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Questions and Answers
What is the purpose of using Raney clips during neurosurgery?
What is the purpose of using Raney clips during neurosurgery?
Which instrument is primarily used for creating a burr hole in the skull?
Which instrument is primarily used for creating a burr hole in the skull?
What is a critical consideration when performing neurosurgery regarding the patient's positioning?
What is a critical consideration when performing neurosurgery regarding the patient's positioning?
In which scenario would a free flap be preferred over a pedicle flap?
In which scenario would a free flap be preferred over a pedicle flap?
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Which hemostatic agent is known for being radiopaque and marked with strings for identification?
Which hemostatic agent is known for being radiopaque and marked with strings for identification?
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What is the primary purpose of the menisci in the knee joint?
What is the primary purpose of the menisci in the knee joint?
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Which ligament is most frequently torn in the knee?
Which ligament is most frequently torn in the knee?
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What common surgical procedure involves replacing worn surfaces of the knee?
What common surgical procedure involves replacing worn surfaces of the knee?
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What should be confirmed with the surgical team before performing a total knee replacement?
What should be confirmed with the surgical team before performing a total knee replacement?
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What is the primary role of the anterior cruciate ligament in the knee?
What is the primary role of the anterior cruciate ligament in the knee?
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Which component is commonly used as a graft for ACL repairs?
Which component is commonly used as a graft for ACL repairs?
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What is essential about knee prostheses during surgery?
What is essential about knee prostheses during surgery?
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What hormone is produced by the parathyroid gland to regulate calcium?
What hormone is produced by the parathyroid gland to regulate calcium?
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Which structures are found in the middle ear that amplify sound?
Which structures are found in the middle ear that amplify sound?
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What is a common diagnosis for performing Total Knee Arthroplasty?
What is a common diagnosis for performing Total Knee Arthroplasty?
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What is the primary function of a pneumatic tourniquet during surgical procedures?
What is the primary function of a pneumatic tourniquet during surgical procedures?
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What is an important nursing consideration when using powered surgical instruments?
What is an important nursing consideration when using powered surgical instruments?
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Which of the following statements about pneumatic tourniquet application is correct?
Which of the following statements about pneumatic tourniquet application is correct?
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What is the role of the Kerrison rongeur in surgical procedures?
What is the role of the Kerrison rongeur in surgical procedures?
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For which procedure is the Jackson spinal table primarily used?
For which procedure is the Jackson spinal table primarily used?
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What is a key consideration when passing powered surgical drills to the surgeon?
What is a key consideration when passing powered surgical drills to the surgeon?
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Which of the following practices is recommended for the inflation of pneumatic tourniquets?
Which of the following practices is recommended for the inflation of pneumatic tourniquets?
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Which type of table is utilized for procedures involving femoral neck or shaft fixation?
Which type of table is utilized for procedures involving femoral neck or shaft fixation?
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What is the primary benefit of using external fixation for fractures?
What is the primary benefit of using external fixation for fractures?
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What type of fracture is most commonly associated with elderly women due to osteoporosis?
What type of fracture is most commonly associated with elderly women due to osteoporosis?
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What is the primary risk associated with femoral neck fractures that necessitates reduction before internal fixation?
What is the primary risk associated with femoral neck fractures that necessitates reduction before internal fixation?
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Which fixation method is typically used for intertrochanteric fractures?
Which fixation method is typically used for intertrochanteric fractures?
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What is the purpose of using a Dynamic Hip Screw (DHS) in hip fracture fixation?
What is the purpose of using a Dynamic Hip Screw (DHS) in hip fracture fixation?
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What crucial factor must be addressed when performing internal fixation on femoral neck fractures?
What crucial factor must be addressed when performing internal fixation on femoral neck fractures?
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What instrumentation is recommended for stable fixation of femoral neck fractures?
What instrumentation is recommended for stable fixation of femoral neck fractures?
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Which of the following is used in total hip arthroplasty (THA) for unstable femoral neck fractures?
Which of the following is used in total hip arthroplasty (THA) for unstable femoral neck fractures?
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What type of incision is made during open reduction and internal fixation (ORIF) to correct a fracture?
What type of incision is made during open reduction and internal fixation (ORIF) to correct a fracture?
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Why are lead gowns worn by all OR personnel during procedures involving fixation?
Why are lead gowns worn by all OR personnel during procedures involving fixation?
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What is the purpose of packing the nasal cavity with patties soaked in vasoconstrictor solution during rhinologic surgeries?
What is the purpose of packing the nasal cavity with patties soaked in vasoconstrictor solution during rhinologic surgeries?
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Which of the following is a contraindication for using chlorhexidine in surgical preparation for laryngeal surgeries?
Which of the following is a contraindication for using chlorhexidine in surgical preparation for laryngeal surgeries?
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What is an indication for performing a tympanoplasty?
What is an indication for performing a tympanoplasty?
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What is the primary goal of Functional Endoscopic Sinus Surgery (FESS)?
What is the primary goal of Functional Endoscopic Sinus Surgery (FESS)?
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During a radical neck dissection, which of the following structures is typically NOT removed?
During a radical neck dissection, which of the following structures is typically NOT removed?
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In what situation is a tracheostomy most commonly indicated?
In what situation is a tracheostomy most commonly indicated?
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Which instrument is specifically used for manipulating tissue back into place during ear surgeries?
Which instrument is specifically used for manipulating tissue back into place during ear surgeries?
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What is the initial patient position recommended for most head and neck surgeries?
What is the initial patient position recommended for most head and neck surgeries?
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What is the recommended method to test a cuff for leaks during tracheostomy preparation?
What is the recommended method to test a cuff for leaks during tracheostomy preparation?
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Which layer is NOT involved in the initial dissection during neurosurgery?
Which layer is NOT involved in the initial dissection during neurosurgery?
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What is a critical consideration when using pneumatic tourniquets during surgery?
What is a critical consideration when using pneumatic tourniquets during surgery?
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What is a key purpose of the powered surgical instruments, particularly drills, in orthopedic procedures?
What is a key purpose of the powered surgical instruments, particularly drills, in orthopedic procedures?
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Which of the following statements best describes the role of the Kerrison rongeur?
Which of the following statements best describes the role of the Kerrison rongeur?
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When operating the C-Arm during surgery, what is an important precaution for the surgical team?
When operating the C-Arm during surgery, what is an important precaution for the surgical team?
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What precaution must be taken regarding powered surgical drills when passing them to the surgeon?
What precaution must be taken regarding powered surgical drills when passing them to the surgeon?
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What is an appropriate maximum inflation pressure for pneumatic tourniquets applied to the thigh?
What is an appropriate maximum inflation pressure for pneumatic tourniquets applied to the thigh?
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What is the primary function of an external fixation device in orthopedic surgery?
What is the primary function of an external fixation device in orthopedic surgery?
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What potential risk is associated with accidentally activating a powered surgical drill in the operating room?
What potential risk is associated with accidentally activating a powered surgical drill in the operating room?
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What is a key advantage of using external fixation for fractures?
What is a key advantage of using external fixation for fractures?
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What type of fracture often leads to avascular necrosis if not properly managed?
What type of fracture often leads to avascular necrosis if not properly managed?
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Which method is typically employed for stable fixation of femoral neck fractures?
Which method is typically employed for stable fixation of femoral neck fractures?
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What is the primary tool used during a surgical procedure for placing a dynamic hip screw?
What is the primary tool used during a surgical procedure for placing a dynamic hip screw?
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In which scenario would Total Hip Arthroplasty be indicated for a femoral neck fracture?
In which scenario would Total Hip Arthroplasty be indicated for a femoral neck fracture?
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What is the primary benefit of open reduction during an ORIF procedure?
What is the primary benefit of open reduction during an ORIF procedure?
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Which condition is particularly associated with intertrochanteric fractures in elderly women?
Which condition is particularly associated with intertrochanteric fractures in elderly women?
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What type of fixation is typically used for intertrochanteric fractures due to their stable blood supply?
What type of fixation is typically used for intertrochanteric fractures due to their stable blood supply?
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What is an essential step in fixation of femoral neck fractures due to the compromised blood supply?
What is an essential step in fixation of femoral neck fractures due to the compromised blood supply?
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What is one of the essential goals a dressing should accomplish in burn surgery?
What is one of the essential goals a dressing should accomplish in burn surgery?
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What is a significant disadvantage of using a Split Thickness Skin Graft (STSG)?
What is a significant disadvantage of using a Split Thickness Skin Graft (STSG)?
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Which procedure involves the removal of the lens without its capsule?
Which procedure involves the removal of the lens without its capsule?
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What condition primarily results from the clouding of the lens in the eye?
What condition primarily results from the clouding of the lens in the eye?
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Which characteristic distinguishes Full Thickness Skin Grafts (FTSG) from Split Thickness Skin Grafts (STSG)?
Which characteristic distinguishes Full Thickness Skin Grafts (FTSG) from Split Thickness Skin Grafts (STSG)?
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What is a primary indication for performing a tympanoplasty?
What is a primary indication for performing a tympanoplasty?
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During which surgical procedure is it critical to ensure adequate drainage of the sinuses?
During which surgical procedure is it critical to ensure adequate drainage of the sinuses?
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What is the purpose of applying lidocaine topically over the larynx during laryngeal surgeries?
What is the purpose of applying lidocaine topically over the larynx during laryngeal surgeries?
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In a radical neck dissection, which structure is typically considered optional for removal depending on the extent of the malignancy?
In a radical neck dissection, which structure is typically considered optional for removal depending on the extent of the malignancy?
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Which positioning is specifically recommended for tracheostomy procedures?
Which positioning is specifically recommended for tracheostomy procedures?
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What is a commonly avoided antiseptic solution in otologic surgeries due to its ototoxic properties?
What is a commonly avoided antiseptic solution in otologic surgeries due to its ototoxic properties?
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Which of the following accurately describes the purpose of the minor counts performed during head and neck surgeries?
Which of the following accurately describes the purpose of the minor counts performed during head and neck surgeries?
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What is the primary purpose of using absorbable sutures in surgical closures?
What is the primary purpose of using absorbable sutures in surgical closures?
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What surgical equipment is specifically utilized for manipulating tissue back into place during ear surgeries?
What surgical equipment is specifically utilized for manipulating tissue back into place during ear surgeries?
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What is a critical consideration before performing a radical neck dissection?
What is a critical consideration before performing a radical neck dissection?
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What is the primary focus of the treatment for a meniscal tear in the knee?
What is the primary focus of the treatment for a meniscal tear in the knee?
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Which component of the knee is most frequently injured due to sports activities?
Which component of the knee is most frequently injured due to sports activities?
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What does Total Knee Arthroplasty (TKA) aim to improve for the patient?
What does Total Knee Arthroplasty (TKA) aim to improve for the patient?
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Why is it crucial to select the correct sided implant before a total knee replacement?
Why is it crucial to select the correct sided implant before a total knee replacement?
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When performing arthroscopic anterior cruciate ligament repair, what is a common method used?
When performing arthroscopic anterior cruciate ligament repair, what is a common method used?
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What anatomical structures are included in the middle ear?
What anatomical structures are included in the middle ear?
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What is the consequence of high levels of parathyroid hormone (PTH) in the blood?
What is the consequence of high levels of parathyroid hormone (PTH) in the blood?
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What characterizes the role of the anterior cruciate ligament in the knee?
What characterizes the role of the anterior cruciate ligament in the knee?
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Which surgical procedure focuses primarily on correcting nasal cavity issues?
Which surgical procedure focuses primarily on correcting nasal cavity issues?
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Study Notes
Orthopedic Surgery Essentials
- Grafts require stabilization with orthopedic hardware (wires/screws) as they do not fuse independently.
-
Instruments:
- Kerrison Rongeur: Grasp and resect lamina bone.
- Pituitary Rongeur: Grasping and removing the intervertebral disc.
Equipment Usage and Nursing Considerations
-
Powered Surgical Instruments (Drills):
- Ensure drills are not in contact with the patient/drapes to prevent injury.
- Safety lock must be engaged when not in use; accidental activation can lead to contamination.
- Test instruments before handling them to the surgeon.
- Verify the correct cord is attached and state size when passing instruments.
Surgical Tables in Orthopedics
- Fracture Table: Used for femoral neck or shaft fixation.
- Jackson Spinal Table: Designed for prone spinal surgeries.
-
Radiography:
- C-Arm provides fluoroscopy during procedures, used by the surgeon or x-ray technician.
- All personnel must wear X-ray lead gowns for protection.
Pneumatic Tourniquets
- Utilized to create a bloodless surgical field in extremity procedures.
- Inflation pressures based on the patient's systolic blood pressure, age, and extremity size.
- Recommended max inflation: 250-300 mmHg for arms, 300-350 mmHg for thighs.
- Cuff inflation duration: 60 minutes for upper, 120 minutes for lower extremities, documented meticulously.
Open Reduction and Internal Fixation (ORIF)
- ORIF applied when fractures cannot be fixed with closed methods, especially for long bones and hips.
- Internal fixation provides direct view and anatomical alignment through skin incision.
Types of Hip Fractures
-
Intertrochanteric Fractures:
- Common in elderly women.
- Fixated using plates and screws; blood supply remains intact.
- Utilizes a Dynamic Hip Screw for stabilization.
-
Femoral Neck Fractures:
- Requires reduction before fixation due to the risk of nonunion.
- Can be fixed with internal fixation using cannulated screws or total hip arthroplasty (THA) if unstable.
Knee Injuries
- Most common injuries include torn medial collateral, medial meniscus, and anterior cruciate ligament.
- Meniscal Tear Repair: Involves arthroscopic resection and repair.
- ACL Repair: Typically uses a patellar tendon graft for reconstruction.
Total Knee Arthroplasty (TKA)
- A surgical procedure to replace worn knee surfaces, primarily due to arthritis.
- Supports joint mobility and stability; requires precise implant selection.
Otolaryngology (ENT) Surgery
- Middle ear consists of tympanic membrane, ossicles, and Eustachian tube.
- Thyroid and parathyroid glands regulate hormones and calcium levels in the blood.
Tympanoplasty and FESS
- Tympanoplasty: Repairs tympanic membrane, indicated for conductive hearing loss.
- FESS: Involves endoscopic surgery for sinus issues; improves sinus drainage.
Radical Neck Dissection
- Involves removal of malignant head and neck tissues, including lymph nodes and surrounding structures.
- Requires tracheostomy prior to dissection for airway management.
Neurosurgery
- Dissection Layers: Include skin, galea, pericranium, skull, and dura.
- Counts: Minor counts are mandatory throughout the procedure (initial, dura, final).
Nursing Considerations in Neurosurgery
- Proper padding and securing of patients essential during long surgeries.
- Common positions: supine, lateral, or prone.
Plastic Surgery Techniques
- Dermatomes: For harvesting split-thickness skin grafts.
-
Flaps:
- Pedicle Flaps: Maintain original blood supply.
- Free Flaps: Require reanastomosis of blood vessels, often needing a two-team approach.
Orthopedic Procedures
- Grafts require stabilization with orthopedic hardware (wires/screws) as they do not fuse independently.
- Instruments such as Kerrison and Pituitary Rongeurs are used for handling lamina bone and intervertebral discs respectively.
Surgical Equipment and Considerations
-
Powered Surgical Instruments (Drills):
- Ensure drills do not rest on the patient or drapes to prevent accidental activation.
- Safety locks must be engaged when not in use; test all equipment before handing to the surgeon.
-
Operating Room Tables:
- Fracture Table is utilized for femoral neck or shaft fixation; Jackson Spinal Table is used for prone spinal surgeries.
- C-Arm provides crucial fluoroscopy during orthopedic procedures, requiring all personnel to wear lead gowns.
Pneumatic Tourniquets
- Employed in extremity procedures to achieve a bloodless field, enhancing visualization.
- Inflation pressure should align with the patient's systolic blood pressure; recommended limits are 250-300 mmHg for arms, 300-350 mmHg for thighs.
- Cuff inflation times are limited to 60 minutes for upper and 120 minutes for lower extremities, with documented inflation timings.
Open Reduction and Internal Fixation (ORIF)
- Utilized when fractures cannot be corrected through closed methods.
- Involves metal plates, screws, and nails for stabilization of fractures, particularly in long bones and hips.
Hip Fracture Fixation
-
Intertrochanteric Fractures:
- Common in elderly women; fixable with plates and screws as the blood supply remains intact.
-
Femoral Neck Fractures:
- Require reduction before internal fixation due to compromised blood supply; may utilize cannulated screws or result in Total Hip Arthroplasty (THA).
Knee Injuries and Surgeries
- Torn medial collateral, medial meniscus, and anterior cruciate ligaments are prevalent knee injuries.
-
Arthroscopic Resection and Repair:
- Meniscus tears are common injuries requiring preservation of knee structures.
-
Anterior Cruciate Ligament Repair:
- Most frequently torn ligament; often involves patellar tendon graft for replacement.
Total Knee Arthroplasty (TKA)
- Used to replace worn knee surfaces, commonly due to arthritis.
- Aims to improve mobility and joint stability. Knee prostheses should be specific for left or right sides.
Otolaryngology (ENT) Surgery
- Middle ear components include the tympanic membrane and ossicles, essential for sound amplification.
- Thyroid and parathyroid glands play significant roles in regulation of hormones and calcium.
Surgical Procedures in ENT
-
Tympanoplasty:
- Repair of tympanic membrane; indicated for conductive hearing loss.
-
Functional Endoscopic Sinus Surgery (FESS):
- Targets inflammatory sinus conditions by resecting tissue to enhance drainage.
-
Radical Neck Dissection:
- Involves removal of malignant tissues and requires tracheostomy for airway management.
Neuro Surgery and Burn Surgery
- Neuro surgery involves careful dissection, usually with a small skin incision.
- For burn surgeries, maintaining a warm environment is critical to prevent hypothermia; dressings serve multiple purposes, including immobilization and comfort.
Skin Grafts in Burn Surgery
-
Split Thickness Skin Graft (STSG):
- Comprises epidermis and part of dermis, heals quickly but can lead to long-term contractures.
-
Full Thickness Skin Graft (FTSG):
- Contains both layers, provides better aesthetic results with minimized contracture, though the donor site cannot be reused.
Ophthalmology: Cataracts
- Cataracts refer to the clouding of the lens, leading to vision impairment.
- Cataract Surgery involves either an extracapsular or intracapsular extraction, both aimed at removing the opaque lens from the eye.
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Description
Test your knowledge of various surgical instruments and their purposes. This quiz covers essential equipment used in surgeries, including bone currettes and powered surgical instruments. Understand the role of different tools in the operating room and important nursing considerations.