Download - Instrumentar Final
![Page 1: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/1.jpg)
INSTRUMENTARUL CHIRURGICAL
Instructor: Toma Mihai
![Page 2: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/2.jpg)
Clasificare
Tăiat
Hemostază
Prehensiune
Depărtătoare
Sutură
Altele
![Page 3: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/3.jpg)
A.Pentru tăiat
![Page 4: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/4.jpg)
1.Bisturiul
•Destinat SECŢIONĂRII ţesuturilor
•Alcătuit din: MÂNER LAMĂ
![Page 5: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/5.jpg)
Tipuri de mâner:
• Nr 3 – ptr. ţesut superficial
• Nr 4 – ptr. tegument
• Nr 7 – ptr. ţesut profund
![Page 6: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/6.jpg)
Tipuri de lamă:• Nr 10 - cea mai utilizată;• Nr 15 - varianta mai mică a #10, folosită în incizii mai delicate;• Nr 12 - ptr indepărtarea suturilor;• Nr 11 - în proceduri artroscopice;• Nr 23 şi 24 - mari,rar folosite.
![Page 7: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/7.jpg)
Montarea/demontarea lamei
• cu pensa Pean• NU SE FOLOSEŞTE MÂNA !!!
![Page 8: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/8.jpg)
Manipularea corectă
![Page 9: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/9.jpg)
Incizia
![Page 10: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/10.jpg)
2. Foarfeca• Utilizare multiplă: disecţie,
secţionarea unor structuri, a firelor de sutură, a pansamentului etc.
• Didactic: -ptr. ţesuturi moi (disecţie) -ptr. ţesuturi dure
!! SE TAIE CU VÂRFUL LAMELOR
![Page 11: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/11.jpg)
Manipularea corectă
![Page 12: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/12.jpg)
Pentru fire De disecţie
![Page 13: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/13.jpg)
• 3.Fierastraie
GigliCharrière
![Page 14: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/14.jpg)
B.Pentru hemostază
![Page 15: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/15.jpg)
1.Pensa Pean• Prezintă elementele: -partea activă -articulaţia -braţele
-cremaliera
2.Pensa Mosquito
![Page 16: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/16.jpg)
3.Pensa Kocher• diferită faţa de Pean
4.Pensa Halstead
![Page 17: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/17.jpg)
![Page 18: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/18.jpg)
5.Pensa Overholt-Barraya
6.Pensa Satinski
7.Pensa Guyon
![Page 19: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/19.jpg)
C.Pentru prehensiune
![Page 20: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/20.jpg)
1.Pensa ANATOMICĂ-de disecţie
• Destinata prinderii si prezentarii structurilor fine (seroase, vase, tesuturi usor lezabile)
• Manipulare :- cu degetele I si II -pivoteaza in jurul
degetului III
![Page 21: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/21.jpg)
2.Pensa CHIRURGICALĂ• Destinată prinderii și
prezentării structurilor mai rezistente
(piele, aponevroze)
• Diferită de pensa ANATOMICĂ
• Manipulare
![Page 22: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/22.jpg)
Manipulare corectă
![Page 23: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/23.jpg)
• 3.Pensa Forester (en-coeur)• 4.Pensa Lovelace• 5.Pensa in T
![Page 24: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/24.jpg)
• 6.Pensa Museux• 7.Pensa intestinală(de coprostază) Peyer• 8.Pensa Mickulicz
![Page 25: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/25.jpg)
D.Depărtătoare
• Destinate îndepărtării marginilor plăgii, ţesuturilor, organelor etc., pentru a facilita actul operator
• Clasificare:1. Mobile2. Autostatice
![Page 26: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/26.jpg)
1. Mobile
a. Departator Farabeuf
b. Departator Volkmann
c. Departator Kocher
![Page 27: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/27.jpg)
2. Autostaticea. Departator Finochietto
b. Departator Balfour
c. Departator Colin(Gelpy)
d. Departator Percy
![Page 28: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/28.jpg)
E.Pentru sutură
![Page 29: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/29.jpg)
1.Portacul• Destinat trecerii acului prin diferite
ţesuturi, in timpul suturării
• Se alege în funcţie de tipul suturii și mărimea acului
1. Portac Mayo-Hégar2. Portac Mathieu
• Manipulare
![Page 30: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/30.jpg)
![Page 31: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/31.jpg)
2. Acul
• Folosit pentru sutura ţesuturilor• Poate fi:
o traumatic = asertizat• triunghiular/ rotund
o atraumatic = “sertizat”
![Page 32: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/32.jpg)
Manipulare corectă
![Page 33: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/33.jpg)
F.Alte instrumente
1.Osteotom
2.Rac Jones
3.Rac Backhaus
4.Pensa de calculi Desjardins
![Page 34: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/34.jpg)
5.Răzușă Farabeuf
6.Chiuretă Volkmann
7.Stapler
8.Ac Reverdin
![Page 35: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/35.jpg)
• 1.Ce diferentiaza un instrument autostatic de un instrument mobil?– R: cremaliera
![Page 36: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/36.jpg)
• 2.Cate tipuri de ace sunt?– R: traumatice/atraumatice; rotunde/triunghiulare
![Page 37: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/37.jpg)
• 3.La ce foloseste pensa Guyon?– R: clamparea pedicului renal
![Page 38: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/38.jpg)
• 4.Ce diferentiaza o pensa Pean de un Kocher?– R: dintii de la varful pensei Kocher
![Page 39: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/39.jpg)
• 5.Care este diferenta dintre un Mathieu si un Hegar?– R: Hegarul seamana cu o pensa hemostatica
![Page 40: Instrumentar Final](https://reader031.vdocuments.mx/reader031/viewer/2022031614/563db8e4550346aa9a97ef50/html5/thumbnails/40.jpg)
Vă mulțumesc!