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Textbook
Introduction
1. Medical assistant
2. Electronic records
3. Medical terminology and anatomy
4. The fundamentals of infection control
5. Introduction to vital signs
6. The patient interview and history
7. The physical examination
8. Appointment scheduling
9. Insurance billing
10. Diagnostic coding and the ICD-10-CM System
11. Procedural coding
12. Medical billing and reimbursement essentials
13. Assisting with medical specialties
14. Assisting with the musculoskeletal system
15. Assisting with the cardiovascular system
16. Assisting with the respiratory system
17. Assisting with the nervous system
18. Anatomy and physiology of the urinary system
19. Assisting in obstetrics and gynecology
20. Assisting in endocrinology
21. Assisting in ophthalmology & otolaryngology
22. Assisting in gastroenterology
23. Assisting in the immune & lymphatic systems
24. Assisting in pediatrics: the developmental stages and care
25. The medical assistant’s role in caring for the older patient
26. The role of the medical assistant in physical therapy examination and assessment
27. Preparing for minor surgery: room, solutions, and supplies
27.1 Assisting in surgery
27.2 Surgical instruments: cutting and grasping
27.3 Surgical instruments: retracting, probing, and specialty
27.4 Drapes and sutures
27.5 Specialty instruments, needles, and wound closure
27.6 Autoclave loading/unloading, chemical sterilization, and professional responsibilities
27.7 Surgical asepsis, instrument care, and the utility room
27.8 The autoclave process: operation, wrapping, and quality assurance
27.9 Dressings, bandages, and professional conduct
27.10 Introduction to minor office surgery and technology
27.11 Specialized procedures and preoperative preparation
27.12 Sterile technique and intraoperative assistance
27.13 Completing surgery and postoperative care
27.14 Wound care and healing
28. Introduction to the clinical laboratory
29. Urinalysis
30. Blood collection
31. Analysis of blood
32. Electrocardiography and heart structure
33. The principles of pharmacology
34. Essential calculations and measurement systems
35. Solid, liquid, & solutions medication doses
36. Administering medications
37. Metabolism and core nutrient roles
38. Medical emergencies in the healthcare setting
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27.3 Surgical instruments: retracting, probing, and specialty
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27. Preparing for minor surgery: room, solutions, and supplies

Surgical instruments: retracting, probing, and specialty

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Retractors

Retracting instruments hold tissue away from the surgical wound (incision). Depending on the provider’s preference, handheld skin hooks and Senn retractors are used to retract during most minor surgical procedures. They have the following characteristics:

  • The flat end is a blunt retractor.
  • The three-prong end may be sharp or dull.
  • They are used to retract small incisions or secure a skin edge for suturing.
Senn retractor used to hold tissue during surgery
Senn retractor
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Probes and dilators

Probes and dilators are used both for surgery and for examinations. Probes can be used to search for a foreign body in a wound or to enter a fistula. Dilators are used to stretch a cavity or opening for examination or before inserting another instrument to obtain a tissue specimen.

Instrument Description
Probes
  • Lengths range from 4 to 12 inches; available with or without bulbous tip
  • May be smooth or may have a grooved director
  • Used to find foreign bodies embedded in dermal tissue or muscle or to trace a wound tract
Trocars and obturators
  • Available in various sizes
  • Consist of a sharply pointed stylus (obturator) contained in a cannula
  • Used to withdraw fluids from cavities or for draining and irrigating with a catheter
  • The assembled unit is inserted through the tissue with the obturator inside the cannula; the obturator is then withdrawn, leaving the cannula in place so a catheter can be passed through it to drain the fluid
Specula
  • Most common dilator used
  • Valves are spread apart, dilating the opening
  • Used to open or distend a body orifice or cavity
  • The most common of these is the vaginal speculum used during gynecologic examinations; vaginal specula can be stainless steel (reusable) or plastic (disposable) and can also have a light source for illumination

Specialty instruments

Although all instruments fall into the same four categories as the surgical instruments just discussed, the following instruments are organized into specialty groupings. Presenting the instruments in this manner makes it easy to see how they relate to particular examinations. In addition to recognizing the name and use of each instrument, the medical assistant must organize and set out the instruments needed for each particular examination in what is called a tray setup.

Gynecologic instruments

Instrument Description
Placenta forceps
  • Used to remove tissue from the uterus
Endocervical curette
  • Smaller than the uterine curette
  • Used in the same way as the uterine curette
Uterine curette
  • Available in several sizes
  • Hollow and spoon shaped; used for scraping
  • Used to remove polyps, secretions, and bits of placental tissue
Schroeder uterine vulsellum forceps
  • Very sharp, pointed tips
  • Used to hold tissue (e.g., the cervix) while a tissue specimen is obtained or to lift the cervix so that the fornix can be seen
Hegar uterine dilators
  • Available in sets
  • Double or single ended
  • Used to dilate the cervix for dilation and curettage
Uterine sounds
  • Used to check the patency of the cervical os or the urethral meatus

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Surgical instruments: retracting, probing, and specialty

Retractors

Retracting instruments hold tissue away from the surgical wound (incision). Depending on the provider’s preference, handheld skin hooks and Senn retractors are used to retract during most minor surgical procedures. They have the following characteristics:

  • The flat end is a blunt retractor.
  • The three-prong end may be sharp or dull.
  • They are used to retract small incisions or secure a skin edge for suturing.

Probes and dilators

Probes and dilators are used both for surgery and for examinations. Probes can be used to search for a foreign body in a wound or to enter a fistula. Dilators are used to stretch a cavity or opening for examination or before inserting another instrument to obtain a tissue specimen.

Instrument Description
Probes
  • Lengths range from 4 to 12 inches; available with or without bulbous tip
  • May be smooth or may have a grooved director
  • Used to find foreign bodies embedded in dermal tissue or muscle or to trace a wound tract
Trocars and obturators
  • Available in various sizes
  • Consist of a sharply pointed stylus (obturator) contained in a cannula
  • Used to withdraw fluids from cavities or for draining and irrigating with a catheter
  • The assembled unit is inserted through the tissue with the obturator inside the cannula; the obturator is then withdrawn, leaving the cannula in place so a catheter can be passed through it to drain the fluid
Specula
  • Most common dilator used
  • Valves are spread apart, dilating the opening
  • Used to open or distend a body orifice or cavity
  • The most common of these is the vaginal speculum used during gynecologic examinations; vaginal specula can be stainless steel (reusable) or plastic (disposable) and can also have a light source for illumination

Specialty instruments

Although all instruments fall into the same four categories as the surgical instruments just discussed, the following instruments are organized into specialty groupings. Presenting the instruments in this manner makes it easy to see how they relate to particular examinations. In addition to recognizing the name and use of each instrument, the medical assistant must organize and set out the instruments needed for each particular examination in what is called a tray setup.

Gynecologic instruments

Instrument Description
Placenta forceps
  • Used to remove tissue from the uterus
Endocervical curette
  • Smaller than the uterine curette
  • Used in the same way as the uterine curette
Uterine curette
  • Available in several sizes
  • Hollow and spoon shaped; used for scraping
  • Used to remove polyps, secretions, and bits of placental tissue
Schroeder uterine vulsellum forceps
  • Very sharp, pointed tips
  • Used to hold tissue (e.g., the cervix) while a tissue specimen is obtained or to lift the cervix so that the fornix can be seen
Hegar uterine dilators
  • Available in sets
  • Double or single ended
  • Used to dilate the cervix for dilation and curettage
Uterine sounds
  • Used to check the patency of the cervical os or the urethral meatus

More from Preparing for minor surgery: room, solutions, and supplies

  • Assisting in surgery
  • Surgical instruments: cutting and grasping
  • Drapes and sutures
  • Specialty instruments, needles, and wound closure
  • Autoclave loading/unloading, chemical sterilization, and professional responsibilities