Surgery Flashcards
what is the proper grip for towel clamp
thumb and ring finger
3 scalpel is used for ____________; #7 scalpel is used for __________
skin; within the abdomen
what type of blade would you use to cut skin
10
what type of blade would be used for neuro surgery
11
what type of blade would you use within the abdomen
15
when do you use a finger grip
initial and longer incisions
when do you use a pencil grip
stab or short incision
how do you cut through the linea alba
reverse press cut (blade facing upwards; with tenting)
thumb forceps should be held in what hand
non-dominant
adson tissue forceps have how many teeth
3
adson tissue forceps are used for
general tissue handling (ex. sub q and linea alba during closure)
adson brown tissue forceps are used for
stronger grasp of tissues (ex. to tent linea alba during abdominal approach)
what is the least traumatic forcep
debakey
debakey forceps are used for
handling vessels, bladder, GI wall
why would you NOT use debakey forceps during an ortho surgery
would sharpen the teeth and cause tissue damage the next time you use them (would use adson tissue instead)
is an olsen or mayo hegar used at OVC
mayo
what is the significance of different sizes of needle drivers
small needle driver for small needles and vice versa
what grip is used for needle drivers
tripod (thumb and fourth finger; index to stabilize)
what type of scissor is long and skinny
metzembaum
when do you use mayo scissors
hard to cut tissues
when do you use metzembaum scissors
delicate tissue (fat; soft tissue)
what do you use sharp-blunt scissors for
cutting sutures
T/F you use metzembaum to cut the linea alba
F; you use mayo
what hemostat is used to clamp large pedicles, such as during ovariohysterectomy
carmalt
carmalts have ____________ striations along the entire length and __________ striations at the tips
longitudinal; cross
what is a kelly or crile hemostat used for
clamping smaller pedicles
how do you tell a kelly from a crile
kelly 1/2 striated; crile full length
what are mosquito hemostats used for
clamping single vessels (using tip) or small pedicles (using body)
what is a spay hook used for
retrieve uterine horn during OHE
swaged needles make ______ holes and are ________ risk of leaking, whereas eyed needles make _______ holes and are _________ risk of leaking
smaller; lower; larger; greater
what is one example of eyed suture
cat gut
all suture at ovc is (swaged or eyed)
swaged
absorbable suture
loses significant tensile strength within 60 days of implantation
non-absorbable suture
retains 100% of tensile strength for at least 60 days
how are natural fibers absorbed
collegenases or elastases (enzymatic digestion)
how are synthetic fibers absorbed
hydrolysis
what influences speed of suture absorption
suture, patient, environment
does PDS or monocril absorb faster
Monocril
what should guide your decision when choosing a suture
the speed in which the tissue will heal (ex. soft tissue vs tendons)
what can speed degradation of suture
infections and pH
how long does fascia such as the linea alba take to heal
6-7 weeks
what type of suture would you use on tendon injuries
non-absorbable
intestine takes how long to heal
3 weeks
what is a factor to consider when choosing suture for the stomach
takes only 2 weeks to heal BUT also low pH
when do you use knotless barbed suture
minimally invasive surgery
why might you use coated sutures
improved pliability, knot formation, reduced drag, reduced risk of infection
T/F good quality suture has a lot of memory
F; it should have little memory
what is capillarity
degree to which a suture will absorb fluid following immersion
what are two examples of natural twisted filaments
catgut, collagen
T/F multifilaments have greater tissue drag
T
T/F there is 1-0 suture
F
there is a tradeoff between __________ and _________ with suture sizes
strength; knot security
match the name to the suture type:
Poliglecaprone 25
Polyglycolic acid
Polyglactin 910
Nylon
Polyglytone 6211
Polydioxanone
Monocril
Vicryl
PDS II
Dexon
Caprosyn
Ethilon
Poliglecaprone 25 - Monocryl
Polyglycolic acid - Dexon
Polyglactin 910 - Vicryl
Nylon - Ethilon
Polyglytone 6211 Caprosyn
Polydioxanone - PDS II
T/F monocryl has a high initial breaking point
T
if needing a slowly absorbable suture, what is a good option
PDS II (polydioxanone)
monocryl loses 50% of its strength after how many weeks
1
PDS II loses 50% of its strength after how many weeks
5-6
what is a good suture option for linea alba
PDS II
what is a good option for sub q, intradermal and urinary tract closure
Monocryl
T/F non-absorbable suture cause little to no reaction
T
when are skin sutures typically removed
10-14 days post-op
when are staples used
when time is of the essence
what is used to close the linea alba at OVC
PDS
what is used for spay/neuter ligations at OVC
PDS or Monocryl
what is used to suture skin at OVC
prolene (or staples if good patient and long anaesthetic time)
what should you use for hollow viscera
PDS (Monocryl if bladder)
What should you use for intradermal or sub q suturing
Monocryl
to remove memory from suture, where should you hold
suture (NOT the needle as it may come off)
apposing suturing is used for (2)
skin, intestine
inverting suturing is used for (2)
bladder, stomach
when would you use simple interrupted
linea alba; GI
what type of suture pattern is good for skin
cruciate
when would you use simple continuous
viscera, linea alba, intradermal, sub Q
what type of suture pattern produces more even tension
simple continuous
what is a square knot
2 opposing, mirror image throws
how many throws are necessary for simple interrupted
5
what is special about a surgeons throw
one extra pass through the first loop
T/F surgeons knot is safer
F
what are the rules for simple continuous
one extra throw for first knot (6) and two extra throws for last know (7)
what are the minimum size tags
2-4 mm
how is a slip knot created
uneven tension; pulling up instead of being parallel with table
how long should tags on skin sutures be
6-10 mm
is a circumferential or transfixing knot more secure
transfixing
