CST Specialty Surgical Procedures 3 — Questions and Answers
Question 1: In neurosurgery, what is the purpose of a Mayfield skull clamp?
- To retract brain tissue
- To rigidly fix the head in position (Correct answer)
- To control intracranial bleeding
- To measure intracranial pressure
Correct answer: To rigidly fix the head in position
The Mayfield three-pin skull clamp rigidly immobilizes the head to prevent any movement during intracranial procedures.
Question 2: Which retractor system is most commonly used to expose the lumbar spine during a posterior spinal fusion?
- Bookwalter retractor
- Taylor retractor
- Weitlaner self-retaining retractor (Correct answer)
- Gelpi retractor
Correct answer: Weitlaner self-retaining retractor
The Weitlaner self-retaining retractor provides sustained lateral retraction of the paraspinal muscles during posterior lumbar spine approaches.
Question 3: During ophthalmic surgery for cataract removal using phacoemulsification, what does the handpiece do?
- Cuts the anterior capsule
- Uses ultrasonic energy to emulsify and aspirate the lens (Correct answer)
- Injects viscoelastic into the anterior chamber
- Measures intraocular pressure
Correct answer: Uses ultrasonic energy to emulsify and aspirate the lens
The phacoemulsification handpiece uses ultrasonic vibration to fragment the lens nucleus, which is then aspirated through the same tip.
Question 4: What is the primary role of the surgical technologist during the intraoperative phase of a liver resection (hepatectomy)?
- Monitor the patient's blood pressure
- Anticipate and pass instruments, maintain sterile field integrity (Correct answer)
- Adjust anesthetic gas delivery
- Document instrument counts only
Correct answer: Anticipate and pass instruments, maintain sterile field integrity
The scrub surgical technologist anticipates the surgeon's needs, passes instruments efficiently, and maintains strict sterile field integrity throughout the procedure.
Question 5: During a Whipple procedure (pancreaticoduodenectomy), which structure is anastomosed to the jejunum to restore biliary drainage?
- Cystic duct
- Common bile duct (choledochojejunostomy) (Correct answer)
- Gallbladder fundus
- Hepatic artery
Correct answer: Common bile duct (choledochojejunostomy)
A choledochojejunostomy reconnects the common bile duct to a loop of jejunum to restore bile flow after removal of the head of the pancreas.
Question 6: Which suture is most appropriate for anastomosing bowel segments during intestinal resection?
- Silk (non-absorbable)
- Polyglycolic acid (absorbable) (Correct answer)
- Stainless steel wire
- Nylon monofilament
Correct answer: Polyglycolic acid (absorbable)
Absorbable sutures such as polyglycolic acid (Vicryl/Dexon) are preferred for bowel anastomoses as the suture is absorbed after the tissue has healed.
Question 7: In thoracic surgery, what is the function of a double-lumen endotracheal tube during a pneumonectomy?
- Deliver higher oxygen concentrations
- Allow one-lung ventilation by isolating each lung (Correct answer)
- Measure pulmonary artery pressure
- Provide CPAP to the operative lung
Correct answer: Allow one-lung ventilation by isolating each lung
A double-lumen ETT allows one-lung ventilation so the operative lung can be deflated and collapsed, providing the surgeon with an unobstructed operative field.
CST Specialty Surgical Procedures 3
In neurosurgery, what is the purpose of a Mayfield skull clamp?