Surgical Tech (Appleton & Lange) Part 7

Shoulder braces would be indicated in the position of extreme Trendelenburg. Extreme Trendelenburg is a position where the patient's head is lowered and the body is tilted at a steep angle with the feet elevated higher than the head. This position is often used in certain surgical procedures, such as pelvic surgeries, to allow better access to the surgical site. Shoulder braces are used to secure the patient's shoulders and prevent them from sliding down the operating table during surgery in this extreme tilted position.

The French scale is a system used to measure the diameter of catheters and other medical devices. The scale starts at 3 and goes up in increments of 2. Therefore, the smallest diameter on a French scale is 3.

The resolving power of an operating microscope refers to its ability to discern detail. This means that the microscope can distinguish and visualize small or fine features with clarity and precision. It is not related to the ability to enlarge the image or adapt the operative procedure to individual patient requirements. The ratio of image size on the viewer's retina with and without magnification is also not relevant to the resolving power.

The correct answer is "moistened with saline" because patties are typically used in medical settings to clean wounds and absorb excess moisture. Saline solution, which is a mixture of salt and water, is commonly used to moisten the patties as it is sterile and helps create a moist environment for wound healing. Using plain water or other solutions like silver nitrate may not provide the same level of cleanliness and moisture required for wound care.

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In surgical procedures, it is necessary to perform a count of sponges used to ensure none are left inside the patient. However, the statement "a count is unnecessary in a vaginal procedure" is incorrect. A count is necessary in all surgical procedures, including vaginal procedures, to prevent any potential complications or harm to the patient. Therefore, this statement is the exception and is not true.

The unacceptable technique in this scenario is when soiled sponges used for prep remain in the kick bucket and are not part of the count. During sponge count procedures, all sponges, including soiled ones used for preparation, should be separated, stacked, and counted in multiples. This ensures that no sponges are left inside the patient's body after the procedure, reducing the risk of complications such as infection or injury. Therefore, not including the soiled sponges used for prep in the count would be considered unacceptable.

A blood warmer is used to maintain a temperature range of 89-105F. This is important because blood needs to be kept at a specific temperature to ensure its effectiveness and safety during transfusions or other medical procedures. If the blood is too cold, it can cause complications such as hypothermia or clotting. On the other hand, if the blood is too warm, it can lead to the destruction of red blood cells and other negative effects. Therefore, a blood warmer is used to regulate and maintain the optimal temperature for blood.

A sponge that is cotton-filled gauze with a cotton thread attached is called a tonsil.

The ilium is a common donor site for an autogenous bone graft. Autogenous bone graft refers to using the patient's own bone from another part of their body to repair or replace damaged bone in a different area. The ilium, which is part of the pelvis, is often chosen as a donor site because it provides a good amount of bone that can be easily accessed and harvested. Additionally, the ilium has a good blood supply, which promotes successful graft integration and healing.

The range of focal lengths of the objective lenses in the operating microscope is 100-400 mm. This means that the microscope has a variety of lenses that can be used depending on the specific needs of the procedure. The range allows for flexibility in adjusting the magnification and focus, ensuring clear and precise visualization of the surgical field. Lenses with shorter focal lengths are used for higher magnification, while lenses with longer focal lengths are used for lower magnification but a wider field of view. This range covers a wide range of surgical procedures, making it a suitable choice for various applications.

Stereotactic surgery is a precise surgical technique that involves the use of a three-dimensional coordinate system to locate and target specific areas within the brain. This procedure is commonly used to treat various neurological conditions such as tumors, Parkinson's disease, and epilepsy. By accurately navigating through the brain, surgeons can minimize damage to surrounding healthy tissue and improve patient outcomes. Therefore, it is clear that stereotactic surgery takes place in the brain.

The shoulder bridge can aid in operative accessibility in thyroid surgery. This device helps to elevate the patient's shoulders, allowing for better access to the surgical site. By lifting the shoulders, it creates more space and improves the surgeon's ability to maneuver and perform the procedure effectively. This can enhance visibility and precision during thyroid surgery, ultimately leading to better outcomes for the patient.

A radiant warmer would be found in a cesarean section procedure. A cesarean section is a surgical procedure in which a baby is delivered through an incision in the mother's abdomen and uterus. A radiant warmer is a device used to provide heat to newborn babies to maintain their body temperature. In a cesarean section, the baby may require additional warmth after delivery, and a radiant warmer would be used for this purpose.

A secondary video monitor is referred to as a "slave" because it is connected to and controlled by the primary or "master" video monitor. The slave monitor displays the same content as the master monitor and does not have independent control or functionality.

Disposable chest drainage units are used to provide drainage collection from the intrapleural space, maintain a seal to prevent air from entering the pleural cavity, and provide suction control determined by water-level. However, they do not aid in re-establishing positive pressure in the intrapleural space.

Universal precautions refer to a set of infection control practices that healthcare workers follow to prevent the transmission of diseases. This includes the use of personal protective equipment such as gloves, masks, and goggles to protect the skin, eyes, and mucous membranes from exposure to surgical smoke when using a laser. Universal precautions are considered the best way to minimize occupational exposure to surgical smoke, as they provide comprehensive protection against various infectious agents present in the smoke. Charcoal filters, copper shields, and standard suction may have limited effectiveness in reducing exposure to surgical smoke and are not as comprehensive as universal precautions.

Suspension microlaryngoscopy is the correct answer because it describes the procedure that uses a self-retaining laryngoscope and microscope. This procedure involves suspending the patient's larynx using a suspension system, which allows for better visualization and access to the larynx for examination or surgery. It is commonly used for diagnostic purposes or to remove lesions or growths in the larynx.

Moistened drapes are not typically used as a measure to control the effects of the laser plume. Smoke evacuators, suctions, and high filtration masks are commonly used to remove or filter the laser plume, which consists of smoke, particles, and potentially harmful gases, from the surgical environment. Moistened drapes, on the other hand, are used to create a sterile barrier or maintain a moist environment during surgery, but they do not directly address the control of laser plume.

A dissecting sponge made of gauze that is used to dissect or absorb fluid is called a peanut. This term is commonly used in medical settings to refer to a small, absorbent sponge that is often shaped like a peanut. It is used during surgical procedures to absorb excess fluids and keep the surgical site clean and dry. The term "peanut" is derived from its shape, which resembles that of a peanut.

The Lukens tube is commonly used for collecting bronchial washings. It is a flexible tube that is inserted into the bronchial tree to obtain samples of fluid or mucus for diagnostic purposes. The other options mentioned (Broyles, Ellik, and Toomey) are not specifically designed for collecting bronchial washings.

A common size chest tube is typically 30 Fr. "Fr" stands for French, which is a unit of measurement used for the diameter of medical devices. The larger the Fr number, the larger the diameter of the tube. A 30 Fr chest tube is commonly used for draining fluid or air from the chest cavity, such as in cases of pneumothorax or pleural effusion.

The operating microscope that visually employs fiberoptics for its light source is coaxial illuminators. Coaxial illuminators are designed with a fiber optic bundle that allows the light to be transmitted directly through the microscope's objective lens. This design provides a more focused and uniform illumination, allowing for better visualization during surgical procedures. The use of fiberoptics also helps to minimize heat generation, making it a safer option for delicate procedures.

The Fogarty catheter is specifically designed for the removal of small gallstones. This type of catheter has a balloon at its tip that can be inflated to grip and remove the gallstones from the gallbladder or bile duct. The balloon is deflated once the stones are extracted. The other options, T-tube, Robinson, and Rehfus catheters, do not have the same functionality and are not suitable for this purpose.

TPN stands for Total Parenteral Nutrition, which is a method of providing nutrition to patients who are unable to eat or digest food normally. It involves delivering a balanced mixture of nutrients directly into the bloodstream through a central venous catheter. TPN is used when the digestive system is not functioning properly or when the patient cannot consume food orally. Therefore, the correct answer is that TPN maintains the patient's nutrition by providing essential nutrients directly into the bloodstream.

Tincture of benzoin is used as a protective skin coating because it forms a thin film on the skin that helps protect against irritants and friction. It also has antiseptic properties, which can help prevent infection. Additionally, tincture of benzoin has a mild adhesive effect, which can help keep dressings or bandages in place.

Ebonization refers to the process of coating instruments to decrease their reflectivity. This coating helps to reduce glare and improve visibility during surgical procedures. By decreasing reflectivity, ebonization enhances the contrast and clarity of the surgical field, allowing surgeons to perform procedures with greater precision. This technique is commonly used in various medical specialties, such as ophthalmology and neurosurgery, where clear visualization is crucial for successful outcomes.

A Minerva jacket is a type of cast that is applied from the hips to the head in order to immobilize cervical fractures. It provides support and stability to the neck and upper body, preventing any movement that could further injure the cervical spine. This type of cast is specifically designed to restrict motion in the neck and upper spine, allowing the fracture to heal properly.

Sequential pneumatic compression boots are a motorized device that applies intermittent pressure to the legs, promoting blood flow and preventing venous stasis. This action reduces the risk of deep-vein clotting, making them beneficial for high-risk patients. Unlike the other options, such as the pneumatic antishock garment or military antishock trousers, which are used for different purposes, sequential pneumatic compression boots specifically target the prevention of venous stasis and clotting. TED stockings, on the other hand, are non-motorized compression stockings that provide a static level of compression and may not be as effective in reducing the risk of deep-vein clotting.

Wearing clear glass or plastic glasses with side guards can protect people from cormeal injuries caused by CO2 laser impact. These glasses provide a physical barrier that prevents the laser from directly reaching the eyes. The side guards also offer additional protection by blocking any stray laser beams that may come from the sides. Amber-tinted lenses and green-tinted lenses do not provide the same level of protection as clear glass or plastic glasses with side guards. Looking away from the energy source may reduce the risk of direct exposure, but it does not offer sufficient protection against potential laser beams that can still reach the eyes.

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The purpose of the "slit" lamp in eye surgery is to define depth perception. This instrument uses a narrow beam of light to create a thin, vertical slit that allows the doctor to examine the different layers of the eye in detail. By observing the depth and position of various structures within the eye, the surgeon can accurately assess any abnormalities or conditions that may require treatment.

A Pezzer is a type of catheter known as a mushroom catheter. It is named after its shape, which resembles a mushroom. This type of catheter is used for drainage or irrigation of a body cavity, such as the bladder or the rectum. The mushroom-shaped end of the catheter helps to secure it in place and prevent it from slipping out.

The placement of a Levin tube would be in the stomach. A Levin tube is a soft, flexible tube that is inserted through the nose or mouth and down into the stomach. It is used for various purposes, such as decompressing the stomach, administering medications or nutrients, or removing gastric contents. The stomach is the correct placement for a Levin tube because it allows for direct access to the stomach and its contents.

Ebonized instruments, anodized instruments, and reflective drapes are all measures employed to reduce laser-induced injuries because they are non-reflective and absorb or disperse laser energy. Plastic vaginal and rectal speculums, on the other hand, are not specifically designed to reduce laser-induced injuries.

A central venous catheter is typically inserted into the external jugular vein. This vein is located on the side of the neck, near the surface of the skin, making it easily accessible for insertion of the catheter. The external jugular vein is a large vein that provides direct access to the central circulation, allowing for the administration of fluids, medications, and monitoring of central venous pressure. Additionally, the external jugular vein is less prone to complications compared to other veins, such as the femoral vein, making it a preferred choice for central venous catheterization.

MAST stands for Military Anti-Shock Trousers, which are a device used to correct and counteract internal bleeding conditions and hypovolemia. These trousers apply pressure to the lower body, specifically the legs and abdomen, to help control bleeding and increase blood flow to vital organs. MAST is commonly used in emergency situations and trauma care to stabilize patients and prevent further blood loss.

Extracorporeal circulation refers to the process of circulating blood outside of the body. This means that the blood is not flowing through the natural circulatory system within the body, but rather through an external device or system. This can be done during certain medical procedures, such as open-heart surgery, where the blood is diverted away from the heart and lungs to a heart-lung machine that oxygenates and pumps the blood back into the body. This allows the surgeon to temporarily stop the heart and perform necessary interventions while maintaining blood flow and oxygenation to the rest of the body.

A stent can be used for both long-term and temporary ureteral drainage. It is a tube-like device that is inserted into the ureter to help keep it open and allow urine to flow freely. Stents are often used after surgeries or procedures to prevent blockages or strictures in the ureter. They can be left in place for a short period of time or for a longer duration depending on the patient's needs. Stents are a common and effective method for maintaining ureteral drainage.

After a transurethral resection (TUR) of the prostate, a 30-cc bag Foley is used for hemostasis. This is because TUR of the prostate involves removing tissue from the prostate gland, which can cause bleeding. The 30-cc bag Foley helps to control bleeding by applying pressure to the surgical site, promoting clot formation and preventing further bleeding. It is important to maintain hemostasis after TUR to prevent complications such as excessive bleeding or clot formation.

A dressing that is held in place by long suture ends crisscrossed and tied is called a stent. A stent is a medical device that is used to support or hold open a tubular structure, such as a blood vessel or an airway. In this context, the suture ends are used to secure the stent in place, providing stability and preventing it from moving or shifting. This technique is commonly used in surgical procedures to ensure proper healing and support of the affected area.

The correct answer is ruby. Ruby lasers are commonly used for port-wine stain lessons of the skin. These lasers emit a red light with a wavelength that is absorbed by the pigmented cells in the skin, causing them to heat up and break apart. This helps to reduce the appearance of the port-wine stain and improve the overall appearance of the skin. Other lasers, such as argon, krypton, and yttrium aluminum garnet (YAG), may have different applications in dermatology, but they are not typically used for port-wine stain treatments.

A Sengstaken-Blakemore tube may be used in a patient with a rupture of esophageal varices to control bleeding. This tube is a type of gastric balloon tamponade device that can be inserted into the esophagus and stomach to apply pressure and stop bleeding. It consists of two balloons - one that is inflated in the esophagus to compress the varices and another that is inflated in the stomach to hold the tube in place. This intervention can be life-saving in cases of severe bleeding from esophageal varices.

A blood filter is the most necessary item for a blood transfusion. During a transfusion, the blood needs to be filtered to remove any impurities or clots that may be present. This ensures that the blood being transfused is clean and safe for the patient. Without a blood filter, there is a risk of complications or adverse reactions occurring during the transfusion. Therefore, a blood filter is essential to ensure the safety and effectiveness of the blood transfusion procedure.

Stockinette is a type of seamless tubular cotton fabric that is known for its ability to stretch and conform to different contours. It is commonly used for padding in various applications, such as in medical bandages or protective gear. Stockinette provides a comfortable and secure fit, making it an ideal choice for providing cushioning and support. Webril and sheet wadding are also materials used for padding, but they do not have the same stretch and contouring properties as stockinette. Ace bandage, on the other hand, is a specific type of bandage that is not made of cotton and does not stretch to fit contours.

Skin closure tapes can be a supplement to a subcuticular closure. Subcuticular closure is a technique used to close a surgical incision by suturing the deeper layers of tissue. However, skin closure tapes can be applied to the surface of the skin to provide additional support and secure the edges of the incision. These tapes are often used in conjunction with sutures to enhance wound healing and minimize tension on the incision site.

A choledochoscopy is a procedure that involves examining the bile ducts using a special instrument called an endoscope. During this procedure, normal saline is often used to flush the bile ducts for better visualization. The sterile IV tubing is used to administer the saline solution, while the IV pole is used to hold the bag of saline and the pressure bag is used to regulate the flow of the solution. Therefore, the setup described in the question is most appropriate for a choledochoscopy.

The correct answer is "candela" because it is a unit of measurement for the intensity of light. A tunable dye laser is used in the process of extracorporeal shock wave lithotripsy (ESWL) to disintegrate kidney stones. The laser emits high-intensity light pulses that are focused on the kidney stones, causing them to break up into smaller pieces. Therefore, the use of a candela laser in ESWL is an effective method for treating kidney stones.

A Hickman catheter is a type of central venous catheter that is specifically designed for the infusion of chemotherapeutic drugs. It is inserted into a large vein, typically the jugular vein, and remains in place for an extended period of time. The Hickman catheter has multiple lumens, allowing for the administration of medications and fluids simultaneously. It is often used in cancer patients who require long-term chemotherapy treatment, as it provides a reliable and convenient access point for drug administration.

A Tenckhoff catheter is commonly used for peritoneal dialysis, not chemotherapy administration. It is a type of indwelling catheter that is inserted into the peritoneal cavity to allow for the exchange of fluids during dialysis. This catheter has a curl or pigtail at the end to prevent it from slipping out of place. It is not designed or recommended for chemotherapy administration, as there are specific catheters designed for that purpose.

The answer "10:1" suggests that the radiation exposure in fluoroscopy is 10 times higher compared to that of a single x-ray. This means that during fluoroscopy, a person is exposed to a significantly higher amount of radiation than when they undergo a single x-ray procedure. This information highlights the potential risks associated with fluoroscopy and the importance of minimizing unnecessary exposure to radiation.

Porcine refers to something that is derived from or related to pigs. In the context of a temporary biologic dressing, porcine likely refers to a dressing made from pig-derived materials. This could include pig skin or other tissues that are used to create a dressing that can be applied to wounds or burns. Porcine dressings are often used in medical settings due to their biocompatibility and ability to promote wound healing.

Argon laser emission is primarily absorbed in tissue by hemoglobin or melanin. This is because argon lasers emit blue-green light, which is in the range of wavelengths that are absorbed by these pigments. Hemoglobin, found in red blood cells, absorbs light in the blue spectrum, while melanin, found in skin and hair, absorbs light in the green spectrum. Therefore, argon lasers are commonly used in medical and cosmetic procedures that target blood vessels or pigmented lesions.

The polyvinyl chloride (PVC) tube is contraindicated during laser surgery because PVC is a flammable material that can ignite when exposed to the laser beam. This can cause a fire hazard and potentially harm the patient. Therefore, it is important to use alternative materials that are non-flammable, such as a flexible metal tube with an external cuff attached or a red rubber tube wrapped with reflecting tape, or to use a commercial laser endotracheal (ET) tube specifically designed for laser procedures.

An image intensifier is a device that enhances the intensity of an image, typically used in medical imaging. It does not refer to an x-ray machine or a microscope, but rather converts the x-ray beam into a fluoroscopic optical image. This means that it takes the incoming x-ray beam and converts it into a visible image that can be viewed in real-time, allowing for better visualization and diagnosis of medical conditions. It does not convert an x-ray image into film, as that would be the function of a traditional x-ray film.

When a sponge is intentionally left in a patient during a surgical procedure, a notation is placed on the operative record. This is done to ensure that there is a clear and documented record of the incident. The notation serves as a reminder for future medical professionals who may be involved in the patient's care, and it helps to prevent similar mistakes from happening again. It also provides important information for legal and liability purposes. Making a report to the supervisor and completing an incident report may also be necessary actions, but the notation on the operative record is specifically related to the incident of the sponge being left in the patient.

The correct answer is argon. Argon laser is commonly used for treating retinal detachment, tears, or holes. It is preferred due to its ability to deliver precise and controlled laser energy to the retina. The argon laser produces a blue-green light that is well-absorbed by the pigmented cells in the retina, allowing for targeted treatment. This laser is effective in sealing retinal tears and creating scar tissue to reattach the retina, preventing further detachment.

When laser surgery is performed in the rectal area, it is important to suction the lower bowel to remove methane gas. Methane gas can be present in the rectal area and can be flammable, posing a risk during laser surgery. Suctioning the lower bowel helps to remove this gas and reduce the risk of any potential fire or explosion hazards. Packing the rectum with dry, counted sponges may be done for other reasons, but it is not specifically related to the removal of methane gas. Therefore, the correct answer is suctioning of lower bowel to remove methane gas.

The correct answer is elastoplast. Elastoplast is an elastic adhesive bandage that is commonly used for supporting and protecting sprains, strains, and other injuries. It is made of a stretchable fabric that allows for flexibility and movement while providing compression and stability to the affected area. Elastoplast bandages are easy to apply and can be cut to the desired length, making them suitable for various body parts. They are also water-resistant and durable, making them ideal for long-term use.

The Pezzar catheter is a type of ureteral catheter tip, so it is not the correct answer. The other options listed (whistle, olive, and Braasch bulb) are all types of ureteral catheter tips.

Balloon angioplasty is a procedure used to open blocked or narrowed blood vessels. It involves the use of a catheter with a balloon at its tip. The balloon is inflated to widen the vessel and improve blood flow. Gruntzig is the correct answer because Andreas Gruntzig was the pioneer who developed and introduced balloon angioplasty in the late 1970s. The procedure is commonly referred to as "Gruntzig angioplasty" or "percutaneous transluminal coronary angioplasty" (PTCA) in his honor.

The given options suggest various measures to prevent heat loss in newborns or children in the operating room. However, the option "hypothermia blanket is prepared" does not align with the objective of preventing heat loss. Instead, preparing a hypothermia blanket would imply preparing a blanket that induces hypothermia, which is the opposite of what is desired. Therefore, this option is the exception among the given measures.

A laminaria tent is a medical device made of dried seaweed that is inserted into the cervix to gradually and gently dilate it. This is typically done before certain medical procedures such as dilation and curettage (D&C) or abortion. The tent absorbs moisture from the cervix, causing it to swell and expand, which helps to open up the cervix and make it easier for instruments to be inserted into the uterus. Therefore, the correct answer is "dilate cervix."

Prolene may be used in the presence of infection because it is a synthetic mesh that is resistant to infection. It is made from polypropylene, which has a low risk of harboring bacteria and is less likely to cause an immune response. This makes Prolene a suitable option for patients who have an infection at the surgical site and need a mesh implant. Gore-tex and Mersilene, on the other hand, are not recommended in the presence of infection as they have a higher risk of complications in such cases.

Mersilene mesh can be steam sterilized once, if unused but not soiled. This means that if the mesh has not been used and is free from any dirt or contamination, it can undergo steam sterilization. However, it cannot be resterilized after the initial sterilization process. It is important to note that if the mesh is soiled or contaminated, it cannot be sterilized and should be discarded.

A roentgenogram is the correct term for an x-ray's photographic image. The term "roentgenogram" is derived from the name of Wilhelm Conrad Roentgen, the German physicist who discovered x-rays in 1895. It is commonly used in medical imaging to refer to the image produced by exposing a patient to x-rays and capturing the resulting image on a photographic film or digital sensor. The term "ultrasound wave" refers to a different imaging modality that uses sound waves, while "magnetic image" and "computerized tomography" are not specific to x-rays.

The Hegar dilator is not used for urethral dilation. Hegar dilators are typically used for cervical dilation during gynecological procedures. Urethral dilation is a procedure used to widen the urethra, and it is typically done using instruments such as McCarthy dilators, VanBuren sounds, or Phillips filiform and followers.

The risks of cone biopsy are minimized by using the CO2 laser because it offers precise and controlled tissue ablation. The laser beam can be easily manipulated to remove the abnormal tissue while minimizing damage to surrounding healthy tissue. Additionally, the CO2 laser provides excellent hemostasis, reducing the risk of bleeding during the procedure. This makes it a safer option compared to other tools like the cervitome or cold knife, which may cause more tissue trauma and bleeding.