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Pima Medical Institute
Pima Medical Institute
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blunt/blunt, blunt/sharp, sharp/sharp.
Curved or straight
Cutting and dissecting dense tissue.
-not really sharp (NOT for delicate tissue), crushing.
Fine tip, long handle
-Cutting delicate tissue.
-Sharper than Mayo scissors.
In spay packs.
-blunt tips with 1 blade terminating into a curved hook.
SPENCER scissors are SMALLER
-NOT in spay packs
-One blade has a flat thick edge and a blunt tip.
-Cut bandage material w/out cutting patient's skin.
-NOT in spay pack.
Adson Tissue forceps
-teeth on tips.
-good tissue grip w/ minimal damage due to "rat tooth" tips.
-IN spay pack.
-fine teeth on sides.
-side blades are wider for easier use.
-minimal tissue damage.
-MOST LIKELY in spay pack.
-have serrations but no teeth.
-useful for handling dressing materials.
-NOT used for retracting + causes tissue damage.
-NOT in spay pack.
-intermeshing teeth for good grip.
-IN spay pack.
-similar to Allis but NO gripping teeth.
-NOT COMMONLY in spay pack.
-typically wrapped individually + used when needed.
-oval in middle to keep ingesta from going through intestines w/out stopping blood flow.
-assists in holding large bundles of tissue.
-massive tissue crushers.
-interlocking (tongue on one side and troth on the other).
-looks like hammerhead.
-RARELY in spay packs.
-hole in center.
-provide hemostasis during surgery.
-NOT in spay packs.
-considered forceps despite name.
-clamp surgery towel to patient's skin during surgery.
-NOT a hemostat.
-IN spay packs.
-transverse serrations over entire length of jaw.
-control capillary bleeding.
-ALWAYS in spay pack (2-4)
-4.5" (can come larger)
-Kelly: Skirt, distal transverse grooves.
-Crile: Pants, complete transverse grooves.
-grasp intermediate vessels.
-IN spay pack (need 2 - doesn't matter which one).
-large (9", about full length of hand)
-Carmalt: longitudinal grooves AND distal transverse grooves.
-Pean: transverse grooves.
-ALWAYS need 2 CARMALTS in spay pack (can have additional Peans, but NEED 2 Carmalts).
-similar to Rochester-Pean and Carmalts, but have an additional 1:2 teeth at the top.
-good for pulling hair.
-NEVER in spay packs.
-can use for almost anything you could use a Carmalt for, but Carmalts are more common.
-combo needle holder + scissors to cut suture w/out using a separate scissor.
-can cut own suture accidentally.
-need at least 1 needle holder in spay packs.
-ONLY needle holders, NO scissors.
-tongue groove inside.
-no rings for fingers.
-springs open and closed via finger pressure.
-not typically used.
-looks like back scratcher.
-useful for skin and superficial muscle retraction.
-bent piece of metal.
-very specific use: small area you want to retract + keeps other tissues back to see area.
-retract large portions of tissue.
-locate + retract uterus during ovariohysterectomy.
-IN EVERY spay pack (only retractor used in spay pack)
-single tip that extends outward to retract muscle.
-multiple prongs at the tips.
-abdominal surgeries where you need a large visual field.
-several sizes available.
-self-retaining and non self-retaining.
-strong gripping teeth.
-manipulate and reduce fractured bone (hold bone together).
-ORTHOPEDIC & DENTAL.
-break up/scrape away bone.
-ACL surgeries = most common.
-often used for teeth trims in rodents and lagomorphs.
-^can use, but saw is preferred b/c of bone splitting.
-used to remove bone.
-used to smooth bone.
-some designed to use on power tools.
-remove muscle from bone by releasing the periosteum.
-look like chisels.
Bard-Parker scalpel handle
-hold disposable scalpel blade.
-different than human medicine (no blade guard -- less blood-borne pathogens in animals).
-#3 HANDLE can use #10, 11, 12, 15 BLADES
-#4 HANDLE can use #20 BLADE (large animal medicine)
-spay/neuter + skin scrapes.
-incision to get into joint + capsule.
-curved on inside.
-not commonly used.
-same shape as #10, but smaller.
-good for cat neuters (small testicles).
-requires #4 handle.
-curved, straight, or half-curved.
Curved surgical needles
described by circle size (1/4 circle, 1/2 circle, etc).
Straight surgical needles
-not very useful.
Half-curve surgical needles
-straight but curve at the tip.
-Tapered (non-cutting): used on DELICATE tissue (muscles and SQ tissue), comes to point, pokes hole in tissue.
-Cutting: NEVER use on DELICATE tissue, triangularly shaped, cut tissue as needle passes through, skin/cartilage/or tendons, 3 sharp sides.
-conventional cutting needle (triangle pointing up symbol).
-reverse cutting needle (triangle pointing down symbol).
-Taper needle (non-cutting). Circle w/dot in center symbol.
-smaller # = LARGER the needle.
-larger # = SMALLER needle.
-eyeless needle attached (by manufacturer) to specific length of suture thread.
-swag is SMALLEST part of the needle.
Non-Swaged or Eyed surgical needles
-needles w/holes (eyes) which are supplied separate from suture thread.
-suture must be threaded on site.
-cause MORE trauma to site, esp. if threaded incorrectly.
USP sizing scale
4, 3, 2, 1, 0, 1-0, 2-0, 3-0, 4-0
-ZERO = AUGHT
-United States Pharmacopeia.
-sutures orig. manufactured ranging in size #1-#6 DIAMETER (1=smallest, 6=largest, #4=tennis string).
-standardized across U.S. (can be different other places).
Modern suture material
-INDEPENDENT and DIFFERENT than needle gauge.
-LARGER # = LARGER diameter.
-smaller sutures recorded as #-0 (2-0 small, 3-0 smaller, 4-0 smallest).
-has gauging system of its own.
-18gauge - 40gauge.
-LOWER # = THICKER diameter.
-will break down harmlessly in body over time w/out intervention.
-10 days to 8 weeks before absorbing, depending on material.
-originally made from intestines of sheep (catgut).
-NEVER autoclave -- WILL MELT.
-lots are synthetic now.
-some amplify scarring due to foreign protein.
Non-absorbable suture material
-MUST be manually removed.
-made of material NOT metabolized by body.
-used on outside of body to hold skin closed OR inside where absorbable sutures are not adequate (bladder b/c of fluids that dissolve absorbable sutures too fast).
Dexon - Plus
-consent form signed by owner
-ask strategic, open-ended questions that give clues to specific systems (ask Qs where client has to fill in blank).
-ANESTHESIA: stay focused on systems that would be affected by anesthesia.
Pre-anesthesia physical exam
HR, RR, mucus membrane color, capillary refill time (CRT), mentation (attitude + responsiveness), temp (DO LAST)
ASA (American Association of Anesthetists) score
I: completely healthy, fit patient in for spay/neuter.
II: patient w/minor systemic disease, hypertension/mild w/out end organ damage.
III: patient w/severe systemic disease that ISN'T incapacitating, moderate - sever cardiac disease.
IV: patient w/incapacitating disease that is a constant threat to life, advanced cardiovascular/respiratory disease/cardiac failure.
V: moribund patient who is not expected to live 24 hours with or w/out surgery
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