FLS FLS Pneumoperitoneum and Insufflation 2

Question 1

What is the primary cardiovascular effect of elevated intraabdominal pressure (>15 mmHg) during laparoscopy?

Accepted Answer

Decreased venous return and reduced cardiac output

Answer

Elevated IAP compresses the inferior vena cava, reducing venous return and preload, which decreases cardiac output.

Question 2

The Palmer's point entry site for Veress needle insertion is located at:

Accepted Answer

3 cm below the left costal margin in the midclavicular line

Answer

Palmer's point, 3 cm below the left costal margin in the midclavicular line, is used as an alternative entry site when umbilical adhesions are suspected.

Question 3

During laparoscopy, hypercarbia (elevated PaCO₂) occurs primarily because:

Accepted Answer

CO₂ diffuses across the peritoneum into the bloodstream

Answer

CO₂ used for insufflation readily diffuses across the peritoneal membrane into the bloodstream, raising PaCO₂ and requiring increased minute ventilation.

Question 4

A 'hissing' sound heard when the Veress needle is inserted into the abdomen most likely indicates:

Accepted Answer

Correct peritoneal entry with free gas flow

Answer

A hissing sound as gas flows freely indicates the needle tip is in the peritoneal cavity with low resistance, confirming correct placement.

Question 5

The 'aspiration test' during Veress needle placement involves attaching a syringe and aspirating; a positive (correct placement) result is:

Accepted Answer

No aspirate and free saline instillation without resistance

Answer

No aspirate combined with free instillation of saline (which drops in without resistance) confirms the needle is in the free peritoneal space.

FLS - Fundamentals of Laparoscopic Surgery Practice Test

FLS - Fundamentals of Laparoscopic Surgery Practice Test

FLS FLS Pneumoperitoneum and Insufflation 2