Atn

Bobbin Quick Reference: Constituent part of a gas flowmeter/rotameter.

Advanced Reference: The bobbin is the measuring indicator within a flowmeter and alters as the needle valve is adjusted to provide more or less gas. The reading of gas flow is taken as the top of the bobbin.

Bodok seal Quick Reference: A rubber seal with an outer metal circumference.

Advanced Reference: Bodok seals were first developed by British Oxygen Company (BOC). They were designed primarily as a seal and to prevent friction and build-up pressure between two metal surfaces, i.e. the cylinder and the pin index holder (yoke). The Bodok seal is placed onto the seating of the yoke around the gas outlet port and offered up against the pin index-locating hole on the anaesthetic machine.

Boiling (water) Quick Reference: Not considered now as a sterilisation process.

Advanced Reference: Is only a method of disinfection as it cannot be guaranteed to kill spores (sporicidal).

Bolus Quick Reference: A single one-off dose.

Advanced Reference: Bolus can be referred to in two different contexts: (1) Abolus of food that is soft after mastication and swallowed. (2) Abolus for injection describes a single amount of medication given as one dose.

Bone nibblers Quick Reference: A surgical instrument may be of heavy or fine design depending on need.

Advanced Reference: Used during orthopaedic or neurosurgery to remove (nibble) small pieces of bone.

Bone wax Quick Reference: A haemostatic material.

Advanced Reference: Used mostly in neuro- and spinal surgery on bleeding cancellous bone surfaces.

Bougie Quick Reference: (boo-gee) Intubation aid. N

Advanced Reference: Name given to a gum-elastic malleable catheter <:

used as an aid in difficult intubation. In the event of poor visualisation o during intubation, the bougie is fed via the vocal cords into the trachea g and the endotracheal (ET) tube introduced over this. i

Bourdon Quick Reference: (bur-don) A pressure gauge usually fitted to ^

high-pressure cylinders, e.g. oxygen. ®

Advanced Reference: The gauge works on the bourdon tube principle g>

that when pressure is exerted into the curved tube the end begins to is straighten, thus manipulating the rack and the pivotal point of the needle 8 to show the reading on the calibrated markers.

Bowel Quick Reference: Referring to the intestines.

Advanced Reference: The bowel or intestine is commonly referred either to the small or large intestines. Small bowel comprises the duodenum, jejunum, ileum and terminates at the ileo-caecal valve, this is where the large bowel begins and becomes the ascending colon, transverse colon, descending colon, sigmoid, rectum, terminating with the anus.

Bowel clamp Quick Reference: A surgical instrument used to occlude the bowel.

Advanced Reference: Bowel clamps are either crushing or non-crushing, and are used in pairs during surgery. Some of the most commonly used being Doyens and Pyres.

Bowie-Dick test Quick Reference: A test used to measure the efficiency of an autoclave.

Advanced Reference: Prior to the daily use of an autoclave for sterilising of surgical equipment, a Bowie-Dick test is performed. The test consists of a small section of surgical paper and an autoclave tape stretched across all corners to make a large X. This is then inserted between a number of surgical drapes and put into the autoclave. A normal autoclave cycle is run and ideally produces a colour change in the autoclave tape which indicates steam penetration but not sterility.

Bowman's capsule Quick Reference: Structure within the kidney nephron proximal to the tubules.

Advanced Reference: Opening area of the nephron, a cup-shaped structure which surrounds the glomerulus.

Boyle's Quick Reference: Indicates a number of anaesthetic-related adjuncts and named after Henry Boyle, an English anaesthetist.

Advanced Reference: The standard anaesthetic machine is named after him and even the modern, much changed machines are still referred to in this way. Also, the Boyles bottle, which is a simple glass jar acting as a vaporiser that allowed the passing of a fresh gas flow over a surface area of volatile liquid. The gas passing over the surface of the liquid would aid vaporisation to take place. To increase the amount of vaporisation taking place, it was found that the surface area of gas to pass over would need to increase. The introduction of wicks and movable plunger meant that the degree of control could be applied offering higher concentrations of volatile agents, i.e. ether.

Boyle-Davis gag Quick Reference: Mouth gag used in ear, nose and throat (ENT) and oral surgery.

Advanced Reference: Used specifically in tonsillectomy and fitted between the teeth to keep the mouth open. Comes with both split and fixed tongue plates.

Brachial Quick Reference: (brake-e-al) Pertaining to the arm.

Advanced Reference: In the strict sense is the upper arm, with the brachial artery being the main blood vessel.

Brachial plexus Quick Reference: A network of nerves at the root of the neck supplying the upper limbs of the body.

Advanced Reference: A complex network of nerves that is formed chiefly by the lower four cervical nerves and the first thoracic nerve, lies partly within the axilla and supplies nerves to the chest, shoulder and arm. It is one of the areas of injury risk related to poor patient positioning on the operating table.

Bradycardia Quick Reference: Patient (adult) with a slow pulse rate below the level of 60 beats per minute (bpm).

Advanced Reference: Brady refers to slow; cardia refers to heart. A bradycardia can occur at any time but must not be confused in a patient, who normally at rest, has a slow pulse, i.e. athletes may have heart rates of 50 bpm or lower.

Brain Quick Reference: Central thinking process area contained within the skull.

Advanced Reference: The brain is a multifunction organ that has two hemispheres with one for logical thinking and the other for abstract thinking. The brain receives and sends messages to all other systems within the human body. Components of the brain are the cerebrum, midbrain, cerebellum, medulla oblongata and pons varolii.

Brain stem Quick Reference: The portion of the spinal system between the brain and the spinal cord.

Advanced Reference: Consists of the medulla oblongata, pons and midbrain.

Breathing systems Quick Reference: A term that describes the apparatus for gas flow to and from the patient.

Advanced Reference: These involve anaesthetic circuits of numerous designs, also those related to ventilators as well as the non-rebreathing types, such as Ambu bag, bagvalve mask (BVM), etc. primarily used in ^ resuscitation. 8

Breech Quick Reference: Buttocks first. I:

Advanced Reference: Applies to the lie/position of the foetus in the c uterus when it presents buttocks first rather than the normal position of tmr head first.

Bretylium Quick Reference: (bret-eel-eum) An antihypertensive and anti- g> arrhythmic drug, e.g. bretylate. fj

Advanced Reference: Used primarily to treat cardiac dysrhythmias and tachycardia.

Brietal Quick Reference: Anaesthetic induction agent, e.g. methohexitone. Advanced Reference: Short-acting barbiturate induction agent available as a powder for reconstitution into a 1% solution. Caused hiccoughing and contraindicated in epilepsy. Mostly been replaced by diprivan (propofol).

Broad ligaments Quick Reference: Ligaments related to attachment of the female uterus.

Advanced Reference: The broad ligaments support the blood vessels to the uterus and uterine tubes and consist of folds of peritoneum which extend from the uterus to the sides of the pelvis.

Bronchial blocker Quick Reference: Term also used to indicate endo-bronchial and double-lumen tubes such as Robert-Shaw, Gordon-Green and Carlins tubes.

Advanced Reference: Used in thoracic surgery to isolate either lung or portion of.

Bronchodilator Quick Reference: (bronco-die-lator) Any agent that relaxes the smooth muscles of the bronchial passages.

Advanced Reference: There are many causes of spasm in the bronchial muscles; most common are asthma and bronchitis. The best known and most used are salbutamol and aminophylline.

Bronchopleural fistula Quick Reference: (bronco-plural) Abnormal connection between the tracheobronchial tree and the pleura.

Advanced Reference: Occurs after surgery (pneumonectomy), following trauma, infection or damage due to a tumour.

Bronchoscopy Quick Reference: Procedure for visually examining the trachea and main bronchus and lung.

Advanced Reference: Carried out using either fibre-optic or rigid bron-choscope. Usually carried out under GA when ventilation is maintained using a Venturi injector.

Bronchospasm Quick Reference: (bron-co-spasm) Narrowing of the bronchi.

Advanced Reference: Narrowing is due to muscular contraction due to a stimulus as in asthma and bronchitis. Relieved with bronchodilator drugs.

Bronchus Quick Reference: (bron-cus) Windpipe or bronchial tube.

Advanced Reference: The bronchi refers to either of the two primary divisions of the trachea that lead, respectively, into the right and left lung.

Brooks airway Quick Reference: Type of oropharyngeal airway.

Advanced Reference: An airway designed for use in mouth-to-mouth resuscitation but allows for non-contact between rescuer and victim. It has a mouth guard/cover which is designed to form an airtight seal.

Brown fat Quick Reference: Specialised adipose tissue involved in the generation of heat.

Advanced Reference: Of special importance in neonates. Distributed throughout the body (mainly in upper back and shoulder area) of the newborn, it allows for increase in the metabolism and thus heat production, while simultaneously using up the fat itself.

Buccal Quick Reference: (book-al) Pertaining to the mouth or cheek.

Advanced Reference: The buccal cavity is the mouth and consists of two parts: the outer or vestibule, which is the space outside of the teeth and within the lips and cheeks, and the inner part which communicates with the oropharynx.

Buffer Quick Reference: A solution in which the concentration of hydrogen ions remains constant despite the addition of an alkali or acid.

Advanced Reference: Sodium bicarbonate is the body's chief buffering system.

Bulldog Quick Reference: A vascular clamp.

Advanced Reference: A small vascular clamp designed to hold the vessel securely but without causing trauma. All bulldog clamps must be counted and recorded within the instrument count.

Bundle branch block Quick Reference: An irregularity in the cardiac conduction system.

Advanced Reference: Involves a delay in conduction along either side (left or right) of the atrio-ventricular (AV) bundle and related to heart block. Detected on an ECG trace.

Bundle of His Quick Reference: Large collection of neuromuscular fibres that pass through the middle of the heart (septum).

Advanced Reference: The beginning of the bundle of His starts with the AV node that collects the electrical activity caused by the sino-atrial node. The electrical current is transmitted down and through the fibres and then brings about contraction within the ventricles. n

Bung Quick Reference: A rubber end or plastic cap that is used to close off J

the end of an IV line. 2

Advanced Reference: Bung can be found in the end of blood specimen ~

bottles. Leur lock caps can be referred to as a bung. j=

Bunion Quick Reference: A deformity of the joint at the base of the big toe. ^

Advanced Reference: Caused by friction and pressure from shoes, form- c?

ing a bursa. Severe forms require surgery, with the operation being fj termed hallux valgus. A bursa is a fibrous sac lined with synovial mem- S. brane and contains a small quantity of synovial fluid.

Bupivacaine Quick Reference: (bu-piv-a-cane) A Local Anaesthetic (LA) agent that has a longer action than lignocaine.

Advanced Reference: Bupivacaine has a slow onset of action but has the distinct advantage of lasting longer than most alternative LAs. Often used for skin infiltration around the wound site to give a degree of pain relief for the patient following surgery. Heavy marcain a form of bupivaine with glucose is used during spinal anaesthesia.

Burette Quick Reference: (be-yur-et) Piece of IV infusion equipment.

Advanced Reference: Involves a measuring chamber which attaches into the IV bag or giving set allowing monitoring of infusion volume. Used when volume and dose are critical, e.g. paediatric infusion and/or drug administration.

Burr Quick Reference: Surgical drill bit.

Advanced Reference: Used for drilling or cutting bone or teeth.

Burr hole Quick Reference: Holes drilled in the cranium.

Advanced Reference: Carried out to gain access to the brain or release pressure inside the cranium.

Bursa Quick Reference: Small fibrous sac containing synovial fluid.

Advanced Reference: Intended to reduce friction where structures move over one another, i.e. around joints, between a tendon and a bone, although they can also be formed in some locations by friction and pressure.

Buscopan Quick Reference: Antispasmodic drug used to relax the intestinal wall.

Advanced Reference: Buscopan is the trade name of hyoscine butyl-bromide. The drug is usually given 20-30 min prior to a patient having a gastroscopy or a sigmoidoscopy. Relaxing the intestines allows greater flexibility for the scope to be advanced through the intestinal system avoiding trauma. Provides for a lighter relief of pain during the diagnostic investigation.

Butterfly needle Quick Reference: A type of IV needle.

Advanced Reference: Has plastic sides which act as a grip for insertion and lie flat on the skin for fixation once sited. Available in a range of gauges.

BVM Quick Reference: Abbreviation for bagvalve mask, which is a self-inflating breathing circuit.

Advanced Reference: Used mainly for resuscitation purposes, has more or less replaced the Ambu bag.

Bypass Quick Reference: Indicates diversion of flow as from the normal route.

Advanced Reference: Can refer to cardiopulmonary bypass as used in cardiac surgery, aorta bi-femoral bypass in vascular surgery, and use of a shunt in carotid artery bypass.

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