Psychomotor and Hand Ties

Question 1

What are psychomotor skills?

Answer 1

learned physical skills involving coordination

Question 2

Give examples of psychomotor skills in everyday life and in clinical medicine.

Answer 2

Everyday life
- playing muscial instrument
- brushing your teeth
Clinical Medicine
- instrument handling
- venipuncture

Question 3

How do you learn psychomotor skills?

Answer 3

Practice

Question 4

Why does instrument handling matter?

Answer 4

• maximized precision
• gentler on patient tissue
• decreases surgical time
• improves surgical outcome
• increases surgeon comfort

Question 5

Explain how to arm a scalpel handle.

Answer 5

• slant on blade and handle should match
• lock needle drivers just above central cut
• do not grasp across cutting edge
• engage blade in wider portion of cut out
• slide blade toward you until it clicks in place
• blade should face away from the hand that is loading the blade

Question 6

Explain how to remove a blade from scalpel handle.

Answer 6

• turn handle and blade upside down so that the central cut out faces the floor
• lock driver at or below central cut out
• gently rotate enough to clear lip
• pull handle up and away from self and others (aim blade toward table or floor)

Question 7

When incising skin, the incision is made from where towards where?

Answer 7

from non dominant hand towards the dominant hand

Question 8

When incising skin, the skin is stretched what direction to the incision?

Answer 8

perpendicular

Question 9

How many throws make a knot?

Answer 9

two

Question 10

How many knots make a secure ligature? Throws?

Answer 10

2 knots
4 throws

Question 11

Knots are named after what?

Answer 11

the first throw

Question 12

All throws after the first are what?

Answer 12

square throws

Question 13

What is the most commonly used knot in surgery?

Answer 13

square knot

Question 14

Which knot is the most secure surgical knot and symmetrical?

Answer 14

square knot

Question 15

What knot is a friction knot?

Answer 15

surgeons knot

Question 16

Which knot is used on large pedicles or closure with tension to prevent loosening of first throw?

Answer 16

surgeons knot

Question 17

What are the disadvantages of a surgeons knot?

Answer 17

• easily pulled up
• less secure
• adds more suture to wound

Question 18

What occurs when uneven tension is applied to suture ends or when suture is oriented away from the direction the suture was placed?

Answer 18

half hitch

Question 19

What occurs when you perform the same throw twice in a row?

Answer 19

granny knot

Question 20

Which knot error is difficult to distinguish from a square knot once tied?

Answer 20

granny knot

Question 21

Do extra throws add strength to a properly tied knot?

Answer 21

No, they just add bulk

Question 22

What is the correct grip for a ringed instrument?

Answer 22

tripod grip

Question 23

Describe a tripod grip.

Answer 23

• forefinger braces shank
• thumb rests on ring

Question 24

What scalpel grip should you use for short incisions?

Answer 24

pencil grip

Question 25

What scalpel grip should you use for long insisions?

Answer 25

slide grip

Question 26

When ligating large vessels or closing tissues (such as skin closure after a mass removal), what knot can be substituted for a square knot?

Answer 26

Surgeon’s knot

Question 27

What is the purpose of substituting a surgeon’s knot for a square knot when ligating large vessels or closing tissues?

Answer 27

To add friction which keep the first throw (surgeon’s throw) tight while the second throw (square throw) is being completed