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Sx skills- Basic surgical instrumentation and instrument handling

rename
untimely's version from 2015-05-07 01:52

yep

Question Answer
7 anatomical parts of a ringed instrument?tips, jaws, lock box+lock box pin (where the two parts come together), shank (long part past lock box), ring handle, ratchet (part that you can click it together to hold it closed)
what is the appropriate way to hold a ringed instrument?tripod grip (thumb and ring fingers in the rings, index stabilizing against the shanks)
what are the 4 hemostatic forceps we care about?halstead, kelly, crile, rochester-carmalt
what are mosquito hemostatic forceps used for?for hemostasis of SMALL blood vessels
what are halsted hemostatic forceps used for?for hemostasis of SMALL blood vessels
with a hemostat, which way do you want to curve pointing when you clamp the vessel?down
what are crile hemostatic forceps used for?clamps larger vessels
what are kelly hemostatic forceps used for?clamps larger vessels (kelly is huge)
what are rochester-carmalt hemostatic forceps used for?crush larger bundles of *tissue (ie. ovarian pedicles during OHE)
what are bulldog-satinsky hemostatic forceps used for?exerts gentle compression on vessel without causing endothelial damage for the purpose of temporary hemostasis
what are satinsky hemostatic forceps used for?exerts gentle compression on vessel without causing endothelial damage for the purpose of temporary hemostasis
application of thumb forceps?used to stabilize tissue and/or expose tissue layers when suturing
use for brown-adson thumb forceps?general tissue manipulation
use for adson (rat-tooth) thumb forceps?stabilize & retract less delicate tissues (general tissue manipulation)
how should you hold thumb forceps??UNDERHANDED not overhanded!
use for allis tissue forceps?enables a firm grasp of tissue (eg. grasp tissue that is being removed from the body) (can be quite harmful to tissues)
use for babcock tissue forceps?enables more gentle grasp of tissues (no teeth on the tips)
use of doyen intestinal forceps?non-crushing, occluding forceps used to temporarily occlude lumen of bowel
use of forester sponge forceps?manipulate/handle sponges or sterile dressing materials
when do you use bone-holding forceps (she wont make us memorize the bone forceps names)hold bones during fracture repair
what is the purpose of needle-holders?grasp & manipulate curved needles
handling--> THUMB-RING FINGER HOLD: when do you use this?High precision, Use when suturing delicate tissues
handling--> PENCIL GRIP HOLD: when do you use this?Ideal for delicate suturing (vascular, ophthalmic sx) (Use with Castroviejo needle holders)
handling--> PALM GRIP HOLD: when do you use this?for high driving force but low precision
handling--> THENAR EMINENCE GRIP HOLD: when do you use this?Allows for good mobility, Good for continuous patterns...thumb isnt in the ring, controlling with meat of thumb (see pic on slide 26 if you need to see it)
use of mayo sciccors?cut more dense tissues
use of metezenbaum scissors?used for sharp and blunt dissection of more delicate tissues (DONT cute sutures with these)
use of doyen scissors?cut suture material (during surgery)
use of lister scissors?cut bandages
use of spencer sciccors?removal of sutures
**what part of the scalpel do you cut with?BELLY of the blade (not the tip!)
what are the two sizes of scalpel handles, and what size blades do they correspond to?(1) #3-- for blades #10-15 (2) #4-- for blades #20-25
(pic on slide 38) Press cutting-- when would you do this?Stab incisions-- think of this as a bladder-- you do this when there's nothing delicate in there, just pee
(pic on slide 38) Finger bumper press cutting-- when would you do this?Stab incisions-- helps to control how deep blade goes into tissue...if getting into preg. uterus for c-section, want more control!!
(pic on slide 38) Invterted blade press cutting-- when would you do this?flip the belly up, want a shallow incision--- use this when dissecting the linea alba
(pic on slide 38) Slide cutting-- when would you do this? use belly to make nice long incisions (skin incision for a spay, for instance)
scalpel blade handling--> fingertip grip-- use when?long incisions
scalpel blade handling--> palm grip-- use when?used where more force is required to incise tissue
scalpel blade handling--> pencil grip-- use when?short precise incisions
scalpel blade handling--> inverted pencil grip-- use when?for the stab incision into linea alba
what is the application for retractors?retracts tissue to facilitate exposure of the surgical field
use of Balfour retractors?retract the abdominal wall for exposure of the abdominal cavity (abdomen is where balf comes from)
use of finochietto retractors?used during thoracotomies to keep ribs separated (some italian dude that wants to break all your ribs)
what is the use of hand-held retractors?retraction of skin and superficial muscle layers (senn-miller, parker, army navy)
what is the use of towel clamps?secure drapes to patient or surgical instrumentation to drapes (ie. suction, electroscalpel)
use of ovariohisterectomy hook? the two kinds are?retrieval of uterine horn during OHE. There is a snook (flat tip) and Covault (ball-tipped)
memorize