L02: Surgical Instrumentation (Case) Flashcards
least traumatic method for incising tissue
scalpel
15 scalpel blade used for:
small animals ie. cat skin, cutting into bowel/bladder, etc.
12 scalpel blade used for:
dissection around something like for dehorning or declawing
11 scalpel blade used for:
puncturing bowel, joint capsule, small ureters, etc.
10 scalpel blade used for:
skin and viscera; cuts deeper with less pressure
2 acceptable grips for scalpel
fingertip grip
pencil grip
purposes of scissors
dissection or sharp cutting
disadv. of scissors
inc. tissue trauma due to shearing forces
adv. of scissors
ease of cutting redundant tissue
improved visibility and control
adv. of curved vs. straight scissors
curved improve control and visibility
3 main types of scissors
blunt/blunt
sharp/blunt
sharp/sharp
purpose of tissue forceps
tissue manipulation with non-dominant hand
-use pencil grip
chars. of tissue forceps
tweezer-like
pointed tips for manipulation of CT
atraumatic serrated tips used for blood vessel manipulation
Debakey forceps used for:
to grasp viscera; have gentle hold with mild serations
Which more traumatic: Rat Tooth or Brown-Adson
brown-adson (because have to crush to grab the skin)
Rat tooth tissue thumb forceps aka
Adson tissue thumb forceps
Which clamps are crushing and which are non-crushing
crushing: Hasted mosquito, Rochester carmalt
non-crushing: Doyen intestinal clamp
main fx of Halsted mosquito clamp
used to crush vessels; teeth go horizontal, which should be applied perpendicular to vessels
main fx of Rochester carmalt clamp
crushes collagen-dense tissues like uterine body; grooves go parallel
main fx of Doyen intestinal clamp
to atraumatically hold off bowel
selection of needle holders
- depends on size of needle being manipulated, NOT surgeon size
- longer needle holders increase power (have longer moment arm)
- shorter needle holders increase precision
use for Mayo Hegar needle holders
suturing body wall, large dog bladder, etc.
use for Ryder needle holders
(shorter than Mayo Hegar)
-small dog/cat bladders, ureter sutures, etc.
use for Microvascular needle holders
cystotomies, etc.
3 grip styles for needle holders
1) Thumb-third finger or “tripod” grip (used in lab)
- slower, more precise
2) Thenar-eminence grip
3) Palm grip
- 2 and 3 are faster, less precise
purpose of retractors
retraction of neurovascular structures, muscle, bone
2 classes of retractors
self-retaining
hand-held
use of Finochietto retractor
retraction of sternum, ribs
Know what Gosset, Pediatric Balfour, Large Balfour, Hohmann, Malleable retractors look like
:)
use of Hohmann retractors
looking into joints
purpose of suction tips
removal of blood or fluid from operative site
-can be traumatic to tissues if used inappropriately
know what Yankauer, Poole, Adson, Frasier suction tips look like
(slide 42)
to avoid instrument corrosion:
- open any hinged instruments before cleaning
- rinse immediately after use
- no distilled or tap water
- NO SALINE (causes pitting)
- hand scrub soil
- use instrument washer
properties of instrument milk
H2O based
antimicrobial
lubricant
