Monitoring the Pediatric Patient

AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

CHAPTER 1 CH. 1 PERIOPERTIVE EDUCATION ORIENTATION TO SURGICAL CH. 2 FOUNDATIONS OF TECHNOLOGY PERIOPERATIVE PATIENT CARE STANDARDS CH. 4 THE PERIOPERATIVE PATIENT CARE TEAM CH. 6 ADMINISTRATION OF PERIOPERATIVE PATIENT CARE SERVICES HISTORY OF SURGERY 3 Historical Background sections are found at the beginning of each chapter. SURGERY TODAY 4 Surgical Specialties 5 HISTORY OF SURGICAL 6 TECHNOLOGY FIELD OF SURGICAL TECHNOLOGY 8 Surgical Technology (Ch. 2) 23 Working Conditions 8 Personal Characteristics 8 Expected Behaviors of Perioperative 8 Caregivers (Ch. 1) Surgical Team Members 8 CH. 4 THE PERIOPERATIVE 56 PATIENT CARE TEAM Surgical Technology Education and 10 Credentialing of Caregivers (Ch. 2) 25 Certification THE SURGICAL TECHNOLOGISTAS A 11 PROFESSIONAL Professionalism 11 Surgical Technologist’s Lifestyle 12 Job Descriptions for the Surgical 13 Technologist Career Opportunities 13 HEALTH CARE FACILITIES 14 Hospital Organization 15 Establishing Administrative Roles (Ch. 6) 73 Hospital Departments and Interdepartmental 17 Patient Care Departments (Ch. 6) 77 Communication Financial Considerations and 19 Reimbursement Organizations Related to Hospitals, Health 20 Care, and Surgical Services

CHAPTER 2 CH. 3 LEGAL AND ETHICAL STANDARDS OF CONDUCT ISSUES CH. 2 FOUNDATIONS OF PERIOPERATIVE PATIENT CARE STANDARDS LEGAL ISSUES 23 Definitions of General Legal Terms 23 Box 3-1 23 Definitions of Traditional Principles 24 Torts 25 Consent for Surgery: A Basic Right 27 Consent 33 Documentation 29 Documentation of Perioperative Patient 35 Care Event/Incident Reports 30 Incident Report 37 Advance Directives 30 Advance Directives 35 ETHICAL AND MORAL ISSUES 30 Ethical Issues 44 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Moral Principles 31 Ethical Issues 44 Bioethics 31 Bioethical Situations 45 AHA Patient’s Bill of Rights 31 Elements of Ethical Decision Making 32 Ethical Issues 44 Professional Codes of Conduct 34 Box 3-4 44 Surgical Conscience 34 Surgical Conscience 48 SCOPE OF PRACTICE 34 Job Descriptions and Competencies 35 Credentialing of Caregivers (Ch. 2) 25 Credentialing 36 Accreditation (Ch. 2) 25 Accreditation 36 Core Curricula for Surgical Technology and 36 Surgical Assisting Career Development 36 Clinical Ladder Program 37 RISK MANAGEMENT AND LIABILITY 38 Liability 30 Medical Errors 38 Safe Medical Device Act 39 Malpractice Insurance 39 Liability Insurance 31

CHAPTER 3 CH. 7 THE PATIENT: THE REASON THE SURGICAL PATIENT. FOR YOUR EXISTENCE THE STSR AND THE SURGICAL 43 Patient-Centered Care 88 PATIENT PHYSICAL, PSYCHOLOGICAL, 43 Patient-Centered Care 89 SOCIAL, AND SPIRITUAL NEEDS OF THE SURGICAL PATIENT Understanding the Surgical Patient 44 Causes of Surgical Intervention 44 The Surgical Patient, a Human Being 44 Patient-Centered Care 88 Prioritizing Needs-Maslow’s Hierachy 45 Hierarchy of Needs 89 Life Stage Development: Select Basic 46 Concepts Cultural and Religious Influences 49 Patient’s Reactions to Illness 91

CHAPTER 4 CH. 7 THE PATIENT: THE REASON SPECIAL POPULATIONS FOR YOUR EXISTENCE CH. 8 PERIOPERATIVE PEDIATRICS CH. 9 PERIOPERATIVE GERIATRICS CH. 34 GYNECOLOGIC AND OBSTETRIC SURGERY INTRODUCTION 57 Patients With Special Needs (Ch. 7) 92 PEDIATRIC PATIENTS 57 Indications for Surgery (Ch. 8) 119 Considerations in Perioperative Pediatrics 121 Preoperative Psychologic Preparation of 126 Pediatric Patients Monitoring the Pediatric Patient 59 Intraoperative Pediatric Patient Care 132 Considerations (Ch. 8) Body Temperature Considerations 123 Shock 60 Fluids and Electrolytes 60 Fluids and Electrolyte Balance 123 Considerations (Ch. 8) Infection 61 Pediatric Infection Risk Considerations 125 (Ch. 8) Metabolic and Nutritional Responses 61 Metabolism and Nutritional 122 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Considerations (Ch. 8)

Trauma 61 Trauma (Ch. 8) 119 PATIENTS WITH OBESITY 62 Obese Patients (Ch. 7) 98 Review of Surgical Considerations 64 Obese Patients (Ch. 7) 98 Specific Considerations of Bariatric Surgery 64 Obese Patients (Ch. 7) 98 PATIENTS WITH DIABETES 64 Patients with Diabetes Mellitus (Ch. 7) 96 Complications Associated with Diabetes 65 Common Complications of Diabetes 96 Mellitus (Ch. 7) Care of the Patient with Diabetes in Surgery 66 Special Considerations (Ch. 7) 97 PREGNANT PATIENTS 66 Perioperative Obstetrics (Ch. 24) 691 Considerations when Caring for Pregnant 67 Considerations for the Care of the 691 Patients Pregnant Patient (Ch. 24) Anesthesia 67 Anesthesia (Ch. 24) 692 Intraoperative Considerations for the 67 Considerations for the Care of the 691 Surgical Technologist Pregnant Patient (Ch. 24) IMMUNOCOMPROMISED PATIENTS 68 Immunocompromised Patients (Ch. 7) 99 Acquired Immunodeficiency Syndrome 68 Acquired Immunodeficiency Syndrome 100 (Ch. 7) Considerations for the Surgical Team 68 Acquired Immunodeficiency Syndrome 100 Members (Ch. 7) PATIENTS WITH DISABILITIES 69 Patients with Sensory Impairment or 92 Physical Challenges (Ch. 7) GERIATRIC PATIENTS 69 CH. 9 PERIOPERATIVE GERIATRICS 155 TRAUMA PATIENTS 71 THE “GOLDEN HOUR” AND TRAUMA 71 PATIENTS KINEMATICS 71 Blunt Trauma 71 Penetrating Trauma 72 TRAUMA SCORING 72 CONSIDERATIONS FOR THE 72 SURGICAL TECHNOLOGIST Preservation of Evidence 72 Hypothermia 73 Infection 73 PREPARATION OF THE CASE 73

CHAPTER 5 CH. 10 PHYSICAL FACILITIES PHYSICAL ENVIRONMENT AND CH. 13 POTENTIAL SOURCES OF SAFETY STANDARDS INJURY TO THE CAREGIVER AND THE PATIENT CH. 15 PRINCIPLES OF ASEPSIS AND STERILE TECHNIQUE PHYSICAL DESIGN OF THE SURGERY 77 Physical Layout of the Surgical Suite 177 DEPARTMENT (Ch. 10) Areas of the OR 78 Space Allocation and Traffic Patterns 181 (Ch. 10) Physical Components of the Operative Suite 79 Operating Room (Ch. 10) 185 Substerile Area 83 Substerile Room (Ch. 10) 185 Direct Support Services 83 Peripheral Support Areas (Ch. 10) 183 HAZARDS AND REGULATORY 85 Environmental Hazards (Ch. 13) 211 AGENCIES SAFETY CONSIDERATIONS 86 Opening paragraphs (Ch. 13) 211 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Air-Handling System 86 Ventilation (Ch. 10) 186 Environmental Factors (Ch. 13) 214 Surgical Lights 86 Lighting (Ch. 10) 188 Environmental Factors (Ch. 13) 214 Noise in the Operating Room 86 Environmental Factors (Ch. 13) 214 Ergonomics and Safety Considerations 86 Body Mechanics (Ch. 13) 215 Fire Hazards and Safety 87 Fire and Explosion (Ch. 13) 220 Electrical Hazards 88 Electricity (Ch. 13) 218 Ionizing Radiation 89 Ionizing Radiation (Ch. 13) 215 BIOLOGICAL HAZARDS AND SAFETY 90 Biological Hazards ad Safeguards 224 CONSIDERATIONS (Ch. 13) Universal Precautions 90 Standard Precautions (Ch. 15) 254 Standard Precautions 90 Standard Precautions (Ch. 15) 254 Laser and Electrosurgical Plume 93 Surgical Plume (Ch. 13) 225 Latex Allergy 94 Latex Sensitivity/Allergy (Ch. 13) 226 CHEMICAL HAZARDS AND SAFETY 94 Chemical Hazards and Safeguards 222 CONSIDERATIONS (Ch.13) Waste Anesthetic Gases 94 Anesthetic Gases (Ch. 13) 222 Methyl Methacrylate 95 Methyl Methacrylate (Ch 13) 224 Formalin 95 Sterilizing Agents (Ch. 13) 223 Ethylene Oxide 95 Sterilizing Agents (Ch. 13) 223 Glutaraldehyde 95 Sterilizing Agents (Ch. 13) 223 CHAPTER 6 NO CHAPTER 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 125 Robotic Components Clinical Applications 125 THE OR OF THE FUTURE 125 Surgical Planning and Rehearsal 125 Surface-Based Registration 126 ROLE OF THE SURGICAL 126 TECHNOLOGIST AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

CHAPTER 7 CH 12 CARE OF THE ASEPSIS AND STERILE TECHNIQUE PERIOPERATIVE ENVIRONMENT CH. 14 MICROBIOLOGIC CONSIDERATIONS CH. 15 PRINCIPLES OF ASEPSIS AND STERILE TECHNIQUE CH. 17 DECONTAMINATION AND DISINFECTION CH. 18 STERILIZATION HISTORY OF STERILIZATION 130 Historical Background (Ch. 15) 248 BASIC TERMINOLOGY 131 PATHOGENS AND INFECTION 131 Microorganisms: Nonpathogens versus 230 Pathogens (Ch. 14) Infection 131 Pathogenic Invasion (Ch. 14) 232 Infectious Processes in the Body Pathogens Associated with Surgical Site 132 Types of Pathogenic Microorganisms 233 Infection (Ch. 14) Methods of Transmission 135 Transmission of Microorganisms (Ch. 15) 249 PRINCIPLES OF ASEPSIS 138 Principles of Sterile Technique (Ch. 15) 257 Principle 1: Sterile Field 138 Principles of Sterile Technique (Ch. 15) 257 Principle 2: Sterile Team Member Attire 139 Principles of Sterile Technique (Ch. 15) 257 Principle 3: Movement in and around 140 Principles of Sterile Technique (Ch. 15) 258 Sterile Field SURGICAL CONSCIENCE 140 Surgical Conscience (Ch. 3) 49 No Compromise of Sterility (Ch. 15) 262 CLEANING, DISINFECTION, AND 141 Instrument Cleaning and Disinfection 281 STERILIZATION (Ch. 17) Cleaning and Disinfection 142 Instrument Cleaning and Disinfection 281 (Ch. 17) Disinfectant and Disinfectant/Sterilant 147 Methods of Disinfection (Ch. 17) 287 Agents INSTRUMENT PREPARATION AND 151 WRAPPING FOR STERILIZATION Instruments 151 Inspecting and Testing (Ch. 17) 284 Specific Procedural Trays 151 Instrument Sets 151 Assembly of Instrument Sets (Ch. 18) 299 PACKAGING FOR STERILIZATION 152 Packaging Instruments and other Items 301 AND STORAGE for Sterilization (Ch. 18) Performance Standards of Packaging 152 Packaging Instruments and other Items 301 Material for Sterilization (Ch. 18) Performance Characteristics 152 Packaging Instruments and other Items 301 for Sterilization (Ch. 18) Types of Packaging Materials 153 Packaging Materials and Methods (Ch. 302 18) General Principles of Packaging 155 Packaging Instruments and other Items 301 for Sterilization (Ch. 18) Sterilization 158 Thermal Sterilization (Ch. 18) 304 Requirements and Essential Factors 159 Reliability Parameters for Sterilization 298 (Ch. 18)

Basic Components of a Steam Sterilizer 160 Thermal Sterilization (Ch. 18) 305 GAS STERILIZATION 163 Chemical Sterilization (Ch. 18) 312 Ethylene Oxide 163 Ethylene Oxide Gas Sterilization (Ch. 18) 312 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Alternative Gas Sterilization Methods 164 Hydrogen Peroxide Plasma Sterilization 316 (Ch. 18) Ozone Gas Sterilization LIQUID CHEMICAL STERILIZATION 165 Chemical Sterilants in Solution (Ch. 18) 317 PROCESSES IONIZING RADIATION 165 Radiation Sterilization (Ch. 18) 319 METHODS OF MONITORING THE 165 Monitoring the Sterilization Cycle 298 STERILIZATION PROCESS (Ch. 18) Mechanical Methods of Monitoring the 165 Mechanical Indicators (Ch. 18) 299 Sterilization Process Chemical Methods of Monitoring the 166 Chemical Indicators (Ch. 18) 299 Sterilization Process Biological Methods of Monitoring the 166 Biologic Indicators (Ch. 18) 299 Sterilization Process Bowie-Dick Test 167 EVENT-RELATED STERILITY 167 Shelf Life (Ch.18) 320 Environmental Decontamination 168 Establishing the Perioperative 204 Environment (Ch.12) Environmental Services 168 Daily Terminal Cleaning (Ch. 12) 208 Case by Case 168 Room Turnover Between Patients 205 (Ch. 12) Daily 168 Daily Terminal Cleaning (Ch. 12) 208 CHAPTER 8 CH. 21 PREOPERATIVE GENERAL PATIENT CARE AND PREPARATION OF THE PATIENT SAFETY CH. 26 POSITIONING, PREPPING, AND DRAPING THE PATIENT CH. 28 HEMOSTASIS AND WOUND CLOSURE CH. 31 POTENTIAL PERIOPERATIVE COMPLICATIONS PREOPERATIVE PATIENT ROUTINES 172 Preoperative Preparation of All Patients 365 (Ch 21) Surgical Consent 173 Preoperative Preparation of All Patients 367 (Ch 21) Preoperative Education 175 Preoperative Teaching (Ch. 21) 371 Patient Possessions 175 Preoperative Preparation of All Patients 367 (Ch 21) Evening/Morning before Surgery 176 Evening before an Elective Surgical 367 Procedure (Ch. 21) Diet 177 Preoperative Preparation of All Patients 366 (Ch 21) Makeup and Dress 177 Preoperative Preparation of All Patients 367 (Ch 21) Call to Operating Room 177 Before Leaving for the Operating Room 374 (Ch. 21) Family Visit 177 Before Leaving for the Operating Room 375 (Ch. 21) Patient Identification 177 Before Leaving for the Operating Room 375 (Ch. 21) Transportation 178 Transportation to the Operating Room 375 Suite (Ch. 21) TRANSFER AND POSITIONING 179 Admission to the Operating Room Suite 376 (Ch. 21) BASIC POSITIONING FOR SURGERY 180 Preliminary Considerations (Ch. 26) 470 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Supine Position 181 Supine (Dorsal) Position (Ch. 26) 483 Trendelenburg Position 183 Trendelenburg’s Position (Ch. 26) 487 Reverse Trendelenburg Position 184 Reverse Trendelenburg’s Position (Ch. 487 26) Fowler’s Position and Sitting Position 184 Fowler’s Position (Ch. 26) 487 Lithotomy Position 185 Lithotomy Position (Ch. 26) 487 Prone Position 186 Prone Position (Ch. 26) 488 Kraske (Jackknife Position) 188 Kraske (Jackknife) Position (Ch. 26) 489 Lateral Position 189 Lateral Positions (Ch. 26) 489 Kidney Position 190 Kidney Position (Ch. 26) 490 Sim’s Position 191 Sim’s Position (Ch. 26) 490 THERMOREGULATORY DEVICES 191 VITAL SIGNS 192 Monitoring Physiologic Functions 513 (Ch. 27) Temperature 192 Metabolic Crises (Ch. 31) 617 Pulse 193 Respiration 194 Physiologic Parameters Monitored 519 (Ch. 27) Blood Pressure 196 Physiologic Parameters Monitored 519 (Ch. 27) URINARY CATHETERIZATION 199 Urinary Catheterization (Ch. 26) 491 Indications 200 Urinary Catheterization (Ch. 26) 492 Procedure 200 Urinary Catheterization (Ch. 26) 492 Considerations 200 Urinary Catheterization (Ch. 26) 492 SKIN PREPARATION 202 Principles of Patient Skin Preparation 494 (Ch. 26) Skin Preparation Setup 203 Antiseptic Skin Cleansing Fundamentals 495 (h. 26) Skin Marking 206 HEMOSTASIS AND BLOOD 206 Hemostasis (Ch. 28) 529 REPLACEMENT Factors Affecting Hemostasis 207 Hemotologic disorders (Ch. 31) 611 Control of Bleeding during Surgery 207 Methods of Hemostasis (Ch. 28) 530 Mechanical Methods 207 External Mechanical Methods (Ch. 28) 531 Internal Mechanical Methods 534 THERMAL HEMOSTASIS 209 Thermal Methods (Ch. 28) 535 PHARMACOLOGICAL AGENTS 209 Chemical Methods (Ch. 28) 530 Blood Loss 210 Blood Volume Complications (Ch. 31) 608 Blood Replacement 210 Blood Loss Replacement (Ch. 31) 612 Hemolytic Transfusion Reactions 211 CARDIOPULMONARY 211 Cardiopulmonary Resuscitation (Ch. 31) 602 RESUSCITATION Cardiac Arrest in the Surgical Setting 212 Cardiac Arrest (Ch. 31) 597 MALIGNANT HYPERTHERMIA 213 Malignant Hyperthermia (Ch. 31) 617 Prevention 213 Malignant Hyperthermia (Ch. 31) 617 Treatment 213 Malignant Hyperthermia (Ch. 31) 618 EMERGENCY MEDICAL SERVICES 213 INDICATIONS OF EMERGENCY 214 SITUATIONS OBJECTIVES AND PRIORITIES IN 214 ERMERGENCY SITUATIONS Syncope 214 Convulsions/Seizures 215 Convulsions (Ch. 31) 616 Anaphalactic Reactions 211 Drug Interactions (Ch. 31) 598 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Clinical Manifestations of Impending 216 Cardiac Arrest (Ch. 31) 597 Cardiac Arrest

CHAPTER 9 CH. 21 PREOPERATIVE SURGICAL PHARMACOLOGY AND PREPARATION OF THE PATIENT ANESTHESIA CH. 23 SURGICAL PHARMACOLOGY CH. 24 ANESTHESIA: TECHNIQUES AND AGENTS CH. 31 POTENTIAL PERIOPERATIVE COMPLICATIONS CH. 31 POSTOPERATIVE PATIENT CARE PHARMACOLOGY 219 CH. 23 SURGICAL PHARMACOLOGY 394 Drug Sources 219 Surgical Drug and Pharmaceutical 398 Sources (Ch. 23) Drug Forms 220 Pharmacologic Forms Used in Surgery 398 (Ch. 23) Drug Nomenclature 220 Drug Names (Ch. 23) 395 Route of Administration 221 Drug Classifications 221 Pharmacokinetics 221 Pharmacodynamics 222 DRUG-HANDLING TECHNIQUES 223 Handling Drugs and Pharmacologic 397 Materials in Surgery (Ch. 23) Medication Identification 223 Supplies for Medication Handling 225 Handling Drugs and Pharmacologic 397 Materials in Surgery (Ch. 23) Transfer of a Medication to the Sterile Field 225 Handling Drugs and Pharmacologic 397 Materials in Surgery (Ch. 23) Medications Commonly Used in the 226 Box 23-4 (Ch. 23) 399 Operating Room HISTORY OF MODERN ANESTHESIA 229 Historical Background (Ch. 24) 401 METHODS AND TECHNIQUES OF 231 Types of Anesthesia (Ch. 24) 402 ANESTHETIC ADMINISTRATION Choice of Anesthesia 403 GENERAL ANESTHESIA 231 General Anesthesia (Ch. 24) 404 Depth of General Anesthesia 231 General Anesthesia (Ch. 24) 404 Phases of General Anesthesia 232 Balanced Anesthesia (Ch. 24) 418 Advantages of General Anesthesia 232 General Anesthesia (Ch. 24) 404 Risks and Complications Associated with 232 CH. 31 POTENTIAL PERIOPERATIVE 588 General Anesthesia COMPLICATIONS Anesthetic Agents 235 Inhalation Anesthetic agents and 410 Intravenous Anesthetic Agents (Ch. 24) Adjuncts to General Anesthesia 240 Controlled Homeostasis (Ch. 24) 418 Anesthesia Equipment 241 Anesthesia Machine (Ch. 24) 407 Monitoring Depth of Anesthesia (Ch. 24) 417 Monitoring Physiologic Function (Ch. 27) 513 NERVE CONDUCTION BLOCKADE 244 Local and Regional Anesthesia (Ch. 24) 423 Nerve Conduction Blocking Agents 244 Table 24-4 429 Topical Anesthesia 246 Topical Application (Ch. 24) 433 Local Anesthesia 246 Local Anesthesia (Ch. 24) 425 Regional Anesthesia 246 Spinal and Epidural Anesthesia (Ch. 24) 427 NONTRADITIONAL ANESTHESIA 249 Alternatives to Conventional Anesthesia 440 OPTIONS (Ch. 24) TEAM MEMBER ROLES DURING 249 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

ANESTHESIA ADMINISTRATION Preoperative Visits 250 PreoperativeVisit by the 368 Perioperative/Perianesthesia Nurse (Ch. 21) PreoperativeVisit by the Anesthesia 372 Provider (Ch. 21) Preoperative Routine-All Types of 250 CH. 21 PREOPERATIVE 364 Anesthesia PREPARATION OF THE PATIENT Postanesthesia Care 253 CH. 31 POSTOPERATIVE PATIENT 581 CARE CHAPTER 10 CH. 19 SURGICAL INSTRUMENTATION, EQUIPMENT, INSTRUMENTATION AND SUPPLIES Also found in various other chapters throughout the book. INSTRUMENTATION 259 Fabrication of Metal Instruments (Ch. 19) 324 Classifications 259 Classification of Instruments (Ch. 19) 326 Instrument Care and Handling 264 Handling Instruments (Ch. 19) 339 Types of Instrument Sets 265 SPECIALTY EQUIPMENT 269 Endoscopes 269 Endoscopes (Ch. 19) 334 Power Tools 270 Powered Surgical Instruments (Ch. 19) 33 Lasers 270 Laser Surgery (Ch. 19) 270 Microscopes 273 Operating Microscope (Ch.20) 357 Video Monitors, Recorders, and Cameras 273 Vision within the Working Space 627 (Ch. 32) Fiber-optic Headlamps and Light Sources 274 Irrigation/Aspiration Units 274 Cryotherapy Units 274 Thermal Methods (Ch. 28) 535 Insufflators 274 Nerve Stimulators 274 Nerve Stimulator (Ch. 36) 749 ACCESSORY EQUIPMENT 275 Suction Systems 275 Suction and Aspirating (Ch. 19) 334 Electrosurgical Unit 275 Electrosurgical Unit (Ch. 20) 344 Lights 278 Lighting (Ch. 10) 188 Pneumatic Tourniquets 279 Pneumatic Tourniquet (Ch. 28) 532 Sequential Compression Devices 280 Sequential Compression Device (Ch. 28) 531 SUPPLIES 280 Drapes 280 Draping Materials (Ch. 26) 502 Sterile Packs 282 Sponges and Dressings 282 Sponges (Ch. 25) 462 Dressings (Ch. 29) 574 Catheters, Tubes, and Drains 285 Drains (Ch. 29) 571 Nonsuture Needles 288 Preparation of the Sterile Field (Ch. 25) 450 Angiography and Arteriography (Ch. 22) 387 Irrigators and Syringes 289 Preparation of the Sterile Field (Ch. 25) 450 CHAPTER 11 CH. 28 HEMOSTASIS AND WOUND WOUND HEALING, SUTURES, CLOSURE NEEDLES, AND STAPLING DEVICES CH. 29 WOUND HEALING

INTRODUCTION 292 TYPES OF WOUNDS 292 Types of Wounds (Ch. 29) 565 Surgical Wound 292 Intentional Wounds (Ch. 29) 565 Traumatic Wound 293 Unintentional Wounds; Traumatic 566 Injuries (Ch. 29) AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Chronic Wound 294 Incidental and Chronic Wounds (Ch. 29) 566 INFLAMMATORY PROCESS 294 Inflammatory and Immune Responses 569 (Ch. 29) TYPES OF WOUND HEALING 294 First Intention (Primary Union) 294 First Intention/Primary Union (Ch. 29) 564 Phases of Wound Healing by First Intention 295 First Intention/Primary Union (Ch. 29) 564 Second Intention (Granulation) 295 Second Intention (Ch. 29) 565 Third Intention (Delayed Primary Closure) 295 Third Intention /Delayed Primary Closure 565 (Ch. 29) FACTORS INFLUENCING WOUND 295 Factors Influencing Wound Healing 568 HEALING (Ch. 29) COMPLICATIONS OF THE HEALING 296 Complications of Wound Healing (Ch. 576 WOUND 29) Intraoperative Wound Care 297 Surgical Technique (Ch. 29) 570 Wound Management 571 Postoperative Wound Care 298 Drains (Ch. 29) 571 Dressings 574 SUTURE 298 Sutures (Ch. 28) 537 History 298 Historical Background (Ch. 28) 528 Types of Suture Material 299 Specifications for Suture Material 540 (Ch. 28) Suture Sizes 300 Specifications for Suture Material 541 (Ch. 28) General Factors Affecting Choice of Suture 300 Choice of Suture Material (Ch. 28) 541 Characteristics of Common Sutures 300 Specifications for Suture Material 540 (Ch. 28) Absorbable Sutures 541 Non absorbable Suture 543 Packaging of Suture 303 Suture and Needles: Packaging and 549 Preparation (Ch. 28) Ligatures 303 Internal Mechanical Methods (Ch. 28) 534 Ligating Methods 303 Internal Mechanical Methods (Ch. 28) 534 Suture for the Procedure 304 Considerations in the Choice of Needle 549 and Suture (Ch. 28) Layer Closure 305 Endoscopic Suture 307 Endoscopic Suturing (Ch. 28) 540 Suturing Techniques 307 Suturing Techniques (Ch. 28) 537 Accessory Devices 309 Retention Bridges, Bolsters, and Bumpers 539 (Ch. 28) Tissue Adhesives 552 STAPLING DEVICES 310 Surgical Staples (Ch. 28) 551 Types of Staplers 312 Stapling Instruments (Ch. 28) 551 Meshes or Fabrics 313 Synthetic Meshes (Ch. 28) 554 NEEDLES 314 Surgical Needles (Ch. 28) 545 Needle Eye 314 Eye of the Needle (Ch. 28) 547 Needle Point 315 Point of the Needle (Ch. 28) 546 Needle Bodies 315 Body of the Needle (Ch. 28) 546 CHAPTER 12 Topics are found in various chapters SURGICAL CASE MANAGEMENT throughout the book. INTRODUCTION 318 Applied Theory 319 Aseptic Technique and Environmental 251 Controls (Ch. 15) PREOPERATIVE CASE MANAGEMENT 323 Attire 323 Appropriate Operating Room Attire 264 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

(Ch. 16) Preparing the OR 327 Principles of Sterile Technique (Ch. 15) 257 Surgical Scrub and Hand Cleansing 271 (Ch. 16) ORGANIZING THE BACK TABLE 341 Preparation of Sterile Field (Ch. 25) 446 Organizing the Mayo Stand 346 Preparation of Sterile Field (Ch. 25) 447 Assisting a Team Member 346 Assisted Gowning and Gloving of a Team 277 Member (Ch. 16) Draping the Surgical Patient 346 Principles of Draping (Ch. 26) 505 Positioning of the Sterile Team Members 353 and the Furniture INTRAOPERATIVE CASE 353 MANAGEMENT General Principles 353 During the Surgical Procedure (Ch. 25) 451 Counting Procedures (Ch. 25) 461 Dismantling the Instrument Table 342 (Ch. 19) Progression of the Surgical Procedure 361 POSTOPERATIVE CASE 363 MANAGEMENT Preservation of the Sterile Field 363 Drape Removal 363 After the Surgical Procedure is Complete 459 (Ch. 25) Gown and Glove Removal 364 After the Surgical Procedure is Complete 460 (Ch. 25) Removing or Changing Contaminated 278 Gown or Gloves (Ch. 16) Immediate Postoperative Care 364 After the Surgical Procedure is Complete 460 (Ch. 25) Patient Transfer and Transportation 364 Patient Transfer from the Operating 460 Room (Ch. 25) Breakdown of the Setup 365 Room Turnover Activities by the Scrub 206 Person (Ch. 12) The Operating Room Cycle 365 Establishing the Perioperative 204 Environment (Ch. 12) Room Turnover Between Patients 205 The Instrument Cycle 366 Handling Instruments (Ch. 19) 339

CHAPTER 13 CH. 21PREOPERATIVE PATIENT DIAGNOSTIC PROCEDURES CARE CH. 22 DIAGNOSTIC POCEDURES SOURCES OF PATIENT DATA 371 History and Physical Examination 371 Preoperative Preparation of all Patients 365 (Ch. 21) Diagnostic Imaging 371 Diagnostic Imaging (Ch. 22) 383 Laboratory Reports 378 Preadmission Procedures (Ch. 21) 365 Electrodiagnostic Studies 381 Preadmission Procedures (Ch. 21) 365 Pulmonary Diagnosis 382 Blood Gases and pH (Ch. 27) 519 Endoscopy 383 Endoscopy (Ch. 22) 392 Plethysmography and Phleborheography 383 Plethysmography (Ch. 22) 392 INDICATIONS FOR SURGERY 383 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

CHAPTER 14 CH. 33 GENERAL SURGERY GENERAL SURGERY CH. 40 OTORHINOLAYNGOLOGIC AND HEAD AND NECK SURGERY ANATOMY 386 Abdominal Cavity: General Dimensions 386 Surface Features 386 Abdominal Musculature 387 Peritoneum 387 Retroperitoneum 388 Alimentary Canal 388 Esophagus 388 Esophageal procedures 652 Stomach 389 Gastric Procedures 654 Small Intestine 390 Intestinal Procedures 659 Mesentery 391 Intestinal Procedures 659 Colon 391 Intestinal Procedures 659 Rectum 393 Anus 393 Omenta 394 Pancreas 394 Pancreatic Procedures 651 Spleen 395 Splenic Procedures 651 Liver 395 Liver Procedures 649 Biliary Tract 396 Biliary Tract Procedures 644 GENERAL SURGERY 397 INSTRUMENTATION 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 Special Considerations for General 636 Surgery DRAPING 400 Special Considerations for General 636 Surgery INCISIONS 402 Types of Abdominal Incisions 642 SURGERY OF THE ABDOMINAL 404 Hernia Procedures 668 WALL: HERNIAS Specific Anatomic Features of the Groin 404 Area Hernias 405 Hernia Procedures 668 Hernia Repair 405 Hernia Procedures 668 SURGERY OF THE ALIMENTARY 407 CANAL Surgery of the Esophagus 408 Esophageal procedures 652 Gastric Surgery 408 Pathological Conditions of the Stomach 408 Gastric Procedures 654 Procedures Related to Gastric Secretion, 416 Gastric Procedures 655 Ulcers, and Neoplasm Procedures for Morbid Obesity 416 Bariatric Surgery 657 Surgery of the Small Bowel 416 Intestinal Procedures 658 Appendectomy 420 Appendectomy 663 Colon Surgery 425 Intestinal Procedures 659 STOMAS 427 Intestinal Stomas 660 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Anorectal Surgery 427 Anorectal Procedures 666 Hemorrhoid Ligation and Excision 430 Hemorrhoidectomy 666 Surgery of the Liver and Biliary Tract 430 Biliary Tract Procedures 644 Liver Procedures 649 Common Bile Duct Exploration 439 Common Bile Duct Exploration 646 SURGERY OF THE PANCREAS AND 447 Pancreatic Procedures 651 SPLEEN Splenic Procedures 651 Select Pathology of the Pancreas 447 Pancreatic Procedures 651 Draining Pancreatic Cysts 448 Pancreaticojejunostomy 651 Pancreatic Resection 448 Pancreatectomy 652 Whipple Pancreaticoduodenectomy 448 Pancreaticoduodenectomy (Whipple 651 Proceure Surgery of the Spleen 452 Splenic Procedures 651 VASCULAR AND OTHER 454 PROCEDURES Varicose Veins 454 Ligation and Stripping of Varicose Veins 919 (Ch. 43) Vascular Access Procedures 455 Muscle and Nerve Biopsies 456 Incision and Drainage 456 Excision of Lesion 456 Endoscopy 457 CH. 32 ENDOSCOPIC SURGERY 622 BREAST SURGERY 457 Breast Procedures 637 Breast Anatomy 457 Breast Procedures 637 Breast and Axilla: Pathology and Diagnosis 457 Breast Procedures 637 Breast Surgery (Noncosmetic) 457 Breast Procedures 637 SURGERY OF THE THYROID AND 461 Surgical Procedures of the Anterior Neck 858 PARATHYROID (Ch. 40) Anatomy of the Thyroid and Parathyroid 461 Surgical Procedures of the Anterior Neck 858 (Ch. 40) Pathological Conditions of the Thyroid and 461 Surgical Procedures of the Anterior Neck 858 Parathyroid Glands (Ch. 40) Thyroidectomy 461 Surgical Procedures of the Anterior Neck 858 (Ch. 40) TRACHEOTOMY 461 Surgical Procedures of the Trachea 856 (Ch. 40) Indications for a Tracheotomy 461 Surgical Procedures of the Trachea 856 (Ch. 40) Illustrative Procedure: Tracheotomy 467 CHAPTER 15 CH. 34 GYNECOLOGIC AND OBSTETRIC AND GYNOCOLOGIC OBSTETRIC SURGERY SURGERY INTRODUCTION TO OBSTETRIC AND 478 CH. 34 GYNECOLOGIC AND 672 GYNOCOLOGICAL SURGERY OBSTETRIC SURGERY ANATOMY 478 Anatomy and Physiology of the Female 673 Reproductive System The Pelvis 478 External Genitalia 481 Female External Genitalia 673 Vagina 481 Internal Female Reproductive Organs 674 Uterus 482 Internal Female Reproductive Organs 674 Fallopian Tubes 483 Internal Female Reproductive Organs 675 Ovaries 483 Internal Female Reproductive Organs 675 PREGNANCY-A SPECIAL CONDITION 485 Perioperative Obstetrics 691 Select Key Terms in Labor and Delivery 486 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Labor 486 SPECIAL INSTRUMENTATION, 487 DRUGS, EQUIPMENT, AND SUPPLIES IN OBSTETRIC AND GYNOCOLOGICAL SURGERY Instrumentation 487 Drugs 487 Equipment 494 Supplies 494 OR SETUP AND BASIC PATIENT 494 Gynecology: General Considerations 676 POSITIONING AND DRAPING Position 692 SURGICAL PROCEDURES: 494 OBSTETRICS AND FERTILITY RELATED Pathology and Surgical Conditions: 494 Obstetrics and Fertility Related Vaginal Delivery 495 Cesarean Section 497 Cesarean Birth 694 Tubal Occlusion (Sterilization) Procedures 503 Tubal Ligation 689 Tuboplasty 504 Tuboplasty Laproscopic Resection of Unruptured Tubal 507 Pregnancy SURGICAL PROCEDURES: 510 GYNECOLOGICAL PROCEDURES Gynecological Pathology 510 SURGICAL INTERVENTION 510 OVERVIEW Abdominal Incisions for Gynecological 510 Surgery Surgical Intervention: Laparoscopy 515 Laparoscopy 681 Basic Colposcopy 518 Colposcopy 679 Hysteroscopy 518 Hysteroscopy 681 Marsupialization of Bartholin’s Gland Cyst 521 Bartholin Glands 683 Simple Vulvectomy 521 Vulvectomy 682 Anterior and Posterior Repair 524 Procedures for Repair of the Pelvic Outlet 684 (Colporrhaphy) Cervical Biopsy, Cryotherapy, Laser 533 Biopsy of the Cervix 678 Treatment, LEEP, and Conization Dilation and Curettage 535 Dilation and Curettage 686 Myomectomy 538 Myomectomy 689 Total Abdominal Hysterectomy and 542 Abdominal Hysterectomy 689 Bilateral Salpingo-oophorectomy (TAH- BSO) Vaginal and Laparoscopically Assisted 546 Vaginal Hysterectomy 687 Vaginal Hysterectomy (LAVH) Radical Cancer Surgery: Total Pelvic 547 Exenteration CHAPTER 16 CHAPTER 38 OPHTHALMIC SURGERY OPHTHALMIC SURGERY ANATOMY OF THE EYE 554 Anatomy and Physiology of the Eye 794 Orbit 554 Anatomy and Physiology of the Eye 794 Extrinsic Muscles 555 Lacrimal System 555 Globe 556 Anatomy and Physiology of the Eye 794 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Cavities and Chambers of the Eye 558 Anatomy and Physiology of the Eye 794 OPHTHALMIC SURGICAL 558 PATHOLOGY Glaucoma 558 Iris 801 Cataract 558 Cataract 803 Small Retinal Detachment 558 Retina 805 Large Retinal Detachment 558 Retina 805 Vitreous Hemorrhage 558 Vitrectomy 807 Proliferative Vitreoretinopathy (PVR) 559 Retina 806 Traction Retinal Detachment 559 Vitrectomy 807 Epiretinal Membarane 559 Corneal Pathology 559 Chalazion 559 Pterygium 559 Pterygium 799 Dacryocystitis 559 Lacrimal Apparatus 799 Strabismus 559 OPTHALMIC MEDICATIONS 560 Ophthalmic Drugs 796 SPECIAL CONSIDERATIONS IN 560 OPHTHALMIC SURGERY Special Equipment 560 Operating Microscope 796 Ophthalmic Lasers 811 Instruments 561 SURGICAL INTERVENTION 562 Ocular Surgical Procedures 797 Surgical Repair of Ptosis 562 Eyelid 798 Iridectomy 563 Iris 801 Trabeculoplasty 563 Iris 802 Strabismus Correction: 563 Recession/Resection Adjustable Suture Surgery 566 Scleral Buckle 567 Retina 806 Enucleation and Evisceration of the Eye 571 Surgical Removal of the Eye 798 (Traditional Approach) Keratoplasty (Corneal Transplant) 573 Intraocular Procedures 799 Cataract Extraction 577 Cataract 803 Phacoemulsification 580 Cataract 804 Vitrectomy 580 Vitrectomy 807

CHAPTER 17 CH. 40 OTORHINOLARYNGOLOGIC OTORHINOLARYNGOLOGIC AND SURGERY HEAD AND NECK SURGERY CH. 41 THORACIC SURGERY ANATOMY OF THE EAR 587 Anatomy of the Ear 839 Outer Ear 587 External Ear 839 Middle Ear 588 Middle Ear 839 Inner Ear 588 Inner Ear 839 PATHOLOGY OF THE EAR 589 Pathology of Hearing 840 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 General Considerations in Ear, Nose, and 837 Throat Procedures General Considerations 841 SPECIAL INSTRUMENTS, SUPPLIES, 592 General Considerations in Ear, Nose, and 838 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

DRUGS Throat Procedures General Considerations 841 EAR PROCEDURES 592 Surgical Procedures of the Ear 841 Myringotomy 592 Myringotomy (Ch. 8) 143 Myringoplasty/Tympanoplasty 596 Tympanoplasty 842 Mastoidectomy 600 Mastoidectomy 842 Stapedectomy 600 Stapedectomy and Stapedotomy 842 Stapedotomy 600 Stapedectomy and Stapedotomy 842 Cochlear Implants 601 Implantation of a Cochlear Prosthesis 843 ANATOMY OF THE NOSE AND 601 Anatomy of the Nose 844 SINUSES External Nose 601 Anatomy of the Nose 844 Internal Nose 601 Anatomy of the Nose 844 Paranasal Sinuses 602 Anatomy of the Nose 844 Blood Supply to the Nose 602 Anatomy of the Nose 844 Olfaction 603 Physiology of the Nose 844 PATHOLOGY OF THE NOSE AND 603 PARANASAL SINUSES Rhinitis/Sinusitis 603 Turbinectomy 846 Nasal Polyps 604 Polypectomy 846 Hypertrophied Turbinates 604 Turbinectomy 846 Deviated Nasal Septum 604 Septoplasty, Septal Reconstruction, and 847 Submucous Resection Septal Perforation 604 Repair of a Perforated Septum 847 Epistaxis 604 Epistaxis 845 DIAGNOSTIC PROCEDURES 605 Direct Vision 605 Mirror Examination 605 Radiography 605 PREOPERATIVE CONSIDERATIONS 605 General Considerations 845 SPECIAL INSTRUMENTS, SUPPLIES, 606 AND DRUGS NASAL PROCEDURES 609 Surgical Procedures of the Nose 845 Submucous Resection (SMR) 609 Septoplasty, Septal Reconstruction, and 847 Submucous Resection Polypectomy 612 Polypectomy 846 Intranasal Antrostomy 612 Removal of Foreign Body 612 Nasal Obstruction 846 Internal Maxillary Artery Ligation 613 Artery Ligation 846 Sinus Procedures 613 Paranasal Sinus Procedures 847 Caldwell-Luc 613 Procedure 847 Ethmoidectomy 615 Ethmoidectomy 847 Sphenoidectomy 616 Sphenoid Sinus Procedure 848 Drainage of the Frontal Sinus 616 Sinus Endoscopy 616 Endoscopic Sinus Surgery 848 ANATOMY OF THE UPPER 618 Anatomy and Physiology of the Oral 848 AERODIGESTIVE TRACT Cavity and Throat Pharynx 618 Anatomy and Physiology of the Oral 848 Cavity and Throat Larynx 620 Anatomy and Physiology of the Neck 853 Trachea 621 Anatomy and Physiology of the Neck 853 Bronchi and Lungs 621 Thoracic Cavity (Ch.41) 867 Esophagus 621 Gastric Procedures (Ch. 33) 654 PATHOLOGY AFFECTING THE UPPER 621 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

AERODIGESTIVE TRACT 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 624 ESOPHAGUS 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, 626 DRUGS AERODIGESTIVE TRACT 628 PROCEDURES Adenoidectomy 628 Adenoidectomy 850 Tonsillectomy 628 Tonsillectomy 850 Incision and Drainage of a Peritonsellar 631 Incision and Drainage of a Peritonsellar 850 Abscess Abscess Uvulopalatopharyngoplasty 631 Uvulopalatopharyngoplasty 849 Laryngoscopy 633 Laryngoscopy 852 Bronchoscopy 636 Bronchoscopy (Ch. 41) 871 Esophagoscopy 636 Esophagoscopy 855 Panendoscopy 636 Radical Neck Dissection with 636 Neck Dissections 859 Mandibulectomy CHAPTER 18 CH. 40 ORAL AND MAXILLOFACIAL OTORHINOLARYNGOLOGIC AND SURGERY HEAD AND NECK SURGERY ANATOMY OF THE ORAL CAVITY 645 Anatomy and Physiology of the Oral 848 Cavity and Throat Lips 645 Teeth 645 Palate 646 Anatomy and Physiology of the Oral 848 Cavity and Throat Cheeks 646 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Tongue 646 Anatomy and Physiology of the Oral 848 Cavity and Throat ANATOMY OF THE FACE AND 646 Anatomy and Physiology of the Face 861 CRANIUM Orbit 647 Anatomy and Physiology of the Face 861 Facial Muscles and Innervation 647 EMBRYOLOGICAL EVELOPMENT OF 648 THE FACE PATHOLOGY OF THE ORAL CAVITY 649 Mouth 649 Jaw Bones 649 Orthognathic Surgery 865 Mandibular Fractures 649 Mandibular Fractures 864 Frontal Fractures 650 Orbital Fractures 650 Reduction of Orbital Fractures 863 Zygomatic Fractures 650 Reduction of Zygomatic Fractures 864 Midfacial Fractures 651 Midfacial Fractures 863 Craniofacial Deformities 651 Resection of Craniofacial Tumors and 863 Dysplasia DIAGNOSTIC TESTS 651 ORAL PROCEDURES: GENERAL 652 CONSIDERATIONS Tooth Extraction/Odontectomy 653 Tooth Restoration 657 Implantation 657 Dental Implant 851 MAXILLOFACIAL PROCEDURES: 658 GENERAL CONSIDERATIONS Graft Materials 658 Inlay Bone Grafts 851 Mandibular Reconstruction 864 Repair of Mandibular/Maxillary Fractures 659 Application of Arch Bars 659 Wire Fixation 662 Plate and Screw Fixation of Mandibular 663 Fracture Frontal Fracture Repair 666 Orbital Floor Fracture Repair 667 Reduction of Zygomatic Fractures 670 Reduction of Zygomatic Fractures 864 Le Fort I Fracture Repair 671 Midfacial Fractures 863 Le Fort II and III Fracture Repair 675 Midfacial Fractures 863 Craniofacial Reconstruction 675 Correction of Retrognathism or 679 Orthognathic Surgery 865 Prognathism Temporomandibular Joint Procedures 682 Temporomandibular Joint Procedures 864 CHAPTER 19 CH. 39 PLASTIC AND RECONSTRUCTIVE PLASTIC AND RECONSTRUCTIVE SURGERY SURGERY ANATOMY 685 Skin and Underlying Structures 685 Palate 687 Nose 687 Hand 687 Breast 694 SURGICAL PATHOLOGY 694 Pathology Affecting the Skin 694 Scars 829 Dermabrasion 830 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Skin Cancer 830 Burns 831 Cleft Lip and Palate 696 Plastic and Reconstructive Surgery 144 (Ch. 8) Pathology Affecting the Hand 697 Plastic and Reconstructive Surgery 145 (Ch. 8) Pathology Affecting the Breast 701 Breast 826 DIAGNOSTIC PROCEDURES AND 701 TESTS SPECIAL INSTRUMENTATION, 701 General Considerations in Plastic Surgery 813 SUPPLIES, DRUGS, AND EQUIPMENT Nasal Set 701 Dermatome 702 Skin Graft Knives and Dermatomes 815 Mesh Graft Device 704 Types of Skin and Tissue Grafts 817 SURGICAL INTERVENTION 704 Rhytidectomy 704 Rhytidectomy 824 Blepharoplasty 706 Blepharoplasty 823 Suction Lipectomy 707 Liposuction 825 Abdominoplasty 708 Abdominoplasty 825 Skin Grafts 709 Skin and Tissue Grafting 815 Dermabrasion 713 Dermabrasion 830 Scar Revision 713 Scar Revision 829 Cheiloplasty and Palatoplasty 713 Rhinoplasty 714 Rhinoplasty 824 Hand Surgery 716 Plastic and Reconstructive Surgery 145 (Ch. 8) Mammoplasty 723 Breast 826

CHAPTER 20 CH. 35 UROLOGIC SURGERY GENITOURINARY SURGERY ANATOMY 732 Anatomy And Physiology of the Urinary 706 System Suprarenal Glands 732 Endocrine Glands 737 Kidneys 732 Kidneys 706 Ureters 735 Ureters 708 Urinary Bladder 736 Urinary Bladder 708 Male Reproductive System 737 Urethra 709 Male Reproductive Organs 728 PATHOLOGY AFFECTING THE 739 ADRENAL GLANDS Cushing’s Syndrome 739 Adrenal Insufficiency (Addison’s Disease) 739 Pheochromocytoma 739 PATHOLOGY AFFECTING THE 739 URINARY SYSTEM Bladder Tumors 739 Urinary Bladder 723 Urinary Calculi 740 Urolithiasis (Urinary Calculus) 718 Kidney Disorders 740 Kidney 715 PATHOLOGY AFFECTING THE MALE 743 Male Reproductive Organs 728 REPRODUCTIVE SYSTEM Phimosis 743 Hypospadias/Epispadias 743 Benign Prostatic Hypertrophy 743 Prostate Gland 730 Cancer of the Prostate 744 Prostate Gland 730 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Cryptorchidism 744 Testicular Torsion 744 Testicular Torsion 729 Testicular Cancer 744 Testes 728 Trauma to the Genitourinary System 745 DIAGNOSTIC PROCEDURES/TESTS 745 History and Physical 745 Laboratory Findings 745 Radiological Findings 751 Biopsy 751 Endoscopy 751 Urologic Endoscopy 709 SPECIAL EQUIPMENT, 751 INSTRUMENTS, SUPPLIES, DRUGS PREOPERATIVE AND 752 INTRAOPERATIVE PREPARATION Incisional Options 754 SURGICAL PROCEDURES 757 Adrenalectomy 757 Adrenal Glands 737 Nephrectomy 757 Nephrectomy 715 Renal Transplant 762 Kidney Transplantation (Ch. 44) 933 Stone Removal 763 Cystostomy 764 Suprapubic Cystostomy 723 Cystectomy/Ileal Conduit 766 Cystectomy 724 Procedures for Stress Incontinence 771 Urinary Incontinence 726 Affecting Women Transurethral Endoscopy of the 774 Genitourinary Tract Circumcision 776 Adult Male Circumcision 735 Orchiectomy 778 Orchiectomy 728 Orchiopexy 778 Orchiopexy (Ch. 8) 138 Hydrocelectomy 781 Hydrocelectomy 729 Varicocelectomy 781 Varicocele Ligation 729 Hypospadias Repair 782 Urethral Repair (Ch. 8) 138 Insertion of Inflatable Penile Prosthesis 782 Penile Prosthesis 735 Vasectomy 783 Vasectomy 729 Vasovasostomy 784 Vasovasostomy 730 Prostatectomy 784 Prostatectomy (Suprapubic and 732 Retropubic)

CHAPTER 21 CH. 21 ORTHOPEDIC SURGERY ORTHOPEDIC SURGERY BONE AND BONE TISSUE 792 Anatomy and Physiology of the 741 Musculoskeletal System Bone Tissue 792 Bones 741 Types of Bones 794 Bones 741 Types of Joints 794 Joints 741 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 PATHOLOGY 798 Types of Fractures 805 Fractures 751 Normal Bone Healing 805 Bone Healing 742 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Pathological Bone Healing 806 Diagnostic Terms and Procedures 808 THE SKELETON 808 The Skull 808 Vertebral Column 811 Bones of the Thoracic Region 812 Clavicles 812 Scapula 812 Pectoral Girdle 812 Humerus 812 Radius and Ulna 813 Hand and Wrist 814 Pelvis 814 Hip and Femur 814 Tibia and Fibula 814 Ankle and Foot 816 EQUIPMENT 818 Special Features of Orthopedic Surgery 744 Positioning Devices 818 Orthopedic Table 749 Special Considerations in Orthopedic 750 Surgery Pneumatic Tourniquets 819 General Considerations 750 Pneumatic Tourniquet 532 Traction 819 Orthopedic Table 749 Skeletal Traction 752 Lasers 819 Lasers 749 Radiography 819 X-Ray Control 749 Air Flow 820 Ultraclean Air System 749 Continuous Passive Range-of-Motion 820 Machines Transcutaneous Electrical Nerve 820 Nerve Simulator 749 Stimulation Electrical Stimulation of Bone 820 Special Considerations in Orthopedic 750 Surgery Saws, Drills, and Reamers 820 Cutting Instruments 745 Arthroscopic Equipment 820 Arthroscopy 759 SUPPLIES 821 Items Used Frequentl 747 Implants 821 Prosthetic Implants 747 Suture 821 Sutures 749 Methyl Methacrylate 821 Methyl Methacrylate (Ch. 28) 558 Pharmacology 821 PROCEDURES 822 Bone Grafting 822 Bone Grafts 747 Biologic Materials (Ch. 28) 555 Knee Arthroscopy 824 Arthroscopy 759 Arthroscopic Repair of Meniscal Tear 827 Knee Injuries 760 Arthroscopic Anterior Cruciate Ligament Knee Injuries 759 Repair Above-the-Knee Amputation Above-Knee Amputation (Ch.33) 669 Endoscopic Carpal Tunnel Release 832 Neurolysis 761 Colle’s Fracture 835 Metacarpal Phalangeal Joint Arthroplasty 840 Total Joint Replacement 758 Triple Arthrodesis 840 Arthrodesis 755 Achilles Tendon Repair 841 Bunionectomy 842 Bunionectomy 760 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Open Reduction-Internal Fixation (ORIF) 842 of the Humerus Shoulder Joint Arthroscopy 845 Arthroscopy 759 Shoulder Injuries 762 Acromioplasty 846 Repair of the Rotator Cuff 846 Shoulder Injuries 762 Internal Fixation of Femoral Shaft Fracture 851 Repair of Hip Fracture 852 Total Hip Arthroplasty 852 Total Joint Replacement 756 Total Knee Arthroplasty 859 Total Joint Replacement 756

CHAPTER 22 CH. 41 THORACIC SURGRY CARDIOTHORACIC SURGERY CH. 42 CARDIAC SURGERY CH. 8 PERIOPERATIVE PEDIATRICS ANATOMY OF THE CHEST 864 Anatomy and Physiology of the Thorax 867 (Ch. 41) The Thorax 864 Thoracic Cavity (Ch. 41) 867 The Trachea 866 Lungs (Ch. 41) 867 The Bronchial Tree 866 Lungs (Ch. 41) 867 The Lungs 867 Lungs (Ch. 41) 867 ANATOMY AND PHYSIOLOGY OF 868 Anatomy of the Heart and Great Vessels 880 THE HEART (Ch. 42) Location of the Heart 868 Heart (Ch. 42) 880 Coverings of the Heart 869 Heart (Ch. 42) 880 The Heart Wall 869 Heart (Ch. 42) 880 The Heart Chambers 869 Heart (Ch. 42) 880 The Heart Valves 869 Valves (Ch. 42) 880 Blood Flow Through the Heart 870 Coronary Circulation (Ch. 42) 881 Blood Supply for the Heart 871 Heart (Ch. 42) 881 The Cardiac Cycle 871 Cardiac Cycle (Ch. 42) 882 Cardiac Output 872 Cardiac Conduction 872 Electrical Conduction of the Heart 881 (Ch. 42) Anatomical Development of the Heart 872 OPERATIVE PATHOLOGY 873 The Chest Wall 873 The Mediastinum 873 The Lungs 874 Thoracic Trauma 875 Chest Trauma (Ch. 41) 877 Thoracic Outlet Syndrome 877 Thoracic Outlet Syndrome (Ch. 41) 876 Thoracic Aortic Aneurysm 877 Coronary Artery Disease 879 Coronary Artery Disease (Ch. 42) 891 Valvular Disease 881 Valvular Heart Disease (Ch. 42) 890 Cardiomyopathy 882 Cardiac Dysrythmias 882 Cardiac Dysrythmias 894 Congenital Heart Defects 884 Cardiovascular Surgery (Ch. 8) 149 DIAGNOSTIC PROCEDURES: THORAX 887 Endoscopy (Ch. 41) 870 Bronchoscopy 887 Bronchoscopy (Ch. 41) 870 Mediastinoscopy 887 Mediastinoscopy (Ch. 41) 871 Thoracoscopy 887 Thoracoscopy (Ch. 41) 872 Thoracentesis 889 Thoracentesis (Ch. 41) 877 DIAGNOSTIC PROCEDURES: 889 CARDIAC Radiological Studies 889 Noninvasive Procedures (Ch. 42) 890 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

SURGICAL INTERVENTION: 889 THORACIC Special Preoperative Considerations 889 Special Features of Thoracic Surgery 868 (Ch. 41) Special Instrumentation, Supplies, Drugs, 889 Special Features of Thoracic Surgery 870 and Equipment (Ch. 41) Patient Preparation 890 Thoracoscopy 892 Thoracoscopy (Ch. 41) 872 Scalene/Supraclavicular Node Biopsy 895 Mediastinotomy (Ch. 41) 874 Thoracotomy for Upper Lobectomy 895 Thoracotomy (Ch. 41) 875 Thoracotomy for Right Pneumonectomy 899 Thoracotomy (Ch. 41) 876 Thoracotomy for Wedge Resection or 899 Thoracotomy (Ch. 41) 875 Segmentectomy Decortication of Lung 899 Pulmonary Decortication (Ch. 41) 876 SURGICAL INTERVENTION: 900 CARDIAC (ADULT) Preoperative Considerations 900 Special Features of Cardiac Surgery 883 (Ch. 42) Patient Preparation 901 Median Sternotomy (Ch. 42) 885 Techniques of Cardiopulmonary Bypass 901 Cardiopulmonary Bypass (Ch. 42) 887 Mechanical Circulatory Assistance 904 Intraaortic Balloon Pump (Ch. 42) 898 Coronary Artery Bypass Grafting 905 Coronary Artery Bypass Graft (Ch. 42) 891 Aortic Valve Replacement 911 Aortic Valve Replacement (Ch. 42) 891 Mitral Valve Replacement 916 Mitral Valve Replacement (Ch. 42) 891 Thoracic Aortic Aneurysmectomy 917 Pericardiectomy/Pericardial Window 918 Heart Transplantation 919 Cardiac Transplantation (Ch. 42) 895 Heart Transplant (Ch. 44) 935 Permanent Pacemaker Insertion 920 Mechanical Assist Devices (Ch. 42) 895 Percutaneous Transluminal Coronary 921 Percutaneous Transluminal Coronary 893 Angioplasty Angioplasty (Ch. 42) SURGICAL INTERVENTION: 921 CARDIAC (PEDIATRIC) Special Preoperative Preparation 922 Atrial Septal Defect 922 Atrial Septal Defect (Ch. 8) 150 Ventricular Septal Defect 922 Ventricular Septal Defect (Ch. 8) 150 Patent Ductus Arteriosus 923 Patent Ductus Arteriosus (Ch. 8) 150 Correction of Aortic Coarctation 924 Coarctation of the Aorta (Ch. 8) 150 Procedure for Correction of Tetralogy of 924 Tetralogy of Fallot (Ch. 8) 151 Fallot Procedure for Correction of Transposition 925 Transposition of the Great Vessels (Ch. 8) 152 of the Great Arteries CHAPTER 23 CH. 43 VASCUAR SURGERY PERIPHERAL VASCULAR SURGERY PERIPHERAL VASCULAR SURGERY 928 SURGICAL ANATOMY 928 Anatomy and Physiology of the Vascular 902 System Blood Vessels 928 Anatomy and Physiology of the Vascular 902 System Blood Pressure 930 The Arterial System 931 The Venous System 933 OPERATIVE PATHOLOGY AND 934 Vascular Disease 905 DIAGNOSIS AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Arterial Embolism 935 Embolectomy 915 Arteriosclerosis Obliterans 935 Vascular Disease 905 Aneurysms of the Abdominal Aorta 936 Aneurysmectomy 913 SURGICAL INTERVENTIONS 937 Peripheral Vessel Angioplasty 937 Percutaneous Transluminal Angioplasty 910 Bypass Grafting and Endarterectomy 939 Vascular Surgical Procedures 912 Features of Peripheral Vascular Procedure 940 Special Features of Vascular Surgery 907 Aortofemoral Bypass 943 Abdominal Aortic Aneurysmectomy 947 Aneurysmectomy 913 Femoropopliteal Bypass 950 Femoropopliteal Bypass 912 Femorofemoral Bypass 954 Axillofemoral Bypass 956 Carotid Endarterectomy 959 Carotid Endarterectomy 912 CHAPTER 24 CH.37 NEUOSURGERY NEUROSURGERY SURGICAL ANATOMY 966 Anatomy and Physiology of the Brain and 768 Spinal Cord Divisions of the Nervous System 966 Cranium 966 Cranium 768 Vertebral Column 973 Vertebral Column and Spinal Cord 771 Blood Supply 974 Peripheral Nerve Surgery 791 Cranial Nerves 974 Peripheral Nerve Surgery 791 Spinal Nerves 974 Peripheral Nerve Surgery 791 NEUROSURGICAL PATHOLOGY 976 Cervical Spine 976 Thoracic Spine 977 Lumbar Spine 978 Neoplasms 979 Intracranial Neoplasms 781 Head Injury 980 Treatment of Head Injuries 783 Spinal Cord Injury 982 Treatment of Spinal Injuries 785 Cerebrovascular Disease 982 Congenital Abnormalities 983 Neurosurgery (Ch. 8) 145 INFECTION 984 Abscess 984 Spinal Tumors 985 Excision of a Spinal Cord Tumor 785 Peripheral Nerve Disorders 985 NEUROSURGICAL PROCEDURES 986 Patient Care Considerations 774 Special Instrumentation, Supplies, Drugs, 986 Special Considerations in Neurosurgery 772 and Equipment Patient Preparation 990 Patient Care Considerations 774 Craniotomy 991 Craniotomy 777 Craniectomy 1001 Craniectomy 777 Ventriculoperitoneal and Ventriculoatrial 1005 Shunt Transsphenoidal Hypophysectomy 1008 Transsphenoidal Procedures 783 Stereotactic Procedure 1011 Stereotaxis 780 Cranioplasty 1012 Cranioplasty 779 Spinal Procedures 1012 Surgical Procedures of the Spine 784 Peripheral Nerve Procedure 1020 Peripheral Nerve Surgery 791 ADVANCES IN NEUROSURGERY 1022 Intraoperative MRI 1022 Three-Dimensional Reconstruction 1022 Stereotaxis 780 Radiosurgery 1022 AST. Surgical Technology, 2E. Phillips. Berry & Kohn’s Operating Room Delmar Learning Technique, 10E. Elsevier

Minimal Invasive Techniques 1022 Stereotaxis 1022 Stereotaxis 780 Intraoperative Ultrasound 1023 Brain Mapping 1023 Endoscopic Neurosurgery 1023 Deep Brain Stimulation 1023

APPENDIX A: ANATOMY PLATES 1025 APPENDIX B: COMMON PREFIXES 1036 AND SUFFIXES APPENDIX C: MEASUREMENTS 1039