Transfers concentrated electrical current into another medium (e.g., electrical current transformed into thermal energy)
active electrode
Refers to the 16th- century philosopher René Descartes, who invented coordinate geometry; also called rectangular coordinate geometry
Cartesian coordinate geometry
What shows applications or documents that are open or running, and provides ability to switch between applications or documents, and keep multiple applications or documents open on desktop
Taskbar
What is a term that means creating a document
Word processing
The number of ways in which a robotic manipulator moves
degrees of freedom
The negatively charged particles circling the nucleus of an atom
electrons
The outermost electrons in the atom’s orbit that can most easily be attracted away from the nucleus
free electrons
A pad that is placed on a patient to complete the pathway for the electrical current back to the electrosurgical unit; also called the dispersive electrode
grounding pad
The weight supported or force imposed
load
The property of a body that causes it to have weight in a gravitational field
mass
Subatomic particles equal in mass to protons but without an electrical charge
neutrons
New term that replaces dispersive (inactive) electrode; also called a grounding pad
patient return electrode
(1) Liquid portion of body fluid; (2) an ionized gas made primarily of free electrons and having a neutral charge
plasma
What shows applications or documents that are open or running and provides ability to switch between applications or documents, and keep multiple applications or documents open on desktop
Taskbar
What can you access through the control panel or "preference planes on a mac"
Changing the desktop
Buttons let user ......... a window or document. The item is restored by clicking its icon at the bottom of the screen
minimize/reduce
What is a device used to open or close a circuit, thereby controlling the flow of electricity
switch
An elemental particle with a positive charge equal to the negative charge of the electron
protons
What is equals to or holds 1 character
Byte
What is 1024 bytes
Kilobye
What is 1024 kilobytes
Megabyte (MB)
What is 1024 megabytes
Gigabyte (GB)
What is 1024 gigabytes
Terabyte (TB)
Who has mandated that health care facilities use an electronic medical record (EMR) system
Centers for Medicare and Medicaid Services (CMS)
The principles that govern the behavior of tiny particles known as electrons are called the .........., which helps to explain electricity and serves as the basis for design of all electrical equipment
electron theory
What is an elemental particle with a POSITIVEcharge equal to the negative charge of the electron
protons
What is the property of a body that causes it to have weight in a gravitational field
mass
What are negatively charged particles circling the nucleus of an atom
electrons
What is called anything that has mass and occupies space
Matter
All matter consists of
Atoms are indivisible (smallest thing that cannot be made smaller)
atoms
What are subatomic particles that are neutral
neutrons
The center of the atom is called the
nucleus
What are negatively charged particles that travel in concentric paths or orbits AROUND the nucleus.
Electrons
What term describes the free electrons moving or flowing from the ring of one atom to another.
electricity
Materials that allow the flow of free electrons are called
conductors
What is the most commonly used conductor because it is the most economical
Copper
Examples of devices that use copper wire as a conductor in the OR include
surgical lamps, ESU, and power drills.
What are the outermost electrons called in the atom’s orbit that can most easily be attracted away from the nucleus
free electrons
Electrons revolve around the nucleus in paths called ......
shells or orbits
Material that inhibits the flow of free electrons; typically prevents electron leakage and directs the flow to a destination
insulators
What is the function of an insulator
They are simply poor conductors. Wrapped around metals they prevent leakage of electrons.
Examples of insulators in the OR are
the rubber and plastic covers around the cords of the ESU or x-ray machine.
Because water is a conductor of electricity, what environmental factor should be a big consideration
humidity
High humidity in the OR often results in
static charge leakage
Low humidity in the OR results in the
formation of sparks
Electrical charges can be either .......... and are simply defined as too many or too few electrons on an atom
negative or positive
What is a magnetic field
it is the lines of magnetic force that flow between the north and south poles on a magnet. Opposites attract
Remember, electricity does not produce power; it is only the means for ........ it. The interaction between the wires and magnets is what produces the power.
transporting
What are devices called that convert mechanical energy (from steam or water) to electric energy. The turbines rapidly spin magnets that create the electricity used by hospitals and clinics, businesses, and homes.
generators
What two principles are briefly discussed that have important applications in the OR:
Magnetism can generate an electric current and
electricity is used to generate magnetism.
What defines electrical potential
Volt
An electric system uses a battery or generator to create a force or ....... to move the electricity from one point to another.
voltage
What is the path that electricity travels between an energy source and its usage device(s)
circuit
What is the potential energy of electrons (or the electric charge) at any given time between two points
Voltage
What is current measured in
AMPS
What is the flow of electric charge or the rate of flow of electrons. For example, a single strand of copper wire is laid on a table; one end of the wire is negative, and the other is positive.
Current
Components of the three-prong plug are
First prong (positive)
Second prong (negative)
Third prong (ground)
One kilowatt equals
1,000 W.
What is typically a 220v circuit used for in the OR
Mobile xray unit
What are metals that become magnetic when a conductor, such as copper wire, is wrapped around them
Electromagnets
What volts are electrical outlets usually in the OR (excluding 1)
110 volts (V),
To facilitate usage, watts are converted to
kilowatts (kW)
Power is measured in
Watts (W)
What are a common example of DC current
Batteries
What are the two types of electrical systems availble
direct current (DC) and alternating current (AC).
What are a common example of DC current
Batteries
What indicates electrical current that flows in one direction from the negative pole to the positive pole
direct current (DC)
What describes the flow of current that reverses direction periodically. A complete cycle occurs when current moves in one direction and then reverses its course
alternating current (AC).
Which current can be delivered at a high voltage and then “stepped down” (reduced) to a lower voltage at the point of use
Alternating current (AC)
The number of AC cycles per second is called
frequency and is indicated by the symbol f
A complete AC cycle is called a
Hertz(Hz)
What are devices that step down or step up (increase) the exiting voltage and only work with alternating current
Transformers
Power lines are a common example
What are common uses of Radiofrequency (RF)
Television and radio transmitters
What transfers concentrated electrical current into another medium (e.g., electrical current transformed into thermal energy)
active electrode
What is the new term that replaces dispersive (inactive) electrode; also called a grounding pad
patient return electrode
The four components of a DC circuit are:
Source of electricity (e.g., battery)
Conductor (e.g., wire from source to load)
Control device (e.g., switch)
Load (e.g., bulb, heater, or other load)
The secondary circuit is isolated from other circuits by the transformer insulation. However, if a person touches both poles of the ............in the area where insulation is absent, current will flow through the body to the ground, producing an electrical shock or burn.
Isolated circuit
Patient Return Electrode
The electric current is channeled back to the generator via the PRE (grounding pad).
PRE
Which organic dye is energized by a laser beam to produce the laser light in various wavelengths.
Liquid
Active Media
Which energy-producing element on a rod is energized by flash lamps to produce the laser light. Examples include ruby and Nd:YAG.
Solid
Active Media
Which energy is delivered directly to tissue through a filter or slit-lamp microscope.
Semiconductor crystals Laser
Active Media
This active medium is energized by electricity to produce the laser light. Examples include carbon dioxide, heliumneon, krypton, argon, and excimer.
Gas
Active Media
What is an occupational hazards of working in the OR
electrical burn or shock during electrosurgery
What is electrosurgery
it is the application of electrical current through tissue to coagulate or cut tissue using an ESU (bovie
Components of the ESU include
the generator (power cord)
optional foot pedal,
an active electrode (electrosurgical pencil)
a patient return electrode (PRE)
Which mode of electrosurgery is more frequently used for coagulation, but may also be used to cut tissue. It is used when large surgical areas are involved
Monopolar electrosurgery
Which mode of electrosurgery is used less frequently and is only used for the purposes of coagulation, not cutting. It tends to be used for delicate surgical procedures, at sites where moisture is nearby, or to prevent damage to delicate tissue and nerves.
bipolar electrosurgery
What are the three main components of the monopolar ESU
generator, active electrode, and grounding pad
•Current travels from the generator to the active electrode.
•The active electrode is activated by the surgeon to deliver the cutting or coagulating current to the tissue or vessel.
•The electrical current passes through the patient’s body to the grounding pad.
•The current exits the patient’s body via the grounding pad and returns to the generator
The pathway of the monopolar ESU
What is the main unit that provides the source of electrical current to the active electrode and completes the pathway for the returning current from the grounding pad
The generator
What two modes does the ESU use to deliver the electrical current to the tissue:
Monopolar & Bipolar
What types of tips are available for placement on the end of the Bovie pencil
blade-shaped, ball-tipped, loop, and needle tips. Long extended tips are available for deep surgical wounds
General safety and patient considerations when placing grounding pad
Let them know its cold
Place it smoothly, no wrinkles
Apply to large fleshy area, preferably over a muscle mass
Never apply over a prosthesis
What is also called the electrosurgical pencil or Bovie pencil,
The active electrode
(a sterile disposable item)
What are commercially available that consist of a small square with adhesive on the bottom for attachment to the drapes and a rough, sandpaper topping that the blade or tip can be scraped upon to remove debris and tissue.
Sterile “scratch pads”
Typically, Bipolar forceps and cord are reusable and reprocessed by
gas sterilization
•Current flows from generator to the active electrode (one of the prongs of the forceps).
•The active electrode delivers the coagulating current to the surgical site.
•Electrical current passes through the tissue between the tips of the forceps prongs.
•Current returns to the generator via the inactive electrode/prong.
The pathway of the bipolar ESU
What can malfunction during electrosurgery.
A pacemaker or internal defibrillator ST should be prepared with a defibrillator
Why is a grounding pad eliminated when using bipolar forceps
The active and inactive electrodes consist of the two prongs of a forceps
What specific product for the argon beam coagulator must be placed on the patient.
a grounding pad
argon gas is heavier than air, the “beam” displaces the air, the energized argon gas appears as a bright beam of light.
causing less tissue damage,
What uses ultrasonic energy rather than electricity to cut and coagulate tissue at the point of impact.
harmonic scalpel
What is more precise and creates lower temperatures (therefore not charring the tissue)compared to traditional electrosurgery
Ultrasonic energy (grounding pad not needed)
How do your prevent RF capacitive coupling when using an Bovie
the tip of the Bovie pencil should be placed below the fingers of the surgeon or assistant who is holding the clamp or forceps.
An alternating current travels from the active electrode, across intact insulation, and into the skin. (Breaking the chain of insulation) Instrument and skin contact = burn
resonant frequency (RF) capacitive coupling
At high electric fields, a material that is normally an electrical insulator may begin to conduct electricity
Dielectric breakdown
The x-ray machine uses ............ to view internal structures
electromagnetic radiation
What is formed when tissue is thermally destroyed and vaporized through the use of the ESU, laser, or other surgical devices such as power equipment used to cut bone
Vaporized tissue plume (smoke and aerosolized tissue)
What is a viewing instrument that is used for diagnosis, biopsy, visualization, repair, retrieval of an object, and hemorrhage control in a hollow structure, such as the abdomen, thorax, heart,
Endoscope
can be used in conjunction with an ESU for coagulation and dissection or paired with a laser for better coagulation and treatment of tumors.
Laser light is ........... which means that its waves are parallel to each other and do not spread out as they travel away from their source.
collimated
Laser light is also ........... meaning that the light waves travel in the same direction and in phase with each other, increasing its amplitude and its power.
coherent
What emphasizes the importance of the surgeon using the highest safest wattage for the shortest time possible to keep damage to the adjacent tissue to a minimum
The concept of fluence
What refers to the precision of the laser beam and consists of three properties: spot size, watts, and time.
Fluence = (watts × time) × spot size.
What are the four interactions when the laser beam contacts the tissue
absorption, transmission, reflection, or scattering
What is used when using lasers to prevent damage to adjacent tissues and limit the absorption of the laser energy. .
A backstop
Wet sponges, titanium, or quartz rods are used as backstops
The factors that decide the penetration depth of the beam include
power of the laser beam, color and consistency of the tissue, laser wavelength, and duration of beam exposure
The force per unit of area; applied evenly over a surface
pressure
As the laser energy is ....... by the tissue, heat is produced and damage to the tissue can occur
absorbed
What cooling mechanisms are used for Laser systems
air cooled (fan) or water cooled.
Which laser is often used to vaporize bladder tumors
Nd:YAG
Which laser consists of a garnet, routinely employed in eye surgeries, dentistry, cancer treatment, and acne treatment
Nd:YAG Laser
laser beam is invisible so requires a helium–neon laser aiming beam
near infra-red wavelength
What can be a hazard if the laser beam reflects off a surgical instrument, causing it to impact tissue elsewhere
Specular reflection
This active medium is energized by electricity to produce the laser light.
Examples include carbon dioxide, heliumneon, krypton, argon, and excimer.
Gas (active media)
An energy-producing element on a rod is energized by flash lamps to produce the laser light. Examples include ruby and Nd:YAG
Solid (active media)
An organic dye is energized by a laser beam to produce the laser light in various wavelengths
Liquid (active media)
What laser has been one of the most frequently used lasers in surgery, delivered through articulated arm that is a hollow tube
CO2
invisible beam
middle of the infrared region
What is transmitted with the CO2 laser beam to aid the surgeon in aiming
a red helium–neon laser beam (has no effect on the tissue)
What wavelength is located in the near-infrared region of the electromagnetic spectrum
Nd:YAG
A type of laser, which discharges a pulsed beam
The laser energy travels to the tissue through a flexible fiber. Popular amongst orthopedic surgeons during arthroscopic procedures, and dentistry.
Holmium: YAG Laser
should be held less than 5mm away from tissue to have any effect. Does not require water cooling.
208-volt service.
Which laser is popular for use among orthopedic surgeons during arthroscopic procedures because the laser beam is transmitted through clear fluids
The holmium:YAG
Which laser is gas laser and has an electrical current that activates medium to create the laser energy. The laser has special electrical requirements and requires a water-cooling system.
Krypton Laser
ophthalmologists use destroy tissue on the retina of the eye.
Which laser systems uses toxic gases and halogens as the active medium. The laser beam is ultraviolet in color and is absorbed by protein with minimal thermal spread, so the system is used to reshape the cornea for radial keratoplasty and to destroy plaque within a stenotic artery for angioplasty.
Excimer
excellent precision
Which laser can be used through a cystoscope to vaporize bladder tumors
argon laser
Which laser produces a blue light or green light in the electromagnetic spectrum. The primary component of the laser system is a plasma tube.
The laser beam can travel through clear fluids and tissues, and is useful for the treatment of diabetic retinopathy
Aragon
laser beam is visible
What is the laser of choice for gastrointestinal endoscopy
Nd:YAG laser system because its beam penetrates deeply into the tissues for better coagulation and destruction of tumor masses
Colonoscopes combined ................systems are used to treat polyps, arteriovenous malformations, and bleeding disorders and to perform the ablation of certain types of tumors.
with argon or Nd:YAG laser
Which endoscopy is used for treatment of certain brain tumors to preserve adjacent neural tissue and to reduce postoperative cerebral edema and recovery time
Stereotactic laser
What is defined as "Broken into sections by joints"
Articulated
Many robot arms have articulated geometry and the versatility is measured in degrees of freedom
What is the ability of humans and robots to determine the direction from which sound is coming. Humans have two ears that provide this ability; robots are given two sound transducers that provide the ability
Binaural hearing
The number of ways in which a robotic manipulator moves
degrees of freedom
What is used for graphing mathematical functions. The axes are always perpendicular to each other. Also called rectangular coordinate geometry.
Cartesian coordinate geometry
What refers to the plane that is used in combination with a plane coordinate system and elevation in conjunction with a robotic arm
Cylindrical coordinate geometry
What is the extent that a robot joint or a set of joints can move clockwise or counterclockwise about an axis. A reference point is established and the angles of the joint are stated in degrees.
Degrees of rotation
What is the method of reasoning in AI used to control smart robots. The expert system consists of facts or data supplied to the robot about the robot’s environment; also called rule-based system.
Expert systems
What is the technical term for robot arms
Manipulators
Extent to which a machine, microscope, human, or robot can differentiate between two objects
Resolution
What refers to a robotic arm that can move in three dimensions, resembling the movements of a human arm, such as rotating through a full circle (360 degrees).
Revolute geometry
What is the ability of a machine or robot to see in dim light or detect weak impulses at invisible wavelengths.
Sensitivity
What name is given to remotely controlled robots.
Telechir
What refers to the operation of a robot at a distance, meaning the operator is situated in one location, usually miles apart, and the robot is on-site with the patient.
Telepresence
One of the most frequently used surgical robots is the
da Vinci
3 working arms - 4th accessory
The instruments have ............, providing surgeons with precision ability in performing surgery
seven degrees of freedom and 90 degrees of articulation
The manipulators of the robot that hold the endoscope and instruments are not sterilized, they need to be ......
covered with special sterile sleeves.
What is the viewing monitor referred to on the da Vinci
“slave” monitor
An innovation by Intuitive Surgical® is the development of the ........ surgical instruments that are placed in the manipulators for the surgeon to perform the procedure.
EndoWrist® 5mm
The da Vinci® system allows the surgeon to perform minimally invasive surgery through
1- to 2-mm incisions
In a da Vinci - An up-and-down movement is known as ...., whereas right and left movements are called ....
Pitch and yaw