CSFA General Practice 4

Question 1

A patient develops sudden oxygen desaturation during a right thoracotomy. The anesthesiologist reports loss of breath sounds on the left side. The MOST likely cause is:

Accepted Answer

Inadvertent endobronchial intubation

Answer

Endobronchial (right mainstem) intubation during repositioning or tube migration results in left lung exclusion, causing left-sided breath sound loss and desaturation.

Question 2

The surgical first assistant is retracting during a carotid endarterectomy. Which intraoperative neurological monitoring modality is MOST commonly used to detect cerebral ischemia during carotid clamping?

Accepted Answer

Electroencephalography (EEG)

Answer

Continuous EEG monitoring during carotid endarterectomy detects cortical ischemia during carotid clamping by showing characteristic frequency slowing or amplitude reduction.

Question 3

During a mastectomy, the surgical first assistant is dissecting along the chest wall. Which muscle forms the posterior boundary of the axilla and must be preserved to maintain shoulder function?

Accepted Answer

Serratus anterior

Answer

The serratus anterior muscle protracts and rotates the scapula; injury to its long thoracic nerve innervation causes winged scapula and impaired shoulder abduction.

Question 4

When using a pneumatic tourniquet on an upper extremity, the cuff should be inflated to approximately how much above the patient's systolic blood pressure?

Accepted Answer

75 mmHg above systolic

Answer

For upper extremity tourniquets, inflation pressure is typically set at 50-75 mmHg above systolic blood pressure (commonly 75 mmHg) to ensure arterial occlusion without excessive pressure.

Question 5

During a splenectomy, the surgical first assistant is dividing the splenic ligaments. Injury to which vessel in the splenorenal ligament would cause the MOST immediate life-threatening hemorrhage?

Accepted Answer

Splenic artery and vein

Answer

The splenic artery and vein are the largest vessels in the splenorenal ligament; injury causes massive hemorrhage requiring immediate vascular control.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA General Practice 4