INSTRUMENTS + APPLICATION Flashcards
1
Q
A
-scissors:
Mayo
> dissecting soft tissue
thick blades approximately 1/3 of the length
> TRIPOD (thumb-ring finger) grip
- Used to cut or dissect tissue and to cut inanimate objects
- Cutting of inanimate objects should be limited to specific instruments
- Tripod (thumb–ring finger) grip is recommended – maximal control
- Using the end of the blade stabilizes tissue more securely and allows
a more precise cut - Can be curved/straight, tips are sharp/blunt
- Curved scissors – greater maneuverability and visibility
- Straight scissors – mechanical advantage for cutting dense tissue
- Sharp (regular cutting) and blunt dissection possible
2
Q
A
-scissors:
Metzenbaum
> dissecting delicate soft tissue
thin delicate blades approximately 1/4 of the overall length
> TRIPOD (thumb-ring finger) grip
- Used to cut or dissect tissue and to cut inanimate objects
- Cutting of inanimate objects should be limited to specific instruments
- Tripod (thumb–ring finger) grip is recommended – maximal control
- Using the end of the blade stabilizes tissue more securely and allows
a more precise cut - Can be curved/straight, tips are sharp/blunt
- Curved scissors – greater maneuverability and visibility
- Straight scissors – mechanical advantage for cutting dense tissue
- Sharp (regular cutting) and blunt dissection possible
3
Q
A
-scissors:
Tenotomy
> delicate and accurate procedures
> orthopedic, plastic surgery, eye surgery, neurosurgery
> TRIPOD (thumb-ring finger) grip
- Used to cut or dissect tissue and to cut inanimate objects
- Cutting of inanimate objects should be limited to specific instruments
- Tripod (thumb–ring finger) grip is recommended – maximal control
- Using the end of the blade stabilizes tissue more securely and allows
a more precise cut - Can be curved/straight, tips are sharp/blunt
- Curved scissors – greater maneuverability and visibility
- Straight scissors – mechanical advantage for cutting dense tissue
- Sharp (regular cutting) and blunt dissection possible
4
Q
A
-needle holders:
Mayo-Hegar
> needle holders: grips:
1. Thenar grip
2. Thumb-ring finger grip (TRIPOD)
3. Palmed grip
4. Pencil grip
- Jaws short and frequently have grooves that are cross-hatched on the
surface intended to limit twisting and rotation of the needle - Should match both the size and the type of the needle being used
- Different locking mechanisms possible
- Needles placed perpendicular to the needle holder– greatest
maneuverability - Needle is generally grasped near its center
5
Q
A
-needle holders:
Olsen-Hegar
> needle holders: grips:
1. Thenar grip
2. Thumb-ring finger grip (TRIPOD)
3. Palmed grip
4. Pencil grip
- Jaws short and frequently have grooves that are cross-hatched on the
surface intended to limit twisting and rotation of the needle - Should match both the size and the type of the needle being used
- Different locking mechanisms possible
- Needles placed perpendicular to the needle holder– greatest
maneuverability - Needle is generally grasped near its center
6
Q
A
-needle holders:
Mathieu
> needle holders: grips:
1. Thenar grip
2. Thumb-ring finger grip (TRIPOD)
3. Palmed grip
4. Pencil grip
- Jaws short and frequently have grooves that are cross-hatched on the
surface intended to limit twisting and rotation of the needle - Should match both the size and the type of the needle being used
- Different locking mechanisms possible
- Needles placed perpendicular to the needle holder– greatest
maneuverability - Needle is generally grasped near its center
7
Q
A
-CRUSHING tissue forceps:
Allis tissue forceps
> CRUSHING TISSUE FORCEPS
should be used to grasp only tissue slated for excision (those that are removed, going to damage tissue)
toothed jaws
- Multiple types of forceps of various sizes and shapes available
- Used for a variety of tasks
- Configuration of jaw serrations determines their use
- Cross-serrations– tip-clamping
- Longitudinal serrations– jaw-clamping
8
Q
A
-NON-crushing tissue forceps:
Doyen intestinal forceps
- Doyen forceps considered noncrushing, but actually
induce tissue trauma (dependent on use duration) - Other noncrushing tissue forceps include:
- Various peripheral vascular clamps
- Partial occlusion forceps
9
Q
A
-Hemostatic forceps:
Halsted-Mosquito hemostats
- Crushing instruments used to clamp blood vessels
- Serrations on the jaws may be transverse, longitudinal, diagonal, or a
combination of these - Longitudinal serrations are generally gentler to tissue than cross-
serrations - As little tissue as possible should be grasped to minimize trauma
- The least amount and duration of pressure applied by closure of the
ratchet on the instrument is the goal
10
Q
A
-Hemostatic forceps:
CRILE hemostats
- CRUSHING instruments used to clamp blood vessels
- Serrations on the jaws may be transverse, longitudinal, diagonal, or a
combination of these - Longitudinal serrations are generally gentler to tissue than cross-
serrations - As little tissue as possible should be grasped to minimize trauma
- The least amount and duration of pressure applied by closure of the
ratchet on the instrument is the goal
11
Q
A
-Hemostatic forceps:
Kelly hemostats
- Crushing instruments used to clamp blood vessels
- Serrations on the jaws may be transverse, longitudinal, diagonal, or a
combination of these - Longitudinal serrations are generally gentler to tissue than cross-
serrations - As little tissue as possible should be grasped to minimize trauma
- The least amount and duration of pressure applied by closure of the
ratchet on the instrument is the goal
12
Q
A
-Hemostatic forceps:
Rochester-Carmalt hemostats
- Crushing instruments used to clamp blood vessels
- Serrations on the jaws may be transverse, longitudinal, diagonal, or a
combination of these - Longitudinal serrations are generally gentler to tissue than cross-
serrations - As little tissue as possible should be grasped to minimize trauma
- The least amount and duration of pressure applied by closure of the
ratchet on the instrument is the goal
13
Q
A
-thumb forceps:
Brown-Adson forceps
- Tweezer-like, nonlocking instruments used to grasp tissue (and
inanimate objects) - Available in various shapes and sizes; tips may be pointed, flat, round,
smooth, or serrated with small or large teeth - Pencil grip preferred
- Can be held in the palm of the nondominant hand when temporarily
not in use
14
Q
A
-thumb forceps:
Adson forceps
- Tweezer-like, nonlocking instruments used to grasp tissue (and
inanimate objects) - Available in various shapes and sizes; tips may be pointed, flat, round,
smooth, or serrated with small or large teeth - Pencil grip preferred
- Can be held in the palm of the nondominant hand when temporarily
not in use
15
Q
A
-thumb forceps:
Dressing forceps
- Tweezer-like, nonlocking instruments used to grasp tissue (and
inanimate objects) - Available in various shapes and sizes; tips may be pointed, flat, round,
smooth, or serrated with small or large teeth - Pencil grip preferred
- Can be held in the palm of the nondominant hand when temporarily
not in use
16
Q
A
-towel clamps:
Backhaus towel clamps
17
Q
A
-towel clamps:
Jones towel clamps
18
Q
A
-Hand-held retractors:
Senn retractor
- Help improve exposure by deflecting tissue away from the area of
interest - Available in hand-held and self-retaining varieties
- Some handheld retractors may be bent to conform to the area of the
body being retracted - Moistened towels or pads are frequently placed under self-retaining
and selected hand-held retractors to minimize trauma and drying
19
Q
A
-Self-retaining retractors:
Gelpi retractor
- Help improve exposure by deflecting tissue away from the area of
interest - Available in hand-held and self-retaining varieties
- Some handheld retractors may be bent to conform to the area of the
body being retracted - Moistened towels or pads are frequently placed under self-retaining
and selected hand-held retractors to minimize trauma and drying
20
Q
A
-Self-retaining retractors:
Weitlaner retractor
- Help improve exposure by deflecting tissue away from the area of
interest - Available in hand-held and self-retaining varieties
- Some handheld retractors may be bent to conform to the area of the
body being retracted - Moistened towels or pads are frequently placed under self-retaining
and selected hand-held retractors to minimize trauma and drying
