A 25-year-old female complains of painful swelling in her left axilla that first began as a pimple 4
days ago. She has no prior history of these symptoms, and she has no known allergies to drugs or
medications. She denies fever, chills, or excessive perspiration, and her vital signs are all within
normal limits. Physcial examination reveals a recently shaved axillary region that is swollen, red,
and exquisitely painful.
1. Based on this presentation, you would diagnose ________ if physical examination revealed
________.
A. ripe abscess; a soft fluctuant mass
B. ripe abscess; an indurated nodular mass
C. sebaceous cyst; a palpable fixed mass
D. sebaceous cyst; a discreet palpable nodule
2. Which procedure would you use to treat her, and what would be the best technique for
administering anesthesia?
A. incision and drainage; field block
B. excision and removal; nerve block
C. incision and drainage; a topical anesthetic
D. excision and removal; direct injection into the lesion
3. Which surgical instruments would be most appropriate?
A. a #11 scalpel and forceps
B. a #11 scalpel and hemostat
C. a #15 scalpel and hemostat
D. a #15 scalpel and iris scissors
4. Post-surgically, the physician should:
A. close the wound with steri-strips.
B. pack the site with iodoform gauze.
C. close the wound with cutaneous removable sutures.
D. close the wound with subcutaneous absorbable sutures.
5. The patient returns 1 week post-op with a purulent drainage at the operative site. What is
the most likely reason for this?
A. There was trauma to the wound site.
B. The drainage is part of the normal healing response.
C. The surgical wound became infected from an extraneous source.
D. The original lesion was multilocular and was not drained completely.
Answers:
1. A 2. A 3. B 4. B 5. D
Scalpels
The No.11 is an elongated triangular blade sharpened along the hypotenuse edge and with a strong pointed tip making it ideal for stab incisions. Used in various procedures such as the creation of incisions for chest drains, opening coronary arteries, opening the aorta and removing calcifications in the aortic or mitral valves. The No.11 blades fit Handles 3, 3L, 3 Graduated, 5B, 7, 9, B3 and B3L.
The No.15 blade has a small curved cutting edge and is the most popular blade shape ideal for making short and precise incisions. It is utilised in a variety of surgical procedures including the excision of a skin lesion or recurrent sebaceous cyst and for opening coronary arteries. The No.15 fits Handles 3, 3L, 3 Graduated, 5B, 7, 9, B3 and B3L.
Forceps and Hemostats
Link: http://www.ehow.com/info_8143345_differences-between-forceps-hemostats.html#ixzz2m3NFh3KY
Haemostatic Forceps
- This instrument which has a catch for locking its blades is utilized for clamping a blood vessel
in order to control hemorrhage. Also termed artery forceps, these instruments are classically used by paramedics to prevent massive blood loss in seriously injured patients who are waiting to be transported to hospital.
Kelly Forceps
- Kelly forceps, also termed Rochester forceps, resemble a pair of household scissors, in which the blade has been replaced with a blunt grip. The Rochester forceps, which are available as either a curved or straight instrument, incorporate a locking feature, so as to function as a clamp. This forceps was designed for gripping and holding tightly onto tissue, including ruptured blood vessels
- Dressing Forceps
- These forceps, which are most commonly used to hold and manipulate gauze and similar dressing material, are also used during autopsies. Dressing forceps may be curved or straight, and select models have the appearance of tweezers. The point or tip of these forceps is blunt, with a rough working surface, to offer grip. The dressing forceps are also used for debriding wounds (removing dying tissue and foreign matter) and when working with sutures (stitches).
Alligator Forceps
- These forceps, with their long shaft, are utilized for retrieving objects from within and between cavities in the patient's body. The shaft of these forceps is set at an angle to the grip, and they are designed to have a serrated tip, reminiscent of an alligator's mouth, from where the common name is derived. The tip of these forceps remains open until the grip (handles) are closed, which allows for efficient gripping of objects, even in difficult to access areas within a body undergoing surgery. Of interest, the serrated tips of this forceps do not damage living tissue, as one might imagine they would.
Biopsy forceps
- These forceps, which resemble domestic scissors, are available in both a locking and non-locking model and can be purchased with either a straight or angled shaft. Biopsy forceps were designed to grip and hold living tissue and are chosen when delicate and precision work is to be performed.
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