Question

A CST is assisting a surgeon with a lumbar discectomy procedure. The CST removes tissue from the jaws of the pituitary rongeur that the surgeon is using to remove the disc material. He looks at the specimen and says to the physician, "I think you should stop and look at this – it doesn’t look like disc material to me." The surgeon asks, "How so?", and the CST responds, "It has a lumen." The surgeon examines the tissue, has the circulator page a genitourinary specialist, completes the discectomy, and assists in the repair of the ureter. What did the CST have to know in order to make this critical observation?

Discuss the relationship between knowledge of anatomy and physiology and its practical application in the OR setting.

Answer 1

The CST's knowledge of anatomy and physiology was crucial during a lumbar discectomy, which led to identifying non-disc material and contacting a specialist. Understanding the types of tissues and structures in the body is essential in the OR for patient safety. Lumbar puncture is performed in the lower lumbar region to avoid CNS damage, with MRI and CT scans used for internal imaging.

Step-by-step explanation:

The Certified Surgical Technologist (CST) made a critical observation during a lumbar discectomy by noticing that the tissue extracted had a lumen, which is not characteristic of disc material. Tissues with a lumen are typically related to tubular structures such as blood vessels or the ureter. The CST's knowledge of anatomy and physiology was crucial in this situation, as it allowed for the immediate identification of potential harm to a non-target structure, leading to the timely intervention by a genitourinary specialist. The CST's role in the operating room required an understanding of the different types of tissues within the body and their appearances. This level of expertise is critical for assisting surgeons effectively and ensuring patient safety.

In the context of clinical practice, familiarity with the spinal cord functions is essential. A lumbar puncture is performed in the lower lumbar area because this avoids the risk of damaging the CNS tissue, as the spinal cord ends at the upper lumbar vertebrae. Sensory discrimination is a method that can pinpoint the level of damage in the spinal cord, which is invaluable for immediate clinical assessments. Imaging technologies such as MRI and CT scanning are also used to visualize internal structures and treat patients appropriately.