Intraoperative Surgical Procedures Flashcards
7 cards from real CSFA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Intraoperative Surgical Procedures flashcards as text
During a thoracotomy, the surgical first assistant is asked to place a rib retractor. After inserting the retractor, how should spreading be performed?
Answer: Spread slowly and incrementally to minimize rib fracture
Gradual incremental spreading reduces the risk of rib fracture and neurovascular injury between intercostal spaces.
Which knot is most appropriate when tying a deep pelvic suture with limited visibility and restricted hand movement?
Answer: Instrument tie
An instrument tie allows precise knot placement in deep, restricted spaces where hand tying is impractical.
In a Whipple procedure (pancreaticoduodenectomy), which anastomosis is typically performed first?
Answer: Pancreaticojejunostomy
The pancreaticojejunostomy is technically the most challenging and is typically constructed first when the field is least fatigued.
A surgeon requests 'figure-of-eight' sutures for fascial closure. The surgical first assistant should pass:
Answer: A single suture passed in a crossing pattern through tissue on each side creating an X configuration
A figure-of-eight suture passes through tissue twice in a crossing pattern, distributing tension and providing secure fascial closure.
During a thyroidectomy, inadvertent injury to which structure would most likely result in immediate hoarseness?
Answer: Recurrent laryngeal nerve
The recurrent laryngeal nerve innervates the intrinsic laryngeal muscles responsible for vocal cord movement; injury causes immediate hoarseness.
When assisting with a laparotomy in a patient with a history of multiple prior abdominal surgeries, the surgical first assistant should anticipate:
Answer: Dense adhesions requiring careful lysis before proceeding
Prior abdominal surgeries reliably result in adhesion formation, which must be carefully lysed to prevent enterotomy.
The surgical first assistant is asked to irrigate the peritoneal cavity at the end of a bowel resection. Which irrigant is most appropriate?
Answer: Warm normal saline or Ringer's lactate
Warm isotonic saline or Ringer's lactate effectively dilutes contaminants without damaging peritoneal tissue.