Surgical Techniques Final Review
With what amount and which fluid is a 16 Fr., two-way Foley catheter with 5 cc balloon filled? Select one: a. 5 mL of sterile normal saline b. 10 mL of sterile water c. 5 mL of sterile water d. 10 mL of sterile normal saline
10 mL of sterile water
Up to what area of the arms does a surgical technologist scrub?
2 in above the elbows
Where is the safety belt to strap placed on a patient in supine position on the OR table?
2 inches proximal to the knees
How many individuals are required to safety transfer a recently anesthetized patient from the OR table to the stretcher?
4
Which suture gauge wound be MOST appropriate for ophthalmic surgery?
8-0
In normal blood gas ranges, arterial oxygen saturation should be at or near what percentage range of capacity?
96% to 100%
For which procedure would the surgical technologist want to be sure to have adequate numbers of allis and allis adair tissue forceps?
A&P Colporrhaphy
Which blood type is considered the universal recipient?
AB
Which of the following is/are NOT Included in operative vital signs measurements? Pulse All of the above are considered operative vital sign measurements height and weight blood pressure
All of the above are considered operative vital sign measurements
which of the following types of stirrups would likely be used for a lapascopically assisted vaginal hysterectomy? (LAVH)
Allen low lithotomy
Which member of the surgical team gives permission for the patient to be positioned or transferred?
Anesthesia provider
Elective surgery patients may be asked to discontinue use of which medications to prevent drug-therapy-induced platelet dysfunctions?
Aspirin
Which of the following is an example of acceptable and safe intraoperative autotransfusion blood collection?
Blood Collected from sponges into a basin of sterile saline during repair of ruptured abdominal aortic aneurysm
Which of the following is an example of an isotope scan that may show "Hot Spots" indicating possible pathology?
Bone Scan
End-to-end, side-to-side, and roux-en-Y are techniques for:
Bowel anastomosis
The triangle of Calot is an anatomical space bounded by structures in which surgical procedure?
Cholecystectomy
An assistant may be needed to properly perform which type of surgical skin prep?
Circumferential extremity
HBV, HCV, and alcohol abuse are precursors to which of the following diseases? Select one: a. diverticulitis b. cholelithiasis c. duodenal ulcer d. cirrhosis
Cirrhosis
Wound classification would be assigned to a vaginal hysterectomy with anterior and posterior colporrhapy?
Class II
Which of the following interweaves its fibers during the maturation phase of wound healing and increasing its tensile strength?
Collagen
Cholangiography is the diagnostic study that images which anatomical structure?
Common Bile Duct
Which of the following is a dye used for identification of bacteria?
Crystal Violet
When a vessel cannot be acessed percutaneously for angiography, how else could it be done?
Cut-down
Which type of needle is preferred for suturing skin?
Cutting
What is the chemical name for Dermabond or Indermil?
Cyanoacrylate
What type of hernia protrudes through the transversalis fascia in the area of Hesselbach's triangl?>
Direct
Which of the following devices would be used within the sterile field to determine the patency of an arterial anastomosis?
Doppler Probe
Which of the following is a display and recording of the electrical activity of skeletal muscle?
EMG
Which of the following terms describes the percentage of blood pumped out of a filled ventricle with each heartbeat?
Ejection fraction
All of the following are techniques for eliminating dead space in a wound except:
Electrical nerve stimulation
Which of the following is NOT an example of blunt dissection of tissue?
Endo Shears are used though laparoscopic trocar to separate tissue
How will the surgeon manipulate skin edges of a wound before the surgical technologist places an approximating skin staple?
Evert the edges outward
Which tissue layer of the abdominal wall provides the greatest strength and support of the wound?
Fascia
Which artery is most commonly accessed with the Seldinger techniquwe during cardiac catherterization?
Femoral
What is the proper way to open a small, sterilely wrapped item for delivery to the sterile field?
First flap is pulled and opened away from self and tucked into palm. side flaps are pulled and tucked into palm, and last flap is pulled toward self and secured before tossing item onto field
Which diagnostic method requires use of an image intensifier?
Fluoroscopy
The sitting position is a modification of which position?
Fowler's
What is the term for tissue that is easily torn or shredded?
Friable
What is the name of the fibrous and serous capsule that covers the liver?
Glisson's
In Gram stain study, the bacteria that retains the blue coloration following staining, alcohol rinse, and restaining is:
Gram Positive
Which of the following types of vessel loops are NOT Available for use?
Green Colored for bile ducts
If a pack of sponges is found to have an incorrect number during the count process and the patient is on the OR table, what should be done? Select one: a. Ask the circulator to record the actual number on the count board for closing count verification. b. Discard the sponge pack into a trash hamper. c. Hand off the pack to the circulator who will bag, label as incorrect, and isolate off field until case completion. d. Hand off the pack to the circulator who will remove it from the room.
Hand off the pack to the circulator who will bag, label as incorrect, and isolate off field until case completion.
Which handheld retractor is specifically designed for use in open cholecystectomy to elevate the liver?
Harrington
Which of the following descriptions of how to pour liquids into a container on the sterile field is correct?
Hold the bottle 12 inches above and with only the lip of the bottle over the basin
What is the name of the 24-hour monitoring device for cardiac dysrhythmias?
Holter Monitor
What would be the likely result of positioning the patient's arms on armboards at the greater than 90 degree angle from the torso?
Hyperextension nerve damage
In laparascopic appendectomy, all of the following methods could be used for dissection of the appendix except:
Intraluminal circular stapler
Which of the following is flexible, atraumatic device used to facilitate proper placement of catheters into lumens of vessels, ducts or ureters?
J-Guidewire
what is the name of the heavy, right-angle scissors frequently ...cervix during hysterectomy?
Jorgenson
Which of the following surgical needles is a solid bore (not hollow) type of needle?
Keith
What is the name of a raised, hypertrophic scar due to excessive collagen formation in some darker-skinned individuals?
Keloid
Another name for a thyroid tenaculum is a:
Lahey
The skin incision for a thyroidectomy will follow which anatomical lines?
Langer's
In general a monofilament suture would require (BLANK) knot throws for security than a multifilament suture
MORE
All of the following studies expose that patient to ionizing radiation EXCEPT:
MRI Scan
which type of hernia repair could a penrose drain be used as a method of gentle traction of the spermatic cord:
Mc Vay inguinal herniorrhapy
Which incision is traditionally used for open appendectomy?
McBurney
Great Care is taken to identify and preserve the long thoracic and thoracodorsal nerves in which surgical procedure?
Modified radical mastectomy
During the process of setting up the sterile field, efficiency and economy of motion recommend that the ST
Move items only once if possible
What should the surgical technologist do with his or her gown and gloves in preparation for donning after scrubbing?
Open gown wrapper on unsterile Mayo stand, and open and toss gloves onto gown
What is the appropriate method for delivering a sterile item to the back table from a peel package?
Open package laterally and completely, gently toss item without touching glued edge or gong over back table
Which absorbable suture provides for the MOST extended wound support?
PDS Plus
Which of the following studies combines tomography with isotope scanning to highlight chemical or metabolic activity?
PET
Thoracentesis is removal of fluid from the
Pleural space
which type of synthetic mesh is absorbable?
Polyglactin 910
Which statement is CORRECT regarding polyp and diverticula in the colon?
Polyps protrude inward, and diverticula protrude outward from the intestine
Side to side
Primary union wound healing occurs
Some multifilament sutures are coated to:
Provide smooth passage through tissue
Intraoperative fluoroscopy for cholangiography would require which of the following?
Radiolucent OR Table
If a mastectomy is scheduled to follow a breast biopsy and frozen section results indicates carcinoma, what is done?
Re-prep, redrape patient; team changes gowns and gloves; and use new instruments
What is the purpose of radio frequency tracking system in the OR?
Reduce possibility of retained foreign objects
which needle has cutting edge on the outside curvature of the needle body?
Reverse
"Bowel Technique" refers to steps used by the surgical team to prevent postoperative:
SSI
Which fascial sheet is attached to the iliac crest, linea alba, and pubis
Scarpa's
A wound that is not sutured and that gradually fills in by granulation heals by which intention?
Second
which of the following is most common permanent colostomy?
Sigmoid
Which position is routinely used for flexible colonoscopy procedures and may be performed on the patient's stretcher?
Sims'
What is another name for an acquired ventral hernia through the linea semilunaris?
Spigelian
Which test involves a lumbar puncture for collection and analysis of CSF?
Spinal Tap
Which stage of breast cancer is characterized by evidence of distal metastasis?
Stage IV
To secure the Mayo stand from moving during draping, what should be done?
Step on one leg of the Mayo stand
the Surgeon may request which of the following for irrigation to aid in destroying any residual tumor cells after dissection?
Sterile Water
Another name for suture ligature is a:
Stick Tie
A continuous suturing technique that places sutures in the endothelial layer of the skin in short, lateral throws is called a
Subcuticular Suture
Which type of suture is often used to create a vascular anastomosis?
Synthetic, nonabsorbable, monofilament with double-armed taper needles
Which wave of cardiac cycle in an electrocardiogram indicates the ventricular repolarization phase?
T-Wave
Which of the following statements is TRUE regarding natural absorbable sutures?
THEY ARE PACKAGED WET
Which of the following statements about lateral kidney positioning is INCORRECT?
The Lower leg is straight and the upper leg is flexed, with a pillow under the lower leg
What does the circulatory verify before the the surgical technologist places the basket of instruments on the back table?
The filters on the bottom are intact and the container is dry
Which of the following statments regarding transfer of an awake, mobile patient from stretcher to OR table is INCORRECT?
The safety strap is secured tightly across patient's waist to prevent possible fall due to narrow OR Table
What is the reason of injecting saline through the cholangiogram catheter prior to the contrast media?
The saline will test patency of the cystic duct prior to injecting the contrast
Which statement is CORRECT regarding monofilament sutures?
They may be used in infected wounds
which of the following is NOT correct about the suture/design of suture needles?
They range from 1/2 circle curvature to 5/8 circle curvature
which statement regarding instrument counts is correct: -They are unnecessary if only one tray is opened for use -They are required by state law for every surgical procedure -They have been replaced by routine practice of post-op x-ray to verify no retained instruments -They should be counted while all still on the back table
They should counted while still on back table
By which intention would a purulent wound treated by debridement and placement of medicated packing, then sutured after resolution of the infection heal?
Third intention
which organization specifies diameter ranges for sutures?
U.S. Pharmacopeia (USP)
Which study uses frequencies of 1 to 10 million Hertz through human tissue for diagnostic purposes? Select one: a. electromyography b. capnography c. ultrasonography d. tomography
Ultrasonography
Which nonsuture needle is used for insufflation of carbon dioxide into the abdomen for laparoscopy?
Veress
Polytetrafluoroethylene
What is the chemical name of Gore-Tex suture?
to prevent sutures from cutting into the skin
What is the primary reason bolsters are used with retention sutures?
Homologous
What is the term for the blood products donated by another person?
Skin closure tapes
What is used to close the epidermal layer when a subcuticular wound closure has been done for good cosmesis?
Traction
What would be the type of suture placed temporarily in the tongue to hold it out of the way in the maxillofacial procedure?
When is the first "uterine count" performed in C Section?
When the first suture is given for closure of the uterus
Halsted
Which historic figure in medicine is credited with creating principles of proper tissue handling and suturing?
Fascia
Which layer of the abdominal wall must be approximated securely, even if the other layers are not?
Surgical Silk
Which of the following is a natural, multifilament suture classified as nonabsorable but loses much of its tensile strength in a year and is undetectable in tissues after 2 years?
Polypropylene
Which of the following is synthetic, monofilament, nonabsorbable, and the most inert synthetic suture used frequently in cardiovascular and ophthalmology procedures?
Plain Surgical Gut
Which of the following sutures has comparatively inconsistent tensile strength and rapid absorption rate in vivo with moderate tissue reaction?
Suture Ligature
Which type of suture ties has an attached needle?
Pancreaticoduocenectomy is also known as which of the following procedures?
Whipple
Inflammation can BEST be described as:
a normal protective response to tissue injury
A type of organism that dies quickly when exposed to air is called:
anaerobic
What is the symptom that a patient with myocardial ischemia would experience?
angina
Rapid serial film changers and pressure injectors are used in which diagnostic imaging study? Select one: a. angiogram b. MRI scan c. echocardiogram d. CT scan
angiogram
Which type of viewing instrument would be used for surgical treatment of hemorrhoids?
anoscope
Which gynecologic procedure is for treatment of urinary incontinence or cystocele
anterior colporrhaphy
Which muscle is incised in transverse abdominal approaches for gynecologic procedures?
anterior rectus
which maneuver might be performed by the surgical technologist during a cesarean section to aid in the delivery as the surgeon gently manipulates the head of the fetus out of the uterus?
application of external pressure over the fundus of the uterus
which of the following is NOT a method of achieving hemostasis?
apportional
Ethicon sutures may be available with a designation of "plus" for some sutures, which means they:
are impregnated with an antibacterial coating
Which of the following is (are) stained in Gram Stain test?
bacteria
During the surgical skin prep, areas that are considered contaminated should:
be scrubbed separately or last
What is the name of a gastric mass of indigestible vegetable fiber and hair that may require surgical excision?
bezoar
What do the parathyroid glands regulate in the body?
blood calcium concentration
Due to the vascular and friable nature of the liver, a surgeon may choose to use a suture on which type of needle?
blunt
Which type of suture needle is used on friable tissue such as liver or kidney?
blunt
A needle-localization procedure may be performed in radiology for assistance in locating discrete masses in the
breast
the fallopian tubes are located bilaterally in the mesosalpinx of which uterine-pelvic ligaments?
broad
What is the term used when a surgical team member who is on standby must return to a facility to do a case?
called in
Which noninvasive study assess the amount of carbon dioxide in the arterial system of a patient on mechanical ventilation?
capnography
Which of the following is NOT a region of the pancreas?
capsule
which of the following is used got creating pneumoperitoneum in laparoscopy?
cardon dioxide
What kind of wound is a sacral decubitus ulcer?
chronic
Which two members of the surgical team are responsible for performing the counts to prevent retained Items?
circulator and ST
What type of incision is made for excisional biopsy of a centrally located breast mass involving the lactiferous ducts?
circumareolar
Which gloving method should be performed by the surgical technologist after donning a sterile gown and before setting up the back table?
closed gloving
Which of the following statements is correct regarding anatomical changes following pelvic exenteration?
colostomy will exit on the left and ileostomy on the right side of the abdomen
Hypaque, Cystografin, and Renografin are:
contrast media
Which study assists a surgeon with determining the MOST effective antibiotic therapy for treatment of an SSI? Select one: a. hemoglobin and hematocrit b. plethysmography c. isotope scanning d. culture and sensitivity
culture and sensitivity
Which of the following describes the configuration of a Mayo stand cover?
cylindrical
what is the term for removal of foreign material or contaminated debris from wound?
debridement
Which type of sterile gown uses battery-powered ventilation for the wearer?
disposable fluid resistent
Where are the parathyroid glands located in relation to the thyroid?
dorsal, superior, and inferior
Which component of personal protective equipment (PPE) has shown the ability to decrease disease transmission from needle punctures?
double gloving
Which of the following are NOT Considered countable items for potential of retained foreign objects?
dressings
cephalopelvic disproportion is a component of which of the following indications for a c section delivery?
dystocia
Tubal ligation is performed for:
elective sterilization
a gastrostomy can be created by all of the following methods except:
endovasular
Natural absorbable sutures are broken down in the body by:
enzymatic digestion
A Maloney bougie dilator is used in which anatomical structure?
esophagus
Which postoperative wound complication wound require immediate surgical treatment?
evisceration
Which suture technique involves making a know in the suture outside of the body and then pushing it inside through a cannula?
extracorporeal method
which type of hernia occurs below the abdominal crease and more frequently in females
femoral
Which type of healing occurs in an aseptic wound with good approximation and ideal surgical conditions?
first intention
what is the term for the normal resident microbial populations found on human skin?
flora
A way in which the surgical technologist can assist the surgeon by keeping the suture strand out of the way during a continuous running closure by:
following
How many stages of labor and delivery does the patient go through?
four
Delivery of the placenta is the conclusion of which stage of labor
fourth
What is the temporary position for a female patient for placement of urinary catheter prior to abdominal hysterectomy?
frog-legged
The patient undergoing laparotomy should be prepped:
from the incision site outward toward the periphery in a circular motion
An AP view on a radiograph is taken:
front to back
A vagotomy is a surgical treatment option for:
gastric ulcers
During cholangiography, bubbles in the contrast media would likely:
give the appearance of a stone on x-ray
When turning the sterile gown, what is handed to the circulator that completes the gowning process?
gown tab or card
Which handheld retractors are frequently used to retract tissues during thyroidectomy?
green
What term describes a benign condition of breast enlargement in men?
gynecomastia
Which of the following statements regarding hair removal is incorrect?
hair must be shaved from every incisional and ECG lead site
what is another way of saying "cephalad to caudad"
head to tail
Which of the following is a genetic clotting deficiency?
hemophilia
Dilation of the submucosal and subcutaneous venous plexus that lines the anal canal is called
hemorrhoid
To achieve the goal of leaving as little foreign material in a wound, the ideal suture selected should have:
high-tensile strength and small diameter
which gynecologic procedure is used for visualization of the endometrium and may be used to treat polyps or myomas?
hysteroscopy
A Patient undergoing chemotherapy and radiation therapy for cancer might experience prolonged wound healing due to
immunosuppresed status
What type of hernia results from a failure of the deep internal ring to close during fetal development and allows intestinal protrusion into the scrotum?
indirect
where is the gallbladder located in relation to the liver:
inferior surface of the right lobe
Which phase of healing for wounds closed by first intention begins within minutes of the incision or injury?
inflammatory
Which of the following wounds would be assigned a Class I?
inguinal hernia repair with no breaks in technique
Which of the following is routinely done first in a basic gynecologic laparoscopy that may require a small separate set up and glove change before proceeding?
insertion of uterine manipulator
The suturing technique MOST appropriate for wounds likely to become infected or suffer potential stress is
interrupted
Doyen, Kocher, Dennis, and Allen are names of which type of instrument? Select one: a. laparoscopic graspers b. tissue scissors c. intestinal clamps d. abdominal retractors
intestinal clamps
which internal stapling device fires a circular double row of staples to reanastomose the colon?
intraluminal stapler
Contrast Media are routinely introduced?
intravenously
Which type of intestinal obstruction involves a telescoping of a portion of the intestine into another portion ?
intussuception
What is a common component of many contrast media that may be a contraindication for use in allergic patients?
iodine
If tissue is approximated too tightly, it can cause
ischemia
Which of the following are endocrine-secreting glands fo the pancreas that make up only 1% of the organ?
islets of langerhans
Instruments used for closure of the vaginal cuff in TAH are:
isolated as contaminated
which surgical position is used exclusively for anorectal surgical procedures?
kraske
what term is used for surgical opening of the abdominal or peritoneal cavity?
laparotomy
For which position would the head of the OR table be moved to the foot before the patient is placed on the table? Select one: a. jackknife b. lateral kidney c. Trendelenburg d. lithotomy
lithotomy
For which anatomic area is ultrasonography ineffective?
lungs
B-Cells and T-Cells are types of:
lymphotcytes
Radiation, convection, conduction, and evaporation are examples of
mechanisms of intraoperative heat loss
In which of the following abdominal incisions would the linea alba be opened down to the peritoneum?
median vertical
Which of the following would NOT be an appropriate method of performing a surgical scrub/skin preparation?
medical hand wash
Which of the following tissues is not part of the abdominal wall closure when retention sutures are placed?
mesentery
in preparing a patient for surgery which of the following should be removed to facilitate oxygen blood level assessment?
nail polish
For which of the following diagnoses would a myelogram MOST likely be ordered?
nerve root compression
What color is the abdominal tissue after staining with lugol's solution in a cervical biopsy?
no color change
What is another term used for diagnostic isotope scanning?
nuclear medicine
Ligatures are used to:
occlude the lumen of a blood vessel
A T-tube or wound drain left in place following laparoscopic cholecystectomy would most likely exit through:
one of the 5 mm right port incisions
Which method of gloving is appropriate for placement of a urinary catheter as part of the skin prep?
open gloving
A corneal abrasion would be assessed using a(n):
opthalmoscope
which medication may be injected into the uterus for hemostasis, before closure of the uterus in a C Section?
oxytocin
Before opening any supplies for delivery to the sterile field, what must be verified?
package integrity being intact and not violated
Which table attachment is required to safely maintain a patient in the reverse trendelenburg position?
padded footboard
A whipple procedure is done for treatment of a tumor in which abdominal organ?
pancreas
What is the name for the type of hernia in which both direct and indirect defects are present?
pantaloon
Which incision is most frequently used for cesarean sections?
pfannedstiel
A deep vein thrombosis can be diagnosed by which diagnostic study?
phleborheography
Which condition of excess fluid is analyzed by thoracentesis?
plural effusion
what is achieved by insufflation of carbon dioxide into the abdominal cavity?
pneumoperitoneum
Which method of tubal ligation (sterilization) is most frequently used?
pomeroy
Bifurcated drains and fluffy pressure dressings are used for following mastectomy primarily to:
prevent formation of hematoma and seroma
cervical cerlage is performed to
prevent spontaneous abortion
Which position requires anesthesia administration and intubation to be performed on the patient's stretcher prior to final positioning?
prone
Evisceration of the abdominal wound is:
protrusion of viscera through all tissue layers
Which suturing technique would be used to close the stump of the appendix in an open appendectomy?
purse-string
which suturing technique is often used on the appendiceal stump?
pursestring
when transporting a patient on a stretcher through the OR Suite corridors, which method should be followed?
push the stretcher with the patient facing feet first in the position most comfortable for the patient
which procedure involves an en bloc removal of the uterus, bilateral ovaries and Fallopian tubes, supporting ligaments, upper third of the vagina, and pelvic lymph nodes?
radical hysterectomy
Roentgenography, named for the german physicist who discovered it, is better known today as:
radiography
An intestinal stoma is created at a point below the costal margin, above the belt line, and at the lateral edge of which muscle?
rectus abdominus
The main purpose for the surgical skin prep is to
reduce the microbial count on the skin to an irreducible minimum
Which of the following techniques of counting sponges on the sterile field is an example of best practice?
remove paper bands around sponges, separate each sponge into separate piles while counting aloud with the circulator
Which position would facilitate exposure of the operative area during a laparoscopic cholecystectomy?
reverse Trendelenburg w. slight tilt to the left
what is the incision rountinely used for open cholecystectomy?
right subcostal
Which towel is placed first when squaring off the operative site?
same side as the person applying towels
A nuerologist might order an EEG for a patient with a which suspected diagnosis?
seizure disorder
What is the name for the first lymph nose in the axillary chain that is frequently biopsied in conjunction with a breast biopsy, lumpectomy, or mastectomy?
sentinel
Surgical removal of the entire breast without any lymph nodes is a(n):
simple mastectomy
What is the name of the device used to manually assess blood pressure
sphygmomanometer
which anatomical structure is the largest mass of lymphatic tissue in the body?
spleen
kitners, cottonoids, and laps are surgical: a. clamps b. ligatures c. sponges d. tourniquets
sponges
Which suture is MOST Inert in tissue?
stainless steel
Auscultation involves use of a(n):
stethoscope
What is the term used for the area beneath the fingernails that is cleaned with a pick during the surgical scrub?
subungual
trendelenburg, reverse trendelenburg, fowler's and lithotomy are variations of which basic position?
supine
Best practice states that all of the following items remain sterile until the patient leaves the room, EXCEPT:
surgical drapes
Which term describes the condition of a surgical technologist's following skin prep?
surgically clean
Tissue trauma is minimized by using which type of suture-needle combination?
suture permanently swaged on an eyeless needle
What is the term for a type of suture that has the strand of suture material inserted into the hollowed-out needle end?
swaged
what is the term that describes the measure of how much a suture strand can be stretched before breaking?
tensile strength
Which potentially life-threatening disease or condition can result from an untreated thyrotoxicosis?
thyroid storm
Tetany is a serious potential post-op complication of which type of surgical intervention?
thyroidectomy/parathyroidectomy
What does TEP stand for in general surgery?
totally extraperitoneal patch
The hepatic and splenic flexures are located proximally and distally in which part of the large intestine?
transverse
A typical end to end bowel anastomosis is accoomplished with which of the following suturinf techniques?
two-layer, interrupted technique for seromuscular approximation with silk, continuous for muscosa, with absorable, surture
For a dilation and curettage (D&C), which of the following orders of instrument use is correct for endometrial biopsy?
weighted vaginal speculum, tenaculum, uterine sound, cervical dilators, endometrial biopsy
What is the name of the common disposable surgical gown style?
wraparound