Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SURG > Chapter 10 > Flashcards

Chapter 10 Flashcards

1
Q

What are most modern instruments made out of and why?

A

Stainless steel (combo of carbon, chromium, iron, and other alloys). They can become magnetized. Combo of metals makes it strong and corrosion resistant.

Some are also made out of titanium. It is stronger and lightweight, nonmagnetic, and more corrosion resistant. Blue finish to reduce glare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different finishes on instruments?

A

Polished (cheapest)
Satin (less reflective)
Ebonized (nonreflective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How are instruments classified?

A

-cutting/dissecting (NTK scalpel handles blade combos)
-gasping/holding
-clamping/occluding
-retracting/viewing
-probing/dilating
-suturing
-suctioning
-accessory

subcategories are:
-micro instruments and endoscopic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cutting/Dissecting

A

Instruments w one or more sharp edges that are used for incision, sharp dissection, or excision of tissue. These typically include knives, scalpels, scissors, and bone-cutting instruments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some components of scalpels?

A

-Scalpel is used interchangeable w knife.
-Typically has a detachable, disposable blade and nondisposable handle, and knives have a nondisposable handle and blade as a single unit.
-safety scalpels are single use and disposable blade w a safety shield. handle may be

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the Bookwalter retractor?

A

Attaches to OR table. self-retaining retractor. Used for large abd cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Greenburg Retractor?

A

Attaches to the OR table. self retaining. used for neuro cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Thompson retractor?

A

Self-retaining retractor that attaches to OR table. For small delicate cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How are Instruments cared and handled preoperatively?

A

-The instruments on DPC are gathered
-Come in sterilized sets or individually packaged peel packs
-Opened onto the sterile field
-Organized on back table and mayo where they are checked for function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are instruments handled intraoperatively?

A

-Anticipate the needs of the pt and surgical team by observing the progression of the procedure to obtain info.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What the CST need to know to anticipate and provide positive care?

A

-Anatomy/Phys
-Operation pathology
-Specific variations
-Caring
-Sterile technique
-Role of care
-Environment concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are instruments handled postop?

A

Prepare the instrument for reuse.
-cleaning and decontamination
-inspection and maintenance
-reassembly of instrument set
-prep for sterilization
-storage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How should instruments be handled in general?

A

Handled w great care to:
-prevent injury to pt/team
-allow the instrument to perform correctly and consistently
-complex and expensive to replace
-may require special handling
-not recommended to use for anything their than intended purpose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is an instrument set?

A

Group of instruments assembled into a pan, sterilized, and stored for later use.
Major/primary set: standardized by procedure and facility
-secondary sets (specific to case)
-individually wrapped instruments (come in peel packs)
Each instrument set has a count sheet.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some components of instrument lists/count sheets?

A

-includes type and number of instruments
-used by an assembler to minimize errors. Assures mistakes can be traced.
-handed to circulator at beginning of case for visual and verbal count. confirmed and written the correct number next to each on list. done at initial count and each cavity closure.
-used to confirm set was complete after and emergency procedure where count was waived. follow policies and procedures of facility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are cryotherapy units?

A

Uses gas to deliver extreme cold though insulated probe to diseased tissues (liquid nitrogen, freon, CO2). Creates necrosis w/o damage to adjacent tissues (diseased tissue can be removed under hemostatic conditions). Procedures include vascular tumors, repair retinal detachments, and extract cataracts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are irrigation/aspiration units?

A

Phaco-Emulsifier: Diseased eye lenses may be removed using specially designed IA tip after it is broken up by a phaco-emulsifier (ultrasound energy). Pressure is automatically adjusted within anterior chamber of the eye.

Piezoelectric machine: Uses electrical impulses to generate heat and is cooled by air or fluid that flows through the power cord. Aspirant flows through transparent tubes away from the operative site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the purpose of drapes?

A

To barrier/isolate the surgical site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some components of drapes?

A

-lint free
-fluid resistant
-antistatic
-tear and puncture resistant
-nontoxic
-porous enough so body heat isn’t retained
-non-reflective color
-flame retardant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the materials that drapes are made out of?

A

Nonwoven fabrics:
-disposable
-synthetic
-aluminum coated
-light and strong
-reinforced fenestration
-cord tabs

Woven fabrics:
-reusable
-cheaper
-water repellent
-must be laundered, inspected, and sterilized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some components of incise drapes? (plastic)

A

-apply after prep is dry
-applied after towel square off
-may be impregnated w antimicrobial iodine agent
-incision is made through the drape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some components of aperture drapes? (plastic)

A

-opening is surrounded by adhesive backing
-clear, plastic drape
-for eyes and ears
-allows surgeons to view landmarks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some components of isolation drapes? (plastic)

A

-large drape for visualization of pt and c-arm
-used in hip procedures w fx table.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some components of fenestrated drapes?

A

-contains an opening specific to the area to be exposed
-must be sufficient enough to cover feet and anesthesia screen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some components of non-fenestrated drapes?

A

-Used to “square off” (most common 1st layer of draping)
-May be used to cover unaffected body parts that are not completely covered by the primary drape
-can be custom to cover specific areas (perineal cases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are some components of sterile packs?

A

-first item opened for procedure
-placed on back table as initial sterile field
-may be commercial or created in-house (reusable items)

Basic sterile pack includes: mayo cover, 2 gowns, suture bag, 4 sticky paper drapes, and 2 paper hand towels

Highly specialized packs: supplies/drapes specific to a specialty or procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What do surgical sponges do?

A

-Absorb blood or fluid
-blunt dissection
-protect structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are some components of sponges?

A

-Soft, lint free
-have a radiopaque band
-they are counted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What types of sponges are there?

A

-Laps
- Raytec
- Cottonoid
-Tonsil
-Kitner
-Peanut

(review in anki/ppt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the function of dressings?

A

-Maintains environment by preserving epithelial tissue
-Conceals wound aesthetically
-Protects from trauma
-Protects from microbes
-Absorb drainage
-Support incision
-Provide pressure which reduces swelling and hematoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How are sponges applied?

A

-Placed on clean, dry skin
-Tincture may be applied for enhance effectiveness (mastisol, benzoin)
-appropriate size and type of specific wound, secure and relatively comfortable
-application and changes are done under sterile conditions (remove soiled outer gloves before handling, changes can be done in OR)
-dressings should only be open onto field when wound is closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How is dressing type determined?

A

-type, size and location of wound
-amt of drainage to be expected
-surgeon preference
-age and size of pt
-underlying medical conditions (allergies)
-condition of surrounding skin
-comfort of pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What do biological dressings do? (biosynthetic skin substitute)

A

-Temporary coverage of open wounds due to trauma, burns, or ulcers
-Protects wounds
-Reduce fluid loss
-May provide matric proteins and growth factors
-Provide an optional wound healing environment
-Ex: integra, dermagraft, apligraf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are some components of skin grafts?

A

-applied to de-epithelialized area of traumatic/thermal injury or for extensive skin loss

-there are full thickness (all layers) and split thickness (epidermis and part of dermis)

-Autograft which is taking patients own skin, homograft is from someone else or cadaver, and heterograft is from a different species.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are some components of one-layer dressings?

A

-for small incisions w minimal drainage

-includes transparent polyurethane film w adhesive back, liquid collodion, hydrocolloids, skin closure tapes, adhesive sprays, foams/gels, and dermabond.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are some components of three-layer dressings?

A

-for any size incision from which drainage is expected
-goes from simple bandaid to very complex
-3 components: inner (contact) layer is primary, intermediate (absorbent) layer is secondary, and outer (securing) layer is teriary

37
Q

What does the three layer of a dressing do?

A

Primary: covers wound and remains in direct contact. has wicking action

Secondary: absorb drainage and secretions, thickness varies, includes kerlix, 4x4s, and ABDs

Tertiary: secures dressing to pts. includes tapes, wraps, stockinettes, etc.

38
Q

What are the different types of primary layer?

A

Non permeable: fine mesh gauze that is impregnated w an emulsion (xerofoam), it is airtight, nonadherent, and around chest tube wound

Semipermeable: hydrocolloid or hydrogel, allows for passage of air and fluid

Permeable: non adherent (adaptic, telfa) draws secretions by wicking, painless removal

39
Q

What are some components of pressure dressings?

A

3 layer dressing with additional material to cause compression. (too much can cause nerve dressing)

Purpose: immobilization of an area, support, absorption of excess drainage, reduce edema

40
Q

What are some components of bulky dressings?

A

3 layer dressing w additional material to immobilize an area and provide additional support to a wound and absorb excess drainage.

41
Q

What are some components of rigid dressings?

A

Provide support and prevent movement. Include casts and splints. Made of plaster, lightweight synthetic, molded plastic, and molded metal

42
Q

What are some components of a splint?

A

-Applied to one side of a structure
-Provides support
-Prevents unidirectional movement.

43
Q

What are some components of a cast?

A

-Encircles a body part
-Provides support
-Prevent any type of movement
-Immobilized the bone proximal and distal to affected area
-Types include cylindrical, body jacket, walking cast, spica cast, and minerva jacket

44
Q

What is a Bolster Dressing?

A

A stent or tie-over dressing. It is sutured into position. You can take a skin graft recipient to provide even pressure and prevent accumulation. It is then secured to contoured area. Usually on face, nose, and nick.

45
Q

What is a wet to dry dressing.

A

Wet gauze is applied on a wound and removed after it dries. For debridement and burn victims under anesthesia.

46
Q

What is a wet to wet dressing?

A

Wet gauze goes on the wound and is removed before it dries. Can be wet w NS, antibiotic, and Dakin’s Solution (bleach). There is minimal wound debridement and is less painful.

47
Q

What is a thyroid collar (Queen Anne’s Collar)?

A

Circumferential neck wrap to secure dressings

48
Q

What is a drain dressing?

A

A 4x4 with a Y slit. Placed around a tube.

49
Q

What is a tracheostomy dressing?

A

Y with cotton tape to tie around the neck. There is a Velcro Strap.

50
Q

What are some components of eye pads?

A

Retains meds and keeps the lid closed. There can also be a rigid shield which protects from pressure or trauma.

51
Q

What is a perineal pad?

A

Pad that absorbs vaginal or perineal drainage. Comes with a belt or mesh underpants to keep in place.

52
Q

What is packing material?

A

Material which assists in hemostasis. It provides pressure and eliminates dead space. In the nose, rectum, vagina, and open wound. Could be a long strop of gauze. Can also be plain, antiseptic and is radiopaque.

53
Q

What is negative pressure wound therapy

A

Foam or gauze covered w an adherent plastic film which connects to a vacuum pump. It draws out fluids and exudates and increases microcirculation. Also encourages approximation of wound edges. (Purvina and KCI)

54
Q

What is the function of catheters, tubes and drains?

A

Placed within surgical wounds, tubular structures, and hollow organs in order to assist with diagnosis, restore function, promote healing, and prevent complications. They are hollow and cylindrical.

55
Q

What are some components of urinary catheters?

A

Drains urine, provide irrigation fluid within a duct, and retracts.
-uses French scale for sizing (5-30)
-may have one or more openings for drainage
-include nonretaining and self-retaining urethral, ureteral, and suprapubic.

56
Q

Review lines, drains and catheters in Anki

A

-urethral (nonretaining)
-urethral (self retaining)
-suprapubic
-ureteral
-intravascular

57
Q

What are some components of scissors?

A

There are tissue, wire, bandage/dressing, and suture scissors. Come in heavy, medium, and light construction.

58
Q

What is the fogarty catheter?

A

Balloon-tipped catheter that is passed beyond an obstruction within the lumen of a vein, artery or duct. The balloon is inflated and then withdrawn along with the obstruction.

59
Q

What is a taut catheter?

A

A cholangiocatheter that identifies the presence of calculi under x-ray. Attaches to a Luer-Lok syringe. One lumen introduces radio-opaque dye.

60
Q

What is a central venous pressure monitoring catheter?

A

For long-term vascular access (years) or poor peripheral venous access. Is a single or multi-lumen radiopaque catheter. Includes double/triple Broviac/Hickman which monitors central venous pressure. Swan-Ganz pulmonary artery catheter which is inserted into subclavian via cut down into superior vena cava or right atrium to comitor CVP.

61
Q

What catheter is used for dialysis?

A

The Tenckhoff silicone catheter. Can be intermittent or continuous peritoneal. Catheter is placed into peritoneal cavity and infuses dialysis fluid. Synthetic cuffs hold it in place (internal in facia and external subcutaneously)

62
Q

What is the function of GI tubes?

A

Aspirate air/fluids from GI tract and instill nutrition. Inserted into stomach/intestine via nose, mouth, rectum, percutaneous. May have sump (dual lumen design). The first lumen allows the evacuation of fluid and the second allows air to enter for equalizing pressure within structure; the third lumen is for instillation.

63
Q

Airway tubes

A

Oral airway
ET
Nasal airway
Trach
Know chest tube

64
Q

What is the different between active and passive drain?

A

Passive: allows pathway for air’fluid to move from area of high pressure to low. Connected to gravity collection device of sponge.

Active Drains: Use negative pressure often from removing air from the collection device. Manually or mechanically electric, battery pump, and vacuum system.

65
Q

Passive drains to know

A

-Penrose
-Cigarette
-T-tube
-GI tube
-cystoscopy tube
-nephrostomy tube

66
Q

Active drains to know?

A

-chest tube
-hemovac
-JP
-stryker

67
Q

What are some components of irrigators and syringes?

A

Used to irrigate wounds, aspirate fluids, inject meds.

Plain (Luer-slip): Needles slips over syringe tip but not as secure

Locking (Leur-lock): Locks the needle onto the syringe w twisting motion

Irrigating syringes include bulb or barrel.

68
Q

Grasping/Holding

A

instruments are designed to manipulate tissue to facilitate dissection or suturing or to reduce and stabilize fractured bone during internal fixation. may or may not be ratcheted.

69
Q

Clamping/Occluding

A

instruments are designed to occlude or constrict tissue and are constructed with opposing ring handles for fingers, interlocking ratchets located just below the ringed handles to lock the instrument in place, and two shanks that connect the ringed handles to the box lock, or hinge joint of the clamp.

70
Q

Retracting/Viewing

A

Instruments designed for the exposure of the operative site.

71
Q

Probing

A

Malleable, wire-like instruments for the exploration of a structure such as a fistula, duct, or vessel are called probes.

72
Q

Dialating

A

Dilators are instruments used to gradually dilate an orifice or duct to allow for introduction of larger instrumentation or to open a stricture

73
Q

Suturing

A

Instruments used to hold a curved suture needle for suturing are called needle holders.

74
Q

Suctioning

A

The removal of blood and body fluids from an operative site to provide better visualization is accomplished with a suction tip that is connected by plastic tubing to a suction canister or other suction device such as the Neptune

75
Q

What are micro-instruments?

A

Instruments that are used to perform microsurgery are very small, delicate, and precise devices that, when used in conjunction with an operating microscope, allow the manipulation and repair of very small structures or tissue

76
Q

Endoscopes

A

-Used pre, intra, and postop for diagnosis, biopsy, visualization, repair of a structure.
-introduced through small skin incision/natural orifice (less recovery time)
-named after atomical region being used
-flexible: maneuverable for introduction of flexible instruments, suction, and fluid injection. used for fixated anatomy to see around corners
-rigid: can be hollow for introducing instruments. can have telescopic lens.
-used in conjunction w light cord w one end attached to scope and other to an electrical light source
-some have ability to be used w ESU.

77
Q

Power Instruments

A

-instruments are powered by nitrogen, electricity, or battery
-nitrogen is supplied from a tank w adaptors to allow hoses to be connected. pressure is regulated by team at specifications of manufacturer (80-100 psi)
-delicate bone work may require a faster air powered instrument
-common uses are to drill holes into skull and turn/ a bone flap, ream the center of a long bone, drill holes to secure a plate, saw the femoral/humeral head, saw through sternum, reshape bone, cut skin, and sand skin for dermabrasion
-used to drill, ream, saw, shave, and cut

78
Q

What are the different actions power instruments can do?

A

Drill: rapid rotary motion for carving bone or holes

Drive: Rotary motion for reaming the shaft of a long bone

Ream: Slow rotary motion for reaming the shaft of a long bone

Cranial Perforators: Rotary motion to drill holes in cranium and stop before penetrating the brain

Saw: Reciprocating or oscillating action for cutting bone. Used on craniotome cuts where delicate tissue is protected by a dural guard. Blades have variety

Shave: 180 alternating direction rotary action to shave off layers of bone

Cut: Some use saw action, some use rotary.

79
Q

Compound Operating Microscopes

A

-Binocular apparatus that uses bent light waves for magnification
-eyepieces and objection lenses are interchangeable
-consist of optical lens which provides magnification and resolving power, objective lens, eyepieces.
-focal length ranges from 100-400mm
-achromatic capabilities sharpen the image
-second set can be attached to microscope for assistant
-total magnification is calculated by multiplying the magnifying power of the objective lens by magnifying power of the oculars
-increase in magnification decreases field of view
-zoom lens w a foot control
-light waves are provided by paraxial or coaxial illuminators
-mounting system for stability (suspended from ceiling or mounted on mobile frame w locks)
-electrical system
-can be adapted for attachment to laser or camera
-covered by sterile drapes or sterile covers attached to focusing knobs.

80
Q

What is the difference between paraxial and coaxial illumination systems in microscopes?

A

Paraxial: contain tungsten/halogen bulbs. focusing lenses are mounted onto body of microscope. can be angled inward to illuminate operative site and has diaphragm which narrows beam.
Coxial: use fiber optics to transmit light waves through microscope’s optical system. light is cool. light intensity in controlled by switch on arm.

81
Q

Video Monitors, Cameras, and Recorders

A

-can be attached to microscopes/endoscopes
-still images can be taken w camera and printed w microcomputer imaging system
-fiber optic light cord attached to an electric source
-light cord and camera is sterilized

82
Q

Fiber-Optic Headlamps and Light Sources

A

-worn by surgeons for additional illumination of operative site
-focuses intense light beams
-fiber optic cord attaches to endoscopes or illuminator mounted retractors

83
Q

Insufflators

A

-creates space for viewing w endoscope and work
-infuses CO2 into abd cavity
-uses veress insufflation needle or hasson blunt trocar
-intraop pressure is 12-15 mmHg

84
Q

Pulse Lavage Irrigator

A

-powered by nitrogen, battery, or electricity
-dibridges traumatic/infected surgical wound
-adjustable pulsed saline solution pulverizes necrotic tissue or clots
-circular shield is used on hand piece or a lap/towel is laid over wound to prevent splatter.

85
Q

Nerve Stimulators

A

-produce very small electrical currents that are applied to tissue to help identify and preserve essential nerves
-anesthesia providers may use to asses actions of neuromuscular blockers
-to operate needle that is attached by wire to locator probe is inserted in adjacent, nonessential tissue. next, structure in question is touched w probe and if nerve is nearby the tissue will move slightly.

86
Q

Sequential Compression Devices (SCD’s)

A

-applied to pt’s leg to prevent venous stasis and DVT that could lead to a PE.
-treats edema and can be used in upper extremity after axillary lymph node dissection
-use pre and postop
-pressure is adjusted according to dr’s order
-has electrical compressor, connecting tubing, sleeves that have chambers filled w fluid or air which pumps fluid proximally.

87
Q

Suction Systems

A

-uses vacuum to remove fluids from surgical site/airway
-two units in OR (one for surgical team, one for anesthesia)
-contains vacuum source, tubing, collection unit, and suction tip
-used in sterile manner

88
Q

Lights

A

-most ORs have 2 but some specialty rooms have 4.
-freely adjustable w intense light
-diameter and focus of light can be adjusted w control (beam should be set at 10-12)
-no shadows, minimal heat, and blue/white color of sunlight
-easily cleaned and do not retain dust
-fixtures have screws or clips for attachment of light handles
OR light should never be tuned off unless dimmer has been turned down.

89
Q

Pneumatic Torniquets

A

-used to restrict bloodflow to extremities which reduces blood loss and improves visualization of field
-if incorrectly used (placement, pressure, or prolonged insuflation) neurovascular damage can occur
-improper application may lead to blistering, bruising, pinching, and necrosis
-contains cuff, tubing, power source, pressure device.
-placed as proximally as possible (surgeon decides)
-pressure is determined by provider according to systolic pressure (leg: 1/2 value; arm: 30-70)
-at one hour pressure should be dropped and inflation/deflation times should be documented.

SURG (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions