Exhaustive Surgical Technology and Anatomy Study Guide

Surgical Anatomy and Physiology

  • Hand and Upper Extremity Anatomy     - Radial Aspect: The anatomical term specifically referring to the thumb side of the hand is radial.     - Metacarpals: These are the bones that comprise the palm of the hand.     - Coronoid Process Attachment: The temporalis muscle is attached to the coronoid process.     - Radial Dysplasia: This is the medical term used to identify the congenital deformity known as "club hand."

  • Head and Neck Anatomy     - Thyroid Cartilage: This structure forms the laryngeal prominence or the "Adam's apple."     - Epiglottis: This structure is classified as an individual elastic cartilage.     - Tonsils and Lymphoid Tissue: Tonsils are composed of lymphoid tissue. Adenoids are clinically referred to as pharyngeal tonsils.     - Mandibular Grafting: The fibula bone is commonly utilized for a mandibular graft.     - Cheekbone Structure: The cheekbones are formed by the zygomatic bones.     - Dental Anatomy: The front teeth are referred to as incisors.

  • Ocular and Otic Anatomy     - Outer Eye Layers: The outermost layer of the eye consists of the cornea and the sclera.     - Posterior Eye Chamber: The vitreous humor is the gel-like substance found in the posterior chamber of the eye. The membrane surrounding the vitreous humor is known as the hyaloid membrane.     - Iris: This is the colored structure of the eye that functions to control light entering the eye.     - Sinuses: The small sinuses located between the eyes are identified as the ethmoid sinuses.     - Arteries and Nerves: Facial nerve compression is a condition that may result in facial twitching.     - External Ear: The pinna and the tragus are anatomical components of the external ear.     - Ceruminous Glands: These glands are responsible for the production of earwax, which is medically termed cerumen.

  • Integumentary and General Systems     - Integumentary System: Skin layers (epidermis and dermis) belong to the integumentary system.     - Lymphoid System: Tonsils are noted to be part of the immune/lymphoid infrastructure.

Obstetrics and Gynecology (OB/GYN)

  • Pregnancy and Labor     - Gravida: This term is used to describe the total number of times a woman has been pregnant.     - Stages of Labor: There are a total of four stages in labor and delivery.     - Dystocia: This term describes difficult labor arising from a mismatch between the size of the fetus and the pelvis.     - Spontaneous Abortion Prevention: Cervical cerclage is a surgical procedure performed to help prevent spontaneous abortion.     - Congenital Deformities: These typically occur during the first (1st) trimester of pregnancy.

  • Anatomy of the Female Reproductive System     - Uterine Support: The largest supporting ligament of the uterus is the broad ligament. The uterosacral ligaments are the last ligaments ligated during an abdominal hysterectomy.     - Non-Supporting Ligament: The Cooper's ligament is NOT a ligament that supports the uterus (it is associated with breast tissue).     - Visualization: Hysteroscopy is the procedure used for the visualization of the uterine lining.

  • Procedures and Clinical Observations     - Hysterectomy: A radical hysterectomy involves the complete removal of the uterus and all related structures.     - C-Section Protocols: The first uterine count in a Cesarean section occurs specifically when the first uterine closure stitch is placed.     - Tubal Procedures: Tubal ligation is performed for the purpose of sterilization. Fine sutures (8-0 or 9-0) are used in tubalplasty procedures. MicromanastimoSIS (tubal reanastimosis) commonly utilizes magnification (loupes).     - Endometrial Ablation: This procedure involves the destruction of endometrial tissue using hot dextrose water.     - Diagnostic Tests: Abnormal cervical tissue shows no color change after the application of Lugol's solution.

Otorhinolaryngology (ENT) and Maxillofacial Surgery

  • Ear Procedures     - Otitis Media: This refers to chronic ear infections that often require the placement of PE (pressure equalizing) tubes.     - Autografts: The most commonly used autograft in ear surgery is the temporalis fascia.     - Drill Motion: The most common drill motion utilized in ear surgery is rotating.     - Complications: A cholesteatoma is a growth that may cause damage to cranial nerve VII (the facial nerve).     - Otoplasty: Costal cartilage grafts may be required for otoplasty repair.

  • Nose and Throat Procedures     - Tracheotomy: This procedure is commonly performed emergently in ICU or ER settings. A spreader and hook are instruments commonly used during a tracheotomy.     - Turbinectomy: A submucosal turbinectomy using rongeurs is classified as the inferior type.     - Nasal Anesthesia: Topical cocaine is frequently used for anesthesia in nasal surgery.     - Oropharyngeal Surgery: A shoulder roll is used to increase exposure during oropharyngeal surgery.     - Oral Surgery Positioning: The common position for oral surgery is supine with the arms tucked at the sides.

  • Maxillofacial Trauma     - Fractures: The most common midface fracture is a LeFort I fracture.     - TMJ Procedures: Temporomandibular Joint (TMJ) procedures involve the lateral jaw region.     - Orthognathic Surgery: This involves splitting the lower jaw into sections.

Ophthalmology (Eye Surgery)

  • Surgical Interventions     - Glaucoma: This condition may be treated surgically with an iridectomy.     - Retinal Tears: Cryotherapy, which utilizes cold, is used to treat retinal tears. Certain gases may also be used to maintain pressure on the retina.     - Lensectomy: A procedure performed in conjunction with a vitrectomy for better visualization is a lensectomy.     - Artificial Implants: Artificial lens implants are referred to as IOL (Intraocular Lens).     - Instrumentation: Keratomes are instruments used specifically to incise the cornea. A colposcope is NOT used for eye visualization (it is a gynecological tool).

Plastic and Reconstructive Surgery

  • Breast Procedures     - Mastopexy: Breast sagging is corrected with a mastopexy. Crescent and Benelli techniques are specific techniques associated with mastopexy. Anchor-shaped incisions are also common in these procedures.     - Augmentation: Breast implants are often placed under the pectoralis major muscle.

  • Facial and Cosmetic Procedures     - Brow Lift: These procedures often involve altering the procerus and corrugator muscles.     - Blepharoplasty: Excess eyelid skin is a condition called dermachalasis. Removing this skin is done using elliptical incisions.     - Abdominoplasty: This procedure functions to tighten the rectus abdominus muscles.     - Liposuction: Tumescent solution is prepared for liposuction procedures. ESU (electrosurgery) is NOT considered a form of liposuction.     - Cleft Lip Repair: This typically uses fine absorbable sutures. Cupid's bow is reconstructed during cleft lip repair surgery.

  • Reconstructive Definitions and Techniques     - Tattooing: A sterile tattoo machine would be required during reconstruction procedures (e.g., nipple/areola reconstruction).     - Syndactyly: This is the medical term for webbed fingers or toes.     - Mohs Surgery: Success rates for Mohs surgery typically reach about 95−97 %95-97\,\%.     - Grants: A graft that maintains its own blood supply is known as a pedicle flap. Split-thickness grafts are often used to cover 3rd-degree burns.     - Debridement: The removal of dead or necrotic tissue is called debridement.     - Craniosynostosis: Endoscopic craniosynostosis repair usually involves two incisions.

Orthopedics and Trauma

  • Surgical Fixation     - Bone Tapping: This process during fixation helps to decrease the torque on screws.     - Plate Fixation Sequence: The correct sequence for plate fixation includes:         1. Placing the plate         2. Drilling         3. Measuring         4. Tapping         5. Inserting screws     - Tendon Attachment: This process typically uses figure-of-8 sutures.

  • Replantation     - Digit Replantation Order: The correct order for digit replantation begins with:         1. Bones         2. Tendons         3. Vessels         4. Nerves

Surgical Instrumentation and Equipment

  • General and Specialized Instruments     - Heaney Needle Holder: A curved needle holder commonly used in hysterectomy procedures.     - Davis and McIvor: These instruments are classified as mouth gags.     - Tischler Forceps: A pistol-grip biopsy instrument used in gynecology.     - Castroviejo: Needle holders commonly used in ophthalmology.     - Jorgenson Scissors: Heavy right-angle scissors used in hysterectomies.     - Rosen Needle: A common name for otologic picks and suction tips.     - Takahashi Forceps: Long nasal forceps.     - Auvard Speculum: A weighted vaginal speculum.     - Graves Speculum: A common vaginal speculum.     - Babcock Forceps: Used to handle fallopian tubes safely.     - Microwipes: Used to clean micro ear instruments.     - Fiber Optic Retractors: Lighted retractors used in plastic surgery.

  • Supplies and Equipment     - Vessel Loops: These are NOT available in the color green.     - Bulb Syringes: Used to suction the mouth and nose of a baby.     - Robotic Surgery: Unique robotic surgery equipment includes the Vision cart.     - Hemostasis: Mineral oil is NOT used for hemostasis.

Surgical Documentation and Classifications

  • Wound Classification     - Class II: Using a uterine manipulator increases the wound classification of a procedure to at least Class II.
  • Imaging     - Panoramic X-ray: A full jaw X-ray view is known as a panoramic view.