SUR 101 unit 4
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SUR 101 unit 4
2 different grades of instruments
instruments that are made from inferior metals, tend to bend and break, show staining and are used in less critical applications?
often classified as single-use items
instruments constructed of high quality stainless steel, carbon, chromium, etc., and resist bending, pitting, scratching and dulling
most common metal used in surgical instruments but also subject to corrosion
instrument finish that reflects light and may cause glare
bright or mirror finish
instrument finish that reduces glare and light reflection which can lead to eye fatigue
which finish tends to stain more easily from the effects of detergents and low water quality?
black chromium finish used for laser surgery
what does ebony finish prevent?
prevents laser beams from reflecting or bouncing off the instruments
maintains sharp edge in scissors and gripping ability in needle holders
tungsten carbide inserts
what are instruments with tungsten carbide inserts usually manufactured with?
gold-plated or black handles
area on an instrument where the lever moves
instruments used for blood vessels
instruments that do not puncture or bruise the tissue
instruments used on fibrous tissue
requires toothed instruments to maintain grasp
clamp that has one or more ratchets that remain closed after they are set
locking box lock clamp
what kind of mechanism do microsurgical instruments use?
spring lock mechanism
what are thumb forceps used for?
grasping, usually during suturing for handling tissue during surgery
what are toothed forceps used for?
grasp skin or other connective tissue
what are smooth forceps used for?
delicate tissue such as serosa, bowel, blood vessels or ducts
what type of forceps are Martin and Russian forceps?
toothed forceps - small, rounded teeth
what are Bayonet forceps used for?
angled for neurosurgical and nasal procedures
has teeth or sharp serrations in the jaws
what are biting clamps used for?
avascular fibrous tissue, bone or tissue that will be removed
has one or more teeth in the jaws that can be delicate or heavy
penetrates tissue rather than just holding it
generally used on fibrous tissue such as cervix
inserted into a bone for manipulation
has locking ratchets but the tips do not close tightly over the tissue
what is atraumatic clamp used for?
delicate tissue that is highly vascular or easily injured
what is Babcock clamp used for?
bowel or fallopian tubes
long clamp placed across a tissue structure at an approximate right angle
when is cross clamping frequently used?
vascular and intestinal surgeries
what does a hemostat do?
blocks flow of blood
what do Kelly, Crile and mosquito hemostats do?
completely occlude a blood vessel while it is tied or sealed with ESU
what do right-angled clamps do?
used for dissection and occlusion in deep wounds
capable of varying low levels of compression between its jaws and are angled to allow access to blood vessels
semioccluding vascular clamp
examples of vascular clamps
what blades fit scalpel handles 3, 3L, 7, 9?
blades 10, 11, 12, 15
what blades fit scalpel handles 4, 4L?
blades 18 to 25
Beaver blade handle
interchangeable, disposable blades (Beaver blades)
used in surgery of eye and ear
what are tissue scissors for?
used to sever tissue and should never be used on other materials or surgical supplies including suture material
what are small, sharp-tipped scissors (tenotomy scissors) used for?
extremely fine dissection in plastic surgery
when are castroviejo scissors used?
what are round-tipped, light dissecting scissors (Metzenbaum scissors) used for?
extensively on delicate tissue in general surgery
what are heavy, curved Mayo scissors used for?
undermining fibrous connective tissue
what are straight Mayo scissors used for?
what is a rongeur used for?
to cut and extract tissue
rongeur with a single hinge
rongeur with two hinges
for which procedures are heavier rongeur (Stille) used?
orthopedic and neurosurgical procedures
what is long-handled Kerrison rongeur used for?
what is long, fine-tipped pituitary rongeur used for?
to remove tissue in difficult-to-reach areas such as vertebral column and nasal sinus
large cutting instruments used to cut bone
designed with small cup with sharpened, serrated, or smooth rim and used for scooping out tissue
what are very fine curettes used for?
ear, paranasal and spinal surgery
what are larger, heavier curettes used for?
what are soft tissue curettes used for?
gynecological surgery for curettage of the endometrium
orthopedic cutting instrument used with a mallet
used to remove bone from the iliac crest for use as a graft elsewhere in the body
V-shaped bone chisel
looks like a small trough
used to separate or "elevate" the tissue
elevator that slices tissue as it elevates it
heavy, round cutting Lambotte elevator
very finely balanced elevators used in soft tissue surgery and vascular surgery to separate atherosclerotic plaque from inside blood vessel
Penfield or Freer elevators
elevator with short handle and strong tip making it ideal for separating connective tissue planes without causing bleeding
used to remodel bone
used to ream medullary canal of long bones in preparation for an implant
used to gently move away tissue layers, blood vessels, nerves, organs, etc. from the focal point of operation as the wound is deepened
5 descriptions of retractors
handheld or self-retaining
deep or superficial
wide or narrow
sharp or dull
retractor used in abdominal procedures
retractor used only for connective tissue
designed to grasp the undersurface of superficial tissues
sharp rakes or hooks
self-retaining retractor used in cardiovascular surgery
retractors used for superficial incisions such as in the groin
Gelpi and Weitlaner
rounded, tubular or tube-like instruments used to widen or stretch the inside diameter of a lumen
removal of tissue by scraping with a surgical curette
used to prepare the bone for joint implant
used in orthopedic surgery to determine the length of screws to be implanted into bone
trial, reusable replica of an implantable prosthesis - allows surgeon to test a replica before surgery
used to grasp a curved needle during suturing
needle holder that is too delicate for the needle will cause what?
the needle to twist during use
needed during a surgical procedure to clear blood, fluids, and small bits of tissue debris from the surgical site to provide unobstructed view
suction designed for abdominal surgery
suction designed for chest cavity and throat
designed to suction in superficial areas in the face, neck, and ear, and in neurological and some peripheral vascular procedures
how do you clean debris and blood clots from suction tips during surgery?
dipping suction tip in sterile water or inserting a stylet into the lumen
fine membrane that covers organs of the body
what types of instruments are needed when handling serosa and why?
the membrane can be easily punctured and underlying tissue layers can bleed profusely
tissue that is very delicate, tends to bleed profusely, tears easily and has little or no resilience
examples of friable tissue
clamps used on lumens, such as intestines, fallopian tubes, etc. should be?
only partly occlusive
examples of clamps used for lumens
tissue that is resilient and able to withstand a limited amount of stretching without injury
examples of elastic tissue
vaginal vault and some glandular tissue such as tonsils
tissue that is heavy with fluid, inflamed or diseased
type of tissue that has high fat content
tissue with few blood vessels compared with other types of tissue
adipose tissue - may require penetrating retractor
tissue that is resilient and somewhat springy when healthy
cartilage and tendon strength
extremely strong and resilient
what is fascia often grasped with?
Kocher clamps (one or two teeth)
areas where a tubular structure forms a Y
purpose of debulking instruments (chisels, osteotomes, gouges, rasps and files)
decrease the bulk of firm tissue and not necessarily cut along defined tissue planes
instruments that remove a small piece of tissue for pathologic examination
biopsy forceps and punches
instruments that remove soft tissue or bone by scraping with the sharp edge of the loop, ring or scoop
blades that are rounded toward the tip and often used to open skin
number 10 blades
blades that have a linear edge with sharp tip - can be used to make initial skin puncture for tiny, deep incisions
number 11 blades
blades that have a curved cutting surface like a hook - used for tonsillectomy
number 12 blades
blades that have a short rounded edge for shallow, short controlled incisions
number 15 blades
blades shaped similar to number 10 blades but larger
number 20 blades
used to mark tissue and to occlude vessels or small lumens of tubes
designed for closing the end of a hollow organ with a double-staggered line of staples
terminal end staplers
commonly used for bowel anastomosis after resection
end-to-end circular staplers
involves application of negative pressure (less than atmospheric pressure) for evacuating blood or fluids for visibility at the surgical site
aspiration or suction
used to cut through tissues for access to fluid or body cavity
two parts of trocar
instrument with blunt end and perforations around the tip used to aspirate fluid without cutting into tissue and also used to open blocked vessels or ducts
what types of dilators are used to dilate the uterine cervix?
Hank, Hawkins, Pratt or Hegar dilators
used to explore a structure or to locate an obstruction, and used to explore depth of a wound or to trace the path of a fistula
cause minimal heating of bone
how do air-powered instruments work?
medical-grade compressed air or pure (99.97%) dry nitrogen is either piped into OR or supplied from a cylinder tank on a stable carrier
saws, drills, dermatomes and nerve stimulators
designed to be explosion-proof
how are battery-operated instruments used in the sterile field?
cordless with rechargeable batteries
batteries are charged and sterilized
power switch should be off before cords are plugged into outlets
supply cord should be connected to the outlet before anesthetic gases are administered and should not be disconnected during anesthesia administration