CFA Instrument Identification & Passing 3 — Questions and Answers
Question 1: The primary distinguishing feature of a Babcock clamp compared to an Allis clamp is:
- Babcock has sharp teeth for better grip
- Babcock has atraumatic, fenestrated jaws that encircle rather than crush tissue (Correct answer)
- Babcock is used exclusively on skin
- Babcock locks with a ratchet while Allis does not
Correct answer: Babcock has atraumatic, fenestrated jaws that encircle rather than crush tissue
Babcock clamps have smooth, rounded, fenestrated jaws designed to encircle delicate structures like bowel without crushing.
Question 2: A Richardson retractor is classified as a:
- Self-retaining retractor requiring no assistant
- Handheld retractor used to retract abdominal wall layers (Correct answer)
- Nerve retractor for spinal procedures
- Vein retractor for vascular procedures
Correct answer: Handheld retractor used to retract abdominal wall layers
The Richardson retractor is a handheld instrument with a curved blade used by an assistant to retract the abdominal wall during laparotomies.
Question 3: When counting instruments at the close of surgery, the first assistant's primary responsibility is to:
- Count independently from the scrub technician and reconcile numbers before wound closure (Correct answer)
- Count once when the case ends
- Let the circulator perform the count alone
- Count only sharps, as soft goods are the scrub's responsibility
Correct answer: Count independently from the scrub technician and reconcile numbers before wound closure
The first assistant and scrub technician must perform independent concurrent counts and reconcile them before closure to ensure all instruments are accounted for.
Question 4: What is the purpose of the fenestration (hole) in a towel clamp such as the Backhaus?
- To reduce the clamp's weight
- To allow the clamp to be secured to the drape and skin simultaneously (Correct answer)
- To pass a suture through the drape
- There is no functional purpose; it is cosmetic
Correct answer: To allow the clamp to be secured to the drape and skin simultaneously
The Backhaus towel clamp has sharp points that penetrate and secure both the drape and skin to hold the sterile field boundary in place.
Question 5: Which instrument would be most appropriate for grasping the appendix during an appendectomy?
- Kocher clamp
- Babcock clamp (Correct answer)
- Crile hemostat
- Army-Navy retractor
Correct answer: Babcock clamp
The Babcock clamp's atraumatic jaws safely encircle and grasp the appendix without lacerating the inflamed tissue.
Question 6: A Deaver retractor is most commonly used to:
- Retract the liver or other large abdominal organs during laparotomy (Correct answer)
- Hold skin edges together during closure
- Occlude blood vessels temporarily
- Retract peripheral nerves
Correct answer: Retract the liver or other large abdominal organs during laparotomy
The Deaver retractor has a large, curved blade designed to retract deep, heavy structures like the liver or bladder during open abdominal surgery.
Question 7: The term 'passing in the neutral zone' refers to:
- Handing instruments directly hand-to-hand at the sterile field boundary
- Placing a sharp instrument in a designated area for the recipient to pick up without direct hand-to-hand contact (Correct answer)
- Passing instruments only between two scrubbed personnel
- A technique used only when the surgeon is left-handed
Correct answer: Placing a sharp instrument in a designated area for the recipient to pick up without direct hand-to-hand contact
The neutral or hands-free zone technique requires placing sharps in a designated basin or pad so neither party holds it during transfer, reducing sharps injuries.
CFA Instrument Identification & Passing 3
The primary distinguishing feature of a Babcock clamp compared to an Allis clamp is: