EXAM 1: Lecture 7 - principles of tissue handling

Question 1

what are the 3 types of heuristics in sx

Answer 1

cognitive, perceptual, and motor

Question 2

what is heuristics

Answer 2

the element of a skill

Question 3

what does cognitive heuristics mean

Answer 3

planning movements

Question 4

what does perceptual heuristics mean

Answer 4

recognizing tissues

Question 5

what does motor heuristics mean

Answer 5

handling of tissues

Question 6

T/F: Tissue handling is a trade off between speed and accuracy

Answer 6

true!

Question 7

what are some things that are important with surgical technique

Answer 7

meticulous techniques, hemostasis, local anesthetics, and patient care

Question 8

what are the 6 principles attributed to Halsted

Answer 8

1. handle tissue gently
2. control hemorrhage meticulously
3. observe strict aseptic technique
4. preserve blood supply to tissues
5. eliminate dead space
6. appose tissues accurately with minimal tension

Question 9

what are the 6 things we need to know to have safe and efficient surgical techniques

Answer 9

1. instrument handling
2. tissue dissection and manipulation
3. suturing
4. knot tying
5. hemostasis
6. wound closure

Question 10

what does correct selection/use of instruments protect the tissues from

Answer 10

crushing, drying, heat loss, hemorrhage, and loss of vascular supply

Question 11

what are the 4 motions of the scalpel

Answer 11

1. sliding
2. pressing
3. sawing
4. scraping`

Question 12

how should the scalpel blade be orientated to the skin

Answer 12

perpendicular with a single sweep to cut the tissue

Question 13

what type of grip is this

Answer 13

pencil grip, “pressing”

Question 14

what type of scalpel grip is this

Answer 14

fingertip grip, “sliding”

Question 15

what are scissors used for

Answer 15

cutting or dissection, cutting inanimate objects

Question 16

what are the benefit of curved scissors

Answer 16

greater maneuverability and visibility

Question 17

what are the advatanges of straight scissors

Answer 17

greater mechanical advantage for cutting dense tissue

Question 18

what happens with inefficient use of the needle holders

Answer 18

it accounts for more wasted time than poor technique with any other surgical instrument

Question 19

what are disadvantages of non-crushing-type tissue forceps

Answer 19

may still damage the tissue depending on length of application

Question 20

What type of forceps are crushing type tissue forceps

Answer 20

Allis and babcock forceps

Question 21

what are hemostatic forceps good for

Answer 21

isolation of bleeders and blunt dissection

Question 22

what are the benefits of thumb forceps with tissue handling

Answer 22

speed suturing time with appropriate use and avoids unnecessary tissue trauma

Question 23

what is important to remember with towel clamps

Answer 23

you need to know what you are penetrating under the drape

Question 24

what should we remember during the placement of retractors

Answer 24

avoid sensitive structures (vessels or nerves) and avoid excess opening

Question 25

when do you use poole tip suction

Answer 25

body cavities

Question 26

when do you use yankauer suction tip

Answer 26

oral cavity

Question 27

when do you use frazier suction tip

Answer 27

neurosurgery or bulla osteotomy

Question 28

what should we remember with tissue dissection and manipulation

Answer 28

use caution and do deliberate dissection, dissect along tissue planes, pay attention to lines of tension, and limit tissue manipulation

Question 29

what is important for suturing with tissue handling

Answer 29

1. use the right suture pattern
2. use the right needle
3. minimize tissue handling when placing sutures
4. dont over tighten!!

Question 30

what should we remember about knot tying

Answer 30

secure the knots, make sure they are appropriately buried, and absorbable is only absorbable when it is buried in tissue!

Question 31

What is important to know about hemostasis

Answer 31

it is one of the surgical skills which results in safe, efficient, and reproducible surgical technique

Question 32

what is important to remember about wound closure

Answer 32

it is one of the surgical skills which results in safe, efficient, and reproducible surgical technique

Question 33

what is an aberdeen knot

Answer 33

alternative to the square knot at the end of a continuous line

Question 34

what is the volume and holding capacity of aberdeen knots compared to square knots

Answer 34

volume - 32-56%
holding - 24% greater

Question 35

what kind of knot is this

Answer 35

aberdeen knot