instruments quiz and suture patterns

Question 1

what sizes are theses?

Answer 1

A - no 4

B - no 3

Question 2

what blades will each accept?

Answer 2

A - 20 - 23
B - 10, 11, 12, 15

Question 3

why do you need different sized scalpel handles?

Answer 3

Handle A is more commonly used in large animal practice to accept larger blade sizes.
Handle B is generally used for small animal general surgery.

Other handles are available for different situations like ophthalmology.

Question 4

what grip do you use for a scalpel? why do we use this?

Answer 4

pen holder grip:
* very stable
* good contact acngle
* allows only short slide cut

Question 5

what is the alternative hold for the scalpel? what is the downside to this, why would you use it?

Answer 5

fingertip grip:
- less stable
- flatter contact angle
- allow long slide cuts

Question 6

what is slide cutting? how is it done?

Answer 6

use the curved part of the blade to insice the skin
the assisting hand, tenses the tissue and reduces the downward force

Question 7

what is the push cut? when is it used and what type of inscision does it make?

Answer 7

Question 8

what is the stab cut used for? what is the downfall to this?

Answer 8

visceral puncture, difficult to control depth

Question 9

what blade is this? what is it used for?

Answer 9

no 10: general purpose, SA

Question 10

what blade is this? what is it used for?

Answer 10

no 12: suture removal

Question 11

what blade is this? what is it used for?

Answer 11

no 15: general purpose, cat

Question 12

what blade is this? what is it used for?

Answer 12

no 20: general purpose, LA

Question 13

what are these and what are they used for?

Answer 13

littauer scissors: to remove tight/small or awkward sutures

Question 14

what are these and what are they used for?

Answer 14

metzenbaum scissors: good for fine dissection of tissue and more delicate work (don’t cut sutures)

Question 15

what are these and what are they used for?

Answer 15

mayo scissors: used for cuttingheavy or tough tissue, eg fascia

Question 16

what are these and what are they used for?

Answer 16

dressing scissors: cutting dressing materis and general work. also used for cutting suture material during surgery

Question 17

what can you use to cause haemostasis in surgery?

Answer 17

• artery forceps
• swabs
• suction
• electro-coagulation (surgical diathermy)

Question 18

what are the names of these artery forceps (haemostats)?

Answer 18

A - mosquito
B - spencer wells
C - rochester pean

Question 19

what is the function and name of this?

Answer 19

bowel clamp - doyen bowel clamp

Question 20

From pictures 1 and 2, which is the artery forceps and which is the bowel clamp and why?

Answer 20

1 Artery forceps (serrated appearance is transverse on the blade)
2 Bowel clamp (serrated appearance runs lengthways along the clamp)

The bowel clamps striations are less traumatic and thought to be more secure in sealing the bowel during surgery.

Question 21

what are the two ways to hold artery forceps and why would you use them?

Answer 21

• curve facing down to pick up small bleeders
• curve facing up to grasp tissue bunch eg body of uterus

Question 22

what do swabs contain and why is this important?

Answer 22

raytex marker - important for cavity surgery, the line is radiodese so can be located on xray

Question 23

what are these and what is their main use?

Answer 23

spay forceps

Elevating the uterine horn in a cat spay. Most forceps have a plain grip, but these have a
Debakey grip which is a secure grip less traumatic than rat toothed forceps.

Good for surgery of ear, bowel or urogenital tract.

Question 24

what are these and what is their use?

Answer 24

block ended serrated dressing forceps
cheap dressing forceps minimal use during surger

Question 25

what are theses?

Answer 25

adson tissue forceps

Question 26

A and B have different working ends, what are these called? What would you use each different end for?

Answer 26

A - rat toothed B - serated use: Ideal for fine surgery. Rat toothed gives more grip when needed but can be traumatic, not for use with visceral organs. Serrated end has less grip but little trauma to tissue good for fine tissue handling.

Question 27

what are these , what are they used for?

Answer 27

treves tissue forceps: - general purpose rat toothec forcepss, - used in general surgey, - traumatic to tissue

Question 28

what are these, what are they used for?

Answer 28

allis tissue forceps: - use for grasping and reteacting more tough connective tissue for example the linea alba - they can be traumatic so not to be uesed on skin

Question 29

what are these, what are they used for?

Answer 29

babcock forceps: - for use in grasping delicate viscera and retracing - less traumatic than allis tissue forceps

Question 30

what is this retractor called? and what is its use?

Answer 30

Gosset - rib/laparotomy

Question 31

what is this retractor called? and what is its use?

Answer 31

hohman - retraction of bone/bone fragments (fracture repair)

Question 32

what is this retractor called? and what is its use?

Answer 32

Gelpi - joint surgery and spinal surgery (for skin/tissue retration)

Question 33

what is this retractor called? and what is its use?

Answer 33

travers - retration of skin and superfical tissue

Question 34

what is this retractor called? and what is its use?

Answer 34

Senn - fat pad retration n medical meniscus repair

Question 35

what is this retractor called? and what is its use?

Answer 35

Balfour - retration of the body wall during exploratory laparotomy

Question 36

what is the difference between ADC and BE?

Answer 36

self-retaining vs hand held hand-geld need and assistant to hold and manipulate the retractor

Question 37

what is this called?

Answer 37

needle holders - mayo with tungsten carbide inserts

Question 38

what is this called?

Answer 38

needle holders - olsen hagar

Question 39

what is this called?

Answer 39

needle holders - gilles

Question 40

what is this called?

Answer 40

needle holders - McPhails

Question 41

What does B and C have that the others do not, how is this useful?

Answer 41

scissors, for cutting suture during surgery, no need for serperate instrument, can continue surgery without putting needle holders down

Question 42

What does A, B and D have the C does not. How is this useful?

Answer 42

locking catch - good grip of needle

Question 43

what are these adn what are they used for? are there any others and why might they be better?

Answer 43

A - Backhaus Towel clamp B - Cross over towel clamp Securing drapes to the patient. Yes. There are some atraumatic towel clamps which are more friendly to the patient and less likely the pierce through the drape material. They can sometimes be less secure.

Question 44

what is this insturment and what is it used for?

Answer 44

spay hook: atraumatically lifting the uterine horns within the abdomen (some surgeons use fingers)

Question 45

what is this instument and what is it used for?

Answer 45

rongeurs - orthopeadic to removing the rough edges of bone in small pieces

Question 46

what is this instument and what is it used for?

Answer 46

periosteal elevator: removal of periosteum from bone

Question 47

what are these instuments andwhat are they used for?

Answer 47

staple removers - removing skin staples post-operatively

Question 48

how do you decide what suture material to use?

Answer 48

- the type of tissue you are repairing and nature of the wound - how long it needs support for - the characteristics of the suture material - size of suture material - the type of needle – cutting or atraumatic - what is available in the practice - preference or what you are used to using

Question 49

what suture is used for dogs and cats? how about with delicate tissue and tough tissue?

Answer 49

Rule of thumb - 3metric for dogs, 2 metric for cats - delicate tissue- reduce by 1 size - tough tissue- increase by one size

Question 50

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture material and size would be suitable for the following tissues? ligature of the uterus?

Answer 50

Monosyn (Monocryl) or Novosyn (Vicryl) (mid-term support) size 3 metric | (in brackets is Ethicon equivalent)

Question 51

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture material and size would be suitable for the following tissues? linea alba

Answer 51

MonoPlus(PDS) – (long term support) 3 metric or for a lively dog consider 3.5metric | (in brackets is Ethicon equivalent)

Question 52

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture material and size would be suitable for the following tissues? subcutaneus tissue

Answer 52

Monosyn (monocryl) size 3 metric | (in brackets is Ethicon equivalent)

Question 53

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture material and size would be suitable for the following tissues? subcuticular tissue?

Answer 53

Monosyn (monocryl) size 3 metric | (in brackets is Ethicon equivalent)

Question 54

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture material and size would be suitable for the following tissues? skin?

Answer 54

Dafilon(Ethilon) Non-absorbable would be the choice but Supramid or Optilene also suitable,this choice ensures your patient comes back for a check-up to have the sutures removed. | (in brackets is Ethicon equivalent)

Question 55

what is the different in subcutaneous and subcuticular?

Answer 55

subcutaneous is the fat layer and subcuticular is the dermis (lower layer of the skin) (same as intradermal suture)

Question 56

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture material and size would be suitable? If this bitch was sick and required surgery for a pyometra, would you change anything?

Answer 56

absorbable braided suture material (Novosyn) would not be suitable. Use monofilament for all layers. Size 3 metric throughout is suitable. Could consider 2 metric for subcutaneous/subcuticular layers

Question 57

what suture material would you use for an ovariohysterectomy in a rabbit?

Answer 57

Monosyn 1.5metric suitable for internal support and intradermal sutures in skin. Rabbits and other small furries will chew out skin sutures so other methods for skin support should be considered.

Question 58

In an orthopaedic surgery, what suture material would be suitable for the following tissues? Fascias?

Answer 58

MonoPlus long term support Size 3 metric

Question 59

In an orthopaedic surgery, what suture material would be suitable for the following tissues? Tendons and ligaments?

Answer 59

MonoPlus long term support. Optilene also a suture material of choice if permanent support is required Size 3 metric

Question 60

In an orthopaedic surgery, what suture material would be suitable for the following tissues? Joint capsule?

Answer 60

MonoPlus long term support Size 3 metric

Question 61

A Jack Russel terrier has had a tooth removed during a dental and the gum needs suturing. What suture material and what size would be suitable?

Answer 61

Monosyn Quick a short-term support (Monosyn and Novosyn quick also suitable)

Question 62

What other methods of skin closure are there available?

Answer 62

Skin staples- quick and easy to apply, requires a special instrument to remove staples Tissue adhesive - useful in rabbits and other small animals as it is more acceptable to them instead of skin sutures