CFA Anatomy, Physiology & Surgical Pathology 3 — Questions and Answers
Question 1: Which type of surgical wound classification carries the highest risk of postoperative infection?
- Class I (Clean)
- Class II (Clean-contaminated)
- Class III (Contaminated)
- Class IV (Dirty-infected) (Correct answer)
Correct answer: Class IV (Dirty-infected)
Class IV dirty-infected wounds involve existing infection or perforated viscera and carry infection rates exceeding 40%.
Question 2: The blood supply to the femoral head is primarily provided by branches of the:
- Obturator artery alone
- Medial femoral circumflex artery (Correct answer)
- Lateral femoral circumflex artery
- Superior gluteal artery
Correct answer: Medial femoral circumflex artery
The medial femoral circumflex artery supplies the majority of blood to the femoral head; its disruption in femoral neck fractures causes avascular necrosis.
Question 3: Surgical emphysema (subcutaneous emphysema) is air trapped in which tissue layer?
- Pleural space
- Peritoneal cavity
- Subcutaneous tissue (Correct answer)
- Fascial compartments of the limb
Correct answer: Subcutaneous tissue
Surgical emphysema refers specifically to air dissecting into the subcutaneous tissue, producing a characteristic crackling sensation on palpation.
Question 4: A patient undergoing thyroidectomy is at risk for hypocalcemia because of inadvertent removal of the:
- Thyroid isthmus
- Parathyroid glands (Correct answer)
- Cervical lymph nodes
- Recurrent laryngeal nerve
Correct answer: Parathyroid glands
The four parathyroid glands regulate calcium homeostasis, and their accidental excision or devascularization during thyroidectomy causes postoperative hypocalcemia.
Question 5: In the context of surgical pathology, 'dysplasia' refers to:
- Irreversible tissue death following ischemia
- Abnormal cellular growth with loss of normal differentiation (Correct answer)
- Increase in cell size without change in number
- Complete replacement of one cell type by another normal cell type
Correct answer: Abnormal cellular growth with loss of normal differentiation
Dysplasia describes disordered, abnormal cellular proliferation that may be a precursor to malignancy but is not yet invasive.
Question 6: The hepatoduodenal ligament forming the anterior border of the epiploic foramen (foramen of Winslow) contains all of the following EXCEPT:
- Portal vein
- Common bile duct
- Hepatic artery
- Inferior vena cava (Correct answer)
Correct answer: Inferior vena cava
The hepatoduodenal ligament contains the portal vein (posterior), hepatic artery (left), and common bile duct (right); the IVC lies behind the foramen, not within the ligament.
Question 7: Which physiological process is primarily responsible for wound contraction during the proliferative phase of healing?
- Epithelial cell migration
- Collagen cross-linking by lysyl oxidase
- Myofibroblast contraction (Correct answer)
- Angiogenesis via VEGF
Correct answer: Myofibroblast contraction
Myofibroblasts, which possess smooth muscle-like contractile properties, are responsible for drawing wound edges together during wound contraction.
CFA Anatomy, Physiology & Surgical Pathology 3
Which type of surgical wound classification carries the highest risk of postoperative infection?