instruments quiz and suture patterns

Question 1

What sizes are these?

What blades will each accept?

Why do you need different sized handles?

Answer 1

What sizes are these?
A No 4

B No 3

What blades will each accept?
A 20, 21, 22, 23

B 10,11,12,15

Why do you need different sized handles?
Handle A is more commonly used in large animal practice to accept larger blade sizes.
Handle B is generally used for small animal general surgery.
Other handles are available for different situations like ophthalmology.

Many other types of blade are also available and each may require a different handle to fit.

Question 2

name and used for

Answer 2

Name?
Littauer scissors

What am I used for?
Used for removal of tight/small or awkward sutures.

Question 3

name, how would you hold, used for

Answer 3

Name
Metzenbaum Scissors

How would you hold me?
Held in the Tripod grip.
Thumb in one ring and third or ring finger in the other ring.
1st and 2nd finger are used to stabilise the instrument along the blade.

What am I used for?
Good for fine dissection of tissues and more delicate work. Not for cutting suture material.

Question 4

name, how hold, used for

Answer 4

Name
Mayo Scissors

How would you hold me?
Held in the tripod grip.
Thumb in one ring and third or ring finger in the other ring.
1st and 2nd finger are used to stabilise the instrument along the blade.

What am I used for?
It is used for cutting heavy or tough tissue, such as fascia.

Question 5

name, how hold, what used for

Answer 5

Name
Dressing scissors

How would you hold me?
Held in the tripod grip.
Thumb in one ring and third or ring finger in the other ring.
1st and 2nd finger are used to stabilise the instrument along the blade.

What am I used for?
Used for cutting dressing material and general work.
Also used for cutting suture material during surgery.

Question 6

names, why are ends different

Answer 6

Name the Artery forceps? (Haemostat’s)
A Mosquito
B Spencer Wells
C Rochester Pean

Name the Bowel clamp?
D Doyen bowel clamp

From pictures 1 and 2, which is the artery forceps and which is the bowel clamp and why?
1 Artery forceps (serrated appearance is transverse on the blade)
2 Bowel clamp (serrated appearance runs lengthways along the clamp)

Why are the ends different?
The bowel clamps striations are less traumatic and thought to be more secure in sealing the bowel during surgery.

Question 7

Answer 7

What is my name?

Adson tissue forceps.

You can have different working ends on this instrument, what are these called?
Serrated.
Rat toothed
But there are many others

What would you use each different end for?
Ideal for fine surgery.

Rat toothed gives more grip when needed but can be traumatic, not for use with visceral organs.

Serrated end has less grip but little trauma to tissue good for fine tissue handling.

Question 8

Answer 8

What is my name?
Treves tissue forceps.

What am I used for?

General purpose rat toothed forceps.
Used in general surgery.
Traumatic to tissues.

Question 9

Answer 9

What am I called?
Allis tissue forceps

What am I used for?
Use for grasping and retracting more tough connective tissue for example the linea alba. They can be traumatic so not to be used on skin.

Question 10

Answer 10

What is my name?
Babcock Forceps

What would I be used for?

For use in grasping more delicate viscera and retracting.
Less traumatic than Allis tissue forceps.

Question 11

Answer 11

What are each of these retractors called?
A Gosset
B Hohman
C Gelpi
D Travers
E Senn
F Balfour

What’s the difference between ADC and BE?
Self-retaining vs Hand-held
Hand-held need an assistant to hold and manipulate the retractor

Can you think of a use for each of them?
A Rib retractor/Laparotomy retractor
B Retraction of bones/bone fragments during fracture repair.
C Useful in joint surgery and spinal surgery.
D Retraction of skin and superficial soft tissue.
E Fat pad retraction in medial meniscus repair.
F Retraction of the body wall during an exploratory laparotomy.

Question 12

Answer 12

What are the names of the instruments
A Mayo (with tungsten carbide inserts)
B Olsen hagar
C Gilles
D McPhails
The gold handles indicate that the instrument has tungsten carbide inserts which means they last longer.

What does B and C have that the others do not, how is this useful?
Scissor
For cutting suture during surgery no need for separate instrument.
Can continue suturing without putting needle holders down

What does A, B and D have the C does not. How is this useful?
Locking catch
Good grip of the needle.

You can tell a pair of needle holders by the working end. It has a cross-hatched effect for extra grip.

Question 13

Answer 13

What is this instrument?
Spay hook

What is it used for?
Atraumatically lifting the uterine horns within the abdomen.
Some surgeons prefer to use their finger.

Question 14

Answer 14

What are instruments A and B?
A Rongeurs
B Periosteal elevator

What are they used for?
A Nibbling away rough edges of bone.
B Removal of periosteum from bone.

Question 15

Answer 15

What are these instruments?
Staple removers.

What are they used for?
Removing skin staples post operatively.

Question 16

What information can you gather from the packet of suture material?
What other information not on the packet do you need to know before you can decide on which suture material to use?

Answer 16

Name of suture material - Monosyn
Monofilament or multifilament - monofilament
Absorbable or non-absorbable - absorbable
Diameter in USP and metric - 3/0 2m
Length - 70cm
Colour or undyed - violet
Details of needle - as illustrated in actual size
Manufacturer – B/Braun
Batch number – LOT 13254R
Expiry date – 2028-06-44
How it is sterilised – Ethylene oxide

not on pack:
absorption time

Question 17

How do you decide which suture material to use?

Answer 17

the type of tissue you are repairing and nature of the wound
-how long it needs support for
-the characteristics of the suture material
-size of suture material
-the type of needle – cutting or atraumatic
-what is available in the practice
-preference or what you are used to using

Question 18

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture
material and size would be suitable for the following tissues?
A. Ligature of the uterus
B. Linea Alba
C. Subcutaneous tissue
D. Subcuticular tissue
E. Skin

Answer 18

Ligature of the uterus –Monosyn (Monocryl) or Novosyn (Vicryl) (mid-term support) size 3 metric
Linea Alba – MonoPlus(PDS) – (long term support) 3 metric or for a lively dog consider 3.5metric
Subcutaneous tissue - Monosyn size 3 metric
Subcuticular tissue - Monosyn size 3 metric
Skin – Dafilon(Ethilon) Non-absorbable would be the choice but Supramid or Optilene also suitable,this choice ensures your patient comes back for a check-up to have the sutures removed.

Question 19

A lively 25 kg labrador bitch is to have an ovariohysterectomy, what suture
material and size would be suitable if it had a pyo

Answer 19

absorbable braided suture material (Novosyn) would not be suitable. Use monofilament for all layers. Size 3 metric throughout is suitable. Could consider 2 metric for subcutaneous/subcuticular layers

Question 20

A Jack Russel terrier has had a tooth removed during a dental and the gum
needs suturing. What suture material and what size would be suitable?

Answer 20

Monosyn Quick a short-term support (Monosyn and Novosyn quick also suitable)

Question 21

In an orthopaedic surgery, what suture material would be suitable for the following tissues?
- fascia
- tendons and ligaments
- joint capsule

Answer 21

Fascias – MonoPlus long term support
Tendons and ligaments – MonoPlus long term support. Optilene also a suture material of choice if permanent support is required
Joint capsule – MonoPlus long term support
Size 3 metric is usually of choice for the above tissues.