Surgical Positioning Flashcards

Study Notes

Surgical Positioning Overview

Supine position: Patient lies on back, useful for anesthesia. Common procedures include mastectomy and laparotomy.
Lateral position: Patient lies on side, ideal for retroperitoneal access. Techniques include thoracotomy and pneumonectomy.
Prone position: Patient lies face down, facilitates spinal access and procedures like achilles tendon repair.
Lithotomy position: Patient on back with legs raised in stirrups for urethral or vaginal access. Example procedures are vaginal hysterectomy and vulvectomy.
Trendelenburg position: Supine with head lower than feet, aids in abdominal organ displacement during cystectomy or thyroidectomy.
Reverse Trendelenburg position: Bed tilted so feet are lower, used for gallbladder visualization during cholecystectomy or splenectomy.
Kraske position: Prone with table flexed, designed for anal access surgeries like hemorrhoidectomy.
Lateral Kidney position: Emphasizes access to retroperitoneal space, often used in nephrectomy or adrenalectomy.
Fowler's position: Semi-sitting, aids in shoulder and head access; procedures include total shoulder arthroplasty.
Sims position: Primarily for endoscopic procedures such as colonoscopy; not typically surgical.

Nerve Injuries Prevention

Ulnar nerve: Affects little-finger side; injuries prevented by padding elbows and adjusting arm position. Can occur in supine, prone, or lateral positions.
Tibial nerve: Located in the posterior lower leg; injuries require careful positioning.
Perineal nerve: Between urethra and anus; injury prevention through padding and careful leg management in lithotomy or lateral positions.
Brachial plexus: C5-T1 nerve roots; avoid injury by minimizing arm board angles or using axillary rolls in lateral or supine configurations.
Lumbar and sacral nerves: Supply hips and legs; injury risk mitigated by padding and careful leg raising.

Safety and Transfer Protocols

Awake patient transfers require a minimum of 2 people; sleeping patient transfers need at least 4.
Safety strap for supine patients should be placed 2 inches above the knees.
In lateral position, the lower leg is bent while the top leg remains straight.
CRNA/anesthesia provider is ultimately responsible for patient safety and monitoring during procedures.

Positioning Equipment and Technique

Lithotomy position requires candy-cane-style stirrups and specific table attachments.
Reverse Trendelenburg is a modification of the supine position, useful for surgeries requiring abdominal visualization.
Padded footboards are necessary to prevent sliding in reverse Trendelenburg position.
Mediastinum becomes inaccessible when the patient is in the lateral position, affecting surgical approach.

Terminology

Alternate name for supine position: Dorsal recumbent.
Kraske position is also known as jackknife.
In the right lateral position, the right side contacts the OR table.
Positioning adjustments are crucial to ensure patient safety and prevent nerve compression during surgeries.

Description

Test your knowledge of surgical positioning with these flashcards. Learn the definitions and applications of various positions such as supine, lateral, and prone. Perfect for students in medical or nursing programs preparing for surgery-related topics.