Lecture 5 8/27/24 Flashcards
Which blades are held by a #3 scalpel handle?
-10
-11
-12
-15
What are the characteristics of the #3 scalpel handle?
-most frequently used
-holds smaller blades
-used for more delicate procedures
Which blades are held by a #4 scalpel handle?
-20
-21
-22
-23
-24
-25
What are the characteristics of a #4 scalpel handle?
-holds larger blades
-used for less delicate procedures
What are the characteristics of a #10 blade?
-preferred by most surgeons
-longest cutting surface of the small blades
What are the characteristics of a #15 blade?
-smaller version of the #10
-smaller cutting surface
-used for precise incisions
What are the characteristics of a #11 blade?
-pointed blade
-used for stab incisions during arthroscopic surgery
What are the characteristics of a #12 blade?
-curved blade
-used for removing sutures
-used for periosteal stripping and for opening abscesses
Why are disposable blades preferred to reusable blades?
-disposable blades are consistently sharp
-reusable blades are dulled by heat and chemicals
What are the characteristics of mayo scissors?
-straight version for straight cuts
-curved version for cuts around corners
-used for cutting connective tissue
What are the characteristics of metzenbaum scissors?
-straight and curved versions
-reserved for delicate soft-tissue dissection
-NOT used for suture cutting
What are suture scissors?
specially designated scissors only used for cutting suture, as suture cutting rapidly dulls the blades
What are the characteristics of all-purpose utility bandage scissors?
-have serrated blade
-serrated blade prevents bandage material from slipping while being cut
What are the characteristics of lister bandage scissors?
-lower blade has blunt tip
-blunt blade allows for insertion beneath bandage without damaging skin
What is unique about the grasping surfaces of needle holders?
they are crosshatched with a central longitudinal groove
What is an olsen-hegar needle holder?
combination of needle holder and scissors
What is a mayo-hegar needle holder?
standard needle holder with cross-hatched grip surface and ring handle only; no scissors
What is a mathieu needle holder?
needle holder that lacks finger holes and instead has a box lock
How does needle size impact choice of needle holder?
-want needle holder with narrow jaw width for small needles
-want needle holder with wide jaw width for larger needles
What is the purpose of thumb forceps?
to grasp and hold tissues and small objects
What are the characteristics of rat tooth thumb forceps?
-most aggressive
-used for manipulating skin and tough connective tissues
-available in 1-to-2, 2-to-3, and 4-to-5 interlocking tooth patterns
What are the characteristics of adson tissue forceps?
-1-to-2 interlocking tooth pattern
-used to grasp thin skin and light fascial planes
What are the characteristics of brown-adson tissue forceps?
-2 longitudinal rows of small intermeshing teeth
-provides a broad, delicate grip
-facilitates grasping of suture needle
What are the characteristics of Russian tissue forceps?
-broad, round tip
-grooved perimeter and concave center
-less traumatic than adson and brown-adson forceps
-good for grasping needles
What are the general characteristics of hemostatic forceps?
-used for hemostasis of vessels
-have transverse grooves to increase purchase of tissue
What are the characteristics of Halstead mosquito forceps?
-smallest and most frequently used
-used on small vessels
What are the characteristics of kelly and crile forceps?
-sturdy
-used for crushing large vessels
How do kelly and crile forceps differ?
-kelly forceps have grooves restricted to the distal half of the jaw
-crile forceps have grooves on the entire jaw surface
What are the characteristics of Rochester-Pean forceps?
-used to clamp large tissue bundles and vessels
-deep transverse grooves over entire jaw
What are the characteristics of Rochester-Ochsner forceps?
-2 interdigitating teeth to prevent tissue slippage
-traumatic and therefore reserved for tissue being removed
What are the characteristics of Rochester-Carmalt forceps?
-often used for pedicle ligation
-jaw grooves run longitudinally
-grooves facilitate removal during ligation
What are the characteristics of Doyen-DeBakey intestinal forceps?
-occlude lumen of small intestine with minimal trauma
-flexible jaw with longitudinal serrations
What are the characteristics of allis tissue forceps?
-teeth are oriented perpendicular to direction of pull
-used to grip heavy tissue or tissues being excised
-NOT for skin
What are the characteristics of Babcock intestinal forceps?
-used to grab viscera
-less traumatic than Allis forceps
What are the characteristics of Satinsky clamps?
-atraumatic, longitudinally grooved jaws with two bends
-used for vascular surgery
What is the purpose of sponge forceps?
used to grab sponges for swabbing tissues or cavities
What are the characteristics of a senn retractor?
-finger-held
-blunt or sharp retractor prongs at one end
-right-angled finger plate at other end
What are the characteristics of an army-navy retractor?
-hand-held
-double-ended retracting blades of two different lengths
What are the characteristics of a kelly retractor?
-hand-held
-loop handle and a broad blade with a round, bent tip
What are the characteristics of a ribbon malleable retractor?
-hand-held
-able to bend blade to desired length
What are the characteristics of a gelpi retractor?
-self-retaining
-grip lock mechanism
-two outwardly pointed tips
What are the characteristics of a weitlaner retractor?
-self-retaining
-2-to-3 or 3-to-4 outwardly pointed blunt or sharp prongs
What are the characteristics of a balfour retractor?
-self-retaining
-improves exposure in abdominal surgeries
What are the characteristics of a finochietto retractor?
-self-retaining
-designed as a rib spreader
-also used for vestibule/vagina/cervix surgery in mares
What are the characteristics of backhaus towel clamps?
-most common
-used to attach draping to patient
What is the main characteristic of roeder towel clamps?
contains ball stops to prevent deep tissue penetration and minimize towel slippage
What is the use of a yankauer suction tube?
removal of large volumes of blood or fluid from surgical site
What is the use of a frazier-ferguson suction tube?
suction in confined areas that can be better controlled by placement of a finger over the hole on the handle
What is the use of the poole suction tube?
useful in the abdomen due to its multiple ports; less likely to be plugged by omentum
What are rongeurs?
tool with opposed cupped cutting jaws used for removal of bone, cartilage, and fibrous tissue
What are curettes?
instruments with sharp oval or round edges for removing diseased bone, cartilage, debris, and/or damaged tissue
What is the function of periosteal elevators?
elevate periosteum and muscle attachments away from bone
How do the different bone-cutting instruments differ?
-osteome: double-beveled
-chisel: single-beveled
-gouge: curved blade
What happens if a chisel is reversed?
it goes from moving along the bone surface to diving deep into bone
What is a Jacobs chuck?
pin insertion instrument that accepts pin and has an extension to protect surgeon
What is a galt trephine?
instrument used to remove a cylinder of bone; has an adjustable central trocar for centering and stabilizing
What is a michele trephine?
trephine with a graduated scale along the shaft to allow for measurement of penetration depth
How should a scalpel be handled?
blade attached and detached with needle holder or hemostat; never fingers
What are the characteristics of the scalpel pencil grip?
-distal end of handle grasped between thumb and index finger while resting on middle finger
-tip of middle finger contacts patient
-only fingers moved
-incision made with tip of scalpel
What are the advantages and disadvantages of the pencil grip?
advantages:
-precise cuts
-good for short incisions
disadvantages:
-steep angle
-decreases contact of cutting edge with skin
What are the characteristics of the scalpel fingertip grip?
-index finger rests on top of blade to control downward pressure
-tips of other fingers placed beneath handle
-tip of thumb placed on other side of handle
What are the advantages of the fingertip grip?
-good for long straight or curved incisions
-greater cutting surface
-optimal for depth control
What are the characteristics of the scalpel palm grip?
-fingers and palm wrapped around handle
-thumb placed on top edge of blade
-strongest grasp
What are the characteristics of scissor handling?
-cutting action is most effective near tips
-straight blades are better for cutting dense tissue
-use a tripod/thumb-ring finger grip
What are the types of needle holder grips?
-tripod grip
-thenar eminence grip
-palm grip
How should thumb forceps be handled?
-pencil grip in non-dominant hand when manipulating or stabilizing tissue
-rested in palm when not in use
How should hemostatic tissue forceps be handled?
tripod grip
What are Halsted’s principles?
-gentle handling of tissue
-meticulous hemostasis
-preservation of blood supply
-strict aseptic technique
-minimum tension on tissues
-accurate tissue apposition
-obliteration of dead space
