Common Surgical Instruments Part 1 (2) Flashcards
Dr. Thompson
T/F: You can use Metzenbaum scissors to cut suture
FALSE
What are the most common scalpels in veterinary medicine?
reusable scalpel handles (#3 and #4)
Name? Use?
No. 10 blade
most commonly used in small animal surgery for incision and excision of tissues
Name? Use?
No. 15 blade
smaller version of a No. 10 and is used for precise incisions in smaller tissues
Name? Use?
No. 11 blade
ideal for stab incisions into fluid-filled structures or organs
Name? Use?
No. 12 blade
most often used in cats for elective dissection onychectomy (declawing)
Label from left to right, top to bottom
No. 3
No. 4
No. 10
No. 11
No. 12
No. 15
No. 20
When incising the skin, the scalpel blade should be kept [parallel/perpendicular] to the skin surface
perpendicular
What are the types of scalpel grips?
- pencil grip
- fingertip grip
- palmed grip
What is the pencil grip?
allows shorter (1-2 cm), finer, and more precise incisions than the other grips because the scalpel is at a 30-40 degree greater angle to the tissue
this angle reduces cutting edge contact, making this grip less useful for long incisions
Grip?
pencil grip
Grip?
fingertip (slide) grip
What are the characteristics of the fingertip (slide) grip?
offers the best accuracy and stability for long (>2cm incisions)
Grip?
palmed grip
What are characteristics of the palmed grip?
- strongest hold on the scalpel
- allows exertion of great pressure on the tissue
- often unnecessary in surgical situations
What is the area between the jaws and shank called?
box lock
What is the thing between the ring handles called?
ratchet
What are the benefits of curved scissors?
offer greater maneuverability and visibility
What are the benefits of straight scissors?
provide the greatest mechanical advantage when cutting tough or thick tissue
What are the two most common scissors in small animal surgery?
- metzenbaum
- mayo
When do you use Metzenbaum scissors?
designed for sharp and blunt dissection or incision of finer tissues
When do you use Mayo scissors?
used for cutting dense, heavy tissue, like fascia
What are these?
suture scissors or blunt-sharp (NOT suture removal scissors)
What are these?
suture removal scissors - have a concavity on one blade to gently hook the suture away from the skin and facilitate easy removal
What are these?
iris scissors
What are iris scissors?
often used in ophthalmic procedures and other meticulous surgeries, such as perineal urethrostomy, that require fine, precise cuts
What are these? Describe
bandage scissors - have a blunt tip, which reduces the risk of cutting skin when the scissors are introduced under the bandage
How do you hold scissors for surgery?
held with the tips of the thumb and ring finger through the finger rings and with the index finger resting on the shanks near the fulcrum - should not fall through handle
rings should be kept near the distal finger joint
(wide-based tripod grip)
What is the most efficient way to hold scissors?
Grip?
backhand grip
Grip?
wide-based tripod grip
What is the backhand grip - scissors?
typically used for cutting from left to right (less awkward)
thumb and middle finger through the rings with handle resting on third and fourth fingers
Why should you cut with scissors using your right hand?
the natural pushing of the thumb and pulling of the fingers in a gripping motion applies the maximal shear and torque to the blades
Using the [front/end] of the scissor blade stabilizes tissue more securely and allows a more precise cut
end
What is blunt dissection? What is it used for?
separation of tissue by inserting the points and opening the handle
used to separate loosely bound tissues, such as muscle or fat, or to undermine skin edges for wound closure
When should blunt dissection not be used?
in tougher tissue or where precise cuts are possible
Scissor type?
stitch (suture removal)
Scissor type?
sharp-blunt
Scissor type?
Metzenbaum
Scissor type?
Mayo wire
Scissor type?
tenotomy (iris)
What do needle holders do?
grasp and manipulate curved needles
Where should you ONLY grasp suture with needle drivers?
at the end
Most needle holders have a _____
ratchet lock just distal to the thumb
Needle holder type?
Mayo-Hegar
Needle holder type?
Olsen-Hegar
Needle holder type? How does it work?
mathieu - have a ratchet lock at the proximal end of the handles of the needle holder
permits locking and unlocking by progressively squeezing the handles together
Needle holder type?
Mayo-Hegar
Needle holder type?
Olsen-Hegar
Needle holder type?
Mathieu
Needle holder type?
Castroviejo
Needles generally should be placed [parallel/perpendicular] to the needle holder because this allows greatest maneuverability
perpendicular
A needle is generally grasped near its _____
center
What happens when the needle is grasped near the eye or swage?
maximum length is available for suturing - more likely to bend or break though
What happens when the needle is held near the pointed end?
allows the greatest driving force - extracting the needle is difficult
What are the types of needle holder grips?
- palmed grip
- thenar grip
- thumb-ring finger grip
- pencil grip
Grip?
palmed grip - strong driving force but less precision
Grip?
thenar grip - good mobility, handles can pop apart
Grip?
thumb-ring finger grip (tripod) - best precision of all grips and is preferable when suturing delicate tissue
Grip? When is it used?
pencil grip - with castroviejo needle holders
Tissue forceps with [small/large] teeth should not be used to handle tissue that is easily traumatized
large
When are these used? what is it called?
DeBakey forceps - recommended for manipulation of delicate tissue, such as viscera or blood vessels
Forceps type?
Brown-Adson - have small serrations on the tips that minimize trauma but facilitate holding tissue securely
How should tissue forceps be held?
pencil position
Tissue forcep type?
left: bishop-harmon (smooth tip)
right: bishop-harmon (toothed)
notice the holes drilled in
Tissue forcep type?
Brown-Adson
Tissue forcep type?
1x2 tissue
Tissue forcep type?
serrated
Tissue forcep type?
DeBakey
Tissue forcep type?
1x2 tissue (rat tooth)
Tissue forcep type?
Brown-Adson
Tissue forcep type?
Bishop-Harmon (smooth tip)
Tissue forcep type?
DeBakey
