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API Lecture 18: Anesthesia for Liposuction, Laparoscopy, and Oppthalmologic Surgery

• Selective α-2 agonist • Benefits: anxiolysis, amnesia, sedation • Benefits: No PONV, minimal resp. depression • Adverse: ↓’d CO, BP, & HR; resp. depression Dexmedetomidine: Mechanism, Advantages (5), Adverse Effects (4)• Hyponatremia • Volume Overload • Local Anesthetic Toxicity • Tachycardia and Hypertension • Significant Blood Loss • Significant Pain 6 Risks of LiposuctionThe ASA guidelines *do not require monitoring* temperature, *only the ability* to measure the patient’s temperature if/when indicated. What is the ASA requirement with regard to monitoring temperature intraoperatively?• Echothiophate (phospholine iodide) • Miosis...

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Surgery Shelf (USMLE World)

PCWP elevation with persistent hypotension following an IV fluid bolus indicates ___? initial treatment of cardiogenic shock? what medications can be used to maintain cardiac output without increasing heart rate? left ventricular failure (leading to cardiogenic shock) intravascular volume expansion up to a PCWP of 15-20 mmHg Inotropic medications such as dopamine or dobutaminea patient with a very full bladder experiences blunt abdominal trauma and then complains of diffuse abdominal pain that refers to his left shoulder; wet injury a counts for these findings? Injury to the dome of the bladder- this is only region of bladder covered by peritoneum; thus it is the only injury that would per...

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Chapter 23-SP for Ambulatory Surgery-Iahcsmm

False The number of ambulatory surgery facilities is decreasing nationwide.True Before the mid-1970s, virtually all surgeries were performed in hospitals.True Ambulatory surgery centers specialize in providing surgeries that do not require hospitalization.False Since the types of surgeries performed are smaller, PPE is not required when cleaning instruments used in ambulatory surgery centers.True In a dental office, clinical contact surfaces are defined as surfaces that can be directly contaminated during patient care.True The Veterans Administration (VA) hospital system has its own certification program for SPD (CS) Technicians.Fals...

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Oral Surgery

Surgical Rotary instruments Larger in size and usually have longer shanks. Used to cut bone or section teeth.Surgical suction apparatus Composed of hose, handle, and tips.Retractors hold back objects in oral cavity.Tissue Retractors hold tissue flaps away from treatment site provie better visibility.Tongue and Cheek Retractors Hold and retract cheeks, tongue, or portion of mucosa during procedures.Mouth Props and gags hold patients mouth open mechanically.Mouth prop solid piece angled rubberMouth Gags lock-type forceps with rubber covered extensions.Surgical Scalpels used to incise or excise soft tissues. Blades come pres...

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Split brain surgery

split brain surgery surgically cutting a patient’s corpus callosum so that the hemispheres are separatedLeft hemisphere effect ability to verbalise objects flashed to the right visual fieldRight hemisphere effect inability to verbalise objects flashed to the left visual fieldMyers and Sperry (1958) Split brain surgery prevents information from passing between hemispheresRoger Sperry Michael GazzanigaSperry (1968) 11 patients had undergone radical disconnection of the cerebral hemispheres; seen as a last resortResults Identified specialised functions of the hemispheres; determined the role of the corpus callosumSperry (197...

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Surgery Shelf – Breast Disease

Breast cancer work up 1. Bilateral mammography 2. Core needle / excisional biopsy If carcinoma confirmed, also get: – CBC – LFTs – CXR [if also bone pain or abdominal sxs, get bone scan or CT abdomen]Breast biopsies FNA = cytologic analysis; can detect cancer but cannot differentiate in situ vs invasive Core needle = histologicAxillary nodes Level 1 = lateral to pectoral minor Level 2= deep to pectoral minor Level 3 = medial to pectoral minorBreast cancer staging T1 = 5 cm T4 = any size with direct extension to chest wall or skin N0 = no palpable axillary nodes N1 = mets to moveable axillary nodes N3 = mets to fixed axillary nodes St...

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Limb salvage surgery

Indication for limb salvage – Fractures • Owners cannot afford repair • Complex fracture with high chance of complications • Initial repair has failed or complications have occurred • Fracture cannot be repaired due to: • Significant bone loss • Significant soft tissue loss • Near amputationIndication for limb salvage- Joint injuries • Complex luxations where primary surgical repair has a significant complication rate. • Injuries involving the tension side of the carpus (palmar) or tarsus (plantar). • Soft tissue injury with significant soft tissue loss particularly of skinIndication for salvage – Neoplasia • Primary bone tumours • Locally invas...

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WW1 on Medicine (most advances were surgery related)

Plastic Surgery Key advances in skin grafting – chance to experiment due to high influx of wounded – foundations laid for plastic surgery.Teamwork In peacetime, surgeons work alone/against eachother, at war, ready to poole resources together for good of countryIndustry Wartime industry = more resources devoted to developing new surgical equipmentSurgeons Do more operations so can experiment and work harder. Head wounds were very common so eye, ear, nose, throat, and brain techniques advanced hugely. Wounds were very deep so more work was put into fighting infection.Limitations? Prevents/distracts from key research – Britain alo...

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Small Animal Medicine and Surgery: Orthopedics: Hip Problems

What kind of the joint is the hip? – coxofemoral joint is a ball and socket joint – permits a wide range of motion in flexion and extension as well as abduction and adduction.what keeps the hip joint in place while the animal bares wait on the limb? • The congruity of the bones (including a “roofing” effect of the dorsal acetabular rim over the femoral head to hold it in place when the limb is bearing weight)What is the suction cup effect? • brought about by surface tension within a small amount of joint fluid holding the femoral head and the acetabulum togetherWhat does the ligament of the head of the femur do? • The ligament ...

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Surg Chapter 16- Ophthalmic Surgery

Lacrimal A facial bone that, along with the zygomatic bone and palate, helps to form the orbit of the eye.Anterior Chamber The cavity of the eye located anterior to the iris and containing the aqueous humor.BSS (Balanced Salt Solution) An irrigant used for the eye during eye procedures.Cataract A pathological condition in which the crystalline lens has become opaque due to age or trauma.Chalazion A small, red, inflamed lump that can be located on the inner or outer surface of the eyelid; caused by an inflammatory reaction to material trapped inside the meibomian gland in the eyelid.Dacryo- Combining form referring to the lacrimal apparatus...

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