2. Instrumentation - Bunions Flashcards
name and classification

- n: number 3 blade handles
- c: cutting and dissection
use?

holds # 10 or #15 blade
10 blade use
- used for making skin incision
- Too big for incision on 5th toe
15 blade use
- smaller
- used for making subsequent (deeper) cuts
classification:

SCISSORS AND TIPS
Summary: name LEFT to RIGHT

- Crown and Collar,
- Utility,
- Metzenbaum,
- Mayo,
- Iris,
- Wire Cutter (“we do not have this”))
name
use
classification

- n: Crown and Collar scissor
- u: used for sesamoidectomies
- c: scissors, tips
name
use
classification

- n: Utility scissors
- u: cuts anything** (gauze, drapes, etc), **except tissue and sutures
- c: scissors, tips
name
use
classification

- n: Curved Metzenbaum scissors
- u: used for sharp and blunt dissection**, **cuts tissue only, operating scissor
- c: scissors, tips
name
use
classification

- n:Mayo scissors –
- u: TUSPM’s suture scissors, not a suture removal scissor, smaller than Utility but heavier than Metzenbaum
- c: scissors, tips
name
use
classification

- n: Iris scissors
- u: sharp tips for tissue dissection, also for eye surgery
- c: scissors, tips
name
use
classification

- n: Wire Cutter –
- u: fine serrated edges, used to cut stainless steel wire sutures, **not K-wires
- c: scissors, tips
name
use
classification

- n : Bone Cutter
- u: sharp-edged blades**, **used to cut MT head**, **both sides bend when you squeeze it**, **flat blade**, **“can be easily mixed up with nail nipper”
- c: scissors, tips
name
use
classification

- n: Ronguer
- u: sharp scoop-like edges**, **used to smooth sharp bone edges
- c: scissors, tips
name
use

- n: Osteotome and Mallets
- u: osteotome is placed on bone to be cut and end is hit (tapped) with the mallet, not used much
name (**TOP)
use
classification

- n: MALTZ RASP
- u: file bones smooth; used for larger bones
- c: rasp
name (**BOTTOM)
use
classification

- n:Joseph nasal rasp
- u: file bones smooth; used for smaller bones
- c: rasp
name/ use (top)
name/use (bottom)
classification

- Bone curette
- Fox Dermal** (soft tissue) – **removal of warts and lesions
- c: currette
- part of the cutting and dissection classification according to classification sheet, although introduced towards the end of lecture
Number 3 scalpel/blade/knife handles
use
- holds #10 or #15 blade
- have sharp edges and are used to cut, dissect, incise, separate or excise tissues or other materials
Crown and Collar scissor:
use
used for sesamoidectomies
Utility scissors
use
cuts anything (gauze, drapes, etc), except tissue and sutures
Curved Metzenbaum scissors
use
used for sharp and blunt dissection, cuts tissue only, operating scissor
Mayo scissors
use
- TUSPM’s suture scissors, not a suture removal scissor, smaller than Utility but heavier than Metzenbaum
Iris scissors
use
sharp tips for tissue dissection, also for eye surgery
Wire Cutter:
use
- fine serrated edges, used to cut stainless steel wire sutures**, **not K-wires
Bone Cutter
use
sharp-edged blades, used to cut MT head, both sides bend when you squeeze it, flat blade
What can easily be mistaken for a BONE CUTTER?
“can be easily mixed up with nail nipper”
Ronguer:
use
- sharp scoop-like edges,
- used to smooth sharp bone edges
Osteotome and Mallets
use
- osteotome is placed on bone to be cut and end is hit (tapped) with the mallet, not used much
Rasp:
use
files bone smooth;
incl: Maltz rasp, Joseph nasal rasp
Curettes
use
- Bone curette
- Fox Dermal** (soft tissue) – **removal of warts and lesions
Classification: Grasping and Holding
Use?
Grasp and hold tissues in place so surgeon can perform the maneuver without injuring surrounding tissues, or sometimes without injuring the tissue excised
name
use

- Forceps (Pickups) – bodies of all 3 look the same
- grasping and holding
what are the 3 “tweezer type” pickups?
- Adson toothed (1x2, “rat-tooth”)
- Brown-Adson (multi-tooth)
- Adson plain (smooth, thumb or dressing)
what are the 2 “scissors-action type”?
hinged
- Allis Grasping Forceps** – **small, fine teeth
- Kocher** – **large sharp tooth on either side**, traumatic, **“often mistaken for large straight hemostat”
name

Adson plain
(smooth, thumb or dressing)
name

- Brown-Adson (multi-tooth)
name

- Adson toothed (1x2, “rat-tooth”)
name (LEFT)
use
classification

- n: Allis Grasping Forceps
- u: small, fine teeth
- c: scissors-action type (hinged) grasping and holding
name
use
classification

- n: Kocher
- u: Large sharp tooth on either side**, traumatic, **“often mistaken for large straight hemostat”
- c: Scissors action type (hinged) grasping and holding
difference between ALLIS and KOCHER tips?

L=Kocher large sharp tips,
R=Allis multiple fine tips)
what is this?

- Allis Grasping Forceps** – **small, fine teeth
what is this?

- KOCHER Grasping Forceps
- large sharp tooth on either side**, traumatic, **“often mistaken for large straight hemostat”
use of clamping instruments?
- instruments which clamp and occlude to apply pressure
purpose of HEMOSTATIC FORCEPS?
- (hemostats, stats) –
- used to occlude blood vessels
What are the 2 categories of hemostats?
straight, and
curved
name (TOP)
use
classification

- n: Straight Kelly
- u: serrations ½ way on blade; used to occlude blood vessels
- c: hemostatic forceps; clamping instruments
name (BOTTOM)
use
classification

- n: Straight Mosquito
- u: serrations all the way on blade, smaller stat
- c: hemostatic forceps; clamping instruments
name
use
classification

- n: CURVED MOSQUITO
- u: serrations all the way, smaller stat
- c: hemostatic forceps
name
use
classification

- n: Curved Kelly
- u: serrations ½ way on blade
- c: hemostatic forceps
retractor: use
- instruments used to pull aside soft tissues, muscles or other structures for exposure to the surgical site
what are the types of HANDHELD RETRACTORS?
- Senn
- Ragnell
- Rake
- Meyerding
- Army-Navy
- Malleable
what is the purpose of HAND-HELD RETRACTORS?
fine sharp skin hooks, used to open up surgical fields so you can see what you’re doing
name
use
classification

- n: Senn Retractors (blunt or sharp)
- u: right angle blade on one end, rake on the other end, rakes could be blunt of sharp
- One of the tips has three sharp hooks, which allows fixating the tissues more precisely, and is mostly used to hold fat tissue
- c: hand-held retractors
name
use
classification

- n: Ragnell Retractors
- u: curved blades at both ends**, **smaller than Senn
- c: handheld retractors
name
use
classification

- n: Rake Retractors
- u: ends may be sharp or dull, not used very often
- c: handheld retractors
name
use
classification

- n: Meyerding Retractors
- u: blades on one end**, also called **finger retractors
- c: handheld retractor
name
use
classification

- n: Army-Navy Retractors
- u: blades on both ends, come in various sizes, also called US Army retractors), not used very often
- c: handheld retractors
name
use
classification

- n: MALLEABLE
- u: ribbon, bendable
- used to retract deep wounds. May be bent to various shapes
- c: malleable handheld retractor
name
use
classification

- n: Seaberger
- u: – malleable on one end**, band on the other end, **fixed end
- reflect and hold tissue around the corner of an exposed bone region
- c: bendable handheld retractors
name
use
classification

- n: Weitlander Self-Retraining Retractor
- u: sharp tips on end**, **used when no assistant is available to retract**, used for **bunions and soft tissue neuromas
- c: bendable retractor
why would you use a Weitlander Self-Retraining Retractor ?
used when no assistant is available to retract,
use of elevator?
instrument inserted under a structure to lift or elevate the structure
what are the 2 types of elevators?
Freer Periosteal
Sayer
name
use
classification

- n: Freer Periosteal Elevator
- u: used to elevate the nail/periosteum**, **“looks like a rasp but don’t have bone files on end”
- c: ELEVATOR
name
use
classification

- n: Sayer Elevator
- u: used to elevate large bone, bunion
- c: ELEVATOR
suturing and stapling:
use
instruments used to facilitate the placement of materials used in wound repair and/or tissue approximation
name
use
classification

- n: Needleholder (Needledriver)
- u: used to hold needle for suturing**, **“can be mistaken or hemostat”
- c: suturing and stapling
suctioning or aspirating:
use
the removal of blood, bodily fluids, tissue and/or irrigating solutions from the surgical site using mechanical suction or manual aspiration
name
use
classification

- n: Frazier Suction Tip
- u: used to remove fluid (blood) from the surgical site, helps keep the field dry for better exposure
- c: suctioning or aspirating
what are the accessory instruments discussed in class?
- k-wire/ pin cutter
- english anvil nail splitter
- pliers
- towel clamps
(mnemonic: “KEPT”) accessory instruments are KEPT handy
name
use
classification

- n: TOWEL CLAMPS
- u: used to hold towels or drapes on the sterile field, not used often
- c: ACCESSORY
name
use
classification

- n: English Anvil Nail Splitter
- u: used for total nail avulsions**, **“easily mistaken for bone cutter”
- c: ACCESSORY
name
use
classification

- n: Pliers
- u: needle-nosed pliers, K-wire bender
- c: ACCESSORY instruments
name
use
classification

- n: K-wire/pin cutter
- u: cuts K-wires and Steinmann pins
- c: ACCESSORY instrument
name
use
classification

- n: Lister bandage scissors
- u: cutting bandages, cutting down drapes after surgery
- c: scissors