Aseptic Laboratory/Suture and Instruments Flashcards Preview

RUSVM Small Animal Surgery 2017 > Aseptic Laboratory/Suture and Instruments > Flashcards

Flashcards in Aseptic Laboratory/Suture and Instruments Deck (136)
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1
Q

Asepsis

A

Prevent wound contamination by destroying organisms before they enter the wound

2
Q

Antisepsis

A

killing bacteria after they have entered the wound

3
Q

Disinfection

A

use of germicidal substances to kill most microorganisms

4
Q

Sterilization

A

the process of destroying all microorganisms such as bacteria, fungi, and spores

5
Q

What is the goal of aseptic surgical technique?

A

minimize contamination of surgical wounds

6
Q

What is not sterile once surgery starts?

A
Your back 
neck 
shoulders
axillae
below waist
7
Q

Physical sterilization

A

Thermal energy
Filtration
Radiation energy

8
Q

Chemical sterilization

A

Plasma

Disinfectants

9
Q

What is the most common method of sterilization?

A

Autoclave

10
Q

What is the minimum standard for autoclaving?

A

250F
15 psi
13 min

11
Q

What is the disadvantage of steam sterilization?

A

dulls sharp instruments

12
Q

What is used for Chemical sterilization?

A

Ethylene Oxide

Gas Plasma

13
Q

What does the effectiveness of Chemical Sterilization depend on?

A

Gas concentration
Temperature
Exposure time
Humidity (minimum of 35%)

14
Q

What is disinfected with “Cold Disinfectants”?

A

Dental Instruments

Scopes

15
Q

What is the shelf life of a sterile pack using Heat sealed paper/transparent plastic pouch?

A

1 years

16
Q

What is the shelf life of a sterile pack using 2 layers of polyethylene + muslin?

A

9 months

17
Q

What is the shelf life of a sterile pack using 2 layers of crepe paper + muslin?

A

10 weeks

18
Q

What is the shelf life of a sterile pack using 2 layers of double wrap muslin?

A

8 weeks

19
Q

What is the shelf life of a sterile pack using 1 layer of crepe paper?

A

3 weeks

20
Q

Halsted’s Principles of Surgery

A
  1. Gentle Tissue Handling
  2. Accurate hemostasis
  3. Preservation of blood supply
  4. Strict aseptic technique
  5. Sutures tied without tension
  6. Accurate tissue apposition
  7. Obliteration of dead space
  8. Postoperative wound protection
21
Q

Primary Hemorrhage

A

Bleeding during procedure

22
Q

Intermediate delayed hemorrhage

A

within 24 hours of surgery

23
Q

Secondary delayed hemorrhage

A

After 24 hours - usually the result of ineffective ligation

24
Q

Gelform

A

Absorbable gelatin sponge Topical hemostatic agent derived from pig skin

25
Q

Surgicel

A

Absorbable plant based cellulose topical hemostatic agent

26
Q

Hemablock

A

microporous polysaccharide powder topical hemostatic agent

27
Q

Types of Definitive Hemostasis

A

Electrocoagulation
Ligature
Vascular clips
Primary vascular repair

28
Q

Electrocoagulation

A

Electric current delivered to the tissues

29
Q

What are the advantages of Electrocoagulation?

A

Decreased blood loss and operative time

Improved visualization

30
Q

What are the disadvantages of Electrocoagulation?

A

Less hemostatic security than ligation

Collateral tissue damage

31
Q

3 scalpel handle

A

used in small animals

32
Q

4 scalpel handle

A

used in large animals

33
Q

What size blade goes with a Bard-Parker #3 scalpel handle?

A
#10
#11
#12
#15
34
Q

What size blade goes with a #4 scalpel handle?

A

20s

35
Q

Metzenbaum Scissors

A

Used for dissection and cutting delicate tissues such as subcutaneous tissues, intestine, or bladder

36
Q

Mayo Scissors

A

Used for general dissection and cutting through tissues such as muscle fascia, tendon, the linea alba, or trimming skin

37
Q

Vernon Cartilage and Wire Scissors

A

Good for cutting sutures and drape material

38
Q

Brown Adson Tissue Forceps

A

Very common general use tissue forceps for general tissue handling but can crush tissue

39
Q

Halstead Mosquito Forceps

A

Delicate hemostat used for ligating individual vessels

40
Q

Rochester-Carmalt Hemostatic Forceps

A

Used to occlude large vascular structures such as the ovarian pedicle

41
Q

Backhaus Towel Clamp

A

Used to secure the quarter drapes or Huck towels to the patient skin

42
Q

Allis Tissue Forceps

A

Forceps used to grasp tissue facilitating retraction, positioning of suction tubing and electrocautery wire on patient drape

43
Q

Snook Ovariohysterectomy Hook

A

Used to blindly exteriorization of uterine horn during ovariohysterectomy

44
Q

What are the Crushing Tissue Forceps?

A

Babcock tissue forceps

Allis tissue forceps

45
Q

What are the Non-crushing forceps?

A

Doyen Intestinal Forceps

46
Q

What are the Hemostatic forceps?

A

Rochester Carmalt forceps
Kelly Hemostat forceps
Halsted mosquito forceps

47
Q

How should you always place curved forceps?

A

tips should be always pointed out of the body cavity or away from the patient

48
Q

Babcock Tissue Forceps

A

Forceps used for helping grasp and retract soft tissues such as the stomach or bladder

49
Q

Straight Doyen Intestinal Tissue Forceps

A

Forceps used for intestinal lumen occlusion in enterotomies, resection and anastomosis

50
Q

Straight and Curved Kelly Hemostatic Forceps

A

Forceps used for tip clamping of small to medium vessels

51
Q

What are the Thumb Forceps?

A

Brown-Adson forceps
Adson forceps
DeBakey forceps
Bishop-Harmon forceps

52
Q

Adson Tissue Forceps

A

Forceps that result in less crush injury than with Brown-Adson tissue forceps but have poor grip on fat or other friable tissues

53
Q

DeBakey Tissue Forceps

A

Most frequently used thumb forceps in soft tissue surgery that are less traumatic than Brown-Adson thumb forceps

54
Q

Bishop-Harmon Forceps

A

Used to grasp tissue in ophthalmic surgery

55
Q

What blades are used with the Beaver Blade Scalpel Handle?

A
#64
#67
56
Q

Describe a #10 Blade use

A

Long flat blade for sharp penetration of hollow organs or for precision

57
Q

Describe a #11 Blade use

A

Sharp penetration of hollow organs or for precision cutting

58
Q

Describe a #12 Blade use

A

Used for Onychectomy in cats

59
Q

Describe a #15 Blade use

A

Used for subcutaneous or fascial incisions

60
Q

When would you use a Beaver Blade Scalpel Handles and blades?

A

Incise the limbus for intraocular surgery

Used by some orthopedic surgeons for incision of intra-articular structures

61
Q

What are the different types of surgical scissors?

A
Mayo scissors 
Metzenbaum scissors
Stevens tenotomy scissors
Spencer stitch scissors 
Vernon cartilage and wire scissors
62
Q

Stevens Tenotomy Scissors

A

Used for precision cutting such as ophthalmic and urologic surgery

63
Q

What is an important feature of the Spencer Stitch Scissors?

A

Hooked tip used to entrap suture for cutting

64
Q

Spencer Stitch Scissors

A

Used for post-op suture removal

65
Q

Vernon Cartilage and Wire Scissors

A

Used to incise thick, tough tissue and orthopedic wire

66
Q

What are the Needle Holders?

A

Mayo-Hegar needle holders
Olsen-Hegar needle holders
Castroviejo needle holders
Derf needle holders

67
Q

Describe the Mayo-Hegar Needle Holders

A

Textured tungsten carbide jaw inserts provide intermediate needle holding security over smooth jaws or jaws with teeth

68
Q

Describe Olsen-Hegar needle holders

A

Combined needle driver/scissors

Same jaw as the Mayo-Hegar needle holders

69
Q

Derf Needle Holders

A

Ophthalmic needle drivers

small size useful for suturing smaller structures such as the eyelid or conjunctiva

70
Q

Castroviejo needle holders

A

Microsurgery needle driver
Used for ophthalmic and vascular surgery
Spring loaded handle

71
Q

Self-Retaining Retractors

A

Balfour retractor
Finochietto retractor
Gelpi retractor
Weitlaner retracter

72
Q

Hand Held Retractors

A
Army-Navy retractor 
Malleable retractor 
Hohmann retractor 
Senn retractor 
Snook hook/ Spay hook
73
Q

Balfour Retractor

A

Blunt blades used to retract abdominal wall laterally

Central “bladder blade” can be used to retract rib cage cranially

74
Q

Finochietto Retractor

A

Adjustable rib retractor
Used for retraction of chest wall during intercostal thoractomy and median sternotomy
Flat retractor blades are perpendicular to instrument

75
Q

Gelpi Retractor

A

Ring retractor with self-retaining ratchet
Used for retraction of soft tissues (especially useful for retraction of muscle bellies during orthopedic or spinal surgery)

76
Q

Weitlaner Retractor

A

Ringed Retractor with self-retaining
Multiple pointed prongs on each arm
Useful for retraction of soft tissue in a small, superficial incision

77
Q

Army-Navy Retractor

A

Double ended blunt retractor
Hand held retractor typically used by assistant
Used for both soft tissue and orthopedic surgery

78
Q

Malleable Retractor

A

Double ended blunt retractor

used for retracting viscera in abdominal and thoracic surgery

79
Q

Hohmann Retractor

A

Used to lever muscle and soft tissues away from surgical field and bone during orthopedic surgeries

80
Q

Senn Retractor

A

Double ended retractor with a 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

81
Q

Orthopedic Instruments

A
Speed lock bone holding forceps
Kern bone holding forceps
Jacob's chuck 
Mallet
Osteotome
Periosteal elevator 
Lampert Rongeur
82
Q

Kern Bone Holding Forceps

A

Used to grip and manipulate bone during fracture reduction and repair

83
Q

Speed Lock Bone Holding Forceps

A

Used to grip and manipulate bone during fracture reduction and repair

84
Q

Jacob’s chuck

A

Used to drive IM pins and K-wires during orthopedic surgery

Key used to tighten or release pin grip

85
Q

Mallet

A

used in orthopedic surgery to advance an osteotome for making precise osteotomies

86
Q

Osteotome

A

two sided beveled instrument used to create osteotomy in numerous orthopedic procedure

87
Q

Chisel

A

one sided beveled instrument used to create osteotomy in numerous orthopedic procedures

88
Q

Periosteal Elevator

A

Used to reflect muscle and soft tissue from bone

89
Q

Free Periosteal Elevator

A

Double ended periosteal elevator

90
Q

Lampert Rongeur

A

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
Has finer tipped jaws and are used in more restricted areas (bulla osteotomy)

91
Q

List the Ophthalmic Instruments

A
Castroviejo needle holders
Derf needle holders
Bishop-Harmon tissue forceps
Barraquer eyelid speculum 
Jaeger eyelid plate
Stevens tenotomy scissors
Beaver blade and handle
92
Q

Barraquer Eyelid Speculum

A

Wire self retaining instrument used hold eyelids open during enucleations and surgery of the cornea and third eyelid

93
Q

Jaeger Eyelid Plate

A

Used to protect globe when making incisions into the eyelid

94
Q

Poole suction tip

A

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

95
Q

Frazier Suction Tip

A

Fine tipped suction tip for removal of small amounts of fluid from surgical field
Used for mostly orthopedic and neurologic surgery

96
Q

List Dental Instruments

A
Wind tipped dental elevator 
Wedge tipped dental elevator 
Curette
Scaler 
Extraction forceps
Calculus removal forceps 
Dental explorer
Periodontal probe
97
Q

Wing Tipped Dental Elevator

A

used to sever the periodontal ligament by rotating the instrument around the tooth

98
Q

Wedge tipped Dental Elevator

A

used to weaken the periodontal ligament and luxate the tooth for extraction

99
Q

Curette

A

used for subgingival cleansing, root planing, and curettage

100
Q

Scaler

A

Removes dental deposits from above gumline

101
Q

Extraction forceps

A

used to grasp loose/luxated teeth for extraction

102
Q

Calculus removal forceps

A

uneven tipped instrument useful in removing large pieces of calculi prior to scaling

103
Q

Dental explorer

A

increased tactile sensation for detecting areas of enamel decay

104
Q

Periodontal probe

A

Used to measure pocket depths around a tooth

105
Q

What are the Absorbable Suture materials?

A
Chromic gut 
Polyglactin 910
Polyglycolic acid 
Glycomer 631
Caprolactone
Poliglecaprone 25
Polydiaxonone
106
Q

What are the nonabsorbable sutures?

A
Nylon 
Silk 
Polypropylene
Polymerized caprolactam
Stainless steel wire
107
Q

When would you use Polyglactin 910?

A

Dental Surgery

108
Q

When would you use Polyglycolic acid?

A

Dental Surgery

109
Q

When would you use Glycomer 631?

A

Closure of entertomies, cystotomies, body wall closure, fascia closure

110
Q

When would you use Caprolactone?

A

Closure of cystotomies (non-infected bladders), subcutaneous tissues

111
Q

When would you use Poliglecaprone 25?

A

Closure of cystotomies (non-infected bladder), subcutaneous tissues

112
Q

When would you use Polidioxanone?

A

Closure of entertomies, cystotomies, body wall closure, fascia closure

113
Q

When would you use Silk?

A

Cardiovascular surgery

114
Q

When would you use Nylon?

A

Skin closure, orthopedic repair (lateral tibiofabellar suture)

115
Q

When would you use Polypropylene?

A

Tendon, ligament, fascial, and joint capsule closures

116
Q

When would you use Polymerized caprolactam?

A

Skin sutures

117
Q

When would you use Stainless Steel Suture?

A

Orthopedic applications (closure of sternotomy)

118
Q

What is a disadvantage of Chromic Gut?

A

Knot security decreases when wet

119
Q

What is a disadvantage of Nylon?

A

Susceptible to degradation

Hydration may lead to disruption of hydrogen bonds leading to loss of tensile strength

120
Q

What is a disadvantage of Polymerized caprolactam?

A

Sinus formation when implanted in tissues

121
Q

What are the properties of ideal suture material?

A
Minimal tissue reaction 
Gental passage through tissues
High knot safety and security 
No Capillarity 
Maximum tensile strength/high breaking strength
Consistent performance
Good and predictable absorption 
Comfortable handling
122
Q

Capillarity

A

Process by which fluid and bacteria are wicked along multifilament fibers

123
Q

3/8 circle needle shape

A

more easily manipulated through superficial tissue

124
Q

1/4 circle needle shape

A

used for ophthalmic procedures

125
Q

5/8 circle needle shape

A

Useful in confined locations or deep tissues

126
Q

Taperpoint needle

A

Sharp tip that pierces and spreads tissue without cutting

127
Q

When would you use a Taperpoint needle?

A

Intestine
Sucutaneous tissue
fasica

128
Q

Tapercut

A

combination of reverse cutting and taperpoint

129
Q

When would you use a Tapercut needle?

A

Heavy thick fascia, tendon, vascular grafts

130
Q

Cutting needle

A

Cutting edge on concave portion of needle. Tends to cut out of tissue

131
Q

Reverse cutting needle

A

Cutting edge on convex surface reducing risk of tissue cut out

132
Q

When would you use a Reverse cutting needle?

A

Skin

133
Q

Spatula point needle

A

Flat on top and bottom

134
Q

When would you use a Spatula point needle?

A

Ophthalmic procedures

135
Q

Blunt point needle

A

Blunt point that dissects through friable tissue without cutting

136
Q

When would you use a Blunt point needle?

A

Soft parenchymal organs (liver or kidneys)