Surgical Instruments

Question 1

cutting

Answer 1

sharp incision

Question 2

tearing

Answer 2

blunt dissection

Question 3

penetrating

Answer 3

puncturing through tissue

use in tough tissues
do NOT use in soft tissues

Question 4

crushing

Answer 4

compression trauma

use in soft tissues
do NOT use in tough tissues

Question 5

types of retractors

Answer 5

1. army navy
2. miller senn
3. gelpi
4. balfour

Question 6

army navy retractor

Answer 6

handheld retractor with double ended right angles

used for active retraction of shallow surgical sites

Question 7

miller senn retractor

Answer 7

small handheld retractor

double ended with one L shaped end and one that ends in curved prongs

Question 8

gelpi retractor

Answer 8

self retaining retractor with two hooked blades

used for retraction in a solo surgery

Question 9

balfour retractor

Answer 9

self retaining retractor on a frame with two smooth arms

used for abdominal cavity retraction only

Question 10

adson thumb forceps

Answer 10

“rat tooth” forceps
two interdigitating teeth in a 2-1 configuration

used for grasping tough, fibrous tissue
can be penetrative but not crushing

Question 11

adson brown forceps

Answer 11

multiple fine, intermeshing teeth

all purpose forceps - allows control of tissue trauma by altering grasp pressure

Question 12

debakey forceps

Answer 12

no teeth, non-penetrative, longitudinal ridges with fine, transverse ribs

grips without causing tissue trauma
good for soft, delicate, and compressible tissues

Question 13

allis tissue forceps

Answer 13

grasps tissues that will be resected - NOT for use in tissues that will remain in patient because causes a lot of tissue trauma

non penetrative

Question 14

Babcock tissue forceps

Answer 14

used to grasp slippery hollow organs when needed

less crushing than allis forceps

Question 15

doyen intestinal forceps

Answer 15

occluding forceps with minimally traumatic longitudinal ridges

low crushing risk

used to occlude luminal viscera to prevent leakage of ingesta

Question 16

right angle dissection forceps

Answer 16

delicate forceps with transverse ridges used for delicate grasping

used for very fine blunt dissection around delicate structures - NOT for general dissection

Question 17

mosquito hemostat forceps

Answer 17

transverse ridges
small and fine with short jaws
ratcheted

used for tip clamping of small bleeding vessels

Question 18

kelly/crile forceps

Answer 18

similar to mosquitoes

kelly: ridges stop halfway and the back half is smooth

crile: ridges run the full length of the jaw; larger than mosquitoes

Question 19

carmalt forceps

Answer 19

longitudinal ridges
large

used for jaw clamping of large vascular pedicles of mixed fat and vessels to facilitate mass ligation

Question 20

scalpel handle and blade sizes

Answer 20

handle: no 3
blades: no 10 or 15
- 10: longer blade curve
- 15: shorter blade curve

optimal cutting surface: maximal curvature of the blade

Question 21

metzenbaum scissors

Answer 21

delicate blades
long and thin
can be curved or straight

used for fine dissection of soft tissues
- NOT on tough fibrous tissue

Question 22

mayo scissors

Answer 22

thick blades

used for cutting heavy, tendinous, or fibrous tissues

Question 23

utility scissors

Answer 23

sharp - blunt blades

used for cutting non-tissue substances

Question 24

towel clamps

Answer 24

perforating instrument

used to fasten surgical drapes to patient’s skin

no crushing injury

Question 25

mayo hegar needle drivers

Answer 25

serrated grasping surface no utility scissor at hinge

Question 26

Olsen hegar needle drivers

Answer 26

serrated grasping surface utility scissor at hinge

Question 27

scalpel fingertip grip

Answer 27

handle held pinched between thumb and middle finger, index finger on top of the spine of the blade to apply pressure flattens the angle with broad direction control good for long, linear cuts

Question 28

pencil grip

Answer 28

handle held between the thumb and index finger steepens the angle with fine direction control good for shorter, more precise cuts with direction change

Question 29

forceps pencil grip

Answer 29

thumb and index finger control the forceps with instrument on top of hand most secure hold

Question 30

tripod grip on ringed instruments

Answer 30

thumb and ring finger placed in the rings; index finger stabilizes the shank of the instrument most stable

Question 31

palm grip for ringed instruments

Answer 31

instrument held in the palm of the hand without placing any fingers through the rings good for suturing long, straight incisions

Question 32

tip clamping

Answer 32

minimizes the amount of surrounding tissue included in the clamp to reduce trauma used with forceps that have transverse ridges

Question 33

jaw clamping

Answer 33

places selected tissues closer to the hinge of the instrument resulting in greater force transmission leading to more crushing/tissue trauma used with forceps that have longitudinal ridges