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Procedures
I Indications for an Artificial Airway A Absolute 1. Hypoxia—inadequate tissue oxygenation (partial pressure of oxygen [P o 2 ] <55 mm Hg), unresponsive to supplemental O 2 2. Hypoventilation—increasing partial pressure of carbon dioxide (P co 2 ; >50…
Robotics and Newer Surgical Technologies
Minimally invasive surgery (MIS) describes an approach where major operations are performed through small incisions. MIS encompasses laparoscopy, robotic surgery, and natural orifice transluminal endoscopic surgery (NOTES), surgical techniques that promise to impact the way surgery is practiced. The goal…
Plastic Surgery: Breast Reconstruction
I Introduction Surgical therapy of breast cancer remains not only an important therapeutic mainstay but has also evolved as common prophylactic intervention. Although the techniques of local excision and mastectomy have changed since Halsted’s time, significant disfigurement may still occur.…
Orthopedic Surgery
I Assessment of the Orthopedic Patient A Basic Advanced Trauma Life Support Principles 1. Airway/breathing/circulation initial assessment 2. Disability/exposure a. Secondary examination of extremities (1) Appearance of abrasions and deep lacerations (2) Range of motion of all joints (3) Presence…
Neurosurgery
There are many nontraumatic neurosurgical conditions that pose an immediate threat to neurologic function or life. Due to the sensitivity of neurologic structures to insult and the relative lack of regenerative capacity in the central nervous system (CNS), the early…
General Pediatric Surgery
I Fluids And Nutrition A Maintenance Fluids 1. Neonates—fluid requirement is 65 mL/kg over 24 hours. 2. By the end of the first week of life—fluid requirements increase to 100 mL/kg over 24 hours. 3. To calculate based on weight:…
Cardiac Transplantation
I History 1. The techniques for heart transplantation were developed by Norm Shumway and Richard Lower at Stanford University in the 1960s. 2. James Hardy performed the first heart transplant into a human with a chimpanzee xenograft in 1964 at…
Cardiac Surgery
I Preoperative Evaluation A History 1. History of present illness—detailed account of symptom chronology: acute versus chronic a. Angina—stable or unstable, arrhythmia, congestive heart failure b. Timing of recent intervention c. Dyspnea: New York Heart Association (NYHA) functional classification for…
Thymus and Mediastinal Tumors
I Anatomy and Embryology 1. The thymus gland originates from the third and fourth pharyngeal pouches (along with the lower parathyroid glands) and typically descends into the anterior mediastinum. 2. The Shields three-compartment model is the most anatomic model and…