Tongue depressor and bipod stand

Boyle- davis tongue depressor

This instrument is used to lower down the tongue and hold it while the Davis mouth gag serves to hold the mouth open during tonsillectomy and other oral procedures. it comes in various sizes and used depending upon the age of patient.

The mouth gag is held in position by using the Draffin bipod stand which consists of two rods.

Thats all
- Jaskunwar Singh

Tonsil holding forceps

Denis Browne's tonsil holding forceps

Used in tonsillectomy to grasp the tonsils and pull medially. (dissection method)

The shaft is bent at an angle towards the handle. Ends of this instrument are cup- shaped with holes.



Thats all
- Jaskunwar Singh

Killian's nasal speculum

Killian's long bladed self- retaining nasal speculum

Used in Submucous resection (SMR) and septoplasty procedures.

It helps keep mucoperichondrial flaps away to make space for proper access and vision to the interior of nose and perform surgery efficiently.

IMPORTANT: In septoplasty, the flap is raised only on one side while in SMR, both sides flaps are raised. So due to cosmetic reasons and high risk of septal complications, septoplasty is preferred over the submucous resection.


Thats all
- Jaskunwar Singh

Direct Laryngoscope

As the name suggests, this instrument is used for direct visualization of larynx and hypopharynx. 

Diamond blackfan anemia notes and mnemonic

Diamond blackfan anemia

It is congenital pure red cell aplasia.

A 7 year old with hyperextensible joints

A 7 year old boy is brought to you. He is intellectually disabled. On examination, you notice hyperextensible joints. Large hands, large feet, protruding ears, elongated face are also seen. The patients testes are large in size compared to his age. Diagnosis?

Marfans syndrome
Ehler Danlos syndrome
Fragile X syndrome
Friedreichs Ataxia
Homocystinuria

Answer below
.
.
.
.
.
It's Fragile X syndrome. Why isn't it's Marfans? Because Marfans has normal IQ.

Here are my notes + mnemonic for Fragile X syndrome.

Did you know?
Fragile X is the most common cause of inherited mental retardation.
It was the first trinucleotide repeat disorder to be recognized.

That's all!
-IkaN

Walsham's forceps

Walsham's forceps

Uses: to correct lateral deviation of fractured nose and disimpaction

and repositioning of bony fragments.

Most students get confused between Walsham's forceps and Asch's forceps. The difference is in the structure of the instruments itself.

Walsham's forceps: paired instrument used for reduction of nasal bone fractures. One nasal blade is placed externally while the other blade goes into the nose and supports the nasal bone.
Also, the blades are not elevated in walsham's forceps as in the case of asch's.

Asch's forceps: unpaired instrument used for reduction of nasal septum and vomer fractures. It is used along with Walsham's forceps for the reduction procedures. The blades are elevated. (ASCh = Ascending)


Thats all
- Jaskunwar Singh

Trousseau's tracheal dilator

Trousseau's tracheal dilator

Used to widen the tracheal incision to aid in the insertion of

 tracheostomy tube.

Remember: It is curved at its ends so that it doesn't block the field of vision of the surgeon while making the incision and insertion of the tube.

Thats all
- Jaskunwar Singh

Toynbee's ear speculum

Toynbee's ear speculum

Uses: Examination of external ear and tympanic membrane

In operative procedures like myringoplasty, myringotomy.
Removal of wax, foreign body, otomycosis, ear discharge.

Different sizes for patients according to age.

Thats all
- Jaskunwar Singh

Tonsil artery forceps

This instrument is of two types: straight and curved.

Straight forceps (Birkitt's tonsil artery forceps) used to catch the bleeding point. (in tonsillar fossa) following tonsillectomy.

Birkitt's first tonsillar artery forceps

Wilson's second artery forceps

Curved forceps used as replacement forceps before tying a ligature to the bleeding points following tonsillectomy. (also called Second tonsillar artery forceps)


Thats all
- Jaskunwar Singh

Asch's forceps

Asch's septum forceps

Used for reducing procedures in cases of nasal septum fractures. (Reduction Rhinoplasty) 

The septum is grasped with the blades of this instrument and straightened to make proper alignment.

The blades are elevated. Remember ASCh- Ascending.

The instrument is often confused with Walsham's fracture. Both are used in reduction procedures of fractures of nasal septum.
To know about differentiating features, click here.

Thats all
- Jaskunwar Singh

Thudicum's nasal speculum

Used to examine external nose.

Light is focused at different sites to examine antero- inferior part of nasal septum, roof, floor, and lateral wall by tilting patient's head in various directions.

There's a specific technique to hold this instrument during examination of the patient. Its really simple but if you don't practice to hold it, you will forget it for sure.
 Keep your ring finger beneath one arm of the speculum and index finger in between the two arms. Press the other arm with middle finger such that the two lower ends meet. 

Here's the picture of the right way to hold it.-

Luc's forceps

Lets start with instruments used in surgical procedures of Otorhinolaryngology..

Firstly, lets talk about Luc's forceps.

This instrument has a fenestrated tip with sharp blades to hold

and grasp a tissue and cut it. So basically it is used for cutting.

Uses:

1. As the name suggests, it is used in Caldwell- Luc's operation (Anterior antrostomy) for removing antral mucosa. 

2. Submucosal Resection of nasal septum. (to remove bone or cartilage from the septum required for a graft)

3. Polypectomy  

4. Turbinectomy

Thats all

- Jaskunwar Singh