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Surgical First Assist

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Lymph channels run parallel to which structures?
veins
Body temperature is regulated by the
hypothalamus
Which two electrolytes are essential for normal cardiac contractions?
potassium and calcium
Water constitutes what average normal percentage of total body weight?
50-70%
The thyroid gland consists of right and left lobes joined by the
isthmus
Langer lines generally lie perpendicular to the direction of
underlying muscle tension
The arterial supply to the intestinal tract, with the exception of the stomach, duodenum, and distal rectum, is derived from the
superior and inferior mesenteric arteries
Excessive secretion of growth hormones in adults causes
acromegaly
The inner lining of the mucosa of the g.i. tract is composed of
epithelium
The large artery that arises from the left side of the aortic arch and descends into the arm is the
subclavian
An enzyme active in the digestion of starches is
amylase
The normal pH of blodd is
7.3 - 7.4
Which cells secrete pepsinogen?
chief
Which of the following veins drains the intracranial venous sinuses to veins on the outside of the skull?
emissary
Which of the following arteries supplies blood to the brain?
*anterior and middle cerebral arteries
*vertebral and internal carotids
*external and internal carotids
*occipital and thyrocervical
vertebral and internal carotids
Which of the follwing arteries divides into the anterior and middle cerebral arteries?
*internal carotid
*external carotid
*vertebral
*basilar
internal carotid
Which of the following arteries is a direct branch of the internal carotid?
middle cerebral
The lateral ventricles within the cerebral hemisphere communicate with the third ventricle through the opening called
Foramen of Monro
The third ventricle of the brain empties into the fourth ventricle through the
Aqueduct of Sylvius
Spinal fluid is produced by the
choroid plexus
The fold of dura mater that seperates the cerebral hemispheres
falx cerebri
Which of the following seperates the frontal and temporal lobes?
*fissure of sylvius
*fissure of rolando
*fissure of bichat
*longitudinal fissure
fissure of sylvius
The frontal lobe is bounded posteriorly by the central sulcus, also called the
fissure of rolando
Which of the following areas located in the fronal gyrus of the brain controls of the function of speech?
brocas
The white line of Hilton is situated
between the external and internal anal sphincters
A chemical reaction that provides energy by the breakdown of food molecules is called
catabolism
Adipose tissue lies in which skin layer?
subcutaneous
Collagen is produced by which connective tissue cells?
fibroblasts
What is normal cardiac output for an adult?
4-8L/minute
Which vein drains the right side of the vertebral column?
azygos
Which arteries supplies the cecum, ascending colon, hepatic flexure, and proximal portion of the transverse colon?
superior mesenteric
The celiac artery trifurcates into the
left gastric, splenic, and hepatic arteries
A prolongation of the breast tissue located in the upper, outer part of the breast that passes through an opening in the axillary fascia is called the
axillary tail of Spence
The mammary gland is fixed to the overlying skin and underlying pectoral fascia by fibrous bands known as
suspensory ligaments of cooper
The arterial blood supply to the breast is supplied from branches of the
internal mammary, axillary and lateral thoracic
What is the loose areolar tissue that seperates the breast fromt he pectoralis major muscle?
retromammary space
Which lymph nodes are located between the pectoralis major and minor muscles?
rotter
Which nerves travel along the anterior-lateral chest wall and innervates the serratus anterior muscle?
long thoracic
What nerves innervates the latissimus dorsi muscle?
thoracodorsal
The nerve of Grassi is associated with the
stomach
The veins of sappey drain the
diaphragm
The node of Lund is located in the
Triangle of Calot
Where is Hartmann's pouch located?
gallbladder infundibulum
The small ducts that drain bile directly into the gallbladder are called
Hepatic
What is the name for the small pancreatic duct?
Santorini
The three structures that form the anatomical triangle of Calot are
cystic duct, common hepatic duct, lower edge of the liver
The point of seperation between the posterior rectus sheath superiorly and absence of the sheath inferiorly is called the
arcuate line
At what point does the external iliac artery become the femoral artery?
at the location of the inguinal ligament
The avascular area located in the mesentery and to the left of the middle colic artery is
the space of riolan
The series of arcades along the mesenteric border thorughout the length of the colon is called the
Margical artery of drummond
Valves of the gallbladder are called
heister
What nerves are located lateral to the long thoracic nerve and innervates the latissimus dorsi muscle
thoracodorsal
Which ligament connects the thryoid to the trachea?
berry
The structure that bind the small intestine to the posterior abdominal wall is the
mesentery
The left gastric, right gastric, right gastroepiploic, left gastroepiploic, and short gastric arteries supply the
stomach
The two muscles that form the pelvic diaphragm are
levator ani and coccygeus
What statement describes a nonrecurrent laryngeal nerve?
Variant laryngeal nerve that branches from the vagus and travels directly into the larynx
Jackson's membrane would be found near the
cecum
The flexure between the transverse colon and the descending colon is called the
splenic
The anastomsis, or linking, of arcades between the superior and inferior mesenteric vessels is known as the long anastomosis of
riolan
Which nerve innervates the the diaphram?
phrenic
The rectus sheath that meet to form a tough fibrous white band that extends from the xiphoid process to the pubic symphysis is the
linea alba
Which organ is completely retorperitoneal?
kidney
The liver is divided into two principal lobes by which ligament?
falciform
The sphincter located at the distal end of the common bile duct that opens into the duodenum is the
Oddi
The cartilage distal to the thyroid cartilage and proximal to the thyroid gland is the
cricoid
Which vein is shared by the pancreas and liver?
portal
The head of the pancreas is surrounded by the
duodenum
Which arteries supplies blood to the thyroid gland?
external carotid
What structures are located in the anterior mediastinum?
thymus, ascending aorta, lymph nodes
The anatomical division between the inguinal and femoral regions is the
poupart's ligament
Hesselbach's triangle is bounded by the rectus abdominis muscle, inferior epigastric vessels and
inguinal ligament
The inner lining of the mucosa within the g.i. tract is composed of
simple columnar epithelium
Another name for the folds on the inner wall of the stomach is
rugae
The area where the common bile duct joins the pancreatic duct and enters the duodenum is called the
ampulla of vater
The uterine artery is a branch of th anterior trunk of the
internal iliac artery
The ovary is suspended from the posterior leaf of the broad ligament by the
mesovarium
The ovarian artery is a branch of the
abdominal aorta
What ligaments travel in the upper part of the broad ligaments below and in front of the fallopian tubes, passing over the vesicle vessels and nerve?
round
The utereine artery is a branch of the anterior trunk of the
internal iliac artery
Which ligaments enclose the round ligament and extends from the lateral surface of the uterus to the pelvic wall?
broad
What is the nourishing coat of the eyeball that consists mainly of blood vessels?
choroid
The opthalmic artery divides into the
supraorbital and supratrochlear
Which rectus muscle moves the eyeball upward and medially?
superior
The recurrent laryngeal nerve that supplies the vocal cords lies very close to the
inferior thyroid artery
The arterial blood supply to the nose is from branches of the internal and external
maxillary
The five branches of the facial nerve from
temporal, zygomatic, buccal, madibular, cervical
Where do the mental nerves and vessels exit from the mandible?
foramen
In addition to the zygoma, which other bone comprises the zygomatic arch?
temporal
What is the principal muscle of the pelvic floor?
levator ani
The junction of the superior mesenteric and splenic veins forms the
portal vein
The tibial and common peroneal nerves are terminal branches of the what nerves?
sciatic
The arterial supply to the bladder is derives mainly from the
internal iliac
What structures of the kidney does urine drain into the major calyces?
renal pelvis
A rounded protuberance found at a point of articulation with another bone is called a
condyle
At which vertebral level is the ondontoid process located?
C2
What cavities within the brain is filled with CSF?
ventricles
Which ligament is attached to the posterior lateral condyle of the femur and to the notch of the midline of the tibia between the tibial condyle?
anterior cruciate
The gelantinous substance within an intervertebral disc is called the
nucleus pulposus
Which vein proximally travels across the neck of the abdominal aorta?
renal
The branches of the aortic arch are
brachiocephalic, left common carotid, left subclavian
The terminal arterial branches of the aorta are the
right and left common iliacs
The coronary arteries originate at the base of the ascending aorta, aka
Sinuses of Valsalva
What are the branches of the left coronary artery?
circumflex and anterior descending arteries
The thoracic duct begins in the
abdomen at the cisterna chyli
Two-thirds of the breast tissue rests on the pectoralis major muscle and the other one-third rests on the
serratus anterior
The carotid body and carotid sinus are two sensory structures; the carotid body is a
chemoreceptor
The valve that prevents the retrograde flow of blood into the atrium from the left ventricle is the
mitral valve
Deoxygenated blood is carried from the right ventricle to the lungs via which structure?
pulmonary arteries
At the base of each internal carotid artery is an enlargement called the
sinus
The three protective tissue layers called the meninges lie in the following order, starting with the most superficial:
duramater, arachnoid, pia mater (DAP)
Fissure Sylvius separates the
frontal and temporal lobe
The great sensory nerve of the face and head is the
trigeminal
Which cranial nerve emerges from the medulla, passes through the skull, and descends through the neck region into the thorax and abdominal region?
X
Which cranial nerves innervate the superior oblique muscle?
trochlear (IV)
Which cranial nerves innervate the inferior, medial, superior rectus, inferior oblique, and levator palpebrae muscle of the eye?
oculomotor (III)
Which cranial nerves innervate the lateral rectus muscle of the eye?
abducens (IV)
The dura plan that seperates the cerebrum from the cerebellum is the
tentorium cerebelli, transverse
Know the arterial branches of the celiac trunk
right hepatic artery
left hepatic artery
proper hepatic artery
celiac trunk
splenic trunk
left gastric artery
common hepatic artery
gastroduodenal artery
Know the following vessels
inferior mesenteric vein, superior mesenteric vein, superior hemorrhoidal vein, splenic vein, right gastric artery, portal vein
Know the nerves int he axillary region
lateral pectoral
long thoracic
thoracodorsal
medial pectoral
Know the structures of the biliary tract
common bile duct
ampulla of vater
intrahepatic ducts
right hepatic duct
left hepatic duct
gallbladder
cystic duct
common hepatic duct
Traffic patterns in the surgery department are designed to
aid in preventing surgical site infections
What is the princial goal of suctioning blood and body fluids fromt the wound?
improve wound visibility
The principal goal of the surgical assistant during the surgical procedure is to
provide exposure
What characteristics of draping materials is true?
flame-retardant
What type of patients are at risk for developing latex sesitivity?
children with spina bifida
What should be confirmed before administraion of any blood product?
date of expiration
The recommended minimum number of air exchanges in the or is
15x/hr with 3 exchanges of fresh air
If a surgical assistant places the operative patient's well-being above all other factors, then the s.a. is aid to have a strong
surgical conscience
Seepage of skin preparation solution under a patient may result in a
chemical burn
The frozen section examination provides the surgen with a
quick preliminary diagnosis
When assisting the surgeon with the draping, where should the surgical assistant stand in relation to the surgeon?
on the opposite side of the OR table from the surgeon
Studies show that the lowest infection rates have been obtained in surgical cases where patient body hair was
not removed
A hemodynmaic complicatino in the patient could be caused by
myocardial ischemia
Infants are at risk of losing body heat quickly due to their
thin layer of subcutaneous brown fat for insulation
Heat loss from the body occurs by all the following methods except
condensation
The earliest sign of MH is
increase in end-tidal CO2
Intraoperative fluid and electroyte imbalance are affected by
blood loss, fluid shifts and replacements
Vitamin D deficiency can lead to
hypocalcemia
Acid based imbalances reflect
hypoxia, hypothermia, and hypovolemia
Platelet concentration is often transfused during the immediate preoperative period for the purpose of
preserving clotting ability
Hemolytic reactions caused by ABO
antibodies to the donor foreign proteins
The correct arm placement when positioning a patient supine with arms extended on armboards is
armboards extended <90* with palms facing up
The force of integumentary injuries that results from the skin remaining stationary while the underlying tissues shift is known as
shearing
What is a potential physiological response when lowering patient's legs from the lithotomy position?
hypotension
The correct range for the pneumatic tourniquet pressure on an average adult for an upper extremity is
250-300mmHg
The setting of the pneumatic tourniquet pressure on an average adult for a lower extremity should be
higher than the systolic pressure by one-half of the value
The most common skin cancer is
basal cell carcinoma
In the event that a child needs an emergency procedure and the parents cannot be located to sign the permission
permission is signed by two consulting physicians
The principle of personal liability
hold everyone legally responsible for their hown negligent acts
By definition, carcinoma in situ is a malignant neoplasm that has not
extended beyound the basement membrane
The blood component administered to patients with a clotting problem is
platelets
What referes to a civil wrong committed against a person or property, not including a breach of contract?
tort
What is the normal value of the BUN for adults?
7-8 mg/dl
The specific gravity of a normal urine sample is
1.015 - 1.025
During lateral positioning, a
pillow is placed between the legs
The lithotomy position does not require
each leg raised slowly and gently as it is grasped by the toes
In which circumstance could the patient sustain an injury to the pudenal nerves?
positioned on the fracture table
An imperforation or closure of a normal opening is called
atresia
A lower oblique incision is called a/an
inguinal
Normal adult male range for RBC is
4.2 - 6.1 mill/ul
The normal adult range of WBC is
5,000 - 10,000/mm3
Normal adult range for sodium is
136 - 145 mEq/L
Normal adult range for potassium is
3.5 - 5.5 mEq/L
What types of blood components is the most common source of bacterial infection in a transfusion?
platelets
The doctrine of respondeat superior refers to
employer liability for employee's negligent conduct
The legal doctrine that mandages every professional to carry out his or her duties according to the national standards of care practiced throughout the country is the
Doctrine of reasonable man
Liability is a legal rule that
holds each individual responsible for his or her own actions
What is a result of potassium imbalance?
cardiac arrhythmias
A vagal response would be
bradycardia
The normal pH of urine is
4.6 - 8.0
A white count of 14,000 cu/mm would most likely indicate
an infection
When an immediate confirmation of malignancy is needed, the specimen will be sent to pathology for
frozen section
A method to protect tissue fromt the CO2 laser is to cover the area with
wet towels
Mechanical, thermal, and chemical are appropriate mechanisms to achieve
hemostasis
Significantly decreased volume of circulating blood or plasma in the body may cause the patient to go into
hypovolemic shock
The purpose of hemostasis is to
prevent blood loss
What is considered to be a biological hazard in the operating room?
body fluids and laser plume
What is the most common change in vital signs that are associated with early hypovolemic shock?
tachycardia
Measures to treat atelectasis include
pain control and early ambulation
The most appropriate devices to prevent skin pressure ulcers and deep tissue injury in the OR are
gel pads
Which nerve can be injured if the legs are improperly flexed at the hip int he lithotomy position?
obturator
Drains are typically passed to the exterior through?
adjacent stab wound incision
Which dressing is used when moderate to heavy fluid drainage is expected?
three layer
In the lateral chest position, a sand bag, or padding is placed under the chest at the axillary level to
prevent pressure on the lower arm
Chvostek's sign can indicate
hypocalcemia
The proper placement of th legs for a patient in the lateral position is
lower leg flexed, upper leg straight
Ulnar nerve damage could result from
placement of an elbow on unpadded table
What is at the greatest risk for fluid volume deficit?
trauma victim with extensive burns of the body
Clostridium perfringens is associated with with clinical condition?
gas gangrene
Phagocystosis by the white blood cells is an example of the body's
second line of defense
Cell "drinking" is called
pinocystosis
An organelle that is responsible for the packaging of proteins is the
golgi complex
An organelle that contains digestive juices is the
lysosome
the anaerobic bacterium that causes gas gangrene is
clostridium perfringens
Which of the following are procaryotic?
*molds
*protozoa
*bacteria
*plants
bacteria
Which of the following are eucaryotic?
*viruses
*fungi
*cyanobacteria
*bacteria
fungi
The gram stain differentiates
bacteria
An emergency drug that increases myocardial contractility is
calcium chloride
What body system evokes a physiologic response that is similar to the response evoked by sympathomimetic cardiovascular drugs?
sympathetic nervous system
One kilogram is equal to
1,000 grams
All of the following statements concerning hematocrit are true EXCEPT:
*normal range for women is 37-43%
*hematocrit value is the volume of rbc expressed as the number of cells per cubic mm
*a decrease in hematocrit indicates a decreases in red blood cells
*hematocrit readings are unreliable after blood transfusion adminstration
hematocrit value is the volume of rbc expressed as the number of cells per cubic mm
General and regional anesthesia contribute to body heat loss by causing
vasodilation
The primary drug utilized to treat MH is
dantrolene
The isotonic solution that is closest to human physiology is
0.9 NS
When a drug loses its effectiveness in a patient, the patient is said to have developed
tachyphylaxis
What is the mechanism of action in heparin?
breaks down the clot
The only depolarizing muscle relaxant in clinical use is
Succinylcholine (Anectine)
Lidocaine with epinephrine is contraindicated in surgery of the
hand
A patient scheduled for surgery has a hematocrit reading of 45% of total blood volume, which is
within normal range
When drawing a blood sample, a safe time lapse between blood drawing and analysis is
10 minutes
When given as a preoperative medication, atropine produces
drying of secretions
A drug combined with heparin that causes a postop loss of anticoagulant activity is
protamine sulfate
The drug added to a local anesthetic to increase diffusion is
hyaluronidase
What is a measurement of the pressure of carbon dioxide in the arterial blood?
PaCO2
What is a measurement of the amount of bicarbonate in arterial blood?
HCO3
What is not an inhalation anesthetic agent?
propofol
Cephalothin sodium (Keflin) is a/an
antibiotic
A drug used to reverse hypotension is
levartenernol (levophed)
Meperidine hydrochlride (demerol) is a/an
analgesic
Dextran is used parenterally to
expand blood plasma volume
A barbituate that may be used for sleep in the night before surgery is
secobarbital
Common pathogens infecting traumatic wounds often require the use of
penicillinase-resistant penicillin
What is the amount of time that heparin is systemically distributed in the adult?
3 minutes
Which of the following is an example of an isotonic IV solution?
0.9% sodium chloride
The volume of red blood cells in whole blood is determined by which of the following tests?
hematocrit
A common complication during emergence from general anesthesia is
hypoxia
What antibiotics should not be given as a preoperative prophylaxis to a pediatric patient?
ciprofloxacin
During the adminstration of general anesthesia, there is a loss of the eyelid reflex in stage
II
Aminoglycosides are a category of antibiotics that
can cause severe ototoxicity and nephrotoxicity
Which of these local anesthetics has a longer duration?
*xylocaine
*marcaine
*novocaine
*cocaine
marcaine
A microscopic blood count that estimates the percentages of each type of leukocyte within a sample is called a
differential
Some patients may show the most severe and lifethreatening type of reaction to certain drugs known as
anaphylaxis
A broad spectrum bactericidal antibiotic that interferes with synthesis of the cell wall and has a chemical structure similar to the penicillins is
cefazolin
Cricoid pressure is applied to prevent
aspiration
Epinephrine should be used in which of the following situations?
*glaucoma
*tachycardia
*hypertension
*anaphylaxis
anaphylaxis
What is a narcotic antagonist?
Naloxone hydrochloride (Narcan)
The reversal agent for heparin-induced anticoagulant is
protamine sulfate
What should not be administered to a patient who is exhibiting asystole?
isoproterenol
According to the Mallampati classification of preoperatively assessing airway adequacy for intubation purposes what is Class III?
only the base of the uvula can be visualized
In cataract surgery, a viscous jelly sometimes used to occupy space is
healon
A miotic drug is
pilocarpine
What local anesthetic is used most frequently for preoperative ocular-instillation?
tetracaine
A solution used for eye irrigation is
balanced salt solution (BSS)
What dye is used in opthalmic surgery to diagnose corneal abrasions?
Fluorescein sodium
The reactions ototoxity and nephrotoxity can be a result of administering
aminoglycosides
What drug paralyzes the sphincter muscle of the iris?
Cycloplegics
What statement describes second-degree AV block?
some, but not all, atrial beats are conducted to the ventricles
The P-wave displays__, and the PR segment is caused by the delay in the AV node.
atrial depolarization
The T-wave indicates
ventricular repolarization
An emergency durg used for treating ventricular fibrilation or tachycardia is
inderal
High doses of nitrous oxide block the metabolism of what vitamin?
vitamin B12
An emergency drug used in cardiac surgery that increases myocardial contractility is
calcium chloride
Cardiac arrhythmias of ventricular origin can be treated with
lidocaine
What is the durg of choice when lidocaine fails to achieve response for treating ventricular tachycardia/ventricular fibrillation during sudden cardiac arrest?
bretylium
What methods should the surgical assistant consider when cutting sutures?
according to surgeon's preference
What would affect normal wound healing?
peripheral vascular disease
The most common cause of delayed wound healing in the operative patient is
wound infection
The three phases wound healing include all of the follwoing EXCEPT:
*fibroplastic phase
*chronic phase
*remodeling phase
*inflammatory phase
chronic phase
What sutures should not be used int he placement of heart valves?
polydioxanone
Woulds in which there is significant bacterial contamination, foreign bodies, or extensive tissue trauma are generally closed by which intention?
granulation
What types of stitch patterns provides an excellent cosmetic closure?
subcuticular stitch
The primary factor when selecting the surgical needle is
reducing as much as possible the trauma to the tissue
What microorganisms is responsbile for causing postoperative wound edge erythema and rebound tenderness?
Group B steptococci
It is recommended that the square knot is
performed as a two handed tie
What is a correct statement concerning the principles of suture placment?
sutures should be placed in deep tissue to prevent hematoma
Sutures placed in a wound to prevent wound evisceration are called
retention
In which incision could retention sutures be used?
vertical midline
What types of stitches incoporates the seromuscular layer and submucosa?
lembert
During hemostasis, prothrombin and thromboplastin, along with calcium ions in the blood, form
thrombin
Endoscopic knot tying performed externally, introduced, and secured intra-abdominally is
extracorporeal
What is an abnormal activiated clotting time?
more than 120 seconds
Wound classification is assigned when
procedure is complete
Removal of devitalized tissue is
debridement
Which phase of healing begins within minutes of injury?
inflammatory
Which type of needle would be selected for use on skin or tendon?
cutting
An absorbable suture that offers extended wound support
pds
Polyglactin 910 suture is
absorbable, synthetic
Continuous lateral stitches placed beneath the epithelial layer of the skin are
subcuticular
The amount of tension or pull expressed in pounds that a suture can withstand before it breaks is
tensile strength
If the suture breaks and the remainder of the suture line stays intact, which suture technique was utitlized?
interrupted
Serosanguineous drainage means
blood-tinged
The term for a wound that completely separates and the internal organs extrude is
evisceration
What is a continuous circular suture placed around the lumen of a structure causing it to close?
purse-string
Postop, skin staples are generally removed
5-7 days
A wound that is left open and closed secondarily when there is no longer evidence of infection is an example of
delayed closure
Wound drains may be secured with
nonabsorbable suture on a cutting needle
Which term refers to the transmission of fluid along a strand of suture?
capillarity
What blood componenets are essential in clot formation?
platelets
What is the body's normal reponse to cell and tissue injury?
inflammation
What causes localized temperature elevation during the inflammatory response?
Increased blood flow
Between what postop days can dehiscence typically occur?
fifth and tenth
Delayed wound healing may be related to
age
A common pathogen associated with decubitus ulcers is Staphyloccocus
aureus
Which wound complication would require immediate surgery?
evisceration
What is used to reinforce a subcuticular closure?
steri-strips
Impaired healing of a vertical abdominal incision can result in
herniation
During a Whipple procedure, what surgical maneuvers are performed to dissect the lateral peritoneal attachments of the duodenum?
Kocher
Which site is used for autotransplanting one or more of the parathyroid glands?
forearm
A major concern in draining a gangrenous gallbladder is
contamination
Which nerve is at the greatest risk for injury during a thyroidectomy?
recurrent laryngeal
Which anastomoses is accomplished during a Whipple procedure (pancreaticoduodenectomy)?
hepaticojejunostomy
A hernia through which bowel or omentum extends and cannot be returned to its normal position through manipulation is referred to as a/an
incarcerated hernia
Which type of hernias occur in Hesselbach's triangle?
direct
What is the most common type of hernia that occurs in females?
femoral hernia
What is the anastomosis of choice when perfoming a total abdominal colectomy for ulcerative colitis?
ileoanal
The flexure at the junction of the duodenum and jejunum is the
ligament of treitz
Intercostal nerves and vessels are located
inferior to the rib
The section of the gastrointestinal tract that is least affected by Crohn's disease is the
rectum
Hernia means
rupture
What nerves must be identified and protected from injury during a thyroidectomy?
recurrent laryngeal
What types of incisions are used for laparscopy?
infraumbilical
Both direct and indirect hernias are the result of tears in the
transversalis fascia
Which nerves must be identified during an inguinal hernia repair?
iliohypogastic and ilioinguinal
Which hernia involves the peritoneum and te abdominal viscera forms what part of the hernia sac?
sliding
During a laparoscopic hernia repair, stapling is avoided in the triangular area inferior to the internal inguinal ring called
triangle of doom
During a laparoscopic hernia repair, staples should not be placed below the lateral iliopubic tract in order to avoid injuring the
genitofemoral and lateral femoral cutaneous nerves
Which nerves are dissected from the lesser curvature of the stomach when performing a highly sensitive selective vagotomy (parietal cell vagotomy)?
nerves of latarjet
the invagination of the proximal intestine into the lumen of the distal intestine is called
intussusception
Failure of the intestines to encapsulate within the peritoneal cavity of a newborn is
omphalocele
Newborn vomiting, free of bile, and projectile in nature, is indicative of
pyloric stenosis
Hirschsprung's disease is synonymous with
congenital aganglionosis
The most common intraabdominal childhood tumor is
nephroblastoma
Pathologic enlargement of the male breast is called
gynecomastia
Surgical enlargement of the passage between the prepylorus of the stomach and the duodenum is a
pyloromyotomy
A left subcostal incision indicates surgery of the
spleen
Which breast procedure removes the entire breast and axillary contents but preserves the pectoral muscles?
modified radical mastectomy
A sigmoid colostomy is brought through the
rectus muscle
Which surgical maneuvers refers to the dissection of the lateral peritoneal attachments of the duodenum to allow inspection of the duodenum, pancreas, and other retroperitoneal structures?
kocher
Which surgical maneuvers mobilizes the descending colon to the midline to expose the abdominal aorta?
mattox
What is the most common liver cancer?
metastatic disease
Removal of all liver tissue to the right of the falciform ligament is called?
trisegmentectomy
Which artery is susceptible to injury during a cholesycstecomy?
right hepatic
Increased WBC, bilirubin, alkaline phosphatase and positive blood culture would be associated with
cholangitis
A tumor that involves the junction of the right and left hepatic ducts?
klatskin
Which paired nerves must be carefully identified during a thyroidectomy?
recurrent laryngeal
The usual location of a Meckel's diverticulum is
approx. 2 feet from the ileocecal valve
Postop complications of an appendectomy include all of the following EXCEPT:
*stenosis of the ileocecal vavle
*intestinal obstruction
*stump rupture
*sepsis
stenosis of the ileocecal valve
All of the following complications can result from a total thyroidectomy EXCEPT:
*hypothyroidism
*tetany
*hoarseness
*esophageal rupture
esophageal rupture
Anatomical landmarks for a laparoscopic inguinal hernia include all of the following EXCEPT:
*inguinal ring
*inferior epigastric vessels
*spermatic vessels
*medial scrotal sac
medial scrotal sac
The incision for the tracheostomy is approx. 1/4" above the
suprasternal notch
Which nerves innervate the trapezius and sternocleidomastoid muscle, and should be identified and preserved when performing a radical neck dissection?
accessory
When closing the peritoneum or intestine, which type of needle is used?
taper
To establish a tracheostomy, a transverse or midilne incision is made in the neck between the
cricoid cartilage and suprasternal notch
Which two arteries must be preserved during pancrease retrieval?
splenic, superior mesenteric
In order to preserve the hepatic artery during liver and pancreas procurement, which branch artery must be identified and ligated?
gastroduodenal
Zenker's diverticulum is an outpouching of the
esophagus
An elderly patient who is one week postabdominal surgery complains of a "popping" sensation associated with coughing or straining. the most likely cause is
dehiscence
Which structures must be anastomosed during a liver transplant?
hepatic artery
During common bile duct exploration, which structures are more likely to be accidently injured?
hepatic artery
Which hernia is typically the result of postoperative wound dehiscence?
incisional
Dumping syndrome is a complication of
gastric bypass
A cholesteatoma is a benign tumor that develops in the
mastoid bone
Adenocarcinoma of th head of the pancreas can result in jaundice, because of compression of the
bile duct
What is an intraoperative hazard of laparascopic surgery?
perforation
Postop hernias are common after which incisions?
paramedian
When performing an inguinal hernia repair and incising the external oblique muscle, the sensory nerve that innervates the scrotum and must be preserved is the
ilioinguinal
Which section of the stomach is wrapped behind the esophagus during a Nissen procedure?
fundus
Which retractors are typically used to retract the strap muscles during a thyroidectomy?
green
What is the most common physically identifiable pathology of portal hypertension?
splenomegaly
A left subcostal incision is typically used for
splenectomy
Which arteries are identified, ligated, and divided during the perineal dissection of an abdominoperineal resection?
inferior rectal artery
The trendelengurg position would be most appropriate for which procedure?
total abdominal hysterectomy
A thoracoabdominal incision should be used for
hiatal hernia repair
A vagotomy is typically performed in conjection with which other procedure?
pyloroplasty
The position used typically in thyroid and gallbladder surgery is
reverse trendelenburg
To perform cholangiography, which duct is identified and incised for placement of the cholangiocatheter?
cystic
Which two tests are the most cost-efficient in preoperative determination of calculi in the bile tract?
percutaneous ultrasound, liver function tests
The condition of imperforate anus includes all of the following EXCEPT:
*stenosis
*agenesis
*membrane atresia
*chalasia
chalasia
Which position would be the most optimal for a pilonidal cycstectomy?
kraske
When removing anal warts with a laser, the rectum is packed with a wet sponge to
prevent escape of methane gas
A herniation of the cul-de-sac of Douglas is a/an
enterocele
A vesicourethral abdominal suspension is aka
Marshall-Marchetti
A Stamey endoscopic procedure is performed to
suspend the vesicle neck
The curved transverse incision used for pelvic surgery is called a/an
pfannensteil
When establishing the pneumoperitoneum for laparoscopic procedures, the CO2 gas pressure is kept between
14 - 16 mmHg
When positioning a patient for a gnecological procedure involving the candy cane stirrups, the surgical assistant is deliverate in avoiding pressure on the laterl aspect of the patient's knee to prevent injury to which nerve?
peroneal
The most commonly identified ovarian cyst is the
follicular
What is the preferred procedure for recurrent or persistent carcinoma of the cervix after radiation therapy has been completed?
pelvic exenteration
Extrauterine disease of the female reproductive system may utilize the following lasers via a colposcope or laparoscope EXCEPT the:
*co2
*nd:yag
*candela
*argon
candela
In which procedures will the patient be placed in supine position with the right side slightly elevated by a wedge?
caesarean section
Which procedures involve abdominal, perineal, and groin dissection?
radical vulvectomy
Which organ is frequently trapped in the inguinal sac of female patients?
ovary
A vulsellum forceps is used in ___ surgery.
gynecologic
Which ligaments that contain fibrous tissue and non-striated muscle fibers passes in the inferior direction from the cervix on each side of the rectum to the front of the sacrum?
uterosacral
If the veres needle is not positioned inside the peritoneal cavity, what happens to the flow of the CO2 and ressure?
flow decreases and pressure increases
Which arteries are contained within the cardinal ligament?
uterine
During cataract surgery, the irrigation/aspiration handpiece is used for
removed residual cortex
Retraction of eyelid tissues requiring intermittent retraction and release over a period of time is accomplished by utilizing
traction sutures
Which lasers are used to destroy the lens casule during cataract surgery?
YAG
Which opthalmic medications are injected into the anteior chamber during a cataract procedure to aid in keeping the iris in position prior to inserting the lens prosthesis?
acetylcholine chloride
The mechanical strength of a weak eye muscle due to strabismus in a pediatric patient can be corrected by all of the following EXCEPT:
*tucking
*advancement
*recession
*resection
recession
A chalazion is a chronic inflammation of the
meibomian gland
Which procedure is done for chronic dacryocystitis?
dacryocystorhinostomy
A procedure to treat retinal detachment is
scleral buckling
What involves small, corneal incisions as treatment for myopia?
radical keratotomy
When performing a tympanoplasty, the graft is secured to the oval window when
the footplate of the stapes cannot move
Which incision is indicated for an esophagogastrectomy?
thoracoabdominal
Which is an alternate procedure to stapedectomy?
stapedotomy
Which structures that travel thoughthe temporal bone must be identified and preserved when performing a mastoidectomy?
mastoid sinus, facial nerve
The term epistaxis means
nasal bleeding
Chronic otitis media can lead to loss of hearing. In the early stages, the patient can be helped by
myringotomy
Which nerve must be preserved to prevent muscle weakness during a parotidectomy?
facial
Which incisions allow for optimal exposure of frontal sinus fractures?
coronal
Which nerve that innervates the muscles around the chin must be protected from injury when repairing a fracture of the madible?
marginal mandibular
Which branch of the trigeminal nerve must be identified and prserved when performing a submandibular gland removal?
lignual
Prior to plating a mandibular fracture, what should be applied to ensure proper occlusion of the teeth?
arch bars
What should be sent postop with the patient who has arch bars applied?
wire scissors
A patient is being evaluated for undergoing a breast reconstruction procedure and indicates she still smokes. Which procedures would the surgical assistant recommend?
free TRAM flap
A common autologous donor site for a free flap graft for replacing the jaw bone is the
fibula
When possible during a plastic surgery procedre, incision should be placed
perpendicular to the long axis of the underlying muscle
Sutures fromt he ear may be removed after
10 - 14 days
Reasons for skin graft failure include
hematoma
Cleft lip repair is usually recommended at
3 months
Which congential anomalies limit the skull's volume and increases the intracranial pressure?
craniosynostosis
What statement is correct concerning the handling of renal calculi?
Kept dry to avoid interference with chemical analysis
Which types of fistulas refers to leakage of urine into the vagina?
vesicovaginal
When performing a radical cystectomy with ileal conduit, which is an alternative patient position that a surgeon may prefer?
low lithotomy
A stagnorn stone is one that lodges and continues to grow int he
renal calyx
Which solutions are used during a diagnostic cystoscopy?
water
What is not considered a permanent urinary diversion?
nephrostomy
A radical lymphadenectomy is performed to treat cancer of the
testicles
A transplanted kidney is placed into the
iliac fossa
The bladder is supported by the rectovesical fascia called
denonvilliers
What is the surgical treatment of vesicoureteral reflux?
ureteral reimplantation
What is the fornix in the kidney organ?
edge of the minor calyces
Which is not a complication of a transurethral prostatectomy?
rectal inury
The fascia surrounding the kidney is called
gerotas
The donor left kidney is preferred in order to procure additional length of the
vein
Which affect renal vascular resistance?
mannitol
A patient who has undergone a right-side herniorrhaphy presents 2-5 days postoperatively with swollen and tender testis. What is a likely complication?
ischemic orchitis
The kidney lift should be situated directly below what part of the patient when positioning a patient for a nephrectomy?
iliac crest
Which vein, in addition to the gonadal and lumbar, should be clamped and ligated when performing a left kidney procurement?
adrenal
Which nerves can be injured during a lateral lower leg fasciotomy?
superficial peroneal
The most reliable tendon graft for primary reconstruction of the anteior cruciate ligament is
patellar
The type of fracture that is caused by impaction of one one upon another is
compression
What can be a cause of locking of the knee joint?
osteochondral defects
Which types of fractures is at the greatest risk for infection?
open
The trauma patient with a cervical spine injury at or near C3 or C5 is at great risk for
respiratory difficulties
Which nerves are affected by carpal tunnel syndrome?
median
An injury to the long thoracic nerve could cause
winged scapula
An injury to the ulnar nerve could cause
claw hand
During a triple arthrodesis, the capsule of the talonavicular, calcaneoocuboid and subtalar joint are circumferentially incised to
gain as much ankle joint mobility as possible
Which muscle is an important anatomical landmark in fractures of the forearm?
pronator teres
Which fractures are caused by falling on the back of the hand with the wrist flexed, aka reverse Colles' fracture?
Smith's
Which carpal bones are fractured most frequently?
scaphoid
Which metacarpals is most commonly fractured when associated with a "boxer's fracture?
fifth
Which disorders are characteriezed by compression of the abductor pollicis longus and extensor pollicis brevis tendon near the radial styloid process?
De Quervain's
The most frequent site of cartilage tears in the knee joint is the
medial meniscus
What statement concerning the Bankart procedure is correct?
Anterior capsule is reattached to rim of the glenoid
Which fractures is most commonly associated with a fat embolism?
femur
Which nerve is at risk for injury in a humerus shaft fracture?
radial
What is a Monteggia fracture?
fracture of the proximal third of the ulna with radial dislocation
Which nerves are compressed in carpal tunnel syndrome?
median
Under which structure is the nerve trapped in carpal tunnel syndrome?
transverse carpal ligament
Which movements of the upper extremity would be most painful if tendinitis of the supraspinatus muscle is present?
abduction of the shoulder
The border of the acetabular fossa of the hip joint that is deficient forming a C-shaped fossa that creates a gap is bridged by the
transverse ligament
What is a fibrocartilage structure of the acetabular fossa that encloses the head of the femur?
labrum
Following injury to the lower limb, your patient's knee is evaluated. His leg can easily be displaced anteriorly on a fixed thigh. This would indicate a torn
anterior cruicate ligament
Which nerves are at risk for injury when a humeral shaft fracture occurs?
radial nerve
Which is not a carppal bone?
cuboid bone
Which is the best indicator for possible failure of a below-th-knee amputation to heal?
absence of a popliteal artery pulse when palpated
A laceration or avulsion of the extensor tendon at the proximal phalanx or proximal interphalangeal (PIP) join is called a
boutonniere deformity
The distal tibia articulates with which structures?
talus
The narrow rim of fibrocartilage around the edge of the glenoid cavity is
glenoid labrum
The superior margin of the hip bone s called the
iliac crest
The patellar ligament is attached proximally to the patella and distally to which structure?
tibial tuberosity
Which tendone is located under the clavicle and is the site of most rotator cuff repairs?
subscapularis
Which knee ligament prevents the femur from sliding posteriorly on the tibia and is the usual site for knee ligament reconstruction?
ACL
Which nerves are most frequently injured due to a shoulder dislocation?
axillary
Which diagnostic imaging techniques are used to aid in diagnosing a rotator cuff tear?
mri
What are complications of internal K-wire fixation f a Colles' fracture?
nerve damage
Which structures may be used for replacement of the ligament during an ACL repair?
patellar tendon
When performing a cannulated screw fixation for nondisplaced femoral neck fractures, compression of the
anterior screws is competed first
Which lymph nodes must be removed and histologically examined when performing a segmental pulmonary resection for lung cancer?
lobar
In severe aortic stenosis all of the following are indications for valve replacement EXCEPT:
*palpitations
*congestive heart failure
*angina
*syncope
palpitations
What is the most common cause of mitral stenosis?
rheumatic fever
The wound classification of a thoracotomy is
clean-contaminated wound
Plication of the inferior vena cava or insertion of an imbrella-type filter is performed to treat
pulmonary embolus
The most common congenital defect of the heart is a
ventricular septal defect
A needle biopsy of the lung may be accomplished with a
Chiba
Which one of the folowing statements about the heart is INCORRECT?
*Aortic valve sound can best be hear over the right second intercostal space
*Most cardiac veins drain into the coronary sinus
*Blood passes though the bicuspid (mitral) valve when it flows fromt he right atrium to the right ventricle
*The fossa ovale is the site of the former, embryonic shunt from the right atrium to the left atrium
blood passes through the bicuspid (mitral) valve when it flows from the right atrium to the right ventricle
Cardioplegia induces cardiac
arrest
When the myocardium weakens and enlarges, losing the ability to pump blood into the systemic circulation, the resulting condition is called
heart failure
Insufficient blood flow to the heart muscle may lead to
myocardial infarction
Which vessels typically utilized for a coronary artery bypass?
saphenous vein and internal mammary artery
When performing a high ligation and stripping of the great saphenous vein, which arteries are located at the saphenofemoral junction and should be kept from injury
superficial external pudendal
In which procedure would a Fogarty catheter be utilized?
embolectomy
What is the purpose for the surgical creation of an arteriovenous fistula?
hemodialysis
When performing an open AAA, which artery or arteries are cross-clamped prior to cross-clamping the aorta?
Iliac
Which cranial nerves are at risk for injury during acarotid endarterectomy?
hypoglassal
During a vascular procedure, monitoring the activated clotting time intraoperatively provides useful data for judging the need for reversal or addition of
heparin
Deep vein thrombosis occurs most commonly in the
left iliac vein
What may be requested during an emergency femoral embolectomy?
arteriograms
What is applied topically to arteries for prevention of vasoconstriction?
papaverine
During a carotid endarterectomy, which arteries are initially incised?
common carotid
What of the following is NOT a layer of an artery?
*tunica media
*tunica intima
*tunica adventitia
*tunica muscularis
tunica musclaris
Meningiomas are benign tumors that originate in the
dura
A potential complication that can occur when the patient is undergoing an occipital craniotomy while in Fowler's position is
hypotension
Incomplete closure of paired verterbral arches that can be treated surgically is know as
spina bifida
What could occur when a posterior fossa craniotomy is performed with the patient in a sitting position?
venous air embolism
Which arteries could be injured if the screws for an anterior cervical discectomy are placed laterally rather than straight or at a medial angle?
vertebral
To prevent the plates, screws and rods from breaking when performing a spinal fusion, bone graft is need to fuse to
bone
Wich hemostatic agents are most frequently used during a spinal fusion?
thrombin
The center structure of the intervertebral disc, which may herniate into the spinal nerve is the
nucleus pulposus
A ventriculoperitoneal shunt is used to
treat hydrocephalus
What is usually caused by an injury to the middle meningeal artery?
epidural hematoma