CFA Surgical Positioning & Draping 2 — Questions and Answers
Question 1: Which positioning device conforms to the patient's body contours and provides stable support in the lateral decubitus position?
- Allen stirrups
- Bean bag positioner (Correct answer)
- Mayfield headrest
- Andrews frame
Correct answer: Bean bag positioner
A bean bag positioner uses small beads that mold to the patient's body when suction is applied, creating a rigid, custom-contoured support for the lateral position.
Question 2: Which complication associated with prone positioning can result from direct pressure on the orbital region?
- Brachial plexus stretch injury only
- Ischemic optic neuropathy causing blindness (Correct answer)
- Lumbosacral nerve compression only
- Deep vein thrombosis
Correct answer: Ischemic optic neuropathy causing blindness
In prone position, direct orbital pressure can compress blood flow to the optic nerve, causing ischemic optic neuropathy and potentially resulting in permanent vision loss.
Question 3: The kidney rest is elevated to improve surgical access during which type of procedure?
- Thoracotomy in lateral position
- Flank surgery for retroperitoneal access (Correct answer)
- Pelvic laparotomy in lithotomy
- Shoulder arthroscopy in beach-chair position
Correct answer: Flank surgery for retroperitoneal access
The kidney rest elevates the flank and lumbar region to open the space between the iliac crest and rib cage, improving retroperitoneal access during kidney surgery.
Question 4: When applying a sterile drape, the first assistant should protect sterility by:
- Folding contaminated edges inward before placement
- Cuffing the drape over gloved hands before contact with the patient (Correct answer)
- Allowing the circulator to unfold and position all drapes
- Grasping only the center of the drape during placement
Correct answer: Cuffing the drape over gloved hands before contact with the patient
Cuffing the drape over gloved hands creates a sterile barrier that prevents the gloves from contacting non-sterile patient skin or table surfaces during draping.
Question 5: Which arm position during supine surgery presents the greatest risk for brachial plexus injury?
- Arms abducted to 90° on padded armboards
- Arms tucked securely at the patient's sides
- Arms hyperabducted beyond 90° (Correct answer)
- Arms resting in a neutral position at the patient's sides
Correct answer: Arms hyperabducted beyond 90°
Abducting the arms beyond 90° places excessive stretch on the brachial plexus, which can result in neuropraxia or permanent nerve injury.
Question 6: During a laparoscopic cholecystectomy, what is the recommended table position to improve visualization of the gallbladder?
- Flat supine with no tilt
- Reverse Trendelenburg with right side elevated (Correct answer)
- Trendelenburg with left side elevated
- Prone with slight head elevation
Correct answer: Reverse Trendelenburg with right side elevated
Reverse Trendelenburg with right-side-up tilt uses gravity to displace bowel away from the liver and gallbladder, improving laparoscopic visualization of the hepatobiliary operative field.
Question 7: If a sterile drape becomes contaminated during placement, what is the correct action?
- Fold the contaminated edge under to conceal it and proceed
- Remove and replace the drape immediately with a new sterile drape (Correct answer)
- Place a sterile towel over the contaminated area and continue
- Document the contamination and notify the surgeon at the end
Correct answer: Remove and replace the drape immediately with a new sterile drape
A contaminated drape must be removed entirely and replaced with a new sterile drape; sterility cannot be restored once a breach has occurred.
CFA Surgical Positioning & Draping 2
Which positioning device conforms to the patient's body contours and provides stable support in the lateral decubitus position?