Lecture 4 - Instruments & Tissue Handling Flashcards Preview

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Flashcards in Lecture 4 - Instruments & Tissue Handling Deck (110)
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1

What are Halsted's Principles of Surgery?

1. Gentle tissue handling 2. Meticulous hemostasis 3. Strict aseptic technique 4. Preservation of blood supply 5. Elimination of dead space 6. Minimize tension 7. Careful approximation of tissues 8. Minimize foreign material 9. Sharp anatomic dissection

2

Tissue damage is proportional to _____ and _____.

time, trauma

3

In which hand should you hold non-articulating instruments?

non-dominant hand

4

In which hand should you hold articulating instruments?

dominant hand

5

How can hand tremors be minimized?

by decreasing the fulcrum distance

6

What are the cutting instruments?

scalpel and scissors

7

What are the grasping instruments?

needle holders, tissue forceps, thumb forceps, towel clamps

8

Besides cutting and grasping, what are the other general types of instruments?

retracting, orthopedic, miscellaneous

9

What is the primary cutting instrument?

scalpel blade

10

Scalpel blades have the _____ amount of tissue trauma.

least

11

What are the sizes of each blade from left to right? Which one is most commonly used?

#10, #11, #12, #15

#10 is the most common

12

What should you use to grip your scalpel blade to load it? On what surface should it be gripped?

Use needle holders to grip the non-cutting surface

13

What is the proper process of loading a scalpel blade onto the handle?

Align slot in handle with hole in the blade and advance the blade until it is locked

14

What should you use to remove the scalpel blade from the handle and how often?

ALWAYS use a needle holder

15

How should the scalpel blade/handle be pointed when unloading the blade?

down and away

16

What are the two grips that can be used to hold the scalpel blade?

Fingertup grip (overhand) and pencil grip

17

What does your non-dominant hand do when making an incision?

applies counter-traction

18

How should the blade be held in relation to the skin when making an incision?

Perpendicular to the skin (held by the dominant hand)

19

How should an incision be made, in general?

Full thickness with a single pass

20

What are the motions a scalpel blade can do?

Sliding, pressing, reverse pressing, press cut (stabbing), sawing, and scraping

21

What is an example of a time when you would use a sawing motion with your scalpel?

removing lung or liver lobe

22

When would you use a scraping motion with your scalpel?

for very specific reasons

23

What are the 2 types of tissue dissection?

blunt vs. sharp

24

What type of grip should be used to hold scissors?

tripod grip

25

What types of forces can be used with scissors?

Closing, shearing, torque forces

26

When should you use mayo scissors?

Fascia, linea alba, extending incision

27

When should you use metzenbaum scissors?

on more delicate tissues (blunt dissection)

28

When should you use operating (utility, sharp-blunt) scissors?

Cutting inanimate objects

29

When should operating (utility, sharp-blunt) scissors NOT be used?

On tissues

Cutting suture in the abdomen because of the sharp end

30

Identify this instrument.

Bandage scissors (Lister)