The image shows an instrument used in obstetric and gynecology for packing and traction. Identify the instrum… - NORCET 9 Mains - 2025

NORCET 9 Mains - 2025

Obstetrics & Gynaecology

Easy

Appeared in: NORCET 9 Mains - 2025

Explanation

The instrument shown in the image is correctly identified as Green-Armytage forceps.
Its most distinctive feature is the broad, flat, triangular fenestrated tip, which is designed for compressing a wide area of tissue.
Inside the tips, horizontal serrations provide a secure grip without causing excessive trauma.
It is primarily used as a hemostat to clamp the bleeding angles of the uterine incision during a caesarean section, which helps in controlling blood loss.

Option B: Allis forceps have multiple short, sharp, interlocking teeth at the tip. They are designed for grasping and holding tough or slippery tissues, not for broad compression and hemostasis like the instrument shown.
Option C: Kocher forceps are characterized by strong, transverse serrations and a single, sharp 1x2 tooth at the tip. This design is for aggressively grasping heavy tissues like bone or fascia and is different from the broad, fenestrated tip in the image.
Option D: Foerster forceps, also known as sponge-holding forceps, have round or oval fenestrated tips. They are designed to hold gauze or sponges for swabbing and preparing surgical sites, not for clamping uterine angles.

Visual 1: Infographic - A side-by-side comparison showing the tips of Green-Armytage, Allis, Kocher, and Foerster forceps. This visual will clearly highlight the unique triangular tip of the Green-Armytage forceps versus the toothed tips of Allis and Kocher, and the round tip of the Foerster forceps.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of surgical instruments used in obstetrics and gynecology as background academic context rather than a clinical decision trigger.
The correct identification and use of Green-Armytage forceps are critical for managing hemorrhage during a caesarean section.
Its application to the uterine angles significantly reduces blood loss, thereby helping to prevent postpartum hemorrhage (PPH), a major cause of maternal morbidity and mortality.
What if? If Green-Armytage forceps are unavailable, a surgeon might use two pairs of large Foerster (sponge-holding) forceps. However, their round shape is less effective at compressing the entire angle of the uterine incision, leading to less effective hemostasis compared to the purpose-built triangular design of the Green-Armytage.

How to Approach the Question

This is an image-based identification question, which requires factual recall.
First, carefully examine the instrument in the image. Pay close attention to its most distinguishing features, especially the design of the tip or jaws.
Observe that the instrument has broad, flat tips with a triangular opening (fenestration).
Next, recall the characteristics of the instruments listed in the options.
Compare the features seen in the image with the known features of each option. Allis and Kocher forceps have teeth. Foerster forceps have round tips.
The triangular fenestrated tip is unique to the Green-Armytage forceps. Match the visual evidence to the correct name.

Concept Tested & Keywords

Concept Tested: Identification of surgical instruments used in obstetrics and gynecology.
Stem keywords: instrument, obstetric, gynecology, packing, traction
Lead-in keywords: Identify the instrument

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