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Surgical Technology, Concepts, Unit Three, Laparotomy

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Concepts of Surgical Procedure, Unit Three, Laparotomy
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Quiz by hey ohh, updated more than 1 year ago
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Created by hey ohh almost 5 years ago
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Question 1

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

Question 2

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

Question 3

Question
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?
Answer
  • 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

Question 4

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

Question 5

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

Question 6

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

Question 7

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

Question 8

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

Question 9

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

Question 10

Question
A [blank_start]kelly[blank_end] clamp is most commonly used on bleeders.
Answer
  • kelly

Question 11

Question
What are the most common ways the peritoneum layer is incised?
Answer
  • 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

Question 12

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

Question 13

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

Question 14

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

Question 15

Question
[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
Answer
  • Mastisol

Question 16

Question
How would a surgeon secure a drain to skin?
Answer
  • 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

Question 17

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

Question 18

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

Question 19

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

Question 20

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

Question 21

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

Question 22

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

Question 23

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

Question 24

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

Question 25

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

Question 26

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

Question 27

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

Question 28

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

Question 29

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

Question 30

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

Question 31

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

Question 32

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

Question 33

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

Question 34

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

Question 35

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

Question 36

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

Question 37

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

Question 38

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

Question 39

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

Question 40

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