Pathophysiology
FHM1 (CACNA1A)
The first discovered FHM locus was the CACNA1A gene (originally named CACNL1A4), which encodes the P/Q-type calcium channel CaV2.1. Currently, 17  mutations in this channel are known (table 1), and these mutations are distributed throughout the channel. Some of these mutations result in patients with notable cerebellar degeneration or other dysfunction, including one mutation (S218L), which may be related to severe responses to mild concussion, up to and including delayed cerebral edema, coma, and death. Fifteen of these mutants have received at least some further analysis at the electrophysiological level to attempt to determine how they might lead to the FHM1 phenotype. Contradiction in the literature is increasing as to the end result of these mutations on channel kinetics and neuronal excitability.A good example of this contradiction can be seen in the literature regarding the R192Q mutation. The first investigation of this mutation, using the rabbit isoform of the channel expressed in oocytes, found that it did not alter any measured channel properties. A subsequent report, using human channels expressed in HEK293 cells, found a small, hyperpolarizing shift in the midpoint for activation, a result common among FHM1 mutants. This shift results in channels that open at more negative potentials, thus have a higher open probability than wild-type channels at most potentials. This report also found that the R192Q mutant produced almost twice as much whole-cell current compared to wild-type channels. This is not due to a change in single channel conductance, but to an equivalent increase in channel density.
Kelly clamp, invented by Howard Kelly, has similar functions but it can clamp larger vessels due to the slightly larger jaw.Accordingly, the nomenclature of surgical instruments follows certain patterns, such as a description of the action it performs (for example, scalpel, hemostat), the name of its inventor(s) (for example, the Kocher forceps), or a compound scientific name related to the kind of surgery (for example, a tracheotomy is a tool used to perform a tracheotomy). Classification
There are several classes of surgical instruments:
Graspers, such as forceps (non-locking forceps/ grasping forceps, thumb forceps, pick-ups) Used for tissue or object grasping. Forceps are categorized into toothed or non-toothed at the tip. (e.g.,Tissue forceps, Adson forceps, Bonney forceps, DeBakey forceps, Russian forceps) 
Clamps (locking forceps)
Clamps stabilize or hold tissue and objects in place. They can be used for traumatic or atraumatic purposes. (e.g., Crile hemostat, Kelly clamp, Kocher clamp)
Surgical scissors
Tool for tissue cutting, dissection, and suture. Straight and curved scissors are used for cutting different structures. (e.g. Mayo scissors, Metzenbaum scissors, Pott’s scissors, Iris Scissors). Bone cutters: unpowered or powered saws, drills and pliers-like devices
Needles/Sutures
Tools used for suturing dissection sites or closing cuts. Needles have different shapes (e.g. j shape, ½ circle, straight) and cutting edges (tapered - round, conventional cutting - triangular) depending on the application and areas of the suture. Sutures can be categorized based on different sizes (e.g.#5-#11, higher numbers represent larger suture diameter) and types (absorbable and nonabsorbable and braided and non-braided) as well.