SUR 101 unit 4

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SUR 101 unit 4
2012-10-15 00:54:55
Surgical Instruments

Surgical Instruments
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  1. 2 different grades of instruments
    • floor grade
    • surgical grade
  2. instruments that are made from inferior metals, tend to bend and break, show staining and are used in less critical applications?
    • floor-grade instruments
    • often classified as single-use items
  3. instruments constructed of high quality stainless steel, carbon, chromium, etc., and resist bending, pitting, scratching and dulling
    surgical-grade instruments
  4. most common metal used in surgical instruments but also subject to corrosion
    stainless steel
  5. instrument finish that reflects light and may cause glare
    bright or mirror finish
  6. instrument finish that reduces glare and light reflection which can lead to eye fatigue
    satin finish
  7. which finish tends to stain more easily from the effects of detergents and low water quality?
    satin finish
  8. black chromium finish used for laser surgery
    ebony finish
  9. what does ebony finish prevent?
    prevents laser beams from reflecting or bouncing off the instruments
  10. maintains sharp edge in scissors and gripping ability in needle holders
    tungsten carbide inserts
  11. what are instruments with tungsten carbide inserts usually manufactured with?
    gold-plated or black handles
  12. area on an instrument where the lever moves
  13. sharpened
  14. instruments used for blood vessels
    instruments that do not puncture or bruise the tissue
  15. instruments used on fibrous tissue
    requires toothed instruments to maintain grasp
  16. clamp that has one or more ratchets that remain closed after they are set
    locking box lock clamp
  17. what kind of mechanism do microsurgical instruments use?
    spring lock mechanism
  18. what are thumb forceps used for?
    grasping, usually during suturing for handling tissue during surgery
  19. what are toothed forceps used for?
    grasp skin or other connective tissue
  20. what are smooth forceps used for?
    delicate tissue such as serosa, bowel, blood vessels or ducts
  21. what type of forceps are Martin and Russian forceps?
    toothed forceps - small, rounded teeth
  22. what are Bayonet forceps used for?
    angled for neurosurgical and nasal procedures
  23. biting clamp
    • has teeth or sharp serrations in the jaws
    • Kocher clamp
  24. what are biting clamps used for?
    avascular fibrous tissue, bone or tissue that will be removed
  25. tenaculum
    • 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
  26. inserted into a bone for manipulation
    bone clamp
  27. has locking ratchets but the tips do not close tightly over the tissue
    atraumatic clamp
  28. what is atraumatic clamp used for?
    delicate tissue that is highly vascular or easily injured
  29. what is Babcock clamp used for?
    bowel or fallopian tubes
  30. long clamp placed across a tissue structure at an approximate right angle
    cross clamping
  31. when is cross clamping frequently used?
    vascular and intestinal surgeries
  32. what does a hemostat do?
    blocks flow of blood
  33. what do Kelly, Crile and mosquito hemostats do?
    completely occlude a blood vessel while it is tied or sealed with ESU
  34. what do right-angled clamps do?
    used for dissection and occlusion in deep wounds
  35. capable of varying low levels of compression between its jaws and are angled to allow access to blood vessels
    semioccluding vascular clamp
  36. examples of vascular clamps
    • bulldog
    • Satinsky
    • Fogarty
    • Crafoord
    • Cooley
  37. what blades fit scalpel handles 3, 3L, 7, 9?
    blades 10, 11, 12, 15
  38. what blades fit scalpel handles 4, 4L?
    blades 18 to 25
  39. Beaver blade handle
    • interchangeable, disposable blades (Beaver blades)
    • used in surgery of eye and ear
  40. what are tissue scissors for?
    used to sever tissue and should never be used on other materials or surgical supplies including suture material
  41. what are small, sharp-tipped scissors (tenotomy scissors) used for?
    extremely fine dissection in plastic surgery
  42. when are castroviejo scissors used?
  43. what are round-tipped, light dissecting scissors (Metzenbaum scissors) used for?
    extensively on delicate tissue in general surgery
  44. what are heavy, curved Mayo scissors used for?
    undermining fibrous connective tissue
  45. what are straight Mayo scissors used for?
    cutting suture
  46. what is a rongeur used for?
    to cut and extract tissue
  47. single-action rongeur
    rongeur with a single hinge
  48. double-action rongeur
    rongeur with two hinges
  49. for which procedures are heavier rongeur (Stille) used?
    orthopedic and neurosurgical procedures
  50. what is long-handled Kerrison rongeur used for?
    spinal surgery
  51. what is long, fine-tipped pituitary rongeur used for?
    to remove tissue in difficult-to-reach areas such as vertebral column and nasal sinus
  52. large cutting instruments used to cut bone
  53. designed with small cup with sharpened, serrated, or smooth rim and used for scooping out tissue
  54. what are very fine curettes used for?
    ear, paranasal and spinal surgery
  55. what are larger, heavier curettes used for?
    orthopedic procedures
  56. what are soft tissue curettes used for?
    gynecological surgery for curettage of the endometrium
  57. orthopedic cutting instrument used with a mallet
  58. used to remove bone from the iliac crest for use as a graft elsewhere in the body
  59. V-shaped bone chisel
    looks like a small trough
  60. used to separate or "elevate" the tissue
  61. elevator that slices tissue as it elevates it
    heavy, round cutting Lambotte elevator
  62. very finely balanced elevators used in soft tissue surgery and vascular surgery to separate atherosclerotic plaque from inside blood vessel
    Penfield or Freer elevators
  63. elevator with short handle and strong tip making it ideal for separating connective tissue planes without causing bleeding
  64. used to remodel bone
  65. used to ream medullary canal of long bones in preparation for an implant
    heavy rasps
  66. used to gently move away tissue layers, blood vessels, nerves, organs, etc. from the focal point of operation as the wound is deepened
  67. 5 descriptions of retractors
    • handheld or self-retaining
    • deep or superficial
    • wide or narrow
    • malleable (bendable)
    • sharp or dull
  68. retractor used in abdominal procedures
    Deaver retractor
  69. retractor used only for connective tissue
    rake retractor
  70. designed to grasp the undersurface of superficial tissues
    sharp rakes or hooks
  71. self-retaining retractor used in cardiovascular surgery
  72. retractors used for superficial incisions such as in the groin
    Gelpi and Weitlaner
  73. rounded, tubular or tube-like instruments used to widen or stretch the inside diameter of a lumen
  74. removal of tissue by scraping with a surgical curette
  75. used to prepare the bone for joint implant
    orthopedic calipers
  76. used in orthopedic surgery to determine the length of screws to be implanted into bone
    depth gauge
  77. trial, reusable replica of an implantable prosthesis - allows surgeon to test a replica before surgery
  78. used to grasp a curved needle during suturing
    needle holder
  79. needle holder that is too delicate for the needle will cause what?
    the needle to twist during use
  80. needed during a surgical procedure to clear blood, fluids, and small bits of tissue debris from the surgical site to provide unobstructed view
    suction (aspiration)
  81. suction designed for abdominal surgery
    Poole suction
  82. suction designed for chest cavity and throat
    Yankauer suction
  83. designed to suction in superficial areas in the face, neck, and ear, and in neurological and some peripheral vascular procedures
    Frazier suction
  84. 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
  85. fine membrane that covers organs of the body
  86. what types of instruments are needed when handling serosa and why?
    • nontraumatic
    • the membrane can be easily punctured and underlying tissue layers can bleed profusely
  87. tissue that is very delicate, tends to bleed profusely, tears easily and has little or no resilience
    friable tissue
  88. examples of friable tissue 
    • liver
    • spleen
    • lung
  89. clamps used on lumens, such as intestines, fallopian tubes, etc. should be?
    only partly occlusive
  90. examples of clamps used for lumens
    • Babcock
    • Allis
  91. tissue that is resilient and able to withstand a limited amount of stretching without injury
    elastic tissue
  92. examples of elastic tissue
    vaginal vault and some glandular tissue such as tonsils
  93. tissue that is heavy with fluid, inflamed or diseased
    boggy tissue
  94. type of tissue that has high fat content
    semisolid tissue
  95. tissue with few blood vessels compared with other types of tissue
    adipose tissue - may require penetrating retractor
  96. tissue that is resilient and somewhat springy when healthy
    bone tissue
  97. cartilage and tendon strength
    extremely strong and resilient
  98. what is fascia often grasped with?
    Kocher clamps (one or two teeth)
  99. areas where a tubular structure forms a Y
  100. purpose of debulking instruments (chisels, osteotomes, gouges, rasps and files)
    decrease the bulk of firm tissue and not necessarily cut along defined tissue planes
  101. instruments that remove a small piece of tissue for pathologic examination
    biopsy forceps and punches
  102. instruments that remove soft tissue or bone by scraping with the sharp edge of the loop, ring or scoop
  103. blades that are rounded toward the tip and often used to open skin
    number 10 blades
  104. blades that have a linear edge with sharp tip - can be used to make initial skin puncture for tiny, deep incisions
    number 11 blades
  105. blades that have a curved cutting surface like a hook - used for tonsillectomy
    number 12 blades
  106. blades that have a short rounded edge for shallow, short controlled incisions
    number 15 blades
  107. blades shaped similar to number 10 blades but larger
    number 20 blades
  108. used to mark tissue and to occlude vessels or small lumens of tubes
    clip appliers
  109. designed for closing the end of a hollow organ with a double-staggered line of staples
    terminal end staplers
  110. commonly used for bowel anastomosis after resection
    end-to-end circular staplers
  111. involves application of negative pressure (less than atmospheric pressure) for evacuating blood or fluids for visibility at the surgical site
    aspiration or suction
  112. used to cut through tissues for access to fluid or body cavity
  113. two parts of trocar
    • obturator
    • sheath
  114. 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
  115. what types of dilators are used to dilate the uterine cervix?
    Hank, Hawkins, Pratt or Hegar dilators
  116. 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
  117. air-powered instruments
    • lightweight
    • cause minimal heating of bone
  118. 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
  119. electrically-powered instruments
    • saws, drills, dermatomes and nerve stimulators
    • designed to be explosion-proof
  120. how are battery-operated instruments used in the sterile field?
    • cordless with rechargeable batteries
    • batteries are charged and sterilized
  121. alternating current
    • 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