front 1 the three basic surgical positions | |
| back 2 The patient lies flat on the back with the arms extended on armboards
with the palms facing upward.
Body regions that may be accessed with the patient in the supine
position include:
- Head and neck.
- Anterior upper extremity.
- Chest/breast.
- Abdomen.
- Pelvis.
- Anterior
lower extremity.
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| back 3 - position is a modification of the supine position
- note
head-down positioning
- It is used to displace the
abdominopelvic organs cephalad to provide better visualization of
the surgical site. Another benefit of the Trendelenburg position is
that blood flow to the lower body is reduced and venous drainage is
promoted. Conversely, the position may be used to increase blood
flow to the upper body, as in the treatment of shock or for
distention of blood vessels to be cannulated. Body regions that may
be accessed with the patient in the Trendelenburg position include
the pelvis and the lower abdomen.
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| back 4 - reverse Trendelenburg position is a modification of the supine
position
- note head up position
- It is used to
displace the abdominal organs caudad to provide better visualization
of the surgical site. Other benefits of the reverse Trendelenburg
position are blood flow to the upper body is reduced, venous
drainage is promoted, and respiration is facilitated.
- Body
regions that may be accessed with the patient in the reverse
Trendelenburg position include the upper abdomen and the head and
neck.
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| back 5 - Fowler’s position is a modification of the supine position
- The Fowler’s position reduces blood flow to the upper body,
promotes venous drainage, and facilitates respiration. Air embolism
is a potential concern when the patient is in the Fowler’s
position.
- Body regions that may be accessed with the patient
in the Fowler’s position include the breast, head and neck, and
shoulder.
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| back 6 - The sitting position is a modification of Fowler’s
position
- The torso is in an upright position. The flexed arms
rest either on a lap pillow or on an adjustable padded table in
front of the patient. A body strap should support the shoulders, and
padding should be added to prevent sciatic nerve damage. When this
position is to be used for a neurosurgical procedure, the head will
be in a cranial headrest.
- used for surgeries neck/shoulders
up
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| back 7 - The lithotomy position is a modification of the supine
position
- Various positioning devices are available to place
the patient in the lithotomy position. The use of candy-cane-style
stirrups is presented here. Legs must be raised and lowered slowly
and simultaneously to prevent muscle strain in the lower back and to
allow for gradual adjustment to blood pressure.
- allen
stirrups may also be used
- body regions that may be accessed
with the patient in the lithotomy position include:
-
Vagina.
- Urethra.
- Perineum.
- Anus
and rectum.
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| back 8 - on stomach, flat
- Prior to placement in the prone
position, the patient is anesthetized on the stretcher
- All
preoperative procedures, such as Foley catheter insertion, must be
performed prior to placement of the patient in the prone
position.
- Body regions that may be accessed with the patient
in the prone position include:
- Posterior cranium.
- Dorsal body surface.
- Spine.
- Posterior
lower extremity.
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front 9 Kraske (jackknife) position | back 9 - is a modification of the prone position
- Body regions
that may be accessed with the patient in the prone position include
the anus and the pilonidal area.
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| back 10 - The lateral position is also referred to as the lateral
recumbent or lateral decubitus position
- laying on side
- The patient in the right lateral position is placed on the
operating table with the right side downward, exposing the left side
of the body. The patient in the left lateral position is placed on
the operating table with the left side downward, exposing the right
side of the body. With the patient in the lateral position, the
bottom leg is flexed and the legs are separated with pillows. All
preoperative procedures, such as Foley catheter insertion, must be
performed prior to placement in the lateral position.
- Body
regions that may be accessed with the patient in the lateral
position include the retroperitoneal space, hip, and
hemithorax.
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| back 11 - is a modification of the lateral position
- Body regions
that may be accessed with the patient in the kidney position include
the retroperitoneal space.
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| back 12 - is a modification of the left lateral position
- This is
the preferred position for endoscopy performed via the anus.
Typically, the patient remains on the stretcher (rather than being
transferred to the operating table) and is awake and able to assist
with positioning.
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