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Concepts of Surgical Procedure, Unit Three, Laparotomy

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Surgical Technology, Concepts, Unit Three, Laparotomy

Question 1 of 40

1

What can be used as the "passer" on a tie with passer?

Select one of the following:

  • mayo

  • forester ring forcep

  • right angle lahey

  • forcept

Explanation

Question 2 of 40

1

When making an incision into the fascia the edges of the fascia are grasped with what instrument?

Select one of the following:

  • mosquito clamp

  • mayo clamp

  • kocher

  • ring forcept

Explanation

Question 3 of 40

1

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?

Select one of the following:

  • 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

Explanation

Question 4 of 40

1

What scissor is used to cut the fascia and the muscle?

Select one of the following:

  • suture scissors

  • curved mayo

  • jones

  • metzenbaum

Explanation

Question 5 of 40

1

Fill the blank space to complete the text.

The scissors are used to extent the peritoneum opening.

Explanation

Question 6 of 40

1

Fill the blank space to complete the text.

Once the surgeon has cut completely through the peritoneum, the retractor may be asked for.

Explanation

Question 7 of 40

1

What is important to hand the surgeon when handling the balfour retractor?

Select one of the following:

  • raytec sponges

  • wet lap sponges

  • dry sponges to soak up bload after incision is made

  • roiled towel

Explanation

Question 8 of 40

1

What are the two forceps commonly used inside the peritoneum?

Select one of the following:

  • debakey and russian

  • addsons with teeth

  • debakey alone

  • russian alone

Explanation

Question 9 of 40

1

What forceps are most commonly used on skin?

Select one of the following:

  • addsons with teeth

  • kochers

  • russian

  • debakey

Explanation

Question 10 of 40

1

Fill the blank space to complete the text.

A clamp is most commonly used on bleeders.

Explanation

Question 11 of 40

1

What are the most common ways the peritoneum layer is incised?

Select one or more of the following:

  • 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

Explanation

Question 12 of 40

1

What instruments would you need on your mayo stand to perform a exploratory laparotomy?

Select one or more of the following:

  • 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

Explanation

Question 13 of 40

1

List two different types of items that can be use to cut during the CCCT routine of the resection concept.

Select one or more of the following:

  • scalpel;mayo or mentzenbaum

  • scissors;mayo or metzenbaum

  • utility scissors

  • suture scissors

Explanation

Question 14 of 40

1

three different ways the surgeon can close the skin after a procedure is finished?

Select one or more of the following:

  • staple

  • dermabond

  • super medical glue, medical grade

  • hard tack

  • suture

Explanation

Question 15 of 40

1

Fill the blank space to complete the text.

is used to cover the incision before dressings are applied when a subcuticular stitch is used to close the skin

Explanation

Question 16 of 40

1

How would a surgeon secure a drain to skin?

Select one or more of the following:

  • 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

Explanation

Question 17 of 40

1

What size and type of suture and needle are used on the peritoneum layer?

Select one of the following:

  • non-absorbable

  • absorbable; 2-0 or 0, CT-1 needle, vicryl suture continuous

Explanation

Question 18 of 40

1

What size of suture and type of suture and needle are used on the muscle/fascia layer?

Select one of the following:

  • muscle does not suture well, fascia us sutured with absorbable vicryl suture or PDS2

  • muscle is sutured very well

Explanation

Question 19 of 40

1

What size, type of suture and needle are used on subcutaneous fat?

Select one or more of the following:

  • 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

Explanation

Question 20 of 40

1

What size, type of suture and needle are used on the subcuticular layer?

Select one or more of the following:

  • 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

Explanation

Question 21 of 40

1

Which steps are used in the placement of a drain during a procedure?

Select one or more of the following:

  • 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

Explanation

Question 22 of 40

1

Three factors that would determine the type of forceps to hand the surgeon?

Select one or more of the following:

  • depth of wound

  • type of tissue

  • surgeon preference

  • size of wound

Explanation

Question 23 of 40

1

When closing the abdominal incision, when are the first and second closing counts completed?

Select one or more of the following:

  • 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

Explanation

Question 24 of 40

1

Why is a good idea to have two knifes besides the clean/dirty knife standard procedure?

Select one or more of the following:

  • surgeon preference

  • blade may wear out during the procedure

  • dull blade

Explanation

Question 25 of 40

1

At what point during the laparotomy procedure do the dry lap sponges get traded out for wet ones?

Select one of the following:

  • after the peritoneum is breached

  • after the fascia is breached

  • after the sub-Q is breached

Explanation

Question 26 of 40

1

Which surgical category listed doesn't belong?

Select one of the following:

  • diagnostic

  • reconstruction

  • cosmetic

  • repair

  • replacement or implantation

  • removal

Explanation

Question 27 of 40

1

Which are the correct conditions for performing an exploratory laparotomy?

Select one or more of the following:

  • appendix rupture

  • intestinal perforation

  • ectopic pregnancy

  • foreign bodies (bullets gunshot victim)

  • internal bleeding

  • diverticulitis

Explanation

Question 28 of 40

1

While planning an exploratory laparotomy which answer is incorrect and not needed?

Select one of the following:

  • knowledge of the case

  • hospital address and name

  • room and time of start of case

  • name of surgeon

  • patient information; age, size, and alergies

Explanation

Question 29 of 40

1

what are the special pre-op for exploratory laparotomy?

Select one or more of the following:

  • foley catheter insertion

  • sequential compression device (SCD)

  • forced warm air blanket

  • cautery

Explanation

Question 30 of 40

1

Which isn't a part of intraoperative preparation for exploratory laparotomy?

Select one of the following:

  • 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

Explanation

Question 31 of 40

1

Which isnt an category for instrumentation for laparotomies?

Select one of the following:

  • cutting & disecting, clamping, grasping & holding, probing, dilating retracting, suctioning

  • cutting & disecting, clamping, grasping & holding, probing, dilating retracting, suctioning, cautery

Explanation

Question 32 of 40

1

Forceps used with the Sub-Q are which?

Select one of the following:

  • tissue forceps with teeth, debakey forcep

  • tissue forceps with teeth, russian forcep

Explanation

Question 33 of 40

1

Forceps used with the muscle fascia are which?

Select one of the following:

  • tissue forceps, ferris smith

  • tissue forceps, debakey

Explanation

Question 34 of 40

1

The muscle/fascia and Sub-Q used the same self retaining retractors except for the?

Select one of the following:

  • weitlander retractor

  • cerebellar retractor

  • gelpi retractor

  • medium/large springs retractor

Explanation

Question 35 of 40

1

The skin layer uses what manual retractor?

Select one of the following:

  • army/navy retractor

  • malleable retractor

  • richardson retractor

  • senn-miller rakes; 4-6 prong

Explanation

Question 36 of 40

1

The Sub-Q uses which manual retractors?

Select one or more of the following:

  • Richardson retractor

  • senn-miller retractor

  • army/navy retractor

  • bards-parker retractor

Explanation

Question 37 of 40

1

Which manual retractor is used on the muscle/fascia?

Select one of the following:

  • deaver retractor

  • army/navy retractor

  • richardson/appy richardson retractor

Explanation

Question 38 of 40

1

which manual retractors are used on the peritoneum?

Select one or more of the following:

  • harrington retractor

  • richardson retractor

  • deaver retractor

  • army/navy retractor

  • senn-miller

Explanation

Question 39 of 40

1

The ligature stick tie and tie on passer use which same suture features?

Select one or more of the following:

  • 2-0 or 0

  • absorbable

  • non-absorbable

Explanation

Question 40 of 40

1

when resecting an orgran which clamps are used?

Select one of the following:

  • crile hemostat and mayo clamp

  • mayo clamp and a kelly clamp

Explanation

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