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Surgery 1 > Lecture 2: Common Surgical Instruments > Flashcards

Lecture 2: Common Surgical Instruments Flashcards

1
Q

List the instrument categories

A
  • Scalpels
  • Scissors
  • Needle holders/ drivers
  • Tissue forceps
  • Hemostatic forceps
  • Tissue forceps
  • Retractors
  • Misc
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2
Q

T/F: Each type of surgical instrument is designed for all uses

A

F; Each type of surgical instrument is designed for a particular use & should be used only for that purpose

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3
Q

What happens if an instrument is used for a procedure it is not designed for

A

They may dull or break

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4
Q

What are the primary cutting instruments used to incise tissue

A

scalpels

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5
Q

What scalpels are most commonly used in vet med

A

Reusable scalpel handles (No 3 & 4) with detachable blades

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6
Q

Why are disposable scalpels w/ locking retractable shield designed

A

To minimize the risk of surgical blade injuries while passing blades btw/ procedural steps & disposal

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7
Q

When is a No 10 blade most commonly used

A

In small animal surgery for incision & excision

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8
Q

Describe incision

A

Getting to the inside

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9
Q

Describe excision

A

Taking out

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10
Q

Describe a No 15 blade

A
  • A smaller version of a No 10
  • Used for precise incisions in smaller tissues
  • Used in small animal surgery
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11
Q

What is a No 11 blade used for

A

For stab incisions into fluid filled structures or organs

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12
Q

Describe a No 12 blade

A
  • Curved angle
  • Limited applicability
  • Most often used in cats for elective dissection onychectomy
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13
Q

What is an dissection onychectomy

A

Declawing

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14
Q

What is this

A

No 10 scalpel blade

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15
Q

What is this

A

No 15 blade

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16
Q

What is this

A

No 11 blade

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17
Q

What is this

A

No 12 blade

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18
Q

Which blades are use w/ No 4 blade

A

No 20

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19
Q
A
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20
Q

What is a No 20 blade used for

A
  • large animals
  • Necropsy
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21
Q

What blades are used w/ a No 3 scalpel handle

A
  • 10
  • 11
  • 12
  • 15
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22
Q

Which on is a No 4 & No 3

A
  • Top arrow = No 4
  • Bottow arrow = No 3
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23
Q

What is this

A

No 20 blade

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24
Q

What fashion are scalpels usually used in

A

Slide cutting

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25
Q

When incising the skin how should the scalpel blade be angled

A

Perpendicular to the stkin surface

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26
Q

List the ways a scalpel can be held

A
  • Pencil grip
  • Fingertip grip
  • Palmed grip
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27
Q

Describe the pencil grip

A
  • Allows for shorter (1 to 2 cm), fine, & precise incisions b/c the scalpel is @ a 30 to 40 degree greater angle to the tissue
  • Only move your fingers not your wrist
  • Reduces cutting edge contact, making it less useful for long incisions
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28
Q

Which grip is this

A

Pencil grip

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29
Q

Describe the fingertip grip (slide grip)

A
  • Offers the best acuracy and stability for long incisions ( >2cm)
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30
Q

What grip is this

A

Fingertip (slide) grip

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31
Q

Describe the palmed grip

A
  • Strongest hold on the scalpel
  • Allows exertion of great pressure on the tissue
  • Often unnecessary in surgical situations
  • Used in necropsy
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32
Q

What grip is this

A

Palmed grip

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33
Q

Label the parts of the hemostatic forceps

A
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34
Q

How are scissors classified

A
  • Type of point
  • Blade shape
  • Cutting edge
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35
Q

Which scissors offer greater maneuverability & visibility

A

Curved scissors

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36
Q

Which scissors provide the greatest mechanical advantage when cutting tough or thick tissue

A

Straight scissors

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37
Q

What are the two most common scissors used in small animal surgery

A
  • Metzenbaum (Nelson, delicate, or tissue scissors)
  • May scissors
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38
Q

Describe Metzenbaum scissors

A
  • More delicate than mayo scissors
  • Designed for sharp & blunt dissection or incision of finer tissues
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39
Q

Describe Mayo scissors

A

Used for cutting dense, heavy tissue such as fascia

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40
Q

What scissors are these

A

Suture scissors

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41
Q

What scissors are these

A

Suture removal scissors

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42
Q

When are delicate scissors (like tenotomy & iris) used

A

In opthalmic procedures & other meticulous surgeries like perineal urethrostomy that require fine precise cuts

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43
Q

Which scissors are these

A

Iris scissors

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44
Q
A
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45
Q

Describe bandage scissors

A

Have a blunt tip which reduces the risk of cutting skin when the scissors are introduced under the badange

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46
Q

What scissors are these

A

Bandage Scissors

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47
Q

Describe the Wide-based Tripod grip when using scissors

A
  • Held w/ the tips of the thumb & ring finger through the finger rings
  • The index finger is resting on the shanks
  • The ring finger or thumb should not be allowed to “fall through” the handle
  • The scissors rings should be kept near the distal finger joint
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48
Q

Why is the index finger placed along the handles towards the fulcrum in the wide-based tripod grip

A

Improves control of the tips

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49
Q

What hold is this

A

Wide Based Tripod Grip

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50
Q

Describe the backhand grip for scissors

A
  • Used for cutting from left to right (less awkward)
  • The thumb & middle finger through the rings w/ the handle resting on the third & fourth fingers
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51
Q

What scissor grip is this

A

Backhand grip

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52
Q

What type of people are scissors designed for

A

Right handed people

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53
Q

The larger the angle btw/ the blades when cutting then (__)

A

the less the scissors stabilize the tissue & the less accurate the cut

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54
Q

What does the direction, control, & accuracy of a cut depend on

A

The stability of the tissue btw/ the blades of the scissors & the stability of the scissors in the operator’s grip

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55
Q

What does using the end of the scissors blade allow

A
  • stabilizes the tissue more securely
  • Allows for a more precise cut
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56
Q

T/F: Scissors should not be competely closed if the incision is to be continued b/c it will make a ragged incision

A

True

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57
Q

How should scissors be moved to make an incision

A

Nearly closed –> advanced –> nearly closed again

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58
Q

Describe blunt dissection & what its used for

A
  • Separation of tissue by inserting the points and opening the handle
  • Used to separate loosely bound tissues like muscle or fat or to undermine skin edges for wound closure
59
Q

When should blunt dissection not be used

A

In tought tissue or where precise cuts are possible b/c it will traumatize more tissue

60
Q

Label the scissors

A
  • A = Stitch (suture removal)
  • B = Sharp-blunt
  • C = Metzenbaum
  • D = Mayo
  • E = Wire
  • F = Tenotomy
61
Q

What do needl holders (drivers) do

A

Grasp & manipulate curved needles

62
Q

What type of needle holders are needed for larger needles

A

Wider heavier jawed needle holder

63
Q

When are long needle holders used

A

In deep wounds

64
Q

How should needle drivers hold suture

A
  • The jaws should be finely serrated or smoot to prevent damaging the suture by fraying or cutting
  • Grasping suture w/ needle holders weakens the suture so grasp only @ the end of the suture where it will not be in the surgical know
65
Q

What are needle holders made of

A
  • Noncorrosive high strength alloy
  • Glare free finish
  • Tips- hardened by a diamond surface or tungsten carbide to the face
66
Q

What needle holders have ratchet locks just distal to the thumb

A
  • Mayo-hegar
  • Olsen-hager
67
Q

What needle holders have a spring & latch mechanism for locking

A

Castroviejo

68
Q

What needle holders are commonly used in vet med for manipulating medium to to coarse needles

A
  • Mayo-Hegar
  • Olsen-Hegar
69
Q

What is different about olsen-hegar needle holders

A
  • Have scissor blades that allow suture to be tied & cut w/ the same instrument
  • Expertise is req to prevent cutting durin knotting
70
Q

What needle holders are these

A

Mayo-Hegar

71
Q

What needle holders are these

A

Olsen-Hegar

72
Q

Describe Mathieu needle holders

A

Have a ratchet lock @ the proximal end of the handles which permits locking & unlocking by squeezing the handles together

73
Q

Which needle holders are these

A

Mathieu

74
Q

Label the needle holders:

A
  • A = Mayo-Hegar
  • B = Olsen-Hegar
  • C = Mathieu
  • D = Castroviejo
75
Q

Why should needles be placed perpendicular to the needle holders

A
  • allows for greates maneuverability
  • When placed @ an angle the handles must move through a wide arc during suturing
76
Q

Label the parts of the needle:

A
77
Q

Where are needles generally grasped to allow it to be advanced through tissue w/ greater force & less risk of breakage

A

Near its center

78
Q

List the pros & cons of grasping a needle near the eye or swage

A
  • Pro: Max needle length is availabe & the risk of the needle slipping is reduced
  • Con: More likely to bend or break in tougher tissue
79
Q

List the pros & cons of holding the needle the the pointed end

A
  • Pros: Allows for the greatest driving force when suturing tough tissue
  • Cons: Extracting the needle is difficult
80
Q

Explain how to hold needle drivers using the palmed grip

A

No fingers are placed in the rings & the upper ring rests against the ball of the thumb

81
Q

Explain how to hold needle drivers using the thenar grip

A

The upper ring rests on the ball of the thumb & the ring finger is inserted through the lower ring

82
Q

Explain how to hold needle drivers using the thumb ring finger grip

A

Thumb is placed through the upper ring finger through the lower ring

83
Q

Can needle holders be held by using the pencil grip

A

Yes

84
Q

Why can left handed surgeons not palm right handed instruments

A

B/c the boxlock closes rather than opens w/ pressure

85
Q

Describe the palmed grip

A

Provides a strong driving force but less precision

86
Q

Explain the thenar grip

A

Provides good mobility but releasing the needle holder by applying pressure w/ the ball of the thumb to the upper ring causes the handles to “pop” apart. This causes some movement of the needle in the tissue being sutured

87
Q

Describe the thumb ring finger grip

A

Allows for the best precision of all grips & is preferable when suturing delicate tissue

88
Q

When is the pencil grip used for needle drivers

A

When using castoviejo needle holders

89
Q

Why can tissue forceps w/ large teeth not be used to handle tissue

A

Can easily traumatize the tissue

90
Q

What are forceps w/ smooth tips (like debakey forceps) used for

A

Manipulation of delicate tissue like viscera or blood vessels

91
Q

Describe the Brown-Adson forceps

A
  • Most commonly used
  • Have small serration on the tips that min trauma but facilitate holding tissue securely
92
Q

T/F: Tissue forceps are held in the dominant hand

A

False; held in the nondominant hand in a pencil position

93
Q

T/F: Holding the shanks in the palm greaatly limits maneuverability

A

True

94
Q

What are tissue forceps used for

A

To stabilize tissue &/or expose tissue layers during suturing

95
Q

How should needles be grasped using forceps

A

Perpendicular to the shaft

96
Q

Label the forceps from left to right

A
97
Q

Label the forceps top to bottom

A
  • Top: 1x2 tissue (rat tooth)
  • Middle: Brown-Adson
  • Bottom: Bishop-Harmon (smooth tip)
98
Q

What forceps are these

A

DeBakey

99
Q

What are hemostatic forceps used for

A

Crushing instruments used to clamp blood vessels

100
Q

What hemostats are these

A

Mosquito hemostats

101
Q

What hemostats are these

A

Angiotribe Hemostats

102
Q

Longitudinal serrations on hemostatic forceps are (harsher/gentler) to tissue than cross serrations

A

Gentler

103
Q

Serrations usually extend from where to where

A

From the tips of the jaws to the boxlocks

104
Q

What is the difference in the kelly forceps serrations

A

Has transverse serrations that extend only over the distal portion of the jaws

105
Q

What is the difference in the crile forceps serrations

A

Has transverse serrations tha textend the entire length of the jaw

106
Q

What hemostats are these

A

Kelly hemostats

107
Q

What hemostats are these

A

Crile hemostats

108
Q

What hemostats are used on larger vessels

A
  • Kelly
  • Crile
109
Q

Describe Rochester-carmalt forceps

A
  • larger crushing forceps often used to control large tissue bundles (ex during an ovariohysterectomy)
  • Have longitudinal grooves w/ cross-grooves @ the tip ends to prevent slippage
110
Q

Which forceps allow occlusion of only a portion of the vessel

A

Specialized cardiovascular forceps like satinsky forceps

111
Q

What forceps are these

A

Rochester-Carmalt forceps

112
Q

What forceps are these

A

Satinsky forceps

113
Q

What do the serrations of cardiovascular clamps provide

A

Tissue compression w/out cutting delicate vessel walls

114
Q

Why are there large teeth @ the tip ends of some forceps (ex Ochsner)

A

To help prevent tissue slippage w/in the forceps

115
Q

Label the following:

A
  • A = Mosquito hemostat
  • B = Kelly hemostat
  • C = Crile hemostat
  • D = Rochester-Carmalt Hemostat
116
Q

Label the jaws of the forceps

A
  • A = Mosquito
  • C = Kelly
  • D = Rochester-Carmalt
117
Q

What are tissue forceps used for

A

To grasp or clamp tissue varying the degree of tissue trauma that is created

118
Q

Describe Allis Tissue Forceps

A
  • Have interlocking sharp teeth
  • Used to firmly grasp tissue that is going to be removed from the body
119
Q

Describe Babcock tissue forceps

A
  • Have broad, flared, & blunt grasping tips
  • More delicate & can be used carefully on tissue remaining in the body (like the stomach)
120
Q

Describe Doyen intestinal forceps

A
  • Noncrushing accluding forceps
  • Shallow longitudinal striations that are used to temporarily occlude the lumen of the bowel
121
Q

What are retractors used for

A

To retract tissue & improve visualization

122
Q

T/F: Some hand held retractors may be bent by the surgeon to conform to the structure or area of the body

A

True

123
Q

Describe Senn (rake) retractors

A
  • Small
  • double ended
  • Three small fingerlike projections on one end
  • Flat curved blade on the other
124
Q

Describe army-navy retractors

A
  • large
  • blunt broad blades on each end
  • Used for retraction of largeamounts of tissue
125
Q

What retractors are these

A

Senn Retractor

126
Q

Label these retractors

A
  • A = Senn
  • B = Army-Navy
  • C = Malleable
  • D = Hohmann
127
Q

What are balfour retractors used for

A

To retract the abdominal wall

128
Q

What are finochietto retractors used for

A

Commonly used during thoracotomies

129
Q

Label the self-retaining retractors

A
  • Left = Gelpi (used in joint surgery)
  • Right = Weitlaner
130
Q

Label the self retaining retractors

A
  • Left = Finochietto (used for spreading the ribs)
  • Right = Balfour (used in the cranial abdomen)
131
Q

What are magnifying loupes useful for

A
  • Precise cutting or suturing of tissue is necessary
  • Handling relatively small tissues
132
Q

What is this

A

Arthrex meniscal knives

133
Q

Label these suction tips

A
  • Top = Poole
  • Middle = Yankauer
  • Bottom = Frazier
134
Q

Label these clamps & forceps

A
  • A = Backhaus towel clamp
  • B = Allis tissue forceps
  • C = Babcock forceps
135
Q

Label the rongeurs from left to right

A
  • Left = Lempert
  • Middle = Ruskin
  • Right = Kerrison
136
Q

What are these

A

Duck bill double action rongeurs

137
Q

Label these bone holding forceps

A
  • A = AO reduction forceps
  • B = Large speed lock reduction forceps
  • C = Lane bone holding forceps
  • D = Small clamshell reduction forceps
138
Q

What is this

A

AO round edge periosteal elevators

139
Q

What is this

A

AO-curved blade & straight edge periosteal elevators

140
Q

What is this

A

Freer perosteal elevators

141
Q

Label this orthopedic equipment from top to bottom

A
  • Top = Chisel
  • Middle = Mallet
  • Bottom = Orthopedic wire & wire twisters
142
Q

Label this orthopedic equipment from left to right

A
  • Left = Jacobs chuck & key
  • Middle = Steinmeann pins & Kirschner wires (pin caddy)
  • Right = bone cutter
143
Q

What is this

A

Hall aire drill & assorted bits

144
Q

Label the neurosurgery equipment

A
  • A = Lens loop
  • B = Small nerve root retractor
  • C = Tartar scraper
  • D = Freer dissector
  • E = Large right angle nerve root retractor

Surgery 1 (4 decks)

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