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what is the most common material used
stainless steel
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stainless steel is the ________
preferred material
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characteristic of Stainless Steel
- strength
- durability
- resist rust and corrosion
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define stainless steel
an alloy or a mixture of metals made from iron orea
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what is carbon used for
provides the hardness
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disadvantage of carbon
enhances the negative effects of rust and corrosion
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What element is used to boost resistance
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How is stainless steel graded
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what are the type types of stainless steel used
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Characteristic of Austenitic Stainless Steel
- non-magnetic
- cannot be heat hardened
- high level of chrome and nickel content
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Austenitic Stainless Steel is used for
- produce utensils: basins, carts and tables.
- selection of surgical instruments: heavy-duty retractors, speculums and dilators.
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Characteristic of Martensitic Stainless Steel
- magnetic
- can be heat hardened
- at risk to staining, corrosion and damage by chemicals
- Low nickel content
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What is the benefit of 400 series in cutting devices
an maintain asharper edge due to the high carbon content.
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Martensitic Stainless Steel is used for
- Scissors
- needle holders
- chisels
- osteotomes
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List the Metal Grading
- disposable
- ward grade
- mid-grade
- Or grade
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Characteristic of Disposable
- low grade
- inexpensive
- one time use
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Characteristic of Ward Grade
- low cost
- good for up to 20 or 30 uses
- non-invasive
- not worth repairing or sharpening
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Ward grade is also know as
- floor grade
- general grade
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Disadvantage of general grade
transfer rust and corrosion by contactto higher-grade metal instruments
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what must you do what low grade and high grade instruments
Lower grade instruments should beprocessed separately from higher-grade metal instruments.
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Characteristic of Surgical Grade
- finest stainless steel and metal alloys.
- 10 years
- worth the cost of repair
- expensive
- invasive surgical procedure
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Characteristic of Titanium
- strong
- lightweight
- resists corrosion
- cannot be magnetized
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Advantage and Disadvantage of Titanium
- helps reduce any fatigue
- Expensive
- Not material for cutting device, cannot hold edge
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why is Titanium is used for implants in orthopedic procedures
joining with bone and other tissue.
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Titanium is used for
- delicate microsurgical devices
- implantables.
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what is the hardest steel used
Tungsten Carbide
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how to identify Tungsten Carbide
Gold-plated finger rings or handle tips
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what are the differences between soldered and welded
- soldered can be separated from the instrument and replaced
- Welded cannot be separated and are not replaceable
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Tungsten carbide is often used for
special inserts
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Scissors made with tungsten carbide inset blades are
- very durable
- stronger cutting edge
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what is atraumtic
minimal damage
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what kind of Detergents and lubricants are used for TC and why
pH neutral because alkaline and acid solutions can cause damage
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The 8 Step Instrument Manufacturing Process
- die
- forging
- milling and grinding
- assembly
- heat hardening
- fitting
- polishing and finishing
- testing
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what is passivation
a chemical bath that builds up a protective oxidized layer
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Ebony finish
matte black finish to reduce light refraction
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Satin finish
dull silver or matte finish
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Mirror finish
shiny finish, resistant to staining
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Mirror finish is fro
lower grade instrument.
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Teflon finish
smooth finish with a high temperature resistant coating
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how to identify ceramic finish
dark bronze surface and gold-plated screws
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Multi-coloured metallic finish
identify titanium metal
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seven distinctive function-specific uses
- To cut or incise and dissect
- To retract and expose
- To grasp, hold, clamp and occlude
- To dilate or probe
- To cannulate, suction, aspirate or drain (Frazier Suction)
- To inject or infuse (Veress Needle)
- To suture or ligate
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How to test for corrosion and rust
pencil eraser
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Staining Prevention
- Separate devices into particular sets.
- Use appropriate detergents
- Use appropriate manual and/or mechanical cleaning.
- Rinse instruments with distilled water
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Specialty scissors called
Supercut or Microgrind
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what are Supercut or Microgrind
- superior cutting ability
- one razor sharp cutting edge and one serrated cutting edge
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how to specially scissors
black-coloured finger rings
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Purplish-black stains are an indication of:
Exposure to detergents containing ammonia
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Ceramic blade inserts allow for a sharper edge than stainless steel. (T/F)
Ture
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The passivation layer on stainless steel instruments deteriorates with regular use and sterilization. (T/F)
False – The passivation layer actually improves with regular use and reprocessing.
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The correct set of a pair of scissors should fall completely closed when tested. (T/F)
False – The blade should close between 1/2 way to 1/3 of the way to the tips of the blades.
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Hemostat forceps are measured from the proximal tip of the jaw to the distal tip of the ring handle. (T/F)
False – the jaws are distal and the handles are proximal.
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A good supply of equipment and personnel guarantee high quality processing of instruments. (T/F)
False – A quality control system must be put in place for quality assurance.
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Instruments are immersed into a chemical bath followed by polishing in a process called ___________ which creates a passive protective outer layer that improves with regular use and sterilization.
passivation
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To determine if a brown or orange discoloration is a stain or corrosion, rub an ____ over the discoloration.
eraser
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Instruments in high demand for repetitive surgical procedures that are given high priority for processing are termed _________ items
high-turnover
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The key components of powered instruments include:
- The controls
- power supply
- hand piece
- accessories/attachments
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A reciprocating saw hand piece uses a:
Forward and backward action
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Different types of rotary hand pieces include all of the following designs except:
a) An osteotome hand piece
b) A power irrigator hand piece
c) A K-wire driver hand piece
d) A drill reamer hand piece
An osteotome hand piece
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The collet assembly is located at the:
Working end of the hand piece
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The following statements are true of tool attachments except:
a) Burrs, drill bits and reamers are especially prone to harboring gross soil.
b) Flexible reamers cannot be processed through the ultrasonic cleaner.
c) A quick coupling device is used to connect tool attachments to the hand piece.
d) Drill bits, burrs and reamers usually require scrubbing with a firm bristle brush.
Flexible reamers cannot be processed through the ultrasonic cleaner.
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what is a powered instrument
instruments with moving parts that are driven by sourcesother than manual operation
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four basic components of powered surgical instruments
- Power supply
- Hand piece
- Controls
- Accessories and/or attachments
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three power source
- battery
- electric
- pneumatic
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Facts about Battery power
- direct current
- recharged prior to sterilization
- does eliminate the need for a hose or cordwhich provides for easier handling within the surgical field.
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before sterilization battery power supply must
recharged
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Facts about electric
alternate current (plug-in )
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Pneumatic
medical grade compressedair, carbon dioxide (CO2) or compressed dry nitrogen
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why is important to have accurate pressure settings
- pressurization may cause damage to the hose greatly reducing its life.
- Under pressurization will reduce the performance of the device and ultimately cause it to malfunction.
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two types of motorized hand pieces
- single purpose
- modular design
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define single purpose hand piece
one specific function- linear motion or rotary motion
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define modular hand piece
interchangeable motorized modules
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Most hand pieces incorporate
collet assembly
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where is collet assembly located
distal end(or working end)
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Collet assembly
used to lock instrument accessories/attachments in position.
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Most powered devices are designed to use a variety of accessories that include:
- power hose, cable or battery pack
- quick coupling device
- Tool attachments
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power hose, cable or battery pack
used to connect the power sourceto the hand piece.
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quick coupling device
used to connect working end attachments ortools to the collet assembly on the hand piece.
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Tool attachments – come in two basic variations; _______________ which are designed to _______________ and _________which are designed to function in a ______________
- saw blade attachments
- linear motion
- rotary attachment
- circular motion
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Rotary attachments include
- drills bits
- burrs
- reamers
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drill bits is for
for preparing screw holes in bone
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burrs is for
shaping or tunnelling through bone
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reamers is for
forming, enlarging or shaping holes on the surface areas of bone.
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Types of Saw hand Pieces
- reciprocating saw hand piece
- oscillating saw hand piece
- sagittal saw hand piece
- sternal saw hand piece
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reciprocating saw hand piece –
uses a forward and backward action ina vertical plane to cut bone.
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oscillating saw hand piece –
uses a windshield wiper action at a 90°angle to the hand piece to cut bone.
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sagittal saw hand piece
– cuts bone with a side-to-side action in linewith the hand piece.
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sternal saw hand piece
reciprocates with a footplate guard to prevent unwanted damage while cutting the sternum or breastbone
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Types of Rotary Hand Pieces
- drill reamer hand piece
- trauma drill hand piece
- K-wire driver hand piece
- power irrigator hand piece
- dermabrader hand piece
- dermatome hand piece
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trauma drill hand pieces
to prepare screw holes using drill bit attachments
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K-wire driver hand piece
used to place pins in bone instead of screws
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power irrigator hand pieces
used for power flushing of surgical site
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dermabrader hand piece
used to abrade or reshape skin surfaces
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dermatome hand piece
used for slicing layers of skin
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what can't you do with motorized had pieces
immersed in a liquid solution and thereforemust be manually cleaned.
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The three basic external components for all flexible endoscopes include the
- control head/body
- insertion tube
- light guide connector
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The Videoscope:
a) transmits images from the proximal end directly to the monitor
b) transmits images to the monitor by way of tiny fibreoptic cables
c) uses a special external attachment to transmit images to a video monitor
d) transmits images directly to a monitor using a camera at the distal end
transmits images directly to a monitor using a camera at the distal end
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The transmission of light is part of the working system
image system
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The following steps are needed to facilitate effective cleaning of internal channels except:
a) extend the brush beyond the distal end
b) inspect the integrity of the cleaning brush
c) retract the brush out of the proximal end
d) inspect the internal surfaces prior to brushing
inspect the internal surfaces prior to brushing
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The process of safely handling flexible endoscopes does not include
a) keeping the device in a loosely coiled position
b) handling the device by the body while protecting the distal tip
c) transporting the device in a towel-lined protective container
d) handling the light guide connector while protecting the proximal tip
handling the light guide connector while protecting the proximal tip
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A flexible Cystoscope is used to visualize the urethra and bladder
(T/F)
True
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A dry leak test has failed if a steady stream of bubbles is detected from the channel opening.
(T/F)
False
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The terminals in the Light Guide Connector of the Videoscope are not waterproof.
True
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The irrigation channel is used for the passage of endoscopic instruments. (T/F)
False
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The Channel System of the flexible scope is used to manipulate the distal tip for optimal viewing of the anatomical site. (T/F)
False
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the type of flexible endoscopes
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How does the fiberscopes transfer the image
use the fibre optic to transfer the image to the eyepieces
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what is the other name for fibrescope
non-video flexible endoscope
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what is the different between the the two type of scopes
the eyepiece
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how does the videoscope transfer the image
image to the monitor using a camera
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Flexible endoscope external part
- control head or body
- intersection tube
- light guide connector
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summary of the Flexible endoscope external parts
- Control head or body contain the angulation control handle that control the distal end and the air, water, suction and biopsy port channels
- Insertion tube grossly contaminated Distil end houses the electrical chip for the videoscope The four working system are housed
- Light guide connector contains the ports ( suction, water, air and CO2) and connect to the light source not waterproof à must be covered
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Flexible endoscope internal system
- mechanical system
- image system
- channel system
- electrical system
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summary of the internal system of Flexible endoscope
- Mechanical system/ Angulation system ᴸ control the distal tips
- Image system ᴸ transmit light and images by fibre optic, electronics and system of optical lenses
- Channel System ᴸ made up of many channels
- Electrical system ᴸ uses electrical components to help the mechanical and image system
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what is the biospy port
pass instrument needed for a procedure
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what is the important thing to remember when insertion thing in the biopsy port
damaged instruments/tool can cause damaged to the internal surfaces
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define bending section
last several inch of the insertion tube
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define distal end
- Located at the very end of the bending section
- Houses the terminal end of the channels nad lens covering
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what must be notes of the distal end
always protect being handling or transporting
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light guide connector must alwasy what and why
must be covered by a cap before cleaning because it is not waterproof
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what is the main purpose of flexible endoscope
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accessories for endoscopic procedure are divided into two basic types of
- diagnostic procedure
- therapeutic procedure
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The three main external components of the rigid endoscope are:
Eyepiece, rigid tube and light post and adaptor
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What is the primary purpose of the rigid endoscope?
Diagnostic
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Which of the following is an example of a rigid endoscope
Laparoscope
Colonoscope
Gastroscope
Bronchoscope
Laparoscope
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What method of sterilization is used to sterilize rigid endoscope
Steam
Peracetic acid
Ethylene bicarbonate
Hydrogen peroxide
Hydrogen peroxide
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The process of safely handling rigid endoscopes includes which one of the following?
1) Keeping the device in a loosely coiled position
2) Handling the device by its body while protecting the distal tip
3) Transporting the device by the distal tip
4) Handling the light guide connector while protecting the proximal tip
Handling the device by its body while protecting the distal tip
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Rigid endoscopy is limited to viewing areas accessible on a straight line. (T/F)
True
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Broken fiberoptics will appear as white spots when looking through a rigid endoscope. (T/F)
False: They will appear as black spots.
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Part of the internal components of a rigid endoscope include a system of lenses, which includes the ocular lens system and the lens train. (T/F)
True
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The rigid endoscope irrigation channel is used for the passage of end(T/F)
False: There is no such channel
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A dry leak test must be performed on rigid endoscopes before performing the wet leak test. (T/F)
False: There is no leak tests performed
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Rigid Endoscope
limited to viewing anatomical site that are assessible on a straight-line basic only
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Rigid Endoscope external parts and explain
- Eyepiece – proximal end for viewing site
- Rigid Tube – houses the internal components and used for insertion
- Light post and light post adaptor – connect to the light source
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Rigid Endoscope internal parts and explain
- System of lenses (ocular lens system) – a series of lenses along the tube that carry the image from the objective lens system back to the eyepiece
- Fibre optic fibres – runs through the body carrying the light form the light source to lighten up the site
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Rigid Endoscope come in _____, _______, _____
lengths, diameter and lens viewing angles
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the key part of a video camera
- Cap
- lens component
- machine end
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