MOS

describe the appearance of the following types of exudates

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list 5 guidelines that should be followed in caring for instruments

1. handle instruments carefully 2. don't pile instruments in a heap 3. keep sharp instruments from the rest of the instruments 4. keep instruments with a ratchet in open position when not using them 5. rinse blood and body secretions off asap to prevent it from drying

list the characteristics of a minor surgical procedure

1. performed in medical office 2. performed in a short period of time 3. require a local anesthetic 4. can be performed with a minimum of patient discomfort 5. does not pose a major risk to the function of an organ or any body parts

list the characteristics of melanoma

1/2 of mole is different than the other, irregular border (uneven), color varies from one area to another, diameter is larger than 1?4 in, painful mole/tender/itches/bleeds/oozes/or has a scaly appearance

what type of bandage turn is used to anchor a bandage

2 circular turns and is passed back and forth over the tip of the joint of the bandage

wound

a break in the continuity of an external or internal surface caused by physical means

incision

a clean cut caused by a cutting instrument

abscess

a collection of pus in a cavity surrounded by inflamed tissue

what occurs during the inflammatory phase of wound healing?

a fibrin network forms, resulting in a blood clot that "plugs" up the opening of the wound and stops the flow of blood - eventually becomes a scab

colopscope

a lighted instrument with a binocular magnifying lens used to examine the vagina and cervix

furuncle

a localized staphylococcal infection that originates deep within a hair follicle; also known as a boil

inflammation

a protective response of the body to trauma and the entrance of foreign matter

what is the advantage of a needle biopsy?

a sample of tissue can be obtained that might otherwise require a major surgical operation

bandage

a strip of woven material used to wrap or cover a part of the body

forceps

a two pronged instrument for grasping and squeezing

abrasion

a wound in which the outer layers of the skin are damaged

laceration

a wound in which the tissues are torn apart, leaving ragged and irregular edges

puncture

a wound made by a sharp, pointed object piercing the skin

what is the purpose of reversing the spiral during a spiral-reverse turn?

allows for a smoother fit and prevents gaping caused by variation in the contour of the limb

fibroblast

an immature cell from which connective tissues can develop

contusion

an injury to the tissues under the skin that causes blood vessels to rupture, allowing blood to seep into the tissues

list 3 functions of a bandage

apply pressure to control bleeding; protect wound from contamination; hold a dressing in place; to protect, support, immobilize injured part of the body

what are the characteristics of benign moles?

brown-black, round, oval, smaller than pencil eraser, raised or flat, hairs grow out of them

serosanguineous

clear and blood-tinged drainage and is commonly seen in surgical incisions

what is the difference between a closed and an open wound

closed wound is an injury to the underlying tissue without a break in the skin; open wounds involve a break in the skin that exposes the underlying tissue

list 4 signs that may indicate a bandage is too tight

coldness, pallor, numbness, cyanosis of nail beds, swelling, pain and tingling sensation

what occurs during the maturation phase of wound healing?

collagen continues to be synthesized, and granulation tissue eventually hardens to white scar tissue

what is the difference between congenital nevi and acquired nevi?

congenital; born with moles acquired; may develop moles over time

what is an exudate?

consists of fluid and cells that have escaped from blood vessels during the inflammatory process and is deposited on tissue surfaces.

puro-sanguineous

consists of pus and blood-tinged drainage and is often seen in a new wound that is infected

serous

consists of serum (clear part of blood)~clear and watery ex. fluid in a blister from a burn

purulent

contains pus (consists of leukocytes)~ thick and has an unpleasant odor; white with tinges of pink, green or yellow

list 2 uses of cryosurgery

destroys abnormal cervical cells that may lead to cancer; treatment for chronic cervicitis

what are the post-op instructions for ingrown toenail removal?

elevate foot for 24 hrs, keep area clean and dry, cleanse toe daily with warm water and towel dry, apply antibiotic ointment daily, wear loose shoes for 2 weeks, avoid strenuous exercise 2 weeks, contact dr. if infection occurs

what are the advantages of tissue adhesives?

eliminate need for sutures and local anesthetic, easy to apply, form a water resistant protectant covering over wound.

what are the advantages of skin closure tape?

eliminate need for sutures, easy to apply and remove; lower incident of wound infection compared with sutures; and they result in less scarring than sutures

explain how an instrument should be handed to the physician during MOS?

firm, confident manner; functional position (position in which it will be used)

sterile

free of all living microorganisms and bacterial spore

what is the purpose of a fenestrated drape?

has an opening placed right over the operative site; it covers a wide area of skin around the operative site, leaving only the operative site exposed.

what is the purpose of performing a cervical punch biopsy?

helps physician determine the type of abnormal tissue present on the cervix so that the physician can determine the best form of treatment

what is the difference in function between mosquito hemostatic forceps and standard hemostatic forceps?

hemostatic have serrated tips, ratchets, ring handles and box locks; mosquito forceps have small, fine tips and are more smaller and delicate.

list 2 uses of the figure eight bandage turn

hold a dressing in place; support and immobilize an injured joint; such as ankle, knee, elbow or wrist

list reasons for the removal of a sebaceous cyst

if they become infected; to relieve discomfort in an area that is easily irritated (armpit)

what is the difference between incision and a laceration?

incision; clean, smooth cut caused by surgical instrument; laceration; tissues are torn apart- jagged looking

what are the most common methods of wound closure?

include sutures, surgical tapes, topical skin adhesives (surgical glue), and skin closure tape

what are the characteristics of a local anesthetic?

infiltration~ produces a loss of sensation in an area to prevent patient from feeling pain during the surgery

why should the MA be careful when applying an elastic bandage

it is easy to apply it too tightly and impede circulation

what is the purpose of adding epinephrine to a local anesthetic?

it prolongs the local effect of the anesthetic; decreases the rate of absorption

what is the purpose of using gauze packing or rubber Penrose drain after incising a localized infection?

keeps the edges of the tissues apart; this facilitates drainage of the exudate

describe the appearance of dysplastic nevi. what concern exists with dysplastic nevi?

larger than normal mole with an irregular color and shape; center is raised and darkened; they are more likely than ordinary moles to develop into malignant melanoma

what are the disadvantages of skin closure tape?

less precise in bringing wound edges together; difficulty adhering to skin (palms, feet, hairy areas)

list the post-op instructions that may be relayed to the patient after a cervical punch biopsy

minimum cramping/ bleeding may occur for about 1 week (call if it lasts longer); thick, dark-colored vaginal discharge may occur; don't douche, use tampons, have intercourse for 1 week after (cervix needs time to heal); contact dr. if anything is wrong

list the post-op instructions that must be relayed to the patient after cervical cryosurgery

normal activities can be performed that day; on first day, a clear watery discharge occurs ( for 2-4 weeks); use pads not tampons for discharge; don't douche, use tampons, have sex

list 4 guidelines to follow when applying a bandage

observe medical asepsis; area is clean and dry; don't apply bandage over an open wound (first apply a dressing); ensure joints and bone prominences are padded correctly to avoid irritation

what is an ingrown toenail?

occurs when the edge of the toenail grows deeply into the nail groove and penetrates the surrounding skin, resulting in pain and discomfort

list 2 reasons for performing a colposcopy?

performed after abnormal pap test results and to evaluate a vaginal or cervical lesions observed during a pelvic exam

what is the purpose of a biopsy?

performed to determine whether a tumor is malignant or benign; a biopsy also may be used as a diagnostic aid for other conditions such as infections.

surgical asepsis

practices that keep objects and areas sterile or free from microorganisms

sanguineous

red and consists of red blood cells~ bright red sanguineous exudate indicates fresh bleeding, and a dark exudate is older bleeding

list 4 signs that occur during inflammation

redness, swelling, pain, oozing, warmth

list the responsibilities of the MA during a minor surgical procedure

responsible for pre-op instructions, obtain patient's signature on a written consent form, prepare treatment room, prepare patient, prepare patient for surgery, prepare mos tray, and assist physician with procedure, clean room.

where do sebaceous cysts most frequently occur? where do they not occur?

scalp, face, neck, ears, back and genital area; don't occur~ palms of hands and soles of feet (no oil glands)

what are the most common methods used to remove moles?

shave excision, surgical excision, and laser surgery

list 5 examples of materials used for nonabsorbable sutures

silk, nylon, polyester, stainless steel and surgical skin staples

what is the purpose of preparing the patient's skin before MOS?

skin contains abundance of microorganisms; a wound infection could develop

what are skin tags? where are they most frequently found on the body?

small, painless benign growths that project from the skin from a small narrow stalk (peduncle)~ found where skin creases; eyelids, neck, armpits, chest and groin

list 2 advantages of using surgical skin staples to approximate a wound

stapling is a faster method of closure; trauma to the tissue is reduced because the tissue doesn't have to be handled as much

what is a swaged needle? list advantages of using a swaged needle.

suture and needle are one continuous unit; suture material doesn't slip off needle; tissue trauma is reduced because there's only one strand being pulled through

absorbable suture

suture material that is gradually digested and absorbed by the body

nonabsorbable suture

suture material that is not absorbed by the body

why does a puncture wound encourage the growth of tetanus bacteria?

tetanus bacteria grow best in a warm anaerobic environment, such as the one in a puncture

capillary action

the action that causes liquid to rise along a wick, a tube, or a gauze dressing

hemostasis

the arrest of bleeding by natural or artificial means

surgery

the branch of medicine that deals with operative and manual procedures for correction of deformities and defects, repair of injuries, and diagnosis and treatment of certain diseases

infection

the condition in which the body is invaded by a pathogen

approximation

the process of bringing two parts, such as tissue, together through the use of sutures or other means

biopsy

the surgical removal and examination of tissue from the living body

cryosurgery

the therapeutic use of freezing temperatures to destroy abnormal tissue

what occurs during the proliferative phase of wound healing?

the wound is rebuilt with new connective tissue (granulation tissue)- fills the wound and protects the surface of the wound

what types of wounds are tissue adhesives most commonly used to close?

they are best suited to close a small superficial lacerations; incisions of face, torso, limbs.

what is the purpose of serrations found on some instruments

they are saw like teeth that grasp tissue and prevent it from slipping out of the jaws of the instrument

how do tissue adhesives work?

they form a strong transparent flexible bond across the top of the skin that binds the skin edges together

why are sutures inserted in the head and neck generally removed sooner than other sutures?

they have a good blood supply; the sutures don't need to be there as long as other areas because they heal more rapidly

what is a sebaceous cyst and what causes it to form?

thin, closed sac located just under the skin; it forms when the outlet of a sebaceous (oil) gland becomes obstructed

list 3 causes of an ingrown toenail

tight shoes/ trauma, improper nail trimming, or infection can cause an ingrown toenail

what is the purpose of wound closure?

to approximate (bring together) the edges of the wound and hold them in place until enough healing has taken place

contaminate

to cause a sterile object or surface to become unsterile

what is the purpose of inflammation?

to destroy invading microorganisms and remove damaged tissue debris from the area

what is the function of an exudate?

to flush foreign debris and dead tissue from the wound and to provide a moist environment to assist in wound healing

what are the functions of a sterile dressing?

to protect the wound from contamination and trauma; to absorb drainage, and restrict motion, which may interfere with proper wound healing

what is the appearance of granulation tissue?

translucent red and dark; soft and moist to touch; bumpy/granular in appearance; painless.

colposcopy

visual examination of the vagina and cervix using a colposcope

when must surgical asepsis be employed

when caring for broken skin, when a skin surface is being penetrated, and when a body cavity is entered that is normally sterile

what is the name of the local anesthetic most frequently used in the medical office during MOS?

xylocaine (lidocaine hydrochloride)