Textbook for Operation Theater Technicians Neelam Rai, Arpit Ravindra Lal
INDEX
Page numbers followed by f refer to figure and t refer to table, respectively.
A
Abdomen 84, 213, 310
Abrasion 202
Acetaminophen 340
Acetylcysteine 339, 340
Acid poisoning 214
Acquired immunodeficiency syndrome 174, 384
Actinomycetes 107
Adenoids 38
Adenosine triphosphate 81
Adenovirus 108
Adhesive dressing 185
Adipose tissue 14
Adrenal 89
cortex 94f
gland 39, 47, 93
Adrenaline 47, 93
Adrenocorticotropin 90
Advanced trauma life support 229
Air and bone conduction test 305
Air
cushion 251, 252f
mattress 253f
pathway of 84
Airway 225
breathing and circulation 184
maintenance 230
management 230
Albumin water 161, 162
Albuterol inhaler 341
Alcohol intoxication 215
Aldehyde 139
Aldosterone 94
Alimentary system 41
Allergy 107
Alveoli 41
Ambu bag 406
Amebic dysentery 107
Amebiasis 143
Amputation injury 202
Amyl nitrate 340
Amylase 42
Anaerobic respiration 81
Analgesia, stages of 329
Anemia 107
Anesthesia
epidural 338
general 329
local 336, 337
spinal 338
Angiogenesis 119
Anorexia 171
Antibiotics 122
Anticholinesterase 340, 341
Anxiety 264, 266
Aorta 29, 69, 73, 74
Aortic valve 73
Aphasias 100
Apnea 227, 267
Appendicular skeleton 16
Appetite 260
loss of 205
Aquathermia pads 406, 423
Arachnoid 54
mater 53
trabeculae 53
Arrhythmia 75
Arteries 29, 34, 36f, 36t, 6870, 70f
forceps 273f
Arterioles 34, 69
Arthrology 22
Articular cartilage 20
Ascaris lumbricoides 107, 366
Ascorbic acid 169
deficiency 169
Aspergillus 107
Aspergillus fumigatus 107
Asphyxia 210, 212
causes of 211
signs of 211
symptoms of 211
treatment of 211
Asthma 89
Atherosclerosis 120
Athlete's foot 107
Atkins diet 165
Atria 72
Atrioventricular valves 31
Atrium 72, 73
Atropine sulfate 340
Auditory ossicles 16, 17
Auricle 72
Autoclaving 113, 178, 406
Autonomic nervous system 99
control of 101
Avulsion 202
Axial skeleton 16
Axilla 28
B
Bacteria 106, 108t, 143
Bandages 184, 186
roller 186
triangular 186, 187, 188f
types of 186
Barley water 161
Bartholin's glands 62, 63
Basal metabolic rate 158
Bee stings 206
Benzocaine 337
Benzodiazepines 340
Beta propiolactone 112
Biceps 27
Bicuspid valve 31, 73
Bile, secretion of 43
Biohazard, warning symbol of 173f
Biot's respiration 267
Biotin 169
deficiency of 169
Blast injury 202
Blood 15, 70
circulation of 73f
clotting 47
components of 71
flow 33, 34f
functions of 70
pressure 205
vascular system 68
vessels 34, 68
B-lymphocytes 71
Body
parts of 189f
temperature, regulation of 101
Boiling 110, 112, 141, 406
Bone
avascular necrosis of 199
facial 17
frontal 53
grating 200
marrow 38
microscopic structure of 19
occipital 19
parts of 20
temporal 17
types of 19
upper limb 18
Boric acid 421
Borrelia 106
Brachialis 27
Brachioradialis 27
Bradycardia 338
Bradypnea 267
Brain 21, 5255
anatomy of 55f
lobes of 56
stem injury 266
wall, cross section of 55f
Breast 309
quadrants of 310f
self-examination 309
steps of 309
Breathing 225, 230
Broca's area 100
Bronchi 41, 82
Bronchial tree 87
Bronchioles 41, 87
Bronchitis
acute 88
chronic 89
Brown adipose tissue 14
Bruise 202, 348
Buccal cavity 75, 76
Bupivacaine 337
Burn 216, 219, 220, 348
causes of 217
chemical 217, 219
dangers of 218
deep 217
degrees of 216
depth 218
electrical 217
radiation 217
severity, classification of 217
size 218
superficial 217
thermal 217, 218
types of 217
wounds 291
C
Calcitonin 92
Calcium 170
channel blockers 340
Calibration 392
Calories 163
Candida albicans 107, 117
Carbohydrate
content 167
deficiency diseases 171
digestion of 79
metabolism 43
Carbon dioxide 29
Cardiac
arrest 75
causes of 227
signs of 227
chest compression, external 228
dysrhythmias 392
monitor 394
Cardiopulmonary resuscitation 227
Carina 87
Carotid artery 307
Cat bite 207
Catalytic enzyme 42
Catarrhal stage 378
Cauda equina 57
Cell wall, disruption of 110
Cellular respiration 87
Central nervous system 51, 98, 99
Cerebellum 99, 102
Cerebral
hemispheres 53
lateralization 100
Cerebrospinal fluid 53, 98, 103
Cerebrum 99
Cervical spiral protection 230
Cervix 65
Chemical 406
disinfection 178
preservatives 160
sterilizing agents, classification of 112t
Cheyne-Stokes respiration 267
Chickenpox 379
Child abuse, types of 347
Child sexual exploitation 347
Chills 205
Chlamydia trachomatis 117
Chlorine
bleach 138
compounds 113
solution of 141
Chloroprocaine 337
Cholera 143, 382
Chordae tendineae 31
Choroid plexuses 103
Chromium 170
Circulatory system 68
Cisterns 142
Clitoris 62, 63
Clostridium 106
Cobalamins 169
Cocaine 337
Coccidioides 107
Coccyx 18
Cold 62
application 410, 424
types of 410
compress 426
pack 427
sponge 428
sweat 205
Colloid 91
Colonic lavage 433
Columnar epithelium 13
Coma 213
Communicable diseases 350, 371
Compartment syndrome 198
Complete blood count 72
Conduction system 32f
Connective tissue 14
Constipation 335
Contact 62, 109
Contusion 202
Convulsion 213, 214
Copper 170
Coracobrachialis 26
Coronary artery disease 75
Corpus callosum 55
Cortex 93
Corynebacterium 106
diphtheriae 373
Costal cartilage 18
Cough 260
Cranial meninges 103
Cranium 17
Crimean war 5
Crush injury 202
Cryptococcus neoformans 107
Cubital fossa 28
Cuboidal epithelium 13
Cyanide 340
Cyanosis 213, 227
Cyclophosphamide 340
Cytomegalovirus 109
D
Damage cell wall 110
Deferoxamine 341
Defibrillator 392
maintenance 392
Deformity 200
Dehydration 220, 223, 369
Delirium 260
stages of 329
Dengue 384
Dense connective tissue 15
Deoxyribonucleic acid 67
Dextrose 339, 341
Diabetes 120
Diaphragm 26, 41, 76, 82
contraction of 84
Diaphragma sellae 53
Diaphysis 20
Diarrhea 107, 143, 205, 359
Diathermy 416
Dibucaine 337
Dichlorodiphenyl trichloroethane poisoning 214
Digestive
enzyme 42
system 75
tract 29
Digoxin 341
Dimercaprol 341
Diphenhydramine 341
Diphtheria 373
Disasters 232
biological 234
cycle 233f
management 232, 234, 236, 238
plans 237
principles of 234
manmade 234
meaning of 233
meteorological 233
mitigation 235
plan 236
telluric and teutonic 234
types of 233
Disinfection 110
Dizziness 335
Dog bite 205
Domestic abuse 347
Dopamine 341
Drain 368
Dressing 184, 185
types of 185
Dry
gangrene 120
heat 111, 423
mouth 369
thermal treatment 178
Duodenum 43, 78
Dural sinuses 53
Dyes 113
Dysentery 107
Dyspepsia 78
E
Ear, structure of 59f
Edentate calcium 341
Elastic fibrocartilage 15
Elastic tissue 15
Electrical conduction system 74, 74f
Emotional abuse 347
Emphysema 89
Endocardium 31, 34
Endocrine
gland 89, 158
system 45
control of 101
organs of 45f
Endometrium 65
Endorphins 90
Endothelium 34
Endotracheal intubation 332
Energy 157, 163
Entamoeba histolytica 107, 366
Enterobius vermicularis 366
Environmental pollution 174
Enzyme 108
inhibition of 110
ptyalin 76
Epicardium 30
Epidermophytosis 107
Epiglottis 40, 86
Epinephrine 93
Epiphysis 20
Epistaxis 208, 209
Epithalamus 101
Epithelia, classification of 14f
Epithelial tissue 12
classification of 13
Esophagus 41, 75, 77
Ethylene
gas 112
glycol 341
oxide 113
Eustachian tube 88
Excitable cells 16
Extensor carpi
radialis longus and brevis 27
ulnaris 27
Extensor digitorum 27
External genitalia, external 62
Extrapyramidal symptoms 341
Eye 301, 304
structure of 58f
surgeries 331
F
Face 303
flushing of 205
mask 406
Fallopian tubes 64
Falx cerebelli 53
Falx cerebri 53
Fat
content, modification of 167
deficiency diseases 171
embolism syndrome 198
metabolism 43
Femoral pulse 227
Femur 18
Fentanyl 334
Fever 205
Fibrocartilage 15
Fibrosis, pulmonary 89
Filamentory fungi 107
Fish stings 206
Fits 227
Fleas, control of 381
Flexor carpi radialis 27
Flu 376
Fluid
diets 161
loss 203
Flumazenil 339, 340
Fluoride 170
Fluorouracil 341
Fly control products 366
Folic acid 169
Follicle stimulating hormone 90
Folliculitis 137
Fomite borne 116
Food 109
composition of 145
groups 159
hygiene 136
poisoning 215, 375
requirements 157
Formaldehyde gas 112
Fournier's gangrene 121
Fowler's position 254
Fracture 188, 192
ankle 198
arm bone 197
bed 250
bones 348
collar bone 196
communicated 189
complications of 198
facial 193
femur 198
fibula 198
foot 198
humerus 197
impacted 189
neck 196
open 192
pelvis 198
radius 197
ribs 195
scapula 197
spine 194
tibia 198
types of 199f
ulna 197
upper jaw 194
Francisella tularensis 368
Fundus 43, 65
Fungi 106, 107
Furuncle 137
G
Gait 312
Gallbladder 41, 44
Ganglia 98
Gangrene 120
causes 120
internal 121
symptoms 121
treatments 121
types of 120
Gap filters 251
Gas
exchange 86, 87
gangrene 121
Gastric
juice 42, 78
ulcer 78
Gastritis 78
Gastrocnemius 28
Gastroesophageal reflux 78
disease 78
Gastrointestinal tract 116, 124
Gastroparesis 78
Genital tract, female 118
Genitalia 63, 310
Genitourinary tract 13
Gentian-violet stain 401
Geotrichum 107
Giardia lamblia 107, 366
Giardiasis 143
Glands
sublingual 76
submaxillary 76
Glia limitans 54
Glomerulus 97f
Gloves, wrapping technique of 273f
Glucagon 92, 340
Glucocorticoids 94
Glucometer 389, 389f
Gluconeogenesis 93f
Glucose 339, 341
homeostasis 94
Glutaraldehyde 112, 113
Glycolysis 81
Gonadotropins 90
Greater curvature 43
Green stick fracture 189
Growth hormone 90
Guinea worm 143
H
Halothane 330
Head 303
Headache 205, 213, 369
Healing 118
Health care levels of 353f
Hearing 56, 59
organ of 59f
Heart 21, 34f, 308
chambers of 31
condition, types of 75
conduction system of 32
failure, congestive 75, 171
gross anatomy of 30f
layers of 30f
murmur 75
precordial points of 308f
rate 29
valve 31
disease 75
wall, structure of 29
Heartbeat 29
Heat 62
application of 409, 424
cradles 414
exhaustion 369
production of 43
Heatstroke 223, 369, 370
Helicobacter pylori 117
Helminths, eggs of 366
Hemarthrosis 209
Hematemesis 208
Hematomyelia 209
Hematopoiesis 21
Hematuria 208
Hemopericardium 209
Hemoperitoneum 209
Hemoptysis 208
Hemorrhage 207, 208, 220, 264
arterial 207
capillaries 207
control 191, 230
types of 207
venous 207
Hemothorax 209
Heparin 341
Hepatitis virus 108
Hepatocytes 42
Herpes simplex virus 108, 137
Hip 187
Hodgkin lymphoma 36
Homeostasis 86
Hookworm 107
Hormone
adrenocorticotropic 46
antidiuretic 46, 90, 101
inactivation of 43
Hot
air oven 113
application 411
types of 410
dry pack 423
moist packs 424
water bottle 405
Housefly 365, 366
control 366
Human
brain, parts of 55f
chronic gonadotropin 65
digestive system 42f
heart 72
immunodeficiency virus 108, 109, 173, 174, 384
rabies 361
respiratory system 83f
Humerus 197
Huntington's disease 100
Hyaline cartilage 15
Hydrocephalus 103
Hydroclave 178
Hydrogen peroxide 139
Hydrolysis 110
Hygiene 133, 303
chemicals, uses of 133f
Hymen 62, 63
Hymenolepis nana 366
Hyoid 16, 17
Hyperpnea 267
Hypersecretion 47
Hyperventilation 267
Hypoglycemia 390
Hyposecretion 47
Hypotension 335, 338
Hypothalamus 39, 45, 89, 90, 91f, 99, 101
Hypothermia 224, 371, 429
Hypoventilation 267
I
Ileum 79
Impetigo 137
Indwelling catheter 129
Infection 114, 203, 218, 382
control 174
Inflammation 114, 119
acute 114
chronic 114
subacute 114
types of 114
Influenza 376
virus 108
Ingestion 109
Inhalation 109
Inoculation 109
Insects 109, 115
Insulin 92, 341
reaction 341
Internal fixation devices 199
Intracranial pressure 103
Iodine 113, 141, 170
Iron 170, 341
stains 401
Ischiorectal fossa 28
Islet of Langerhans 92f
Isolation 381
J
Jaw
fractures 193
thrust 225
Jejunum 78
Joints 199
acromioclavicular 22
ball and socket
hip 18
shoulder 18
carpal 23
carpometacarpal 23
cartilaginous 22
elbow 18, 22
fibrous 22
fingers 23
foot 24
hand 23
hinge 18
hip 24
humeroscapula 22
interphalangeal 24
knee 18, 24
lower extremity 24
metacarpophalangeal 24
radioulnar 23
shoulder 22
sternoclavicular 22
synovial 22
temporomandibular 22
tibiofibular 24
upper extremity 22
vertebral arches 22
wrist 23
Jugular vein 306, 306f
K
Kala-azar 107
Keratinized stratified epithelium 14
Ketamine hydrochloride 333
Kidneys 50
cross section of 51f, 97f
functions of 51
location of 96
microscopic
anatomy of 97
structure of 50
Knee 188
chest position 255
rest 251
Kussmaul respiration 267
Kwashiorkor 172
L
Labia majora 62
Labia minora 62
Laceration 202
Lacrimation 205
Large intestine 76, 79, 80f, 117
functions of 80
Laryngitis 88
Laryngotracheal diphtheria 373
Larynx 40, 82, 86
Latissimus dorsi 26
Lead 341
Leech bite 207
Leishmania 107
Leptomeninges 54
Leptospira 106
Leucovorin calcium 339, 341
Levator palpebrae superioris 24
Lidocaine 337
Lignocaine 337
Limbic system 100
Lingual papillae 42
Lipids, digestion of 79
Lithotomy position 255
Liver 41, 42
abscess of 107
functions of 43
Lobules 42
Local dry heat applications 411
Local moist heat application 416
Loop of Henle 97f
Lower jaw fracture 193
Lower limb 16
bones 18
Lower respiratory tract 82, 86
disorders 88
Lund and Browder method 218
Lungs 41, 82
structure of 85f
Luteinizing hormone 90
Lymph 36, 37f
drainage 63
nodes 37, 306
vessels 37
Lymphatic system 36, 68
Lymphocytes 36, 37
Lymphoid tissue 15
M
Macrophages 37
Madurella mycetomatis 107
Maggot therapy 122
Magnesium 170
sulphate 339
Malaria 360, 383
Manganese 171
Marasmus 172
Maxillary sinuses 305, 305f
Measles 372
Medulla 93
oblongata 99, 102
Medullary cavity 21
Melena 208
Memory 56, 314
Meninges 53
Meningitis, meningococcal 54
Menorrhagia 209
Mensa 340
Mental
assessment 313
symptoms 299
Mepivacaine 337
Metaphysis 20
Methotrexate 341
Metrostaxis 209
Microorganisms, classification of 106
Microsporum 107
Midbrain 99, 102
Mid-clavicular line 308
Middle ear surgeries 331
Midstream urine, collection of 128t
Migration 119
Mineral 19
deficiency diseases 170
Mineralocorticoids 94
Mitral valve 31, 73
Moist heat 110
Monitor vital sign 383
Morphine 335
Mosquito 367
borne disease 367
prevention 368
protection 368
Motor system 312
Mumps virus 108
Muscles 27, 28, 199
arm 27
back 26
contraction 47
cramps 369
face 24
fibers, internal intercostal 26
hip 28
intercostal 26
layer 44
lower limb 28
neck 25
pelvic floor 26
reflexes of 312
respiration 41
rigidity 335
shoulder 26
thorax 26
tissue
cardiac 16
skeletal 16
smooth 16
tongue 17
upper limb 26
Muscular tissue 16
Mycobacterium 363
tuberculosis 105, 106, 110
Mycosis
subcutaneous 107
superficial 107
systematic 107
Myocardial infarction 75
Myocarditis 75
Myocardium 30
Myometrium 65
N
Naloxone 339, 341
Narcotics 341
Nasal
cannula 283, 332
cavities 39, 61f, 82, 85
diphtheria 373
Nasogastric tube 381
National AIDS Control Organization 357, 358
National Antimalaria Programme 355
National Health Policy 354
National Health Programs 355
National Population Policy 354
Nausea 205, 213, 335
Neck 306
Neostigmine 339
Nephron 50, 97
functions of 98
Nerve impulse transmission 47
Nervous system 51, 52f
Niacin 168
Nirmal Gram Puraskar Yojna 134
Nitrous oxide 330
Non-keratinized stratified epithelium 13
Noradrenaline gland 47
Nosocomial infections 174
Nucleic acid synthesis 110
Nucleus 108
Nutrition 145, 155
principles of 155
Nutritional deficiency 168
diseases 168
O
Obesity 120
Occipitofrontalis 24
Opioid analgesics 341
Opportunistic fungi 107
Optic nerve 58
Oral
care 271
cavity 39, 117
ingestion 325
thrush 107
Orbicularis oculi 25
Orbicularis oris 25
Organic phosphate poisoning 213
Orthopnea 267
Osteocytes 20
Ovaries 64, 94, 95
functions of 64
suspensory ligament of 64
Oxygen 331
administration of 282
concentrators 393
delivery, methods of 283
mask 331
tent 284, 332
therapy 122, 283
Oxytocin 90, 101
Ozone 139
P
Padding splint 192
Pain 62, 199, 213, 264
abdominal 205
acute 266
severe 205
superficial 313
Palmarus longus 27
Palpation 297, 310
Pancreas 41, 48, 89, 92
body of 48
head of 48
tail of 48
Pancreatic islets 48
Pantothenic acid 169
Papillomavirus 108
Paraffin bath 422
Parasites 106, 143
Parathyroid 89
glands 47
Paratyphoid 374
fever 374
Parental route 326
Paresthesia 214
Parietal lobe 56, 99
Parotid glands 76
Parotitis 375
Pectoral girdle 16, 18
Pectoralis major 26
Pediculosis capitis 138
Pellet implantation 328
Pelvic girdle 16, 18
Penicillamine 339
Penicillium 107
Penile erection 205
Pentazocine 334
Pepsin 78
Peptic ulcer disease 78
Pericardial cavity 29
Pericardium 72
Perimetrium 65
Periosteum 20
Peripheral nervous system 51, 98, 99
Pertussis 378
Pethidine 335
Pharyngeal tonsil 38
Pharyngotonsillar diphtheria 373
Pharynx 40, 76, 82, 85
Phenolics 139
Phentolamine 339, 341
Phrenic nerves stimulate diaphragm 84
Physical abuse 347, 348
Physostigmine 340, 341
Phytomenadione 340
Phytonadione 340
Pia mater 53, 54
Pills 325
Pineal
body 89
gland 101
Pinworm 107
Pisiform bone 19
Pituitary gland 39, 46, 90, 91f
Plague 381
Plasma 71, 87
Plaster, definition of 420
Platelets 72
Pneumonia 88
Pneumoperitoneum 331
Pneumothorax 331
Poisoning 212
causes of 212
classification of 212
prevention of 216
Polio 143
eradication 358
Poliovirus 107
Pons 99, 102
Portal veins 29
Potassium 171, 341
permanganate 139, 421
sulphate 421
Poxvirus 108
Pralidoxime 340
Pregnancy test 130
Procaine 337
Progesterone 96
Prolactin 90
Pronator teres 27
Propofol 333
Protamine sulfate 340, 341
Protein 164
coagulation of 110
content 167
deficiency diseases 172
digestion of 79
energy malnutrition 172
metabolism 43
Protozoa 106, 143
Psoas 28
Psoriasis 137
Pterygoid 25
Pulse 263
characteristics of 264
oximeter 387
polio immunization 358
regulation of 263
Pupils, constriction of 213
Pyloric
antrum 43
canal 43
sphincter 43
Pyrethrin insecticide aerosols 367
Pyridoxine 169, 340
Pyruvic acid, oxidation of 81
Q
Quadratus lumborum 26
R
Rabies 361
virus 108
Rachitis 169
Radius 197
Rail covers 252
Rat bite 207
Raynaud's phenomenon 120
Rectum 76, 310
Rectus abdominis 27
Red blood cells 71
Reflexes, loss of 213
Refrigeration 160
Reproductive system 62
female 62, 63f, 95f
male 66, 66f, 95f
Respiration 81, 266, 267
characteristics of 266
depth of 266
external 87
types of 81
Respiratory
failure 214
infection 88
system 38, 82, 85
anatomy of 39f
tract 211
Resuscitation techniques 225
Revised national TB control program 356, 357
Rhinorrhea 205
Rhinovirus 107
Rhonchi 308
Rhythms 264266
Riboflavin 168
Ribonucleic acid viruses 107
Ribosomes 108
Ribs 16, 18
Rickets 169
Ringworm 362
Rinne's test 305, 305f
Romberg's test 312
Ropivacaine 337
Rotavirus 108
Roundworm 107, 143, 364
Rubella virus 109
Rugae 98
Rule of nines 218
S
Sacrospinalis 27
Sacrum 18
Salbutamol inhaler 339
Salivary glands 41, 76
Salmonella typhi 363
Sartorius 28
Scabies 137
Scalds 348
Scalp 107, 187, 303
Schaffer's method 226
Scorpion bite 205
Scrotum 66
Seizures 213, 214, 227
Selenium 171
Semilunar valves 31
Sensory neurons 53
Serous glands 42
Sexual abuse 347
Seymour tent 284
Shock 184, 198, 218, 219
anaphylactic 220
cardiogenic 221
distributive 220
hypovolemic 203, 220
neurogenic 221
septic 221
Short wave diathermy 394
Silver nitrate 113
Silvester method 226
Sinoatrial node 32
Sinuses 82, 305
Sinusitis 88
Sitz bath 422
Skeletal system 16, 17f
Skeleton 23f
thoracic region of 18
Skin 61
discoloration of 200
diseases 137
infection, prevention of 138
Skull 16, 17
fracture 192
Small intestine 76, 78, 80f
Smallpox 362
Snake bite 204
Sodium 171
bicarbonate 340, 421
hypochloride 139
nitrate 340
thiosulfate 340
Somatic nervous system 99
Sore throat 206
Speech 56, 303, 314
Sperm 67
Spermatic cords 67
Spermatozoa 67
Spinal
cord 5254, 56, 57f, 102
meninges 103
nerves 57
Spirilum minus 106
Spleen 38
Sprains 199, 200
Sputum, observation of 125t
Squamous epithelium 13
Stab wound 202
Staphylococcus aureus 137
Steam inhalation 285
Sterile dressing tray 322f
Sterilization 111, 179
physical methods of 141
Sternum 16, 18
Steroid 94
Stomach 41, 43, 76, 77, 77f, 117
bleeding 78
body of 43
conditions 78
functions of 44
parts of 43
structure of 43
ulcer 78
walls of 44
Stool specimen, collection of 130t
Stratified squamous epithelium 13
Streptococcus faecalis 111, 117
Stroke 100, 428
Subsartorial canal 28
Sudden cardiac death 75
Sulphate 335
Sunburn 224, 369, 370
Superior vena cava 69
Surgical asepsis 315
principles of 320
Swelling 107, 199, 205, 312
T
Tachycardia 205
Tachypnea 205, 267
Taenia solium 107
Tapeworm 107
Taste buds 60
tongue 60f
Tension 265
Tentorium cerebelli 53
Teres major 26
Testes 66, 94
structure of 67
Testosterone 94
Tetanus 380
Tetracaine 337
Thalamus 101
Thiamine 168, 340
Thiopentone sodium 332
Threadworm 143
Thrombocytes 72
Thumb forceps 273f
Thymus 38
gland 47
Thyroid 89, 91f, 306
follicles 91
gland 46, 91
isthmus of 46
stimulating hormone 91
Thyrotropin 90
Thyroxine 92
Tinea
barbae 107
capitis 107
corporis 107, 137
cruris 107
pedis 107
Tissue 12
damage 203
fibrous 15
healing of 119
T-lymphocytes 71
Toe clefts 107
Tongue 41
Tonsils 38
Tonsillitis 88
Touch, sense of 61f
Toxoplasma gondii 109
Trabeculae 20
Trachea 17, 40, 82, 87
Transitional epithelium 14
Transmission, mode of 109, 360362, 382384
Transtracheal oxygen 283
Transverse abdominis 27
Trapezius 26
Trauma 120, 229
Trendelenburg position 255
Treponema 106
Triceps 27
Trichomonas vaginalis 107
Trichophytons 107
Trichuris trichiura 366
Tricuspid valve 31, 72
Tricycle antidepressants 341
Triiodothyronine 92
Tuberculosis 105, 363
Tunica albuginea 67
Tunica vaginalis 66
Typhoid 143, 363, 374
Typhus 364
U
Ulna 197
Ultraviolet radiation 112
Upper respiratory tract 82, 85
Ureters 48, 98
Urethra 98
Urinary
bladder 49, 98
retention 205
system 48, 49f, 96f
Urine 123, 130
characteristics of 123t
color of 98
specimen, collection of 128t
Uterine tubes 64
Uterus 65
functions of 66
neck of 65
V
Vagina 63
structure of 64
Vaginal orifice 62
Vaginitis 107
Varicella 379
Vasopressin 90
Veins 29, 35, 36f, 36t, 68–70, 70f
Venereal disease 365
Venous drainage 44, 63, 66
Ventilation 83, 226, 230
Ventricles 72
Ventricular fibrillation 392
Venturi mask 331
Venules 35
Vertebrae 18, 53
Vertebral column 16, 18
Vertical transmission 116
Vestibular glands 62, 63
Vestibule 62
Vibrio cholera 105
Viruses 106, 107, 108t, 143
Vision, blurred 213
Vitamin
A 168
absorption of 80
B1 168
B12 169
B2 168
B3 168
B5 169
B6 169
B7 169
B9 169
C 169, 340
D 169
deficiency diseases 168
E 169
K 170, 340
Vitamins and mineral nutrition information system 168
Vocal cords 86
Vomeronasal organ 61
Vomiting 205, 213, 214, 335
Vulva 62
W
Warts 137
Wasp stings 206
Waste
biomedical 173
chemical 174, 176
hospital 174, 176
infectious 176
management 176
categories of 179
non-hazardous 174
pathological 176
pharmaceutical 174, 176
potential toxic 174
potentially infectious 174
radioactive 174, 176
segregation of 175, 176, 176f
soiled infected 175
types of 179, 180
Water borne diseases 143
Wax bath 422
Webber's test 304, 304f
Wernicke's area 56, 100
West Nile virus 368
Wet gangrene 120, 121
types of 121
Wheeze 308
Whirlpool bath 424
White adipose tissue 14
White blood cells 36, 71
Whooping cough 378
Wound 201
closed 202, 203
dressing 287
first aid management of 202
hazard of 203
healing 118, 119
irrigation 293
missile 202
open 202, 203
puncture 202
types of 201
Wuchereria bancrofti 107
X
Xylocaine 337
Y
Yersinia pestis 381
Z
Ziehl-Neelsen technique 106
Zollinger-Ellison syndrome 78
Zygomatic bones 19
×
Chapter Notes

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1
  • 1. History of Nursing
  • 2. Anatomy
  • 3. Physiology
  • 4. Elementary Pathology and Microbiology
  • 5. Hygiene, Sanitation and Uses of Hygiene Chemicals
  • 6. Nutrition and Dietetics
  • 7. Biomedical Waste Management
  • 8. First Aid and Bandaging
  • 9. Disaster Management2

History of NursingCHAPTER 1

Chapter Outline
  • • Pre-Nightingale Reforms
  • • Florence Nightingale
  • • Contemporary Developments
  • • Nursing in India
 
ABSTRACT
This chapter looks at the pre-Nightingale reforms led by St. Vincent De Paul and Mile Le Gras, Elizabeth Fry. The second face of this chapter involves the life and work of Florence Nighingale who is the founder of Nursing and started a nursing school at St. Thomas Hospital. It includes her interest in India and her work at Military hospital and Sanitation. It also contains the contemporary developments which explain the discoveries of Pasteur, Lister and Kosch, and the relationship of nursing to hospital reform. The final face involves the modern day of nursing in India which explains the introduction and growth of nursing in India, developments of schools, examination and registration. It also includes a brief review of organization in India today.
 
PRE-NIGHTINGALE REFORMS
(i) St. Vincent De Paul and Mile Le Gras: Vincent de Paul (24 April, 1581 – 27 September, 1660) was a priest of the Catholic Church who dedicated himself to serving the poor. He is venerated as a saint in the Catholic Church and the Anglican Communion. He was canonized in 1737. He was renowned for his compassion, humility, and generosity and is known as the Great Apostle of Charity.
Saint Louise de Marillac, DC, also Louise Le Gras (August 12, 1591-March 15, 1660) was the co-founder, with Saint Vincent de Paul, of the Daughters of Charity. She is venerated as a saint by the Roman Catholic Church.
Louise de Marillac and Vincent de Paul met around the time of Antoine's passing. Widowed and lacking financial means, she had to move. Vincent de Paul lived near her new dwelling. At first, he was reluctant to be her confessor, busy as he was with his Confraternities of Charity. Members were aristocratic ladies of charity who were helping him nurse the poor and look after neglected children, a real need of the day. But the ladies were busy with many of their own concerns and duties.
Over the next four years, Vincent and Louise communicated often through letters and personal meetings, with Vincent guiding Louise to greater balance in a life of moderation, peace and calm. In 1629, Vincent invited Louise to get involved in his work with the Confraternities of Charity.
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She found great success in these endeavors. Then, in 1632, Louise made a spiritual retreat seeking inner guidance regarding her next step. Her intuition led her to understand that it was time to intensify her ministry with poor and needy persons, while still maintaining a deep spiritual life. Louise, at age 42, drawn to focus on mission, communicated this aspiration to Monsieur Vincent. By the end of 1633, he too had received the guidance needed for them to bring the Daughters of Charity into existence.
(ii) Elizabeth Fry: Elizabeth (Betsy) Fry (21 May 1780–12 October 1845), was an English prison reformer, social reformer and, as a Quaker, a Christian philanthropist. She has sometimes been referred to as the ‘angel of prisons’.
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Fry was a major driving force behind new legislation to make the treatment of prisoners more humane, and she was supported in her efforts by the reigning monarch.
Prompted by a family friend, Stephen Grellet, Fry visited Newgate Prison. The conditions she saw they horrified her. The women's section was overcrowded with women and children, some of whom had not even received a trial. The prisoners did their own cooking and washing in the small cells in which they slept on straw.
She returned the following day with food and clothes for some prisoners. She was unable to further her work for nearly four years because of difficulties within the Fry family, including financial difficulties in the Fry bank. Fry returned in 1816 and was eventually able to found a prison school for the children who were imprisoned with their mothers. She began a system of supervision and required the women to sew and to read the Bible. In 1817 she helped found the Association for the Reformation of the Female Prisoners in Newgate. This led to the eventual creation of the British Ladies’ Society for Promoting the Reformation of Female Prisoners, widely described by biographers and historians as constituting the first ‘nationwide’ women's organization in Britain.5
 
FLORENCE NIGHTINGALE
(12 May 1820 – 13 August 1910)
Florence Nightingale came to prominence while serving as a manager of nurses trained by her during the Crimean War, where she organized the tending to wounded soldiers. She gave nursing a highly favorable reputation and became an icon of Victorian culture, especially in the persona of ‘The Lady with the Lamp’ making rounds of wounded soldiers at night.
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Some recent commentators have asserted Nightingale's achievements in the Crimean War were exaggerated by the media at the time, to satisfy the public's need for a hero. Nevertheless, critics agree on the decisive importance of her follow-up achievements in professionalizing nursing roles for women. In 1860, Nightingale laid the foundation of professional nursing with the establishment of her nursing school at St Thomas’ Hospital in London. It was the first secular nursing school in the world, now part of King's College London. The Nightingale Pledge taken by new nurses was named in her honor, and the annual International Nurses Day is celebrated around the world on her birthday. Her social reforms include improving health care for all sections of British society, advocating better hunger relief in India, helping to abolish prostitution laws that were over-harsh to women, and expanding the acceptable forms of female participation in the workforce.
Nightingale was a prodigious and versatile writer. In her lifetime, much of her published work was concerned with spreading medical knowledge. Some of her tracts were written in simple English so that they could easily be understood by those with poor literary skills. She also helped popularize the graphical presentation of statistical data. Much of her writing, including her extensive work on religion and mysticism, has only been published posthumously.
 
Crimean War
Florence Nightingale's most famous contribution came during the Crimean War, which became her central focus when reports got back to Britain about the horrific conditions for the wounded. On 21 October 1854, she and the staff of 38 women volunteer nurses that she trained, including her aunt Mai Smith, and 15 Catholic nuns (mobilized by Henry Edward Manning) were sent (under the authorization of Sidney Herbert) to the Ottoman Empire. Nightingale was assisted in Paris by her friend Mary Clarke. They were deployed about 295 nautical miles (546 km; 339 mi) across the Black Sea from Balaklava in the Crimea, where the main British camp was based.
Nightingale arrived early in November 1854 at Selimiye Barracks in Scutari (modern-day Üsküdar in Istanbul). Her team found that poor care for wounded soldiers was being delivered by overworked medical staff in the face of official indifference. Medicines were in short supply, hygiene was being neglected, and mass infections were common, many of them fatal. There was no equipment to process food for the patients.
After Nightingale sent a plea to The Times for a government solution to the poor condition of the facilities, the British Government commissioned Isambard Kingdom Brunel to design a prefabricated hospital that could be built in England and shipped to the Dardanelles. The result was Renkioi Hospital, a civilian facility that, under the management of Dr Edmund Alexander Parkes, had a death rate less than 1/10th that of Scutari.6
Stephen Paget in the Dictionary of National Biography asserted that Nightingale reduced the death rate from 42% to 2%, either by making improvements in hygiene herself, or by calling for the Sanitary Commission. For example, Nightingale implemented handwashing and other hygiene practices in the war hospital in which she worked.
Nightingale still believed that the death rates were due to poor nutrition, lack of supplies, stale air and overworking of the soldiers. After she returned to Britain and began collecting evidence before the Royal Commission on the Health of the Army, she came to believe that most of the soldiers at the hospital were killed by poor living conditions. This experience influenced her later career, when she advocated sanitary living conditions as of great importance. Consequently, she reduced peacetime deaths in the army and turned her attention to the sanitary design of hospitals and the introduction of sanitation in working-class homes.
 
Foundation of First Nursing School
Friday, 15 June 1860
Florence Nightingale was a revered English nurse, writer and statistician. Nightingale chose to become a nurse over the popular role of wife and mother. Though her family was against it, they could not change her mind. She believed that she had been called by God to pursue a nursing career.
Nightingale gained popularity during the Crimean war where she cared for wounded soldiers. In 1860 she established a nursing school at St Thomas Hospital in London. It was the first professional nursing school in the world. The nursing school is now part of King's College London where nursing graduates take the Nightingale pledge, so named in her honor.
 
Interest in India: Sanitary Reform
After the Crimean War, Florence Nightingale persisted in researching the health conditions of British troops throughout the Empire. Undaunted by geographic limitations, she surveyed and publicized data that documented the mismanagement of living conditions and health care among the occupational forces on the Indian continent. Nightingale proposed widespread changes in the reporting of military health status and biostatistics, in sanitary engineering, and in self-care activities. With dogged persistence, she continued to gather follow-up data to measure the changing health status of soldiers in a land she never saw.
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It begins with her work to establish the Royal Commission on the Sanitary State of the Army in India, for which she drafted questionnaires, analyzed returns, and did much of the final writing, going on to promote the implementation of its recommendations. In this volume a gradual shift of attention can be seen from the health of the army to that of the civilian population. Famine and epidemics were frequent and closely interrelated occurrences. To combat them, Nightingale recommended a comprehensive set of sanitary measures, and educational and legal reforms, to be overseen by a public health agency. Skillful in implementing the expertise, influence and power of others, she worked with her impressive network of well-placed collaborators, having them send her information and meet with her 7back in London. The volume includes Nightingale's work on the royal commission itself, related correspondence, numerous published pamphlets, articles and letters to the editor, and correspondence with her growing network of viceroys, governors of presidencies, and public health experts. Working with British collaborators, she began this work; over time Nightingale increased her contact with Indian nationals and promoted their work and associations.
 
CONTEMPORARY DEVELOPMENTS
 
Louis Pasteur
(December 27, 1822 – September 28, 1895)
Louis Pasteur was a French chemist and microbiologist for his discoveries of the principles of vaccination, microbial fermentation and pasteurization. He is remembered for his remarkable breakthroughs in the causes and preventions of diseases, and his discoveries have saved countless lives ever since. He reduced mortality from puerperal fever, and created the first vaccines for rabies and anthrax. His medical discoveries provided direct support for the germ theory of disease and its application in clinical medicine. He is best known to the general public for his invention of the technique of treating milk and wine to stop bacterial contamination, a process now called pasteurization. He is regarded as one of the three main founders of bacteriology, together with Ferdinand Cohn and Robert Koch, and is popularly known as the ‘father of microbiology’.
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Joseph Lister
(5 April 1827 – 10 February 1912)
Joseph Lister, 1st Baron Lister, known as Sir Joseph Lister, Bt., between 1883 and 1897, was a British surgeon and a pioneer of antiseptic surgery. By applying Louis Pasteur's advances in microbiology, he promoted the idea of sterile portable ports while working at the Glasgow Royal Infirmary. Lister successfully introduced carbolic acid (now known as phenol) to sterilize surgical instruments and to clean wounds, which led to a reduction in post-operative infections and made surgery safer for patients.
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Robert Koch
(11 December 1843 – 27 May 1910)
Robert Koch was a celebrated German physician and pioneering. The founder of modern bacteriology, he is known for his role in identifying the specific causative agents of tuberculosis, cholera, and anthrax and for giving experimental support for the concept of infectious disease. In addition to his trail-blazing studies on these diseases, Koch created and improved laboratory technologies and techniques in the field of microbiology, and made key discoveries in public health.
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His research led to the creation of Koch's postulates, a series of four generalized principles linking specific microorganisms to specific diseases that remain today the ‘gold standard’ in medical microbiology. As a result of his groundbreaking research on tuberculosis, Koch received the Nobel Prize in Physiology or Medicine in 1905.8
 
NURSING IN INDIA
Nursing in India is the practice of care for medical patients in that nation.
Its history indicates that the principles and practices of nursing are ancient. These ancient nursing practices are so clear, intelligent and scientific, that many of them might fit into any of the modern textbook. Prior to the 20th century, Indian nurses were usually young men, with women acting as midwives for assisting with childbirth. The acceptance of nursing as a profession in India was obstructed by the low status of women, the caste system, illiteracy and political unrest.
 
Nursing History
Nursing is the largest, the most diverse and one of the most respected among the health care professions. Nursing is a profession which focuses on protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human responses and advocacy while caring for individuals, families, communities and populations, assuming responsibility for the continuous care of the sick 24 × 7, the injured, the disabled and the dying.
Globally, health systems are experiencing major shifts in their structure, organization, functions and management. Globalization and the technological transformation of health sectors are creating an increasingly diverse yet interconnected world. Within this ever-changing milieu, nurses are faced with many challenges, each demanding valuable and self-motivated leadership and managerial abilities if they are to be addressed effectively.
Nurses are different from other health care providers by their approach to patient care and varied scope of practice. Professional nurses work both independently and in collaboration with other health care professionals. Nurses practice in a wide diversified practice areas with a different scope of practice and level of authority in each. Many nurses provide care within the ordering scope of physicians, and this traditional role has come to shape the historic public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. Nursing education has undergone a process of diversification towards advanced and specialized courses and many of the traditional regulations and provider roles are shifting to advanced practice levels.
‘Nursing is a profession in which the element of service to humanity is very strong and is characterized by distinctive traditions, skills, knowledge, values and qualities of a discipline. Articulating this value to the community is one of the challenges nursing faces as it evolves responding to very different practice environments’.
Nursing is well known by its practice ingrained with value of ‘caring’ and this intrinsic nursing value is a part of the development of the discipline of nursing and it now evolves to meet the emerging needs of the community. Nurses and midwives are frontline providers in delivery of cost-effective and quality health care and their contributions to health care development and towards achieving the Millennium Development Goals (MDGs) are extremely crucial.
Nursing services and educational facilities in India have expanded considerably since independence. Nurses are accessible even where doctors are not available and provide health care at the doorstep. Nursing roles and responsibilities have multiplied over the years, but there are huge concerns with regard to the development of the pre-service and in-service training and human resources (HR) issues for their career growth.9
It has been observed that there is a workforce crisis due to unemployment and underemployment in nursing across the country irrespective of having immense human resource potential in nursing. The retarded development of nursing and nursing profession seems to be mainly due to the fact that no serious thought has been given to this discipline over the years. Timely action on the various reports submitted to the government would have prepared nurses to take care of all areas of health care delivery and would have also avoided multiplication of other categories like physician assistants, respiratory therapists, technicians, health educators, etc. All these are doing nursing duties.
 
Nursing Education in India
Nursing education prepares nurses to practice in a variety of settings. Ancient days’ nurses were trained using an apprenticeship model. Long hours at the bedside were supplemented by some pearls of wisdom dispensed by physicians. By the middle of the twentieth century, it became clear that effective nursing practice required a distinctive body of knowledge. Nursing interventions had gradually become independent of the physician's orders, and nursing required integrated knowledge of the physiological, psychological, and social dimensions of the patient. By developing programs of research, nurses asserted ownership over the knowledge required for practice.
On 15th August 1947, India became independent and social changes were taking place rapidly but an alarming absence of public health and sanitary measures continued. The ratio of nurse to patient remained dangerously low. The opening of nursing schools associated with college gave nursing profession a higher social and economic status, than it had previously known. The formation of many commission and committees, establishment of INC brought about change in nursing education.
 
Growth of Nursing in India
  • ANM institutions increased from 307 to 1,642 with admission capacity enhanced from 6,860 to 46,719
  • GNM institutions increased from 753 to 2,670 with admission capacity enhanced from 29,008 to 109,224
  • BSc(N) institutions increased from 266 to 1,578 with admission capacity enhanced from 11,953 to 80,245
  • PBBSc(N) institutions increased from 38 to 617 with admission capacity enhanced from 893 to 20,378
  • MSc(N) institutions increased from 38 to 535 with admission capacity enhanced from 483 to 10,026.
History of evolution of nursing education in India
1871—School of nursing started in general hospital Madras.
1886—School of nursing in a full-fledged form was started in JJ Hospital, Bombay.
1892—Many hospitals in Bombay started nursing associations which were intended to provide additional facilities for the training of local nurses.
1908—Trained Nurses Association of India (TNAI) established.
1909—Bombay presidency nursing association was formed.10
1910—United board of examination for nurses was organized.
1913—South India Board was organized.
1926—First nurses’ registration act passed in Madras.
1935—Madras and Bombay nursing councils were established.
1942—ANM program started.
1943—School of Nursing at RAK College, New Delhi.
1943—Diploma program in nursing administration started in New Delhi.
1946—Four year BSc nursing program started in RAK College and CMC, Vellore.
1947—INC act was passed.
1949—INC was established.
1959—MSc Nursing started in RAK College of Nursing.
1963—Postbasic BSc program started in various institutions.
1968—MSc Nursing at CMC, Vellore.
1972—Basic degree program started in Kerala.
1985—MSc nursing started in CMC Ludhiana.
1985—IGNOU established.
1986—Curriculum change for GNM program from three and a half years to three years.
1986—M Phil. program started in RAK, Delhi.
1987—MSc Nursing started in Kerala.
1987—Separate directorate of nursing was created in Karnataka State.
1988—MSc Nursing at NIMHANS.
1992—PhD in RAK College, New Delhi.
1992—Postbasic program started under IGNOU
1994—MSc nursing at Mahe, Manipal
1994—Basic BSc program under school of medical education in Mahatma Gandhi University, Kottayam.
1996—MPhil and PhD at Mahe, Manipal.
2001—PhD at NIMHANS.
2004—Syllabus of all nursing courses revised and implemented from 2006 onwards.
2008—Post basic diploma in 10 nursing specialties including independent nurse practitioner in midwifery was developed.
2004–2012—Growth of Nursing Educational Institutions with 5 to 16% in government sector and 84 to 94% of admission capacity produced by private schools and colleges of nursing emerged.
 
Review of Organization in India
 
Indian Nursing Council
The Indian Nursing Council is a national regulatory body for nurses and nurse education in India. It is an autonomous body under the Government of India, Ministry of Health and Family Welfare, constituted by the Central Government under section 3(1) of the Indian Nursing Council Act, 1947 of Indian parliament.
Aims
‘To establish a uniform standard of training for nurses midwives and health visitors.’11
Functions
  • To establish and monitor a uniform standard of nursing education for nurses midwife, auxiliary nurse-midwives and health visitors by doing inspection of the institutions.
  • To establish and monitor a uniform standard of nursing education for nurses midwife, auxiliary nurse-midwives and health visitors by doing inspection of the institutions.
  • To recognize the qualifications under section 10(2)(4) of the Indian Nursing Council Act, 1947 for the purpose of registration and employment in India and abroad.
  • To give approval for registration of Indian and Foreign Nurses possessing foreign qualification under section 11(2)(a) of the Indian Nursing Council Act, 1947.
  • To prescribe minimum standards of education and training in various nursing programs and prescribe the syllabus and regulations for nursing programs.
  • Power to withdraw the recognition of qualification under section 14 of the Act in case the institution fails to maintain its standards under Section 14 (1)(b) that an institution recognized by a State Council for the training of nurses, midwives, auxiliary nurse midwives or health visitors does not satisfy the requirements of the Council.
  • To advise the State Nursing Councils, Examining Boards, State Governments and Central Government in various important items regarding nursing education in the country.
  • To regulate the training policies and programs in the field of nursing.
  • To recognize Institutions/Organization/Universities imparting Master's Degree/Bachelor's degree/PG Diploma/Diploma/Certificate Courses in the field of nursing.
  • To recognize Degree/Diploma/Certificate awarded by Foreign Universities/Institutions on reciprocal basis.
  • To promote research in nursing.
  • To maintain Indian Nurses Register for registration of Nursing Personnel.
  • Prescribe code of ethics and professional conduct.
  • To improve the quality of nursing education.
Organization Structure
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