CSFA Intraoperative Surgical Procedures 3

Question 1

During a thoracotomy, the surgical first assistant is asked to place a rib retractor. After inserting the retractor, how should spreading be performed?

Accepted Answer

Spread slowly and incrementally to minimize rib fracture

Answer

Gradual incremental spreading reduces the risk of rib fracture and neurovascular injury between intercostal spaces.

Question 2

Which knot is most appropriate when tying a deep pelvic suture with limited visibility and restricted hand movement?

Accepted Answer

Instrument tie

Answer

An instrument tie allows precise knot placement in deep, restricted spaces where hand tying is impractical.

Question 3

In a Whipple procedure (pancreaticoduodenectomy), which anastomosis is typically performed first?

Accepted Answer

Pancreaticojejunostomy

Answer

The pancreaticojejunostomy is technically the most challenging and is typically constructed first when the field is least fatigued.

Question 4

A surgeon requests 'figure-of-eight' sutures for fascial closure. The surgical first assistant should pass:

Accepted Answer

A single suture passed in a crossing pattern through tissue on each side creating an X configuration

Answer

A figure-of-eight suture passes through tissue twice in a crossing pattern, distributing tension and providing secure fascial closure.

Question 5

During a thyroidectomy, inadvertent injury to which structure would most likely result in immediate hoarseness?

Accepted Answer

Recurrent laryngeal nerve

Answer

The recurrent laryngeal nerve innervates the intrinsic laryngeal muscles responsible for vocal cord movement; injury causes immediate hoarseness.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Intraoperative Surgical Procedures 3