Surgical instruments Flashcards
Use: designed to grasp and hold tissues and small objects (suture needles) and thus serve as an extension of the surgeon’s fingers.
Consist of two blades attached at the proximal end, and the tips come together to hold tissue as finger pressure is applied on the blades.
Thumb Forceps
Types of thumb forceps and there uses:
Anatomic/traumatic (smooth tipped) thumb forceps not for sx
Rat tooth/tissue forceps used for manipulating the skin and tough connective tissue
Adson forceps 1-to-2 toothed tip but affords precise control of instrument pressure used to grasp thin skin and light fascial planes
Brown-Adson forceps two longitudinal rows of small, fine, intermeshing teeth broad but delicate tissue grip
Russian forceps broad, round tip with grooved perimeter and concave center
DeBakey and Cooley forceps longitudinal grooves and fine horizontal striations used for vascular, thoracic, and intestinal surgeries
Use: crushing instruments designed to collapse vessels until hemostasis occurs.
Most have transverse grooves on the inner jaw surface that increase tissue purchase.
Hemostatic forceps
Types of hemostatic forceps:
Halstead mosquito forceps Kelly and Crile forceps Rochester-Pean forceps Rochester-Carmalt forceps Rochester-Ochsner forceps
These are the smallest and most frequently used hemostatic forceps. Should only be used on small vessels
Halstead mosquito forceps
These forceps are sturdier than Halstead mosquito forceps; can be used on larger vessels. (name two types and how they are different from each other)
Kelly and Crile forceps (the Crile has transverse grooves on the entire inner jaw surface while the Kelly only has grooves on half)
These forceps have deep transverse grooves over the entire surface; Used to clamp large tissue bundles or vessels.
Rochester-Pean forceps
These forceps have longitudinal grooves with a few horizontal cross-striations at the tips; made to assist in pedicle ligation.
Rochester-Carmalt forceps
These forceps have transverse grooves and 1-to-2 interdigitating teeth located at the jaw tip to help prevent tissue slippage; considered traumatic and should be reserved for tissue that is to be removed.
Rochester-Ochsner forceps
These tissue forceps have slightly bowed, flexible jaws with longitudinal striations; least traumatic to tissue
Doyen-DeBakey intestinal forceps
These tissue forceps have teeth are oriented perpendicular to the direction of pull; can be traumatic and should only be used on heavy tissue planes or on tissue to be excised
Allis tissue forceps
These tissue forceps pull in a direction perpendicular to the tissue; less traumatic than Allis tissue forceps
Babcock intestinal forceps
These tissue forceps are used to grab sponges and clean or swab tissues/cavities
(Foerster) Sponge forceps
These clamps have atraumatic longitudinally grooved jaws that contain two bends; mainly used for vascular surgery
Satinsky clamps
Use: designed to spread the wound edges to facilitate exposure of the surgical field; can be finger-held, hand-held, or self-retaining.
Retractors
Types of finger-held retractors:
Senn retractor Volkman finger retractor Parker retractor Farabeuf Meyerding
This retractor has either blunt or sharp retractor prongs on one end and a right-angled fingerplate on the other; used to retract skin and superficial muscle layers; less useful for retracting large muscle mass.
Senn retractor (finger-held)
This retractor has sharp or blunt retractor prongs and a single-ring handle
Volkman finger retractor
This retractor is larger with deeper, flat blades on both ends; allows retraction of more tissue
Parker retractor (finger-held)
Types of hand-held retractors:
Army-Navy retractors Hohmann retractors Kelly retractor Meyerding Lahey retractor
These retractors are a standard 21.5 cm (8.5 in) length; have double-ended retracting blades of two different lengths, which allows the surgeon to select a blade according to tissue depth.
Army-Navy retractors (hand-held)
These retractors have a wide variety of blade widths (6 to 70 mm); the blade has a blunt projection that is useful in exposing bone while retracting muscle.
Hohmann retractors (hand-held)
This retractor has a loop handle and broad blade that projects at a right angle relative to the long axis of the instrument with a rounded, bent-down tip.
Kelly retractor (hand-held)
This hand-held retractor has teeth
Meyerding retractor
This retractor has a smooth handle and a rectangular narrow blade that provides good tissue visibility.
Lahey retractor (hand-held)
Types of self-retaining retractors:
Gelpi retractor
Weitlaner retractor
Adson Cerebellar retractor
Aanes retractor/speculum
Balfour self-retaining abdominal retractor
Finochietto
Guyton-Park/Maumenee-Park eyelid speculum
Types of towel clamps: (4 types; what is unique characteristic)
Backhaus towel clamps; traditions, two prongs, penetrating
Jones towel clamps; spring-loaded
Lorna-Edna towel clamps; non-penetrating
Peers towel clamp; non-penetrating
Types of suction tube tips:
Yankauer tip
Frazier-Ferguson suction tip
Poole Suction tube
This suction tube tip is relatively large, allowing removal of large volumes of blood/fluid
Yankauer tip
This suction tip can have either curved or straight tube; can adjust the suction intensity by placing index finger over the hole in the handle
Frazier-Ferguson suction tip
This suction tube has multiple ports along the tube to prevent occlusion and distribute suction forces
Poole Suction tube
Use: have opposed cupping cutting jaws that allow precise removal of bone, cartilage, and fibrous tissue.
Most are single- or double-action
Rongeurs
Types of rongeurs:
Ruskin rongeurs
Stille-Luer duckbill rongeurs
Friedman rongeur/Hartman bone rongeur
Use: removing diseased bone, cartilage, debris, and damaged tissue from dense tissue surfaces. Also useful for harvesting cancellous bone grafts.
Curettes
2 Types of curettes (and describe them)
Burns curette; have a straight or angled single oval cup at the end of a grooved handle
Volkman curette; double ended with an oval cup on one end and an oval or round cup on the other.
Use: elevate periosteum and muscle attachments away from bone.
Periosteal elevator
Types of periosteal elevators:
Adson elevator
McIlwraith
Foerner
Freer
This periosteal elevator is available in blunt or sharp, and straight, curved, or full curved tip
Adson elevator
This periosteal elevator has only a sharp tip
McIlwraith periosteal elevator
This periosteal elevator is the sharpest of all, designed to free the attachment of the interosseous ligament from the proximal sesamoid bone
Foerner elevator/knife
This periosteal elevator is double-ended; narrow and has one end that is blunt and one that is sharp
Freer elevator
What are four types of bone cutting instruments?
Osteotomes
Chisels
Gouges
Bone cutting forceps
These bone cutting instruments are double-beveled at their cutting tip, better control than with a chisel.
Osteotomes
These bone cutting instruments are single beveled (moves away from the beveled edge, so need to be applied beveled side towards bone to avoid driving into the bone); preferred for removal of exostoses.
Chisels
These bone cutting instruments have a concave shape
Gouges
These bone cutting instruments can be single- (Liston) or double-action (Ruskin-Liston or Stille-Liston)
Bone cutting forceps
What are common types of Osteotomes/Chisels/Gouges?
Army-Navy, Hibbs, and Smith-Peterson
What are the types of Bone cutting forceps?
Liston bone-cutting forceps (single-action)
Ruskin-Liston or Stille-Liston (double-action)
This bone-holding forceps is curved to the side with one are longer than the other, and has a speed-lock.
Verbrugge bone-holding forceps
This bone-holding clamp is symmetric, straight, strong jaws and has a ratchet at the end to maintain bone-holding force; good for equine long bone reduction.
Kern bone-holding clamp
This bone-holding forceps contains a speed-lock and the jaws are rounded and sturdy.
Stefan bone-holding forceps
This clamp has two pointed and thin jaws; comes with either a speed-lock or ratch; most frequently used bone clamp.
Bone-reduction clamp
Which of the following is not a type of bone clamp?
- Stefan
- Kern
- Verbrugge
- Ruskin-Liston
- Ruskin-Liston bone-cutting forceps
Which of the following retractors is not self-retaining?
- Balfour
- Finochietto
- Gelpi
- Volkman
- Weitlaner
- Volkman
Which of the following are non-crushing forceps?
- Kelly
- Rochester-Ochsner
- Rochester-Carmalt
- Doyen-DeBakey
- Babcock
Doyen-DeBakey intestinal forceps are the least traumatic to tissue
Babcock intestinal forceps are also considered less traumatic.
Kelly, Rochester-Oschner, and Rochester-Carmalt are all hemostatic forceps, and therefore are “crushing” forceps
T/F: Depth control with the electro scalpel is more precise than with the cold scalpel.
False; Depth control with the electro scalpel is less precise than with the cold scalpel. Because the electrode cuts all tissue it contacts, visual control is of paramount importance. Electrosurgical incision should not be used in areas with poorly defined anatomic planes. Thermal necrosis at the wound edges can be reduced and depth control can be improved by using the lowest setting on the controls that allows clean cutting.