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8/14/2019 Positions Evangelist A
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SURGICAL POSITIONSSURGICAL POSITIONS
by:by: EUNICE GRACE C. EVANGELISTAEUNICE GRACE C. EVANGELISTA
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SUPINE POSITION
The supine position is a position of the body; lyingdown with the face up, as opposed to theprone position, which is face down. When used insurgical procedures, it allows access to the peritoneal,thoracic and pericardial regions; as well as the head,neck and extremities.
Using terms defined in the anatomical position, thedorsal side is down, and the ventral side is up.
The Supine or Dorsal Position is the usual position forinduction of general anesthesia and for entering themajor body cavities.
http://en.wikipedia.org/wiki/Human_bodyhttp://en.wikipedia.org/wiki/Facehttp://en.wikipedia.org/wiki/Prone_positionhttp://en.wikipedia.org/wiki/Peritonealhttp://en.wikipedia.org/wiki/Thoracichttp://en.wikipedia.org/wiki/Pericardiumhttp://en.wikipedia.org/wiki/Anatomical_positionhttp://en.wikipedia.org/wiki/Anatomical_positionhttp://en.wikipedia.org/wiki/Pericardiumhttp://en.wikipedia.org/wiki/Thoracichttp://en.wikipedia.org/wiki/Peritonealhttp://en.wikipedia.org/wiki/Prone_positionhttp://en.wikipedia.org/wiki/Facehttp://en.wikipedia.org/wiki/Human_body8/14/2019 Positions Evangelist A
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SUPINE POSITION
The patient lies on his back with his
arms in anatomical position and the legsslightly apart. The palm of the hands
should be facing the body to prevent
undue muscle strain on the arms.
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SUPINE POSITION
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MODIFIED TRENDELENBERGPOSITION
In the Trendelenburg position the body is laid flat onthe back (supine position) with the feet higher than thehead, in contrast to the reverse Trendelenburgposition, where the body is tilted in the opposite
direction. This is a standard position used inabdominal and gynecologicalsurgery. It allows betteraccess to the pelvic organs as gravity pulls theintestines away from the pelvis.
It can also be used in some lower extremity surgery toassist in hemostasis.
The patient is positioned as in the supine position,
and the entire operating table is slightly tilted so thatthe patients head is lower than his feet by 1 to 5
http://en.wikipedia.org/wiki/Bodyhttp://en.wikipedia.org/wiki/Supine_positionhttp://en.wikipedia.org/wiki/Headhttp://en.wikipedia.org/wiki/Abdominalhttp://en.wikipedia.org/wiki/Gynecologyhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Gravityhttp://en.wikipedia.org/wiki/Intestineshttp://en.wikipedia.org/wiki/Intestineshttp://en.wikipedia.org/wiki/Gravityhttp://en.wikipedia.org/wiki/Surgeryhttp://en.wikipedia.org/wiki/Gynecologyhttp://en.wikipedia.org/wiki/Abdominalhttp://en.wikipedia.org/wiki/Headhttp://en.wikipedia.org/wiki/Supine_positionhttp://en.wikipedia.org/wiki/Body8/14/2019 Positions Evangelist A
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MODIFIED TRENDELENBERGPOSITION
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REVERSE TRENDELENBERGPOSITION
The Modified Reverse Trendelenberg
position is generally used for upper
abdominal surgery and for neck and facesurgery.
The position permits improved operativeexposure because gravity keeps the
intestines mostly in the lower part of the
abdomen.
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LITHOTOMY POSITION
The lithotomy position is a medical term referring to acommon position for surgical procedures and medical
examinations involving the pelvis and lower abdomen.
References to the position have been found in some of
the oldest known medical documents includingversions of the Hippocratic oath; the position is
named after the ancient surgical procedure for
removing kidney stones, gall stones and
bladder stones via the perineum. The position is
perhaps most recognizable as the 'often used'
position for childbirth: the patient is laid on the back
with knees bent, positioned above the hips, and
spread apart through the use ofstirrups.
http://en.wikipedia.org/wiki/Hippocratic_oathhttp://en.wikipedia.org/wiki/Kidney_stoneshttp://en.wikipedia.org/wiki/Gall_stoneshttp://en.wikipedia.org/w/index.php?title=Bladder_stones&action=edit&redlink=1http://en.wikipedia.org/wiki/Perineumhttp://en.wikipedia.org/wiki/Stirruphttp://en.wikipedia.org/wiki/Stirruphttp://en.wikipedia.org/wiki/Perineumhttp://en.wikipedia.org/w/index.php?title=Bladder_stones&action=edit&redlink=1http://en.wikipedia.org/wiki/Gall_stoneshttp://en.wikipedia.org/wiki/Kidney_stoneshttp://en.wikipedia.org/wiki/Hippocratic_oath8/14/2019 Positions Evangelist A
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LITHOTOMY POSITION
The position is frequently used and has many obviousbenefits from the doctor's perspective. Most notably
the position provides good visual and physical access
to the perineal region. The position is used for
procedures ranging from simple pelvic exams tosurgeries and procedures involving, but not limited to
reproductive organs, urology, and gastrointestinal
systems. New observations and scientific findings,
combined with a greater sensitivity to patient needs
have raised awareness of the physical and
psychological risks the position may pose for
prolonged surgical procedures, pelvic examinations,
and, most notably, childbirth.
http://en.wikipedia.org/wiki/Reproductivehttp://en.wikipedia.org/wiki/Urologicalhttp://en.wikipedia.org/wiki/Gastrointestinalhttp://en.wikipedia.org/wiki/Gastrointestinalhttp://en.wikipedia.org/wiki/Urologicalhttp://en.wikipedia.org/wiki/Reproductive8/14/2019 Positions Evangelist A
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LITHOTOMY POSITION
Lithotomy positio n and child birt h As a birth position, it has been popular in the past
with obstetricians as it allows a good view of the birthprocess. However, the position is not conducive to a
smooth labor as it constricts the birth canal, putspressure on the coccyx, prevents thefetal ejection reflex from occurring, and does not allowthe mother to move during the process, thereforeincreasing pain in labor. During labor, the position
appears to cause compression of the main maternalblood vessels including the vena cava, therebyreducing the flow of blood to the infant. Restrictedblood flow frequently results in higher rates ofmorbidity and mortality for both fetus and mother.
http://en.wikipedia.org/wiki/Obstetricianhttp://en.wikipedia.org/wiki/Coccyxhttp://en.wikipedia.org/w/index.php?title=Fetal_ejection_reflex&action=edit&redlink=1http://en.wikipedia.org/wiki/Vena_cavahttp://en.wikipedia.org/wiki/Vena_cavahttp://en.wikipedia.org/w/index.php?title=Fetal_ejection_reflex&action=edit&redlink=1http://en.wikipedia.org/wiki/Coccyxhttp://en.wikipedia.org/wiki/Obstetrician8/14/2019 Positions Evangelist A
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LITHOTOMY POSITION
Additionally, since the lithotomy position essentially"fights gravity" leading to a less active birthingprocess. Passive birthing, which often requires moreinvasive medical interventions, is associated withincreased trauma to both infant and mother, may lead
to serious birth complications. In Western countries the use of the lithotomy position
for active labour has seen a decline in recent years.One notable exception, however, is the United States,
where the lithotomy position remains commonpractice despite solid scientific evidence to thecontrary. Many attribute the use of the lithotomyposition, named after surgical procedure to removekidney stones and bladder stones, to a centuries-long
trend towards the medicalization of birth.
http://en.wikipedia.org/wiki/Gravityhttp://en.wikipedia.org/w/index.php?title=Active_birth&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Passive_birth&action=edit&redlink=1http://en.wikipedia.org/wiki/Physical_traumahttp://en.wikipedia.org/wiki/Kidney_stoneshttp://en.wikipedia.org/w/index.php?title=Bladder_stones&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Bladder_stones&action=edit&redlink=1http://en.wikipedia.org/wiki/Kidney_stoneshttp://en.wikipedia.org/wiki/Physical_traumahttp://en.wikipedia.org/w/index.php?title=Passive_birth&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Active_birth&action=edit&redlink=1http://en.wikipedia.org/wiki/Gravity8/14/2019 Positions Evangelist A
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LITHOTOMY POSITION
Additionally, since the lithotomy position essentially"fights gravity" leading to a less active birthingprocess. Passive birthing, which often requires moreinvasive medical interventions, is associated withincreased trauma to both infant and mother, may lead
to serious birth complications. In Western countries the use of the lithotomy position
for active labour has seen a decline in recent years.One notable exception, however, is the United States,
where the lithotomy position remains commonpractice despite solid scientific evidence to thecontrary. Many attribute the use of the lithotomyposition, named after surgical procedure to removekidney stones and bladder stones, to a centuries-long
trend towards the medicalization of birth.
http://en.wikipedia.org/wiki/Gravityhttp://en.wikipedia.org/w/index.php?title=Active_birth&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Passive_birth&action=edit&redlink=1http://en.wikipedia.org/wiki/Physical_traumahttp://en.wikipedia.org/wiki/Kidney_stoneshttp://en.wikipedia.org/w/index.php?title=Bladder_stones&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Bladder_stones&action=edit&redlink=1http://en.wikipedia.org/wiki/Kidney_stoneshttp://en.wikipedia.org/wiki/Physical_traumahttp://en.wikipedia.org/w/index.php?title=Passive_birth&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Active_birth&action=edit&redlink=1http://en.wikipedia.org/wiki/Gravity8/14/2019 Positions Evangelist A
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LITHOTOMY POSITION
Lithotomy positio n, pro longedsurgical procedures and circula torycomp lic ations Some studies have found a significant relationship
between prolonged surgical procedures with the
patient in the lithotomy position and a circulatory
complication known as "compartment syndrome",...a
condition in which increased tissue pressure within a
limited tissue space compromises the circulation andfunction of the contents of the space."
http://en.wikipedia.org/wiki/Compartment_syndromehttp://en.wikipedia.org/wiki/Compartment_syndrome8/14/2019 Positions Evangelist A
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LITHOTOMY POSITION
Lithotomy positio n and pelv icexams Patients have reported feeling a loss of control and
increased sense of vulnerability when examined in the
lithotomy position because they cannot see the area beingexamined. Other, equally effective positions have been
suggested for examinations of conscious patients.
The lithotomy position affords physicians and surgeons
with easy and helpful access to the perineal region, lower
abdomen, and pelvis and is widely used in both surgery
and examinations. Of all the medical uses, the lithotomy
position, whose ancient roots come from the treatment of
the painfully ill, has logically received the most scrutiny of
late in association with childbirth, the only condition listedherein that is not an "illness".
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LITHOTOMY POSITION
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PRONE POSITION
Patients who are having surgery on the posterior partof the body are placed in prone position.
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FOWLERs position
The Modified Fowlers position or the sitting position is usedmostly in neurosurgery.
In medicine, the Fowler position is a standard patient position. It
is used to relax tension of the abdominal muscles, allowing for
improved breathing in immobile patients, and to increase comfortduring eating and other activities. It is also used in postpartum
women to improve uterine drainage. The patient is placed in a
semi-upright sitting position (45-60 degrees) and may have knees
either bent or straight.
There are several types of Fowlers positions: Low, Semi-, and
High Fowler's. High Fowler's position is when the patient's head
is raised 80-90 degrees, whereas semi-Fowler's position is when
the patient's head is elevated 30-45 degrees.
http://en.wikipedia.org/wiki/Postpartumhttp://en.wikipedia.org/wiki/Postpartum8/14/2019 Positions Evangelist A
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FOWLERs position
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THEENDTHANK YOU
AND
GOD BLESS