Aseptic Technique

Question 1

PREVENT Wound Contamination by Destroying Organisms Before they Enter the Wound

Answer 1

Asepsis

Question 2

Killing of Bacteria AFTER They have Entered the Wound

Answer 2

Antisepsis

Question 3

The process of Destroying ALL Microorganisms (Bacteria, Fungi, Spores)

Answer 3

Sterilization

Question 4

Goal of Aseptic Surgical Technique

Answer 4

Goal is to MINIMIZE Contamination of Surgical Wounds

*Most Surgical Wounds contain Bacteria by the time the Procedure is Completed

Question 5

Scrub that Removes Gross Dirt and Debris

Answer 5

Primary (“Rough”) Scrub

Question 6

Germicidal Soap Scrub:

Circular Motion: Site to Periphery

Scrub GENTLY

_____ Minute Minimum Contact Time

Answer 6

Five

Question 7

Primary Aerial Bacterial Source

Answer 7

YOU (Surgeon)

Question 8

Lab Coat Protects Scrubs from Hair and Loose Debris and should be Worn Anytime _____ in Sterile Area

Answer 8

NOT

*Remove Lab Coat when Entering Sterile Area

Question 9

Surgeon Skin Preparation/Washing:

Remove Gross Dirt and Oil

Reduce Surface Bacterial Count

Suppress Bacterial Growth

Hands always Higher than ______\_

Answer 9

Elbows

Question 10

The _____ Gloving Technique is Preferred because there is much LESS Risk of Breaking Aseptic Technique

Answer 10

Closed

Question 11

Which of the Following is NOT Sterile once Surgery Starts?

A. Back, Neck, Shoulders, Axillae, Below Waist

B. Anything Below Table Height

C. Wet Gowns or Drapes (unless Waterproof)

D. Any Instrument or Surface you are not sure of

Answer 11

All the Above are NOT Sterile once Surgery Starts

Question 12

Most Common Method of Sterilization:

Causes Destruction or Denaturation of Cellular Proteins

Steam must Contact Surface to Sterilize

Minimum Standard: 250 Degrees F, 15 psi, 13 Minutes

Answer 12

Steam Sterilization (Autoclaving)

Question 13

Method of Sterilization Described Below:

Takes Longer than Other Methods: 12-24 Hour Cycles

Aerate Thoroughly: Gas Permeable Items should NOT be used for 24 Hours after Sterilization (Irritant/Carcinogen)

Effectiveness Dependent on Gas Concentration, Temperature, Exposure Time and Humidity

Answer 13

Chemical Sterilization- Ethylene Oxide

Question 14

Method of Sterilization Described Below:

Two Phases: Peracetic Acid Vapor Phase and Plasma Phase

Ionized or Partially Ionized Gas

Produced by Passing Electromagnetic Energy through a Mixture of Stable Gases

Cheaper/Load and Safer than Ethylene Oxide but Higher initial Cost

Answer 14

Chemical Sterilization- Gas Plasma

Question 15

Method of Sterilization Described Below:

Used to Wash and Disinfect Surfaces

Dental Instruments and Scopes

Used for Scopes ect. which can’t be Sterilized by other Methods

Answer 15

Chemical Sterilization- “Cold” Disinfectants

*Ex. Chlorhexidine and Glutaraldehyde

Question 16

When Preparing Packs for Sterilization:

Place Sterilization Indicator in Center of Pack and Indicator Tape on Outside

Identify Date Pack was Sterilized and Who Packed it

Put _______ on Infrequently Used Packs

Answer 16

Expiration Date

Question 17

Heat Sealed Paper/Transparent Plastic Pouch has a Shelf Life of______

Answer 17

1 Year

Question 18

_______ Principles of Surgery

Answer 18

Halsted’s

Question 19

______ Reduces Risk of Infection by Removing Bacteria and Loose Tissue Fragments From Wound

Answer 19

Wound Lavage

*Moist Tissues = Happy Tissues

Question 20

_____ Dissection is Preferred in Most Instances

Answer 20

Sharp

Question 21

Tissue Manipulation = ________

Answer 21

Tissue Trauma

*Minimize Trauma by using Most Direct Approach with Ample Length of Incision

Question 22

Instrument that Divides Tissue with Least Collateral Damage and Precise Control

Answer 22

Scalpel

Question 23

Hemorrhage that Occurs AFTER 24 Hours Post-Op usually the Result of Ineffective Ligation

Answer 23

Secondary Delayed Hemorrhage

*Ex. Ligatures Slipping Off Larger Vessels

Question 24

Hemorrhage that Occurs WITHIN 24 Hours of Surgery

Answer 24

Intermediate Delayed Hemorrhage

Question 25

**Hemorrhage** that Occurs **DURING Surgery**

Answer 25

**Primary Hemorrhage**

Question 26

**Complications** of _______ during Surgical Procedure: _Obscured Surgical Field_ _Increases Rate of Infection_ _Hematoma Formation- Painful_ _May be Life Threatening_

Answer 26

**Uncontrolled Bleeding/Hemorrhage**

Question 27

True/False: Most **Bleeding** can be Controlled by Applying Pressure while Deciding How to Best Manage the Situation

Answer 27

**True**

Question 28

Name _Three Techniques_ used for **Temporary Hemostasis**

Answer 28

**Pressure** **Hemostatic Forceps** **Topical Hemostatic Agents**

Question 29

Name _Four Techniques_ used for **Definitive Hemostasis**

Answer 29

**Electrocoagulation** **Ligature** **Vascular Clips** **Primary Vascular Repair**

Question 30

Technique used for **Definitive Hemostasis** Described Below: **_Electrical Current Delivered to Tissues_** **_Heat is Produced by Tissue Resistance to the Current: Hemostasis_** **Advantages:** _Decreased Blood Loss and Operative Time_ **Disadvantages:** **_Less Hemostatic Security than Ligation_** _Collateral Tissue Damage_

Answer 30

**Electrocoagulation**

Question 31

Technique used for **Definitive Hemostasis** Described Below: **_MOST SECURE Occlusion_** _No Limit to Vessel Size_

Answer 31

**Ligatures**

Question 32

Technique used for **Definitive Hemostasis** Described Below: _Rapidly, Easily Applied_ **_Risk of Dislodgement_** _Vessels up to 5mm_

Answer 32

**Vascular Clips**

Question 33

**Scalpel Handle** Used in Small Animals vs. Large Animals

Answer 33

**# 3- Small Animals** **# 4- Large Animals**

Question 34

Correct **Blade Angle** used for Cutting with a **#10 Blade**

Answer 34

**30 Degrees** _**\***10s Blades used on # 3 Handles_

Question 35

**Scalpel Grip** used for: _Finger Movement_ **_Excellent Control_** **_Short Precise Incisions_**

Answer 35

**Pencil Grip**

Question 36

**Scalpel Grip** used for: _Arm Motion_ **_Long Incision_**

Answer 36

**Fingertip Grip**

Question 37

**Review Card: Scalpel Grips**

Question 38

**Cutting Technique** Described Below: _Pencil Grip or FInger Tip Grip_ **_Pressure Applied at 90 Degrees Angle to Blade Motion_** **_Incision Made with One Continuous Motion Through the Entire Tissue Layer_**

Answer 38

**Slide Cutting**

Question 39

**Cutting Technique** Described Below: **_Fingertip Grip_** **_Sub-Bursting Pressure Applied to Blade while Moving in Perpendicular Motion_** _Tissue Layer Separation Without Risk of Cutting_ _Indications: **Granulation Tissue Debridement, Elevation of Muscles**_

Answer 39

**Scraping**

Question 40

Describe How to Hold **Ringed Instruments**

Answer 40

**Thumb and Ring Finger Placed in Rings** **Index Finger can be Placed Along the Shank for Added Control and Stability**

Question 41

**Scissors** Described Below: _Identified by Slender Blades_ **_Used for Dissection and Cutting DELICATE Tissues_**

Answer 41

**Metzenbaum Scissors** _**\***Do NOT use to Cut Heavy Fascia_

Question 42

**Scissors** Described Below: _Thicker Blades_ **_Used for General Dissection and Cutting Tougher Tissue such as Muscle Fascia, Tendon and the LINEA ALBA_**

Answer 42

**Mayo Scissors**

Question 43

**Scissors** Described Below: _Short Thick Blades with **Serrated Edges**_ **_Good for Cutting Sutures and Drape Material_**

Answer 43

**Vernon Cartilage and Wire Scissors**

Question 44

Most Commonly used **Scissor Grip**

Answer 44

**Forehand Grip**

Question 45

**Scissor Technique** Described Below: _Initiate with Small Scissor Cut_ **_When Blades are Nearly Closed, Push Scissors to Cut tissue Layer in one Continuous Motion_** _Used to Separate Sheets of Tissue- Ex. Reflecting Subcutaneous_

Answer 45

**Push Cutting** _**\***Just like Cutting Wrapping Paper_

Question 46

Most Common _Grip_ for using **Thumb Forceps**

Answer 46

**Pencil Grip**

Question 47

Very Common General Use **Thumb Forceps**

Answer 47

**Adson-Brown Thumb Forceps** _\*Grasp as little Tissue with as Little Pressure as Possible_

Question 48

Where should we Grasp Needle with **Needle Holders?**

Answer 48

**1/2 to 2/3 from Tip**

Question 49

Name these **Needle Holders**

Answer 49

**Mayo Hegar Needle Holders**

Question 50

**Recommended Grip** for **Needle Holders** that _Provides Excellent Control_

Answer 50

**Thumb-Ring Finger Grip**

Question 51

**Grip used for Needle Holders** Described below: _Ring Finger Placed in Ring_ _Thumb placed along Shaft and used to Open/Close Ratchets_ **_Maintains good Control but Increases Speed_**

Answer 51

**Thenar Eminence Grip**

Question 52

**Grip used for Needle Holders** Described below: ## Footnote **_Rapid Suturing but Less Precise Control_** **_Strong Driving Force for Placing Sutures in Tough Tissues_**

Answer 52

**Palm Grip**

Question 53

List the Three Types of **Hemostatic Forceps**

Answer 53

Question 54

**Temporarily Loosening Hemostat** to Facilitate Tightening of Ligature on Vascular Pedicles

Answer 54

**Flashing**

Question 55

**Hemostatic Forcep** Described Below: ## Footnote **_Delicate Hemostat used for Ligating Individual Vessels_** **_Transverse Serrations Extend down Entire Length of Jaw_**

Answer 55

**Halstead Mosquito Forceps**

Question 56

**Hemostatic Forcep** Described Below: ## Footnote **_Intermediate Size Hemostat_** **_Transverse Serrations Extend HALF WAY down Jaws_**

Answer 56

**Kelly Hemostatic Forceps**

Question 57

**Hemostatic Forcep** Described Below: ## Footnote **_Used to Occlude Large Vascular Structures such as the Ovarian Pedicle_**

Answer 57

**Rochester-Carmalt Hemostatic Forceps**

Question 58

**Instrument used to Secure the Drapes to the Skin**

Answer 58

**Backhaus Towel Clamps**

Question 59

Instrument Described Below: ## Footnote **_Used to Grasp Tissue Facilitating Retraction_** **_DO NOT place on Skin_**

Answer 59

**Allis Tissue Forceps**

Question 60

**Instrument used to Aid Exteriorization of Uterine Horn during Ovariohysterectomy**

Answer 60

**Snook Ovariohysterectomy Hook**