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