surgical theoretical questions Flashcards
1.List the periods of the history of surgery! What were the milestones!
• Period 1: From primeval times to middle of 19th century: Only removal of
injured tissue.
•Period 2: Discovery of narcosis (1846 Ether day) until the sixties(1960)
removal of injured tissue + reconstruction.
•Milestones:
1) Application of antisepsis the principle of sepsis/antisepsis- joseph lister?
2) Laughing gas „joseph Priestley” 1772, nitrous oxide.
3) Ether day 1846, 16th october, william morton- narcotized a patient.
4) Semmelweis ignac (1818-1865)- compulsory hand washing with chlorinated lime to prevent pueperal fever.
–Discovery of blood groups- karl landsteiner
–Developement of intensive therapy
•Period 3: From 1960 until today:
–Developement of instruments
–Natural science researchers(eg. Physiology, biochemestry etc)
–Technical improvements (endoscopy and laprascopy)
- When was ether day, who did and what on this day?
•October 16th 1846,William Morton a dentist put a patient under narcosis by the help of Ether in Boston.
Morton in cooperation with C.Jackson, who was a
chemist, discovered the ether and performed the experiment.
Used a bulb with two openings. In the inner he put pieces of sponge which were impregnated in ether. Patient inhaled the gas. After removal of jaw neoplasm patient said he felt nothing-> new era in surgical treatment.
3.When and by whom was the chlorinated lime hand-washing introduced?What were his findings?
•In 1847, by Ignac Semmelweis. He introduced compulsory hand washing with
chlorine to prevent puerpueral fever caused by Strep. Agalacia. Thereafter the mortality rate of women in labour decreased from 30-1%.
In 1847; Kolletschka(professor in forensic medicine), died following an injury during an autopsy. Semmelweis determined that his septic clinical picture
was similar to those seen in autopsies of women who died of purperal fever-> recognized the common cause: the corpusles from the dead body could enter into bloodstream.
who created the antiseptic theory?
4.Who created the “antiseptic theory”?
a. Louis Pasteur = Germ theory; assumed that microscopic particles, which are originated from the surrounding tissues, cause wound infection and pus
formation. Introduced the disinfectioning process in surgery.
b. Josepth Lister = Antiseptic theory; in 1867, based on the ”germ theory”. Lister found the carbolic acid (phenol). He sprayed carbolic acid onto the operative are, onto instruments and bandages, and even into the air. He revolutionized surgery, since untill that time surgeons had difficulty dealing with wound infections.
- who introduced the antiseptic theory in hungarian surgery?
•Hümér Hültl( 1868-1940)
- Name 4 surgical instruments which refer to doctors involved in the development of surgery!
- Kocher (Grasping Instrument)- traumatic hemostatic.
- Lumnitzer (grasping instrument) – traumatic hemostatic forceps. Sandor lumnitzer, a Hungarian surgeon, dealed with plastic surgery. Excellent traumathologist.
- Mathuey (Needle holder) – has curved shanks with a spring and a locking mechaninsm.
- Hegar (Needle holder)- long shanks should be used
- Janos Veres. Was a pulmonologist in Kapuvar. In order to prevent injuries of the lung while getting through the thoracic wall, Veres used his special spring- loaded needle to create safely an artificial pneumothorax( technique used for TB at that time). The needle is now spreaded world-wide in creating pneumoperitoneum during laparascopy.
- What does the acronym notes mean? what are the synonyms for notes technique
•Natural Orifice Transluminal Endoscopic Surgery. Started in 2004.
synonyms;
1.No pain surgery; Use of the technique promise the reduction of postoperative pain, adhesions and post op hernias. also less chance for scar.
2.No scar surgery
- What is the definition of operation?
•All such diagnostic or therapeutic interventions in which we disrupt the body integrity or reconstruct the continuity of the tissues.
Two types: Bloodless (eg. Reducing a joint dislocatin or treating a closed
fracture) and bloody operation(eg. Abdominal/thoracic operations)
- List some examples of bloodless and bloody procedures!
- List some examples of bloodless and bloody procedures!
- Bloodless: Thyroid operation, Reducing Joint dilocation. Treating a closed fracture
- Bloody: Abdominal or thoracic operation.
- What do the septic and aseptic operating theaters stand for? (layout and equipment of the operation room)
- Septic operating theater: Is used for operating on infected parts of the body (eg. Infected purulent wounds or gangrenous part)
- Aseptic operating theatre: risk of bacterial infection is very low, operation is on a patient free of infections. (eg. Varicectomy)
No need to build the two in seperate areas, they can even have a common corridor.
logic behind it is to keep lower the chance of infection of patient.
11.How shall the staff and the patient enter the operating room?
Essence is: always prepare the surgica area for the patient in a way that we do not put him/her in a danger of infection.
Before entering into the operating room, you should change your dresses in the dressing(or locker) room of the operating complex, and wear the surgical cap and the face mask.
The patients are brought into the operating theatre with the help of a specifically used transporting chair or bed- after passing through a separate locker room.
- Describe the structure of the operating room!
- Describe the structure of the operating room!
•The operating theatre is a 50-70 m2 room, no windows. It is adequatly lighted and its walls are covered with tiles up to the ceiling. It is artificially ventilated and is air-conditioned. The operating complex must be architecturally separated
from the wards and the intensive care unit. The walls and floor of the operating room should have no gaps. They should be cleaned easily. Doors should work
automatically. It is equipped with central and portable vacuum system, as well as pipes for gases.
(The operating complex consist of locker rooms, scrub up area, preparing rooms and operating theatres.)
- List 8 equipments /instruments within the operating room!
- Operating lamp
- Operating table
- Sonnenburg’s table
- Supplementary instrument stand
- Suction apparatus
- Diathermy
- Anesthesia machine
- Waste bin.
- Explain the rules of behaviour in the operating room!
- Only those people whose presence is absolutely necessary whould stay in the operating room
- Activity causing superflous air flow( talking, laughing and walking around) should be avoided.
- Entry into the operating theatre is allowed only in operating room attire and shoes worn exclusively in the operating room. This complete change
to garmets used in the operating theatre should also apply for the patient placed in the holdeing area( ie.dressing room)
- Leaving the operating are in surgical attire is forbidden
- The doors of the operating room must be closed
- Movement into the operating room out of the holding area is alowed only in a cap and mask covering hair, mouth and nose.
Describe the general rules of the aseptic operating room!
Taking part in an operation is permitted only after surgical handwash and
scrubbing.
Scrubbing person must not wear jewels.Watches and rings should be removed.
Fingers and nails should be clean. Nails short. Nail polish and artificial nail are forbidden.
Surgical team members in sterile attire should keep well within the sterile area; the sterile area is limited by isolation.
Scrupped team members should always face each other, and never show
their backs to each other. They should face the sterile field at all times.
Non-scrubbed peronnel should not come close to the sterile field or the
scrubbed sterile person, they should not reach over sterile surfaces, and
they should handle only non-sterile instruments
