Surgery & Anatomy

Notes

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  • Created by: Emily O
  • Created on: 24-04-11 18:38

Four Major Problems with Surgery.

Pain

Blood Loss

Infection During Surgery

Inferction After Surgery

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Pre History

Meaning of Pre- history- before development of writing. This lack of evidence means it can be difficult for us to be certain about what happenend during this period.

We base much of our understanding of groups of people who have changed little over many thousands of rs such as AUSTRLIAN ABORIGINES.

One Surgical procedure that we knopw was carried out successfully was TREPHINATION. This means drilling a hole in the skull. They probably did this to release evil spirits trapped in the body.

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Ancient Egypt

They knew about:

  • Heart
  • Lungs
  • Liver
  • Brain
  • Veins and Arteries

But there is no evidence that they knew what each part did e.g the heart is a pump.

No dissection of humans

They got much of the anatomical knowledge from trating wounded soldiers

Some of their knowledge could of come from removing organs during the embalming process

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Egyptian Surgery

 New better bronze instruments were made. Simple external surgery carried out.

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Greek Anatomy

Aristotle-

He argued that the brain and heart were the most important organs in the body.

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Greek Surgery

No effective anaesthetic

They could set bones and amputate limbs

They could also drian lungs. However there was little internal surgery.

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Roman Surgery

Wonded soldiers gave Roman surgeones plenty to experience of dealing with external surgery.

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Roman Anatomy

Cladius Galen made a lot of important discoveries such as the brian controls speech and that veins and arteries carried blood. He did this through his work at Alexandria and by diddecting animals such as pigs. However becuase he could not dissect humans, he had to assume that they were the same as animals. Consequently he made errors.

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Middle ages/ christian world No real changes

Dissections were used to prove Galen right.

Surgeons became skilled at bleeding patients.

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Middle ages/ Islamic world.

Some breakthroughs

Ibn Al Nafis suggested that blood did not move through the heart. However this was not proven until Renasissance.

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Renaissance

This literally means re-birth of learning. In Europe people began to look for scientifi explantions for things, rather than just relying on old ideas such of those of Galen.

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Renasissance Anatomy

Dissection was allowed.

Andreas Vesalius- Challenged Galen. He proved that blood does not move from one side of the heart to the other. He also showed that the human jaw has one bone not 2.

William Harvey- Showed that blood circulated around the blood and that the heart acted like a pump. This dispelled Galen's idea that blood simply burnt up in the body.

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Renasissance Surgery

Ambroise Pare made major breakthroughs in surgery. He stopped using boiling oil to treat gun shot wounds and instead used his own mix of oil and roses, egg yolk and turpentine. He also used Ligatures to tie up blood vessels instead of cauterising them.

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19th Century

Development of Anaesthtics-

Sir Humphrey Davy- Nitrous oxide "laughing gas" 1799- it didn't make patients completely unconscious and sometimes didn't work.

William Morton- Ether 1846- Very flammable. Also cause irritations to eyes and lungs.

James simpson- Chloroform 1847- Smells and tastes bad if you used to much it can cause vomiting.

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Opposition to Chloroform why?

Confusion about correct doses and side effects

High death rate from more complex surgery

Accidental deaths Hannah Greener died whilst having a toenail removed

Pain was God's invention and therefore a good thing (child birth)

Pain was actually healthy.

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Why did this change?

Queen Victoria used chloroform durnig the birth of the eighth child in 1857. People were likely to follow her lead.

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Germ theory

Louis Pasteur- did not believ in spontaneous generation or harmful miroboes.

Surgeons like lister used this research to influence their own work. Knowing about germs that they could try to prevent infection.

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Infection

In 1847 Ignaz Semmelweiss an Austrian doctor ordered that people should was their hands. He noticed that babies delivered by mid wives had a much higher surival rate than those delivered by doctors.

In 1865- Joseph lister used carbolic Acid to treat wounds to kill infections. Theew was still opposition to this.

Eventually lister's ideas caught on his antisptic techniques were replaced with aseptic techniques. This means making the operation area sterile before you start.

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Opposition to carbolic acid. why?

It Stank

It slowed operations down

Some people used it worng

Joseph lister himself. Some surgeones did not like him. They thought he was arrogant and was criticising them.

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X-RAYS

At the turn of the twentieth century Wilhelm Rontgen discovered x-rays. World war one 1914-1918 urged goverments to spend money on x-ray mechines to scan wounded men.

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Marie Curie Radiation Therapy

Marie Curie Continued research in to X-rays and discovered Radium. This has been used to diagnose Cancers and treat them reducing the need for intrusive surgeries.

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Penicillin

1928- aLEXANDER FLEMING went on hoilday left petri dishes containing bacteria out. He noticed it could killed germs but he could not produce enough quickly.

1938- HOWARD FLOREY & ERNST CHAIN  managed to grow enough penicillin to treat one man with an infection. He got better however they ran out before he had fully recovered and got ill again and died.

The british goverment would not fund their work. But us goverment did becuase of world war 2.

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Blood Transfusions

1902 Karl Landsteiner discovered blood groups.

During world war one 2 major breakthroughs.

  • Fristly sodium cirate added to prevent clotting
  • Later scientists discovered how to store blood cells 4 furture use.
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Plastic Surgery

Had been trialled many years earlier but was limited by pain and infection. During the 2 world wars new techniques improved rapidly particularly skin grafts due to horric explosion and burn injuries.

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Transplant, keyhole and Mirco-surgery

Transplants

  • Kindneys 1954
  • Liver 1963
  • Heart 1967
  • Bone Marrow 1980
  • Hear and lungs 1982

Keyhole surgery- To aviod trauma to a patient, surgeons can now perform sugery by making only a small incision. This requires  great skill, cameras and fantastic equitment.

Micro surgery - surgeons can now rejoin blood vessels and nerves and sometimes re attach severed limbs. This is due to improvements in technology

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Improved Anaesthetics

1930'S Helmut Wasse developed anaesthetics that could be injected into the blood stream making does more precise.

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Problems solved

Pain Solution found

Blood Loss Solution found

Infection During Surgery Solution found

Inferction After Surgery Solution Found

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