Patient Preparation |901 | | |

|Techniques of Cardiopulmonary Bypass |901 |Cardiopulmonary Bypass |497 |

|Mechanical Circulatory Assistance |904 |Insertion and Removal of Intra-Aortic Ballon Catheter |523 |

|Coronary Artery Bypass Grafting |905 |Coronary Artery Bypass |507 |

|Aortic Valve Replacement |911 |Aortic Valve Replacement |512 |

|Mitral Valve Replacement |916 |Mitral Valve Replacement |513 |

|Thoracic Aortic Aneurysmectomy |917 |Resection of Aneurysms of the Descending Thoracic |491 |

| | |Aorta | |

|Pericardiectomy/Pericardial Window |918 | | |

|Heart Transplantation |919 | | |

|Permanent Pacemaker Insertion |920 |Implantation of a Pacemaker |505 |

|Percutaneous Transluminal Coronary Angioplasty |921 |Coronary Angioplasty |512 |

|SURGICAL INTERVENTION: CARDIAC (PEDIATRIC) |921 | | |

|Special Preoperative Preparation |922 | | |

|Atrial Septal Defect |922 |Closure of Atrial Septal Defect |518 |

|Ventricular Septal Defect |922 |Closure of Ventricular Septal Defect |519 |

|Patent Ductus Arteriosus |923 |Closure of Patent Ductus Arteriosus |487 |

|Correction of Aortic Coarctation |924 |Correction of Coarctation of the Thoracic Aorta |489 |

|Procedure for Correction of Tetralogy of Fallot |924 |Total Correction of Tetralogy of Fallot |522 |

|Procedure for Correction of Transposition of the Great |925 | | |

|Arteries | | | |

|CHAPTER 23 | |CH. 25 | |

|PERIPHERAL VASCULAR SURGERY | |PERIPHERAL VASCULAR SURGERY | |

|PERIPHERAL VASCULAR SURGERY |928 |Intro. Paragraph |527 |

|SURGICAL ANATOMY |928 |Surgical Anatomy |527 |

|Blood Vessels |928 |Surgical Anatomy |527 |

|Blood Pressure |930 | | |

|The Arterial System |931 | | |

|The Venous System |933 | | |

|OPERATIVE PATHOLOGY AND DIAGNOSIS |934 | | |

|Arterial Embolism |935 | | |

|Arteriosclerosis Obliterans |935 | | |

|Aneurysms of the Abdominal Aorta |936 | | |

|SURGICAL INTERVENTIONS |937 |Surgical Procedures |530 |

|Peripheral Vessel Angioplasty |937 | | |

|Bypass Grafting and Endarterectomy |939 |Special Equipment |527 |

|Features of Peripheral Vascular Procedure |940 |Special Equipment |527 |

|Aortofemoral Bypass |943 |Resection of Abdominal Aortic Aneurysm and Aortic |532 |

| | |Femoral Bypass | |

|Abdominal Aortic Aneurysmectomy |947 |Resection of Abdominal Aortic Aneurysm and Aortic |532 |

| | |Femoral Bypass | |

|Femoropopliteal Bypass |950 |Femoral Popliteal Bypass |534 |

|Femorofemoral Bypass |954 | | |

|Axillofemoral Bypass |956 | | |

|Carotid Endarterectomy |959 |Carotid Endarterectomy |530 |

|CHAPTER 24 | |CH. 26 NEUROSURGERY | |

|NEUROSURGERY | | | |

|SURGICAL ANATOMY |966 |Surgical Anatomy |549 |

|Divisions of the Nervous System |966 |Surgical Anatomy |549 |

|Cranium |966 |Central Nervous System |549 |

|Vertebral Column |973 |Spinal Cord |552 |

|Blood Supply |974 | | |

|Cranial Nerves |974 |Cranial Nerves |552 |

|Spinal Nerves |974 |Spinal Nerves |553 |

|NEUROSURGICAL PATHOLOGY |976 | | |

|Cervical Spine |976 | | |

|Thoracic Spine |977 | | |

|Lumbar Spine |978 | | |

|Neoplasms |979 | | |

|Head Injury |980 | | |

|Spinal Cord Injury |982 | | |

|Cerebrovascular Disease |982 | | |

|Congenital Abnormalities |983 | | |

|INFECTION |984 | | |

|Abscess |984 | | |

|Spinal Tumors |985 | | |

|Peripheral Nerve Disorders |985 | | |

|NEUROSURGICAL PROCEDURES |986 |Surgical Procedures |559 |

|Special Instrumentation, Supplies, Drugs, and Equipment|986 |Special Equipment |555 |

| | |Drugs Used in Neurosurgery |558 |

|Patient Preparation |990 |Positioning, Prepping, and Draping |554 |

|Craniotomy |991 |Craniotomy |564 |

|Craniectomy |1001 | | |

|Ventriculoperitoneal and Ventriculoatrial Shunt |1005 |Shunting Procedures |570 |

|Transsphenoidal Hypophysectomy |1008 | | |

|Stereotactic Procedure |1011 | | |

|Cranioplasty |1012 |Cranioplasty |568 |

|Spinal Procedures |1012 |Lumbar Laminectomy |560 |

| | |Anterior Cervical Fusion |563 |

|Peripheral Nerve Procedure |1020 |Peripheral Nerve Repair |559 |

|ADVANCES IN NEUROSURGERY |1022 |Intracranial Microsurgery |567 |

| Intraoperative MRI |1022 | | |

|Three-Dimensional Reconstruction |1022 | | |

|Radiosurgery |1022 | | |

|Minimal Invasive Techniques |1022 | | |

|Stereotaxis |1022 | | |

|Intraoperative Ultrasound |1023 | | |

|Brain Mapping |1023 | | |

|Endoscopic Neurosurgery |1023 | | |

|Deep Brain Stimulation |1023 | | |

| | | | |

|APPENDIX A: ANATOMY PLATES |1025 | | |

|APPENDIX B: COMMON PREFIXES AND SUFFIXES |1036 | | |

|APPENDIX C: MEASUREMENTS |1039 | | |

| | | | |

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