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OR FINAL REQUIREMENT
Mr. Antonio Valera III
Amelee Grace Ting Yu
babcock clamps. Strong stamina is also critical because they are on their feet in the operating room for hours at a time. ties the gowns for the scrub nurse and the surgeon as well as providing scrub personnel with stools as needed during long procedures. army navy retractors. ochners. towel clips. senn rakes. #15). folded towel What is thyroidectomy? A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. Thyroidectomy is a common surgical procedure that has several potential complications or sequela including: temporary or permanent change in voice. cherry. thumb forceps. bleeding. The circulating nurse also serves as the patient advocate during the procedure when they are unable to care for themselves. Other indications for surgery include cosmetic (very enlarged thyroid). bullets (peanuts). single skin hooks. Richardson retractors. A scrub nurse hands the surgical equipment to the surgeon and helps monitor the patient’s health during procedures. Pick up forcep. double skin hooks. Addison toothed. Circulating nurse The circulating nurse's responsibilities include arranging the operating room. allis. straight mayo scissors. nylon needle holder.large towel clips. gathering all of the supplies needed for the surgery. The circulating nurse is also essential in proper management of the operating room. blades (#20). #3 knife handles and #7 knife handles (2nd knife). sponges. carmalt. temporary or permanently low calcium. especially ones with a broad experience in different procedures. baby metzenbaum scissors. Patient care is an essential role B. A scrub nurse is a person with the stamina to be able to assist during long surgical procedures. during and after the procedure to ensure a successful result. vein retractors. mixter. and the remote possibility of airway obstruction . ochners. A circulating nurse is a person with an acute attention to detail. What are the responsibilities of a scrub nurse and a circulating nurse? A. Scrub nurses. #4 knife handle (first knife/skin). square packing ring. straight mosquito clamps. need for lifelong thyroid hormone replacement. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland (such as hyperthyroidism) or goiter. kelly straight.What is surgery? Surgery is a branch of medicine concerned with disease or conditions requiring or amenable to operative or manual procedure. infection. blades (#10. What are the instruments/supplies that are used for thyroidectomy? Sponge holder. The circulating nurse will check the patient’s condition before. or symptomatic obstruction (causing difficulties in swallowing or breathing). Scrub nurse Scrub nurses are fully sterilized with special soap and sterile garments because they work side by side with the surgical team. forceps. regular metzenbaum scissors. are highly sought-after members of the surgical team. curved mosquito clamps. long thumb. suture scissor. Addison. Kelly curved.
The thyroid gland is a butterfly-shaped organ and is composed of two cone-like lobes or wings. The thyroid gland is found in the neck. or 'Adam's Apple'). referred to as hypothyroidism. which plays a role in calcium homeostasis.to preventhypothyroidism. is one of the largest endocrine glands. which itself is regulated by thyrotropin-releasing hormone (TRH) produced by the hypothalamus. reaching posteriorly the oesophagus and carotid sheath. The thyroid also produces calcitonin. The thyroid gland controls how quickly the body uses energy. due to the shape of the related thyroid cartilage. triiodothyronine (T3). and an underactive thyroid gland. The thyroid produces several hormones.due to bilateral vocal cord paralysis. and controls how sensitive the body is to otherhormones. the principal ones being triiodothyronine (T3) andthyroxine which can sometimes be referred to as tetraiodothyronine (T4). connected via the isthmus. Complications are uncommon when the procedure is performed by an experienced surgeon. The thyroid gets its name from the Greek word for "shield". . What is the anatomy of the thyroid gland/thyroid? The thyroid gland or simply. or "Adam's apple"). referred to as hyperthyroidism. the thyroid. The organ is situated on the anterior side of the neck. lobus dexter (right lobe) and lobus sinister (left lobe). Hormonal output from the thyroid is regulated by thyroid-stimulating hormone (TSH) produced by the anterior pituitary. The most common problems of the thyroid gland consist of an overactive thyroid gland. It participates in these processes by producing thyroid hormones. T3 and T4 are synthesized from both iodine and tyrosine. It is difficult to demarcate the gland's upper and lower border with vertebral levels because it moves position in relation to these during swallowing. and calcitonin. It starts cranially at the oblique line on the thyroid cartilage (just below the laryngeal prominence. These hormones regulate the rate of metabolism and affect the growth and rate of function of many other systems in the body. lying against and around the larynx and trachea. makes proteins. in vertebrate anatomy. such as thyroxine (T4). below the thyroid cartilage (which forms the laryngeal prominence. patients usually take a prescribed oral synthetic thyroid hormone levothyroxine (Synthroid) . and extends inferiorly to approximately the fifth or sixth tracheal ring. The isthmus (the bridge between the two lobes of the thyroid) is located inferior to the cricoid cartilage. After the removal of a thyroid.
is not diseased. remnant of the thyroglossal duct. if any. The gland is covered anteriorly with infrahyoid muscles and laterally with the sternocleidomastoid muscle also known as sternomastoid muscle. Special care is taken not to harm or disturb the parathyroid glands and the vocal cords. is present at the most anterior side of the lobe. The thyroid is one of the larger endocrine glands. Lymphatic drainage passes frequently the lateral deep cervical lymph nodes and the pre.The thyroid gland is covered by a thin fibrous sheath. Between the two layers of the capsule and on the posterior side of the lobes. draining in the internal jugular vein. Lalouette's Pyramid. In this region. a branch of the thyrocervical trunk. On the posterior side. A biopsy may also be done to examine the tissues of the thyroid. and is increased in pregnancy. draining via the plexus thyroideus impar in the left brachiocephalic vein. both of which rest in the neck near the thyroid. branching directly from the subclavian artery. Based on the tests performed before the procedure and the appearance of the thyroid. This is done to make sure that the portion of the thyroid that is left. The gland is supplied by parasympathetic nerve input from the superior laryngeal nerve and the recurrent laryngeal nerve. composed of an internal and external layer. and via inferior thyroid veins. The thyroid gland's firm attachment to the underlying trachea is the reason behind its movement with swallowing. . nearby lymph nodes. the capsula glandulae thyroidea. in rare cases. the parathyroid and. followed by the administration of general anesthesia. The venous blood is drained via superior thyroid veins. weighing 2-3 grams in neonates and 18-60 grams in adults. a pyramidal extension of the thyroid lobe. can change shape and size. there are on each side two parathyroid glands. In variable extent. The external layer is anteriorly continuous with the lamina pretrachealis fasciae cervicalis and posteriorolaterally continuous with the carotid sheath. The thyroid is supplied with arterial blood from the superior thyroid artery. At this point. and sometimes by the thyroid ima artery. and can encompass a cranially extending pyramid lobe (lobus pyramidalis or processus pyramidalis). the tissue is examined by a pathologist immediately. the procedure begins with an incision 2 inches to 4 inches long that stretches horizontally over the thyroid. the gland is fixed to the cricoid and tracheal cartilage and cricopharyngeus muscle by a thickening of the fascia to form the posterior suspensory ligament of Berry. the recurrent laryngeal nerve and the inferior thyroid artery pass next to or in the ligament and tubercle. In some cases. a branch of the external carotid artery.and parathracheal lymph nodes. and the inferior thyroid artery. How is the surgical procedure done? Thyroid surgical procedures begin with the insertion of an endotracheal tube. the portion or portions of the thyroid are removed using a scalpel. the final determination of how much of the thyroid should be removed is made. The thyroid isthmus is variable in presence and size. so that a second surgery to remove a diseased portion of the thyroid is not necessary. Once the anesthesia takes effect.
While these side effects are normal immediately after surgery.Once the thyroid has been removed and any necessary samples have been taken. These hormones will be replaced with hormone replacement drugs. Your throat may also be sore. Once a sterile bandage is applied to the incision. This is especially true if the parathyroid glands were involved in the procedure. let your physician know. The level of calcium and vitamin D in your blood may also be monitored. a surgical drain may be placed to remove fluid from the area in the days after surgery. it will need to be closely monitored to prevent the symptoms of hyper or hypothyroidism. Anesthesia is discontinued and medication is given to wake the patient. In most cases. you may find that people refer to the entire category of thyroid replacement drugs as “synthroid. and in some cases. such as bleeding or difficulty breathing. This is normal immediately following the procedure. While synthroid is a particular type of thyroid hormone replacement.” Your thyroid replacement may begin immediately after your surgery or it may be started several weeks later. Once the hormone replacement is started. If you are able to drink fluids without a problem. you will be given instructions on how to care for your surgical incision and when to see your surgeon. In most cases. you will be taken to the recovery room. you will probably begin eating soft foods the next morning. the surgery is completed. and it may hurt to talk and swallow. In some cases. Initially. your body will no longer produce necessary thyroid hormones. . barring any unforeseen complications. you will be limited to taking fluids. Before your discharge. After surgery to remove your thyroid. After your thyroid surgery. you should begin to feel a normal level of energy. If you experience ongoing problems with your voice or hoarseness after surgery. the area is examined for bleeding. they should resolve during the recovery process. Symptoms of ongoing lethargy. you will be able to return to a normal diet within 72 hours of surgery. The patient is then taken to the recovery room to be closely monitored while the remaining anesthetic wears off. Once the surgeon is confident that there is no bleeding present. Once the medication is dosed properly. It may be closed with staples or sutures. Most patients are able to return home within 24 hours after the procedure. you will stay in the hospital for the first night of your recovery to be monitored for any complications. It is normal to feel some pain in your neck after a thyroid procedure. the incision is closed. a daily supplement will be necessary every day. fatigue and feeling chronically tired should be reported to the physician managing your thyroid-replacement medication. depending upon the condition that made the surgery necessary.
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