Chapter 12 - Surgical techniques Flashcards
A) The surgeon’s hand is stretched out to the assistant, indicating the need for a clamping instrument. (
B) The surgeon requests scissors by the repeated motion of the index and middle fingers in a back and forth cutting action
C) By pronating the hand back and forth with the tips of thumb, index, and middle fingers together, the need for a scalpel is signaled.
(D) By pronating the hand and making a grasping motion with the index and thumb, the surgeon indicates the request for a thumb forceps. (
E) The needle holder with mounted needle is requested by performing a rotating wrist movement with closed hand.
F) By showing a pronated motionless open hand, the surgeon indicates the need for a free tie ligature suture.
G) Using a peaked hand and a dipping movement, the surgeon requests the need for surgical sponges. (
(H) The surgeon signals for a right-angle clamp by a motionless thumb and index finger in a clawed position.
I) By making a pronated outstretched hand, the surgeon indicates the need for a retractor
J) By pronating the open hand and spreading the fingers, the surgeon requests a wound spreader.
A) In this scenario, one loose strand is held horizontally and the other vertically; it is the latter that will be cut by the assistant.
B) In this scenario, both loose ends are held up vertically, meaning they are both to be cut.
Figure
A) In this scenario, one loose strand is held horizontally and the other vertically; it is the latter that will be cut by the assistant.
What primary factor influences the rate of surgical morbidity and mortality?
A) Patient age B) Surgeon’s experience and skills C) Type of anesthesia used D) Duration of surgery
B) Surgeon’s experience and skills
According to the text, what should be the focus of pregraduate surgical training?
A) Surgical instruments B) Theoretical knowledge C) Understanding surgical principles D) Patient management
C) Understanding surgical principles
What are the “Halsted Principles” primarily aimed at minimizing?
A) Surgical costs B) Surgical site infections C) Tissue trauma and blood loss D) Patient discomfort
C) Tissue trauma and blood loss
Which principle of Halsted emphasizes the importance of controlling bleeding?
A) Avoid dead space B) Maintain blood supply C) Assure good hemostasis D) Apply strict asepsis
C) Assure good hemostasis
What is a key factor in reducing surgical complications according to the text?
A) More assistants in the operating room B) Familiarity with roles in the surgical team C) Longer procedure times D) Frequent team changes
B) Familiarity with roles in the surgical team
How can surgical etiquette improve patient care?
A) By allowing more personnel in the operating room B) By creating a noisy environment C) By promoting teamwork and efficiency D) By reducing the need for communication
C) By promoting teamwork and efficiency
What is one reason many medical errors occur in the operating room?
A) Excessive equipment B) Ineffective team interaction C) Overconfidence of surgeons D) Poor surgical instruments
B) Ineffective team interaction
What is a significant risk factor for increased surgical morbidity identified in the study?
A) Use of outdated techniques B) Lapses in discipline by the surgical team C) Inadequate training D) Limited use of instruments
B) Lapses in discipline by the surgical team
Why is the preparation of the surgical facility crucial?
A) It reduces surgery costs. B) It ensures the availability of instruments. C) It helps achieve aseptic conditions. D) It enhances team communication.
C) It helps achieve aseptic conditions.
What is one method to maintain aseptic conditions during surgery?
A) Using single gloves B) Double gloving C) Minimal draping D) Allowing visitors in the room
B) Double gloving
What type of incision technique is most commonly associated with a scalpel?
A) Blunt dissection B) Laser incision C) Steel scalpel incision D) Electrosurgical incision
C) Steel scalpel incision
In terms of grip techniques, which grip is most effective for precise cuts with a scalpel?
A) Palm grip B) Pencil grip C) Finger grip D) Tripod grip
B) Pencil grip
Which scalpel grip is best suited for long, straight incisions?
A) Pencil grip B) Palm grip C) Fingertip grip D) Tripod grip
C) Fingertip grip
What distinguishes the electro scalpel technique from the traditional steel scalpel technique?
A) The angle of incision B) The type of tissue cut C) The grip used D) The method of energy application
D) The method of energy application
Why should scissors not be used near the hinge for cutting?
A) It causes tissue to slip. B) It crushes rather than cuts tissue. C) It is too difficult to maneuver. D) It does not provide sufficient control.
B) It crushes rather than cuts tissue.
What type of scissors are most effective for precise cutting in surgery?
A) Curved scissors B) Blunt scissors C) Straight-bladed scissors D) Large scissors
C) Straight-bladed scissors
Which grip is commonly used to hold operating scissors?
A) Palm grip B) Tripod grip C) Fingertip grip D) Pencil grip
B) Tripod grip
Why is nonverbal communication important in the operating room?
A) It reduces the need for verbal instructions. B) It allows for better focus and less noise. C) It prevents misunderstandings entirely. D) It makes the environment more relaxed.
B) It allows for better focus and less noise.
What is one strategy to improve communication during surgeries?
A) Encourage loud discussions B) Utilize nonverbal signals C) Minimize the number of team members D) Allow interruptions from visitors
B) Utilize nonverbal signals
What does adherence to Halsted’s principles aim to achieve?
A) Lower costs of surgery B) Improved surgical aesthetics C) Enhanced surgical outcomes D) Faster surgeries
C) Enhanced surgical outcomes
Which of the following is NOT a Halsted Principle?
A) Maintain blood supply B) Ensure adequate training C) Avoid undue tension on tissues D) Apply strict asepsis
B) Ensure adequate training
Which aspect of surgical training can reduce stress and improve decision-making?
A) Lack of experience B) Cognitive training C) Focus on technical skills only D) Minimizing hands-on practice
B) Cognitive training
What is the main advantage of using double layers of draping?
A) Improved visibility B) Enhanced comfort for the team C) Better maintenance of aseptic conditions D) Easier access to instruments
C) Better maintenance of aseptic conditions
What role does teamwork play in surgical outcomes?
A) It increases surgery duration. B) It is essential for minimizing errors and improving outcomes. C) It complicates communication. D) It has no significant impact.
B) It is essential for minimizing errors and improving outcomes.
What should be done to avoid delays during surgical procedures?
A) Limit team communication B) Ensure thorough preparation and planning C) Keep the surgical team small D) Rely on improvisation
B) Ensure thorough preparation and planning
Which of the following is essential for maintaining a sterile field?
A) Wearing single gloves B) Proper draping techniques C) Allowing visitors in the OR D) Using outdated techniques
B) Proper draping techniques
What is the main purpose of a scalpel in surgical procedures?
A) To retract tissues B) To cut and incise tissues C) To clamp blood vessels D) To suture wounds
B) To cut and incise tissues
How can the use of checklists in the operating room benefit surgical outcomes?
A) They increase noise levels. B) They distract the team. C) They improve discipline and reduce complications. D) They take away from hands-on experience.
C) They improve discipline and reduce complications.
Which factor is most critical for successful surgical interventions?
A) Use of advanced technology B) Experience of the surgeon alone C) Comprehensive training of the entire surgical team D) Length of the surgery
C) Comprehensive training of the entire surgical team
What can excessive movement in the operating room lead to?
A) Improved efficiency B) Increased risk of infection C) Decreased surgical site infection rates D) Enhanced communication
B) Increased risk of infection
What is one way to maintain focus and minimize distractions during surgery?
A) Encourage discussions about non-surgical matters B) Maintain a quiet operating environment C) Allow visitors in the OR D) Use multiple communication devices
B) Maintain a quiet operating environment
What should be the surgeon’s primary concern during a procedure?
A) Speed of the operation B) Adherence to aseptic principles C) Personal comfort D) Use of multiple instruments
B) Adherence to aseptic principles
What is the role of the scrub nurse during surgery?
A) To assist with anesthesia B) To maintain sterile technique and assist the surgeon C) To document the surgery D) To control the surgical instruments
B) To maintain sterile technique and assist the surgeon
Which grip provides stability for cutting with scissors?
A) Pencil grip B) Fingertip grip C) Tripod grip D) Palm grip
C) Tripod grip
Why is it important for the surgical team to communicate clearly?
A) To create a friendly environment B) To minimize noise C) To ensure patient safety and correct information transfer D) To entertain visitors
C) To ensure patient safety and correct information transfer
What can be an independent risk factor for increased morbidity in surgeries?
A) Shorter surgical times B) Lapses in team discipline C) Familiarity with instruments D) Advanced surgical techniques
B) Lapses in team discipline
What is the effect of prolonged surgical duration on outcomes?
A) It has no effect. B) It can lead to higher complication rates. C) It improves surgical outcomes. D) It decreases recovery time.
B) It can lead to higher complication rates.
What is the main reason for using a modified pencil grip with an electro scalpel?
A) To create a broader incision B) To minimize energy contact area C) To enhance visibility D) To reduce fatigue
B) To minimize energy contact area
What is a significant benefit of using nonverbal signals in the OR?
A) They allow for louder communication. B) They reduce distractions and maintain focus. C) They make it easier to train new staff. D) They eliminate the need for verbal communication.
B) They reduce distractions and maintain focus.
The fingertip grip for holding a surgical scalpel.
The palm grip for holding a surgical scalpel.
The palm grip of a needle holder.
Figure 12-10. The thenar grip of a needle holder.
Figure 12-11. Proper technique for holding and using thumb forceps
Figure 12-12. Several mosquito forceps are held in the surgeon’s palm, allowing effective sequential application to a number of vessels.
Figure 12-13. Stabilizing and stretching the skin between the thumb and index finger facilitates incision of the skin.
Figure 12-14. Skin incisions. Correctly performed incision (a). Timid slide cutting resulted in jagged incision edges (b). Slide cutting with a sideways-angled blade resulting in an obliquely angled skin incision (c).
VetBooks
Figure 12-15. Stab or press cutting into a hollow organ.
Figure 12-16. Bumper cutting into a structure elevated and stretched between two Allis forceps.
Figure 12-17. The technique of inverted-blade press cutting facilitates blade control.
Figure 12-19. Circumferential (A) and transfixation (B) ligatures.
Figure 12-21. Ligation of large bundles of tissues. (A) Divide and conquer technique. (B and C) Three-forceps technique. The third hemostat has been removed (arrow) and in its place a ligature is applied (B). The bundle is separated between the two remaining hemostats and ligatures are applied at the location of the hemostats or immediately adjacent to them (on the distant hemostat side relative to the division line) (C).
Figure 12-23. (A) An Esmarch bandage (a) and pneumatic tourniquet (b) used for occluding blood flow in a limb. (B) Application of an Esmarch bandage and a pneumatic tourniquet. Gauze rolls are placed over vascular pressure points under the tourniquet (arrow).
