Instrumentation, Equipments, and Supplies Chapter 10 (Nicola)
What is the name for an opening
For this type of electrosurgery, both the active electrode and return electrode functions are performed at the site of surgery.
By which action does liquid travels along an established path; often used in reference to suture in which infectious fluid travels along the length of the suture strand placed in a wound; also referred to as wicking
What is a hollow, cylindrical tube that allows for the removal of fluids or air from the body, injection of fluids, removal of obstruction from ducts, or intravascular monitoring; may be plain tipped or may contain a retention balloon
What is another name for neurosurgical sponge; used to protect delicate neural tissue and to assist with hemostasis
What is the prefix or combining form meaning cold
What is a cylindrical device that is used to evacuate air and/or fluids from a surgical wound; may be passive or active
What do we call an opening, for instance in a drape
What is it called when forcing powder, gas, or vapor into a body cavity
What is it called when washing with a stream of fluid
What is the process of enlarging the size of an object with the use of a device such as a microscope
What is monopolar electrocautery in which the electrical circuit completes a path from the generator, to the patient, and then back again to the generator
What is (1) Opposing or counteracting force; (2) a force that delays or impedes action
What is to draw back; to expose
What are grooves that are located on the jaws of surgical instruments that are either longitudinal, crosshatched, or horizontal
What is the name for a type of metal that is a combination of carbon, chromium, iron, and other metals; most often used in the manufacture of surgical instruments
What are small projections from the tip(s) of the jaw of certain surgical instruments; used to aid in grasping tissue or vessels
What pertains to the ureters that exit the kidney and transport urine from the kidney to the bladder
What pertains to the urethra, which travels from the bladder to the exterior of the body
What is stronger and lighter in weight, non magnetic, and more resistant to corrosion than stainless steel.
What type of finish - bright finish increases resistance to corrosion but can be distracting to the surgical team because of its tendency to reflect light.
A highly polished,
What type of finish - is less reflective and reduces glare.
A satin (dull) finish
What type of finish - is non reflective and virtually eliminates glare. This type of finish is recommended for procedures involving a laser because it prevents deflection of the laser beam.
An ebonized (black chromium) finish
Instruments are classified as:
Accessory for anything else
Instruments with one or more sharp edges that are used for incision, sharp dissection, or excision of tissue are classified as .........
knives, scalpels, scissors, and bone-cutting instruments (osteotomes, curettes, chisels, gouges, and rongeurs). Saws, drills, biopsy punches, adenotomes, and dermatomes may also be classified as cutting instruments are examples of......
Examples of cutting/dissecting instruments
What organizations? ..... as well as the frequency of employee sharps injuries has driven many organizations to convert to safety scalpels
The OSHA Bloodborne Pathogen Standard
Long knife handles are available for number ...... knife handles
Other knife handles are 5" in length
#7 is a slightly longer knife handle than a regular handle but not as long as a 3L or 4L
What blade will fit the #3 knife handle
Blades #10, #11, #12, #15
What blade will fit the #4 knife handle
What blade will fit the #7 knife handle
Blades #10, #11, #12, #15
What blade will fit the #9 knife handle
Blades #10, #11, #12, #15
What is thee most frequently used Beaver blade
What is the blade most frequently used and is typically loaded onto the #3 handle
The #10 blade
The #11, #12, and #15 blades are usually loaded onto the ........
What is frequently used with the #3 handle for superficial procedures requiring a small incision, such as plastic or hand procedures or the #3L handle for use in deep surgical wounds
the #15 blade
The #12 blade is used almost exclusively for ........
The #20 blade is occasionally used for ...........
long and deep abdominal incisions.
Which scissors may be of heavy for tough tissue, medium construction for tissue that is neither tough nor delicate, or light construction for thin, friable tissue
What is the term when scissors are used to spread and open tissue planes
Which scissors are often the scissors of choice for heavy tissue
Curved Mayo scissors
Which scissors are always used to cut suture and rarely used to cut tissue
straight Mayo scissors
Which scissors are used for medium to fine tissue.
curved Metzenbaum scissors
Delicate tissue is frequently dissected with .....
curved iris, Jamison, Westcott, Stephen’s tenotomy, or Potts-Smith scissors
Which instruments are designed to manipulate tissue to facilitate dissection or suturing or to reduce and stabilize fractured bone during internal fixation
May or may not have ratcheted locking mechanism
Ratcheted grasping/holding instruments include
Allis, Babcock, and Kocher (Ochsner), tenaculum
Forceps, adsons, DeBakey, Russian
Bone holding clamps
Clamping/occluding instruments are designed to .......
occlude or constrict tissue
Which clamps are small, spring-loaded devices with atraumatic serrations
Which clamps are designed to occlude bleeding vessels until they can be ligated, occluded with stainless steel or titanium ligaclips, or coagulated
Curved hemostatic clamps
Which clamps are frequently utilized for “tagging” sutures; “tagging” is performed when a suture strand is not immediately cut.
These type of retractors are what? Weitlaner, Gelpi, Bookwalter, O’Connor–O’Sullivan, and Balfour retractors,
A ............ with a blunt edge are typically used to retract the abdominal wall or abdominal and thoracic organs
Which retractors are used for retraction of nonvital structures, such as fat or skin.
Sharp rake-like retractors
What are typically found in abdominal, gallbladder, or rectal instrument sets and are often used with guides called ........
& grooved directors
What are instruments used to gradually dilate an orifice or duct to allow for introduction of larger instrumentation or to open a stricture
Dilators gradually taper to the .........
The proximal end is where it is held by the surgeon
What type of needled holder is called a Heaney needle holders, and are used during certain genitourinary and gynecological procedures.
curved needle holders,
Which surgeon prefers an angled suction tip with a proximal thumbhole that allows for variability in suction strength.
Commonly used for aspiration of abdominal fluids are the .......... abdominal suction tips
Yankauer and Poole
Which suction tip resembles a large, bent hypodermic needle and is included with an adapter for suction tubing attachment
Which procedures typically require a major lapa-rotomy or a minor laparotomy set (also called a major or minor procedures set
What are used for diagnosis, biopsy, visualization, and/or repair of a structure within a body cavity or the interior of a hollow organ
Edoscopes with or without a ...... can be inserted into body cavities, these include arthroscopes, laparoscopes, and thoracoscopes.
Which scope is used for exploration of the biliary system
Which scope is used for visualization and biopsy of the structures of the mediastinum
Which scope is used for exploration of the brain’s ventricular system
Which scope is used for visualization of a fetus in utero
Which scope is used for exploration of the ureters
The ........ uses a monopolar electric current to shave hypertrophied prostate tissue from within the proximal urethra
What uses compressed air, nitrogen, electricity, or battery
Power saws have either a ....... (back-and-forth) motion
Power saws have either a ....... (side-to-side) action for cutting bone
The blade of a craniotome cuts through the cranium with a
What motion does a reamers utilize
slower rotary motion
What is a binocular apparatus that uses bent light waves for variable magnification of tissues during microsurgery
The compound operating microscope
What in a microscope refers to the ability of the optical system to filter out adjacent images and to clarify detail.
What is the focal length of the objective lens in a microscope
ranges from 100 to 400 mm
What use fiber optics to transmit light waves through the microscope’s optical system
Which specialties makes use of the fiber-optic headlamp, most frequently
neuro-, cardiovascular and otorhinolaryngology surgeons
What is powered by nitrogen, battery, or electricity and is utilized to thoroughly irrigate a traumatic, infected, or surgical wound.
pulse lavage irrigator
What is often used during orthopedic procedures to irrigate contaminated fractures to clean out the debris and in total joint arthroplasties. Surgical team must wear a face shield to protect from splatter
pulse lavage irrigator
Diseased eye lenses may be fragmented and removed with a .........
What machine that uses ultrasonic energy (cavitation) to fragment the lens, and an irrigator/aspirator (I/A) to remove the fragments
Which therapy is useful for the removal of vascular tumors, brain tumors, and the prostate gland
What is utilized to repair retinal detachments and extract cataracts.
Laparoscopic procedures cannot be performed unless CO2 gas is infused into the abdominal cavity through either a ..............
Verres insufflation needle or a Hasson blunt trocar.
The machine that infuses the CO2 gas into the abdominal cavity is called an
What creates a space for viewing an endo-scope and for work within the cavity through cannulas inserted at strategic points through the abdominal wall
What produce very small electric currents that, when applied to tissue, help to identify and preserve essential nerves for cranial, facial, neck, or hand reconstructive procedures
what is useful for identifying the seventh cranial (facial) nerve during acoustic neuroma removal, nerve branches, cochlear
Who may use the nerve stimulator to assess the actions of neuromuscular blockers administered during anesthesia.
What may be portable or centralized, and is accessed via outlets located in each operating room (OR).
What connects the vacuum source with the collection unit.
Vacuum source tubing
What may be reusable or contain a disposable liner, it may have incremental markings to allow estimation of the amount of fluid contained within.
What connects the collection unit to the suction tip. Is usually disposable and may be sterile or nonsterile according to the situation.
What removes the fluid from the source. May be sterile or nonsterile, disposable or reusable, and one of a variety of styles (
What beam should generally be set at a 10- to 12-in. depth of focus so that the intensity of the beam is relatively equal at the surface and depth of the incision.
Overhead operating light
What is used during some procedures on the extremities to restrict blood flow to the surgical site.
The tourniquet serves two main purposes in surgery
The amount of blood lost by the patient is minimized
Visualization of the surgical site for the sterile team members is improved.
What may also lead to blistering, bruising, pinching, or necrosis of the skin.
Improper application of the tourniquet
What consists of a rubber bladder contained within a fabric or plastic covering, similar to a blood pressure cuff and may house a single or double chamber. The double-chamber tourniquet is used for intravenous regional (Bier) blocks
What connects the cuff to the pressure source.
What consists of an air compressor, pressure controls, pressure gauge, and timer.
Where is the cuff placed on the patient
as far proximally on the extremity as possible
The tourniquet pressure for the upper extremity is approximately ............than the patient’s systolic blood pressure
30-70 mm Hg higher
What is the recommended time period that the tourniquet be temporarily deflated periodically to permit limb reperfusion.
What consists of a compressor that is electrically operated, connecting tubing, and one or more sleeves that enclose that patient’s limb
The sequential compression device (SCD)
What are used by the surgical team to serve as a barrier to isolate and protect the operative site from contaminants and microbes that can cause a surgical site infection (SSI).
What may be nonwoven textile fabrics, woven textile fabrics, or plastic.
What are reusable drapes made out of
Woven Textile Fabrics
What are disposable drapes made out of
compressed synthetic fibers, such as nylon or polyester bonded with cellulose
What have an adhesive backing that may be impregnated with an antimicrobial iodine agent that is slowly released after application to destroy bacteria from the patient’s skin during the surgical procedure
What are applied to the patient’s skin after four towels have been placed “squaring off” the incision site
What are small, clear plastic drapes with openings that are surrounded by an adhesive backing. They are used to drape eyes and ears. These types of drapes allow the surgeon to view landmarks that would normally be covered.
What are large, clear plastic drapes with an adhesive backing surrounding the fenestration and are frequently utilized as drapes for hip pinning
Isolation aperture drapes
“lap sheet”: Abdomen
Pediatric or “pedi” sheet:
Transverse lap sheet:
Thorax and kidney
Neck, especially the thyroid
The free ends of the drape are referred to as the .......... of the drape
What sterile pack is used for General surgery
laparotomy pack; thyroidectomy pack
What sterile pack is used for Gynecological surgery
vaginal hysterectomy pack; laparoscopy pack
What sterile pack is used for Orthopedic surgery
arthroscopic pack; total hip pack
What sterile pack is used for GU surgery
What sterile pack is used for Cardiovascular surgery
What skin preparation material may be applied before application of a dressing
tincture of benzoin or Mastisol
What are used for temporary coverage of open wounds due to trauma, burns, or skin ulcer
Biologic dressings or biosynthetic skin substitutes
What is a material that is surgically taken from a specific area of the patient’s own body.
skin graft (autologous)
Other species Xenografts or heterografts
What is used to cover a small incision from which drainage is expected to be minimal (e.g., endoscopic incision).
A one-layer dressing
What are used to maintain approximation of the wound edges and may be used alone or in conjunction with another type of dressing
Skin closure tapes
What is a liquid skin adhesive applied by surgeons to close wounds. This strong, flexible agent supports many wounds and incisions with needle-free wound closure
What is used to cover any size incision from which drainage (light, moderate, or heavy) is expected
A three-layer dressing
What extends from the axillae to the hips to immobilize the lower thoracic and lumbar vertebrae
Body jacket cast
What is secured to the torso to support the hip or shoulder in the desired position
What extends from the head (incorporating the mandible while exposing the face) to the hips to immobilize the cervical and upper thoracic vertebrae
Minerva jacket cast
What cylindrical cast of the lower extremity that has a polyurethane sole or rubber heel added to allow for ambulation
What type of dressing is a wet gauze, soaked in saline, antibiotic solution, Dakin’s solution, applied to the wound and allowed to dry. The dried dressing is removed along with any tissue that has adhered to the dressing. Often performed on burn wounds and may be performed under anesthesia in the OR to provide patient comfort.
What type of dressing is a gauze sponge that is manufactured, Sof-Wick drain sponge, or fashioned with a scissors, slit or “Y” shape, to accommodate a wound that contains a drain.
What is used to assist with hemostasis, provide pressure, support a wound, and/or eliminate dead space
What are examples of packing material
NuGauze Packing Strip-Plain), impregnated with an antiseptic (e.g., NuGauze Packing Strip with Iodoform 5%), or contain a radiopaque marker.
What are used to remove fluid or other objects, such as thrombi and stones, from the body
What use the French scale for sizing, and are available as small as 5Fr. for infants and pediatric patients and up to the largest size 30Fr
What are temporarily inserted through the urethra into the bladder to obtain a urine specimen, decompress the bladder, or maneuver around an obstruction
What are used to measure urinary output over an extended period or provide bladder decompression
Self-retaining or indwelling urethral catheters
What uses a balloon to retain the catheter within the bladder, allowing for continuous drainage of urine. The balloon may have a 5- or 30-cc capacity.
The Foley catheter
What is placed into the bladder through a surgical opening in the abdominal wall. Examples are the Foley, Pezzer (mushroom), and the Malecot (winged tip).
The suprapubic catheter
What are placed in the ureter(s) with the assistance of a cystoscope. They are used to decompress the kidney, identify and protect the ureter(s) during pelvic procedures, and introduce contrast media during retrograde pyelography
What are used to infuse fluids (including nutrients and medications), obtain a diagnosis, monitor body functions, and remove thrombi. May be inserted percutaneously or via a small incision referred to as a cut-down.
Which catheter is passed beyond an obstruction within the lumen of a vein, artery, or duct. The balloon is then inflated, and the catheter is withdrawn along with the obstruction
A Fogarty is a balloon-tipped catheter
What are used to aspirate air and fluids from the gastrointestinal tract
What may be passed through the nose or mouth into the stomach or intestine, through the rectum into the intestine, or may be inserted surgically
What term refers to a dual-lumen tube in which one lumen is used for evacuation of fluid and the second allows air to enter for equalizing the pressure within the structure, reducing the risk of damage to delicate tissues by preventing constant negative pressure.
The term sump
What are used to maintain patency of the upper respiratory tract.
What tube is available in adult and pediatric sizes as well as cuffed and uncuffed styles. The tube is passed through the nose or mouth, between the vocal cords, and into the trachea of the unconscious patient.
Endotracheal (ET) tube
What is inserted through the mouth to separate the jaws and depress the tongue.
What is placed directly into the trachea via an incision in the neck.
What are the three components of a tracheotomy tube
What are inserted percutaneously through a “stab” wound to treat pneumothorax or following cardiothoracic surgical procedures to evacuate air and fluid from the pleural space
What system uses water in the collection unit to prevent air from reentering the pleural space, thereby maintaining the negative pressure necessary for effective respiration
The water-seal drainage
What allow a pathway for fluid or air to move from an area of high pressure to one of lower pressure
What is a latex tubing that is placed partially within the wound, allowing fluid to move out of the wound into the dressing by capillary action
What is a Penrose drain with gauze inside encourages fluid to move out of the wound into the dressing by wicking action.
What is placed within the biliary system, it drains bile via gravity into a specialized collection unit called a bile bag.
What is inserted through the abdominal wall into the stomach; removes gastric contents or provides instillation of nourishment (“tube feeding”).
What is inserted through the abdominal wall into the urinary bladder; removes urine.
What is inserted percutaneously into the kidney; removes urine.
What make use of negative pressure, and is created by removing air from the collection device manually or mechanically
What is typically used following orthopedic procedures when a moderate amount of drainage is expected.
What are typically used following abdominal procedures when a moderate amount of drainage is expected. Also used in neurosurgery and other general surgery procedures such as a mammoplasty.
Jackson, Pratt, drains
What is typically used following orthopedic procedures. Effective in reducing dead space due to the strength of the battery-operated evacuation pump.
What syringe consists of a tip that may be plain
needles that simply slip over the syringe tip
What syringe consists of a tip that may be locking
locks the needle onto the syringe tip with a twisting motion
What are calibrated in milliliters and/or cubic centimeters
What syringes are calculated in units
What syringes are calculated in tenths or hundredths of a cubic centimeter, and contain up to 1 cc of fluid
What is the most commonly used standard syringe.
Which syringe holds approximately 120 cc.