Surgical Technology, Concepts, Unit Three, Laparotomy

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Concepts of Surgical Procedure, Unit Three, Laparotomy
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Pregunta 1

Pregunta
What can be used as the "passer" on a tie with passer?
Respuesta
  • mayo
  • forester ring forcep
  • right angle lahey
  • forcept

Pregunta 2

Pregunta
When making an incision into the fascia the edges of the fascia are grasped with what instrument?
Respuesta
  • mosquito clamp
  • mayo clamp
  • kocher
  • ring forcept

Pregunta 3

Pregunta
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?
Respuesta
  • 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

Pregunta 4

Pregunta
What scissor is used to cut the fascia and the muscle?
Respuesta
  • suture scissors
  • curved mayo
  • jones
  • metzenbaum

Pregunta 5

Pregunta
The [blank_start]metzenbaum[blank_end] scissors are used to extent the peritoneum opening.
Respuesta
  • metzenbaum

Pregunta 6

Pregunta
Once the surgeon has cut completely through the peritoneum, the [blank_start]balfour[blank_end] retractor may be asked for.
Respuesta
  • balfour

Pregunta 7

Pregunta
What is important to hand the surgeon when handling the balfour retractor?
Respuesta
  • raytec sponges
  • wet lap sponges
  • dry sponges to soak up bload after incision is made
  • roiled towel

Pregunta 8

Pregunta
What are the two forceps commonly used inside the peritoneum?
Respuesta
  • debakey and russian
  • addsons with teeth
  • debakey alone
  • russian alone

Pregunta 9

Pregunta
What forceps are most commonly used on skin?
Respuesta
  • addsons with teeth
  • kochers
  • russian
  • debakey

Pregunta 10

Pregunta
A [blank_start]kelly[blank_end] clamp is most commonly used on bleeders.
Respuesta
  • kelly

Pregunta 11

Pregunta
What are the most common ways the peritoneum layer is incised?
Respuesta
  • 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

Pregunta 12

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

Pregunta 13

Pregunta
List two different types of items that can be use to cut during the CCCT routine of the resection concept.
Respuesta
  • scalpel;mayo or mentzenbaum
  • scissors;mayo or metzenbaum
  • utility scissors
  • suture scissors

Pregunta 14

Pregunta
three different ways the surgeon can close the skin after a procedure is finished?
Respuesta
  • staple
  • dermabond
  • super medical glue, medical grade
  • hard tack
  • suture

Pregunta 15

Pregunta
[blank_start]Mastisol[blank_end] is used to cover the incision before dressings are applied when a subcuticular stitch is used to close the skin
Respuesta
  • Mastisol

Pregunta 16

Pregunta
How would a surgeon secure a drain to skin?
Respuesta
  • 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

Pregunta 17

Pregunta
What size and type of suture and needle are used on the peritoneum layer?
Respuesta
  • non-absorbable
  • absorbable; 2-0 or 0, CT-1 needle, vicryl suture continuous

Pregunta 18

Pregunta
What size of suture and type of suture and needle are used on the muscle/fascia layer?
Respuesta
  • muscle does not suture well, fascia us sutured with absorbable vicryl suture or PDS2
  • muscle is sutured very well

Pregunta 19

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

Pregunta 20

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

Pregunta 21

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

Pregunta 22

Pregunta
Three factors that would determine the type of forceps to hand the surgeon?
Respuesta
  • depth of wound
  • type of tissue
  • surgeon preference
  • size of wound

Pregunta 23

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

Pregunta 24

Pregunta
Why is a good idea to have two knifes besides the clean/dirty knife standard procedure?
Respuesta
  • surgeon preference
  • blade may wear out during the procedure
  • dull blade

Pregunta 25

Pregunta
At what point during the laparotomy procedure do the dry lap sponges get traded out for wet ones?
Respuesta
  • after the peritoneum is breached
  • after the fascia is breached
  • after the sub-Q is breached

Pregunta 26

Pregunta
Which surgical category listed doesn't belong?
Respuesta
  • diagnostic
  • reconstruction
  • cosmetic
  • repair
  • replacement or implantation
  • removal

Pregunta 27

Pregunta
Which are the correct conditions for performing an exploratory laparotomy?
Respuesta
  • appendix rupture
  • intestinal perforation
  • ectopic pregnancy
  • foreign bodies (bullets gunshot victim)
  • internal bleeding
  • diverticulitis

Pregunta 28

Pregunta
While planning an exploratory laparotomy which answer is incorrect and not needed?
Respuesta
  • knowledge of the case
  • hospital address and name
  • room and time of start of case
  • name of surgeon
  • patient information; age, size, and alergies

Pregunta 29

Pregunta
what are the special pre-op for exploratory laparotomy?
Respuesta
  • foley catheter insertion
  • sequential compression device (SCD)
  • forced warm air blanket
  • cautery

Pregunta 30

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

Pregunta 31

Pregunta
Which isnt an category for instrumentation for laparotomies?
Respuesta
  • cutting & disecting, clamping, grasping & holding, probing, dilating retracting, suctioning
  • cutting & disecting, clamping, grasping & holding, probing, dilating retracting, suctioning, cautery

Pregunta 32

Pregunta
Forceps used with the Sub-Q are which?
Respuesta
  • tissue forceps with teeth, debakey forcep
  • tissue forceps with teeth, russian forcep

Pregunta 33

Pregunta
Forceps used with the muscle fascia are which?
Respuesta
  • tissue forceps, ferris smith
  • tissue forceps, debakey

Pregunta 34

Pregunta
The muscle/fascia and Sub-Q used the same self retaining retractors except for the?
Respuesta
  • weitlander retractor
  • cerebellar retractor
  • gelpi retractor
  • medium/large springs retractor

Pregunta 35

Pregunta
The skin layer uses what manual retractor?
Respuesta
  • army/navy retractor
  • malleable retractor
  • richardson retractor
  • senn-miller rakes; 4-6 prong

Pregunta 36

Pregunta
The Sub-Q uses which manual retractors?
Respuesta
  • Richardson retractor
  • senn-miller retractor
  • army/navy retractor
  • bards-parker retractor

Pregunta 37

Pregunta
Which manual retractor is used on the muscle/fascia?
Respuesta
  • deaver retractor
  • army/navy retractor
  • richardson/appy richardson retractor

Pregunta 38

Pregunta
which manual retractors are used on the peritoneum?
Respuesta
  • harrington retractor
  • richardson retractor
  • deaver retractor
  • army/navy retractor
  • senn-miller

Pregunta 39

Pregunta
The ligature stick tie and tie on passer use which same suture features?
Respuesta
  • 2-0 or 0
  • absorbable
  • non-absorbable

Pregunta 40

Pregunta
when resecting an orgran which clamps are used?
Respuesta
  • crile hemostat and mayo clamp
  • mayo clamp and a kelly clamp
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