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Surginal Procedures > Ophthalmic and Otorhinolaryngologic Surgery > Flashcards

Ophthalmic and Otorhinolaryngologic Surgery Flashcards

(101 cards)

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1
Q

Define Cataract extraction ECCE

A

extracapsular cataract extraction
Removal of opaque ocular lens and replacing it with an IOL implant
Anterior capsule, cortex and nucleus removed with posterior capsule left in place

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2
Q

Anatomy and physiology Cataract extraction ECCE

A 
Conjunctiva
Cornea
Sclera
Limbus
Anterior chamber of the globe
Lens plus parts: nucleus, cortex, capsule (learn all 3 parts)
Iris
Physiology: Vision; refraction (focus)
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3
Q

Pathology/indication Cataract extraction ECCE

A

Opaque ocular lens

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4
Q

Procedure steps summary Cataract extraction ECCE

A

Apply local (topical gtts); place lid speculum
Incisions: Limbal flap and 2ndport; inject Healon
Perform capsulotomy (capsulorrhexis forceps)
Loosen nucleus (hydrodissect or cyclodialysis spatula)
Emulsify nucleus with phacoemulsification machine
Remove cortex by irrigating and aspirating (I&A)
Place implant; I&A Healon
Administer topical medications, dress PRN

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5
Q

Define Tympanoplasty

A

Surgical repair of the tympanic membrane (eardrum)

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6
Q

Anatomy and physiology Tympanoplasty

A 
External ear:
     Pinna
     External auditory canal
     Tympanic membrane
Middle ear: 
     Malleus
     Incus
     Stapes
Temporalis fascia (for graft)
Physiology: hearing
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7
Q

Pathology/indication Tympanoplasty

A

Perforated tympanic membrane
Cholesteatoma (noncancerous skin growth that develops in the middle ear)
Ossicular discontinuity

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8
Q

Procedure steps summary Tympanoplasty

A

Inject local, place speculum, make incision
Harvest and prepare temporalis fascia for graft
FYI: Periosteal elevator; scissors/adsons; close
FYI: Place graft on silastic block; thin it out; dry out
Prepare ear drum for graft
Explore middle ear cavity; treat ossicles PRN
Trim and place graft; pack edges of graft with gelfoam
Pack canal; close, apply dressings

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9
Q

Define Sinus endoscopy (FESS)

A

Functional endoscopic sinus surgery

Visual exam of sinus cavities using minimally invasive technique.

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10
Q

Anatomy and Physiology Sinus endoscopy (FESS)

A 
Nose
Paranasal sinuses and ostia
Maxillary
Ethmoid
Sphenoid
Frontal
Physiology: Unclear; may have to do with moistening and warming air
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11
Q

Pathology/Indication Sinus endoscopy (FESS)

A 
Treat Chronic sinusitis
Remove Polyps (allergies)
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12
Q

Procedure steps summary Sinus endoscopy (FESS)

A 
Apply local agent; insert endoscope into nose
Enlarge ostia
     FYI: aka maxillary antrostomy
Remove diseased tissue
     FYI: Debrider; Blakesley forceps
Ethmoidectomy and/or sphenoidotomy PRN
Hemostasis, nasal packing, dress
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13
Q

Define Breast Reconstruction (TRAM)

A

Reconstruction of breast tissue using a transverse rectus abdominis myocutaneous pedicle flap graft
TRAM = transverse rectus abdominis myocutaneous

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14
Q

Anatomy and Physiology Breast Reconstruction (TRAM)

A

Lower abdominal wall
Skin, subcutaneous tissue
Rectus abdominis muscle
Physiology: body wall support

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15
Q

Pathology/Indication Breast Reconstruction (TRAM)

A

Post-mastectomy reconstruction

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16
Q

Procedure steps summary Breast Reconstruction (TRAM)

A

Incisions made for mastectomy scar and abdomen
Lower abdominal transverse elliptical incision is made
Tunnel subcutaneously up to breast area
Dissect flap with muscle attachment
FYI: divide rectus abdominis at its inferior attachment
Swing tissue into place, trim PRN, and secure
Close both areas; dress
4x4’s, ABD, tape (abdomen)
Non-adherent dressing; 4x4’s, supportive cover

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17
Q

Define Blepharoplasty

A

Surgical repair; eyelid/s

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18
Q

Anatomy and physiology Blepharoplasty

A

Eyelids

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19
Q

Pathology/Indication Blepharoplasty

A

Dermatochalasis obstructing visual field

Aesthetic purposes

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20
Q

Define Entropion/ectropion repair

A

Repair of:
Entropion: turning inward of eyelid; inverted lower eyelid margin
Ectropion: turning outward of eyelid; eversion of lower lid

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21
Q

Anatomy and physiology Entropion/ectropion repair

A

Eyelids

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22
Q

Pathology/Indication Entropion/ectropion repair

A

Entropion: turning inward of eyelid; inverted lower eyelid margin
Ectropion: turning outward of eyelid; eversion of lower lid

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23
Q

Define Enucleation

A

Removal of entire ocular globe with insertion of implant

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24
Q

Anatomy and physiology Enucleation

A

entire globe
extraocular muscles (3 pairs) of the eye:
Superior oblique & Inferior oblique
Superior rectus & Inferior rectus
Lateral rectus & Medial rectus

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25
Pathology/Indication Enucleation
Intraocular tumors; trauma; infection (intractable)
26
Define Vitrectomy w/scleral buckle
Removal of all or part of vitreous body with placement of device to press sclera toward retina with internal access via the pars plana
27
Anatomy and physiology Vitrectomy w/scleral buckle
globe and layers, vitreous, retina, pars plana
28
Pathology/Indication Vitrectomy w/scleral buckle
Retinal detachment
29
Define Iridectomy
Excision of (part of) iris
30
Anatomy and physiology Iridectomy
anterior ocular cavity - choroid layer, ciliary body, iris, trabecular meshwork
31
Pathology/Indication Iridectomy
Angle-closure glaucoma (acute, sub-acute, or chronic)
32
Define Dacryocystorhinostomy
Making a new opening between the tear sac and the nose
33
Anatomy and physiology Dacryocystorhinostomy
lacrimal duct system
34
Pathology/Indication Dacryocystorhinostomy
Resistant obstruction of the nasolacrimal duct
35
Define Stapedectomy
Removal of entire stapes with oval window graft and replacement with a prosthesis
36
Anatomy and physiology Stapedectomy
``` External ear: Pinna External auditory canal Tympanic membrane Middle ear: Malleus Incus Stapes Temporalis fascia (for graft) Physiology: hearing ```
37
Pathology/Indication Stapedectomy
Otosclerosis (hardened bone) causing conductive hearing loss
38
Define Cochlear implant
Insertion of a device to stimulate the cochlea
39
Anatomy and Physiology Cochlear implant
``` External ear: Pinna External auditory canal Tympanic membrane Middle ear: Malleus Incus Stapes Temporalis fascia (for graft) cochlea, temporal bone and mastoid process Physiology: hearing ```
40
Pathology/Indication Cochlear implant
Profound hearing loss; sensorineural
41
Define Turbinectomy
Excision or reduction of one or more nasal turbinates
42
Anatomy and Physiology Turbinectomy
``` Nares Septum–FYI: Nasal cartilage, ethmoid plate, vomer Columella Mucoperichondrium Turbinates (AKA: nasal conchae) Physiology: prepare air for lungs ```
43
Pathology/Indication Turbinectomy
Turbinate hypertrophy causing obstruction
44
Define UPPP
Uvulopalatopharyngoplasty | Surgical repair of the uvula, soft palate, and throat
45
Anatomy and Physiology UPPP
``` Mouth tongue uvula Palatine tonsils tonsil mucosa tonsillar pillar Pharyngeal tonsils FYI: Blood supply from external carotid Soft palate Physiology: airway, phonation ```
46
Pathology/Indication UPPP
Obstructive sleep apnea
47
Define Glossectomy
Excision of all or part of tongue
48
Anatomy and Physiology Glossectomy
mouth; tongue | Physiology: phonation, ingestion
49
Pathology/Indication Glossectomy
Carcinoma of the tongue
50
Define Laryngectomy
Complete removal of larynx, hyoid bone and strap muscles
51
Anatomy and physiology Laryngectomy
``` Larynx hyoid bone strap muscles suprasternal notch hypoglossal nerves superior laryngeal nerve thyroid gland and cartilage trachea and cricoid cartilage pharynx and epiglottis Physiology: respiration and phonation ```
52
Pathology/Indication Laryngectomy
Laryngeal carcinoma | Trauma to the larynx
53
Define Radical neck dissection with mandibulectomy
En bloc dissection and removal of all soft tissue from mandible to clavicle including lymph nodes. Including excision of mandible
54
Anatomy and Physiology Radical neck dissection with mandibulectomy
``` Larynx hyoid bone strap muscles suprasternal notch hypoglossal nerves superior laryngeal nerve thyroid gland and cartilage trachea and cricoid cartilage pharynx and epiglottis mandible clavicle trapezius muscle lymph nodes sternocleidomastoid muscle carotid artery jugular vein vagus nerve ```
55
Pathology/Indication Radical neck dissection with mandibulectomy
Carcinoma of head or neck with metastases to cervical lymph nodes Malignant cancer on the mandible
56
Define LeFort II and LeFort III
repair of a pyramidal fracture of the face and repair of craniofacial dysjunction
57
Anatomy and Physiology LeFort II and LeFort III
``` Le Fort II: nasal cavity, hard palate, orbital rim Le Fort III: all plus zygoma on both sides and nose Maxilla Mouth Teeth Palate Nasal floor Nasal septum Physiology: Support (bone structure) ```
58
Pathology/Indication LeFort II and LeFort III
I: Pyramidal maxillary fracture III: Craniofacial dysjunction
59
Define ORIF mandible with arch bars
Open reduction, internal fixation mandible with application of arch bars
60
Anatomy and physiology ORIF mandible with arch bars
Mandible; mouth; teeth
61
Pathology/Indication ORIF mandible with arch bars
Fractured mandible
62
Define Mastopexy
Fixation or suspension of the breast
63
Anatomy and Physiology Mastopexy
``` Breast Areola/nipple Adipose tissue Glandular tissue (lobes) Lactiferous ducts FYI: blood vessels and lymphatic drainage Physiology: Lactation/nourish infant ```
64
Pathology/Indication Mastopexy
``` Breast ptosis (drooping); improve appearance May be reconstructive if causing neck/back problems ```
65
Define Augmentation mammoplasty
Surgical repair of the breast with insertion of a prosthesis
66
Anatomy and Physiology Augmentation mammoplasty
``` Breast Areola/nipple Adipose tissue Glandular tissue (lobes) Lactiferous ducts FYI: blood vessels and lymphatic drainage Physiology: Lactation/nourish infant ```
67
Pathology/Indication Augmentation mammoplasty
Hypomastia (Aesthetic; To improve appearance) Correct breast asymmetry (Aesthetic; To improve appearance) Or as a part of post-mastectomy breast reconstruction
68
Define Strabismus repair
Shortening (resection) or lengthening (recession) of the extraocular muscles to correct misalignment of the eye/s
69
Anatomy and physiology Strabismus repair
``` Extraocular muscles Superior and inferior rectus Medial and lateral rectus Superior and inferior oblique Sclera Conjunctiva Physiology: Focus eyes bilaterally ```
70
Pathology/Indication Strabismus repair
Misalignment or deviation of the eyes due to unequal muscle tone
71
Define Keratoplasty
Surgical repair of cornea by replacing it with a donor tissue
72
Anatomy and physiology Keratoplasty
Cornea | Physiology: refraction
73
Pathology/Indication Keratoplasty
Thickened or opacified cornea due to trauma, disease, or degeneration
74
Define myringotomy/tubes
Incision into tympanic membrane and Placement of pressure equalization tubes to drain the fluid in the middle ear.
75
Anatomy and physiology myringotomy/tubes
External ear: Pinna (auricle) External auditory canal Tympanic membrane (ear drum) Middle ear cavity Malleus (incus and stapes not relevant here) Physiology:–Amplifies and concentrates sound waves
76
Pathology/Indication myringotomy/tubes
Recurrent otitis media (inflammation in the middle ear)
77
Define Septoplasty (SMR)
Surgical repair to straighten the nasal septum
78
Anatomy and physiology Septoplasty (SMR)
``` Nares Septum–FYI: Nasal cartilage, ethmoid plate, vomer Columella Mucoperichondrium Physiology: prepare air for lungs ```
79
Pathology/Indication Septoplasty (SMR)
Deviated nasal septum; obstructive | Trauma
80
Define tonsillectomy/adenoidectomy
Surgical excision of enlarged palatine tonsils and adenoids
81
Anatomy and physiology tonsillectomy/adenoidectomy
``` Mouth tongue uvula Palatine tonsils tonsil mucosa tonsillar pillar Pharyngeal tonsils FYI: Blood supply from external carotid Physiology: Unclear; immune function (make lymphocytes?) ```
82
Pathology/Indication tonsillectomy/adenoidectomy
Recurrent tonsillitis | Adenomegaly (due to recurrent adenoiditis)
83
Define Tracheotomy/tracheostomy
Incision into the trachea to allow direct access to the breathing tube and insertion of a cannula
84
Anatomy and physiology Tracheotomy/tracheostomy
``` Trachea Tracheal rings Cricoid cartilage Thyroid gland Physiology: respiration ```
85
Pathology/indication Tracheotomy/tracheostomy
Patients unable to breath and relies on a ventilator | Blocked airway
86
Define Parotidectomy
Excision of all or part of the parotid gland
87
Anatomy and physiology Parotidectomy
Parotid gland Steno’s duct (AKA: Stensen’s duct) Facial nerve and branches Physiology: Produce and secrete saliva
88
Pathology/Indication Parotidectomy
Parotid gland tumors; benign or malignant
89
Define LeFort I facial fracture fixation
Surgical fixation/repair of a transverse fracture through the floor of the maxillary sinuses using plates, screws and wires
90
Anatomy and physiology LeFort I facial fracture fixation
``` Maxilla Mouth Teeth Palate Nasal floor Nasal septum Physiology: Support (bone structure) ```
91
Pathology/Indication LeFort I facial fracture fixation
Transverse maxillary fracture
92
Define Split thickness skin graft (STSG)
Obtaining a segment of epidermis and part of dermis for wound coverage
93
Anatomy and physiology Split thickness skin graft (STSG)
Epidermis Dermis STSG includes epidermis and partial section of dermis Physiology: Skin is a barrier to infection; prevents moisture loss; maintains temperature stability
94
Pathology/Indication Split thickness skin graft (STSG)
Burns - Full-thickness (3rd°) | Traumatic injury with tissue loss
95
Procedure steps summary Split thickness skin graft (STSG)
Obtain graft with dermatome; cover donor site Mesh graft, set aside and keep moist Prepare recipient site Attach graft to recipient site with suture FYI: may use staples at edges Dress both sites Donor site: Scarlet Red; 4x4’s; ABD; Coban/Ace or simple OP-site Recipient site: “tie-over” bolster dressing such as: Owen’s gauze; wet cotton balls; 4x4’s; Kerlix roll; Ace or ABD’s, tape
96
Define Rhytidectomy
Excision of wrinkles | Elevation and tightening of facial and neck tissue
97
Anatomy and Physiology Rhytidectomy
``` Face Neck Ears Scalp Platysma muscle FYI: Superficial muscular aponeurotic system (SMAS) Physiology: Facial movement ```
98
pars plana
Area inside globe where ciliary body and anterior retina meet
99
occlusion
Bringing teeth into natural alignment
100
edentulous
Pertaining to; without teeth
101
Pathology/Indication Rhytidectomy
Aesthetic; desire to correct sagging skin

Surginal Procedures (14 decks)

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