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Anatomical Positions of a patient.

 


In the surgical procedures the suitable position of the patient is important to make procedure easy not only for the surgeon but also for the patient.The position of the patient gives easiest approach to the surgeon towards part which is to be operated.

                                                                         Such type of position gives relief to the patient from complaints like in acute pancreatitis, some patients may gain relief by sitting or leaning forwards. The position of the patient will of course depend upon the type of operation.

Following positions are used routinely in he surgical procedures & examinations such as

  1. Dorsal position

    • Commonest
    • Lying on the back with hip flexed
    • Clinician stands on the right side
2.Lateral position
    • Lying on the side
    • It is given in operations on the kidney & related region.

3.Left Lateral position (Sim's Position)

    • It is simplest.
    • Hip flexed more than 90 & kne flexed less than 90 for avoiding ankles coming in the way of examination.
    • Used to give spinal anaesthesia.
    • It helps in straightening the lower & upper curves of the rectum in ano rectal examination.

4.Right Lateral position

    • Preferred in a suspected growth at pelvirectal junction.

5.Prone position

    • For operations of the back
    • Lying on ventral side
    • Used for pilonidal sinus

6.Lithotomy position

    • Lying on the back with the leg suspended in stirrups.
    • For operations of the perineum
    • Also for proctoscopic or sigmoidoscopic examination.
    • For bimanual examination of the abdomen.

7.Trendelenburg's position (Head-low position)

    • Head end of the table is lower down, shoulders are supported with shoulders guard fixed to the table.
    • This position is useful in management of shock because peripheral blood diverts to right heart chamber in this way cardiac volume increased.
    • Use for operations of the pelvis including prostate.

8.Reverse Trendelenburg'a position

    • For operations of the upper abdomen & brain

9.Knee elbow position

    • Ideal position in a physically fit patient
    • it is used for palpating the prostate & seminal vesicle

10.Knee-chest position (Genupectoral position)

    • Knees & chest remains in contact with the bed, head is supported on patients own hand.
    • for introduction of proctoscope or sigmoidooscope.

11.Neck extended position

    • Pillows below the shoulder blades while the head rests on the ring.
    • For operations on the anterior aspect of the neck like thyroidectomy.

12.Head extended position

    • In this position head is extended over the edge of the table.
    • For operations inside the mouth eg. Tonsillectomy cleft palate etc.

13.Sitting position

    • Patient is advised to sit on the operative table & legs are rested on the able edges.
    • Hands are rested on the shoulder and neck is flexed resting on the chest. Patient is advised to extend the spine.
    • It is useful for spinal anaesthesia.
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