What can be used as the "passer" on a tie with passer?
mayo
forester ring forcep
right angle lahey
forcept
When making an incision into the fascia the edges of the fascia are grasped with what instrument?
mosquito clamp
mayo clamp
kocher
ring forcept
Sometimes a surgeon will make an incision with a scalpel and hand it back to the surgical technologist and then ask for a deep knife. What is the difference between a skin knife and a deep knife?
a deep knife cuts better
a deep knife is longer
a deep knife could be less contaminated from bacteria
a deep knife could be cleaner
What scissor is used to cut the fascia and the muscle?
suture scissors
curved mayo
jones
metzenbaum
The scissors are used to extent the peritoneum opening.
Once the surgeon has cut completely through the peritoneum, the retractor may be asked for.
What is important to hand the surgeon when handling the balfour retractor?
raytec sponges
wet lap sponges
dry sponges to soak up bload after incision is made
roiled towel
What are the two forceps commonly used inside the peritoneum?
debakey and russian
addsons with teeth
debakey alone
russian alone
What forceps are most commonly used on skin?
kochers
russian
debakey
A clamp is most commonly used on bleeders.
What are the most common ways the peritoneum layer is incised?
using a sharp retractor to keep the peritoneum tensile
elevated from bowel with debakey forceps, mayo clamp or crile clamp
elevate from bowel using only the crile clamp
#10 blade used with #3 handle to knick opening into peritoneum
metzenbaum used to extent opening
What instruments would you need on your mayo stand to perform a exploratory laparotomy?
2 kelly/crile clamps, 2 mayo clamps, 2 kockers, 2 babcocks, 1 right angle loaded, 2 army/navy retractors
lots of instruments
2#3 handles with #10 blades, mayo scissors, metzenbaum, suture scissors, basic tissue forceps with teeth, medium debakey pickups, medium mayo hegar needle holder
List two different types of items that can be use to cut during the CCCT routine of the resection concept.
scalpel;mayo or mentzenbaum
scissors;mayo or metzenbaum
utility scissors
three different ways the surgeon can close the skin after a procedure is finished?
staple
dermabond
super medical glue, medical grade
hard tack
suture
is used to cover the incision before dressings are applied when a subcuticular stitch is used to close the skin
How would a surgeon secure a drain to skin?
drain is secured to skin using non-absorbable suture, 2-0 to 3-0 on a large cutting needle
Suture is tied, wrapped around tube a few times, tied again and cut long to half inch.
suture is tightly woven around drain
drain is secured using absorbable suture
What size and type of suture and needle are used on the peritoneum layer?
non-absorbable
absorbable; 2-0 or 0, CT-1 needle, vicryl suture continuous
What size of suture and type of suture and needle are used on the muscle/fascia layer?
muscle does not suture well, fascia us sutured with absorbable vicryl suture or PDS2
muscle is sutured very well
What size, type of suture and needle are used on subcutaneous fat?
Sub-Q does not tolerate suture well
non absorbable suture, CT1 needle with vicryle
When used, absorbable, 3-0 or 2-0, CT1 needle, Vicryl suture, interupted
What size, type of suture and needle are used on the subcuticular layer?
absorbable or non-absorbable, 3-0 or 2-0, FS-1 or FS-2, PS-1 or PS-2 needles, continuous.
does not tolerate suture well
Which steps are used in the placement of a drain during a procedure?
Drain is attached to sharp trocar, trocar is used to puncture through the abdominal wall staying out of incision
trocar is pushed through abdominal wall inserting drain
trocar is wrapped around the limb and sutured shut
Mayo clamp is used to pull out trocar tip that made it through the abdominal layers, trocar is cut from drain tube using bandage scissors
Three factors that would determine the type of forceps to hand the surgeon?
depth of wound
type of tissue
surgeon preference
size of wound
When closing the abdominal incision, when are the first and second closing counts completed?
when the final layer of skin has been stitched
second count started when SUB-Q has been stitched.
first closing count when peritoneal layer has been stitched
Why is a good idea to have two knifes besides the clean/dirty knife standard procedure?
blade may wear out during the procedure
dull blade
At what point during the laparotomy procedure do the dry lap sponges get traded out for wet ones?
after the peritoneum is breached
after the fascia is breached
after the sub-Q is breached
Which surgical category listed doesn't belong?
diagnostic
reconstruction
cosmetic
repair
replacement or implantation
removal
Which are the correct conditions for performing an exploratory laparotomy?
appendix rupture
intestinal perforation
ectopic pregnancy
foreign bodies (bullets gunshot victim)
internal bleeding
diverticulitis
While planning an exploratory laparotomy which answer is incorrect and not needed?
knowledge of the case
hospital address and name
room and time of start of case
name of surgeon
patient information; age, size, and alergies
what are the special pre-op for exploratory laparotomy?
foley catheter insertion
sequential compression device (SCD)
forced warm air blanket
cautery
Which isn't a part of intraoperative preparation for exploratory laparotomy?
anesthesia;general, NG tube may be placed
position;supine with or without arm boards
monitors placed behind patient head
draping; routine laparotomy
skin prep;nipple to symphysis pubis, bed line to bed line
Which isnt an category for instrumentation for laparotomies?
cutting & disecting, clamping, grasping & holding, probing, dilating retracting, suctioning
cutting & disecting, clamping, grasping & holding, probing, dilating retracting, suctioning, cautery
Forceps used with the Sub-Q are which?
tissue forceps with teeth, debakey forcep
tissue forceps with teeth, russian forcep
Forceps used with the muscle fascia are which?
tissue forceps, ferris smith
tissue forceps, debakey
The muscle/fascia and Sub-Q used the same self retaining retractors except for the?
weitlander retractor
cerebellar retractor
gelpi retractor
medium/large springs retractor
The skin layer uses what manual retractor?
army/navy retractor
malleable retractor
richardson retractor
senn-miller rakes; 4-6 prong
The Sub-Q uses which manual retractors?
Richardson retractor
senn-miller retractor
bards-parker retractor
Which manual retractor is used on the muscle/fascia?
deaver retractor
richardson/appy richardson retractor
which manual retractors are used on the peritoneum?
harrington retractor
senn-miller
The ligature stick tie and tie on passer use which same suture features?
2-0 or 0
absorbable
when resecting an orgran which clamps are used?
crile hemostat and mayo clamp
mayo clamp and a kelly clamp