Surgical Technology for the Surgical Technologist

by Price, Paul; Frey, Kevin B.; Junge, Teri L.

• ISBN13: 9781401838485
• ISBN10: 1401838480
• Additional ISBN(s): 9780766806627, 9781418051686
• Edition: 2nd
• Format: Hardcover
• Copyright: 2003-12-23
• Publisher: Cengage Learning
• More Book Details
• Purchase Benefits

Summary

This new edition meets the requirements of the revised Core Curriculum for Surgical Technologists, 5th edition. It is written by surgical technologists for surgical technologists. The content focuses on the concepts and skill development (cognitive and procedural) required of surgical technologists in the operative environment. The text uses the A POSitive CARE approach to surgical problem solving that concentrates on the ability of the surgical technologist to predict the patient's and surgeon's needs through the intraoperative period. The goal is for the surgical technologist to apply this model in daily practice for maximum efficiency and effectiveness during the surgical procedure. The surgical procedures included in the text were selected for their instructive value and because the skills demonstrated can be applied to many other procedures.

Table of Contents

List of Tables	xix
Introduction to the second Edition	xxiii
Preface	xxvii
Contributors	xxxix
Reviewers	xl
How to Use This Book	xlii
SECTION 1 Introduction to Surgical Technology
CHAPTER 1 Orientation to surgical Technology	2	(20)
History of Surgery	3	(1)
Surgery Today	4	(2)
Surgical specialties	5	(1)
History of Surgical Technology	6	(2)
Field of Surgical Technology	8	(3)
Working Conditions	8	(1)
Personal Characteristics	8	(1)
Surgical Team Members	8	(2)
Surgical Technology Education and Certification	10	(1)
The Surgical Technologist as a Professional	11	(3)
Professionalism	11	(1)
Surgical Technologist's Lifestyle	12	(1)
Job Descriptions for the Surgical Technologist	13	(1)
Career Opportunities	13	(1)
Health Care Facilities	14	(1)
Hospital Organization	15	(7)
Hospital Departments and Interdepartmental Communication	17	(2)
Financial Considerations and Reimbursement	19	(1)
Organizations Related to Hospitals, Health Care, and Surgical Services	20	(2)
CHAPTER 2 Standards of Conduct	22	(20)
Legal Issues	23	(7)
Definitions of General Legal Terms	23	(1)
Definitions of Traditional Principles	24	(1)
Torts	25	(2)
Consent for Surgery: A Basic Right	27	(2)
Documentation	29	(1)
Event/Incident Reports	30	(1)
Advance Directives	30	(1)
Ethical and Moral Issues	30	(4)
Moral Principles	31	(1)
Bioethics	31	(1)
AHA Patient's Bill of Rights	31	(1)
Elements of Ethical Decision Making	32	(2)
Professional Codes of Conduct	34	(1)
Surgical Conscience	34	(1)
Scope of Practice	34	(4)
Job Descriptions and Competencies	35	(1)
Credentialing	36	(1)
Accreditation	36	(1)
Core Curricula for Surgical Technology and Surgical Assisting	36	(1)
Career Development	36	(1)
Clinical Ladder Program	37	(1)
Risk Management and Liability	38	(4)
Medical Errors	38	(1)
Safe Medical Device Act	39	(1)
Malpractice Insurance	39	(3)
CHAPTER 3 The Surgical Patient	42	(14)
The STSR and the Surgical Patient	43	(1)
Physical, Psychological, Social, and Spiritual Needs of the Surgical Patient	43	(13)
Understanding the Surgical Patient	44	(1)
Causes of Surgical Intervention	44	(1)
The Surgical Patient, a Human Being	44	(1)
Prioritizing Needs: Maslows Hierarchy	45	(1)
Life Stage Development: Select Basic Concepts	46	(3)
Cultural and Religious Influences	49	(7)
CHAPTER 4 Special Populations	56	(20)
Introduction	57	(1)
Pediatric Patients	57	(8)
Monitoring the Pediatric Patient	59	(1)
Shock	60	(1)
Fluids and Electrolytes	60	(1)
Infection	61	(1)
Metabolic and Nutritional Responses	61	(1)
Trauma	61	(1)
Patients with Obesity	62	(2)
Review of Surgical Considerations	64	(1)
Specific Considerations of Bariatric Surgery	64	(1)
Patients with Diabetes	65	(1)
Complications Associated with Diabetes	65	(1)
Care of the Patient with Diabetes in Surgery	66	(1)
Pregnant Patients	66	(2)
Considerations When Caring for Pregnant Patients	67	(1)
Anesthesia	67	(1)
Intraoperative Considerations for the Surgical Technologist	67	(1)
Immunocompromised Patients	68	(1)
Acquired Immunodeficiency Syndrome	68	(1)
Considerations for the Surgical Team Members	68	(1)
Patients with Disabilities	69	(1)
Geriatric Patients	69	(2)
Trauma Patients	71	(1)
The "Golden Hour" and Trauma system	71	(1)
Kinematics	71	(1)
Blunt Trauma	71	(1)
Penetrating Trauma	72	(1)
Trauma Scoring	72	(1)
Considerations for the Surgical Technologist	72	(1)
Preservation of Evidence	72	(1)
Hypothermia	73	(1)
Infection	73	(1)
Preparation of the Case	73	(3)
CHAPTER 5 Physical Environment and safety standards	76	(22)
Physical Design of the Surgery Department	77	(8)
Areas of the OR	78	(1)
Physical Components of the Operative Suite	79	(4)
Substerile Area	83	(1)
Direct Support Services	83	(2)
Hazards and Regulatory Agencies	85	(1)
Safety Considerations	86	(4)
Air-Handling System	86	(1)
Surgical Lights	86	(1)
Noise in the Operating Room	86	(1)
Ergonomics and Safety Considerations	86	(1)
Fire Hazards and Safety	87	(1)
Electrical Hazards	88	(1)
Ionizing Radiation	89	(1)
Biological Hazards and Safety Considerations	90	(4)
Universal Precautions	90	(1)
Standard Precautions	90	(3)
Laser and Electrosurgical Plume	93	(1)
Latex Allergy	94	(1)
Chemical Hazards and Safety Considerations	94	(4)
Waste Anesthetic Gases	94	(1)
Methyl Methacrylate	95	(1)
Formalin	95	(1)
Ethylene Oxide	95	(1)
Glutaraldehyde	95	(3)
SECTION 2 Principles and Practice of surgical Technology
CHAPTER 6 Biomedical science	98	(31)
Introduction	99	(1)
Computers	99	(8)
Surgical Applications	99	(1)
Hardware	100	(3)
Software	103	(1)
Word Processing	104	(1)
Graphics	105	(1)
Internet Basics	106	(1)
Electricity	107	(5)
Surgical Applications	107	(1)
Basic Principles of Electricity	108	(4)
Physics	112	(10)
Medical and Surgical Applications	112	(1)
Mechanics	113	(9)
Nuclear Physics	122	(1)
Gravity	122	(1)
Surgical Robots	122	(3)
Terminology	123	(1)
Design	123	(1)
Remote Manipulation	124	(1)
Geometry	124	(1)
Hearing and Vision	125	(1)
Decontamination and Sterilization of Robotic Components	125	(1)
Clinical Applications	125	(1)
The OR of the Future	125	(1)
Surgical Planning and Rehearsal	125	(1)
Surface-Based Registration	126	(1)
Role of the Surgical Technologist	126	(3)
CHAPTER 7 Asepsis and Sterile Technique	129	(42)
History of sterilization	130	(1)
Basic Terminology	131	(1)
Pathogens and Infection	131	(7)
Infection	131	(1)
Pathogens Associated with Surgical Site Infection	132	(3)
Methods of Transmission	135	(3)
Principles of Asepsis	138	(2)
Principle 1: Sterile Field	138	(1)
Principle 2: Sterile Team Member Attire	139	(1)
Principle 3: Movement in and Around Sterile Field	140	(1)
Surgical Conscience	140	(1)
Cleaning, Disinfection, and sterilization	141	(10)
Cleaning and Disinfection	142	(5)
Disinfectant and Disinfectant/Sterilant Agents	147	(4)
Instrument Preparation and Wrapping for Sterilization	151	(1)
Instruments	151	(1)
Specific Procedural Trays	151	(1)
Instrument Sets	151	(1)
Packaging for Sterilization and Storage	152	(11)
Performance Standards of Packaging Material	152	(1)
Performance Characteristics	152	(1)
Types of Packaging Materials	153	(2)
General Principles of Packaging	155	(3)
Sterilization	158	(1)
Requirements and Essential Factors	159	(1)
Basic Components of a Steam Sterilizer	160	(3)
Gas Sterilization	163	(2)
Ethylene Oxide	163	(1)
Alternative Sterilization Methods	164	(1)
Liquid Chemical Sterilization Processes	165	(1)
Ionizing Radiation	165	(1)
Methods of Monitoring the Sterilization Process	165	(2)
Mechanical Methods of Monitoring the Sterilization Process	165	(1)
Chemical Methods of Monitoring the Sterilization Process	166	(1)
Biological Methods of Monitoring the Sterilization Process	166	(1)
Bowie-Dick Test	167	(1)
Event-Related Sterility	167	(4)
Environmental Decontamination	168	(1)
Environmental Services	168	(1)
Case by Case	168	(1)
Daily	168	(3)
CHAPTER 8 General Patient Care and safety	171	(47)
Preoperative Patient Routines	172	(7)
Surgical Consent	173	(2)
Preoperative Education	175	(1)
Patient Possessions	175	(1)
Evening/Morning Before Surgery	176	(1)
Diet	177	(1)
Makeup and Dress	177	(1)
Call to the Operating Room	177	(1)
Family Visit	177	(1)
Patient Identification	177	(1)
Transportation	178	(1)
Transfer and Positioning	179	(1)
Basic Positioning for Surgery	180	(11)
Supine Position	181	(2)
Trendelenburg Position	183	(1)
Reverse Trendelenburg Position	184	(1)
Fowler's Position and Sitting Position	184	(1)
Lithotomy Position	185	(1)
Prone Position	186	(2)
Kraske (Jackknife) Position	188	(1)
Lateral Position	189	(1)
Kidney Position	190	(1)
Sims' Position	191	(1)
Thermoregulatory Devices	191	(1)
Vital Signs	192	(7)
Temperature	192	(1)
Pulse	193	(1)
Respiration	194	(2)
Blood Pressure	196	(3)
Urinary Catheterization	199	(3)
Indications	200	(1)
Considerations	200	(1)
Procedure	200	(2)
Skin Preparation	202	(4)
Skin Preparation Setup	203	(3)
Skin Marking	206	(1)
Hemostasis and Blood Replacement	206	(5)
Factors Affecting Hemostasis	207	(1)
Control of Bleeding During Surgery	207	(1)
Mechanical Methods	207	(2)
Thermal Hemostasis	209	(1)
Pharmacological Agents	209	(1)
Blood Loss	210	(1)
Blood Replacement	210	(1)
Hemolytic Transfusion Reactions	211	(1)
Cardiopulmonary Resuscitation	211	(2)
Cardiac Arrest in the Surgical Setting	212	(1)
Malignant Hyperthermia	213	(1)
Prevention	213	(1)
Treatment	213	(1)
Emergency Medical Services	213	(1)
Indications of Emergency Situations	214	(1)
Objectives and Priorities in Emergency Situations	214	(4)
Syncope	214	(1)
Convulsions/Seizures	215	(1)
Anaphylactic Reactions	215	(1)
Clinical Manifestations of Impending Cardiac Arrest	216	(2)
CHAPTER 9 Surgical Pharmacology and Anesthesia	218	(40)
Pharmacology	219	(4)
Drug Sources	219	(1)
Drug Forms	220	(1)
Drug Nomenclature	220	(1)
Route of Administration	221	(1)
Drug Classifications	221	(1)
Pharmacokinetics	221	(1)
Pharmacodynamics	222	(1)
Drug-Handling Techniques	223	(6)
Medication Identification	223	(2)
Supplies for Medication Handling	225	(1)
Transfer of a Medication to the Sterile Field	225	(1)
Medications Commonly Used in the Operating Roam	226	(3)
History of Modern Anesthesia	229	(2)
Methods and Techniques of Anesthetic Administration	231	(1)
General Anesthesia	231	(13)
Depth of General Anesthesia	231	(1)
Phases of General Anesthesia	232	(1)
Advantages of General Anesthesia	232	(1)
Risks and Complication Associated with General Anesthesia	232	(3)
Anesthetic Agents	235	(5)
Adjuncts to General Anesthesia	240	(1)
Anesthesia Equipment	241	(3)
Nerve Conduction Blockade	244	(5)
Nerve Conduction Blocking Agents	244	(2)
Topical Anesthesia	246	(1)
Local Anesthesia	246	(1)
Regional Anesthesia	246	(3)
Nontraditional Anesthesia Options	249	(1)
Team Member Roles During Anesthesia Administration	249	(9)
Preoperative Visits	250	(1)
Preoperative Routine-All Types of Anesthesia	250	(3)
Postanesthesia Care	253	(5)
CHAPTER 10 Instrumentation, Equipment, and Supplies	258	(33)
Instrumentation	259	(10)
Classifications	259	(5)
Instrument Care and Handling	264	(1)
Types of Instrument Sets	265	(4)
Specialty Equipment	269	(6)
Endoscopes	269	(1)
Power Tools	270	(1)
Lasers	270	(3)
Microscopes	273	(1)
Video Monitors, Recorders, and Cameras	273	(1)
Fiber-Optic Headlamps and Light Sources	274	(1)
Irrigation/Aspiration Unit	274	(1)
Cryotherapy Units	274	(1)
Insufflators	274	(1)
Nerve Stimulators	274	(1)
Accessory Equipment	275	(5)
Suction Systems	275	(1)
Electrosurgical Unit	275	(3)
Lights	278	(1)
Pneumatic Tourniquets	279	(1)
Sequential Compression Devices	280	(1)
Supplies	280	(11)
Drapes	280	(2)
Sterile Packs	282	(1)
Sponges and Dressings	282	(3)
Catheters, Tubes, and Drains	285	(3)
Nonsuture Needles	288	(1)
Irrigators and Syringes	289	(2)
CHAPTER 11 Wound Healing, Sutures, Needles, and Stapling Devices	291	(26)
Introduction	292	(1)
Types of Wounds	292	(2)
Surgical Wound	292	(1)
Traumatic Wound	293	(1)
Chronic Wound	294	(1)
Inflammatory Process	294	(1)
Types of Wound Healing	294	(1)
First Intention (Primary Union)	294	(1)
Phases of Wound Healing by First Intention	295	(1)
Second Intention (Granulation)	295	(1)
Third Intention (Delayed Primary Closure)	295	(1)
Factors Influencing Wound Healing	295	(1)
Complications of the Healing Wound	296	(2)
Intraoperative Wound Care	297	(1)
Postoperative Wound Care	298	(1)
Suture	298	(12)
History	298	(1)
Types of Suture Material	299	(1)
Suture Sizes	300	(1)
General Factors Affecting Choice of Suture	300	(1)
Characteristics of Common Sutures	300	(3)
Packaging of Suture	303	(1)
Ligatures	303	(1)
Ligating Methods	303	(1)
Suture for the Procedure	304	(1)
Layer Closure	305	(2)
Endoscopic Suture	307	(1)
Suturing Techniques	307	(2)
Accessory Devices	309	(1)
Stapling Devices	310	(3)
Types of Staplers	312	(1)
Meshes or Fabrics	313	(1)
Needles	313	(4)
Needle Eye	314	(1)
Needle Point	315	(1)
Needle Bodies	315	(2)
CHAPTER 12 Surgical Case Management	317	(53)
Introduction	318	(5)
Applied Theory	319	(4)
Preoperative Case Management	323	(18)
Attire	323	(4)
Preparing the OR	327	(14)
Organizing the Back Table	341	(12)
Organizing the Mayo Stand	346	(1)
Assisting a Team Member	346	(1)
Draping the Surgical Patient	346	(7)
Positioning of the Sterile Team Members and the Furniture	353	(1)
Intraoperative Case Management	353	(10)
General Principles	353	(8)
Progression of the Surgical Procedure	361	(2)
Postoperative Case Management	363	(7)
Preservation of the Sterile Field	363	(1)
Drape Removal	363	(1)
Gown and Glove Removal	364	(1)
Immediate Postoperative Patient Care	364	(1)
Patient Transfer and Transportation	364	(1)
Breakdown of the Setup	365	(1)
The Operating Room Cycle	365	(1)
The Instrument Cycle	366	(4)
SECTION 3 Surgical Procedures
CHAPTER 13 Diagnostic Procedures	370	(15)
Sources of Patient Data	371	(12)
History and Physical Examination	371	(1)
Diagnostic Imaging	371	(7)
Laboratory Reports	378	(3)
Electrodiagnostic Studies	381	(1)
Pulmonary Diagnosis	382	(1)
Endoscopy	383	(1)
Plethysmography and Phleborheography	383	(1)
Indications for Surgery	383	(2)
CHAPTER 14 General surgery	385	(92)
Anatomy	386	(11)
Abdominal Cavity: General Dimensions	386	(1)
Surface Features	386	(1)
Abdominal Musculature	387	(1)
Peritoneum	387	(1)
Retroperitoneum	388	(1)
Alimentary Canal	388	(1)
Esophagus	388	(1)
Stomach	389	(1)
Small Intestine	390	(1)
Mesentery	391	(1)
Colon	391	(2)
Rectum	393	(1)
Anus	393	(1)
Omenta	394	(1)
Pancreas	394	(1)
Spleen	395	(1)
Liver	395	(1)
Biliary Tract	396	(1)
General Surgery Instrumentation	397	(3)
Major Set	397	(1)
Minor Set	397	(2)
Local Excision Instruments	399	(1)
Biliary Instruments	399	(1)
Intestinal Instruments	400	(1)
Other General Instruments	400	(1)
Room Setup	400	(1)
Positioning	400	(1)
Draping	400	(2)
Incisions	402	(2)
Surgery of the Abdominal Wall: Hernias	404	(3)
Specific Anatomical Features of the Groin Area	404	(1)
Hernias	405	(1)
Hernia Repair	405	(2)
Surgery of the Alimentary Canal	407	(20)
Surgery of the Esophagus	408	(1)
Gastric Surgery	408	(1)
Pathological Conditions of the Stomach	408	(6)
Procedures Related to Gastric Secretion, Ulcers, and Neoplasm	414	(2)
Procedures for Morbid Obesity	416	(1)
Surgery of the Small Bowel	416	(4)
Appendectomy	420	(5)
Colon Surgery	425	(2)
Stomas	427	(20)
Anorectal Surgery	427	(3)
Hemorrhoid Ligation and Excision	430	(1)
Surgery of the Liver and Biliary Tract	430	(9)
Common Bile Duct Exploration	439	(8)
Surgery of the Pancreas and Spleen	447	(7)
Select Pathology of the Pancreas	447	(1)
Draining Pancreatic Cysts	448	(1)
Pancreatic Resection	448	(1)
Whipple Pancreaticoduodenectomy	448	(4)
Surgery of the Spleen	452	(2)
Vascular and Other Procedures	454	(3)
Varicose Veins	454	(1)
Vascular Access Procedures	455	(1)
Muscle and Nerve Biopsies	456	(1)
Incision and Drainage	456	(1)
Excision of Lesion	456	(1)
Endoscopy	457	(1)
Breast Surgery	457	(4)
Breast Anatomy	457	(1)
Breast and Axilla: Pathology and Diagnosis	457	(1)
Breast Surgery (Noncosmetic)	457	(4)
Surgery of the Thyroid and Parathyroid	461	(1)
Anatomy of the Thyroid and Parathyroid	461	(1)
Pathological Conditions of the Thyroid and Parathyroid Glands	461	(1)
Thyroidectomy	461	(1)
Tracheotomy	461	(16)
Indications for Tracheotomy	461	(6)
Illustrative Procedure: Tracheotomy	467	(10)
CHAPTER 15 Obstetric and Gynecologic surgery	477	(76)
Introduction to Obstetric and Gynecologic Surgery	478	(1)
Anatomy	478	(7)
Pelvis	478	(3)
External Genitalia	481	(1)
Vagina	481	(1)
Uterus	482	(1)
Fallopian Tubes	483	(1)
Ovaries	483	(2)
Pregnancy-A Special Condition	485	(2)
Select Key Terms in Labor and Delivery	486	(1)
Labor	486	(1)
Special Instrumentation, Drugs, Equipment, and Supplies in Obstetric and Gynecologic surgery	487	(7)
Instrumentation	467	(20)
Drugs	487	(7)
Equipment	494	(1)
Supplies	494	(1)
OR Setup and Basic Patient Positioning and Draping	494	(1)
Surgical Procedures: Obstetrics and Fertility Related	494	(59)
Pathology and Surgical Conditions: Obstetrics and Fertility Related	494	(16)
Vaginal Delivery	495	(2)
Cesarean Section	497	(6)
Tubal Occlusion (Sterilization) Procedures	503	(1)
Tuboplasty	504	(3)
Laparoscopic Resection of Unruptured Tubal Pregnancy	507	(3)
Surgical Procedures: Gynecologic Procedures	510	(1)
Gynecologic Pathology	510	(1)
Surgical Intervention: Overview	510	(44)
Abdominal Incisions for Gynecologic Surgery	510	(5)
Surgical Intervention: Laparoscopy	515	(3)
Basic Colposcopy	518	(1)
Hysteroscopy	518	(3)
Marsupialization of Bartholin's Gland Cyst	521	(1)
Simple Vulvectomy	521	(3)
Anterior and Posterior Repair (Colporrhaphy)	524	(9)
Cervical Biopsy, Cryotherapy, Laser Treatment, LEEP, and Conization	533	(2)
Dilation and Curettage	535	(3)
Myomectomy	538	(4)
Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy (TAH-BSO)	542	(4)
Vaginal and Laparoscopically Assisted Vaginal Hysterectomy (LAVH)	546	(1)
Radical Cancer Surgery: Total Pelvic Exenteration	547	(6)
CHAPTER 16 Ophthalmic surgery	553	(33)
Anatomy of the Eye	554	(4)
Orbit	554	(1)
Extrinsic Muscles	555	(1)
Lacrimal System	555	(1)
Globe	556	(2)
Cavities and Chambers of the Eye	558	(1)
Ophthalmic Surgical Pathology	558	(2)
Glaucoma	558	(1)
Cataract	558	(1)
Small Retinal Detachment	558	(1)
Large Retinal Detachment	558	(1)
Vitreous Hemorrhage	558	(1)
Proliferative Vitreoretinopathy (PVR)	559	(1)
Traction Retinal Detachment	559	(1)
Epiretinal Membrane	559	(1)
Corneal Pathology	559	(1)
Chalazion	559	(1)
Pterygium	559	(1)
Dacryocystitis	559	(1)
Strabismus	559	(1)
Ophthalmic Medications	560	(1)
Special Considerations in Ophthalmic Surgery	560	(2)
Special Equipment	560	(1)
Instruments	561	(1)
Surgical Intervention	562	(24)
Surgical Repair of Ptosis	562	(1)
Iridectomy	563	(1)
Trabeculoplasty	563	(1)
Strabismus Correction: Recession/Resection	563	(3)
Adjustable Suture Surgery	566	(1)
Scleral Buckle	567	(4)
Enucleation and Evisceration of the Eye (Traditional Approach)	571	(2)
Keratoplasty (Cornea I Transplant)	573	(4)
Cataract Extraction	577	(3)
Phacoemulsification	580	(1)
Vitrectomy	580	(6)
CHAPTER 17 Otorhinolaryngologic Surgery	586	(58)
Anatomy of the Ear	587	(2)
Outer Ear	587	(1)
Middle Ear	588	(1)
Inner Ear	588	(1)
Pathology of the Ear	589	(2)
Pathology Affecting the Outer Ear	589	(1)
Pathology Affecting the Middle Ear	589	(1)
Pathology Affecting the Inner Ear	590	(1)
Diagnostic Procedures/Tests for the Ear	590	(1)
Preoperative Considerations	591	(1)
Special Instruments, Supplies, and Drugs	592	(1)
Ear Procedures	592	(9)
Myringotomy	592	(4)
Myringoplasty/Tympanoplasty	596	(4)
Mastoidectomy	600	(1)
Stapedectomy	600	(1)
Stapedotomy	600	(1)
Cochlear Implants	601	(1)
Anatomy of the Nose and sinuses	601	(2)
External Nose	601	(1)
Internal Nose	601	(1)
Paranasal sinuses	602	(1)
Blood Supply to the Nose	602	(1)
Olfaction	603	(1)
Pathology of the Nose and Paranasal Sinuses	603	(2)
Rhinitis/Sinusitis	603	(1)
Nasal Polyps	604	(1)
Hypertrophied Turbinates	604	(1)
Deviated Nasal Septum	604	(1)
Septal Perforation	604	(1)
Epistaxis	604	(1)
Diagnostic Procedures/Tests	605	(1)
Direct Vision	605	(1)
Mirror Examination	605	(1)
Radiography	605	(1)
Preoperative Considerations	605	(1)
Special Instruments, Supplies, and Drugs	606	(3)
Nasal Procedures	609	(9)
Submucous Resection (SMR)	609	(3)
Polypectomy	612	(1)
Intranasal Antrostomy	612	(1)
Removal of Foreign Body	612	(1)
Internal Maxillary Artery Ligation	613	(1)
Sinus Procedures	613	(1)
Caldwell-Luc	613	(2)
Ethmoidectomy	615	(1)
Sphenoidectomy	616	(1)
Drainage of the Frontal Sinus	616	(1)
Sinus Endoscopy	616	(2)
Anatomy of the Upper Aerodigestive Tract	618	(3)
Pharnx	618	(2)
Larynx	620	(1)
Trachea	621	(1)
Bronchi and Lungs	621	(1)
Esophagus	621	(1)
Pathology Affecting the Upper Aerodigestive Tract	621	(3)
Pharyngitis	621	(1)
Epiglottitis	622	(1)
Tonsillitis	622	(1)
Sleep Apnea	623	(1)
Laryngitis	623	(1)
Polypoid Corditis or Vocal Cord Polyps	623	(1)
Vocal Cord Nodules	623	(1)
Vocal Cord Granulomas	623	(1)
Laryngeal Neoplasms	624	(1)
Tracheitis and Bronchitis	624	(1)
Laryngotracheobronchitis (Croup)	624	(1)
Foreign Bodies	624	(1)
Pathology Affecting the Esophagus	624	(1)
Esophagitis	624	(1)
Ulceration of the Esophagus	624	(1)
Neoplasms Affecting the Esophagus	624	(1)
Foreign Bodies	625	(1)
Zenker's Diverticulum	625	(1)
Diagnostic Procedures/Tests	625	(1)
Direct Visualization	625	(1)
Indirect Visualization	625	(1)
Laboratory Tests	625	(1)
Radiologic Examinations	625	(1)
Videostroboscopy	626	(1)
Polysomnography	626	(1)
Multiple Sleep Latency Test (MSLT)	626	(1)
Preoperative Considerations	626	(1)
Special instruments, Supplies, and Drugs	626	(2)
Aerodigestive Tract Procedures	628	(16)
Adenoidectomy	628	(1)
Tonsillectomy	628	(3)
Incision and Drainage of a Peritonsillar Abscess	631	(1)
Uvulopalatopharyngoplasty	631	(2)
Laryngoscopy	633	(3)
Bronchoscopy	636	(1)
Esophagoscopy	636	(1)
Panendoscopy	636	(1)
Radical Neck Dissection with Mandibulectomy	636	(8)
CHAPTER 18 Oral and Maxillofacial surgery	644	(40)
Anatomy of the Oral Cavity	645	(1)
Lips	645	(1)
Teeth	645	(1)
Palate	646	(1)
Cheeks	646	(1)
Tongue	646	(1)
Anatomy of the Face and Cranium	646	(2)
Orbit	647	(1)
Facial Muscles and Innervation	647	(1)
Embryologic Development of the Face	648	(1)
Pathology of the Oral Cavity	649	(2)
Mouth	649	(1)
Jaw Bones	649	(1)
Mandibular Fractures	649	(1)
Frontal Fractures	650	(1)
Orbital Fractures	650	(1)
Zygomatic Fractures	650	(1)
Midfacial Fractures	651	(1)
Craniofacial Deformities	651	(1)
Diagnostic Tests	651	(1)
Oral Procedures: General Considerations	652	(6)
Tooth Extraction/Odontectomy	653	(4)
Tooth Restoration	657	(1)
Implantation	657	(1)
Maxillofacial Procedures: General Considerations	658	(26)
Graft Materials	658	(1)
Repair of Mandibular/Maxillary Fractures	659	(1)
Application of Arch Bars	659	(3)
Wire Fixation	662	(1)
Plate and Screw Fixation of Mandibular Fracture	663	(3)
Frontal Fracture Repair	666	(1)
Orbital Floor Fracture Repair	667	(3)
Reduction of Zygomatic Fractures	670	(1)
Le Fort I Fracture Repair	671	(4)
Le Fort II and III Fracture Repair	675	(1)
Craniofacial Reconstruction	675	(4)
Correction of Retrognathism or Prognathism	679	(3)
Temporomandibular Joint Procedures	682	(2)
CHAPTER 19 Plastic and Reconstructive surgery	684	(47)
Anatomy	685	(9)
Skin and Underlying Structures	685	(2)
Palate	687	(1)
Nose	687	(1)
Hand	687	(7)
Breast	694	(1)
Surgical Pathology	694	(7)
Pathology Affecting the Skin	694	(2)
Cleft Lip and Palate	696	(1)
Pathology Affecting the Hand	697	(4)
Pathology Affecting the Breast	701	(1)
Diagnostic Procedures and Tests	701	(1)
Special Instrumentation, Supplies, Drugs, and Equipment	701	(3)
Nasal Set	701	(1)
Dermatome	702	(2)
Mesh Graft Device	704	(1)
Surgical Intervention	704	(27)
Rhytidectomy	704	(2)
Blepharoplasty	706	(1)
Suction Lipectomy	707	(1)
Abdominoplasty	708	(1)
Skin Grafts	709	(4)
Dermabrasion	713	(1)
Scar Revision	713	(1)
Cheiloplasty and Palatoplasty	713	(1)
Rhinoplasty	714	(2)
Hand Surgery	716	(7)
Mammoplasty	723	(8)
CHAPTER 20 Genitourinary Surgery	731	(60)
Anatomy	732	(7)
Suprarenal Glands	732	(1)
Kidneys	732	(3)
Ureters	735	(1)
Urinary Bladder	736	(1)
Male Reproductive System	737	(2)
Pathology Affecting the Adrenal Glands	739	(1)
Cushing's Syndrome	739	(1)
Adrenal Insufficiency (Addison's Disease)	739	(1)
Pheochromocytoma	739	(1)
Pathology Affecting the Urinary system	739	(4)
Bladder Tumors	739	(1)
Urinary Calculi	740	(1)
Kidney Disorders	740	(3)
Pathology Affecting the Male Reproductive System	743	(2)
Phimosis	743	(1)
Hypospadias/Epispadias	743	(1)
Benign Prostatic Hypertrophy	743	(1)
Cancer of the Prostate	744	(1)
Cryptorchidism	744	(1)
Testicular Torsion	744	(1)
Testicular Cancer	744	(1)
Trauma to the Genitourinary System	745	(1)
Diagnostic Procedures/Tests	745	(6)
History and Physical	745	(1)
Laboratory Findings	745	(6)
Radiologic Findings	751	(1)
Biopsy	751	(1)
Endoscopy	751	(1)
Special Equipment, Instruments, Supplies, and Drugs	751	(1)
Preoperative and Intraoperative Preparation	752	(5)
Incisional Options	754	(3)
Surgical Procedures	757	(34)
Adrenalectomy	757	(1)
Nephrectomy	757	(5)
Renal Transplant	762	(1)
Stone Removal	763	(1)
Cystostomy	764	(2)
Cystectomy/Ileal Conduit	766	(5)
Procedures for Stress Incontinence Affecting Women	771	(3)
Transurethral Endoscopy of the Genitourinary Tract	774	(2)
Circumcision	776	(2)
Orchiectomy	778	(1)
Orchiopexy	778	(3)
Hydrocelectomy	781	(1)
Varicocelectomy	781	(1)
Hypospadias Repair	782	(1)
Insertion of Inflatable Penile Prosthesis	782	(1)
Vasectomy	783	(1)
Vasovasostomy	784	(1)
Prostatectomy	784	(7)
CHAPTER 21 Orthopedic surgery	791	(72)
Bone and Bone Tissue	792	(6)
Bone Tissue	792	(2)
Types of Bones	794	(1)
Types of Joints	794	(3)
Bone Growth and Bone Cells	797	(1)
Intramembranous Bones	798	(1)
Endochondral Bone	798	(1)
Mineral storage	798	(1)
Factors That Affect Bone Growth	798	(1)
Clinical and Bone Landmark Terms	798	(1)
Pathology	798	(10)
Types of Fractures	805	(1)
Normal Bone Healing	805	(1)
Pathological Bone Healing	806	(2)
Diagnostic Terms and Procedures	808	(1)
The skeleton	808	(10)
The Skull	808	(3)
Vertebral Column	811	(1)
Bones of the Thoracic Region	812	(1)
Clavicles	812	(1)
Scapula	812	(1)
Pectoral Girdle	812	(1)
Humerus	812	(1)
Radius and Ulna	813	(1)
Hand and Wrist	814	(1)
Pelvis	814	(1)
Hip and Femur	814	(1)
Tibia and Fibula	814	(2)
Ankle and Foot	816	(2)
Equipment	818	(3)
Positioning Devices	818	(1)
Pneumatic Tourniquets	819	(1)
Traction	819	(1)
Laser	819	(1)
Radiography	819	(1)
Air Flow	820	(1)
Continuous Passive Range-of-Motion Machines	820	(1)
Transcutaneous Electric Nerve Stimulation	820	(1)
Electrical Stimulation of Bone	820	(1)
Saws, Drills, and Reamers	820	(1)
Arthroscopic Equipment	820	(1)
Supplies	821	(1)
Implants	821	(1)
Suture	821	(1)
Methyl Methacrylate	821	(1)
Pharmacology	821	(1)
Procedures	822	(41)
Bone Grafting	822	(2)
Knee Arthroscopy	824	(3)
Arthroscopic Repair of Meniscal Tear	827	(3)
Arthroscopic Anterior Cruciate Ligament Repair	830	(2)
Above-the-Knee Amputation	832	(1)
Endoscopic Carpal Tunnel Release	832	(3)
Colles' Fracture	835	(5)
Metacarpal Phalangeal Joint Arthroplasty	840	(1)
Triple Arthrodesis	840	(1)
Achilles Tendon Repair	841	(1)
Bunionectomy	842	(1)
Open Reduction-Internal Fixation of the Humerus	842	(3)
Shoulder Joint Arthroscopy	845	(1)
Acromioplasty	846	(1)
Repair of Rotator Cuff	846	(5)
Internal Fixation of Femoral Shaft Fracture	851	(1)
Repair of Hip Fracture	852	(1)
Total Hip Arthroplasty	853	(6)
Total Knee Arthroplasty	859	(4)
CHAPTER 22 Cardiothoracic surgery	863	(64)
Anatomy of the Chest	864	(4)
The Thorax	864	(2)
The Trachea	866	(1)
The Bronchial Tree	866	(1)
The Lungs	867	(1)
Anatomy and Physiology of the Heart	868	(5)
Location of the Heart	868	(1)
Coverings of the Heart	869	(1)
The Heart Wall	869	(1)
The Heart Chambers	869	(1)
The Heart Valves	869	(1)
Blood Flow Through the Heart	870	(1)
Blood Supply for the Heart	871	(1)
The Cardiac Cycle	871	(1)
Cardiac Output	872	(1)
Cardiac Conduction	872	(1)
Anatomical Development of the Heart	872	(1)
Operative Pathology	873	(14)
The Chest Wall	873	(1)
The Mediastinum	873	(1)
The Lungs	874	(1)
Thoracic Trauma	875	(2)
Thoracic Outlet Syndrome	877	(1)
Thoracic Aortic Aneurysm	877	(2)
Coronary Artery Disease	879	(2)
Valvular Disease	881	(1)
Cardiomyopathy	882	(1)
Cardiac Dysrhythmias	882	(2)
Congenital Heart Defects	884	(3)
Diagnostic Procedures: Thorax	887	(2)
Bronchoscopy	887	(1)
Mediastinoscopy	887	(1)
Thoracoscopy	887	(2)
Thoracentesis	889	(1)
Diagnostic Procedures: Cardiac	889	(1)
Radiologic Studies	889	(1)
Surgical Intervention: Thoracic	889	(11)
Special Preoperative Considerations	889	(1)
Special Instrumentation, Supplies, Drugs, and Equipment	889	(1)
Patient Preparation	890	(2)
Thoracoscopy	892	(3)
Scalene/Supraclavicular Node Biopsy	895	(1)
Thoracotomy for Upper Lobectomy	895	(4)
Thoracotomy for Right Pneumonectomy	899	(1)
Thoracotomy for Wedge Resection or Segmentectomy	899	(1)
Decortication of Lung	899	(1)
Surgical Intervention: Cardiac (Adult)	900	(21)
Preoperative Considerations	900	(1)
Patient Preparation	901	(1)
Techniques of Cardiopulmonary Bypass	901	(3)
Mechanical Circulatory Assistance	904	(1)
Coronary Artery Bypass Grafting	905	(6)
Aortic Valve Replacement	911	(5)
Mitral Valve Replacement	916	(1)
Thoracic Aortic Aneurysmectomy	917	(1)
Pericardiectomy/Pericardial Window	918	(1)
Heart Transplantation	919	(1)
Permanent Pacemaker Insertion	920	(1)
Percutaneous Transluminal Coronary Angioplasty	921	(1)
Surgical Intervention: Cardiac (Pediatric)	921	(6)
Special Preoperative Preparation	922	(1)
Atrial Septal Defect	922	(1)
Ventricular Septal Defect	922	(1)
Patent Ductus Arteriosus	923	(1)
Correction of Aortic Coarctation	924	(1)
Procedure for Correction of Tetralogy of Fallot	924	(1)
Procedure for Correction of Transposition of the Great Arteries	925	(2)
CHAPTER 23 Peripheral Vascular surgery	927	(38)
Peripheral Vascular Surgery	928	(1)
Surgical Anatomy	928	(6)
Blood Vessels	928	(2)
Blood Pressure	930	(1)
The Arterial System	931	(2)
The Venous System	933	(1)
Operative Pathology and Diagnosis	934	(3)
Arterial Embolism	935	(1)
Arteriosclerosis Obliterans	935	(1)
Aneurysms of the Abdominal Aorta	936	(1)
Surgical Interventions	937	(28)
Peripheral Vessel Angioplasty	937	(2)
Bypass Grafting and Endarterectomy	939	(1)
Features of Peripheral Vascular Procedures	940	(3)
Aortofemoral Bypass	943	(4)
Abdominal Aortic Aneurysmectomy	947	(3)
Femoropopliteal Bypass	950	(4)
Femorofemoral Bypass	954	(2)
Axillofemoral Bypass	956	(3)
Carotid Endarterectomy	959	(6)
CHAPTER 24 Neurosurgery	965	(60)
Surgical Anatomy	966	(10)
Divisions of the Nervous System	966	(1)
Cranium	966	(7)
Vertebral Column	973	(1)
Blood Supply	974	(1)
Cranial Nerves	974	(1)
Spinal Nerves	974	(2)
Neurosurgical Pathology	976	(8)
Cervical Spine	976	(1)
Thoracic Spine	977	(1)
Lumbar Spine	978	(1)
Neoplasms	979	(1)
Head Injury	980	(2)
Spinal Cord Injury	982	(1)
Cerebrovascular Disease	982	(1)
Congenital Abnormalities	983	(1)
Infection	984	(2)
Abscess	984	(1)
Spinal Tumors	985	(1)
Peripheral Nerve Disorders	985	(1)
Neurosurgical Procedures	986	(36)
Special Instrumentation, Supplies, Drugs, and Equipment	986	(4)
Patient Preparation	990	(1)
Craniotomy	991	(10)
Craniectomy	1001	(4)
Ventriculoperitoneal and Ventriculoatrial Shunt	1005	(3)
Transphenoidal Hypophysectomy	1008	(3)
Stereotactic Procedures	1011	(1)
Cranioplasty	1012	(1)
Spinal Procedures	1012	(8)
Peripheral Nerve Procedures	1020	(2)
Advances in Neurosurgery	1022	(3)
Intraoperative MRI	1022	(1)
Three-Dimensional Reconstruction	1022	(1)
Radiosurgery	1022	(1)
Minimally Invasive Techniques	1022	(1)
Stereotaxis	1022	(1)
lntraoperative Ultrasound	1023	(1)
Brain Mapping	1023	(1)
Endoscopic Neurosurgery	1023	(1)
Deep Brain Stimulation	1023	(2)
Appendix A Anatomy Plates	1025	(11)
Appendix B Common Prefixes and Suffixes	1036	(3)
Appendix C Measurements	1039	(2)
Glossary	1041	(30)
Index	1071