Surgical Instruments and Suture Review Flashcards
1
Q
Identify this instrument.
A
Jacob’s Chuck
- Used to drive IM pins and K-wires during orthopedic surgery
- Key used to tighten or release pin grip
- May have attachment for protecting surgeon’s hands from pin penetration near top of handle
2
Q
Identify this instrument.
A
Straight Mayo Dissecting Scissors
- Plain edge (vs. serrated edge)
- Thick blades (~1/3 of instrument length)
- Used to incise dense tissue (fascia, linea alba, trimming skin)
- Blades can be straight or curved
- Straight blade: greater mechanical advantage
- Curved blade: improved visualization of tissue, more versatile
3
Q
Is polypropylene an absorbable or non-absorbable suture material?
A
non-absorbable
4
Q
These suture properties are ideal for use in infected tissues:
A
absorbable and monofilament
5
Q
These are small, specialized tissue forceps used for ophthalmic surgery:
A
Bishop-Harmon Tissue Forceps
6
Q
This antibiotic can be added to a suture coating to help prevent bacterial growth in a surgical wound:
A
Triclosan
7
Q
Identify this instrument.
A
Babcock Tissue Forceps
- Smooth flat tips are used to grasp tissue
- Grasps tissue at right angles of tension application
- Tips can crush but are less traumatic than Allis tissue forceps
- Used for helping to grasp and retract robust soft tissues (stomach, bladder)
8
Q
When is silk suture used?
A
Cardiovascular surgery
9
Q
Is chromic gut an absorbable or non-absorbable suture material?
A
Absorbable
10
Q
This refers to a suture’s ability to resist deformation or breakage:
A
tensile strength
11
Q
Self-inflicted injuries can occur when using this instrument to drive Steinman pins:
A
Jacob’s chuck
12
Q
T/F: Nylon suture is very resistant to degradation due to its lack of hydrolyzable bonds
A
False
Nylon is susceptible to degradation. Hydration may lead to disruption of hydrogen bonds leading to loss of tensile strength.
13
Q
This hemostat has multiple uses including occlusion of small vessels and securing stay sutures:
A
Mosquito hemostats
14
Q
This suture is rarely used due to the severe inflammatory reaction it can cause:
A
catgut
15
Q
Identify this instrument
A
Backhaus Towel Clamp
- Penetrating clamp
- Used to hold quarter drapes or Huck towels securely to patient skin
16
Q
Identify this instrument.
A
Straight Metzenbaum Scissors
- Plain edge (vs. serrated edge)
- Thin, delicate blades (~1/4 of length of instrument)
- Used to incise soft tissues (subcutaneous tissues, intestine, bladder, etc)
- Blades can be straight or curved
- Straight blade: greater mechanical advantage
- Curved blade: improved visualization of tissue, more versatile
17
Q
This type of monofilament suture has many uses including closure of enterotomies, cystotomies, and many other –otomies:
A
polydioxanone
18
Q
Identify this instrument
A
Extraction Forceps
- Strong, heavy instrument used to grasp loose/luxated teeth for extraction
- Various sizes and tips to accommodate different shaped teeth
19
Q
Identify this instrument
A
Dental Explorer
- Increases tactile sensation for detecting areas of enamel decay
20
Q
When is polymerized caprolactam suture used?
A
Skin sutures ONLY
Not recommended for implantation in tissues due to sinus formation
21
Q
Because of rapid loss in tensile strength, this suture type should not be used for slower healing tissues:
A
polyglycolic acid or polyglactin 910
22
Q
Identify this instrument
A
Straight Kelly Hemostatic Forceps
- Transversely oriented serrations
- Serrations do not extend the entire length of the jaw (unlike with Mosquito or Crile hemostatis forceps)
- Designed for tip clamping of small to medium vessels
- Smaller than Rochester-Carmalt, bigger than Halstead-Mosquito
23
Q
Identify this instrument
A
Periodontal Probe
- Long, thin, blunt tipped instrument
- Used to measure pocket depths around a tooth
- Establishes the state of health of the periodontium.
24
Q
Identify this instrument
A
Lempert Rongeur
- Forceps with cupped jaws and blunted or tapered tips
- Used to remove small fragments of bone, to recontour bone, or to prepare bone for grafting
- Jaws mat be straight, curved or angled
- Lempert has finer tipped jaws and are used in more restricted areas (bulla osteotomy)
25
Identify this instrument.
**Malleable Retractor**
* Double ended blunt retractor
* Various sizes
* Can be bent at various angles
* Used for retracting viscera in abdominal and thoracic surgery
26
Identify this instrument
**Scaler**
* Removes dental deposits from above gumline
* Variety of tips and shank angles to allow access between teeth
27
When is **caprolactone suture** used?
**Closure of cystotomies (non-infected bladders), subcutaneous tissues**
28
In what application is **Polyglactin 910 suture** most commonly used?
**Dental surgery**
29
Identify this instrument.
**Spencer Stitch Scissors**
* Hooked tip used to entrap suture for cutting
* Used for post-op suture removal
* Not generally used in OR
30
This concentration of chlorhexidine solution is appropriate for preputial flushes and cleaning open wounds:
**0.05%**
31
Identify this instrument.
**Hohmann Retractor**
* Various sizes with variety of tip lengths and styles (blunt vs. sharp)
* Used to lever muscle and soft tissues away from surgical field and bone during orthopedic surgeries
32
Identify this instrument
**Freer Periosteal Elevator**
* Small periosteal elevator
* Double ended
* Standard in every orthopedic surgery pack
33
Identify this instrument.
**Olsen-Hegar Needle Holders**
* Combined needle driver/scissor
* Must have experience with instrument to avoid accidentally cutting suture prematurely
* Various sizes available
* Size of driver jaws should match needle size
* Textured tungsten-carbide jaw inserts provide intermediate needle holding security over smooth jaws or jaws with teeth
* Limits twisting and rotation of needle
34
Identify this instrument.
**Stevens Tenotomy Scissors**
* Narrow, delicate tipped precision scissors – Pointed or blunted tips
* Used for precision cutting, such as in ophthalmic and urologic surgery
* Straight or curved blade
35
Identify this instrument.
**Bishop-Harmon Forceps**
* Tips consist of fine teeth (2 x1) at a right angle
* Smaller than other thumb forceps
* Used to grasp tissue in ophthalmologic surgery
36
This self-retaining retractor is used to keep the abdominal wall open during a laparotomy:
**Balfour Retractor**
37
Identify this instrument.
**Castroviejo Needle Holders**
* Microsurgery needle driver
* Used for ophthalmic and vascular surgery
* Spring loaded handle
* Releases and grabs needle with minimal motion of hands
* Locking and non-locking styles
38
T/F: **Polypropylene suture** is very resistant to degradation due to its lack of hydrolyzable bonds
**True**
39
Identify this instrument.
**Balfour Retractor**
* Blunt blades of used to retract abdominal wall laterally
* Various sizes (pediatric- large)
* Central “bladder blade” can be used to retract rib cage cranially (access to liver and diaphragm
* Must be used with caution to protect underlying tissues
40
Identify this instrument.
**Mallet**
* Metal or nylon capped
* Used in orthopedic surgery to advance an osteotome for making precise osteotomies
41
Identify this instrument.
**Finochietto Retractor**
* Adjustable rib retractor
* Various sizes (pediatric – large)
* Used for retraction of chest wall during intercostal thoracotomy and median sternotomy
* Flat retractor blades are perpendicular to instrument
42
Identify this instrument
**Wing Tipped Dental Elevator**
* Wing tipped elevators are used to sever the periodontal ligament by rotating the instrument around the tooth
43
Identify this instrument.
**Vernon Cartilage and Wire Scissor**
* Smooth or serrated blades
* Used to incise thick, tough tissue and orthopedic wire
* Can be used to cut suture intra-operatively
44
Identify these instruments
**Chisel (A) and Osteotome (B)**
* Osteotome is bevelled on both sides and a chisel is bevelled on one side
* Osteotomes are used more commonly
* Various tip widths
* Used to create osteotomy in numerous orthopedic procedures
45
This “Jekyll and Hyde” retractor has a blunt and a forked end for increasing its utility:
**Senn Retractor**
46
Identify this instrument.
**Kern Bone Holding Forceps**
* Used to grip and manipulate bone during fracture reduction and repair
* Pediatric and adult sized instruments
* Jaws are serrated with grasping points at tips to promote strong grip on bone
* Ratcheted handle with quick release lever
47
Identify this instrument
**Barraquer Eyelid Speculum**
* Wire self retaining instrument used hold eyelids open during enucleations, and surgery of the cornea and third eyelid
48
This type of needle driver can also cut suture:
**Olsen Hagar**
49
This surgical prep has residual activity lasting hours beyond the actual contact time:
**Chlorhexidine**
50
What is the most commonly utilized scalpel handle?
**Bard-Parker Number 3 Scalpel Handle**
* Accepts disposable blades
* #10, 11, 12, and 15
* Ribbed grip area
* May have measurement scale on handle
51
Identify this instrument.
**Adson Tissue Forceps**
* Tips consist of fine teeth (2x1)
* Results in less crush injury than with Brown-Adson tissue forceps
* Poor grip of fat or other friable tissues
52
Identify this instrument.
**Snook Hook/Spay Hook**
* Flat, thin handle allows for better visualization of tissue
* Used to blindly hook the uterine horn/mesometrium during OHE
* Can be used to retract thinner layers of superficial tissue
53
Identify this instrument.
**Mayo-Hegar Needle Holders**
* Various sizes available
* Size of driver jaws should match needle size
* Textured tungsten-carbide jaw inserts provide intermediate needle holding security over smooth jaws or jaws with teeth
* Limits twisting and rotation of needle
54
Is **Glycomer 631** an absorbable or non-absorbable suture material?
**absorbable**
55
Identify this instrument
**Poole Suction Tip**
* Attaches to suction hose
* Used to suction large amounts of fluid from body cavity
* Blunt tip prevents trauma to organs
* Inner cannula unscrews and can be used as a modified Frazier suction tip
56
Identify this instrument.
**Derf Needle Holders**
* Ophthalmic needle drivers
* Small size useful for suturing smaller structures (eyelids, conjunctiva)
57
Identify this instrument.
**Weitlaner Retractor**
* Ringed retractor with self-retaining ratchet
* Various sizes
* Multiple pointed prongs on each arm
* Useful for retraction of soft tissue in a small, superficial incision
* Must take care with tips to avoid injury to underlying soft tissues
58
What is the most commonly used needle shape?
**1/2 circle**
59
This monofilament, non-absorbable suture is commonly used to place skin sutures:
**Nylon**
60
Identify this instrument
**Curved Halsted Mosquito Hemostatic Forceps**
* Transversely oriented serrations
* Serrations extend along the entire length of the jaw
* Designed for tip clamping of small vessels
* Smaller than Rochester-Carmalt and Kelly hemostatic forceps
61
Identify this instrument.
**Speed Lock Bone Holding Forceps**
* Used to grip and manipulate bone during fracture reduction and repair
* Pediatric and adult sized instruments
* Tips can be serrated or pointed
* Locking mechanism easily manipulated with fingers
62
Identify this instrument.
**Allis Tissue Forceps**
* Intermeshing teeth at tip are used to grasp tissue
* Grasps tissue at right angles of tension application
* Should only be used on tissues to be discarded due to crushing effect of tips
* Will create severe crush artifact therefore should not be used on tissues submitted for histopathology
* Frequently used for positioning of suction tubing and electrocautery wire on patient drape
63
Identify this instrument
**Curette**
* Used for subgingival cleansing, root planing and curettage
* Double ended instrument
* Each end has one blade with one cutting edge
64
Identify this instrument.
**Senn Retractor**
* Double ended retractor
* Blunt or sharp fork on one end and right angle blade on other end
* Used in soft tissue and orthopedic surgery for retraction of tissues in small working spaces
* Hand held retractor typically used by assistant
* Used for both soft tissue and orthopedic surgery
65
This group of surgical scrubs has a broad spectrum of activity but is deactivated in the presence of organic material:
**iodophors**
66
Identify this instrument
**Periosteal Elevator**
* Used to reflect muscle and soft tissue from bone
* Various sizes with round or straight edges
67
Identify this instrument
**Calculus removal forceps**
* Uneven tipped instrument useful in removing large pieces of calculi prior to scaling
68
When is **nylon suture** used?
**Skin closure, orthopedic repair (lateral tibiofabellar suture)**
69
Identify this instrument.
**Straight Kelly Hemostatic Forceps**
* Transversely oriented serrations
* Serrations do not extend the entire length of the jaw (unlike with Mosquito or Crile hemostatis forceps)
* Designed for tip clamping of small to medium vessels
* Smaller than Rochester-Carmalt, bigger than Halstead-Mosquito
70
Identify this instrument.
**Army-Navy Retractor**
* Double ended blunt retractor
* Blades differ in length
* Hand held retractor typically used by assistant
* Used for both soft tissue and orthopedic surgery
71
This retractor is great at retracting the biceps femoris and vastus lateralis but watch out to not puncture that sciatic nerve:
**Gelpi Retractor**
72
Identify this instrument.
**DeBakey Tissue Forceps**
* Parallel ribbed tips
* Most frequently used thumb forceps in soft tissue surgery
* Less traumatic than Brown-Adson thumb forceps
73
Identify this instrument.
**Straight Rochester-Carmalt Hemostatic Forceps**
* Designed for jaw clamping (vs. tip clamping)
* Used for clamping pedicles/tissue
* Longitudinally oriented serrations with cross-hatched tips
* Jaws can be straight or curved
74
Identify this instrument
**Frazier Suction Tip**
* Fine tipped suction tip for removal of small amounts of fluid from surgical field
* Used mostly for orthopedic and neurologic surgery
* Covering hole on top of instrument created stronger negative pressure
* Can clog easily with blood clots/small tissue remnants
75
Identify this instrument.
**Gelpi Retractor**
* Ring retractor with self-retaining ratchet
* Various sizes
* Used for retraction of soft tissues (especially useful for retraction of muscle bellies during orthopedic or spinal surgery)
* Sharp tips must be placed with caution
76
Identify this instrument.
**Straight Doyen Intestinal Tissue Forceps**
* Thin, slightly bowed jaws
* Fine, longitudinally oriented grooves
* Straight or curved configuration
* Used for intestinal lumen occlusion (enterotomies, resection and anastomosis)
77
Identify this instrument.
**Brown Adson Tissue Forceps**
* Tips consist of fine teeth in two parallel rows
* Used frequently for general tissue handling but serrated teeth can crush tissue
78
Identify this instrument
**Jaeger Eyelid Plate**
* Used to protect globe when making incisions into the eyelid
* Placed between the eyelid and globe
79
Identify this instrument
**Wedge Tipped Dental Elevator**
* Wedge tipped elevators (luxators) are used to weaken the periodontal ligament and luxate the tooth for extraction.
* Note the flat vs. concave tip
80
This instrument comes in various shapes and sizes and is used to remove small bits of bone from the surgical field:
**Rongeur**
81
This frequently used antiseptic skin prep has broad spectrum activity but should never be applied to open skin or mucosa:
**isopropyl alcohol**
