ARTICLES FOR PRACTICAL

Rubber and plastic articles: Other articles:

1. Ryles tube 1. Thermometer
2. Catheter 2. B.P instrument
3. Suction catheter 3. Stethoscope
4. Uro bag (urine collection bag) 4. Hot water bag
5. Ambu bag 5. Ice bag
6. Oxygen mask 6. Air cushion
7. Asepto syringe
8. Tracheostomy tube
9. Airway
10. Endo tracheal tube
11. Intra cath
12. Scalp vein
13. Syringes
14. Insulin syringe
15. Needles
16. Intravenous set
17. Blood transfusion set
18. Sputum cum
19. Enema can
Steel articles/instruments
1. Artery forcep
2. Allis’ forcep
3. Babcock’s forcep
4. Cheatle forcep
5. Sponge holding forcep
6. Dissecting forcep
7. Needle holder
8. Knife holder
9. Tuning fork
10. Aural syringe
11. Surgical scissor
12. Tongue depressor
13. Mouth gag
14. Nasal speculum
15. Percussion hammer
16. Otoscope
17. Laryngoscope
18. Ophthalmoscope
 RUBBER AND PLASTIC ARTICLES

Ryle’s tube/Nasogastric tube

 Image:

 Identification point/parts:
It is flexible rubber tube with enough length for gastrointestinal tract.
It has three parts:
1. Tip
2. Body
3. Base
1. Tip: it is blunt to avoid trauma and has perforations (holes) on all side and it contain metal
ball. Metal ball facilitate easy insertion.

2. Body: body has four marking on it:

Mark I: situated at a 40 cm from tip. After introduction this mark indicates that the tube has
reached the cardiac orifice.

Mark II: situated at 50 cm from tip. After introduction this mark indicates that the tube has
reached the body of stomach.

Mark- III: situated at distance of 57 cm from tip. After introduction this mark indicates that the
tube has reached the pylorus.

Mark IV: situated at a distance of 65 cm. After introduction this mark indicates that the tube has
reached the duodenum.

Ryle’s tube contains radio opaque line throughout the length so radiology can confirm its
position in X-ray.

3. Base: it has an opening to which syringe or funnel can be fitted to push in or draw out
material.
  Uses:
- To aspirate gastric or duodenal content for laboratory examination.
- To give ryles tube feeding/ gastric gavage.

 Sterilization:
- It is pre sterilized by ethylene oxide.

Catheter
Image:

 Types of catheter:
I. Straight-single use catheters: it is used when the catheter is to be inserted and removed
immediately.
II. 2-way Foley catheter (retention catheter): this type of catheter has an inflatable
balloon that encircles the tip near the lumen or opening of the catheter.
III. 3-way Foley catheter: this type of catheter has 3 channels that encircle the body of the
catheter. One channel drains the urine through the catheter into a collection bag. The
second channel holds the sterile water when the catheter is inflated and is also used to
deflate the balloon. The third channel may be used to instill medications into the bladder
or provide a route for continuous bladder irrigation.
IV. Malecot catheter: it is used for supra pubic catheterization. It has stylet with which it
can be inserted in body. It is self retaining catheter.

 Identification point/parts:
- It has simple tube like design
- It is usually made up of latex rubber.
- There is three parts- tip, body and base.
- Tip is blunt with perforations.
- Retention catheter has balloon at tip
- It is available in different sizes.
- Base has channel for balloon in two and three way catheter.
- In three ways catheter additional channel for bladder irrigation is given.

 Size of catheter:
- 5Fr, 6fr, 8fr 10fr, 12fr, 14fr, 16fr, 18fr, 20fr, 22fr, 24fr, 26fr.
- Fr means French scale or French gauge.
- The higher the number the larger the diameter of the catheter.

 Uses:
- To relieve urinary retention.
- To introduce dye into the bladder for investigation.
- To obtain sterile specimen or to obtain specimen from unconscious patient.
- To empty the bladder prior to surgery.
- To prevent bed wetting in case of urinary incontinence.

 Sterilization:
 It is pre sterilized by ethylene oxide.

Uro bag (urine collection bag)

 Image:

 Identification point/parts:
 It has reservoir bag, tubing, emptying port/valve etc parts.
 It has capacity of 2000 ml/ 2 L.
 Tubing is attached to drainage channel of catheter after removing cap.
 Emptying valve is used to empty uro bag at regular interval.
 It should not be used more than 4-6 days and should be changed after that.

 Uses:
 It is used to attach catheter for urine collection for prolong catheterization.

 Sterilization:
 It is pre sterilized by ethylene oxide.

Suction catheter
 Image:

 Identification point/parts:
- It has simple tube like design
- It is usually made up of silicon rubber.
- It is soft and flexible tube to avoid trauma.
- There is three parts- tip, body and base.
- Tip is blunt with hole at the end to suction secretion.
- Base is connected to suction machine tubing.

 Uses:
- Suction catheters are medical devices that are used to remove bodily secretions from the
mouth, nose and tracheal region of a patient.

 Sterilization:
- It is pre sterilized by ethylene oxide.
 AMBU bag/ Artificial Manual Breathing Unit.
 Image:

 Identification point/parts:
- It has face mask, self inflating bag, reservoir bag, oxygen inlet with tubing as main parts.
- Self-inflating bag made up of rubber material that re-expand after being manually
collapsed
- Various capacity e.g. 240 ml, 500 ml, 1600 ml bag sizes for infants, children and adults
respectively.
- Oxygen inlet for connecting to oxygen supply
- Oxygen reservoir with two one way valves. Air Inlet valve allows room air to enter if
fresh gas flow is inadequate and an outlet valve allow oxygen to flow out if pressure is
excessive

 Uses:
- For cardio pulmonary resuscitation in case of cardiac and respiratory arrest to provide
breathing.

 Care of AMBU bag after use:

- To clean and disinfect masks, gently wash the mask in warm soapy water. Rinse in clean
water and immerge in disinfection solution of chlorine 5%. Let stand in solution for 10
minutes and rinse with fresh water. Air dry.
- Other parts can be cleaned with spirit swab if needed.
 Oxygen mask
 Images:

Simple face mask Re breathing mask

Venture mask
 Identification point/parts:
- Oxygen administration can be delivered via low-flow or high-flow systems, with
humidity or not, and with a reservoir or not.
- Oxygen masks are shaped to fit to the mouth and nose and are secured in place with a
strap. Various types of masks are used as following:
o simple face mask
o Re breathing mask
o venture mask
- Simple face mask has exhalation port, strap, adjustable nose clip and tubing for
connecting to oxygen supply.
- Re breathing mask have exhalation port, strap, adjustable nose clip, tubing for connecting
to oxygen supply and reservoir to collect extra oxygen.
- Venturi mask has exhalation port, strap, adjustable nose clip, tubing for connecting to
oxygen supply and venturi barrel
 Uses:
- Simple face mask is used to provide oxygen at low concentration.
- Re breathing masks are used for gathering and storing extra oxygen during respiration
Patients draw from the oxygen reservoir anytime when flow rate is low thus it maintains
proper oxygenation.
- A Venturi mask mixes oxygen with room air, creating high-flow enriched oxygen of a
desired concentration. It provides an accurate and constant Flow despite varied
respiratory rates.

 Care of oxygen mask after use:

- Now a days oxygen mask are disposed after using on one patient
- To clean and disinfect masks, gently wash the mask in warm soapy water. Rinse in clean
water and immerge in disinfection solution of chlorine 5%. Let stand in solution for 10
minutes and rinse with fresh water. Air dry.
- It also can be clean using spirit swab.

Asepto syringe
 Image:

 Identification points:
- Asepto syringe has rubber bulb attached at one end and its body is pointed at other end to
fit into catheter to introduce fluid into bladder.

 Uses:
- It is used for introducing fluids into bladder during bladder wash or bladder irrigation.

 Care after use:

- After use detach rubber bulb from syringe wash it with soapy water, clean water and
disinfected using chemical sterilization.
- Body of syringe is washed with soapy water, clean water and disinfects it with boiling or
chemical sterilization.
 Endo tracheal tube
Image:

 Identification points:
- Endotracheal tubes are available in two types cuffed and uncuffed.
- Cuffed endotracheal tube has three parts- tip, body, and base.
- Tip is beveled and has Murphy eyes and cuff. Body has inflation tube with pilot balloon,
valve for inflating cuff, radio opaque line for x- ray position and depth marking. Base has
connector for attaching oxygen source or ventilator.
- Uncuffed endotracheal tube has three parts tip with Murphy eyes, body with, radio
opaque line for x- ray position & depth marking and base with connector.

 Uses:
- Establishing and maintaining a patent airway and to ensure the adequate exchange of
oxygen and carbon dioxide.
- The purpose of endotracheal intubation is to permit air to pass freely to and from the
lungs in order to ventilate the lungs. Endotracheal tubes can be connected to ventilator
machines to provide artificial respiration.
 Sterilization
- It is disposable article pre sterilize with ethylene oxide.

 Complications of airway obstructions:

- Airway obstructions
- Failed intubation.
- Bronchospasm
- Trauma
- Displacement

Airway:
 Images:
 Identification points:
- It has parts like tip, body, and flange. Body is grooved from middle and tip has hollow
centre. It is also called guedel airway
- They are made up of metal or plastic.

 Uses:
- It is used to maintain airway, prevent tongue bite, prevent endotracheal tube occlusion
and facilitate suction.

 Sterilization/after care

- They are sterilized by cleaning in cold running water with soap and then boiling /
autoclaving / chemical disinfection.

Tracheostomy tube
 Images:

 Identification points:
- A tracheostomy tube is a curved tube that is inserted into a tracheostomy stoma (the hole
made in the neck and Trachea.
- There are different types of tracheostomy tubes available and the patient should be given
the tube that best suits his/her needs. It can be made up of metal or synthetic material.
Metal tube are not used frequently nowadays.
- A commonly used tracheostomy tube consists of three parts: outer cannula with neck
plate, inner cannula, and an obturator. The outer cannula is the outer tube that holds
the tracheostomy open. A neck plate extends from the sides of the outer tube and has hole
to strap around the neck. The inner cannula fits inside the outer cannula. It has a lock to
keep it from being coughed out, and it is removed for cleaning. The obturator is used to
insert a tracheostomy tube.

 Uses:
- Establishing and maintaining a patent airway and to ensure the adequate exchange of
oxygen and carbon dioxide.
- Tracheostomy tubes can be connected to ventilator machines to provide artificial
respiration.

 Sterilization
- It is disposable article pre sterilize with ethylene oxide.
- Metal tube can be washed under running water, soapy water, dried and autoclaved for
next use.

Intra cath

 Identification point:
- It has luer lock (cork), injection port, wings, needle, sheath etc. parts.
- Needle is used as guide while introduction and removed after introducing.
- It is fixed with tap in place for injection.
- Three way cork can be attached to intra cath for multiple infusion.
 Use:
- Intra cath (I.V.Cannula) is used for long term infusion therapy and I.V (intra venous)
treatment with minimum incidence of thrombophlebitis.

 Sterilization:
- It is disposable article pre sterilize with ethylene oxide.

Scalp vein
 Images:

 Identification point:
- It has luer lock (cork), wings, needle, tubing etc. parts.
- It is fixed with tap in place for injection.

 Use:
- It is used for infusion therapy in infants and children mainly.
(Placing an IV line into a peripheral vein in a small child or infant can be a difficult task,
for many reasons. Small children and infants have smaller peripheral veins, they may
have more subcutaneous fat, they are prone to vasoconstriction, and they are much less
likely to remain motionless and cooperative during a painful procedure than adults. The
scalp veins provide a secondary option for peripheral intravascular access in small
children and infants)
- It can be used in adults for infusion therapy and injection if larger veins are not visible.
- It can be used for blood collection.

 Sterilization:
- It is disposable article pre sterilize with ethylene oxide.
 Syringes
 Images:

 Identification point:
- It has parts like tip, barrel, plunger, volume marking, flange etc parts.
- Syringes are available in several different designs and varieties. Most syringes are
disposable and many come with an attached needle or with no needle at all.
- It is available in various sizes like 1 ml, 2 ml, 5 ml, 10 ml, 20 ml, 50 ml etc. Nurse may
select the size of the syringe by the volume of medication it holds.

 Use:
- Syringe medical device that is used to inject fluid into, or withdraw fluid from, the body.
A medical syringe consists of a needle attached to a hollow tip that is fitted with a sliding
plunger. The downward movement of the plunger injects fluid; upward movement
withdraws fluid.
- Medical syringes were once made of metal or glass, and required cleaning and
sterilization before they could be used again. Now most syringes used in medicine
are plastic and disposable.

 Sterilization:
- It is disposable article pre sterilize with ethylene oxide.
 Insulin syringe
 Images:

 Identification point:
- It has parts like cap, needle, barrel, plunger, volume marking, and flange etc parts.
- It has needle attached to it.
- It is available in 30 units, 50 units and 100 units size. A 100-unit syringe holds 100 units
of insulin in a volume of 1 cc (or 1 ml). A 50-unit syringe holds 50 units of insulin in 0.5
ml of liquid. A 30-unit syringe holds 30 units of insulin in 0.3 ml.
- Size of syringe is selected according to need of client. For example, if client need to take
45 units of insulin use a 50-unit syringe. A 30-unit syringe (the next smallest size) is
handy for giving injections of 30 units or less

 Use:
- It is used for routine administration of subcutaneous insulin in diabetic client.
- Insulin syringes are made specifically for self injections and have friendly features:
shorter needles, as insulin injections are subcutaneous (under the skin), finer gauge
needles for less pain and markings of insulin in units to simplify drawing a measured
dose of insulin.

 Sterilization:
- It is disposable article pre sterilize with ethylene oxide.
- Insulin syringe should not be re used but in some case patient reuse it. If it is reused then
following points should be remembered:-
o Recap the needle as soon as you are done using it. Place the cap on a table or hard
surface and slide the needle into the cap.
o Do not let the needle touch anything but clean skin or the top of the insulin bottle.
o Never share syringes with anyone.
o Throw out any syringe that bends or touches anything other than clean skin.
 Needles:
 Images:

 Identification point:
- It has parts like hub, shaft, bevel and lumen etc.
- Tip of the syringe is fitted in hub of the needle before injection.
- It is available in various sizes according to thickness, diameter and length and selected
according to types and purpose of procedure.
- Gauge numbers are arranged so that the highest number represents smaller needle while
the lowest numbers represent the largest needle.
- For intradermal and subcutaneous injections higher gauze number needles are used.
- For intra venous injection and blood collection lower gauze number needle are used.
 Use:
- Needle is commonly used with a syringe to inject substances into the body or extract
fluids from it. They may also be used to take liquid samples from the body, for example
taking blood from a vein
- It is used for intradermal, subcutaneous, intramuscular and intravenous medication
administration.

 Sterilization:
- It is disposable article pre sterilize with ethylene oxide.

Intravenous set
 Images:

 Identification point:
- It has parts like spike with cap, drip chamber, roller clamp, tubing and luer adapter etc.
- Spike is used to make hole and attaching pint and luer adapter is attached to intra cath.

 Use:
- It is used for administration of fluid therapy to patient.

 Sterilization:
- It is disposable article pre sterilize with ethylene oxide.
 Blood transfusion set
 Images:

 Identification point:
- It has parts like spike with cap, drip chamber with filter, roller clamp, tubing and luer
adapter etc.
- Spike is used for attaching to blood bag and luer adapter is attached to intra cath.

 Use:
- It is used for giving blood transfusion

 Sterilization:
- It is disposable article pre sterilize with ethylene oxide.

Sputum cup
 Image:
 Identification point:
- A cup usually made of plastic or metal to receive and isolate the sputum of a patient
with respiratory disease.
- It is cup sized with lid and handle.
- It is filled half with antiseptic and water in 1:40 ratio to avoid sticking of sputum in
cup.

 Use:
- It is used for collecting cough of patient with respiratory problem.
- Specifically given to patient after nebulization and steam inhalation.

 Sterilization:
- It is cleaned with running water, soapy water, clean water and then sterilized by chemical
sterilization or autoclaving.

Enema can
 Image:

 Identification point:
- An enema can usually made of plastic or metal.
- It has parts like can, tubing, clamp or flow regulator and tip. Rectal catheter is attached to
tip of tubing.

 Use:
- The most frequent uses of enemas are to relieve constipation and for bowel cleansing
before a medical examination or procedure
  Sterilization:
- It is cleaned with running water, soapy water, clean water and then sterilized by chemical
sterilization or autoclaving.

OTHER ARTICLES:

Thermometer
 Images:

Scale Stem

Mercury bulb

Glass Clinical
thermometer

Tympanic membrane
thermometer
Digital thermometer

 Identification point:
- There are different types of thermometer like glass thermometer, digital thermometer and
tympanic membrane thermometer. Glass thermometer can be oral or rectal thermometer
and has two parts mercury bulb and stem.
- Mercury is used in thermometer because it is very sensitive to small changes in
temperature and expansion of mercury is uniform.

 Use:
- Thermometer is used for taking body temperature.
 Care of thermometer after use:
- Wash the thermometer with cool, soapy water and rinse it with clean water. Then, let it
air-dry or wipe it dry with a clean cloth or paper towel. Be sure to wash the
thermometer before and after each use. It can be cleaned using rubbing alcohol.
- Clean digital thermometer with rubbing alcohol swab.

B.P instrument/ sphygmomanometer

 Images:

 Identification point:
- Sphygmomanometer can be mercury based or digital. Mercury based machine require
stethoscope for blood pressure measurement.
- It has parts like scale, manometer, nozel (mercury tank), rubber tube, linen cuff, adjusting
screw, rubber pump (bulb) and front lock etc.

 Use:
- It is used for blood pressure measurement and monitoring.

Stethoscope
 Images:
 Identification point:
- Stethoscope has parts like diaphragm, bell, earpieces and tubing etc.

 Use:
- It is used for listening to the internal sounds of a human body.
- It is used for auscultation of apical pulse (heart rate), lungs sound and bowel sound.
- It is used for blood pressure measurement and monitoring.

Hot water bag/bottle

- A hot water bag is a container, usually made of rubber or similar material that is filled
with hot water and sealed with a stopper. Hot water bags are used to provide warmth and
for the local application of heat to relieve pain and discomfort.

 Care while using hot water bag:

- Always use a cover or wrap a towel around the bag to prevent contact burns.
- Never use hot water bottles where babies or children may come into contact with them.
- Before using a hot water bottle, check it for cracks, splits, brittleness, breaks and other
damage.
- Never use a damaged hot water bottle—throw it away and get a new one
- Do not use boiling water. If the water is very hot, add cold water from the tap.
- Pour water into the bottle slowly until it is two-thirds full. Remove excess air.

 After care of hot water bag:

- Remove the cloth cover of hot water bag and wash it.
- Empty hot water bottle by removing water.
- Clean the outer surface with soap and water.
- After cleaning, hang them upside down for drying.
- To check leakage blow air inside.
- Store it in dry and cool place.
 Ice bag

- An ice bag is a container, usually made of rubber or similar material that is filled with ice
sealed with a stopper. Ice bags are used for dry cold application and filled with crushed
ice and salt. The salt lowers the melting point and delayed melting of ice.
- It is used to relieve local pain, control bleeding, reduce inflammation and reduce body
temperature.

 Care while using ice bag:

- Always use a cover or wrap a towel around the ice bag.
- Before using an ice bag, check it for cracks, splits, brittleness, breaks and other damage.
- Never use a damaged ice bag —throw it away and get a new one

 After care of ice bag:

- Remove the cloth cover of ice bag and wash it.
- Empty ice bag.
- Clean the outer surface with soap and water.
- After cleaning, hang them upside down for drying.
- To check leakage blow air inside.
- Store it in dry and cool place.

Air cushion
 - An air cushion is a container, usually made of rubber or similar material that is filled
with air sealed with a stopper. It is used to take weight of the body and to relieve pressure
on certain parts of the body.

 Care while using air cushion:

- Always use a cover or wrap a towel around the air cushion to avoid direct contact with
skin as it can cause friction.
- Before using an air cushion, check it for cracks, splits, brittleness, breaks and other
damage.

 After care of air cushion:

- Remove the cloth cover of air cushion and wash it.
- Empty air cushion.
- Clean the outer surface with soap and water.
- After cleaning, hang them upside down for drying.
- To check leakage blow air inside.
- Store it in dry and cool place.

STEEL ARTICLES/INSTRUMENTS

Artery forcep
Image:

Identification points:
- Artery forceps are available in curved or straight varieties and made up of stainless steel.
- It has parts like finger bows, catches, shaft and blades.
- Blades have transverse serrations on inner aspect.
- Handle have catches and finger bow.

Uses:
- Artery forcep is primarily used to grasp blood vessels and arrest bleeding during surgery.
- It is also used in procedure like wound dressing, bladder wash, perineal care etc.
After care and sterilization:
- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.

Allis’ forcep
Image:

Identification point:
- The instrument is very light and it has parts like finger bows, catches, shaft and blades.
- It is made up of stainless steel.
- Blades are straight and its tip has interlocking teeths.
- Handle have catches and finger bow.

Uses:
- It is used to hold thinner structures like skin, fibrous tissue and subcutaneous tissue while
surgery

After care and sterilization:

- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.
 Babcock’s forcep
Image:

Identification point:
- The instrument is extra light and it has parts like finger bows, catches, shaft and blades.
- Blades are curved, fenestrated and have transverse bar, which is also transversely
serrated.
- It is made up of stainless steel.
- Handle have catches and finger bow.

Uses:
- It is used to hold the delicate structure and soft tissue like intestine, ovary, and fallopian
tube during surgery as it can cause minimum trauma.
- It is used in surgery like appendictectomy, stomach surgery and other abdominal surgery.

After care and sterilization:

- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.
 Cheatle forcep
Image:

Identification point:
- The instrument is long and it has parts like finger bows, shaft and blades.
- It is made up of stainless steel.
- Blades are curved and it has few transverse serration for better grip
- Handle have finger bow but does not have catches.
- This forcep is placed in container of savlon or other antiseptic in 1:40 ratio.
- If glass container is used then cotton is placed at bottom to avoid breaking.

Uses:
- It is used to handle sterile articles to maintain aseptic technique.

After care and sterilization:

- Periodically it is washed with running water, soap water, clean water, dried and then
sterilized by chemical sterilization or autoclaving.
 Sponge holding forcep
Image:

Identification point:
- The instrument is long and it has parts like finger bows, catches, shaft and blades.
- Blades are fenestrated and have transverse serration on the inner aspects.
- The instrument is approximately nine and half inches in length.
- It is made up of stainless steel.
- Handle have catches and finger bow.

Uses:
- Antiseptic dressing before surgery.
- For swabbing cavity.
- May be used to hold some structure.

After care and sterilization:

- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.
 Needle holder
Image:

Identification point:
- The instrument has parts like finger bows, catches, shaft and blades.
- It could be straight or curved.
- Blades are smaller in comparison to artery forcep and have criss cross serration with
groove for better grip on needle.
- It is made up of stainless steel.
- Handle have catches and finger bow.

Uses:
- A needle holder is used for grasping needle when passing sutures in a cavity or other part
not easily reached by fingers.

After care and sterilization:

- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.
 Dissecting forcep
Images:

Identification point:
- It is made up of stainless steel and has two types- non toothed or plain dissecting forcep
and toothed dissecting forcep.
- It has parts like handle, shaft and blades
- Most important feature of this forcep is that the handles have spring like action.
- The shaft has few rough ridges on outer surface for better grip.
- The blades are serrated transversely on inner aspect.
- In toothed variety it has interlocking teeth.

Uses:
- It can be used for holding soft tissue without causing injury.
- It is also used while suturing.
- It is used for procedure like wound dressing.

After care and sterilization:

- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.

Knife holder/scalpels
Image:
Identification point:
- It is made up of stainless steel and light in weight.
- It has parts like handle, shaft and blade.
- Blade has structure for accommodating various blades for incision.

Uses:
- It is used to make incision before operation.

After care and sterilization:

- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.
- Blade attached to this instrument is disposable in nature and not be re used.

Surgical scissor
Images:

Identification point:
- It is made up of stainless steel and can be straight or curved.
- It has parts like handle, shaft and blade.
- Handle has finger bow for grip and blades are sharp as it is used for cutting.

Uses:
- It is used to cut tissue and muscles during operation.
- It is also used for cutting suture.

After care and sterilization:

- It is washed with running water, soap water, clean water, dried and then sterilized by
chemical sterilization or autoclaving.
- Boiling is never used for sterilization of sharp instrument as it can affect sharpness of
blades.
 - Repeated use of autoclaving can also damage sharpness so chemical sterilization is best
method used for it.

Tuning fork
Images:

Identification point:
- It is made up of stainless steel and has parts like handle and two blades.
- Handle have flat base for performing test.

Uses:
- This instrument is used for assessment of hearing.
- Weber test and rinne test are performed for assessing hearing.

Rinne test
- The doctor strikes a tuning fork and places it on the mastoid bone behind one ear.
- When patient can no longer hear the sound, he/she signal to the doctor.
- Then, the doctor moves the tuning fork next to ear canal.
- When patient can no longer hear that sound, he/she once again signal the doctor.
- The doctor records the length of time patient hear each sound.
- Normal hearing will show an air conduction time that is twice as long as the bone
conduction time.
Weber test
- The doctor strikes a tuning fork and places it on the middle of patient’s head.
- Patient note where the sound is best heard: the left ear, the right ear, or both equally.
- Normal hearing will produce equal sound in both ears.
After care :
- It is washed with running water, soap water, clean water, dried and stored in place.
 Aural syringe
Image:

Identification point:
- It is metal syringe consisting o cylinder with nozzle, a guard and piston.
- The nozzle can be separated from the cylinder.
- It has got three ring

Uses:
- It is used for removal of foreign body and wax.
- It is also used for washing out infection.

After care and sterilization:

- After used it is washed with soap water, clean water and sterilized by boiling or
autoclaving or chemical sterilization.

Tongue depressor
Image:
Identification point:
- There are two types of tongue depressor- angular (curved) and straight.
- The angular type is used for physical examination in sitting position.
- The straight type is used for physical examination in lying down patient.
- An angular type has two parts- holding part and depressing part.

Uses:
- It is used during physical examination of oral cavity.
- It is used for removing foreign body from pharynx and oral cavity.

After care and sterilization:

- After used it is washed with soap water, clean water and sterilized by boiling or
autoclaving or chemical sterilization.

Mouth gag
Image:

Identification point:
- It is stainless steel instrument and has parts like finger bow, screw, blade.
- Blade is slightly curved from tip.

Uses:
- It is used for removing foreign body from pharynx and oral cavity.
- It is also used during dental surgery to open mouth
- It is used for tonsillectomy operation.
- It is used for opening mouth of unconscious patient.
After care and sterilization:
- After used it is washed with soap water, clean water and sterilized by boiling or
autoclaving or chemical sterilization.

Nasal speculum
Image:

Identification point:
- It is stainless steel instrument and has two thin blades, connected with U- shaped rim.
- While using blades are pressed close, introduced into nose and slowly opened as needed.

Uses:
- It is used for examination of nose.
- It is used during nasal surgery and removal of foreign body from nose.

After care and sterilization:

- After used it is washed with soap water, clean water and sterilized by boiling or
autoclaving or chemical sterilization.

Percussion hammer
Image:
Identification point-
- Percussion hammer has two main parts handle and body. Body is made up of synthetic
material and used for striking area for reflex testing. Handle can be opened from bottom
to check sensation.

Uses:
- A percussion hammer is a medical instrument used by practitioners to test deep tendon
reflexes. Testing for reflexes is an important part of the neurological physical
examination in order to detect abnormalities in the central or peripheral nervous system.
After care and sterilization:
- After use it can be cleaned with spirit swab and stored for next use.

Laryngoscope
Image:

Identification point-
- It is instrument operated with batteries for getting proper view pharynx, larynx and
trachea.
- It has parts like handle, light source, blade etc.

Uses:
- It is used for endotracheal tube insertion.
- Sometimes used for examination of oral cavity.

After care and sterilization:

- After used blade can be cleaned with soap water, clean water and sterilized using boiling,
autoclaving or chemical sterilization.
 Otoscope
Image:

Identification point-
- It is instrument operated with batteries for getting magnified view of tympanic membrane
and ear canal.
- It has parts like handle, magnifying glass, tip (aural speculum) etc.

Uses:
- It is used for ear examination in case of infection and perforated tympanic membrane.

After care and sterilization:

- After used tip (aural speculum) can be cleaned with spirit swab and stored for next use.

Ophthalmoscope
Image:
Identification point-
- It is instrument operated with batteries for getting magnified view of eye structure.
- It has parts like handle and magnifying glass

Uses:
- It is used for eye examination in case of cataract, glaucoma and other conditions

After care:
- It is stored in box after use.