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Surginal Procedures > Ophthalmic and Otorhinolaryngologic Surgery > Flashcards

Ophthalmic and Otorhinolaryngologic Surgery Flashcards

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
Q

Pathology/Indication Enucleation

A

Intraocular tumors; trauma; infection (intractable)

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26
Q

Define Vitrectomy w/scleral buckle

A

Removal of all or part of vitreous body with placement of device to press sclera toward retina with internal access via the pars plana

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27
Q

Anatomy and physiology Vitrectomy w/scleral buckle

A

globe and layers, vitreous, retina, pars plana

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28
Q

Pathology/Indication Vitrectomy w/scleral buckle

A

Retinal detachment

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29
Q

Define Iridectomy

A

Excision of (part of) iris

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30
Q

Anatomy and physiology Iridectomy

A

anterior ocular cavity - choroid layer, ciliary body, iris, trabecular meshwork

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31
Q

Pathology/Indication Iridectomy

A

Angle-closure glaucoma (acute, sub-acute, or chronic)

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32
Q

Define Dacryocystorhinostomy

A

Making a new opening between the tear sac and the nose

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33
Q

Anatomy and physiology Dacryocystorhinostomy

A

lacrimal duct system

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34
Q

Pathology/Indication Dacryocystorhinostomy

A

Resistant obstruction of the nasolacrimal duct

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35
Q

Define Stapedectomy

A

Removal of entire stapes with oval window graft and replacement with a prosthesis

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36
Q

Anatomy and physiology Stapedectomy

A 
External ear:
     Pinna
     External auditory canal
     Tympanic membrane
Middle ear: 
     Malleus
     Incus
     Stapes
Temporalis fascia (for graft)
Physiology: hearing
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37
Q

Pathology/Indication Stapedectomy

A

Otosclerosis (hardened bone) causing conductive hearing loss

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38
Q

Define Cochlear implant

A

Insertion of a device to stimulate the cochlea

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39
Q

Anatomy and Physiology Cochlear implant

A 
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
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40
Q

Pathology/Indication Cochlear implant

A

Profound hearing loss; sensorineural

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41
Q

Define Turbinectomy

A

Excision or reduction of one or more nasal turbinates

42
Q

Anatomy and Physiology Turbinectomy

A 
Nares
Septum–FYI: Nasal cartilage, ethmoid plate, vomer
Columella
Mucoperichondrium
Turbinates (AKA: nasal conchae)
Physiology: prepare air for lungs
43
Q

Pathology/Indication Turbinectomy

A

Turbinate hypertrophy causing obstruction

44
Q

Define UPPP

A

Uvulopalatopharyngoplasty

Surgical repair of the uvula, soft palate, and throat

45
Q

Anatomy and Physiology UPPP

A 
Mouth
tongue
uvula
Palatine tonsils
tonsil mucosa
tonsillar pillar
Pharyngeal tonsils
FYI: Blood supply from external carotid
Soft palate
Physiology:  airway, phonation
46
Q

Pathology/Indication UPPP

A

Obstructive sleep apnea

47
Q

Define Glossectomy

A

Excision of all or part of tongue

48
Q

Anatomy and Physiology Glossectomy

A

mouth; tongue

Physiology: phonation, ingestion

49
Q

Pathology/Indication Glossectomy

A

Carcinoma of the tongue

50
Q

Define Laryngectomy

A

Complete removal of larynx, hyoid bone and strap muscles

51
Q

Anatomy and physiology Laryngectomy

A 
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
Q

Pathology/Indication Laryngectomy

A

Laryngeal carcinoma

Trauma to the larynx

53
Q

Define Radical neck dissection with mandibulectomy

A

En bloc dissection and removal of all soft tissue from mandible to clavicle including lymph nodes. Including excision of mandible

54
Q

Anatomy and Physiology Radical neck dissection with mandibulectomy

A 
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
Q

Pathology/Indication Radical neck dissection with mandibulectomy

A

Carcinoma of head or neck with metastases to cervical lymph nodes
Malignant cancer on the mandible

56
Q

Define LeFort II and LeFort III

A

repair of a pyramidal fracture of the face and repair of craniofacial dysjunction

57
Q

Anatomy and Physiology LeFort II and LeFort III

A 
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
Q

Pathology/Indication LeFort II and LeFort III

A

I: Pyramidal maxillary fracture
III: Craniofacial dysjunction

59
Q

Define ORIF mandible with arch bars

A

Open reduction, internal fixation mandible with application of arch bars

60
Q

Anatomy and physiology ORIF mandible with arch bars

A

Mandible; mouth; teeth

61
Q

Pathology/Indication ORIF mandible with arch bars

A

Fractured mandible

62
Q

Define Mastopexy

A

Fixation or suspension of the breast

63
Q

Anatomy and Physiology Mastopexy

A 
Breast
Areola/nipple
Adipose tissue
Glandular tissue (lobes)
Lactiferous ducts
     FYI: blood vessels and lymphatic drainage
Physiology: Lactation/nourish infant
64
Q

Pathology/Indication Mastopexy

A 
Breast ptosis (drooping); improve appearance
May be reconstructive if causing neck/back problems
65
Q

Define Augmentation mammoplasty

A

Surgical repair of the breast with insertion of a prosthesis

66
Q

Anatomy and Physiology Augmentation mammoplasty

A 
Breast
Areola/nipple
Adipose tissue
Glandular tissue (lobes)
Lactiferous ducts
     FYI: blood vessels and lymphatic drainage
Physiology: Lactation/nourish infant
67
Q

Pathology/Indication Augmentation mammoplasty

A

Hypomastia (Aesthetic; To improve appearance)
Correct breast asymmetry (Aesthetic; To improve appearance)
Or as a part of post-mastectomy breast reconstruction

68
Q

Define Strabismus repair

A

Shortening (resection) or lengthening (recession) of the extraocular muscles to correct misalignment of the eye/s

69
Q

Anatomy and physiology Strabismus repair

A 
Extraocular muscles
     Superior and inferior rectus
     Medial and lateral rectus
     Superior and inferior oblique
Sclera
Conjunctiva
Physiology: Focus eyes bilaterally
70
Q

Pathology/Indication Strabismus repair

A

Misalignment or deviation of the eyes due to unequal muscle tone

71
Q

Define Keratoplasty

A

Surgical repair of cornea by replacing it with a donor tissue

72
Q

Anatomy and physiology Keratoplasty

A

Cornea

Physiology: refraction

73
Q

Pathology/Indication Keratoplasty

A

Thickened or opacified cornea due to trauma, disease, or degeneration

74
Q

Define myringotomy/tubes

A

Incision into tympanic membrane and Placement of pressure equalization tubes to drain the fluid in the middle ear.

75
Q

Anatomy and physiology myringotomy/tubes

A

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
Q

Pathology/Indication myringotomy/tubes

A

Recurrent otitis media (inflammation in the middle ear)

77
Q

Define Septoplasty (SMR)

A

Surgical repair to straighten the nasal septum

78
Q

Anatomy and physiology Septoplasty (SMR)

A 
Nares 
Septum–FYI: Nasal cartilage, ethmoid plate, vomer
Columella
Mucoperichondrium
Physiology: prepare air for lungs
79
Q

Pathology/Indication Septoplasty (SMR)

A

Deviated nasal septum; obstructive

Trauma

80
Q

Define tonsillectomy/adenoidectomy

A

Surgical excision of enlarged palatine tonsils and adenoids

81
Q

Anatomy and physiology tonsillectomy/adenoidectomy

A 
Mouth
tongue
uvula
Palatine tonsils
tonsil mucosa
tonsillar pillar
Pharyngeal tonsils
FYI: Blood supply from external carotid
Physiology: Unclear; immune function (make lymphocytes?)
82
Q

Pathology/Indication tonsillectomy/adenoidectomy

A

Recurrent tonsillitis

Adenomegaly (due to recurrent adenoiditis)

83
Q

Define Tracheotomy/tracheostomy

A

Incision into the trachea to allow direct access to the breathing tube and insertion of a cannula

84
Q

Anatomy and physiology Tracheotomy/tracheostomy

A 
Trachea
Tracheal rings
Cricoid cartilage
Thyroid gland
Physiology: respiration
85
Q

Pathology/indication Tracheotomy/tracheostomy

A

Patients unable to breath and relies on a ventilator

Blocked airway

86
Q

Define Parotidectomy

A

Excision of all or part of the parotid gland

87
Q

Anatomy and physiology Parotidectomy

A

Parotid gland
Steno’s duct (AKA: Stensen’s duct)
Facial nerve and branches
Physiology: Produce and secrete saliva

88
Q

Pathology/Indication Parotidectomy

A

Parotid gland tumors; benign or malignant

89
Q

Define LeFort I facial fracture fixation

A

Surgical fixation/repair of a transverse fracture through the floor of the maxillary sinuses using plates, screws and wires

90
Q

Anatomy and physiology LeFort I facial fracture fixation

A 
Maxilla
Mouth
Teeth
Palate
Nasal floor
Nasal septum 
Physiology: Support (bone structure)
91
Q

Pathology/Indication LeFort I facial fracture fixation

A

Transverse maxillary fracture

92
Q

Define Split thickness skin graft (STSG)

A

Obtaining a segment of epidermis and part of dermis for wound coverage

93
Q

Anatomy and physiology Split thickness skin graft (STSG)

A

Epidermis
Dermis
STSG includes epidermis and partial section of dermis
Physiology: Skin is a barrier to infection; prevents moisture loss; maintains temperature stability

94
Q

Pathology/Indication Split thickness skin graft (STSG)

A

Burns - Full-thickness (3rd°)

Traumatic injury with tissue loss

95
Q

Procedure steps summary Split thickness skin graft (STSG)

A

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
Q

Define Rhytidectomy

A

Excision of wrinkles

Elevation and tightening of facial and neck tissue

97
Q

Anatomy and Physiology Rhytidectomy

A 
Face
Neck
Ears
Scalp
Platysma muscle
     FYI: Superficial muscular aponeurotic system (SMAS)
Physiology: Facial movement
98
Q

pars plana

A

Area inside globe where ciliary body and anterior retina meet

99
Q

occlusion

A

Bringing teeth into natural alignment

100
Q

edentulous

A

Pertaining to; without teeth

101
Q

Pathology/Indication Rhytidectomy

A

Aesthetic; desire to correct sagging skin

Surginal Procedures (14 decks)

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