Certified Surgical Technologist Intraoperative Procedures 3 — Questions and Answers
Question 1: During a craniotomy, bone wax is used to:
- Secure the bone flap in place after closure
- Control bleeding from cancellous bone of the skull (Correct answer)
- Prevent cerebrospinal fluid leakage
- Reduce brain swelling during the procedure
Correct answer: Control bleeding from cancellous bone of the skull
Bone wax is a hemostatic agent packed into bleeding diploë (cancellous bone) of the skull to mechanically tamponade hemorrhage.
Question 2: Which position places the patient flat on their back with legs elevated in stirrups?
- Trendelenburg
- Reverse Trendelenburg
- Lithotomy (Correct answer)
- Lateral decubitus
Correct answer: Lithotomy
Lithotomy position has the patient supine with hips flexed and legs elevated in stirrups, used for gynecological, urological, and colorectal procedures.
Question 3: When handing a scalpel to the surgeon, the scrub tech should use the:
- Direct hand-to-hand pass with blade pointing up
- Neutral zone (hands-free) technique placing it in a designated area (Correct answer)
- Dominant hand with the handle facing the surgeon's thumb
- Non-dominant hand while maintaining eye contact
Correct answer: Neutral zone (hands-free) technique placing it in a designated area
The neutral zone (hands-free) technique requires placing sharp instruments in a designated basin or pad so neither party is exposed to simultaneous contact with the blade.
Question 4: The purpose of a self-retaining retractor such as a Balfour retractor is to:
- Provide manual retraction by the assistant
- Hold the wound open without requiring manual effort (Correct answer)
- Retract delicate neurovascular structures
- Provide counter-traction during fascial closure
Correct answer: Hold the wound open without requiring manual effort
Self-retaining retractors like the Balfour maintain wound exposure independently, freeing surgical team members from manual retraction duties.
Question 5: Raytec (X-ray detectable) sponges are used intraoperatively rather than standard gauze because:
- They are more absorbent than regular gauze
- They can be identified on postoperative X-ray if accidentally retained (Correct answer)
- They are less likely to adhere to delicate tissue
- They are cheaper and more readily available
Correct answer: They can be identified on postoperative X-ray if accidentally retained
Raytec sponges contain a radiopaque filament detectable on X-ray, which allows identification of any retained sponge during postoperative imaging.
Question 6: During a thyroidectomy, the surgeon asks for a nerve stimulator. This instrument is used to:
- Coagulate small bleeding vessels near the thyroid
- Identify and confirm the recurrent laryngeal nerve to avoid injury (Correct answer)
- Measure parathyroid hormone levels intraoperatively
- Stimulate thyroid gland contraction during excision
Correct answer: Identify and confirm the recurrent laryngeal nerve to avoid injury
A nerve stimulator delivers a small electrical impulse to identify and map the recurrent laryngeal nerve, preventing inadvertent injury during thyroidectomy.
Question 7: Which hemostatic agent is derived from oxidized cellulose and works by creating an artificial clot?
- Gelfoam (gelatin sponge)
- Surgicel (oxidized regenerated cellulose) (Correct answer)
- Thrombin
- Bone wax
Correct answer: Surgicel (oxidized regenerated cellulose)
Surgicel is made from oxidized regenerated cellulose that lowers pH and denatures blood proteins, creating a coagulum that promotes hemostasis.
Certified Surgical Technologist Intraoperative Procedures 3
During a craniotomy, bone wax is used to: