Surgical Technology for the Surgical Technologist - Chapter 13

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ST 230

angina

a heart condition marked by paroxysms of chest pain due to reduced oxygen to the heart

auscultation

listening to sounds within the body (usually with a stethoscope) IE: lungs, heart, & abdomen

biopsy

the removal of living tissue from the body for diagnostic examination

capnography

a recording or display of the measurement of exhaled carbon dioxide concentrations

C-arm

A mobile unit used in surgery or at the bedside that produces "real time" fluoroscopic images for the surgeon, or radiographer.

cholangiography

roentgenographic examination of the bile ducts after a contrast medium has been injected

contrast medium

substance injected into the body, introduced via an enema, intravenously, catheter, or swallowed to facilitate radio-graphic images of internal structures that otherwise are difficult to visualize on x-ray films - IE: Hypaque, Renografin, or Cystografin - iodine content based, which determines the radiodensity of the material.

cerebral spinal fluid

AKA: CSF - A solution that fills the hollow cavities of the brain and circulates around the brain and spinal cord. Provides nourishment, cushions, and removes wastes.

cystoscopy

examination of the bladder using a rigid or flexible cystoscope

ECG

Abbreviation for electrocardiogram, which is a record of the electrical activity of the heart.

EEG

Abbreviation for electroencephalogram; an amplified recording of the waves of electrical activity that sweep across the brain's surface. These waves are measured by electrodes placed on the scalp

frozen section

quick preparation of a biopsy sample for examination during an actual surgical procedure. determines if a sample is benign or malignant

gram

written record

Gram stain

Method for identifying bacteria. Bacteria are washed with a violet dye that stains the bacteria. The violet dye is then washed off and pink dye is added. If the bacteria are purple, then they are Gram+ because they have a thick cell wall and retain the purple dye. If the bacteria are pink, they are Gram- because their membranes are thinner. Doctors use this method to prescribe the correct antibiotics to patients.

graph

draw or write

indwelling

An _______________ or Foley catheter remains in place until a patient is able to void completely and voluntarily or continuous accurate measurements are no longer needed.

isotope scanning

Involves the intravenous injection of a radioactive isotope into the patient prior to an imaging study; also referred to as nuclear medicine study or radionuclide imaging

obstruction

something that causes or forms a blockage or hindrance of a passage

palpation

an examination technique in which the examiner's hands are used to feel the texture, size, consistency, and location of certain body parts

prosthesis

Replacement of a missing part by an artificial substitute, such as an artificial extremity

roentgenography

process of recording x-rays and radiation

sign

(medicine) any objective evidence of the presence of a disorder or disease

symptom

(medicine) any sensation or change in bodily function that is experienced by a patient and is associated with a particular disease

urinalysis

UA (medicine) the chemical analysis of urine (for medical diagnosis)

ultrasonography

image produced by using high-frequency sound waves and displaying the reflected "echoes" on a monitor; commonly used to observe fetal growth or study bodily organs

direct visualization

examining tissue directly with the human eye to assess its auto-fluorescent pattern of the tissue.

indirect visualization

pharyngeal mirror to see tonsils

enhanced visualization

otoscope
opthalmoscope

radiography

process of producing images using an x-ray passed through the body or area and captured on a film - used by anesthesia providers pre-operatively to detect lung abnormalities.

mammography

a radiographic examination of the breasts to detect the presence of tumors or precancerous cells - in the early stages

myelography

this technique has been replaced by MRI. It is roentgenography of the spinal cord to detect possible lesions - usually after injection of a contrast medium into the subarachnoid space - for patients with neck, back, and leg pain

fluoroscopy

procedure for viewing the interior of the body using x-rays and projecting the image onto a monitor - in real time to see the action of joints and organs for functionality

CAT scan

abbreviation for computerized axial tomography, uses a computer and a rotating x-ray device to create detailed, cross-sectional images, or slices, of organs and body parts

angiography

An invasive preoperative roentgenographic examination - that must be done under sterile conditions - of blood vessels, after injection of a radiopaque contrast medium - includes cardiac catheterization - to determine the presence, and or cause of vascular disease - most performed in a Catheterization Lab, or special studies room in Radiology dept. Remains the reference standard for assessing peripheral vascular disease. Various sizes of catheters are used - 18Fr. is the most common

retrograde urography

a radiograph of the urinary system taken after dye has been placed in the urethra through a sterile catheter and caused to flow upward (backward) through the urinary tract

endarterectomy

surgical removal of the inner lining of an artery that is clogged with atherosclerosis

angioplasty

surgical repair of a vessel

bypass grafting

using a healthy artery or vein from another part of the body by connecting, or grafting, them to a blocked artery

embolectomy

surgical removal of an embolus (usually from an artery)

cardiac catheterization

procedure where a catheter is inserted into an artery and guided into the heart; may be used for diagnosis of blockages or treatment

MRI

AKA: Magnetic Resonance Imaging - Passing non-harmful radio waves (NO X-RAYS) through the brain giving a highly detailed image of the brain's structure. Images are taken before and after injection of Non-Iodine based contrast

PET scan

AKA: positron emission tomography - involves the injection of radioactive dye into the blood stream that can be traced and detected to monitor blood flow to various regions of the brain, by highlighting chemical or metabolic activity

treatment of tissue specimens

- loss of specimen: may call for 2nd procedure, or delay treatment
- correct labeling: crucial for proper orientation of abnormal cell locations
- incorrect labeling: can lead to improper diagnosis, or improper location for surgical intervention

smear and brush biopsy

during the surgery, STSR must wipe the brush on a slide using aseptic technique to create a smear and cut the tip of the brush off and place it in formalin

aspiration biopsy

involves suctioning tissue from a fluid-filled lesion through a fine needle into a syringe

incisional biopsy

Piece of tumor is removed for examination to establish a diagnosis.

permanent sections

Requires fixation in formalin (usually overnight). Specimen is "grossed in" in the laboratory. Described, weighed, measured. Appropriate sections taken. Put in a cassette for further processing. Cut from paraffin block. 5-10 microns thick. Blocks and slides retained for years. Wet tissue (left in formalin after sections taken for permanent sections) usually disposed of in a month. Many are kept for 10 years--many indefinitely. Can usually be used later for special studies (if patient is still sick--test for things). Permanent--come out the next day. May be even longer. creates a permanent record of what was seen.

calculi

stone formed in the gallbladder, kidneys, or other parts of the body - must be sent to pathology lab dry!

Spinal tap

removal by centesis of fluid from the subarachnoid space of the lumbar region of the spinal cord for diagnostic or therapeutic purposes

centesis

(surgery) the act of puncturing a body cavity or organ with a hollow needle in order to draw out fluid

thoracentesis

surgical puncture of the thoracic cavity, usually using a needle, to remove fluids from the pleural space

etiology

study of the cause of disease

Swan-Ganz pulmonary artery catheter

soft flexible catheter that is inserted through a vein into the pulmonary artery. it is a type of IV catheter used to measure the pumping ability of the heart, to obtain pressure readings, and to introduce medications and IV fluids; If the physician is interested in assessing the proper placement of a Swan-Ganz catheter, the lungs may have to be slightly overexposed in order to clearly delineate the proper placement of the tip of the Swan-Ganz catheter, which will overlap the denser cardiac silhouette. NOTE: helps rule out pulmonary embolism, in the pulmonary atery.

atelectasis

collapse of an expanded lung (especially in infants)

diagnostic imaging

any diagnostic test that produces an image of the gland or organ under study; includes radiography, nuclear medicine (MRI, CT) scans, and ultrasonography

AP view

Anterior-Posterior view, refers to anterior/posterior view, as in an x-ray view with the patient facing the x-ray machine and the film behind their back; the image passes from front (anter/o) to back (posterior). PA view is just the opposite

contrast

difference in optical density in a radiograph that results from a difference in radiolucency or penetrability of an object

non-selective aortography

may require 30-50 mL, of the more concentrated solutions of contrast medium, at a rate of 10-25 mL p/sec

selective arterial injections

may require 10-12 mL, of the less concentrated solutions of contrast medium, at a rate of 7-8 mL p/sec.

Potts-Cournand arterial needle

a sterile, single-use, three-part arterial needle designed for fast, efficient identification of pulsating arterial flow.
Outer Needle with Thin-Wall Cannula
Short bevel plus precise fit allows atraumatic vessel entry. Slight protrusion of the outer needle cannula minimizes chance of blood coagulation within the hub. Nonradiopaque plastic winged hub permits comfortable use of the needle in bevel-up or bevel-down position.
Inner Cannula
Needle point with arterial bevel allows fast, accurate entry, even in mobile neck vessels. Precision fit with outer needle cannula helps minimize penetration problems. Bevel orientation assured by key interlock.
Rounded Blunt ObturatorHemispherical top compliments needle for easy threading into the vessel. Precision fit minimizes blood accumulation during intermittent procedures. is the most commonly used for angiography

Seldinger technique

easy access into most vessels of the body - method used to insert a catheter in angiographic studies, where the femoral route is the method of choice.
- Inject the vessel with 1% Xylocaine
- incise with #11 blade
- slow needle/cannula insertion - at 45-60 degree angle, stylet is gently withdrawn until blood spurts from the proximal end of cannula
- guidewire insertion into artery
- catheter is threaded over guidewire

cut down method

refers to making the an incision and dissecting through the tissue layers to expose the vessel and making an incision into the vessel for the introduction of the catheter. The veins most commonly used for catheter placement are:
* femoral vein (most common)
* subclavian vein
* internal jugular vein

ejection fraction

The fraction of the end-diastolic volume ejected from the filled ventricles in a single contraction of the heart. The ejection fraction is normally around 55-75% of the end diastolic volume. The GOLD STANDARD for ejection fraction is the use of "ventriculography" - (x-ray study of the heart's ventricles after introduction of an opaque dye by means of a catheter).

spirometry

Testing method that utilizes a spirometer to record the volume of air inhaled or exhaled and the length of time each breath takes. Helps detect leaks in the ventilatory system and patients with either COPD or ARDS

COPD

abbreviation for chronic obstructive pulmonary disease; chronic bronchitis - bronchiole lining inflamed, excess mucus formed; emphysema - walls of alveoli break down; HYPOXIC DRIVE (not in asthma)

ARDS

abbreviation for Acute Respiratory Distress Syndrome. No gas is exchanged. No surfactant, alveoli collapse = hypoxia

plethysmography

this method calculates the density of the body utilizing the amount of air displacement during testing within a specialized closed chamber. The mercury strain gauge, and air plethysmography (pulse volume recorder) are the common techniques used in patients with diffuse small vessel arterial disease - especially diabetics

phleborheography

Deep Vein Thrombosis can be diagnosed by this study, and a plethysmography (measuring and recording rhythmic changes in venous volume in the legs associated with respiration) is used by the compression of the foot or calf, employing a plethysmograph having cuffs applied to the abdomen, thigh, upper, mid, and lower calf, and foot;

TEE

transesophageal echocardiography

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