Instruments, Sutures, And Needles

Question 1

Name the parts for instrument anatomy

Answer 1

Tips
Jaws
Box lock
Box lock pin
Shanks
Ratchet
Ring handles

Question 2

How are instruments selected for surgery?

Answer 2

Pt physical condition
Surgeons preference
Anatomical structure

Question 3

What are the basic categories for instruments?

Answer 3

Cutting
Retracting
Clamping
Grasping

Question 4

Blades are ___________ and handles are ____________.

Answer 4

Disposable, reusable

Question 5

Blades that start with 1 fit handle _________ and those that start with 2 fit on ________

Answer 5

3 and 7

4

Question 6

Type of scalpel handles?

Answer 6

3
3long
4
7
Beaver

Question 7

Instruments used to cut through bone and cartilage?

Answer 7

Chisels
Rongeurs
Osteotomes
Gouges
Files/rasps
Powered instruments

Question 8

What instruments are typically used for blunt dissection

Answer 8

Scalpel handle
Blunt sides of scissor blades
Sponge on sponge stick

Question 9

Allis is typically used for what?

Answer 9

Grabbing skin edges, has teeth

Question 10

What is the Babcock?

Answer 10

A grasping instrument used for the bowels

Question 11

What instrument family is the kosher a part of?

Answer 11

Grasping

Question 12

Tissue forceps may also be known as__________.

Answer 12

Thumbs or pickups

Question 13

What does a Tuttle forcep look like and what is it typically used for?

Answer 13

Long with round ends without centre.
Has a pin in centre of forcep handle that travels through a small hole across from it to keep alignment
Used for bowels

Question 14

What are debakeys?

Answer 14

Forceps
Can be long or regular
Has tooth on top and bottom
Either 1:2, 2:3, 3:4

Question 15

Why are some stone forceps curved?

Answer 15

So you can reach in duct

Question 16

What family does the tenaculum belong to? What are they for?

Answer 16

Grasping
Have single or multiple teeth
Penetrate tissue to grasp firmly
Used in uterus, etc

Question 17

What are the most commonly used instruments?

Answer 17

Hemostats

Question 18

What are haemostats used for?

Answer 18

To clamp blood vessels

Question 19

What should you never do withs hemostat?

Answer 19

Use it to attach items to drapes because they are pointier and sharp and could poke through sterile sheet.

Question 20

The rib spreader is an example of what?

Answer 20

A self retaining retractor

Question 21

When would a terminal end stapler be used?

Answer 21

Closing end of hollow organ

Question 22

When would an internal anastomosis stapler be used?

Answer 22

To connect hollow organ segments

Makes larger pouch or reservoir

Question 23

What if the doctor asks you for for multiples of the same instruments in rapid succession?

Answer 23

May be picked up in multiples but must be handed individually

Question 24

How do you pass an instrument to a surgeon on the opposite side of the table?

Answer 24

Pass across right hand to right hand or left hand to left handed surgeon.

Question 25

How do you pass to a surgeon or assistant who is on the same side of the table as you?

Answer 25

If on right side pass with left hand | If on left side pass with right hand

Question 26

What are some physical suture characteristics?

Answer 26

Physical configuration (single or multifilament) Capillarity (ability to transmit fluid) Fluid absorption ability Diameter (sizes) Tensile strength (breaking load) Knot strength (force needed to made a knot slip) Elasticity (ability to regain original for and length after stretch) Plasticity ( Memory (retain former shape after removed. The higher the les knot security)

Question 27

Explain the handling characteristics of sutures

Answer 27

Pliability (how easily material bends) Coefficient of friction (how easily the suture slips through tissue and can be tied) - too high can drag through tissue and cannot tie knots. Too low and knots may come loose

Question 28

What are some tissue reaction characteristics of sutures?

Answer 28

May have inflammatory response Allergic reaction Absorption Potentiation for infection

Question 29

Explain absorbable sutures

Answer 29

They are flexible Prepared from collagen of healthy animal or synthetic fibre Absorbable in living mammal tissue By enzymatic activity or hydrolyzed (water in tissue) Treated with chromium salt which delays absorption

Question 30

What are the types of absorbable sutures, how long do they last, and where are they typically used?

Answer 30

Plain and chromic gut - 21 days - skin, intestines, stomach Vicryl - 70 days - skin, fascia, muscle, bowel Monocryl - 119 days - skin PDS - 180 days - peritoneum, lung

Question 31

What are some non absorbable sutures and where may they be used?

Answer 31

Silk - skin, drains, tie off vessels Nylon (Ethlon & Nurolon) - skin and drains Polyester (Mersilene & Ethibond) - tendons Polypropylene (Prolene) - vascular grafts, skin, hernia repairs, muscle Stainless steel - tension band wiring in fractures

Question 32

Parts of a needle?

Answer 32

Point, body/shaft, eye or swaged end

Question 33

Types of needles?

Answer 33

``` Conventional cutting Reverse cutting Taper Tapercut Blunt ```

Question 34

What type of needle has cutting edges on outer curvature?

Answer 34

Reverse cutting

Question 35

What needle has a rounded tip and why is this?

Answer 35

Blunt, less apt to puncture vessels within organs. Usually used in liver. Or cervix

Question 36

Which needles are triangular shaped?

Answer 36

Conventional cutting and reverse cutting

Question 37

Which needles are used for skin closure?

Answer 37

Conventional and reverse cutting

Question 38

Which needle is smooth and has no cutting edge? Where is it used?

Answer 38

Taper needle | Used to push aside tissue, used on delicate tissue.

Question 39

What makes the taper cut different from the other cutting needles?

Answer 39

Cutting edge is only at point.

Question 40

Which needle is used for touch tissue without tearing it?

Answer 40

Taper. Eg fascia

Question 41

What three areas of the set up do you keep your needles?

Answer 41

In the package On a driver Or in needle book/ sharps

Question 42

Why shouldn't you run your fingers along suture to remove knots?

Answer 42

Causes fraying

Question 43

What should u watch for when passing needle to surgeon?

Answer 43

Not to get picked | Avoid contamination by helping suture string over sterile field

Question 44

What should you do with the suture packages once opened?

Answer 44

Keep on set up

Question 45

What type of suturing methods are there?

Answer 45

``` Retention/ stay suture Interrupted Continuous Continuous locking Horizontal/vertical mattress stitch Subticular Purse string Ties ```

Question 46

Why must surgical gut and collagen sutures be used immediately after removal from package?

Answer 46

Wet packaged in alcohol solution to provide max pliability. Once removed the alcohol evaporates and strand will lose its pliability. Can restore by submersing into sterile water or snow at body temp for a few sec. Increased moisture decreases tensile strength