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https://studentshare.org/miscellaneous/1570977-case-study-for-surgical-technologist-student.
Surgical Technologist (Case Studies) 12 October Case Study Gregory may be suffering from a compressed sciatic nerve and tests may be ordered that will thoroughly examine his lower back. Various tests include determining for any slipped disk, spinal stenosis, pelvic injury, tumors or degenerative disk disease. The first thing to do is have the leg examined by a neuromuscular doctor. Laboratory tests will include blood tests, X-rays or MRI. If it is determined conclusively that sciatica is involved, then the most likely surgical procedure will be for lumbar disk protrusions (Barrett & Golding, 1984, p. 97). The observed difficulty in speaking may be due to a series of mini-strokes or silent ischemia.
A recommended test will be either a CT scan or an MRI of the brain preferably together with an echocardiogram. The possible diagnosis is a transient ischemic attack or TIA due to smoking. If there is blockage, then a balloon angioplasty or coronary artery bypass surgery is needed. Case Study 2 Diabetes causes hyperglycemia which is elevated blood sugar in which an excessive amount of glucose circulates in the blood plasma. Hyperglycemia can cause neuropathy which also includes collateral damage from microvascular injuries as well as macrovascular injuries due to repeated trauma or insults (either vascular or biochemical in nature) and an increased capillary hydrostatic pressure (Joslin & Khan, 2005, p. 1135). Hugos prognosis is five years without claudication when his own vein is used but the fem-pop bypass will remain open in about 50% of the cases five years after surgery if an artificial graft is used.
Considering Hugo is now 65 years old, possible complications include leg swelling, bleeding and heart attack or stroke as he is a high-risk case. The risk of death is estimated at 1% to 3% of all surgery cases. 1. Collateral flow – refers to the alternative blood supply flow to the myocardium that has been jeopardized by ischemia (sometimes spelled as ischaemia). This is the process in which small and normally closed blood vessels (arteries) open up to serve as alternate routes if there is coronary heart disease, myocardial ischemia or a stroke (www.
americanheart.org).2. The difference – an ischemia is just a temporary stoppage in the supply of the needed oxygen to the heart for a very brief period of time while an infarction occurs when the heart muscles are deprived of the oxygen for too long that the muscles eventually die. There are other cases of ischemia and infarction occurring other than the heart such as what happens in the intestines due to a hernia, adhesions, arterial thrombosis, embolus (blood clots/plaques), venous thrombosis and extremely low blood pressure.3. Neurological deficits – in cases of temporary or transient ischemic attacks or TIA, the neurological deficits are not permanent because the nerve cells in the brain did not actually die.
The cells were able to recover due to the resumption of the oxygen supply and so there are no permanent neurological deficits or damage. The neurological deficits frequently experienced during a TIA are vision loss (amaurosis fugax), difficulty speaking (aphasia), a weakness on one side of the body (hemiparesis) and numbness (paresthesia) but all of them are only temporary lasting at the most up to one hour only and then disappear. 4. Loading a pledget – the Gelfoam torpedo is loaded retrogradely and tamped snugly into the syringe containing a contrast.
It is then injected into the diagnostic catheter.5. Pre-clotting a PTFE – this is no longer necessary as polytetrafluoroethylene or PTFE is non-porous that reduces the risk of interstitial bleeding (Branchereau, 1997, p. 290). 6. Two Surgical Instruments – the two instruments needed during the operation of endarterectomy are the straight Yasargil and Jacobson scissors (Connolly, 2002, p. 5). These include a sleeve, a fixed blade mounted at the distal end of the sleeve and an actuation rod.
ReferencesAmerican Heart (2010). Collateral Circulation. Retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4583Barrett, J. & Golding, D. N. (1984). The Practical Treatment of Backache and Sciatica. Hingham, MA, USA: Springer.Branchereau, A. (1997). Long-term Results of Arterial Interventions. Armonk, NY, USA: Futura Publishing Company, Inc.Connolly, E. S. (2002). Fundamentals of Operative Techniques in Neurosurgery. New York, NY, USA: Thieme Medical Publishers, Inc. Joslin, E. P. & Khan, C. R. (2005).
Joslins Diabetes Mellitus. Hagerstown, MD, USA: Lippincott Williams & Wilkins.
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