Instruments Flashcards
What are examples of Viewing Instrument?
Viewing instruments allow visualization of a structure or cavity.
ex.
. (Vienna) nasal speculum
. specula’s
. ridged and flexible endoscopes
. endoscopic camera
. Graves & Pederson Specula
Used to spread the nares, allowing visualization of the internal nose?
Vienna Nasal Speculum
Used to retract the vaginal walls in gynecologic procedures, allowing the visualization of the cervix?
Graves & Pederson specula
What are examples of Self Retracting instrument to expose the operative site?
Self retaining: Do/Not have
interchangeable blades
– Weitlaner (small/med) [skin/sub cu]
– Balfour (intestinal)
[peritoneal]
– Book Walter (mayor
ABD) [large opening]
- Gelpi: retraction of deep and superficial tissues. It’s ideal for retracting bulkier tissues as well as hard to reach incision sites.
- O’connor-O’Sullivan ?
- Thompson ?
- Greenberg ?
- Omni-Tract ?
- Burford ?
-Finochietto ?
Bookwalter, Balfour & O’connor-O’Sullivan have interchangeable blades for varying wound depths and tissue types.
What are examples of Handheld Retracting instrument to expose the operative site?
Handheld: Do/Not have
double sided blades
– Jackson “Double Prong”
– Senn “Triple Prong”
– USA “Army Navy”
– Volkmann
– Richardson
– Deaver
– Malleable “Ribbon”
- Thyroid Retractor “Lahey”
- Joseph Skin Hook
- Ragnell ?
Example of instruments used for Abdominal or brain procedures that may attach to the OR table for stabilization?
Self Retaining Retractor
. Thompson
. Greenberg
Explain Blunt edge, Sharp Rake-Like & Single/Double hook retractors?
Provide examples if possible.
Blunt edge retractors - used to retract the abdominal wall or abdominal and thoracic organs ex. US Navy, Richardson, Deaver, Malleable “Ribbon”
Sharp Rake-Like retractors - used for retraction of nonfatal structures, such as fat or skin ex. Jackson, Sean & Volkmann
Single-hook or double-hook retractors - are utilized for the retraction of the skin during plastic procedure.
What is found in abdominal, gallbladder or rectal instrument sets and are often used with guides “groves directors.”
Probing instruments - are used to explore a structure, opening, or tract. These are often blunt, malleable, and wire-like instruments.
Probes for coronary arteries are small and malleable and can also be used to dilate the coronary artery.
Used to gradually dilate an orifice or duct to allow for introduction of larger instrumentation or to open a structure?
Dilating instruments - They come in sets numbered from the smallest to the largest. Dilators gradually taper to the distal end from the wider proximal end where it is held by the surgeon.
Ex. Hanks, Van Buren, Bakes, and Mahoney.
Heaney & Hegar Cervical Dilators,
What are examples of Dilating Instruments?
. Hanks,
. Van Buren: Urethral dilators for men
. Bakes
. Mahoney
. Heaney & Hegar Cervical Dilators: double ended with the opposite end one size up or down in diameter
. Single-ended female urethral dilators: are short than single-ended
. Long single-ended flexible Bougie esophageal dilators: are gradually tapered to the end of the dilator
Explain retracting and exposing instruments.
Explain Self-retaining Vs Handheld
- are designed to hold back or pull aside wound edges, organs, vessels, nerves, and other tissues to gain access to the operative site. They are generally referred to as retractors and are either manual (handheld) or self-retaining (stay open on their own). Retractors have one or more blades. These blades are used for holding back tissues without causing trauma and should not be confused with a cutting blade. Retractor blades are usually curved or angled and may be blunt or have sharp or dull prongs. The blades will vary in size according to the depth of the wound and the area of placement.
. Handheld retractors consist of a blade attached to some type of handle, which is pulled back or held in place by the user. Manual retractors are often used in pairs, one on each side of the wound. Some are double-ended, with a blade on each end and a slight variation in size or shape.
. Self-retaining retractors are holding devices with two or more blades that spread the wound apart or hold tissues back. A self-retaining retractor has a ratchet, crank, spring, or locking device that holds it open. Some will have permanent attached blades, whereas others will have interchangeable blades that come in a variety of shapes, lengths, and widths, depending on the operative location. Screws, hooks, wing nuts, or clamping devices secure the blades in place. Some retractors attach directly to the operating room table for stability.
Give examples of stapling devices.
. skin staplers
. ligating clips
. linear cutters
. intraluminal staplers
- Stapling devices are used to ligate, anastomose, or approximate tissues. Stainless steel, titanium, and INSORB absorbable material are used for stapling.
- Staples are designed to be noncrushing when inserted into the tissues to promote healing.
- A nondisposable stapler uses disposable stapling cartridges that have to be assembled during setup.
- Disposable staplers are assembled, packaged, and sterilized by the manufacturer. They are designed to be reloaded with a new cartridge for multiple uses on the same patient.
Give examples of Suturing Instruments.
. Heaney Needle Holder: used during certain genitourinary and gynecological procedure (GYN)
. Castroviejo Needle Holder: used for plastic & ophthalmic procedures have a locking device to hold the needle in place
. Ryder (vascular)
. Crime Wood (vascular)
. Mayo Heagar (general)
- Suturing instruments are used to ligate, repair, and approximate tissues during a surgical procedure. This mainly includes needle holders, which are used to hold curved suture needles, but also includes other items such as a knot pusher, endo stitch, and endo loops.
What suturing instrument is used during certain genitourinary and gynecological procedures?
. Heaney Needle Holder: used during certain genitourinary and gynecological procedure.
What suturing instrument is used for plastic & ophthalmic procedures?
. Castroviejo Needle Holder: used for plastic & ophthalmic procedures have a locking device to hold the needle in place
What are some examples of suctioning & aspirating instruments?
. Frazier & Baron - are used by neuro, plastic & orthopedic surgeons.
. Yankauer & Poole- commonly used for aspiration of abdominal fluids.
. Yankauer - was designed for pharyngeal suctioning during tonsillectomy but is frequently used for abdominal procedures.
. Poole - suction tip has a removable guard with multiple holes that allows the surgeon to rapidly aspirate large amounts of fluid usually irrigation fluid for the abdominal cavity without interference from abdominal viscera
Suctioning and aspirating devices are used to remove blood, fluid, and debris from operative sites. These suction tips may be disposable or nondisposable and come in a variety of shapes and sizes according to use.
What are examples of Cutting and Dissecting instruments?
. cone tip dissectors
. biopsy forceps
. knives
. scalpels
. scissors
. bone-cutting (osteotomes, curettes, chisels, gouges & rongeurs) ?
. Saw
. Drills
. Biopsy punches (skin biopsy)
. Adenotomes (removing adenoids)
. Dermatomes (skin grafting)
- Cutting and dissecting instruments are used to in-cise, dissect, and excise tissues.
- Cutting instruments have single or double razor-sharp edges or blades, such as a scalpel, scissors, or osteotome.
- Dissecting instruments may have a cutting edge and come in a variety of designs.
Give examples of scalpels/knifes
. Amputation Knife
. Cataract Knife
. Arachnoid Knife - a delicate knife with an ageless tip, is frequently used for neurosurgery
. Beaver Handle - any size beaver blade will fit beaver handle #69 frequently used
Blades 10, 11, 12 & 15 fit what size handles?
&
Blades 20-25 fit what size handles?
. Blades 10, 11, 12 & 15 fit #3, #7 & #9 handles
. Blades 20-25 fit a #4 handle
What is the blade most frequently used & what handle is it loaded on?
10 is the blade most frequently used & is typically loaded onto #3 handle
10 blade makes varying sizes of incision in skin & muscle
11, 12 & 15 blades are usually loaded onto what size handle?
. 11, 12 & 15 blades are usually loaded onto the #7 handle
11 blade when elaborate, detailed cuts need to be made
