chapter 2 surgery

Preferred metal for surgical instrument manufacturing

German stainless steel (composed of iron, chromium, and carbon)

Characteristics and uses of Martensitic stainless steel

Higher carbon content, very hard, holds an edge well; used for cutting instruments like scissors

Characteristics and uses of Austenitic stainless steel

Lower carbon, higher chromium content; used in needle holders and hemostats

Why tungsten carbide inserts are added to needle holders

To make them more durable and extend instrument life (indicated by gold finger rings)

Five production steps of surgical instruments

Forging, Milling, Tempering, Passivation, and Polishing

Why instrument box locks must be autoclaved unlocked

Autoclaving while locked creates stress that leads to cracking the box lock

Primary use of Mayo scissors

Cutting large muscle masses and heavy cartilage

Primary use of Metzenbaum scissors

Delicate surgical dissection (blades are thin and short, roughly 1/4 of total length)

Primary use of Operating scissors

Cutting only inanimate objects such as suture, drapes, and sponges

Difference between Kelly and Crile hemostats

Kelly has serrations on only half the jaw; Crile has serrations running the full length of the jaw

Difference between Rochester Carmalt and Rochester Pean hemostats

Carmalt serrations run lengthways to hold vessels securely; Pean serrations run perpendicular to the jaw

Primary use of Ferguson Angiotribe

Clamping chest tubes or crushing tissue/nails during declawing

Difference between Olsen-Hegar and Mayo-Hegar needle holders

Olsen-Hegar includes built-in suture scissors in the jaw; Mayo-Hegar does not

Which scalpel handle holds smaller blades (#10, #11, #12, #15), and which holds larger blades (#20)?

Handle #3 uses smaller blades (#10, #11, #12, #15); Handle #4 uses #20 blades

Scalpel blade shapes (#10, #11, #12, #15)

10 is general surgery, #11 has a tapered point, #12 has a hooked point, and #15 has a small tip

Differences between Adson Dressing, Adson Brown, and Adson 1x2 forceps

Adson Dressing has flat serrations (no teeth); Adson Brown has parallel rows of shallow teeth; Adson 1x2 has 1 tooth over 2

Primary use of Allis tissue forceps

Grasping tissue securely (traumatic design, usually with 4x5 teeth arrangement)

Handheld retractor examples and features

Army-Navy (double-ended, smooth, atraumatic), Senn (blade and toothed end), and Volkman rake (rake-like teeth)

Self-retaining retractor examples and uses

Gelpi (ortho/neuro), Weitlaner (ortho), and Balfour (abdominal; retracts in 3 directions)

Difference between Backhaus, Roeder, and Lorna towel clamps

Backhaus and Roeder have penetrating tips (Roeder has ball stops); Lorna is non-penetrating

Purpose of a Snook or Covault spay hook

To locate and exteriorize the uterine horn during an OHE

Three common uses for sterile saline in a surgery bowl

Wiping glove coating, moistening sponges to keep tissue hydrated, and lavaging tissues/cavities

Primary use of Doyen forceps

Clamping intestines (long, flat blades with no serrations/teeth; atraumatic)

Primary use of Finochietto retractor

Retracting the thoracic wall during chest surgery

Primary use of a Jamshidi needle

Obtaining bone core biopsy samples

Function of bone rongeurs

Cutting or breaking bone into smaller pieces for bone grafting

Function of a periosteal elevator

Lifting the periosteum off bone or separating gums for tooth extraction

Common bone plate/screw sizes by animal size

2.0 and 2.7 (cats/small dogs), 3.5 (medium dogs), and 4.5 (large dogs)

Tool used to measure necessary screw length in bone plating

Depth gauge

Orthopedic tool used to create threads in a drilled bone hole

Bone tap

Purpose of a plate bender

To contour a bone plate to match the natural curve of the bone

Ophthalmic instrument used to hold eyelids open

Lid speculum (e.g., Barraquer wire speculum or Castroviejo screw speculum)

Needle holders designed for fine ophthalmic sutures (5-0 to 8-0)

Castroviejo needle holders

Difference between taper point and cutting edge needles

Taper point pierces tissue without cutting (organs/intestines); cutting edge cuts through tough fibrous tissue

Difference between closed eye, French eye, and swaged-on needles

Closed eye requires threading; French eye snaps into a split eye; Swaged-on has suture attached directly (preferred)

Suture tensile strength vs. memory

Tensile strength is pulling force before breaking; Memory is the tendency to return to original packaged shape

Two methods of body breakdown for absorbable suture

Phagocytosis (leukocytes ingest fibers) and Hydrolysis (breakdown via water exposure)

Suture capillarity and prevention

The ability to wick fluid; prevented using coatings like Teflon, wax, paraffin, or silicone

Suture sizing rules on the USP scale

Uses "ought" (zero); the more zeros, the smaller the diameter (e.g., 4-0 is smaller than 2-0)

Benefits of external skin staples over traditional suture

Causes less tissue irritation, reduces patient licking/chewing, and allows faster closur