Week 6: Surgical Instrumentation

Question 1

name the parts of the surgical instrument

Answer 1

• jaws
• jaw insert
• joint
• shank
• ring
• ratchet

Question 2

what are the crushing tissue forceps

Answer 2

• babcock tissue forceps
• allis tissue forceps

Question 3

what are the non-crushing tissue forceps

Answer 3

doyen intestinal forceps

Question 4

what are hemostatic forceps

Answer 4

• rochester carmalt forceps
• kelly hemostatic forceps
• halsted mosquito forceps

Question 5

Answer 5

allis tissue forceps
* grasp tissue
* only used on tissue to be discarded
* used to position suction tubing and electrocautery wire

Question 6

Answer 6

**babcock tissue forceps **
* grap tissue
* can crush but less than allis
* helping to grasp and retract robust sodt tissues (stomach, bladder)

Question 7

Answer 7

**straight doyen intestinal tissue forceps **
* longitudinally oriented grooves
* intestinal lumen occlusion (enterotomies, resection, and anastomosis)

Question 8

Answer 8

**straight rochester-carmalt hemostatic forceps **
* jaw clamping
* claming pedicles/tissue
* longitudinally proented serrations with cross-hatched tips
* straight or curved

Question 9

Answer 9

straight and curved kelly hemostatic forceps
* transversely oriented serrations
* serrations only go halfway
* tip clamping of small to medium vessels
* smaller than rochester-carmalt, bigger than halstead-mosquito

Question 10

Answer 10

straight and curved halsted mosquito hemostatic forceps
* transversely oriented serrations - go entire length
* tip clamping of small vessels

Question 11

what are the types of thumb forceps

Answer 11

• brown-adson
• adson
• DeBakey
• Bishop-Harmon

Question 12

Answer 12

Brown Adson Tissue Forceps
* fine teeth in two parallel rows
* general tissue handling but serrated teeth can crush tissue

Question 13

Answer 13

Adson tissue forceps
* fine teeth (2x1)
* less crush injury than brown-adson
* poor grip of fat or other friable tissues

Question 14

Answer 14

DeBakey tissue forceps
* parallel ribbed tips
* most frequently used thumb forceps in soft tissue surgery
* less traumatic than brown-adson thumb forceps

Question 15

Answer 15

Bishop-Harmon Forceps
* fine teeth (2x1) at right angle
* smaller than other thumb forceps
* grasp tissue in opthalmologic surgery

Question 16

Answer 16

**Bard-Parker Number 3 Scalpel Handle **
* most commonly utilized
* accepts #10, 11, 12, 15
* ribbed grip area
* may have measurement scale

Question 17

what are the types of surgical scissors

Answer 17

• mayo
• metzenbaum
• stevens tenotomy
• spencer stitch

Question 18

Answer 18

**straight mayo dissecting scissors **
* plain edge
* thick blades
* incise dense tissue (fascia, linae alba, trimming skin)
* straight (mechanical advantage)
* curved (improved visualization)

Question 19

Answer 19

straight metzenbaum scissors
* plain edge
* thin, delicate blades
* incise soft tissues
* straight or curved

Question 20

Answer 20

stevens tenotomy scissors
* narrow, delicate
* precision cutting, ophthalmic and urologic surgery
* straight or curved

Question 21

Answer 21

spencer stitch scissors
* hooked tip
* post-op suture removal

Question 22

what are the types of needle holders

Answer 22

• mayo-hegar
• olsen-hegar
• castroviejo
• derf

Question 23

Answer 23

mayo-hegar needle holders
* textured tungsten-carbide jaw inserts provide intermediate needle holding security
* limits twisting and rotation

Question 24

Answer 24

olsen-hegar needle holders
* combined needle driver/scissor
* textured tungsten-carbide jaw inserts

Question 25

what are the types of self-retaining retractors

Answer 25

* balfour * finochietto * gelpi * weitlaner

Question 26

what are the types of hand-held retractors

Answer 26

* army-navy * malleable * hohmann * senn * snook hook/spay hook

Question 27

Answer 27

**balfour retractor ** * blunt blades used to retract abdoinal wall laterally * central bladder blade retract rib cage cranially

Question 28

Answer 28

**finochietto retractor ** * adjustable rib retractor * retraction of chest wall during intercostal thoracotomy and median sternotomy * flat retractor blades are perpendicular

Question 29

Answer 29

**gelpi retractor ** * ring retractor with self-retaining ratchet * retraction of soft tissues (muscle bellies during orthopedic or spinal surgery)

Question 30

Answer 30

** weitlaner retractor ** * ringed retractor with self-retaining ratchet * multiple pointed prongs on each arm * retraction of soft tissue in small, superficial incision

Question 31

Answer 31

**army-navy retractor ** * double ended blunt * hand held used by assistant * soft tissue and orthopedic

Question 32

Answer 32

**malleable retractor ** * double ended blunt retractor * bent at various angles * retracting viscera in abdominal and thoracic surgery

Question 33

Answer 33

**hohmann retractor ** * various sizes with variety of tip lengths and styles * lever muscle and soft tissues away from surgical field and bone during orthopedic

Question 34

Answer 34

**senn retractor** * double ended - blunt or sharp fork and right angle on other * soft tissue and orthopedic surgery * hand held by assistant

Question 35

Answer 35

**spay hook** * flat, thin handle * hook uterine horn

Question 36

what are the types of orthopedic instruments

Answer 36

* jacobs chuck * mallet * osteotome and chisel * periosteal elevator * freer periosteal elevator * rongeurs

Question 37

Answer 37

**jacobs chuck** * drive IM pins and K-wires during orthopedic surgeyr * key used to tighten or release pin grip * attachment to protect hand from pin penetration

Question 38

Answer 38

**mallet** * metal or nylon * orthopedic surgery to advance osteotome or chisel

Question 39

Answer 39

osteotome and chisel * osteotome - beleveled on both sides * chisel - beveled on one side * create osteotomy in orthopedic procedures

Question 40

Answer 40

**periosteal elevator ** * reflect muscle and soft tissue from bone

Question 41

Answer 41

**freer periosteal elevator ** * small periosteal elevator * double ended * standard in every ortho pack

Question 42

Answer 42

**lempert rongeur ** * forceps with cupped jaws and blunted or tapered tips * remove small fragments of bone, recontour bone or prepare bone for grafting * straight curved or angled

Question 43

Answer 43

**backhaus towel clamp** * hold quater drapes or huck towels securely

Question 44

Answer 44

**poole suction tip** * attaches to suction hose * suction large amounts of fluid * inner cannula unscrews and can be used as modified frazier suction tip

Question 45

Answer 45

**frazier suction tip** * tine tipped * removal of small amounts of fluid * orthopedic and neurologic surgery * covering hole on top creates stronger negative pressure * can clog easily