-
2 different grades of instruments
- floor grade
- surgical grade
-
instruments that are made from inferior metals, tend to bend and break, show staining and are used in less critical applications?
- floor-grade instruments
- often classified as single-use items
-
instruments constructed of high quality stainless steel, carbon, chromium, etc., and resist bending, pitting, scratching and dulling
surgical-grade instruments
-
most common metal used in surgical instruments but also subject to corrosion
stainless steel
-
instrument finish that reflects light and may cause glare
bright or mirror finish
-
instrument finish that reduces glare and light reflection which can lead to eye fatigue
satin finish
-
which finish tends to stain more easily from the effects of detergents and low water quality?
satin finish
-
black chromium finish used for laser surgery
ebony finish
-
what does ebony finish prevent?
prevents laser beams from reflecting or bouncing off the instruments
-
maintains sharp edge in scissors and gripping ability in needle holders
tungsten carbide inserts
-
what are instruments with tungsten carbide inserts usually manufactured with?
gold-plated or black handles
-
area on an instrument where the lever moves
fulcrum
-
-
instruments used for blood vessels
instruments that do not puncture or bruise the tissue
-
instruments used on fibrous tissue
requires toothed instruments to maintain grasp
-
clamp that has one or more ratchets that remain closed after they are set
locking box lock clamp
-
what kind of mechanism do microsurgical instruments use?
spring lock mechanism
-
what are thumb forceps used for?
grasping, usually during suturing for handling tissue during surgery
-
what are toothed forceps used for?
grasp skin or other connective tissue
-
what are smooth forceps used for?
delicate tissue such as serosa, bowel, blood vessels or ducts
-
what type of forceps are Martin and Russian forceps?
toothed forceps - small, rounded teeth
-
what are Bayonet forceps used for?
angled for neurosurgical and nasal procedures
-
biting clamp
- has teeth or sharp serrations in the jaws
- Kocher clamp
-
what are biting clamps used for?
avascular fibrous tissue, bone or tissue that will be removed
-
tenaculum
- has one or more teeth in the jaws that can be delicate or heavy
- penetrates tissue rather than just holding it
- generally used on fibrous tissue such as cervix
-
inserted into a bone for manipulation
bone clamp
-
has locking ratchets but the tips do not close tightly over the tissue
atraumatic clamp
-
what is atraumatic clamp used for?
delicate tissue that is highly vascular or easily injured
-
what is Babcock clamp used for?
bowel or fallopian tubes
-
long clamp placed across a tissue structure at an approximate right angle
cross clamping
-
when is cross clamping frequently used?
vascular and intestinal surgeries
-
what does a hemostat do?
blocks flow of blood
-
what do Kelly, Crile and mosquito hemostats do?
completely occlude a blood vessel while it is tied or sealed with ESU
-
what do right-angled clamps do?
used for dissection and occlusion in deep wounds
-
capable of varying low levels of compression between its jaws and are angled to allow access to blood vessels
semioccluding vascular clamp
-
examples of vascular clamps
- bulldog
- Satinsky
- Fogarty
- Crafoord
- Cooley
-
what blades fit scalpel handles 3, 3L, 7, 9?
blades 10, 11, 12, 15
-
what blades fit scalpel handles 4, 4L?
blades 18 to 25
-
Beaver blade handle
- interchangeable, disposable blades (Beaver blades)
- used in surgery of eye and ear
-
what are tissue scissors for?
used to sever tissue and should never be used on other materials or surgical supplies including suture material
-
what are small, sharp-tipped scissors (tenotomy scissors) used for?
extremely fine dissection in plastic surgery
-
when are castroviejo scissors used?
microsurgery
-
what are round-tipped, light dissecting scissors (Metzenbaum scissors) used for?
extensively on delicate tissue in general surgery
-
what are heavy, curved Mayo scissors used for?
undermining fibrous connective tissue
-
what are straight Mayo scissors used for?
cutting suture
-
what is a rongeur used for?
to cut and extract tissue
-
single-action rongeur
rongeur with a single hinge
-
double-action rongeur
rongeur with two hinges
-
for which procedures are heavier rongeur (Stille) used?
orthopedic and neurosurgical procedures
-
what is long-handled Kerrison rongeur used for?
spinal surgery
-
what is long, fine-tipped pituitary rongeur used for?
to remove tissue in difficult-to-reach areas such as vertebral column and nasal sinus
-
large cutting instruments used to cut bone
shears
-
designed with small cup with sharpened, serrated, or smooth rim and used for scooping out tissue
curette
-
what are very fine curettes used for?
ear, paranasal and spinal surgery
-
what are larger, heavier curettes used for?
orthopedic procedures
-
what are soft tissue curettes used for?
gynecological surgery for curettage of the endometrium
-
orthopedic cutting instrument used with a mallet
chisel
-
used to remove bone from the iliac crest for use as a graft elsewhere in the body
osteotome
-
V-shaped bone chisel
looks like a small trough
gouge
-
used to separate or "elevate" the tissue
elevator
-
elevator that slices tissue as it elevates it
heavy, round cutting Lambotte elevator
-
very finely balanced elevators used in soft tissue surgery and vascular surgery to separate atherosclerotic plaque from inside blood vessel
Penfield or Freer elevators
-
elevator with short handle and strong tip making it ideal for separating connective tissue planes without causing bleeding
joker
-
used to remodel bone
rasp
-
used to ream medullary canal of long bones in preparation for an implant
heavy rasps
-
used to gently move away tissue layers, blood vessels, nerves, organs, etc. from the focal point of operation as the wound is deepened
retractor
-
5 descriptions of retractors
- handheld or self-retaining
- deep or superficial
- wide or narrow
- malleable (bendable)
- sharp or dull
-
retractor used in abdominal procedures
Deaver retractor
-
retractor used only for connective tissue
rake retractor
-
designed to grasp the undersurface of superficial tissues
sharp rakes or hooks
-
self-retaining retractor used in cardiovascular surgery
Finochietto
-
retractors used for superficial incisions such as in the groin
Gelpi and Weitlaner
-
rounded, tubular or tube-like instruments used to widen or stretch the inside diameter of a lumen
dilator
-
removal of tissue by scraping with a surgical curette
curettage
-
used to prepare the bone for joint implant
orthopedic calipers
-
used in orthopedic surgery to determine the length of screws to be implanted into bone
depth gauge
-
trial, reusable replica of an implantable prosthesis - allows surgeon to test a replica before surgery
sizer
-
used to grasp a curved needle during suturing
needle holder
-
needle holder that is too delicate for the needle will cause what?
the needle to twist during use
-
needed during a surgical procedure to clear blood, fluids, and small bits of tissue debris from the surgical site to provide unobstructed view
suction (aspiration)
-
suction designed for abdominal surgery
Poole suction
-
suction designed for chest cavity and throat
Yankauer suction
-
designed to suction in superficial areas in the face, neck, and ear, and in neurological and some peripheral vascular procedures
Frazier suction
-
how do you clean debris and blood clots from suction tips during surgery?
dipping suction tip in sterile water or inserting a stylet into the lumen
-
fine membrane that covers organs of the body
serosa
-
what types of instruments are needed when handling serosa and why?
- nontraumatic
- the membrane can be easily punctured and underlying tissue layers can bleed profusely
-
tissue that is very delicate, tends to bleed profusely, tears easily and has little or no resilience
friable tissue
-
examples of friable tissue
-
clamps used on lumens, such as intestines, fallopian tubes, etc. should be?
only partly occlusive
-
examples of clamps used for lumens
-
tissue that is resilient and able to withstand a limited amount of stretching without injury
elastic tissue
-
examples of elastic tissue
vaginal vault and some glandular tissue such as tonsils
-
tissue that is heavy with fluid, inflamed or diseased
boggy tissue
-
type of tissue that has high fat content
semisolid tissue
-
tissue with few blood vessels compared with other types of tissue
adipose tissue - may require penetrating retractor
-
tissue that is resilient and somewhat springy when healthy
bone tissue
-
cartilage and tendon strength
extremely strong and resilient
-
what is fascia often grasped with?
Kocher clamps (one or two teeth)
-
areas where a tubular structure forms a Y
bifurcation
-
purpose of debulking instruments (chisels, osteotomes, gouges, rasps and files)
decrease the bulk of firm tissue and not necessarily cut along defined tissue planes
-
instruments that remove a small piece of tissue for pathologic examination
biopsy forceps and punches
-
instruments that remove soft tissue or bone by scraping with the sharp edge of the loop, ring or scoop
curette
-
blades that are rounded toward the tip and often used to open skin
number 10 blades
-
blades that have a linear edge with sharp tip - can be used to make initial skin puncture for tiny, deep incisions
number 11 blades
-
blades that have a curved cutting surface like a hook - used for tonsillectomy
number 12 blades
-
blades that have a short rounded edge for shallow, short controlled incisions
number 15 blades
-
blades shaped similar to number 10 blades but larger
number 20 blades
-
used to mark tissue and to occlude vessels or small lumens of tubes
clip appliers
-
designed for closing the end of a hollow organ with a double-staggered line of staples
terminal end staplers
-
commonly used for bowel anastomosis after resection
end-to-end circular staplers
-
involves application of negative pressure (less than atmospheric pressure) for evacuating blood or fluids for visibility at the surgical site
aspiration or suction
-
used to cut through tissues for access to fluid or body cavity
trocar
-
-
instrument with blunt end and perforations around the tip used to aspirate fluid without cutting into tissue and also used to open blocked vessels or ducts
cannula
-
what types of dilators are used to dilate the uterine cervix?
Hank, Hawkins, Pratt or Hegar dilators
-
used to explore a structure or to locate an obstruction, and used to explore depth of a wound or to trace the path of a fistula
probe
-
air-powered instruments
- lightweight
- cause minimal heating of bone
-
how do air-powered instruments work?
medical-grade compressed air or pure (99.97%) dry nitrogen is either piped into OR or supplied from a cylinder tank on a stable carrier
-
electrically-powered instruments
- saws, drills, dermatomes and nerve stimulators
- designed to be explosion-proof
-
how are battery-operated instruments used in the sterile field?
- cordless with rechargeable batteries
- batteries are charged and sterilized
-
alternating current
- power switch should be off before cords are plugged into outlets
- supply cord should be connected to the outlet before anesthetic gases are administered and should not be disconnected during anesthesia administration
|
|