questions

Question 1

Most commonly used knot in surgery

Answer 1

Square knot

Question 2

Square knots are composed of

Answer 2

2 simple throws

Question 3

How does a surgeons knot allow for greater knot security?

Answer 3

Higher knot friction

Question 4

How is a knot always secured?

Answer 4

By tying 2 additional throws minimum

Question 5

What type of knot is useful for tying knots in deep cavities or tight spaces ?

Answer 5

Slip knot

Question 6

Knot security is inversely related to _______

Answer 6

the diameter of the suture material

Question 7

Suture end should be cut short (3mm)….What is the exception to this?

Answer 7

Surgical gut –> 6mm due to swelling

Question 8

Stabilizes tissue &/or expose tissue layers during suturing

Answer 8

Thumb forceps

Question 9

Used for delicate grasp of skin & fascial planes

Answer 9

Adson thumb forceps

Question 10

General tissue manipulation & handling needle during suturing

Answer 10

Adson Brown thumb forceps

Question 11

Stabilize & retract less delicate tissues

Answer 11

Rat-tooth thumb forceps

Question 12

Grasps more dense tissues

Answer 12

Allis tissue forceps

type of ratcheted forceps

Question 13

Grasping intestines or other hollow organs

Answer 13

Babcock tissue forcepst

type of ratcheted forcep

Question 14

Used for intestinal R & A, gastric sx

R & A - retraction and anastomoses???

Answer 14

Doyen intestinal forceps

ratcheted forcep

Question 15

Control point bleeders

Answer 15

Halstead/Mosquito Hemostatic Forceps

Question 16

Hemostasis of larger vessels

Answer 16

Kelly Hemo. Forceps

Crile Hemo. Forceps

Question 17

Rochester - Carmalt Hemo. Forceps –> aids in hemostasis by _____

Answer 17

crushing ovarian pedicles and/or uterus during OHE

Question 18

Exerts gentle compression of vessel without causing endothelial damage for the purpose of temporary hemostasis (ex. vena cava)

Answer 18

Bulldog satinsky and satinsky hemo. forceps

Question 19

used to cut suture material

Answer 19

Doyen scissors

Question 20

Delicate tissue dissection

Answer 20

Metzenbaum

Question 21

Cut more dense tissue

Answer 21

Mayo scissors

Question 22

Retract skin and superficial tissues to improve visualization & accessibility of deeper tissues

Answer 22

Self retractors

ex. Gelpi, Weitlaner

Question 23

Hold abdominal cavity open

Answer 23

Balfour retractors

Question 24

Hand-held retraction of skin and superficial muscle layers

Answer 24

Senn-Miller
Parker
Army-Navy

Question 25

Suture pattern that brings edges together

Answer 25

Appositional

Question 26

When would you use an appositional suture pattern?

Answer 26

when no excessive tension on skin

Question 27

Suture pattern - edges turned inward

Answer 27

Inverting

Question 28

When would you use an inverting pattern?

Answer 28

Use on hollow organs to minimize risk of luminal leakage

Question 29

Suture pattern - edges turn upward

Answer 29

Everting

Question 30

When would you use everting suture pattern?

Answer 30

Use in areas under tension

Question 31

What are the goals of suturing?

Answer 31

``` Revert tissue to its normal position Close dead space Appose like-tissues Avoid eversion or inversion when closing skin Symmetry ```

Question 32

Why would you want to avoid eversion of inversion when closing skin?

Answer 32

Delays healing

Question 33

Elimination of ALL microbes on an inanimate object

Answer 33

Sterilization

Question 34

*Reduction of microbial load on inanimate object*

Answer 34

Disinfection

Question 35

Reduction of microbial load on animate (living) object

Answer 35

Antisepsis

Question 36

What are the 2 types of sterilization?

Answer 36

Physical | Chemical

Question 37

Agents of physical sterilization?

Answer 37

Heat (steam) Filtration Ionizing radiation

Question 38

Agents of chemical sterilization?

Answer 38

``` Ethylene oxide Gas plasma (H2O2) ```

Question 39

*Most reliable means of sterilization (steam steril.)

Answer 39

Autoclave

Question 40

What is microbial death dependent upon with autoclaving?

Answer 40

Time Temp Pressure

Question 41

*What is the fxn of sterilization indicators?

Answer 41

Method of monitoring the effectiveness of the sterilization process

Question 42

Only way to ensure sterility following sterilization

Answer 42

Biological sterilization indicators

Question 43

Limitations of radiation sterilization

Answer 43

Some plastics & pharmaceuticals

Question 44

*Cannot attain sufficient temperature for sterilization*

Answer 44

Ineffective sterilization (ex boiling water)

Question 45

*Efficiency of Ethylene oxide (EtO) chemical sterilization is dependent upon

Answer 45

Temperature (120-140 F) Concentration Exposure time (4 hr min) Humidity (20-40% ideal)

Question 46

*What is the limitation of chemical sterilization w/ Ethylene oxide?

Answer 46

TOXIC! | aeration is essential

Question 47

Safe level of EtO vs Olfactory detection of EtO

Answer 47

Safe level = 10ppm | Olfactory detection = 700ppm

Question 48

Toxic effects of EtO

Answer 48

CNS depression Irritation of skin/eyes/mucous membranes Probable carcinogen

Question 49

*Type of sterilization that does not require aeration?*

Answer 49

Gas plasma - rapid sterilization (1 hr)

Question 50

*#1 option to sterilize heat-sensitive items*

Answer 50

Gas plasma | low temp sterilization & no harmful emissions

Question 51

Limitations of gas plasma sterilization

Answer 51

gas cannot penetrate walls of items that have lumens (unless used w/special adaptor)

Question 52

Which instruments would you use cold sterilization on?

Answer 52

Frequent-use instruments Instruments that can't tolerate high heat or have lenses ET tubes Anesthetic machine hoses

Question 53

*Cold sterilization requires what time length for immersion*

Answer 53

minimum of 3 hrs of immersion

Question 54

*If use Glutaraldehyde 2%, what must you do before using the instrument*

Answer 54

it is and irritant | so must rinse with distilled water or sterile saline and dry with a sterile towel before use

Question 55

Chemical agents that reduce microbial load on inanimate objects

Answer 55

Disinfectants

Question 56

Chemical agents that reduce microbial load or inhibit growth of microbes on living tissue

Answer 56

Antiseptics

Question 57

Chlorhexidine is an antiseptic that has residual activity which means _____

Answer 57

efficacy increases with repeated use

Question 58

*Cholorhex solution for surgical prep? wound management?*

Answer 58

Surgical prep - 4% solution | Wound management - 0.05% solution

Question 59

Antiseptic with a one step "scrubless" process = single application & let dry

Answer 59

Alcohol based solutions

Question 60

Less effective than povidone iodine or chlorhex

Answer 60

Alcohol

Question 61

Disinfectant + Antiseptic that is inactivated by sweat & alcohol, & its effectiveness is decreased by the presence of organic material

Answer 61

Povidone-Iodine

Question 62

*Povidone-iodine solution used for wound management? surgical prep?

Answer 62

``` 0.1% - 1% solution - wound management high concentrations (10%) - may be applied to surgical site during surgical prep ```

Question 63

Sources of microorganisms

Answer 63

Environment Patient Surgical team Surgical equipment

Question 64

*Primary source of bacterial contamination

Answer 64

Patient

Question 65

Absence of pathogenic microbes or their toxin in blood or other tissues

Answer 65

Asepsis

Question 66

Minimize/prevent contamination of the surgical field

Answer 66

Aseptic technique

Question 67

*Halstead surgical principles*

Answer 67

``` Asepsis Hemostasis Accurate anatomical dissection Gentle tissue manipulation Avoid excess tension on tissue during wound closure Accurate tissue approx. in wound closure ```

Question 68

How to reduce the potential for surgical infection non-surgically?

Answer 68

Tx existing infections Minimize hospitalization time (pre & post) *Clip surgical area, don't shave