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|00000000| 0d 00 1c 00 ce 00 ec 01 | ba 02 f2 03 da 04 bc 05 |........|........|
|00000010| 6a 06 e2 07 f8 08 ec 09 | 66 0a 81 0b 41 73 73 75 |j.......|f...Assu|
|00000020| 6d 69 6e 67 20 79 6f 75 | 27 76 65 20 67 6f 74 74 |ming you|'ve gott|
|00000030| 65 6e 20 74 68 69 73 20 | 66 61 72 20 77 69 74 68 |en this |far with|
|00000040| 6f 75 74 20 61 20 6d 61 | 6a 6f 72 20 6d 69 73 68 |out a ma|jor mish|
|00000050| 61 70 2c 20 74 68 65 20 | 62 6f 6e 65 20 66 6c 61 |ap, the |bone fla|
|00000060| 70 20 69 73 20 6f 75 74 | 2c 20 61 6c 6c 20 62 6c |p is out|, all bl|
|00000070| 65 65 64 65 72 73 20 68 | 61 76 65 20 62 65 65 6e |eeders h|ave been|
|00000080| 20 73 74 61 6e 63 68 65 | 64 2c 20 74 68 65 20 70 | stanche|d, the p|
|00000090| 61 74 69 65 6e 74 20 69 | 73 20 73 74 61 62 69 6c |atient i|s stabil|
|000000a0| 69 7a 65 64 20 61 6e 64 | 20 79 6f 75 27 72 65 20 |ized and| you're |
|000000b0| 72 65 61 64 79 20 74 6f | 20 6f 70 65 6e 20 74 68 |ready to| open th|
|000000c0| 65 20 64 75 72 61 20 6d | 61 74 65 72 2e 00 43 6c |e dura m|ater..Cl|
|000000d0| 69 63 6b 20 74 68 65 20 | 66 69 6e 65 20 64 72 69 |ick the |fine dri|
|000000e0| 6c 6c 20 68 65 61 64 20 | 28 6e 65 65 64 6c 65 2d |ll head |(needle-|
|000000f0| 73 68 61 70 65 64 29 20 | 74 6f 20 70 6c 61 63 65 |shaped) |to place|
|00000100| 20 69 74 20 6f 6e 20 74 | 68 65 20 64 72 69 6c 6c | it on t|he drill|
|00000110| 2e 20 53 65 6c 65 63 74 | 20 74 68 65 20 6d 65 74 |. Select| the met|
|00000120| 61 6c 20 72 69 62 62 6f | 6e 20 28 6f 76 61 6c 20 |al ribbo|n (oval |
|00000130| 73 68 61 70 65 64 20 73 | 74 72 69 70 29 20 61 6e |shaped s|trip) an|
|00000140| 64 20 63 6c 69 63 6b 20 | 6f 6e 20 74 68 65 20 62 |d click |on the b|
|00000150| 6f 6e 65 20 65 64 67 65 | 20 72 75 6e 6e 69 6e 67 |one edge| running|
|00000160| 20 66 72 6f 6d 20 75 70 | 70 65 72 20 6c 65 66 74 | from up|per left|
|00000170| 20 74 6f 20 6c 6f 77 65 | 72 20 6d 69 64 64 6c 65 | to lowe|r middle|
|00000180| 2e 20 54 68 65 20 72 69 | 62 62 6f 6e 20 73 68 6f |. The ri|bbon sho|
|00000190| 75 6c 64 20 61 70 70 65 | 61 72 20 69 6e 20 61 20 |uld appe|ar in a |
|000001a0| 70 6f 73 69 74 69 6f 6e | 20 75 6e 64 65 72 6e 65 |position| underne|
|000001b0| 61 74 68 20 74 68 65 20 | 73 6b 75 6c 6c 20 65 64 |ath the |skull ed|
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|000001e0| 6d 20 64 72 69 6c 6c 69 | 6e 67 2e 00 4e 6f 77 20 |m drilli|ng..Now |
|000001f0| 73 65 6c 65 63 74 20 64 | 72 69 6c 6c 20 61 6e 64 |select d|rill and|
|00000200| 20 63 6c 69 63 6b 20 6f | 6e 20 74 68 65 20 62 6f | click o|n the bo|
|00000210| 6e 65 20 65 64 67 65 20 | 72 75 6e 6e 69 6e 67 20 |ne edge |running |
|00000220| 66 72 6f 6d 20 75 70 70 | 65 72 20 6c 65 66 74 20 |from upp|er left |
|00000230| 74 6f 20 6c 6f 77 65 72 | 20 6d 69 64 64 6c 65 2c |to lower| middle,|
|00000240| 20 61 62 6f 75 74 20 6d | 69 64 77 61 79 20 62 65 | about m|idway be|
|00000250| 74 77 65 65 6e 20 74 68 | 65 20 62 6f 6e 65 20 65 |tween th|e bone e|
|00000260| 64 67 65 20 61 6e 64 20 | 74 68 65 20 65 64 67 65 |dge and |the edge|
|00000270| 20 6f 66 20 74 68 65 20 | 64 72 61 70 65 2e 20 54 | of the |drape. T|
|00000280| 68 69 73 20 63 72 65 61 | 74 65 73 20 73 75 74 75 |his crea|tes sutu|
|00000290| 72 65 20 68 6f 6c 65 73 | 20 69 6e 20 74 68 65 20 |re holes| in the |
|000002a0| 72 69 6d 20 6f 66 20 74 | 68 65 20 73 6b 75 6c 6c |rim of t|he skull|
|000002b0| 20 6f 70 65 6e 69 6e 67 | 2e 00 49 4d 50 4f 52 54 | opening|..IMPORT|
|000002c0| 41 4e 54 3a 20 6d 61 6b | 65 20 73 75 72 65 20 74 |ANT: mak|e sure t|
|000002d0| 68 65 20 64 72 69 6c 6c | 20 69 73 20 77 69 74 68 |he drill| is with|
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|000002f0| 74 6c 69 6e 65 20 61 73 | 20 69 74 20 77 6f 75 6c |tline as| it woul|
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|00000320| 64 67 65 20 6f 72 20 79 | 6f 75 20 77 69 6c 6c 20 |dge or y|ou will |
|00000330| 64 72 69 6c 6c 20 69 6e | 74 6f 20 74 68 65 20 70 |drill in|to the p|
|00000340| 61 74 69 65 6e 74 27 73 | 20 62 72 61 69 6e 2e 20 |atient's| brain. |
|00000350| 43 6c 69 63 6b 20 6f 6e | 20 74 72 61 79 20 74 6f |Click on| tray to|
|00000360| 20 72 65 70 6c 61 63 65 | 20 64 72 69 6c 6c 2e 20 | replace| drill. |
|00000370| 52 65 70 65 61 74 20 74 | 68 6f 73 65 20 65 78 61 |Repeat t|hose exa|
|00000380| 63 74 20 73 74 65 70 73 | 20 66 6f 72 20 74 68 65 |ct steps| for the|
|00000390| 20 6f 74 68 65 72 20 74 | 68 72 65 65 20 65 64 67 | other t|hree edg|
|000003a0| 65 73 2e 20 43 6c 69 63 | 6b 20 68 61 6e 64 20 6f |es. Clic|k hand o|
|000003b0| 6e 20 6d 65 74 61 6c 20 | 72 69 62 62 6f 6e 20 74 |n metal |ribbon t|
|000003c0| 6f 20 70 69 63 6b 20 69 | 74 20 75 70 20 61 6e 64 |o pick i|t up and|
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|000003e0| 61 79 20 74 6f 20 72 65 | 70 6c 61 63 65 20 69 74 |ay to re|place it|
|000003f0| 2e 00 4e 6f 77 20 63 72 | 65 61 74 65 20 73 75 74 |..Now cr|eate sut|
|00000400| 75 72 65 20 68 6f 6c 65 | 73 20 69 6e 20 74 68 65 |ure hole|s in the|
|00000410| 20 62 6f 6e 65 20 66 6c | 61 70 20 74 68 65 20 73 | bone fl|ap the s|
|00000420| 61 6d 65 20 77 61 79 2e | 20 53 65 6c 65 63 74 20 |ame way.| Select |
|00000430| 64 72 69 6c 6c 20 61 6e | 64 20 6d 61 6b 65 20 73 |drill an|d make s|
|00000440| 75 72 65 20 69 74 20 73 | 74 69 6c 6c 20 68 61 73 |ure it s|till has|
|00000450| 20 74 68 65 20 66 69 6e | 65 20 62 69 74 2e 20 43 | the fin|e bit. C|
|00000460| 6c 69 63 6b 20 61 6e 64 | 20 64 72 69 6c 6c 20 6f |lick and| drill o|
|00000470| 6e 20 74 68 65 20 62 6f | 6e 65 20 66 6c 61 70 20 |n the bo|ne flap |
|00000480| 6f 6e 63 65 20 69 6e 20 | 74 68 65 20 6d 69 64 64 |once in |the midd|
|00000490| 6c 65 2c 20 61 6e 64 20 | 6f 6e 63 65 20 6e 65 61 |le, and |once nea|
|000004a0| 72 20 74 68 65 20 63 65 | 6e 74 65 72 20 6f 66 20 |r the ce|nter of |
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|000004c0| 63 65 20 74 68 65 20 64 | 72 69 6c 6c 20 6f 6e 20 |ce the d|rill on |
|000004d0| 74 68 65 20 74 72 61 79 | 2e 00 4e 6f 77 20 67 72 |the tray|..Now gr|
|000004e0| 61 73 70 20 74 68 65 20 | 73 75 74 75 72 65 20 28 |asp the |suture (|
|000004f0| 75 70 70 65 72 20 74 72 | 61 79 2c 20 63 75 72 76 |upper tr|ay, curv|
|00000500| 65 64 20 6e 65 65 64 6c | 65 20 61 6e 64 20 74 68 |ed needl|e and th|
|00000510| 72 65 61 64 29 2c 20 61 | 6e 64 20 63 6c 69 63 6b |read), a|nd click|
|00000520| 20 6f 6e 20 74 68 65 20 | 66 69 6e 65 20 64 72 69 | on the |fine dri|
|00000530| 6c 6c 20 68 6f 6c 65 73 | 20 61 6c 6f 6e 67 20 74 |ll holes| along t|
|00000540| 68 65 20 62 6f 6e 65 20 | 65 64 67 65 20 74 6f 20 |he bone |edge to |
|00000550| 69 6e 73 65 72 74 20 73 | 75 74 75 72 65 2e 20 41 |insert s|uture. A|
|00000560| 6c 73 6f 20 70 75 74 20 | 6f 6e 65 20 73 75 74 75 |lso put |one sutu|
|00000570| 72 65 20 69 6e 20 74 68 | 65 20 63 65 6e 74 65 72 |re in th|e center|
|00000580| 20 6f 66 20 74 68 65 20 | 65 78 70 6f 73 65 64 20 | of the |exposed |
|00000590| 64 75 72 61 20 6d 61 74 | 65 72 2e 20 52 65 70 6c |dura mat|er. Repl|
|000005a0| 61 63 65 20 74 68 65 20 | 73 75 74 75 72 65 20 6f |ace the |suture o|
|000005b0| 6e 20 74 68 65 20 74 72 | 61 79 2e 00 50 6c 61 63 |n the tr|ay..Plac|
|000005c0| 65 20 79 6f 75 72 20 68 | 61 6e 64 20 6f 76 65 72 |e your h|and over|
|000005d0| 20 74 68 65 20 62 6f 6e | 65 20 66 6c 61 70 20 61 | the bon|e flap a|
|000005e0| 6e 64 20 63 6c 69 63 6b | 20 6f 6e 63 65 2e 20 44 |nd click| once. D|
|000005f0| 72 61 67 20 74 68 65 20 | 62 6f 6e 65 20 66 6c 61 |rag the |bone fla|
|00000600| 70 20 74 6f 20 74 68 65 | 20 74 72 61 79 20 61 6e |p to the| tray an|
|00000610| 64 20 6c 65 74 20 67 6f | 2e 20 54 68 65 20 62 6f |d let go|. The bo|
|00000620| 6e 65 20 66 6c 61 70 20 | 77 69 6c 6c 20 6e 6f 77 |ne flap |will now|
|00000630| 20 61 70 70 65 61 72 20 | 6f 6e 20 74 68 65 20 74 | appear |on the t|
|00000640| 72 61 79 20 6f 75 74 20 | 6f 66 20 79 6f 75 72 20 |ray out |of your |
|00000650| 77 61 79 20 66 6f 72 20 | 74 68 65 20 74 72 69 63 |way for |the tric|
|00000660| 6b 79 20 73 74 75 66 66 | 2e 00 59 6f 75 20 6d 75 |ky stuff|..You mu|
|00000670| 73 74 20 6e 6f 77 20 69 | 6e 64 75 63 65 20 68 79 |st now i|nduce hy|
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|000006b0| 79 72 69 6e 67 65 20 6d | 61 72 6b 65 64 20 22 4e |yringe m|arked "N|
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|000006d0| 6e 74 6f 20 74 68 65 20 | 70 61 74 69 65 6e 74 2e |nto the |patient.|
|000006e0| 20 54 68 69 73 20 61 72 | 74 69 66 69 63 69 61 6c | This ar|tificial|
|000006f0| 6c 79 20 72 65 64 75 63 | 65 73 20 74 68 65 20 70 |ly reduc|es the p|
|00000700| 61 74 69 65 6e 74 27 73 | 20 62 6c 6f 6f 64 20 70 |atient's| blood p|
|00000710| 72 65 73 73 75 72 65 20 | 74 6f 20 70 72 65 76 65 |ressure |to preve|
|00000720| 6e 74 20 6d 61 73 73 69 | 76 65 20 62 6c 65 65 64 |nt massi|ve bleed|
|00000730| 69 6e 67 20 77 68 65 6e | 20 63 75 74 74 69 6e 67 |ing when| cutting|
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|00000750| 68 65 20 62 72 61 69 6e | 2e 20 44 6f 20 6e 6f 74 |he brain|. Do not|
|00000760| 20 61 74 74 65 6d 70 74 | 20 74 6f 20 69 6e 6a 65 | attempt| to inje|
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|000007a0| 61 69 6e 20 69 73 20 72 | 65 74 72 61 63 74 65 64 |ain is r|etracted|
|000007b0| 2c 20 6f 72 20 74 68 65 | 20 70 61 74 69 65 6e 74 |, or the| patient|
|000007c0| 20 6d 61 79 20 64 69 65 | 20 66 72 6f 6d 20 65 78 | may die| from ex|
|000007d0| 63 65 73 73 69 76 65 20 | 62 6c 65 65 64 69 6e 67 |cessive |bleeding|
|000007e0| 2e 00 41 74 20 74 68 69 | 73 20 70 6f 69 6e 74 20 |..At thi|s point |
|000007f0| 79 6f 75 20 6d 75 73 74 | 20 72 65 6c 61 78 20 74 |you must| relax t|
|00000800| 68 65 20 70 61 74 69 65 | 6e 74 27 73 20 62 72 61 |he patie|nt's bra|
|00000810| 69 6e 2e 20 54 6f 20 64 | 6f 20 74 68 69 73 2c 20 |in. To d|o this, |
|00000820| 70 6c 61 63 65 20 79 6f | 75 72 20 68 61 6e 64 20 |place yo|ur hand |
|00000830| 6f 6e 20 74 68 65 20 62 | 72 61 69 6e 20 61 6e 64 |on the b|rain and|
|00000840| 20 63 6c 69 63 6b 2e 20 | 49 66 20 74 68 65 20 62 | click. |If the b|
|00000850| 72 61 69 6e 20 69 73 20 | 74 69 67 68 74 2c 20 79 |rain is |tight, y|
|00000860| 6f 75 20 77 69 6c 6c 20 | 62 65 20 74 6f 6c 64 2e |ou will |be told.|
|00000870| 20 41 74 20 74 68 61 74 | 20 70 6f 69 6e 74 20 79 | At that| point y|
|00000880| 6f 75 20 6d 75 73 74 20 | 6f 70 65 6e 20 74 68 65 |ou must |open the|
|00000890| 20 73 70 69 6e 61 6c 20 | 74 61 70 20 61 6e 64 20 | spinal |tap and |
|000008a0| 63 6c 69 63 6b 20 6f 6e | 20 74 68 65 20 62 72 61 |click on| the bra|
|000008b0| 69 6e 20 74 6f 20 72 65 | 6c 61 78 20 69 74 2e 20 |in to re|lax it. |
|000008c0| 44 6f 6e 27 74 20 66 6f | 72 67 65 74 20 74 6f 20 |Don't fo|rget to |
|000008d0| 63 6c 6f 73 65 20 74 68 | 65 20 73 70 69 6e 61 6c |close th|e spinal|
|000008e0| 20 74 61 70 20 77 68 65 | 6e 20 79 6f 75 20 61 72 | tap whe|n you ar|
|000008f0| 65 20 64 6f 6e 65 2e 00 | 49 6e 63 69 73 65 20 74 |e done..|Incise t|
|00000900| 68 65 20 64 75 72 61 20 | 62 79 20 73 65 6c 65 63 |he dura |by selec|
|00000910| 74 69 6e 67 20 74 68 65 | 20 73 63 61 6c 70 65 6c |ting the| scalpel|
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|00000930| 20 74 68 65 20 65 78 70 | 6f 73 65 64 20 64 75 72 | the exp|osed dur|
|00000940| 61 20 6e 65 61 72 20 74 | 68 65 20 62 6f 6e 65 20 |a near t|he bone |
|00000950| 65 64 67 65 2c 20 6a 75 | 73 74 20 61 20 6c 69 74 |edge, ju|st a lit|
|00000960| 74 6c 65 20 74 6f 20 74 | 68 65 20 6c 65 66 74 20 |tle to t|he left |
|00000970| 6f 66 20 74 68 65 20 74 | 6f 70 20 63 6f 72 6e 65 |of the t|op corne|
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|00000990| 67 20 63 6f 75 6e 74 65 | 72 63 6c 6f 63 6b 77 69 |g counte|rclockwi|
|000009a0| 73 65 20 68 75 67 67 69 | 6e 67 20 74 68 65 20 62 |se huggi|ng the b|
|000009b0| 6f 6e 65 20 65 64 67 65 | 20 75 6e 74 69 6c 20 79 |one edge| until y|
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|000009d0| 68 65 20 72 69 67 68 74 | 20 6f 66 20 74 68 65 20 |he right| of the |
|000009e0| 74 6f 70 20 63 6f 72 6e | 65 72 2e 00 44 4f 20 4e |top corn|er..DO N|
|000009f0| 4f 54 20 43 4f 4d 50 4c | 45 54 45 4c 59 20 43 4f |OT COMPL|ETELY CO|
|00000a00| 4e 4e 45 43 54 20 54 48 | 45 20 49 4e 43 49 53 49 |NNECT TH|E INCISI|
|00000a10| 4f 4e 2e 20 49 66 20 79 | 6f 75 20 63 75 74 20 6f |ON. If y|ou cut o|
|00000a20| 66 66 20 74 68 65 20 64 | 75 72 61 20 63 6f 6d 70 |ff the d|ura comp|
|00000a30| 6c 65 74 65 6c 79 2c 20 | 74 68 61 74 20 74 69 73 |letely, |that tis|
|00000a40| 73 75 65 20 77 69 6c 6c | 20 64 69 65 2e 20 43 61 |sue will| die. Ca|
|00000a50| 75 74 65 72 69 7a 65 20 | 61 6e 79 20 62 6c 65 65 |uterize |any blee|
|00000a60| 64 65 72 73 2e 00 42 65 | 66 6f 72 65 20 6c 69 66 |ders..Be|fore lif|
|00000a70| 74 69 6e 67 20 74 68 65 | 20 64 75 72 61 20 6d 61 |ting the| dura ma|
|00000a80| 74 65 72 2c 20 67 72 61 | 62 20 74 68 65 20 67 61 |ter, gra|b the ga|
|00000a90| 75 7a 65 20 72 6f 6c 6c | 20 61 6e 64 20 63 6c 69 |uze roll| and cli|
|00000aa0| 63 6b 20 6f 6e 20 74 68 | 65 20 73 63 61 6c 70 20 |ck on th|e scalp |
|00000ab0| 66 6c 61 70 20 74 6f 20 | 61 70 70 6c 79 20 6d 6f |flap to |apply mo|
|00000ac0| 69 73 74 65 6e 65 64 20 | 67 61 75 7a 65 2e 20 59 |istened |gauze. Y|
|00000ad0| 6f 75 20 77 69 6c 6c 20 | 74 68 65 6e 20 73 65 65 |ou will |then see|
|00000ae0| 20 61 20 6c 61 79 65 72 | 20 6f 66 20 67 61 75 7a | a layer| of gauz|
|00000af0| 65 20 73 74 72 69 70 73 | 2e 20 50 6c 61 63 65 20 |e strips|. Place |
|00000b00| 79 6f 75 72 20 68 61 6e | 64 20 6f 6e 20 74 68 65 |your han|d on the|
|00000b10| 20 64 75 72 61 20 61 6e | 64 20 63 6c 69 63 6b 2e | dura an|d click.|
|00000b20| 20 54 68 65 20 66 6c 61 | 70 20 77 69 6c 6c 20 66 | The fla|p will f|
|00000b30| 6f 6c 64 20 75 70 2e 20 | 49 66 20 79 6f 75 20 66 |old up. |If you f|
|00000b40| 6f 72 67 65 74 20 74 68 | 65 20 67 61 75 7a 65 2c |orget th|e gauze,|
|00000b50| 20 74 68 65 20 64 75 72 | 61 20 77 69 6c 6c 20 64 | the dur|a will d|
|00000b60| 72 79 20 6f 75 74 20 61 | 6e 64 20 74 68 61 74 20 |ry out a|nd that |
|00000b70| 74 69 73 73 75 65 20 77 | 69 6c 6c 20 64 69 65 2e |tissue w|ill die.|
|00000b80| 00 52 45 4d 45 4d 42 45 | 52 3a 20 20 74 68 65 20 |.REMEMBE|R:  the |
|00000b90| 62 72 61 69 6e 20 6d 75 | 73 74 20 62 65 20 69 72 |brain mu|st be ir|
|00000ba0| 72 69 67 61 74 65 64 20 | 65 76 65 72 79 20 66 69 |rigated |every fi|
|00000bb0| 76 65 20 6d 69 6e 75 74 | 65 73 20 77 68 69 6c 65 |ve minut|es while|
|00000bc0| 20 69 74 20 69 73 20 65 | 78 70 6f 73 65 64 2c 20 | it is e|xposed, |
|00000bd0| 6f 72 20 69 74 20 77 69 | 6c 6c 20 64 72 79 20 6f |or it wi|ll dry o|
|00000be0| 75 74 2e 20 59 6f 75 20 | 61 72 65 20 72 65 61 64 |ut. You |are read|
|00000bf0| 79 20 66 6f 72 20 74 68 | 65 20 6e 65 78 74 20 70 |y for th|e next p|
|00000c00| 72 6f 63 65 64 75 72 65 | 73 20 28 73 65 65 20 45 |rocedure|s (see E|
|00000c10| 78 63 69 73 69 6e 67 20 | 42 72 61 69 6e 20 54 75 |xcising |Brain Tu|
|00000c20| 6d 6f 72 73 20 6f 72 20 | 54 72 65 61 74 69 6e 67 |mors or |Treating|
|00000c30| 20 42 72 61 69 6e 20 41 | 6e 65 75 72 79 73 6d 73 | Brain A|neurysms|
|00000c40| 20 64 65 70 65 6e 64 69 | 6e 67 20 6f 6e 20 79 6f | dependi|ng on yo|
|00000c50| 75 72 20 70 61 74 69 65 | 6e 74 27 73 20 63 6f 6e |ur patie|nt's con|
|00000c60| 64 69 74 69 6f 6e 29 2e | 00 72 77 69 73 65 2c 20 |dition).|.rwise, |
+--------+-------------------------+-------------------------+--------+--------+