Surg 101--Chapter 22 Flashcards
(150 cards)
1
Q
The knowledge base for instrumentation includes the _____ of instruments.
A
classification
2
Q
The knowledge base for instrumentation includes the relationship between the _____ of an instrument and the instrument’s use in the _____.
A
design, body
3
Q
The knowledge base for instrumentation includes the _____ of instruments.
A
care
4
Q
The knowledge base for instrumentation includes the ability to recognize _____ instruments.
A
high quality
5
Q
_____ (as it applies to the ST) means applying knowledge of an instrument’s capabilities, structure, design, size, and type to the surgical task at hand.
A
Critical thinking
6
Q
The ST must plan the set up and arrangement of instruments so that as the surgery progresses, needed instruments are immediately available on the _____.
A
instrument (Mayo) stand
7
Q
_____ are assembled according to the particular surgical specialty.
A
Instrument trays
8
Q
There are two different grades of instruments–_____ and _____.
A
floor grade and surgical grade
9
Q
_____ instruments are made from inferior metals and are imprecisely constructed.
A
Floor-grade
10
Q
_____ instruments tend to bend and break easily.
A
Floor-grade
11
Q
_____ instruments often show pitting and staining within the first few sterilization processes.
A
Floor-grade
12
Q
_____ instruments are intended for use in less critical applications (such as suture and suture removal kits in the ER).
A
Floor-grade
13
Q
_____ instruments are often classified as single-use items.
A
Floor-grade
14
Q
_____ instruments are constructed of high quality stainless steel and other metal alloys (such as carbon and chromium).
A
Surgical-grade
15
Q
_____ instruments resist bending, pitting, scratching, and dulling.
A
Surgical-grade
16
Q
_____ is the most common metal used in surgical instruments but is also subject to corrosion.
A
Stainless steel
17
Q
The three types of finishes used on metal instruments are _____, _____, and _____.
A
bright, satin, and ebony
18
Q
A _____ (or mirror) finish is highly polished, reflects light, and may cause glare in the surgical field, affecting the surgeon’s vision.
A
bright
19
Q
A _____ finish reduces glare and light reflection which can lead to eye fatigue.
A
satin
20
Q
_____ finish instruments tend to stain more easily from the effects of detergents and low water quality.
A
Satin
21
Q
_____ is a black chromium finish used for laser surgery.
A
Ebony
22
Q
The dull black finish of ebony prevents _____ from reflecting or bouncing off of instruments.
A
laser beams
23
Q
Many instruments have expensive _____ inserts to maintain a sharp edge in scissors and gripping ability in needle holders.
A
tungsten carbide
24
Q
Instruments with tungsten carbide inserts usually are manufactured with _____ or _____ handles.
A
gold-plated or black
25
Tungsten carbide instruments are very _____.
expensive
26
The distribution of weight between the handle (finger rings) and the _____ is measured and tested for optimum performance.
fulcrum
27
Instruments are designed to match their use and the type of _____ on which they are used.
tissue
28
Blood vessels are never handled with an instrument that might _____ or ______ the tissue.
puncture or bruise
29
Fibrous tissue is very resilient and requires _____ instruments to maintain grasp.
toothed
30
A _____ (also called a box lock) has one or more ratchets that remain closed after they are set.
locking box lock clamp
31
Microsurgical instruments use a _____, which is used in the design of needle holders.
spring lock mechanism
32
Thumb forceps are used for _____, usually during suturing or handling tissue during surgery.
grasping
33
Thumb forceps are often called _____.
“pickups”
34
Toothed forceps have one or more _____ in the _____.
teeth, jaws
35
Thumb forceps are used to grasp _____ or other _____.
skin, connective tissue
36
Examples of toothed forceps include _____, _____, _____, and _____.
Adson forceps with teeth, thumb tissue forceps with teeth, Bonney tissue forceps, and Cushing forceps
37
_____ are used on delicate tissue such as serosa, bowel, blood vessels, or ducts.
Smooth forceps (no teeth)
38
Examples of smooth forceps include _____, _____, _____, _____.
smooth thumb forceps, smooth Adson forceps, DeBakey forceps, and smooth Cushing forceps
39
A _____ has teeth or sharp serrations in the jaws.
biting clamp
40
An example of a biting clamp is the _____ clamp.
Kocher
41
A _____ is used on avascular fibrous tissue, bone, or on tissue that will be removed as part of the procedure.
biting clamp
42
A _____ has one or more teeth in jaws that can be delicate or heavy.
tenaculum
43
A _____ penetrates the tissue rather than just holding it with pressure on the outside surface.
tenaculum
44
A tenaculum is used in _____, such as the cervix.
fibrous tissue
45
An _____ usually has locking ratchets, but the tips do not close tightly over the tissue.
atraumatic clamp
46
An _____ is used on delicate tissue that is highly vascular or easily injured.
atraumatic clamp
47
An example of an atraumatic clamp is the _____.
Duval lung clamp
48
The _____ is an atraumatic, non-crushing clamp usually used on the bowel or fallopian tube.
Babcock clamp
49
The Bainbridge intestinal clamp and the Doyen intestinal clamp have jaws with _____ that occlude but do not crush the tissue.
flexible blades
50
Whenever a long clamp (such as a vascular clamp) is placed across a tissue structure, at an approximated right angel, this is called _____.
cross clamping
51
Cross clamping is frequently used in _____ surgery and in _____ surgery.
vascular, intestinal
52
A _____ blocks the flow of blood.
hemostat
53
The _____, _____, and _____hemostats are used to completely occlude a blood vessel while it is tied or sealed with the ESU.
Kelly, Crile, and mosquito
54
A _____ is capable of varying low levels of compression between its jaws.
semi-occluding vascular clamp
55
Semi-occluding vascular clamps are _____ to allow access to blood vessels.
angled
56
Examples of vascular clamps include _____, _____, _____, _____, and _____.
bulldog, Satinsky, Fogarty, Crafoord, and Cooley clamps
57
The _____ is used whenever razor-sharp cutting is required for tissue dissections.
common surgical scalpel
58
A _____ is detachable from the knife handle.
scalpel blade
59
Scalpel blades are numbered consistently among manufacturers, and the number indicates the _____ and _____.
shape and size
60
Scalpel handles: 3, 3L, 7, 9
Blades: 10, 11, 12, 15
61
Scalpel handles: 4, 4L
Blades: 18 to 25
62
The _____ blade handle is used in surgery of the eye and ear.
beaver blade handle
63
_____ are among the most frequently used and important instruments in surgery.
scissors
64
Tissue scissors are used to sever _____ and should never be used on other materials or surgical supplies, including suture material.
tissue
65
Small, sharp-tipped scissors, such as _____ scissors, are used for extremely fine dissection in plastic surgery.
tenotomy
66
4. Castroviejo scissors are commonly used in _____.
microsurgery
67
Round-tipped, light dissecting scissors, such as _____ scissors, are used extensively on delicate tissue in general surgery.
Metzenbaum
68
Fibrous connective tissue requires heavier scissors, such as the _____ scissors.
curved Mayo
69
Dissecting scissors are often used to _____ tissue.
undermine
70
_____ scissors are used for cutting suture.
Straight Mayo
71
Scissors designed to cut tissue should never be used to cut _____, because this dulls the blades.
suture
72
A _____ is used to cut and extract tissue.
rongeur
73
The rongeur tips are _____, and the edges of the cups are _____.
cupped, sharp
74
A rongeur with a single hinge is called a _____.
single-action rongeur
75
A rongeur with two hinges is called a _____.
double-action rongeur
76
A double-action rongeur creates _____ the leverage as a single-action rongeur.
twice
77
Shears are large cutting instruments used to cut _____.
bone
78
Some shears are designed so that the cutting edge is left or right of the _____.
hinge
79
The basic design of the _____ is a small cup with a sharpened, serrated, or smooth rim at the end of a long handle.
curette
80
The curette is used in many specialties for scooping out _____.
tissue
81
Very fine curettes are used in _____, _____, and _____ surgery.
ear, paranasal, and spinal
82
Larger, heavier curettes are used in _____ procedures.
orthopedic
83
Soft tissue curettes are used in _____ surgery for curettage of the endometrium.
gynecological
84
A _____ is an orthopedic cutting instrument that is used with a mallet.
chisel
85
A _____ is often used to remove bone from the _____ for use as a graft elsewhere in the body.
large osteotome, iliac crest
86
A _____ is V-shaped bone chisel, its cut looks like a small trough.
gouge
87
An _____ is used to separate or “elevate” tissue.
elevator
88
The heavy, round cutting elevator, such as the _____ elevator, slices tissue as it elevates.
Lambotte
89
Very finely balanced elevators, such as the _____ and _____ elevators are used in soft tissue surgery.
Penfield and Freer
90
In vascular surgery, Penfield and Freer elevators are used to separate atherosclerotic plaque from the inside of a _____.
blood vessels
91
The _____ is a very commonly used elevator.
Joker
92
The Joker’s short handle and strong tip make it ideal for separating _____ planes without causing bleeding.
connective tissue
93
A _____ is used to remodel bone.
rasp
94
As the surgical wound is deepened, tissue layers and other structures such as _____, _____, _____, and other tissue must be moved away from the focal point of the operation.
blood vessels, nerves, organs
95
The _____ retractor is generally used only for connective tissue.
rake
96
Self-retaining retractors hold tissue against the walls of the surgical wound by _____.
mechanical action
97
Examples of self-retaining are the _____ self-retaining, _____, and _____ retractor.
Thompson, Bookwalter, and Balfour
98
The _____ self-retaining retractor is used in cardiothoracic surgery.
Finochietto
99
The potential for bruising, nerve and vessel damage, and even serious injury, exists for any _____ used on living tissue.
mechanical device
100
The retractor is placed carefully and may be cushioned using _____ so that the bare blades do not press against the tissue.
laparotomy sponges
101
The selection of a retractor is based on the _____ and _____ of the incision.
length and depth
102
The _____ of the retractor blade is determined by the size of the incision and the tissue to be retracted.
width
103
_____ are rounded tubular or tube-like instruments used to widen or stretch the inside diameter of a lumen.
Dilators
104
The _____ is inserted into the cervix to measure the depth of the uterus from the cervix to the fundus.
uterine sound
105
Orthopedic calipers are used to prepare the bone for a _____.
joint implant
106
A _____ is used in orthopedic surgery to determine the length of screws to be implanted into bone.
depth gauge
107
A _____ is a trial, reusable replica of an implantable prosthesis.
sizer
108
A _____ is used to grasp a curved needle during suturing.
needle holder
109
The length, weight, and type of tip (for needle holders) must be matched to the _____ and _____.
suture and tissue
110
Very fine sutures require fine _____.
needle holders
111
If the needle holder is too heavy, the surgeon will lose the _____ of the needle.
“feel”
112
A needle holder that is too delicate for the needle will cause the needle to _____ during use.
twist
113
Most needle holders are _____ or _____ locked.
ratchet or spring
114
Always test the _____ before the needle holder is used.
ratchets
115
_____ is needed during a surgical procedure to clear blood, fluids, and small bits of tissue debris from the surgical site and provide an unobstructed view of the anatomy.
Suction
116
Suction is provided using _____, which attaches to a suction tip at one end and a closed suction canister at the other.
sterile plastic tubing
117
The selection of a particular surgical instrument is based on the _____, the depth of the _____, the technical requirements of the instrument, and the surgeon’s preference.
tissue type, surgical wound
118
_____ differ in texture, strength, elasticity, water, fat content, and permeability.
Normal tissues
119
The viscera, or organs of the body, are each covered by a fine membrane called the _____.
serosa
120
The _____ is easily punctured and the underlying tissue layers can bleed profusely.
serosa
121
_____ instruments are needed when handling the serosa.
Nontraumatic
122
Non-penetrating forceps, wide retractors which do not cut into the tissue and suction tips which have a guard to decrease the aspirating pressure are used on _____.
serosa
123
Tissue that is _____ is very delicate, tends to bleed profusely, tears easily, and has little or no resilience.
friable
124
_____ or _____ can cause normally strong tissue to become friable.
Infection or advanced age
125
Tissues such as the _____, _____, and _____ normally are friable.
liver, spleen, and lung
126
Friable tissue must be handled by hand or with _____ instruments.
Nontraumatic
127
_____ used on friable tissue must be nonoccluding and _____ nontoothed.
Clamps, forceps
128
Many anatomical structures with a _____ must be protected from puncture.
lumen
129
Structures with a lumen are usually handled with smooth, _____ instruments.
Nontraumatic
130
_____ used to temporarily occlude the intestine, fallopian tube, vas deferns, ureters, large blood vessels, and other ducts are only partly occlusive.
Clamps
131
_____ is resilient and able to withstand a limited amount of stretching without injury.
Elastic tissue
132
The _____ lining of body cavities, although elastic, can tear with extreme or repeated pressure.
peritoneal
133
The _____ and some glandular tissue, such as the tonsils, are elastic.
vaginal vault
134
Tissue is described as _____ when it is heavy with fluid, inflamed, or diseased.
boggy
135
Infected or edematous tissue is _____ and difficult to clamp and suture.
boggy
136
Boggy tissue is usually handled manually and non-occlusive clamps such as the _____ are used.
Babcock
137
Semi-solid tissue has a high _____ content.
fat
138
_____ does not compress well and tends to fragment into small pieces when clamped.
Fatty tissue
139
Adipose tissue has few _____ compared with other types of tissue.
blood vessels
140
Adipose tissue may require a penetrating retractor such as a _____.
sharp rake
141
The _____, which has fine serration at the tip, often is used to clamp or grasp adipose tissue.
Allis clamp
142
_____ are required for suturing fatty tissue.
Forceps with teeth
143
_____ is resilient and somewhat springy when healthy.
Bone tissue
144
Large bones usually are manipulated with _____ or _____ rather than direct pulling pressure.
traction or leverage
145
Other types of connective tissues, such as _____ and _____, are extremely strong and resilient.
cartilage and tendon
146
Most joint surfaces are exposed to _____, which has an oily consistency.
synovial fluid
147
Fascia is often grasped with _____, which have one or two teeth at the tip.
Kocher clamps
148
Used on mucous membrane organ tissue and on any tissue that bleeds easily.
Smooth forceps
149
Used on connective tissue, including the skin.
Toothed forceps
150
Specially designed with a scored insert at the working tip; this prevents puncturing of the blood vessels but provides sufficient friction to hold.
Vascular forceps
