Instruments and knots

Question 1

How are instruments sterilised

Answer 1

1. high temperatures

2. autoclave

Question 2

What are the basic groups of instruments?

Answer 2

1. Towel clamps
2. Cutting Instruments
3. Forceps
4. Needle holders

Question 3

What are the different types of cutting instruments

Answer 3

1. Scalpel handle and blade

2. Scissors (metzenbaum and mayo)

Question 4

What are the different types of forceps?

Answer 4

1. Tissue Forceps (Allis, Treaves, Adson)
2. Dressing Forceps (Adson)
3. Artery forceps (Spencer-wells, Halstead, Rochester-pean)

Question 5

What are the different types of needle holders

Answer 5

1. Olsen-Hagar, Mayo-Hagar, Gillies

Question 6

What are towel clamps designed for

Answer 6

To attach drapes to skin of patient

Question 7

What should you remember to do when applying towel clamps to patient?

Answer 7

1. Pin point so won’t reduce blood supply to the area of skin therefore less traumatic then if blunt
2. Still causes pain so surgeon should warn anaesthetist prior to application
3. minimal amount of skin
4. avoid puckering of drape = can increase contamination

Question 8

What are different parts of needle holders

Answer 8

1. Tips
2. Jaws (with or without cuting edge)
3. Hinge
4. Shank
5. Ratchet (not always)
6. Ring handle

Question 9

How do you hold needle holders?

Answer 9

1. thumb and 4th (ring finger) digits placed through handles
2. 2nd digit (forefinger) placed on top of hinge, providing vertical stability
3. 3rd digit (middle) placed on side of shank providing horizontal stability

Question 10

Where should needle be placed in the needle holder

Answer 10

1. held in middle third of curve, not suture end as that causes breakage

Question 11

How do you identify olsen hegar needle holders

Answer 11

1. blade = called jaws
2. ratchet
3. rough edged tip
4. hinge
5. long shank
6. ring holders

Question 12

How do you identify mayo hegar needle hodlers

Answer 12

1. no blade

2. ratchet

Question 13

How do you identify gilleis needle hodlers

Answer 13

1. off set loops
2. blade
3. no ratchet

Question 14

What will the sharpest/ bluntest cut cause

Answer 14

1. sharpest = minimal haemostasis of blood vessels = beneficial to healing
2. bluntest = maximal haemostasis of blood vessels

Question 15

What are the 2 types of scalpel handle

Answer 15

1. number 3 = blade sizes beginning with 1

2. number 4 = blade sizes beginnign with 2

Question 16

How to identify Metzenbaum scissors

Answer 16

Remember scissors come with both straight and curved blades and 1 or both tips can be sharp or blunt

1. thinner more delicate and sharp
2. short tips
3. long shank

Question 17

How to identify mayo scissors

Answer 17

1. bulkier and stronger

2. tips about same length of shank

Question 18

What are mayo scissors used for

Answer 18

1. cutting fibrous material, suture material as tougher

Question 19

When use metzenbaum scissors

Answer 19

1. for delicate tissue cutting

NEVER FOR CUTTING SUTURE MATERIAL

Question 20

What is the purpose of curved bladed scissors

Answer 20

to improve the visibility if the curve is facing downwards

Question 21

What are the purposes of artery forceps and what are the different types of artery forecep

Answer 21

PURPOSE: control haemostasis (stopping flow of blood)
3 different types:
1. smallest and delicate tips = halsted mosquito

Question 22

What to remember when identifing scissors and artery foreceps

Answer 22

1. both come with straight and curved tips so don’t be put off!
2. just name straight or curved - e.g. straight halsted mosquito forceps

Question 23

How to identify halsted mosquito artery foreceps and what appropirate for

Answer 23

1. smallest and delicate
2. finely serrated edge
3. appropriate for accluding small blood vessels
4. ratchet

Question 24

How to identify spencer wells artery forceps

Answer 24

1. Ratchet

2. serrated edge whihc is more chunky that HM so used to acclude medium sized blood vessels

Question 25

How to identify Rochester-Pean artery forceps

Answer 25

1. LArgest 2. Long jaw area 3. appropriate for medium to large blood vessels 4. serrated edge

Question 26

What are the two types of forcep ends and what are these subsequently used for

Answer 26

1. sharp tips: tissue forceps for holding tissue, never hollow organs as can penetrate 2. dressing forceps = flat tip with no jaw

Question 27

What are the types of forceps?

Answer 27

1. Treaves = tissue forceps as rat teeth, wide all way along = hold tissue 2. Addson tissue forceps = wider grip and fine delicate tips = sharp 3. Addson dressing forceps = flat tips 4. Alls tissue forceps = wider tips, smaller jaws, ratchet = used to hold tissue out of way while doing other procedures

Question 28

Name and describe Miscellaneous Instruments

Answer 28

1. Cat spay hook: scoop uterus from abdomen = curve tip with blunt end. Use with caution as don't want to damage other organs 2. Mickey mouse = scalpel director

Question 29

What to remember when knot tying with hands

Answer 29

1. don't let the loose bits of string dangle down and become contaminated

Question 30

When tyign a surgeons knot what to remember

Answer 30

once done the know, complete it by tying 2/3 full square knots to ensure security