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Questions and Answers
What is the primary use of Rampley's sponge holder?
What is the primary use of Rampley's sponge holder?
- Hold towels
- Cut tissues
- Grip sponge for part preparation (correct)
- Mount blades
Towel clips can be used to hold a suction catheter during surgery.
Towel clips can be used to hold a suction catheter during surgery.
True (A)
What type of joint is associated with a higher incidence of threads getting stuck?
What type of joint is associated with a higher incidence of threads getting stuck?
Screw joint
The BP (Brad Parker) handle is primarily used to ________ blades.
The BP (Brad Parker) handle is primarily used to ________ blades.
Match the surgical instrument with its usage:
Match the surgical instrument with its usage:
What is the primary use of Lung Forceps?
What is the primary use of Lung Forceps?
Joll's Thyroid Retractor is still widely used in surgical procedures.
Joll's Thyroid Retractor is still widely used in surgical procedures.
What unique feature does the Bulldog Clamp possess?
What unique feature does the Bulldog Clamp possess?
The __________ Needle is used for ligation of aneurysms.
The __________ Needle is used for ligation of aneurysms.
Match the following surgical instruments with their description:
Match the following surgical instruments with their description:
Which type of ulcer has well-defined edges and is associated with arterial issues?
Which type of ulcer has well-defined edges and is associated with arterial issues?
The sloping type of ulcer edge is typically associated with cappilarial issues.
The sloping type of ulcer edge is typically associated with cappilarial issues.
What potential causes are associated with rolled out, pearly white ulcer edges?
What potential causes are associated with rolled out, pearly white ulcer edges?
The edges of an ulcer that are recessed into the surrounding skin are described as ______.
The edges of an ulcer that are recessed into the surrounding skin are described as ______.
Match the following types of ulcers with their corresponding potential causes:
Match the following types of ulcers with their corresponding potential causes:
Which of the following is a risk factor for arterial ulcers?
Which of the following is a risk factor for arterial ulcers?
Diabetic ulcers primarily occur due to increased glucose levels and microangiopathy.
Diabetic ulcers primarily occur due to increased glucose levels and microangiopathy.
What is the management approach for a Stage 3 ulcer?
What is the management approach for a Stage 3 ulcer?
A common management strategy for ulcers is the use of _____ dressings.
A common management strategy for ulcers is the use of _____ dressings.
Match the ulcer stages with their descriptions:
Match the ulcer stages with their descriptions:
What is the primary advantage of Doyen's retractor?
What is the primary advantage of Doyen's retractor?
Malleable retractors are primarily used for retraction of bladder during surgical procedures.
Malleable retractors are primarily used for retraction of bladder during surgical procedures.
What type of surgery are mastoid retractors typically used in?
What type of surgery are mastoid retractors typically used in?
The ________ retractor is specifically designed for complex abdominal malignancy surgeries.
The ________ retractor is specifically designed for complex abdominal malignancy surgeries.
Match the artery forceps with their specific characteristics:
Match the artery forceps with their specific characteristics:
Which of the following scissors is finer than Metzenbaum scissors?
Which of the following scissors is finer than Metzenbaum scissors?
Metzenbaum scissors should be used to cut sutures.
Metzenbaum scissors should be used to cut sutures.
What type of retractor is the Morris retractor known for compared to the Langenbeck's retractor?
What type of retractor is the Morris retractor known for compared to the Langenbeck's retractor?
The __________ retractor is used to hold raised flaps during mastectomy, thyroidectomy, and parotidectomy.
The __________ retractor is used to hold raised flaps during mastectomy, thyroidectomy, and parotidectomy.
Match the following retractors with their primary usage:
Match the following retractors with their primary usage:
What is the primary function of Yankauer's suction cannula during surgery?
What is the primary function of Yankauer's suction cannula during surgery?
Toothed forceps are relatively atraumatic.
Toothed forceps are relatively atraumatic.
What type of forceps is designed specifically for gripping vascular structures?
What type of forceps is designed specifically for gripping vascular structures?
The main use of scissors in surgery, such as Heavy (Mayo) scissors, is for cutting ________.
The main use of scissors in surgery, such as Heavy (Mayo) scissors, is for cutting ________.
Match the surgical instruments with their respective types or uses:
Match the surgical instruments with their respective types or uses:
Which forceps are primarily used to hold tubular structures without crushing them?
Which forceps are primarily used to hold tubular structures without crushing them?
Kocher Tissue Forceps are primarily used to crush delicate tissues.
Kocher Tissue Forceps are primarily used to crush delicate tissues.
What is the unique feature of Allis Forceps?
What is the unique feature of Allis Forceps?
The __________ Needle is used for creating pneumoperitoneum.
The __________ Needle is used for creating pneumoperitoneum.
Match the following forceps with their primary usage:
Match the following forceps with their primary usage:
Which type of trocar is commonly known as Hassan's trocar?
Which type of trocar is commonly known as Hassan's trocar?
The periosteal elevator is also known as Farabeuf's periosteal elevator.
The periosteal elevator is also known as Farabeuf's periosteal elevator.
What is the primary function of a rib raspatory?
What is the primary function of a rib raspatory?
The _______ is used to nibble off sharp edges after cutting bones.
The _______ is used to nibble off sharp edges after cutting bones.
Match the following thoracotomy instruments to their description:
Match the following thoracotomy instruments to their description:
Which type of ulcer is most commonly associated with the medial malleolus?
Which type of ulcer is most commonly associated with the medial malleolus?
Marjolin's Ulcer is caused by squamous cell cancer.
Marjolin's Ulcer is caused by squamous cell cancer.
What are the features of a Varicose Ulcer?
What are the features of a Varicose Ulcer?
The site where Diabetic Ulcers typically occur is the ________.
The site where Diabetic Ulcers typically occur is the ________.
Match the type of ulcer with its characteristics:
Match the type of ulcer with its characteristics:
What is the primary use of Cheatle's Forceps?
What is the primary use of Cheatle's Forceps?
Pyelolithotomy Forceps are still commonly used in surgical procedures.
Pyelolithotomy Forceps are still commonly used in surgical procedures.
What feature of Cystolithotomy Forceps helps in preventing the crushing of stones?
What feature of Cystolithotomy Forceps helps in preventing the crushing of stones?
Doyen's Intestinal Clamp has __________ serrations to prevent tissue crushing.
Doyen's Intestinal Clamp has __________ serrations to prevent tissue crushing.
Match the following surgical instruments with their primary use:
Match the following surgical instruments with their primary use:
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Study Notes
Surgical Instruments
- Open Instruments: Open instruments are commonly used tools in surgeries, each possessing unique parts that contribute to their functionality:
- Rings: Used for gripping.
- Ratchets: Prevent wear and tear and provide a secure hold.
- Joint: Connects different parts of the instrument. Box joints are more reliable compared to screw joints, which are prone to thread issues.
- Blades: Come in two types:
- Fenestrated: Have holes or openings.
- Serrated: Have ridges or grooves for better grip.
- Rampley's Sponge Holder: Instrument with a fenestrated blade and serrations. Used to grip sponges during surgical preparation.
- Towel Clips: Several uses: To hold towels during draping, pass and hold suction/cautery devices, and hold the tongue during tongue resection. Two common types include Mayo's and Doyen's.
- BP (Brad Parker) Handle: Handle used for attaching blades. Used like a paint brush or with a palming grip.
- Lung Retractor: Instrument with a fenestrated blade for lung expansion during retraction. This allows surgeons to visualize and access the lung more effectively.
- Lung Forceps: Designed to remove small tissues like hamartomas or nodules during lung surgery. Features a triangular end to create a bloodless field.
- Joll's Thyroid Retractor: An obsolete retractor that uses two separate retractors to hold back the thyroid during surgery.
Vascular Surgical Instruments
- Clamps: Used to temporarily stop blood flow in specific areas for surgical procedures.
- Bulldog clamp (self-retaining): Has a pinch-cork effect and serrations for temporary clamping without crushing tissues.
- Satinsky Vascular Clamp (curved): Has serrations and helps clamp over a pedicle for better visualization.
- Aneurysm Needle (J-hook): Used for ligating aneurysms (bulges in blood vessels).
Miscellaneous Instruments
- Metzenbaum Scissors (tissue dissecting): Lighter than Mayo scissors, used for dissecting tissue. It is crucial to avoid using them to cut sutures.
- McIndoe Scissors: Finer and more precise than Metzenbaum scissors. Used for ophthalmic and ENT (ear, nose, throat) surgeries.
- Retractors: Devices used to hold back tissue and allow for clear visualization of the surgical site.
- Non-self-retaining: Manually held by the surgeon.
- Skin Hooks: Hold back raised flaps during various surgeries such as mastectomy, thyroidectomy, and parotidectomy.
- Cat's Paw Retractor: Retracts superficial tissue.
- Langenbeck Retractor (right-angled): Retracts superficial tissue, with a fenestration option for a lighter instrument.
- Army Navy/Czerney's Retractor: Has a 90-degree angle on one end, with a clawed, gapped design on the other. Used for tissue retraction during suturing.
- Morris Retractor (wider than Langenbeck's): Provides a better grip, preventing structures from slipping.
- Doyen's Retractor: Used for bladder retraction, offers increased convexity for easier manipulation.
- Malleable Retractor (flexible and pliable): Commonly used in abdominal surgeries, particularly for bowel retraction. Malleability allows for adapting to different positions and curved surfaces.
- Self-retaining: Securely hold back tissues without the surgeon's continuous holding.
- Mastoid Retractors: Used for superficial tissue retraction and often used in thyroid and parotid surgeries. They lock into place for self-retraction.
- Balfour Self-retaining Retractor: Suitable for deeper retraction in the abdomen. Consists of a bar that is adjusted within the abdomen and blades for retraction.
- Bookwalter Retractor: Designed for complex abdominal procedures. It consists of a ring attached to the operating table that allows for attaching multiple retractors to create a customized retraction system.
- Non-self-retaining: Manually held by the surgeon.
Artery Forceps
- Spencer Wells Forceps (straight): Artery forceps designed to clamp and hold blood vessels during surgery. Available in various sizes.
- Curved Artery Forceps: Offer improved visualization compared to straight forceps, allowing for more controlled clamping of bleeders.
- Mosquito Forcep (smallest artery forcep): Used for delicate clamping in specific procedures.
Special Forceps
- Kelly's Forceps: Curved, larger than other forceps, with a more gradual curve. Used in abdominal surgeries.
- Right Angle Forceps: Have a right-angle curve, used for tying pedicles.
- Allis Forceps: Designed for holding tougher structures. Features blades with serrations and teeth.
- Babcock Forceps: Has a gap between two fenestrated ends. Used for holding tubular structures like the appendix, vas deferens, or fallopian tubes. Minimize crushing of delicate structures.
- Kocher Tissue Forceps: Feature interlocks and are used to crush tissue. Hold tough structures and the cervix during hysterectomies.
Laparoscopic Instruments
- Long Instruments: Used in laparoscopic procedures that require reaching deeper into the body.
- Insulated Instruments: Prevent leakage of electrical current from cautery devices during laparoscopic procedures.
- Veress Needle: Used for creating pneumoperitoneum in laparoscopic surgeries (introducing gas to create a more visible workspace). Features spring-loaded mechanism, an outlet/inlet valve, and a blunt tip for safety.
- Laparoscopic port/trocar: Placed in the abdomen to allow passage of laparoscopic instruments. The first port is inserted blindly, different types include:
- Sharp trocars: Can cause tissue injury if inserted blindly.
- Blunt trocars (Hassan's trocar): Offer less risk of tissue injury.
- Bladeless trocars (Optiport): Reduce the risk of injury as they don't have blades.
- Maryland's Dissector: A curved laparoscopic instrument with serrations similar to those found on artery forceps, widely used in laparoscopic surgery.
Thoracotomy Instruments
- Periosteal Elevator (Farabeuf's): Used to lift the periosteum off the rib during rib surgeries.
- Rib Raspatory: Resects periosteum and associated muscles. Two types, each for the right or left rib, with the handle on the lateral side, convexity upwards, and tip downwards.
- Rib Cutter: Features a blunt lower edge to avoid pleural injury and sharp edges for cutting bone.
- Bone Nibbler: Removes sharp edges from bone after cutting.
- Yankauer's Suction Cannula: Draws blood and fumes during surgery, two types:
- Plastic.
- Metallic.
- Forceps (spring-loaded): Hold tissues during surgery, several types:
- Plain.
- Toothed.
- Vascular.
- Special.
- Forceps with transverse serrations without teeth: Less traumatic for tissues.
- Needle Holder: Holds needles during suturing, often used with toothed forceps for needle grip. Criss-cross serrations prevent needle movement during suturing.
- Scissors: Cut sutures and sheaths during surgery. Heavy-duty types like Mayo scissors have screw joints and blades.
Common Ulcers
- Ulcers: A breach in the continuity of the epithelium or mucosa.
- Types:
- Venous Ulcer: Often found in the gaiter area (lower leg). Features: Normal arterial pulsations, dilated veins, normal sensations, sloping margins.
- Arterial Ulcer: Located on the dorsum (top of the foot) or lateral side of the leg. Features: Absent arterial pulsations, no dilated veins, painful, punched-out margins.
- Trophic Ulcer: Found on the sole or base of the big toe. Features: Normal arterial pulsations, no dilated veins, decreased sensations, punched-out margins.
- Diabetic Ulcer: Often occurs on the sole or base of the big toe. Features: May have no arterial pulsations, no dilated veins, decreased sensations, punched-out margins.
- Varicose Ulcers: Typically occur near the medial malleolus (inner ankle). Features: Shallow, pale granulation tissue, pigmented margin (due to hemosiderin), often resistant to healing.
- Marjolin's Ulcer: A squamous cell cancer that can develop in long-standing venous ulcers, burn scars, or other chronic wounds. Features: Raised, everted margins. Management: Wide local excision, radiotherapy may be used for scarring or recurrence.
Ovum Forceps
- Have 2 convex ends with fenestrations
- Used to remove retained placental or fetal tissue
Cheatle's Forceps
- Ends without a lock
- Used to pick up gauze pieces
Cystolithotomy Forceps
- Have one complete ring for the thumb
- One open part for the other 4 fingers
- No lock to prevent crushing of stones
- Studs at the end for a better grip
Pyelolithotomy Forceps
- Now obsolete
- Varied angulations for better calyceal access
- Ends with transverse serrations without a lock
Bowel Clamps
- Two main types: Non-crushing and crushing
- Non-crushing clamps - Doyen's Intestinal Clamp, have longitudinal serrations, prevent tissue crushing and fecal spillage
- Payr's crushing clamps - Used to remove portions of bowel
Choledocholithotomy Forceps
- Desjardin's forceps are an example
- Used to bring down CBD stones
- No serrations
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