Aseptic Laboratory/Suture and Instruments Flashcards
1
Q
Asepsis
A
Prevent wound contamination by destroying organisms before they enter the wound
2
Q
Antisepsis
A
killing bacteria after they have entered the wound
3
Q
Disinfection
A
use of germicidal substances to kill most microorganisms
4
Q
Sterilization
A
the process of destroying all microorganisms such as bacteria, fungi, and spores
5
Q
What is the goal of aseptic surgical technique?
A
minimize contamination of surgical wounds
6
Q
What is not sterile once surgery starts?
A
Your back neck shoulders axillae below waist
7
Q
Physical sterilization
A
Thermal energy
Filtration
Radiation energy
8
Q
Chemical sterilization
A
Plasma
Disinfectants
9
Q
What is the most common method of sterilization?
A
Autoclave
10
Q
What is the minimum standard for autoclaving?
A
250F
15 psi
13 min
11
Q
What is the disadvantage of steam sterilization?
A
dulls sharp instruments
12
Q
What is used for Chemical sterilization?
A
Ethylene Oxide
Gas Plasma
13
Q
What does the effectiveness of Chemical Sterilization depend on?
A
Gas concentration
Temperature
Exposure time
Humidity (minimum of 35%)
14
Q
What is disinfected with “Cold Disinfectants”?
A
Dental Instruments
Scopes
15
Q
What is the shelf life of a sterile pack using Heat sealed paper/transparent plastic pouch?
A
1 years
16
Q
What is the shelf life of a sterile pack using 2 layers of polyethylene + muslin?
A
9 months
17
Q
What is the shelf life of a sterile pack using 2 layers of crepe paper + muslin?
A
10 weeks
18
Q
What is the shelf life of a sterile pack using 2 layers of double wrap muslin?
A
8 weeks
19
Q
What is the shelf life of a sterile pack using 1 layer of crepe paper?
A
3 weeks
20
Q
Halsted’s Principles of Surgery
A
- Gentle Tissue Handling
- Accurate hemostasis
- Preservation of blood supply
- Strict aseptic technique
- Sutures tied without tension
- Accurate tissue apposition
- Obliteration of dead space
- Postoperative wound protection
21
Q
Primary Hemorrhage
A
Bleeding during procedure
22
Q
Intermediate delayed hemorrhage
A
within 24 hours of surgery
23
Q
Secondary delayed hemorrhage
A
After 24 hours - usually the result of ineffective ligation
24
Q
Gelform
A
Absorbable gelatin sponge Topical hemostatic agent derived from pig skin
25
Surgicel
Absorbable plant based cellulose topical hemostatic agent
26
Hemablock
microporous polysaccharide powder topical hemostatic agent
27
Types of Definitive Hemostasis
Electrocoagulation
Ligature
Vascular clips
Primary vascular repair
28
Electrocoagulation
Electric current delivered to the tissues
29
What are the advantages of Electrocoagulation?
Decreased blood loss and operative time
| Improved visualization
30
What are the disadvantages of Electrocoagulation?
Less hemostatic security than ligation
| Collateral tissue damage
31
#3 scalpel handle
used in small animals
32
#4 scalpel handle
used in large animals
33
What size blade goes with a Bard-Parker #3 scalpel handle?
```
#10
#11
#12
#15
```
34
What size blade goes with a #4 scalpel handle?
20s
35
Metzenbaum Scissors
Used for dissection and cutting delicate tissues such as subcutaneous tissues, intestine, or bladder
36
Mayo Scissors
Used for general dissection and cutting through tissues such as muscle fascia, tendon, the linea alba, or trimming skin
37
Vernon Cartilage and Wire Scissors
Good for cutting sutures and drape material
38
Brown Adson Tissue Forceps
Very common general use tissue forceps for general tissue handling but can crush tissue
39
Halstead Mosquito Forceps
Delicate hemostat used for ligating individual vessels
40
Rochester-Carmalt Hemostatic Forceps
Used to occlude large vascular structures such as the ovarian pedicle
41
Backhaus Towel Clamp
Used to secure the quarter drapes or Huck towels to the patient skin
42
Allis Tissue Forceps
Forceps used to grasp tissue facilitating retraction, positioning of suction tubing and electrocautery wire on patient drape
43
Snook Ovariohysterectomy Hook
Used to blindly exteriorization of uterine horn during ovariohysterectomy
44
What are the Crushing Tissue Forceps?
Babcock tissue forceps
| Allis tissue forceps
45
What are the Non-crushing forceps?
Doyen Intestinal Forceps
46
What are the Hemostatic forceps?
Rochester Carmalt forceps
Kelly Hemostat forceps
Halsted mosquito forceps
47
How should you always place curved forceps?
tips should be always pointed out of the body cavity or away from the patient
48
Babcock Tissue Forceps
Forceps used for helping grasp and retract soft tissues such as the stomach or bladder
49
Straight Doyen Intestinal Tissue Forceps
Forceps used for intestinal lumen occlusion in enterotomies, resection and anastomosis
50
Straight and Curved Kelly Hemostatic Forceps
Forceps used for tip clamping of small to medium vessels
51
What are the Thumb Forceps?
Brown-Adson forceps
Adson forceps
DeBakey forceps
Bishop-Harmon forceps
52
Adson Tissue Forceps
Forceps that result in less crush injury than with Brown-Adson tissue forceps but have poor grip on fat or other friable tissues
53
DeBakey Tissue Forceps
Most frequently used thumb forceps in soft tissue surgery that are less traumatic than Brown-Adson thumb forceps
54
Bishop-Harmon Forceps
Used to grasp tissue in ophthalmic surgery
55
What blades are used with the Beaver Blade Scalpel Handle?
```
#64
#67
```
56
Describe a #10 Blade use
Long flat blade for sharp penetration of hollow organs or for precision
57
Describe a #11 Blade use
Sharp penetration of hollow organs or for precision cutting
58
Describe a #12 Blade use
Used for Onychectomy in cats
59
Describe a #15 Blade use
Used for subcutaneous or fascial incisions
60
When would you use a Beaver Blade Scalpel Handles and blades?
Incise the limbus for intraocular surgery
| Used by some orthopedic surgeons for incision of intra-articular structures
61
What are the different types of surgical scissors?
```
Mayo scissors
Metzenbaum scissors
Stevens tenotomy scissors
Spencer stitch scissors
Vernon cartilage and wire scissors
```
62
Stevens Tenotomy Scissors
Used for precision cutting such as ophthalmic and urologic surgery
63
What is an important feature of the Spencer Stitch Scissors?
Hooked tip used to entrap suture for cutting
64
Spencer Stitch Scissors
Used for post-op suture removal
65
Vernon Cartilage and Wire Scissors
Used to incise thick, tough tissue and orthopedic wire
66
What are the Needle Holders?
Mayo-Hegar needle holders
Olsen-Hegar needle holders
Castroviejo needle holders
Derf needle holders
67
Describe the Mayo-Hegar Needle Holders
Textured tungsten carbide jaw inserts provide intermediate needle holding security over smooth jaws or jaws with teeth
68
Describe Olsen-Hegar needle holders
Combined needle driver/scissors
| Same jaw as the Mayo-Hegar needle holders
69
Derf Needle Holders
Ophthalmic needle drivers
| small size useful for suturing smaller structures such as the eyelid or conjunctiva
70
Castroviejo needle holders
Microsurgery needle driver
Used for ophthalmic and vascular surgery
Spring loaded handle
71
Self-Retaining Retractors
Balfour retractor
Finochietto retractor
Gelpi retractor
Weitlaner retracter
72
Hand Held Retractors
```
Army-Navy retractor
Malleable retractor
Hohmann retractor
Senn retractor
Snook hook/ Spay hook
```
73
Balfour Retractor
Blunt blades used to retract abdominal wall laterally
| Central "bladder blade" can be used to retract rib cage cranially
74
Finochietto Retractor
Adjustable rib retractor
Used for retraction of chest wall during intercostal thoractomy and median sternotomy
Flat retractor blades are perpendicular to instrument
75
Gelpi Retractor
Ring retractor with self-retaining ratchet
Used for retraction of soft tissues (especially useful for retraction of muscle bellies during orthopedic or spinal surgery)
76
Weitlaner Retractor
Ringed Retractor with self-retaining
Multiple pointed prongs on each arm
Useful for retraction of soft tissue in a small, superficial incision
77
Army-Navy Retractor
Double ended blunt retractor
Hand held retractor typically used by assistant
Used for both soft tissue and orthopedic surgery
78
Malleable Retractor
Double ended blunt retractor
| used for retracting viscera in abdominal and thoracic surgery
79
Hohmann Retractor
Used to lever muscle and soft tissues away from surgical field and bone during orthopedic surgeries
80
Senn Retractor
Double ended retractor with a blunt or sharp fork on one end and right angle blade on other end
Used in soft tissue and orthopedic surgery for retraction of tissues in small working spaces
81
Orthopedic Instruments
```
Speed lock bone holding forceps
Kern bone holding forceps
Jacob's chuck
Mallet
Osteotome
Periosteal elevator
Lampert Rongeur
```
82
Kern Bone Holding Forceps
Used to grip and manipulate bone during fracture reduction and repair
83
Speed Lock Bone Holding Forceps
Used to grip and manipulate bone during fracture reduction and repair
84
Jacob's chuck
Used to drive IM pins and K-wires during orthopedic surgery
| Key used to tighten or release pin grip
85
Mallet
used in orthopedic surgery to advance an osteotome for making precise osteotomies
86
Osteotome
two sided beveled instrument used to create osteotomy in numerous orthopedic procedure
87
Chisel
one sided beveled instrument used to create osteotomy in numerous orthopedic procedures
88
Periosteal Elevator
Used to reflect muscle and soft tissue from bone
89
Free Periosteal Elevator
Double ended periosteal elevator
90
Lampert Rongeur
Forceps with cupped jaws and blunted or tapered tips
Used to remove small fragments of bone, to recontour bone, or to prepare bone for grafting
Has finer tipped jaws and are used in more restricted areas (bulla osteotomy)
91
List the Ophthalmic Instruments
```
Castroviejo needle holders
Derf needle holders
Bishop-Harmon tissue forceps
Barraquer eyelid speculum
Jaeger eyelid plate
Stevens tenotomy scissors
Beaver blade and handle
```
92
Barraquer Eyelid Speculum
Wire self retaining instrument used hold eyelids open during enucleations and surgery of the cornea and third eyelid
93
Jaeger Eyelid Plate
Used to protect globe when making incisions into the eyelid
94
Poole suction tip
Used to suction large amounts of fluid from body cavity
Blunt tip prevents trauma to organs
Inner cannula unscrews and can be used as a modified Frazier suction tip
95
Frazier Suction Tip
Fine tipped suction tip for removal of small amounts of fluid from surgical field
Used for mostly orthopedic and neurologic surgery
96
List Dental Instruments
```
Wind tipped dental elevator
Wedge tipped dental elevator
Curette
Scaler
Extraction forceps
Calculus removal forceps
Dental explorer
Periodontal probe
```
97
Wing Tipped Dental Elevator
used to sever the periodontal ligament by rotating the instrument around the tooth
98
Wedge tipped Dental Elevator
used to weaken the periodontal ligament and luxate the tooth for extraction
99
Curette
used for subgingival cleansing, root planing, and curettage
100
Scaler
Removes dental deposits from above gumline
101
Extraction forceps
used to grasp loose/luxated teeth for extraction
102
Calculus removal forceps
uneven tipped instrument useful in removing large pieces of calculi prior to scaling
103
Dental explorer
increased tactile sensation for detecting areas of enamel decay
104
Periodontal probe
Used to measure pocket depths around a tooth
105
What are the Absorbable Suture materials?
```
Chromic gut
Polyglactin 910
Polyglycolic acid
Glycomer 631
Caprolactone
Poliglecaprone 25
Polydiaxonone
```
106
What are the nonabsorbable sutures?
```
Nylon
Silk
Polypropylene
Polymerized caprolactam
Stainless steel wire
```
107
When would you use Polyglactin 910?
Dental Surgery
108
When would you use Polyglycolic acid?
Dental Surgery
109
When would you use Glycomer 631?
Closure of entertomies, cystotomies, body wall closure, fascia closure
110
When would you use Caprolactone?
Closure of cystotomies (non-infected bladders), subcutaneous tissues
111
When would you use Poliglecaprone 25?
Closure of cystotomies (non-infected bladder), subcutaneous tissues
112
When would you use Polidioxanone?
Closure of entertomies, cystotomies, body wall closure, fascia closure
113
When would you use Silk?
Cardiovascular surgery
114
When would you use Nylon?
Skin closure, orthopedic repair (lateral tibiofabellar suture)
115
When would you use Polypropylene?
Tendon, ligament, fascial, and joint capsule closures
116
When would you use Polymerized caprolactam?
Skin sutures
117
When would you use Stainless Steel Suture?
Orthopedic applications (closure of sternotomy)
118
What is a disadvantage of Chromic Gut?
Knot security decreases when wet
119
What is a disadvantage of Nylon?
Susceptible to degradation
| Hydration may lead to disruption of hydrogen bonds leading to loss of tensile strength
120
What is a disadvantage of Polymerized caprolactam?
Sinus formation when implanted in tissues
121
What are the properties of ideal suture material?
```
Minimal tissue reaction
Gental passage through tissues
High knot safety and security
No Capillarity
Maximum tensile strength/high breaking strength
Consistent performance
Good and predictable absorption
Comfortable handling
```
122
Capillarity
Process by which fluid and bacteria are wicked along multifilament fibers
123
3/8 circle needle shape
more easily manipulated through superficial tissue
124
1/4 circle needle shape
used for ophthalmic procedures
125
5/8 circle needle shape
Useful in confined locations or deep tissues
126
Taperpoint needle
Sharp tip that pierces and spreads tissue without cutting
127
When would you use a Taperpoint needle?
Intestine
Sucutaneous tissue
fasica
128
Tapercut
combination of reverse cutting and taperpoint
129
When would you use a Tapercut needle?
Heavy thick fascia, tendon, vascular grafts
130
Cutting needle
Cutting edge on concave portion of needle. Tends to cut out of tissue
131
Reverse cutting needle
Cutting edge on convex surface reducing risk of tissue cut out
132
When would you use a Reverse cutting needle?
Skin
133
Spatula point needle
Flat on top and bottom
134
When would you use a Spatula point needle?
Ophthalmic procedures
135
Blunt point needle
Blunt point that dissects through friable tissue without cutting
136
When would you use a Blunt point needle?
Soft parenchymal organs (liver or kidneys)
