Surgical Instruments Identification Quiz

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Questions and Answers

What is the purpose of using Raney clips during neurosurgery?

For hemostasis of the scalp (correct)

To secure the patient to the OR bed

To perform precise incisions in the skull

For closing the dura mater

Which instrument is primarily used for creating a burr hole in the skull?

Surgical spatula

Love Adson

Metz scissors

Drill with perforator (correct)

What is a critical consideration when performing neurosurgery regarding the patient's positioning?

Ensure the patient is lying flat without any head support

Avoid padding on pressure points to monitor skin integrity

Secure the patient's head to prevent movement during the procedure (correct)

Position the patient in semi-Fowler's position for better access

In which scenario would a free flap be preferred over a pedicle flap?

When a two-team approach can be utilized effectively Signup and view all the answers

Which hemostatic agent is known for being radiopaque and marked with strings for identification?

Neuro patties Signup and view all the answers

What is the primary purpose of the menisci in the knee joint?

Distribute load and provide stability Signup and view all the answers

Which ligament is most frequently torn in the knee?

Anterior cruciate ligament Signup and view all the answers

What common surgical procedure involves replacing worn surfaces of the knee?

Total Knee Arthroplasty Signup and view all the answers

What should be confirmed with the surgical team before performing a total knee replacement?

The sidedness of the knee implant Signup and view all the answers

What is the primary role of the anterior cruciate ligament in the knee?

To stabilize the knee during lateral movements Signup and view all the answers

Which component is commonly used as a graft for ACL repairs?

Patellar tendon graft Signup and view all the answers

What is essential about knee prostheses during surgery?

They are left and right specific Signup and view all the answers

What hormone is produced by the parathyroid gland to regulate calcium?

Parathyroid hormone (PTH) Signup and view all the answers

Which structures are found in the middle ear that amplify sound?

Ossicles - malleus, incus, stapes Signup and view all the answers

What is a common diagnosis for performing Total Knee Arthroplasty?

Rheumatoid arthritis Signup and view all the answers

What is the primary function of a pneumatic tourniquet during surgical procedures?

To prevent blood flow and create a bloodless surgical field Signup and view all the answers

What is an important nursing consideration when using powered surgical instruments?

Safety locks should be engaged while instruments are being passed Signup and view all the answers

Which of the following statements about pneumatic tourniquet application is correct?

Tourniquets should be completely deflated after 60 minutes on the upper extremity Signup and view all the answers

What is the role of the Kerrison rongeur in surgical procedures?

To grasp and resect lamina bone Signup and view all the answers

For which procedure is the Jackson spinal table primarily used?

Prone spinal surgery Signup and view all the answers

What is a key consideration when passing powered surgical drills to the surgeon?

The scrub nurse must state the size of the drill when passing it Signup and view all the answers

Which of the following practices is recommended for the inflation of pneumatic tourniquets?

Best practice suggests cuffs should not overlap by more than 3-6 inches Signup and view all the answers

Which type of table is utilized for procedures involving femoral neck or shaft fixation?

Fracture table Signup and view all the answers

What is the primary benefit of using external fixation for fractures?

It stabilizes the fracture at a distance, facilitating other procedures. Signup and view all the answers

What type of fracture is most commonly associated with elderly women due to osteoporosis?

Intertrochanteric fractures Signup and view all the answers

What is the primary risk associated with femoral neck fractures that necessitates reduction before internal fixation?

Risk of nonunion and avascular necrosis Signup and view all the answers

Which fixation method is typically used for intertrochanteric fractures?

Plate and screws Signup and view all the answers

What is the purpose of using a Dynamic Hip Screw (DHS) in hip fracture fixation?

To ensure compression and stability at the fracture site Signup and view all the answers

What crucial factor must be addressed when performing internal fixation on femoral neck fractures?

Restoration of blood supply Signup and view all the answers

What instrumentation is recommended for stable fixation of femoral neck fractures?

Cannulated screws Signup and view all the answers

Which of the following is used in total hip arthroplasty (THA) for unstable femoral neck fractures?

Total hip replacement component Signup and view all the answers

What type of incision is made during open reduction and internal fixation (ORIF) to correct a fracture?

Skin incision for direct exposure Signup and view all the answers

Why are lead gowns worn by all OR personnel during procedures involving fixation?

To protect against radiation exposure Signup and view all the answers

What is the purpose of packing the nasal cavity with patties soaked in vasoconstrictor solution during rhinologic surgeries?

To prevent bleeding during the procedure Signup and view all the answers

Which of the following is a contraindication for using chlorhexidine in surgical preparation for laryngeal surgeries?

Ototoxicity Signup and view all the answers

What is an indication for performing a tympanoplasty?

Conductive hearing loss Signup and view all the answers

What is the primary goal of Functional Endoscopic Sinus Surgery (FESS)?

To ensure adequate drainage of sinuses Signup and view all the answers

During a radical neck dissection, which of the following structures is typically NOT removed?

Ear canal Signup and view all the answers

In what situation is a tracheostomy most commonly indicated?

Prolonged intubation during critical illness Signup and view all the answers

Which instrument is specifically used for manipulating tissue back into place during ear surgeries?

Boies elevator Signup and view all the answers

What is the initial patient position recommended for most head and neck surgeries?

Supine with shoulder roll Signup and view all the answers

What is the recommended method to test a cuff for leaks during tracheostomy preparation?

Using sterile water Signup and view all the answers

Which layer is NOT involved in the initial dissection during neurosurgery?

Cerebellum Signup and view all the answers

What is a critical consideration when using pneumatic tourniquets during surgery?

They should not be inflated for longer than the specified time limits to avoid complications. Signup and view all the answers

What is a key purpose of the powered surgical instruments, particularly drills, in orthopedic procedures?

To assist in cutting bone or tissue effectively. Signup and view all the answers

Which of the following statements best describes the role of the Kerrison rongeur?

It is used for grasping and resecting lamina bone. Signup and view all the answers

When operating the C-Arm during surgery, what is an important precaution for the surgical team?

All personnel must wear X-ray lead gowns for protection against radiation exposure. Signup and view all the answers

What precaution must be taken regarding powered surgical drills when passing them to the surgeon?

Always state the size of the drill before handing it over. Signup and view all the answers

What is an appropriate maximum inflation pressure for pneumatic tourniquets applied to the thigh?

300-350mmHg Signup and view all the answers

What is the primary function of an external fixation device in orthopedic surgery?

To stabilize fractures and allow for visual assessment. Signup and view all the answers

What potential risk is associated with accidentally activating a powered surgical drill in the operating room?

The drill could potentially break the sterile drapes, leading to contamination. Signup and view all the answers

What is a key advantage of using external fixation for fractures?

It allows for stabilization at a distance from the injury. Signup and view all the answers

What type of fracture often leads to avascular necrosis if not properly managed?

Femoral Neck Fracture Signup and view all the answers

Which method is typically employed for stable fixation of femoral neck fractures?

Cannulated Screws Signup and view all the answers

What is the primary tool used during a surgical procedure for placing a dynamic hip screw?

Guide Pin Signup and view all the answers

In which scenario would Total Hip Arthroplasty be indicated for a femoral neck fracture?

When the fracture is unstable and blood supply is compromised. Signup and view all the answers

What is the primary benefit of open reduction during an ORIF procedure?

It allows direct visualization of the fracture site. Signup and view all the answers

Which condition is particularly associated with intertrochanteric fractures in elderly women?

Osteoporosis Signup and view all the answers

What type of fixation is typically used for intertrochanteric fractures due to their stable blood supply?

Dynamic Hip Screw Signup and view all the answers

What is an essential step in fixation of femoral neck fractures due to the compromised blood supply?

Precise alignment achieved prior to fixation. Signup and view all the answers

What is one of the essential goals a dressing should accomplish in burn surgery?

Apply even pressure on the wound Signup and view all the answers

What is a significant disadvantage of using a Split Thickness Skin Graft (STSG)?

The patient is at risk of developing skin contractures long term Signup and view all the answers

Which procedure involves the removal of the lens without its capsule?

Extra Capsular Cataract Extraction (ECCE) Signup and view all the answers

What condition primarily results from the clouding of the lens in the eye?

Cataracts Signup and view all the answers

Which characteristic distinguishes Full Thickness Skin Grafts (FTSG) from Split Thickness Skin Grafts (STSG)?

FTSG includes both epidermis and dermis Signup and view all the answers

What is a primary indication for performing a tympanoplasty?

Conductive hearing loss Signup and view all the answers

During which surgical procedure is it critical to ensure adequate drainage of the sinuses?

FESS (Functional Endoscopic Sinus Surgery) Signup and view all the answers

What is the purpose of applying lidocaine topically over the larynx during laryngeal surgeries?

To numb the area and prevent coughing Signup and view all the answers

In a radical neck dissection, which structure is typically considered optional for removal depending on the extent of the malignancy?

Maxilla Signup and view all the answers

Which positioning is specifically recommended for tracheostomy procedures?

Supine position with shoulder roll Signup and view all the answers

What is a commonly avoided antiseptic solution in otologic surgeries due to its ototoxic properties?

Chlorhexidine Signup and view all the answers

Which of the following accurately describes the purpose of the minor counts performed during head and neck surgeries?

To ensure no instruments are left inside the patient Signup and view all the answers

What is the primary purpose of using absorbable sutures in surgical closures?

To avoid the need for suture removal Signup and view all the answers

What surgical equipment is specifically utilized for manipulating tissue back into place during ear surgeries?

Alligator forcep Signup and view all the answers

What is a critical consideration before performing a radical neck dissection?

Performing tracheostomy if indicated Signup and view all the answers

What is the primary focus of the treatment for a meniscal tear in the knee?

Preservation of knee structures Signup and view all the answers

Which component of the knee is most frequently injured due to sports activities?

Anterior cruciate ligament Signup and view all the answers

What does Total Knee Arthroplasty (TKA) aim to improve for the patient?

Mobility and stability of the knee joint Signup and view all the answers

Why is it crucial to select the correct sided implant before a total knee replacement?

To maintain proper anatomical alignment and function Signup and view all the answers

When performing arthroscopic anterior cruciate ligament repair, what is a common method used?

Patellar tendon graft Signup and view all the answers

What anatomical structures are included in the middle ear?

Eustachian tube, tympanic membrane, and ossicles Signup and view all the answers

What is the consequence of high levels of parathyroid hormone (PTH) in the blood?

Increased absorption of calcium in the intestines Signup and view all the answers

What characterizes the role of the anterior cruciate ligament in the knee?

It stabilizes the knee during both anterior and rotational stresses. Signup and view all the answers

Which surgical procedure focuses primarily on correcting nasal cavity issues?

Functional Endoscopic Sinus Surgery (FESS) Signup and view all the answers

Study Notes

Orthopedic Surgery Essentials

Grafts require stabilization with orthopedic hardware (wires/screws) as they do not fuse independently.
Instruments:
- Kerrison Rongeur: Grasp and resect lamina bone.
- Pituitary Rongeur: Grasping and removing the intervertebral disc.

Equipment Usage and Nursing Considerations

Powered Surgical Instruments (Drills):
- Ensure drills are not in contact with the patient/drapes to prevent injury.
- Safety lock must be engaged when not in use; accidental activation can lead to contamination.
- Test instruments before handling them to the surgeon.
- Verify the correct cord is attached and state size when passing instruments.

Surgical Tables in Orthopedics

Fracture Table: Used for femoral neck or shaft fixation.
Jackson Spinal Table: Designed for prone spinal surgeries.
Radiography:
- C-Arm provides fluoroscopy during procedures, used by the surgeon or x-ray technician.
- All personnel must wear X-ray lead gowns for protection.

Pneumatic Tourniquets

Utilized to create a bloodless surgical field in extremity procedures.
Inflation pressures based on the patient's systolic blood pressure, age, and extremity size.
Recommended max inflation: 250-300 mmHg for arms, 300-350 mmHg for thighs.
Cuff inflation duration: 60 minutes for upper, 120 minutes for lower extremities, documented meticulously.

Open Reduction and Internal Fixation (ORIF)

ORIF applied when fractures cannot be fixed with closed methods, especially for long bones and hips.
Internal fixation provides direct view and anatomical alignment through skin incision.

Types of Hip Fractures

Intertrochanteric Fractures:
- Common in elderly women.
- Fixated using plates and screws; blood supply remains intact.
- Utilizes a Dynamic Hip Screw for stabilization.
Femoral Neck Fractures:
- Requires reduction before fixation due to the risk of nonunion.
- Can be fixed with internal fixation using cannulated screws or total hip arthroplasty (THA) if unstable.

Knee Injuries

Most common injuries include torn medial collateral, medial meniscus, and anterior cruciate ligament.
Meniscal Tear Repair: Involves arthroscopic resection and repair.
ACL Repair: Typically uses a patellar tendon graft for reconstruction.

Total Knee Arthroplasty (TKA)

A surgical procedure to replace worn knee surfaces, primarily due to arthritis.
Supports joint mobility and stability; requires precise implant selection.

Otolaryngology (ENT) Surgery

Middle ear consists of tympanic membrane, ossicles, and Eustachian tube.
Thyroid and parathyroid glands regulate hormones and calcium levels in the blood.

Tympanoplasty and FESS

Tympanoplasty: Repairs tympanic membrane, indicated for conductive hearing loss.
FESS: Involves endoscopic surgery for sinus issues; improves sinus drainage.

Radical Neck Dissection

Involves removal of malignant head and neck tissues, including lymph nodes and surrounding structures.
Requires tracheostomy prior to dissection for airway management.

Neurosurgery

Dissection Layers: Include skin, galea, pericranium, skull, and dura.
Counts: Minor counts are mandatory throughout the procedure (initial, dura, final).

Nursing Considerations in Neurosurgery

Proper padding and securing of patients essential during long surgeries.
Common positions: supine, lateral, or prone.

Plastic Surgery Techniques

Dermatomes: For harvesting split-thickness skin grafts.
Flaps:
- Pedicle Flaps: Maintain original blood supply.
- Free Flaps: Require reanastomosis of blood vessels, often needing a two-team approach.

Orthopedic Procedures

Grafts require stabilization with orthopedic hardware (wires/screws) as they do not fuse independently.
Instruments such as Kerrison and Pituitary Rongeurs are used for handling lamina bone and intervertebral discs respectively.

Surgical Equipment and Considerations

Powered Surgical Instruments (Drills):
- Ensure drills do not rest on the patient or drapes to prevent accidental activation.
- Safety locks must be engaged when not in use; test all equipment before handing to the surgeon.
Operating Room Tables:
- Fracture Table is utilized for femoral neck or shaft fixation; Jackson Spinal Table is used for prone spinal surgeries.
- C-Arm provides crucial fluoroscopy during orthopedic procedures, requiring all personnel to wear lead gowns.

Pneumatic Tourniquets

Employed in extremity procedures to achieve a bloodless field, enhancing visualization.
Inflation pressure should align with the patient's systolic blood pressure; recommended limits are 250-300 mmHg for arms, 300-350 mmHg for thighs.
Cuff inflation times are limited to 60 minutes for upper and 120 minutes for lower extremities, with documented inflation timings.

Open Reduction and Internal Fixation (ORIF)

Utilized when fractures cannot be corrected through closed methods.
Involves metal plates, screws, and nails for stabilization of fractures, particularly in long bones and hips.

Hip Fracture Fixation

Intertrochanteric Fractures:
- Common in elderly women; fixable with plates and screws as the blood supply remains intact.
Femoral Neck Fractures:
- Require reduction before internal fixation due to compromised blood supply; may utilize cannulated screws or result in Total Hip Arthroplasty (THA).

Knee Injuries and Surgeries

Torn medial collateral, medial meniscus, and anterior cruciate ligaments are prevalent knee injuries.
Arthroscopic Resection and Repair:
- Meniscus tears are common injuries requiring preservation of knee structures.
Anterior Cruciate Ligament Repair:
- Most frequently torn ligament; often involves patellar tendon graft for replacement.

Total Knee Arthroplasty (TKA)

Used to replace worn knee surfaces, commonly due to arthritis.
Aims to improve mobility and joint stability. Knee prostheses should be specific for left or right sides.

Otolaryngology (ENT) Surgery

Middle ear components include the tympanic membrane and ossicles, essential for sound amplification.
Thyroid and parathyroid glands play significant roles in regulation of hormones and calcium.

Surgical Procedures in ENT

Tympanoplasty:
- Repair of tympanic membrane; indicated for conductive hearing loss.
Functional Endoscopic Sinus Surgery (FESS):
- Targets inflammatory sinus conditions by resecting tissue to enhance drainage.
Radical Neck Dissection:
- Involves removal of malignant tissues and requires tracheostomy for airway management.

Neuro Surgery and Burn Surgery

Neuro surgery involves careful dissection, usually with a small skin incision.
For burn surgeries, maintaining a warm environment is critical to prevent hypothermia; dressings serve multiple purposes, including immobilization and comfort.

Skin Grafts in Burn Surgery

Split Thickness Skin Graft (STSG):
- Comprises epidermis and part of dermis, heals quickly but can lead to long-term contractures.
Full Thickness Skin Graft (FTSG):
- Contains both layers, provides better aesthetic results with minimized contracture, though the donor site cannot be reused.

Ophthalmology: Cataracts

Cataracts refer to the clouding of the lens, leading to vision impairment.
Cataract Surgery involves either an extracapsular or intracapsular extraction, both aimed at removing the opaque lens from the eye.

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Description

Test your knowledge of various surgical instruments and their purposes. This quiz covers essential equipment used in surgeries, including bone currettes and powered surgical instruments. Understand the role of different tools in the operating room and important nursing considerations.