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SURG TESTS > Chapter 10 > Flashcards

Chapter 10 Flashcards

instrumentation, equipment, and supplies

1
Q

what are most instruments made of

A

stainless steel
carbon, chromium, and iron
may become magnetized

titanium
stronger, lighter weight, non magnetic

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2
Q

finishes on instruments

A

polish- cheapest
satin- little glare, doesn’t last
ebonized - when dealing with laser, non reflective

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3
Q

instruments classifications
read info in text

A

cutting/ dissecting
grasping/ holding
clamping/ occluding
retracting/ viewing
probing/ dialating
suturing
suctioning
accessory

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4
Q

subcategory instrument classifications

A

micro- instruments
endoscopic

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5
Q

cutting/ dissecting example

A

NTK scalpel handles blades combos

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6
Q

bookwalter retractor

A

self retaining OR retractor

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7
Q

greenburg retractor

A

self retaining OR neuro retractor

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8
Q

thompson retractor

A

self retaining abdominal retractor
used for smaller things like veins
attached to the OR table

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9
Q

instrument care and handling cycle pt 1

A

pre op care
-gather instruments
-come in sterilized sets
-open onto sterile field
-organize back table and may
-check for proper function

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10
Q

instrument care and handling cycle pt 2

A

intra op care
-anticipate needs of patient + team
-need a proper knowledge of
- anatomy + physiology
- pathology
- sterile technique
- watching team for sterile tech.
- environment concerns

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11
Q

instrument care and handling cycle
pt 3

A

post op care
- prepare instruments for reuse
- clean + decontaminate
- inspect + maintenance
- reassemble set
- sterilize
- storage

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12
Q

benefits of proper instrument care and handling

A

prevent injuries
extend instrument life
allow correct performance
complex and expensive to replace

don’t use for anything other than intended purpose

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13
Q

what is an instrument set

A

group of instruments assembled into pan + sterilized
- primary set, general
- secondary set, more specific
- individ. wrapped inst, peel pack
includes a count sheet, inst, list

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14
Q

what is instrument list/ count sheet

A

type and number of instruments

used by an assembler to minimize errors

handed to circulator at beginning of case for verbal/ visual count

count before each case + closure

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15
Q

cryotherapy units

A

uses gas to deliver extreme cold to diseased tissues

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16
Q

what chemicals does cryotherapy use

A

liquid nitrogen
freon
carbon dioxide

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17
Q

how does cryotherapy work

A

creates necrosis without damage to adjacent tissues

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18
Q

examples of cryotherapy units

A

remove tumors
repair retinal detachments
extract cataracts

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19
Q

irrigation/ aspiration units

A

phaco-emulsifier
- ultrasonic energy to remove diseased eye lenses
- liquifies tissue to suck it up
-pressure automatically adjusted in ant chamber of eye

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20
Q

piezoelectric machine

A

irrigation/ aspiration unit

uses electric impulses to generate heat, targets a single tissue then immediately cools down

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21
Q

what kind of instrument is used for ortho

A

power instruments

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22
Q

three kinds of power instruments

A

battery- chargeable battery
pneumatic
electric- power from wall

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23
Q

pulse lavage irrigator

A

trauma + total hip/ knee
irrigates wound w/ pressure hose
suctions while irrigating

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24
Q

insufflator

A

abdominal cavity
swells it up for MIS so scope can see

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25
nerve stimulators
checks function of nerve locates nerve prevents severing nerves
26
pneumatic tourniquets
air flows through and blows up to cutoff blood flow
27
what are drapes for
barrier to isolate and protect surgical site
28
qualities of drapes
lint free fluid resistant antistatic tear resistance nontoxic no retina body heat non reflective color flame retardant
29
drape materials fabrics: non woven
non woven - disposable - synthetic - aluminum coated - light + strong
30
drape materials fabrics: woven
woven - reusable - water repellent - laundered and sterilized
31
three plastic adhesive drapes
incise aperture isolation
32
incise drape
apply after prep is dry incision made through the drape
33
aperture drape
adhesive around the edges for eyes and ears allows surgeon to view landmarks
34
isolation drape
large drape for visualization of patient + c arm used in hip procedures with fracture table
35
fenestrated drapes
contains opening specific to the area to be exposed covers feet and anesthesia screen
36
non fenestrated drapes
used to "square off" 1st layer of draping used to cover unaffected body parts custom design to cover specific areas ex: blue towel + stockinette
37
sterile packs
first item opened for procedure placed on back table commercial or created in house basic + highly specialized cases
38
basic sterile pack examples
mayo stand cover 2 gowns suture bags 4 sticky drapes 2 paper hand towels
39
functions of surgical sponges
absorb blood and fluid blunt dissection protect structures
40
all sponges are:
counted + radiopaque
41
lap sponges
pack of 5 large blood loss expected moistened in saline
42
raytec sponge
pack of 10 small incision minimal blood loss put on sponge stick for blunt dissection
43
cottonoid sponges
pack of 10 also called patties + neurosurgical soaked in hemostatic agent- liquid cocaine
44
tonsil sponge
5 pack round loaded on tonsil/ Schmidt clamp
45
kitner sponge
5 pack roll of cotton tape used for blunt dissection
46
peanut sponge
5 pack small gauze sponge used for blunt dissection
47
functions of dressings
protect from trauma + microbes absorb drainage support incision provide pressure- prevent swelling + bruise
48
tinctures to increase dressing adhesivness
benzoin mastisol
49
application and changes of dressings are done in:
sterile conditions remove outer gloves before handling
50
dressings vs sponges
no radiopaque mark open after final count
51
dressings determines by
type, size, location of wound amount of drainage expected age and size condition of surrounding skin underlying medical conditions
52
biological dressings used to:
work on patients with burns trauma ulcers etc. to protect wounds prevent contamination reduce fluid loss temporary coverage
53
skin grafts applied to:
thermal injury, burn/ road rash extensive skin loss
54
skin graft classifications
full thickness- composite grafts split thickness
55
autograft- skin graft
autologous taken from one part of body to another
56
homograft- skin graft
homologus taken from cadaver or another person
57
heterograft- skin graft
xenograft different species usually porcine or bovine (pig or cow)
58
one layer dressings include
transparent film w/ adhesive back liquid collodion hydrocolloids skin closure tapes adhesive sprays foams or gels derma bond
59
three layer dressings
expecting drainage simple (bandaid) to very complex 3 components - inner (contact) : primary -intermediate (absorbent): secondary -outer (securing): tertiary
60
examples of intermediate (absorbent) layer
kerlix fluffs, abd pads, 4x4 gauze sponge
61
what does the primary layer of dressings do
covers wound completely wicking action
62
what does secondary layer of dressings do
absorbs any drainage
63
what does tertiary layer of dressings do
secures dressings to patient
64
3 types of primary layer dressings
non permeable (occlusive) -fine mesh gaule semipermeable (semi occlusive) permeable (non occlusive)
65
pressure dressing
3 layer with additional material, causes compression purpose -support -absorbtion -pressure distribution
66
bulky dressings
3 layer dressing, no compression lots of support and padding absorbs excessive drainage
67
rigid dressings
casts and splints provide support/ prevent movement made of -plaster -fiberglass -molded plastic -molded metal (aluminum)
68
rigid dressing: splint
applied to one side provide support prevent unidirectional movement
69
rigid dressings: cast
encircles body part provide support prevent any type movement types: -cylindrical -body jacket -walking cast -spica cast (mold extremity to something else) -minerva jacket
70
specialty dressings: bolster dressing
-tie over dressing -sutured into position -skin graft recipient site -provide even pressure - prevent fluid accumulation - secure to contorted area
71
specialty dressings: wet to dry
wet gauze on wound removed after it dies debridement (gravel) burn victims put under anesthesia
72
specialty dressings: wet to wet
*wet gauze on wound removed before it dries -N.S. -antibiotic -dakins solution (bleach)* minimal wound debridement less painful
73
specialty dressings: thyroid collar
(queen annes collar) circumferential neck wrap to secure dressings
74
specialty dressings: ostomy bags
intestinal stoma to contain excretions
75
specialty dressing: drain dressing
4x4 with Y slit
76
specialty dressing: tracheotomy dressing
Y with cotton tape to tie around the neck velcro strap (manufacture)
77
specialty dressings: eye pad
retains meds and keep lid closed
78
specialty dressings: eye shield
rigid oval shield protects from pressure or trauma
79
specialty dressings: perineal pad
absorbs vaginal or perineal drainage belt or mesh underpants to keep in place
80
packing material
assist with hemostasis provide pressure eliminate dead space packs open wound can use long strip of gauze plain, antiseptic or radiopaque
81
negative wound pressure dressing
foam or gauze covered with an adherent plastic -vacuum pump then connected draws fluid out increases microcirculation encourages closure of wound edges
82
catheters tubes and drains are used for
diagnosis restore function promote Healing prevent ocmplications not easy to categorize
83
catheters
remove air/fluid installation of meds maintain lumen potency monitor body functions -urinary -intravascular -specialty
84
urinary catheter
drain urine provide irrigation retraction scaling: 5 (infants) -30 urethral: non retaining/ self retaining ureteral suprapubic
85
urethral non retaining
function: obtain urine specimens decompress bladder maneuver around obstruction temporary, no drain bag ex: straight + coude
86
urethral self retaining
(indwelling, foley) function: measures pee output bladder decompression uses a balloon, 5-30 cc features: 2 way and 3 way ports require drainage bag
87
suprapubic catheter
placed through opening in abd wall types: foley pezzer malcot *3 way, balloon inflation, urine drainage, irrigation secure to skin to prevent dislodging*
88
ureteral catheters
assistance of cystoscope *decompress/ drain kidney* tip: whistle, olive, cone radiopaque+ drainage bag (if retained)
89
intravascular catheter
infuse fluids, diagnosis, monitor body gauged or French sizing single or double lumen
90
venous access IV
peripherally upper extremity angtiocath
91
centrally IV
subclavian or jugular vein groshong
92
IV: fogarty
balloon tipped catheter used to take out obstruction
93
specialty catheters: cholangiocatheter
-detects calculi w/ radiopaque dye
94
specialty catheters: central venous pressure monitoring catheter
longterm vascular access *monitor central venous pressure, inserted into subclavian to monitor CVP* broviac/ swan ganz
95
dialysis
tenckhoff silicone catheter peritoneal cavity synthetic cuffs hold it in place
96
three types of tubes
GI tubes airway chest
97
functions of all tubes
removes air/ fluids instillation of meds maintain lumen patency
98
GI tubes
aspirate air/ fluids into GI tract feeding tube inserted into stomach via -nose, mouth, rectum, percutaneous 3 lumen design
99
airway tubes
maintain patency of URT oral airway ET tube nasal airway tracheotomy tube (directly into neck)
100
chest tube
upper tube: evac air lower tube: evac fluid "Y" connecter for two tubes closed water seal drainage system maintains negative pressure for respiration
101
chest tube drain types
active + passive
102
active drain
negative pressure connected to suction device manual or mechanic connected to collection device
103
passive drain
allows path for fluid to move form high pressure to low pressure connected to gravity collection device
104
passive drain example
Penrose - * capillary action* cigarette - *wicking action* t-tube- biliary system bile bag
105
more passive drains
gastrostomy tube cycstostomy tube - removes urine nephrostomy tube - removes urine (from kidney)
106
active drains
chest tube water seal drainage system hemovac - orthopedic JP stryker - batter power, orthopedic
107
irrigators + syringes functions
irrigate wounds/ aspirate fluids/ inject med
108
types of irrigators + syringes
plain- not secure locking - locks needle into syringe plastic or glass - most basic irrigating syringe - bulb/ asepto, ear size: 1-60, anesthetics

SURG TESTS (24 decks)

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