Surgical Tech (Appleton & Lange) Part 10

Tetracaine is a synthetic local anesthetic that is commonly used in ophthalmology as a surface agent. It is effective on the mucous membrane and helps to numb the area, providing relief from pain and discomfort. Tetracaine is often used during eye examinations, surgeries, and other procedures to ensure patient comfort and minimize any potential discomfort. Miochol, Zolyse, and Dibucaine are not specifically used as surface agents in ophthalmology, making tetracaine the correct answer.

Dilating eye drops are called mydriatics because they are used to dilate the pupil of the eye. This helps to improve the visibility of the back of the eye during certain eye examinations or surgeries. Mydriatics work by relaxing the muscles that control the size of the pupil, allowing it to open wider. This allows more light to enter the eye, making it easier for the healthcare professional to examine the structures at the back of the eye. Miotics, on the other hand, are eye drops that constrict the pupil and are used to treat conditions such as glaucoma. Myopics refer to individuals with nearsightedness, and oxytocics are medications that stimulate uterine contractions during labor.

The procedure that accomplishes correction of myopia is a combination of keratoplasty and keratotomy. Keratoplasty involves reshaping the cornea through surgical intervention, while keratotomy involves making incisions in the cornea to reshape it. By combining these two procedures, the shape of the cornea is altered to correct myopia, which is a condition where the eye is unable to focus on distant objects. Therefore, the correct answer is B and C.

Facial nerve decompression is a surgical procedure that aims to relieve pressure or compression on the facial nerve. Bell's palsy is a condition characterized by sudden weakness or paralysis of the facial muscles, often caused by inflammation or compression of the facial nerve. Therefore, facial nerve decompression can be an appropriate treatment option for Bell's palsy to alleviate the compression on the facial nerve and restore normal function.

Dupuytren's contracture is a progressive disease that affects the palmar fascia, causing it to thicken and form nodules. Over time, this can result in the fingers being pulled towards the palm, leading to a contracture or bending of the fingers. This condition is characterized by the formation of fibrous tissue bands that restrict the movement of the affected fingers. It is a common condition that primarily affects the ring and little fingers, and it is more common in men and individuals of Northern European descent.

Miocol solution is prepared for a cataract procedure no more than 30 minutes before the actual instillation. This time frame ensures that the solution remains sterile and effective for the procedure. If the solution is prepared too far in advance, there is a risk of contamination or degradation of the solution, which could potentially lead to complications during the procedure. Therefore, it is important to prepare Miocol solution within the recommended time frame of 30 minutes before instillation.

The Candela laser is not typically used for treating extrauterine diseases of the female reproductive system. While CO2, Nd:YAG, and argon lasers can be used via a colposcope or laparoscope for various procedures such as laser ablation, coagulation, or vaporization, the Candela laser is more commonly used for cosmetic procedures like hair removal or skin rejuvenation. Therefore, the correct answer is Candela.

When using a sterile syringe, the scrub nurse should never touch the plunger except at the end. This is because the plunger is considered a sterile part of the syringe, and touching it can introduce contaminants and compromise the sterility of the syringe. By avoiding touching the plunger except at the end, the nurse ensures that the syringe remains sterile and ready for use during the surgical procedure.

A face lift is a surgical procedure that is also known as rhytidectomy. It involves removing excess skin and tightening the underlying tissues in order to reduce the appearance of wrinkles and sagging on the face and neck. This procedure helps to rejuvenate the facial appearance and create a more youthful look. Blepharoplasty refers to eyelid surgery, mentoplasty refers to chin surgery, and lipectomy refers to the removal of fat from specific areas of the body.

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In cochlear implantation, the receiver is placed into the mastoid bone of the skull. This bone is located behind the ear and is part of the temporal bone. The mastoid bone is chosen as the location for the receiver because it provides a stable and secure placement for the device. It also allows for easy access to the inner ear, where the electrodes of the cochlear implant will be inserted. By placing the receiver in the mastoid bone, it can gather impulses from the electrodes and send them along to the cerebral cortex for processing and interpretation of sound.

A fleshy, triangular encroachment onto the cornea is surgically termed a pterygium. A pterygium is a growth of pink, fleshy tissue on the conjunctiva, which is the clear tissue that lines the eyelids and covers the white part of the eye. It usually starts on the side closest to the nose and can gradually grow onto the cornea, affecting vision. Surgical intervention may be required to remove the pterygium if it causes discomfort or affects vision significantly. Chalazion, ectropion, and entropion are different conditions that involve the eyelids and are not related to a fleshy growth on the cornea.

The correct answer is "porcine" because porcine refers to something that is derived from or related to pigs. In the context of a temporary biologic dressing, porcine likely means that the dressing is made from pig-derived materials, such as pig skin or pig collagen. This type of dressing may be used to cover and protect wounds, promote healing, and provide a temporary barrier against infection.

A pressure dressing is used to apply pressure to a wound or injury in order to control bleeding. It helps to prevent edema by reducing swelling and promotes healing by distributing pressure evenly. It also absorbs extensive drainage from the wound. However, the purpose of a pressure dressing is not to conform to the body contour, as it is more important to apply consistent pressure to the wound rather than conforming to the body shape.

The majority of benign salivary gland tumors occur in the parotid gland. The parotid gland is the largest salivary gland located in front of the ear and produces saliva that helps in the digestion process. Benign tumors in the parotid gland are more common compared to other salivary glands. These tumors are usually non-cancerous and can be easily treated with surgery, if necessary.

Following a tonsillectomy, the patient is positioned on their side, horizontally. This position allows for proper drainage of any blood or fluids that may accumulate in the throat or mouth after the surgery. It also helps to prevent the patient from choking or aspirating any secretions. Additionally, positioning the patient on their side reduces the risk of airway obstruction and facilitates easier monitoring of vital signs during the recovery period.

The correct answer is argon or Nd:YAG laser. These lasers are commonly used in a noninvasive process to treat glaucoma. They work by using focused beams of light to target and treat specific areas of the eye, helping to reduce intraocular pressure and manage the symptoms of glaucoma. The use of lasers in this treatment method is considered noninvasive because it does not require any surgical incisions or invasive procedures.

CO2 laser is commonly used for surgical procedures involving the larynx and vocal cords. This laser emits a wavelength that is well absorbed by water, making it highly effective for cutting and vaporizing tissues. It provides precise control and minimal damage to surrounding tissues, making it a preferred choice for delicate procedures in the larynx and vocal cords. The CO2 laser can be used to remove lesions, treat vocal cord nodules or polyps, and correct other abnormalities in the larynx and vocal cords.

Microtia is a condition characterized by the absence of the external ear. It is a congenital deformity where the external ear is either underdeveloped or completely missing. This can affect one or both ears. The condition can vary in severity, with some individuals having a small, malformed ear, while others may have no ear at all. Microtia can cause hearing loss and can be associated with other abnormalities in the ear and facial structures. Treatment options for microtia include reconstructive surgery and the use of hearing aids or assistive devices to improve hearing.

Healon is a vesicoelastic drug that is commonly used in cataract surgery to occupy space in the posterior cavity of the eye. It helps maintain the shape of the eye during the surgery and prevents the collapse of the eye's structure. Healon is a clear, viscous substance that is injected into the eye and provides temporary support and protection to the delicate tissues during the surgical procedure. It is an important tool in ensuring successful cataract surgery outcomes.

The Jansen-Middleton forceps are used to remove the septal cartilage in a rhinoplasty. This instrument is specifically designed for this purpose and allows for precise and controlled removal of the cartilage. It is commonly used by surgeons during the procedure to reshape and reconstruct the nasal septum. The other options listed are not specifically designed for this purpose and are not commonly used in rhinoplasty procedures.

Iridectomy is a surgical treatment for chronic wide angle closure glaucoma that involves the removal of a portion of the iris. By creating a hole in the iris, this procedure allows for the re-establishment of communication between the posterior and anterior chamber of the eye. This helps to relieve the pressure buildup caused by the closure of the angle, thereby reducing the risk of glaucoma-related complications. Elliot trephination, cyclodialysis, and posterior lid sclerectomies are not specifically indicated for re-establishing communication between the chambers of the eye in cases of wide angle closure glaucoma.

Collecting needles in a medicine cup is the least desirable method for needle accountability because it does not provide a secure and organized way to keep track of the needles. The needles can easily get misplaced or mixed up with other needles, leading to potential safety hazards and difficulty in finding the right needle when needed. Using an original packet, adhesive or magnetic board, or a needle rack provides better organization and ensures that the needles are easily identifiable and accessible.

Wydase is an enzymatic drug commonly used with anesthetic solutions to increase tissue diffusion. It works by breaking down the extracellular matrix, which allows for better penetration of the anesthetic solution into the surrounding tissues. This increased tissue diffusion helps to enhance the effectiveness of the anesthetic and improve its overall efficacy.

Resection refers to the surgical removal of a portion of an ocular muscle with subsequent reattachment. This procedure is commonly performed to correct strabismus, a condition characterized by misalignment of the eyes. By removing a portion of the muscle and reattaching it, the tension and position of the muscle can be adjusted to improve the alignment of the eyes. Therefore, resection is the correct term to describe this surgical technique.

Hyaluronidase is added to a local ophthalmic anesthetic to increase diffusion. Hyaluronidase is an enzyme that breaks down hyaluronic acid, a substance found in the extracellular matrix of tissues. By breaking down hyaluronic acid, hyaluronidase increases the permeability of tissues, allowing the anesthetic to diffuse more easily and quickly into the surrounding area. This helps to enhance the effectiveness of the anesthetic by ensuring a wider distribution and faster onset of action.

Endometrial ablation is a surgical procedure performed to correct menorrhagia, which is excessive or prolonged menstrual bleeding. This procedure aims to remove or destroy the lining of the uterus, reducing or stopping the heavy bleeding. Amenorrhea refers to the absence of menstrual periods, metrorrhagia is irregular bleeding between periods, and endometriosis is a condition where the tissue lining the uterus grows outside of it. However, the question specifically asks for the reason for performing endometrial ablation, which is to address menorrhagia.

The given answer states that "prosthesis must be dried completely before implant" is not a rule that covers handling of prosthetic devices during plastic surgery procedures. This means that drying the prosthesis completely before implant is actually a rule that should be followed. The other options mentioned in the question are rules that cover handling of prosthetic devices, such as wiping powder from gloves before handling, using gloves to prevent skin oils from causing an inflammatory response, and placing the prosthesis on a lint-free surface to sterilize.

Total laryngectomy is a surgical procedure that involves the removal of the entire larynx, which includes the vocal cords. The soft palate, strap muscles, and hyoid bone are not part of the larynx. Therefore, they are not included in a total laryngectomy procedure.

Glaucoma is the correct answer because it is an eye disease that can be diagnosed and monitored using the argon slit lamp, a noninvasive procedure. If the treatment for glaucoma is successful, it can prevent the need for more invasive surgeries such as trabeculectomy or laser surgery. Cataract, retinal detachment, and pterygium are not typically associated with the use of the argon slit lamp or noninvasive procedures for diagnosis or treatment.

Labyrinthectomy is the correct answer because it involves the surgical removal of the labyrinth, which is the inner ear structure responsible for balance and hearing. Severe vertigo can be caused by problems in the inner ear, such as Meniere's disease, which can be treated by removing the affected labyrinth. This procedure eliminates the source of vertigo and can provide relief for the patient. Stapedectomy, myringotomy, and endolymphatic shunt are not appropriate treatments for severe vertigo.

Trabeculectomy is a surgical procedure used to treat glaucoma by creating a new drainage channel for the fluid inside the eye to reduce intraocular pressure. Molteno implants are often used during trabeculectomy to help maintain the new drainage pathway and prevent scarring. Therefore, the correct answer is trabeculectomy.

Miocol is the correct answer because it is a drug used to contract the sphincter of the iris during an intracapsular cataract extraction. This drug helps to constrict the iris muscles, which can improve surgical outcomes and prevent complications during the procedure.

Pilocarpine is a miotic drug because it causes constriction of the pupil. Miotic drugs are used to treat conditions such as glaucoma, where increased pressure in the eye can damage the optic nerve. Pilocarpine works by stimulating the muscles in the eye that control the size of the pupil, leading to a decrease in intraocular pressure. Homatropine, atropine, and scopolamine are not miotic drugs, as they have different mechanisms of action and are used for different purposes such as dilating the pupil or preventing motion sickness.

The Graves self-retaining retractor is commonly used in vaginal procedures. It consists of two curved blades that can be adjusted to hold the vaginal walls apart, providing optimal visibility and access to the surgical site. This retractor is designed to stay in place without the need for constant manual holding, allowing the surgeon to focus on the procedure.

Keratoplasty is a surgical procedure performed when the cornea is thickened or opacified. It involves removing a portion of the damaged cornea and replacing it with a healthy donor cornea. This procedure is commonly used to improve vision in patients with conditions such as corneal scarring, keratoconus, or corneal dystrophy.

A chalazion is a chronic inflammation of the meibomian gland. The meibomian gland is located in the eyelid and produces an oily substance that helps lubricate the eye. When the meibomian gland becomes blocked or infected, it can lead to the formation of a chalazion. This condition is characterized by a painless lump or swelling on the eyelid. Treatment options include warm compresses, gentle massage, and in some cases, surgical drainage.

Ectropion refers to the sagging and eversion of the lower eyelid. This condition causes the eyelid to turn outward, exposing the inner surface of the eyelid and leading to symptoms such as watery eyes, redness, and irritation. Entropion, on the other hand, is the opposite condition where the eyelid turns inward. Blepharitis is inflammation of the eyelid, and ptosis refers to drooping of the eyelid. Therefore, the correct answer for the given question is ectropion.

A stent dressing is used to facilitate good contact between a skin graft and the recipient site. A stent dressing is a type of dressing that is designed to hold the graft in place and provide support, allowing it to adhere to the recipient site. This type of dressing helps to ensure that the graft remains in the correct position and minimizes the risk of movement or displacement, which can hinder the healing process. By providing stability and support, a stent dressing promotes successful graft integration and improves overall outcomes.

When a tracheostomy tube is inserted, the obturator is quickly removed to allow air to flow through the tube. After the obturator is removed, the trachea may need to be suctioned to remove any secretions or blockages. This is typically done using a catheter, which is a thin tube that is inserted into the trachea to suction out any fluids or mucus. The Frazier, Poole, and Yankauer are all types of suction tips that are used for different purposes, but in this case, a catheter would be the most appropriate tool to suction the trachea.

Hypospadias is a penile defect in which the urethra ends on the ventral surface of the penile shaft or in the perineum. This condition occurs during fetal development when the urethral opening does not form at the tip of the penis as it should. Instead, it is located on the underside of the penis. Hypospadias can vary in severity, with some cases only involving a slight misplacement of the opening and others involving a more significant displacement. Surgery is often required to correct hypospadias and restore normal urinary and sexual function.

A submucous resection is a surgical procedure used to correct a deviated septum. The deviated septum refers to the displacement of the wall that separates the two nostrils, causing breathing difficulties. During a submucous resection, the surgeon removes or repositions the obstructing tissues or bone within the nasal passage to improve airflow and alleviate symptoms. This procedure is specifically targeted at correcting the deviated septum and is different from other surgical interventions such as antrostomy (opening of the maxillary sinus), rhinoplasty (cosmetic surgery to reshape the nose), or turbinectomy (removal of nasal turbinates to improve airflow).

A 120-degree endoscope is used ONLY in maxillary sinus surgery because it provides a wider field of view compared to the other options. This degree of angulation allows for better visualization and access to the maxillary sinus, which is located in the cheek area. The larger angle allows surgeons to navigate through the narrow and complex anatomy of the sinus, improving the accuracy and effectiveness of the surgical procedure.

Anterior vitrectomy is the procedure used to correct accidental vitreous loss during a cataract extraction. This involves removing the vitreous gel from the anterior chamber of the eye to prevent complications such as retinal detachment or infection. Posterior vitrectomy and pars plana vitrectomy are not specifically used for correcting vitreous loss during cataract extraction, but for other conditions involving the vitreous humor. Therefore, the correct answer is anterior vitrectomy.

During an intranasal antrostomy (antral window), the maxillary sinus is entered. This procedure involves creating an opening in the wall of the maxillary sinus, which is located in the cheek area. By entering the maxillary sinus, surgeons can access and treat conditions such as chronic sinusitis or remove polyps or tumors. The ethmoid sinus is located between the eyes, the sphenoid sinus is behind the nose, and the frontal sinus is in the forehead area.

Bone allografts are commonly used in surgeries to replace or repair damaged bone. To ensure their safety and effectiveness, certain responses are required from the scrub team. These include culturing the allograft before implantation to check for any infections, washing it with an antibiotic solution to minimize the risk of infection, and completely thawing the allograft before use. However, the correct answer states that "completely thaw" is not required from the scrub team. This suggests that the bone allografts can be used without being completely thawed, which is incorrect. Thawing the allograft is necessary to ensure its proper handling and integration with the patient's bone. Therefore, the correct answer is incorrect, and the explanation highlights this discrepancy.

Glycerol is a hyperosmotic drug that is given orally before surgery to increase osmotic pressure and lower intraocular pressure. It works by drawing fluid out of the eye, reducing the pressure inside the eye. This can be beneficial in eye surgeries where high intraocular pressure can cause complications. Glycerol is administered orally, unlike other hyperosmotic drugs like mannitol or urea, which may be given intravenously. Diamox is not a hyperosmotic drug and is typically used to treat glaucoma by reducing the production of fluid in the eye.

Pledgets are small pieces of absorbent material that are used to control bleeding during ear surgery. Epinephrine is a vasoconstrictor, meaning it constricts blood vessels, which helps to reduce bleeding. Therefore, pledgets soaked in epinephrine would be effective in controlling bleeding during ear surgery.

Mytingotomy is the correct answer because it is a surgical procedure that involves making an incision in the eardrum to relieve pressure and improve ventilation in the middle ear. This procedure is commonly used to treat conditions such as chronic otitis media with effusion or Eustachian tube dysfunction, which can cause a buildup of fluid or pressure in the middle ear. By creating a small hole in the eardrum, mytingotomy allows for the equalization of pressure between the middle ear and the external environment, promoting better ventilation and reducing the risk of complications.

CO2 and helium-neon lasers are particularly useful in surgery of the larynx and vocal cords. CO2 lasers are commonly used for cutting and vaporizing tissue, while helium-neon lasers are used for precise targeting and coagulation. The combination of these two lasers allows for both cutting and sealing of blood vessels, making them ideal for surgical procedures in delicate areas like the larynx and vocal cords.