Chapter 10 Flashcards

Question

What are some components of non-fenestrated drapes?

Answer 1

-Used to "square off" (most common 1st layer of draping) -May be used to cover unaffected body parts that are not completely covered by the primary drape -can be custom to cover specific areas (perineal cases)

Answer 2

-first item opened for procedure -placed on back table as initial sterile field -may be commercial or created in-house (reusable items) Basic sterile pack includes: mayo cover, 2 gowns, suture bag, 4 sticky paper drapes, and 2 paper hand towels Highly specialized packs: supplies/drapes specific to a specialty or procedure

Answer 3

-Absorb blood or fluid -blunt dissection -protect structures

Answer 4

-Soft, lint free -have a radiopaque band -they are counted

Answer 5

-Laps - Raytec - Cottonoid -Tonsil -Kitner -Peanut (review in anki/ppt)

Answer 6

-Maintains environment by preserving epithelial tissue -Conceals wound aesthetically -Protects from trauma -Protects from microbes -Absorb drainage -Support incision -Provide pressure which reduces swelling and hematoma.

Answer 7

-Placed on clean, dry skin -Tincture may be applied for enhance effectiveness (mastisol, benzoin) -appropriate size and type of specific wound, secure and relatively comfortable -application and changes are done under sterile conditions (remove soiled outer gloves before handling, changes can be done in OR) -dressings should only be open onto field when wound is closed

Answer 8

-type, size and location of wound -amt of drainage to be expected -surgeon preference -age and size of pt -underlying medical conditions (allergies) -condition of surrounding skin -comfort of pt

Answer 9

-Temporary coverage of open wounds due to trauma, burns, or ulcers -Protects wounds -Reduce fluid loss -May provide matric proteins and growth factors -Provide an optional wound healing environment -Ex: integra, dermagraft, apligraf

Answer 10

-applied to de-epithelialized area of traumatic/thermal injury or for extensive skin loss -there are full thickness (all layers) and split thickness (epidermis and part of dermis) -Autograft which is taking patients own skin, homograft is from someone else or cadaver, and heterograft is from a different species.

Answer 11

-for small incisions w minimal drainage -includes transparent polyurethane film w adhesive back, liquid collodion, hydrocolloids, skin closure tapes, adhesive sprays, foams/gels, and dermabond.

Answer 12

-for any size incision from which drainage is expected -goes from simple bandaid to very complex -3 components: inner (contact) layer is primary, intermediate (absorbent) layer is secondary, and outer (securing) layer is teriary

Answer 13

Primary: covers wound and remains in direct contact. has wicking action Secondary: absorb drainage and secretions, thickness varies, includes kerlix, 4x4s, and ABDs Tertiary: secures dressing to pts. includes tapes, wraps, stockinettes, etc.

Answer 14

Non permeable: fine mesh gauze that is impregnated w an emulsion (xerofoam), it is airtight, nonadherent, and around chest tube wound Semipermeable: hydrocolloid or hydrogel, allows for passage of air and fluid Permeable: non adherent (adaptic, telfa) draws secretions by wicking, painless removal

Answer 15

3 layer dressing with additional material to cause compression. (too much can cause nerve dressing) Purpose: immobilization of an area, support, absorption of excess drainage, reduce edema

Answer 16

3 layer dressing w additional material to immobilize an area and provide additional support to a wound and absorb excess drainage.

Answer 17

Provide support and prevent movement. Include casts and splints. Made of plaster, lightweight synthetic, molded plastic, and molded metal

Answer 18

-Applied to one side of a structure -Provides support -Prevents unidirectional movement.

Answer 19

-Encircles a body part -Provides support -Prevent any type of movement -Immobilized the bone proximal and distal to affected area -Types include cylindrical, body jacket, walking cast, spica cast, and minerva jacket

Answer 20

A stent or tie-over dressing. It is sutured into position. You can take a skin graft recipient to provide even pressure and prevent accumulation. It is then secured to contoured area. Usually on face, nose, and nick.

Answer 21

Wet gauze is applied on a wound and removed after it dries. For debridement and burn victims under anesthesia.

Answer 22

Wet gauze goes on the wound and is removed before it dries. Can be wet w NS, antibiotic, and Dakin's Solution (bleach). There is minimal wound debridement and is less painful.

Answer 23

Circumferential neck wrap to secure dressings

Answer 24

A 4x4 with a Y slit. Placed around a tube.

Answer 25

Y with cotton tape to tie around the neck. There is a Velcro Strap.

Answer 26

Retains meds and keeps the lid closed. There can also be a rigid shield which protects from pressure or trauma.

Answer 27

Pad that absorbs vaginal or perineal drainage. Comes with a belt or mesh underpants to keep in place.

Answer 28

Material which assists in hemostasis. It provides pressure and eliminates dead space. In the nose, rectum, vagina, and open wound. Could be a long strop of gauze. Can also be plain, antiseptic and is radiopaque.

Answer 29

Foam or gauze covered w an adherent plastic film which connects to a vacuum pump. It draws out fluids and exudates and increases microcirculation. Also encourages approximation of wound edges. (Purvina and KCI)

Answer 30

Placed within surgical wounds, tubular structures, and hollow organs in order to assist with diagnosis, restore function, promote healing, and prevent complications. They are hollow and cylindrical.

Answer 31

Drains urine, provide irrigation fluid within a duct, and retracts. -uses French scale for sizing (5-30) -may have one or more openings for drainage -include nonretaining and self-retaining urethral, ureteral, and suprapubic.

Answer 32

-urethral (nonretaining) -urethral (self retaining) -suprapubic -ureteral -intravascular

Answer 33

There are tissue, wire, bandage/dressing, and suture scissors. Come in heavy, medium, and light construction.

Answer 34

Balloon-tipped catheter that is passed beyond an obstruction within the lumen of a vein, artery or duct. The balloon is inflated and then withdrawn along with the obstruction.

Answer 35

A cholangiocatheter that identifies the presence of calculi under x-ray. Attaches to a Luer-Lok syringe. One lumen introduces radio-opaque dye.

Answer 36

For long-term vascular access (years) or poor peripheral venous access. Is a single or multi-lumen radiopaque catheter. Includes double/triple Broviac/Hickman which monitors central venous pressure. Swan-Ganz pulmonary artery catheter which is inserted into subclavian via cut down into superior vena cava or right atrium to comitor CVP.

Answer 37

The Tenckhoff silicone catheter. Can be intermittent or continuous peritoneal. Catheter is placed into peritoneal cavity and infuses dialysis fluid. Synthetic cuffs hold it in place (internal in facia and external subcutaneously)

Answer 38

Aspirate air/fluids from GI tract and instill nutrition. Inserted into stomach/intestine via nose, mouth, rectum, percutaneous. May have sump (dual lumen design). The first lumen allows the evacuation of fluid and the second allows air to enter for equalizing pressure within structure; the third lumen is for instillation.

Answer 39

Oral airway ET Nasal airway Trach Know chest tube

Answer 40

Passive: allows pathway for air'fluid to move from area of high pressure to low. Connected to gravity collection device of sponge. Active Drains: Use negative pressure often from removing air from the collection device. Manually or mechanically electric, battery pump, and vacuum system.

Answer 41

-Penrose -Cigarette -T-tube -GI tube -cystoscopy tube -nephrostomy tube

Answer 42

-chest tube -hemovac -JP -stryker

Answer 43

Used to irrigate wounds, aspirate fluids, inject meds. Plain (Luer-slip): Needles slips over syringe tip but not as secure Locking (Leur-lock): Locks the needle onto the syringe w twisting motion Irrigating syringes include bulb or barrel.

Answer 44

instruments are designed to manipulate tissue to facilitate dissection or suturing or to reduce and stabilize fractured bone during internal fixation. may or may not be ratcheted.

Answer 45

instruments are designed to occlude or constrict tissue and are constructed with opposing ring handles for fingers, interlocking ratchets located just below the ringed handles to lock the instrument in place, and two shanks that connect the ringed handles to the box lock, or hinge joint of the clamp.

Answer 46

Instruments designed for the exposure of the operative site.

Answer 47

Malleable, wire-like instruments for the exploration of a structure such as a fistula, duct, or vessel are called probes.

Answer 48

Dilators are instruments used to gradually dilate an orifice or duct to allow for introduction of larger instrumentation or to open a stricture

Answer 49

Instruments used to hold a curved suture needle for suturing are called needle holders.

Answer 50

The removal of blood and body fluids from an operative site to provide better visualization is accomplished with a suction tip that is connected by plastic tubing to a suction canister or other suction device such as the Neptune

Answer 51

Instruments that are used to perform microsurgery are very small, delicate, and precise devices that, when used in conjunction with an operating microscope, allow the manipulation and repair of very small structures or tissue

Answer 52

-Used pre, intra, and postop for diagnosis, biopsy, visualization, repair of a structure. -introduced through small skin incision/natural orifice (less recovery time) -named after atomical region being used -flexible: maneuverable for introduction of flexible instruments, suction, and fluid injection. used for fixated anatomy to see around corners -rigid: can be hollow for introducing instruments. can have telescopic lens. -used in conjunction w light cord w one end attached to scope and other to an electrical light source -some have ability to be used w ESU.

Answer 53

-instruments are powered by nitrogen, electricity, or battery -nitrogen is supplied from a tank w adaptors to allow hoses to be connected. pressure is regulated by team at specifications of manufacturer (80-100 psi) -delicate bone work may require a faster air powered instrument -common uses are to drill holes into skull and turn/ a bone flap, ream the center of a long bone, drill holes to secure a plate, saw the femoral/humeral head, saw through sternum, reshape bone, cut skin, and sand skin for dermabrasion -used to drill, ream, saw, shave, and cut

Answer 54

Drill: rapid rotary motion for carving bone or holes Drive: Rotary motion for reaming the shaft of a long bone Ream: Slow rotary motion for reaming the shaft of a long bone Cranial Perforators: Rotary motion to drill holes in cranium and stop before penetrating the brain Saw: Reciprocating or oscillating action for cutting bone. Used on craniotome cuts where delicate tissue is protected by a dural guard. Blades have variety Shave: 180 alternating direction rotary action to shave off layers of bone Cut: Some use saw action, some use rotary.

Answer 55

-Binocular apparatus that uses bent light waves for magnification -eyepieces and objection lenses are interchangeable -consist of optical lens which provides magnification and resolving power, objective lens, eyepieces. -focal length ranges from 100-400mm -achromatic capabilities sharpen the image -second set can be attached to microscope for assistant -total magnification is calculated by multiplying the magnifying power of the objective lens by magnifying power of the oculars -increase in magnification decreases field of view -zoom lens w a foot control -light waves are provided by paraxial or coaxial illuminators -mounting system for stability (suspended from ceiling or mounted on mobile frame w locks) -electrical system -can be adapted for attachment to laser or camera -covered by sterile drapes or sterile covers attached to focusing knobs.

Answer 56

Paraxial: contain tungsten/halogen bulbs. focusing lenses are mounted onto body of microscope. can be angled inward to illuminate operative site and has diaphragm which narrows beam. Coxial: use fiber optics to transmit light waves through microscope's optical system. light is cool. light intensity in controlled by switch on arm.

Answer 57

-can be attached to microscopes/endoscopes -still images can be taken w camera and printed w microcomputer imaging system -fiber optic light cord attached to an electric source -light cord and camera is sterilized

Answer 58

-worn by surgeons for additional illumination of operative site -focuses intense light beams -fiber optic cord attaches to endoscopes or illuminator mounted retractors

Answer 59

-creates space for viewing w endoscope and work -infuses CO2 into abd cavity -uses veress insufflation needle or hasson blunt trocar -intraop pressure is 12-15 mmHg

Answer 60

-powered by nitrogen, battery, or electricity -dibridges traumatic/infected surgical wound -adjustable pulsed saline solution pulverizes necrotic tissue or clots -circular shield is used on hand piece or a lap/towel is laid over wound to prevent splatter.

Answer 61

-produce very small electrical currents that are applied to tissue to help identify and preserve essential nerves -anesthesia providers may use to asses actions of neuromuscular blockers -to operate needle that is attached by wire to locator probe is inserted in adjacent, nonessential tissue. next, structure in question is touched w probe and if nerve is nearby the tissue will move slightly.

Answer 62

-applied to pt's leg to prevent venous stasis and DVT that could lead to a PE. -treats edema and can be used in upper extremity after axillary lymph node dissection -use pre and postop -pressure is adjusted according to dr's order -has electrical compressor, connecting tubing, sleeves that have chambers filled w fluid or air which pumps fluid proximally.

Answer 63

-uses vacuum to remove fluids from surgical site/airway -two units in OR (one for surgical team, one for anesthesia) -contains vacuum source, tubing, collection unit, and suction tip -used in sterile manner

Answer 64

-most ORs have 2 but some specialty rooms have 4. -freely adjustable w intense light -diameter and focus of light can be adjusted w control (beam should be set at 10-12) -no shadows, minimal heat, and blue/white color of sunlight -easily cleaned and do not retain dust -fixtures have screws or clips for attachment of light handles OR light should never be tuned off unless dimmer has been turned down.

Answer 65

-used to restrict bloodflow to extremities which reduces blood loss and improves visualization of field -if incorrectly used (placement, pressure, or prolonged insuflation) neurovascular damage can occur -improper application may lead to blistering, bruising, pinching, and necrosis -contains cuff, tubing, power source, pressure device. -placed as proximally as possible (surgeon decides) -pressure is determined by provider according to systolic pressure (leg: 1/2 value; arm: 30-70) -at one hour pressure should be dropped and inflation/deflation times should be documented.

Chapter 10 Flashcards

Instrumentation, Equipment, Supplies