Outline History of surgery Commonly used word roots

Outline • • • History of surgery Commonly used word roots Commonly used medical terms Common diseases Take a look at the operation room

History of Surgery and Surgeons

Barber Poles and Surgeons

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Notable Milestones in Surgical History • 1540 C. E. - English barbers and surgeons unite to form The United Barber-Surgeons Company. These barber-surgeons performed tooth extractions and blood letting. • 1846 - First public use of anesthesia during surgery. Ether was used. The patient was conscious but felt no pain • 1867 - British surgeon Joseph Lister publishes Antiseptic Principle in the Practice of Surgery, extolling the virtues of cleanliness in surgery. • 1890 s - Widespread use of chemical agents to minimize germs. Carbolic acid was put on incisions to minimize germs and decrease infection rates.

In the 19 th century, introduction of anesthesia and methods of preventing infection possible to correct musculoskeletal deformities surgically

• 1895 - First X-ray performed, in Germany. • 1928 - Antibiotics discovered. • 1940 - First metal hip replacement surgery performed. • 1975 - First organ surgery performed using laparoscopic, or minimally invasive, technique. • 1985 - First documented robotic surgery. • 2000 - da Vinci robotic surgical system wins U. S. Food and Drug Administration approval. • 2010 - World's first full-face transplant performed, in Spain.

Etymology • Nicolas Andry (1658 -1742) derived orthopaedic from the Greek words • Orthon: straight, free from deformity splinting • Paidion: child • Orthopaedia: The Art of Correcting and Preventing Deformities in Children

• Orthopedists extended the scope of the specialty to include adults with musculoskeletal disorders • World War I stimulated further development of the specialty

splinting The musculoskeletal system could change with growth and changes in loading and use; he advised manipulation, splinting, and active exercise to prevent and treat deformities

Osteotomy Opening Wedge Osteotomy Closing Wedge Osteotomy Dome Osteotomy

Guided Growth • Hemi-epiphysiodesis surgery: by using a guided growth device to guide the growth of bone Metaphysis Physis (growth plate) Epiphysis

Common Word Roots

Common Word Roots Word Part tomos ex(ec) os stoma in cis(incisio) Origin Greek Latin/Greek Latin Meaning cut of, away, from opening like a mouth inside, into cut, cut with a knife Tomography / Computed Tomography/ Excision/ exostosis / exophthalmos Gastrostomy/ colostomy/ incision

• This is a free frame for those who are interested. Others may go on. Root ect/o tom/o -y combining form noun suffix meaning outside cut • Add ect + om + y = ectomy means excision/ appendectomy/ gastrectomy/ ostectomy • NOTE: One “t” is dropped when –tome is preceded by “ect. ”

• Here’s another free frame for those interested in – ostomy. Root os tom/o -y combining form noun suffix meaning mouth, opening cut • Add os + tom + y = ostomy means opening by cutting gastrostomy/ colostomy/ nephrostomy

Greek origin: tomos From the Greek word tomos we build many of the suffixes representing surgical cutting procedures. Word Part -tome -tomy -ectomy -ostomy Meaning instrument used to cut slices cut into, incise, incision cut out, remove, excision cut a new surgical opening Osteotome/ osteotomy/ ostectomy/ fenestration gastrotomy/ gastrectomy/ gastrostomy

Medical Terms (Review) • -ectomy: surgical removal Colectomy, Gastrectomy, Nephrectomy • -scopy: viewing, observation Colonoscopy, Gastroscopy, Arthroscopy • -stomy : make an artificial opening Colostomy, Nephrostomy, Gastrostomy • -tomy: cutting, incision Osteotomy, Tenotomy, Arthrotomy • -desis: binding, fixation Tenodesis, Arthrodesis • -plasty: surgical repair on a body part Arthroplasty, Tenoplasty, Osteoplasty

Oste(o)Root Oste(o) Origin Greek meaning bone • Osteo + logy = the study of bone • Osteo + tomy = incision of a bone • Osteo + pathy = any disease of bone • Osteo + penia = reduction in bone mass • Oste + oma = a tumor of bone tissue • Oste + itis = inflammation of bone Osteoporosis/ Osteomyelitis/ Osteochondroma

Arthr(o)Root Arthro Origin Greek meaning joint • Arthro + scopy = examination of the interior of a joint • Arthro + tomy = incision of a joint • Arthro + pathy = any disease of a joint • Arthro + plasty = surgical repair of a joint • Arthr + itis = inflammation of a joint Orthopedics/ Orthopedic Surgeon/ Orthosis/ Orthotics/ Orthodontist/ Orthopnea

Ten(o), Tendin(o) Root Tend(o), Tendin(o) Ten(o) Origin Latin meaning tendon Greek tendon • Teno + plasty = plastic repair of a tendon • Teno + tomy = surgical cutting of a tendon • Teno + desis = surgical fixation of a tendon • Tendino + pathy = any disease of a tendon • Tendin + itis = inflammation of a tendon Tenosynovitis/ Tenolysis

Try it ! • Gastr(o) means stomach. • If a person is unable to swallow and a tube feeding directly into the stomach is necessary, a new opening may be made through the stomach, called a gastro stomy / • ex/cision of the stomach → gastr / ectomy • in/cision into the stomach → gastro / tomy

• duoden/o is the combining form for the duodenum, which is the first section of the small instine. Build a word that means excision (removal) of the duodenum. Duodenectomy/ Duodenotomy/ Gastroduodenostomy

A surgeon who removes the natural connection between the duodenum and stomach and then forms a new connection is performing a Gastr/o/duoden/o/stomy

-graph • -graph is a suffix taken from the Greek verb graphein, meaning to write of record. In medical words, -graph refers to an instrument used to record data. • • X-ray: Radiograph Ultrasound: Sonograph Arthograph Computed Tomography (CT)

Commonly Used Terms

During Operation Surgical procedures may include • Incision • • Excision Repair Replacement Destruction Ablation Cauterization Dilation

During Operation • Aspirator: suctions fluids • Clamp: grasps tissue; controls bleeding • Curette: scrapes & removes tissue • D & C: Dilation & Curettage • Dilator: enlarges an opening by stretching • Endoscope: look inside the body • Forceps: grasps tissue/ teeth or smooth Retractor/ Elevator/ Drill/ Saw/ Osteotome/ Screw Driver

During Operation • GA: General Anesthesia: loss of consciousness, no pain • Hemostasis: stop flow of blood using instruments, pressure, or medication • I & D: Incision & Drainage • laser surgery: use of controlled beam of light • Local Anesthesia: no pain in one localized area, conscious • OR: Operating Room • Perioperative: before, during, after surgical procedure • Postoperative: after surgery • Prone position: face down, horizontal • Supine position: face up, horizontal (aka: dorsal recumbent)

During Operation • Regional Anesthesia: nerve block, no pain in particular region, conscious • Topical anesthesia: anesthetic liquid or gel placed directly onto specific area, conscious • Resection: surgically cut out; excision • Scalpel: cuts and separates tissue • -scopic: view inside (arthroscopic, gastroscopic, endoscopic…) • Scrub Nurse: surgical assistant ; hands in instruments to surgeon • Suture: to close a wound or incision

Operation Note • Under general anesthesia, the patient was placed in the prone position with the affected extremity resting on an arm support. After inflation of a pneumatic tourniquet, the surgery was performed on the elbow through a midline posterior skin incision extending from 6 cm proximal to 2 cm distal to the olecranon. …

History taking • Symptoms: pain, numbness, tenderness, weakness, or crepitus • Deformities: angulation/rotational abnormalities, masses, or diffuse swelling • Disturbances: function, restricted motion, or stiffness • Combinations of above

History Taking • N: Have you seen a doctor? • P: Yes, the doctor at the clinic has told me there is serious nerve compression, and has suggested an operation. • N: All right. So you know there is going to be an operation? • P: Yes. I was told about it. • N: OK. Let me check your muscle power. Lift your feet and push against me. • P: Like this (pushes with his right foot, then his left)? • N: Uh huh. Your right foot is weaker than your left. Now, let me orient you to the hospital.

Physical Examination • General Orthopaedic Examination • Local Orthopaedic Examination – Inspection – Palpation – Range of Motion – Joint Position – Measurement – Neurologic Examination

Radiographic Examination • • • Tomography Computed Tomography (CT) Magnetic Resonance Image (MRI) Bone Scanning Arthrography

• Tom/o/graphy is a radi/o/graphic procedure that uses x -rays to produce images of a slice or plane of the body. Each of the following imaging procedures is a type of tomography. • MRI → magnetic resonance imaging • CT → computed tomography (CAT scan) • PET → positron emission tomography • SPECT → single photon emission computed tomography For more information use your medical dictionary or perform a library or Internet search of these topics.

Operative Treatment • Soft tissue: Arthrotomy Synovectomy Tenotomy Capsulotomy • Bone procedures: Osteotomy Arthrodesis Arthroplasty

Common Deformity

Deformity on the coronal plane • Cubitus: deformity on the coronal plane of elbow Normal Cubitus valgus: forearm is angled away from the body Cubitus varus: forearm deviates toward the midline of the bod

Deformity on the coronal plane • Coxa: deformity on the coronal plane of hip

Deformity on the coronal plane • Genu: deformity on the coronal plane of knee

Deformity on the sagittal plane • Genu recurvatum: deformity on the sagittal plane of the knee

Deformity on the sagittal plane • Coxa : deformity on the sagittal plane of the hip

Fracture The bone is bent. It occurs mainly in children. The broken pieces are separated. The bone is broken into several pieces.

Fracture The broken pieces are pushed together. There is a break in the skin.

Arthritis • Osteoarthritis • the most common form of arthritis • chronic degenerative joint disease, affects mostly middleaged and older adults • can occur in any joint but most often hands, knees, hips, or spine • Symptoms: tend to build up over time • Joint pain • Joint stiffness (especially after sleep or inactivity) • Less movement in the joint over time • A grinding feeling of the joint when moved, as the cartilage wears away in more advanced stages

Arthritis • Rheumatoid Arthritis – – – an autoimmune disorder a chronic disease causing inflammation of the joints can occur at any age but most often in people from 35 to 50 happens more in women than in men Symptoms: may begin suddenly or slowly over time • Joint pain • Joint stiffness (especially in the morning) • Fatigue, lack of energy • Nodules • Affects the joints symmetrically (on both sides of the body) • Can affect other organs

Take a Look at the Operation Room

Operating Room

• Hybrid OR Equipment by SKYTRON includes (*Click on the links for more information): • 1. Surgical Lights, Recessed & Extended Length • 2. Video / Audio OR Integration • 3. Ceiling Mounted Booms • 4. Equipment Carriers • 5. Anesthesia Booms • 6. Surgical Displays • 7. Mobile Surgical Tables • 8. Stainless Cabinetry & Supply Storage Solutions • 9. Nurse Desks & Documentation Centers • 10. Scrub Sinks

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