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Surg tools and equip
| Question | Answer |
|---|---|
| What are instruments made of? | Stainless steel, high in carbon to harden and less likely to wear, and chromium which is more corrosive resistant |
| Three types of instrument finishes? | Polish mirror finish- have more chromium, but alot of glare Stain or dull finish- more common in OR bc of less glare Ebonized (black chromium)- no reflective, used in laser cases |
| Name the parts of an instrument | shank-Area b ratchets, finger rings |
| Jaws | hold tissue securely, serrated, some have carbide insert that is replaceable, working end of instrument. |
| box lock | joins the 2 halves of the instrument and allows the opening and closing. Maybe the a "screw joint" |
| Shank | -Area between box lock and finger ring. -Gives instrument leverage -Should be balance on both ends -Length is appropriate to wound depth |
| Ratchets | Keep instrument "locked shut: when the instrument is closed on tissue or object that is being grasped. |
| What ratchet do instruments need to be on when on the Mayo stand?? | the 1st ratchet |
| Finger rings | Provide for ease of holding and manipulating instrument |
| What are the 9 categories of instruments? | 1. Cutting and Dissecting 2. Grasping 3. Clamping 4. Retracting 5. Probing 6. Dilating 7. Needle holders 8. Suction 9. Accessories |
| Mayo Scissors | Cutting and dissecting, 2 types: curved, used for heavier tissue. Straight, or suture, used for delicate tissue cuts sutures and drapes |
| Metz scissors | Cutting and dissecting, Used to delicate tissue |
| Jorgenson | Cutting and dissecting used for hysterectomies and OBGYN surgeries |
| Potts Smith | Cutting and dissecting'used on delicate procedures |
| what knife blades can be used on a #3 knife handle? | #10,#11, #12, #15 (used for superficial procedures) |
| What is the most common blade for skin? | #10 |
| What knife blades will fit a #4 knife handle? | Only a #20, used deeper in the body |
| Rongeurs | Cutting and Dissecting, Cut and extract tissue, tips are cupped, very sharp, used for orthopedic and neurosurgery |
| Beaver blade | used for ear and eye procedures |
| Forceps | Grasping and holding, holds tissue in place, Ex. Adson and tissue forceps |
| Kocher | Biting clamp, Grasping and holding used on hysterectomies |
| Tenaculum | Grasping and holding, penetrates tissue like the cervix, holds tissue |
| Debakey | Grasping and holding, tissue forceps that are used on delicate tissue inside the body |
| Babcock | Clamping and occluding, Atraumatic clamp that is meant to surround or clasp. Used on bowel or Fallopian tube, non crushing |
| Hemostat | Clamping and occluding, Occluding clamp that stops blood flow |
| Murphy rake | retracting and viewing, 4 or 3 prong, can be sharp or dull(rounded) |
| Self retaining retractor | retracting and viewing, better visualization, can be sharp or dull |
| Richardson | Retracting and viewing |
| Probing | Detects and obstruction or follows a hollow tract. used to enter a lumen that occurs naturally. Urethra or anus is a natural lumen |
| Dilating | Widen or stretch the inside of lumen, allows for larger instruments to enter.Used to increase the diameter of a lumen, cervix in gyny surgery, Ex. Cervix, urethral, esophgeal |
| Suturing | Needle-holder fine, regular or heavy. Grasp needle Place or remove blade on scalpel |
| Suctioning | Removal of blood and fluids from surgical site |
| 3 types of suctioning | Yankauer-all purpose Frazier-primarily orthopedic, neurologic surgery Poole-Primarily abdominal and thoracic surgery |
| Suctioning | Removal of blood and fluids from surgical site |
| 3 types of suctioning | Yankauer-all purpose Frazier-primarily orthopedic, neurologic surgery Poole-Primarily abdominal and thoracic surgery |
| What are two types of accessories | Towel clips and ring forceps |
| How do you handle instruments? | -handle gently -do Not throw them into basins -Protect cutting surfaces -Do NOT soak or rinse in saline -Keep them wiped off during a case -Use the correct instrument |
| What causes instruments have a reduced life? | -Most damage is caused by improper cleaning and processing, and handling |
| Who does the "counts" before and after the procedure? | Scrub or circulator |
| What to do when dismantling instruments. | -Check drapes, towels, and table covers -Collect instruments from Mayo stand -Separate delicate, small instruments -Disassemble all instruments -Open all hinged instruments -Separate instruments of dissimilar metals |
| Dismantling cont.. | -Flush cold distilled water through hollow instruments -Rinse off blood and debris |
| What to remember! | Handle loose instruments seperately to prevent interlocking or crushing -Keep ring-handled instruments together -inspect/sort instruments -leave retractors and other heavy instruments in the tray -Protect sharp blades, edges and tips |
| Richardson Retractor | -Specialty: General -Usually comes in pairs -Retracting/Exposing |
| Parker Retractor | -Specialty: General -Retracting/Exposing |
| Army-Navy retractor | -Specialty: GEN -Retracting/Exposing |
| Senn Rake Retractor | -can be Sharpe/Dull -Specialty: General/Plastics -Retracting/Exposing |
| Vein retractor | instrument ending in a rounded flange set transversely for engaging and retracting soft tissues. |
| Poole suction | -Specialty: General/Thoracic -Suctioning -primarily abdominal region |
| Metz scissors (2 types) | -Comes curved or straight. -Most often curved. -Also can come as Thyroid Metz (small), Regular Metz, and Extra long Metz. -Used to dissect delicate tissue. -Usually called "Metz" -Specialty: General -Cutting |
| Mayo scissors (2 types) | -Curved are used for dissection. -Straight for cutting suture. -All specialties. -Cutting |
| Bandage or trauma scissors | -Lister Bandage Scissors -General utility scissors used in -most specialties. -Cutting -Not used on tissue |
| Debakey Forceps | -Used on delicate tissue. -Specialty: General -Grasping |
| Adson forceps w/ teeth | -frequently used to close the skin when using suture or for everting skin edges for staple placement. -Specialty: General/Plastics -Grasping/Holding -Always hand to surgeon after suture |
| -Toothed Thumb Forcep | -Specialty: General/GYN -Grasping/Holding - commonly held between the thumb and two or three fingers of one hand |
| Smooth Thumb Forceps | -Specialty: General/GYN -Grasping/Holding |
| Crilewood Needle Holder | -Specialty: Small Gen and Plastics -Suturing |
| Mayo Heager Needle Holder | -All specialties -Suturing |
| Heaney Needle Holder | -Specialty: GYN -Always load the needle with the curve of the needle holder pointing away from the tip of the needle. -Suturing |
| Forester Sponge Stick Also known as a ring forcep. | -It doesn't become a sponge stick until the sponge is put on it. -Specialty: General/GYN |
| Kelly Clamp | -Used in all specialties -Also known as a pean (pee-on) -Clamping/Occluding |
| Allis Clamp | -Specialty: General -Grasping/Holding |
| Allis-Adair Clamp | -Looks like an Allis but with a wider tip and more teeth. -Specialty: GYN -Grasping/Holding |
| Babcock | Babcock Specialty: Gen/GYN -Autraumatic clamp most often used delicate tissue such as the bowel and fallopian tubes. -Grasping/Holding |
| Kocher clamp | Kocher Clamp -Multiple specialties -Grasping/Holding/Clamping |
| Bachaus Towel Clip | -Used for holding towel drapes in all specialties. -Grasping/Holding -Can be used to grasp bone,myomas or skin when placing the verres needle. |
| Russian Forceps | -Specialty: GYN -Grasping/Holding |
| What is the Electrosurgical Unit? | -Application of heat speeds up the natural chemical reaction of blood to stop clotting. -Electric current can be used to cut or coagulate most tissues. |
| Components of the ESU | Generator, Active electrodes, and Inactive dispersive electrode |
| Generator | -Machine that produces the power for the "active electrode" to coagulate or cut tissue. |
| Active electrode | sterile handpiece that directs the flow of current to the operative site. -activated by surgeon -can have hand or foot switch |
| Inactive Disperive electrode | -known as the "grounding pad" -disperses the current released through the active electrode and provides a return from the tissues back to the generator. -plugged into generator "Bovie machine" -never place on metal implants |
| Two types of ESU | Monopolar and Bipolar Unit |
| Monopolar Unit | The current flows from generator to active electrode, through the patient to an inactive dispersive electrode, and then back to the generator. -HAS "grounding pad" |
| Bipolar Unit | Alows current to flow only b/w the tips of the active electrode and returns to the generator. -Does NOT have a "grounding pad" |
| Endoscopic Units | -Used for diagnosis, biopsy, visualization or repair. -used through an existing body opening (urethra) -may be rigid(not flexible) or flexible (bendable) |
| Flexible Endoscope | -Needs light and air source -has accessory items such as biopsy forceps, brushes, and polyp snares |
| Rigid scopes | -Need "lap tower" needs light source, light cable, monitor, video recorder,insufflator, and instruments |
| Insufflator | taking of a veress needle and putting it in the belly button and attach CO2 to inflates the belly and brings organs down |
| Operating microscopes | -Used for microsurgery -Ex. neurosurgery and eye surgery -Has objective lens and Ocular lens |
| 3 types of power surgical saws | Rotary- Used to drill holes or insert screws, wires, or pins Reciprocating- a cutting action from front to back/back and forth Oscillating- a cutting action from side to side All three may be powered by battery, nitrogen, or compressed air |
| Pneumatic Tourniquet | -Used on extremities to restrict blood flow -Everyone in the OR should be aware what time this is turned on -Used for a maximum of 1-1.5 hours -If on too long, could cause tissue or nerve damage |
| What is the purpose of drapes? | -Isolate and protect the surgical site -Barrier against contaminates -Fluid, tear and flame retardant -Disposable or non-disposable |
| Types of drapes | -Fenestrated- has opening, laparotomy -nonfenestrated- "square drape" split sheet or U-drape -extremities -Stockinette- rolls up and goes around legs, used for leg surgery, cut already in it,sticky -Incise- sticky & have antimicrobial, accordion like |
| Types of sponges | lap sponges, radiopaque sponges 4x4's Kitners and peanuts, tonsil sponges, and cottnoids |
| Laparotomy sponges | -Most absorbant -5 per package - If the count in a pack is off, the STSR must open a new pack and the old one must be discarded |
| Radiopaque 4x4's | -Smaller, less absorbent -"Raytec sponges," shows up on x-rays -10 per pack |
| Kitners and Peanuts | -Dissecting sponges Peanuts -rolled up sponges used for fluid absorption on the tip of an instrument -radiopaque -put into its own container when don using Kitner- small roll of cotton tape, not sticky |
| Tonsil sponges | -Cotton filled with strings -used for tonsillectomy -5 per package |
| Cottonoids | -10 per package -neurosurgical patties -protect delicate neural tissue -Radiopaque with string -need to be moistened with saline -used on brain and spinal procedures -saline prevents sticking |
| What is the purpose of dressings? | -To prevent the wound from trauma/contamination -Absorb drainage -Support incision -Provide pressure -Conceal wound |
Created by:
junkman3120
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