instruments

Question 1

Needle holders should be tested for function regularly by:

Answer 1

placing an appropriate sized needle in the jaws and noting if needle rotation is possible

Question 2

This instrument is used to hold and manipulate curved needles during surgical procedures. This is a heavy needle driver with a mildly tapered tip and no cutting blade.

Answer 2

Mayo-Hegar

Question 3

This needle holder also contains scissor blades at the base of the jaws which can save time to surgeons working without an assistant. It offers the disadvantage that one may accidentally cut the suture material while working.

Answer 3

Olsen-Hegar:

Question 4

These needle holders have a ratchet lock at the proximal end of the handles enabling the surgeon to lock and unlock the instrument by squeezing the handles together using a palmed grip.

Answer 4

Mathieu

Question 5

These needle holders are small and are designed to be used with a pencil grip. They have a spring and latch mechanism which allows gentle locking and unlocking and are typically used for microvascular surgery.

Answer 5

Castroviejo (Microvascular)

Question 6

The ___ and ___ should be used when grasping an instrument with a tripod grip.

Answer 6

thumb, ring finger

Question 7

____ implies the instrument is held in the palm of the hand while placing the ring finger through the bottom ring of the instrument.

Answer 7

Thenar grip

Question 8

___ implies the instrument is held in the palm of the hand without placing any finger through the rings.

Answer 8

Palm grip/ modified thenar eminence

Question 9

_____ is the technique used for handling microvascular needle drivers such as Castroviejo.

Answer 9

pencil grip

Question 10

most commonly used scalpel handle

Answer 10

3

Question 11

At our institution, we use a #_ scalpel with a #_ blade to make the initial skin incision and then use the #_ scalpel with a #_ blade (sometimes a #11) for all other scalpel incisions. This may vary with surgeon preference.

Answer 11

• 3, 10
• 7, 15

Question 12

___ scalpel handles are smaller than regular scalpel handles and will hold a variety of small blades. These are often used for ophthalmic surgery and in restricted spaces such as joints.

Answer 12

Beaver

Question 13

(scalpel grip) The ____ allows maximum control over the cut but reduces the contact surface between the blade and the tissues because of the angle created, making it ideal for short incisions.

Answer 13

pencil grip, short incisions

Question 14

(scalpel grip) The ___and ___ result in better contact of the cutting edge of the blade against the tissues (horizontal position); this is advantageous when making long incisions.

Answer 14

-The palm and fingertip grips (aka dinner knife grip)
-long incisions

Question 15

The ___ grip involves holding the scalpel handle within the palm of the hand. The thumb can be placed on the upper surface of the handle to create more force and increase control. It is best suited for ____.

Answer 15

palm, long incisions requiring greater pressure

Question 16

The tip of a scalpel blade can be used to create a stab incision into a cavity (abdomen) or a hollow viscus such as the stomach, intestine or urinary bladder. For this, the scalpel is typically held with a ____ position to allow maximum control of penetration depth.

Answer 16

pencil grip

Question 17

___ scissors are typically used to cut fascia, ___ scissors are used to cut through thin and soft tissues such as bowel and fat

Answer 17

Mayo, Metzenbaum

Question 18

Simple ___ scissors are generally used to cut suture intraoperatively.

Answer 18

sharp-Blunt

Question 19

Mayo scissors are available in varying lengths and can be curved or straight. These scissors are very strong and are mainly used for cutting ____ and ____. They can also be used for cutting ____.

Answer 19

connective tissues, fascia, sutures

Question 20

Metzenbaum scissors typically have a long handle to blade ratio. They are available in varying sizes, with a curved or straight blade, and are used for cutting ____ and for _____.

Answer 20

delicate tissues, blunt tissue dissection

Question 21

Iris scissors can be curved or straight and vary in size. They are reserved for cutting ____ and are often used for ____.

Answer 21

delicate tissues, ophthalmic procedures

Question 22

Tenotomy scissors are available in varying sizes and can be straight or curved. They have a blunt tip and are used for cutting ____ especially in ____.

Answer 22

fine, delicate tissues
ophthalmic surgery

Question 23

Suture scissors are typically used to remove skin sutures after the incision has healed. A ___ in one of the blades allows the loop of suture to be easily hooked and prevents excessive lifting of the tissues during cutting.

Answer 23

notch

Question 24

Hemostatic forceps are crushing instruments used to ______.

Answer 24

temporarily clamp and occlude bleeding vessels.

Question 25

Hemostatic forceps of larger size (e.g. Rochester-Carmalt) are typically used to _____ prior to ligation and transection.

Answer 25

crush pedicles and stumps

Question 26

The jaw of the mosquito forceps contains ____ along its entire length making it a good choice for _____.

Answer 26

transverse striations, the occlusion of small vessels

Question 27

_____ are larger and less delicate than mosquito forceps. These forceps have transverse serrations along the distal half of the jaws only.

Answer 27

Kelly forceps

Question 28

Kelly forceps are often used for the occlusion of:

Answer 28

small to medium sized vessels.

Question 28

Kelly forceps are often used for the occlusion of:

Answer 28

small to medium sized vessels.

Question 29

_____ are larger and less delicate than mosquito forceps. These forceps have transverse serrations along the entire length of the jaw surface and are available with straight or curved jaws. These instruments are often used for the occlusion of small to medium sized vessels.

Answer 29

Crile forceps

Question 30

describe the striations on rochester-carmalt forceps. What is their purpose?

Answer 30

The serrations on the jaw surface run longitudinally for the entire length, except at the jaw tip where they also run in a transverse direction (resulting in cross striations)

-The longitudinal serrations allow easy removal during suture ligation, and the cross striations at the tip of the jaw help hold tissues within the confines of the instrument. These are available with straight or curved jaws.

Question 31

Satinsky or tangential clamps are designed to:

Answer 31

non-traumatically occlude a portion of a large blood vessel such as the vena cava while allowing blood to flow in the non-occluded portion of the vessel.

Question 32

What are bull-dog clamps used for? what is their advantage?

Answer 32

Bull dog clamps are used to temporarily occlude blood vessels during vascular surgery. They are small and fairly light which is an advantage when working in confined spaces or when there is little support from the surrounding tissues. Various modifications of these clamps are available with some that allow to adjust the pressure created by the clamp on the vascular wall. The instruments are available in various sizes and with straight or curved jaws.

Question 33

Thumb forceps should be held between the thumb and index finger with a ___ grip when in use, and in the ____ when not in use.

Answer 33

pencil, palmed position

Question 34

Adson forceps are equipped with _____ tips that provide a ____ grasp of tissues. These forceps are freqently used in surgery to ______.

Answer 34

fine, rat tooth
gentle
manipulate soft tissues such as fascia and skin during suturing

Question 35

Adson-Brown forcep characteristics

Answer 35

These forceps are similar to the Adson tissue forceps, except that the tip configuration is characterized by multiple, fine intermeshing teeth that provide a secure (although slightly more traumatic) grasp of tissues and suture needles.

Question 35

Adson-Brown forcep characteristics

Answer 35

These forceps are similar to the Adson tissue forceps, except that the tip configuration is characterized by multiple, fine intermeshing teeth that provide a secure (although slightly more traumatic) grasp of tissues and suture needles.

Question 36

Rat tooth forceps have ____ enabling _____ (i.e. fascia) without slipping.

Answer 36

larger interdigitating teeth, strong grasp of skin or dense tissue

Question 37

striations of DeBakey forceps and their advantages. When are they used?

Answer 37

The specific design of the DeBakey tissue forceps (striated in a longitudinal direction) provides a delicate grasp of soft tissues by minimizing tissue damage. It is used preferentially during thoracic and vascular procedures but many surgeons also prefer to use DeBakey forceps during abdominal procedures (e.g. bowel or bladder surgery). The instruments are available in various lengths and tip width.

Question 38

These forceps have a very broad tip characterized by a circular serrated gripping surface. This instrument is available in varying lengths. These forceps are sturdy and provide a strong holding grasp of tissues. The gripping surface is traumatic to tissues, and care should be taken to prevent damage. I often use these forceps to manipulate the pericardial sac during a pericardectomy.

Answer 38

Russian forceps

Question 39

tissue forceps should never be applied to what?

Answer 39

should never be applied to the skin or organs that are meant to remain functional (an exception is the Doyen clamp).

Question 40

what should allis tissue forceps be used for? what do they have on their gripping surface?

Answer 40

Allis tissue forceps have a varying number of teeth on their gripping surface and are available in various sizes. These forceps are extremely traumatic and should only be applied to fascial planes or connective tissue (if applied to any tissues at all).

Question 41

what kind of striations do babcock tissue forceps have?

Answer 41

These forceps are less traumatic than Allis tissue forceps because of their fine longitudinal striations along the gripping surface of the jaws. Although designed to handle the intestines, it is not recommended for this use.

Question 42

gripping surface of doyen forceps. what is their use? how do they avoid causing trauma?

Answer 42

Doyen forceps are characteristic because of their long, thin and bowed jaws covered with fine (generally) longitudinal serrations along the entire length of the gripping surface. They are available in lengths ranging from 6.5 to 9 inches as curved or straight instruments. These forceps are used for gastric and intestinal surgery. Their gentle, atraumatic grip is achieved by having only the tips of the jaws meet when the first teeth of the ratchet are engage (because of their bowed shape).

Question 43

mixter forceps shape and use

Answer 43

Mixter forceps have a blunted tip and transversely serrated jaws that are bent at various angles (e.g. 45 to 90 degree angle). These forceps are used to dissect vessels or for blunt dissection in areas that are relatively hard to reach. These instruments are particularly important in cardiovascular and thoracic surgery and are also used for gall bladder and biliary duct surgery.

Question 44

use of ochsner forceps

Answer 44

-have transverse striations and are equipped with large teeth at the tip ends which were designed to prevent tissue slippage
-The teeth are inconvenient and traumatic therefore these forceps are rarely used in veterinary soft tissue surgery. Some surgeons find use for this instrument in orthopedic surgery to manipulate bony fragments during fracture repair.

Question 45

_____ towel clamps are most commonly used to secure drapes to the patient’s skin. These have sharp points and are available in varying sizes.

Answer 45

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