Instrumentation and Physiologic Principles Flashcards

During monopolar cautery, which method involves quickly turning cell water to steam, causing the cell to explode?

Answer: Cutting

Explanation: During monopolar cautery, the cutting mode uses high-frequency electrical current to rapidly vaporize tissue, turning cell water into steam and causing the cell to explode. This process allows for precise tissue cutting during surgery.

What does ASA class 3 indicate?

Answer: Severe systemic disease that limits the patient's activity and may or may not be related to the reason for surgery

Explanation: ASA class 3 denotes a patient with severe systemic disease that limits their activity, and this condition may or may not be related to the reason for surgery. It indicates significant health concerns that may impact the patient's perioperative care and overall outcome.

The use of all-plastic or all-metal trocars can avoid which problem?

Answer: Capacitative coupling

Explanation: All-plastic or all-metal trocars eliminate the risk of capacitative coupling, which can occur when a metal trocar comes into contact with an insulated electrosurgical instrument, leading to unintended energy transfer and tissue injury. Using trocars made of non-conductive materials prevents this problem.

What should you do with the harmonic scalpel to avoid inadvertent injury?

Answer: All of the above

Explanation: To avoid inadvertent injury with the harmonic scalpel, it's important to be aware of the blade, grab and elevate your target, and keep the active blade upwards and in view to prevent unintended tissue damage. These precautions help ensure safe and effective use of the harmonic scalpel during laparoscopic surgery.

Which statement is NOT true about general anesthesia in laparoscopic surgery?

Answer: Fewer hemodynamic changes compared to local anesthesia

Explanation: General anesthesia typically induces significant hemodynamic changes, including alterations in blood pressure and heart rate, whereas local anesthesia generally produces fewer systemic effects.

What is the recommended initial trocar location for laparoscopic surgery?

Answer: Umbilicus

Explanation: The umbilicus is the standard initial trocar insertion site for laparoscopic surgery. This location provides central access to the abdominal cavity and facilitates instrument insertion for various procedures. Additionally, it minimizes the risk of injury to surrounding structures.

When checking the Veress needle during laparoscopic surgery, which is the most accurate indicator to ensure proper placement?

Answer: Flow of CO2 and low pressures

Explanation: The most accurate indicator of proper Veress needle placement is the flow of CO2 with low pressures. This indicates that the needle tip is in the peritoneal cavity, allowing for safe insufflation of the abdomen. Aspirating blood or enteric contents may indicate inadvertent vessel or bowel penetration, while no flow of CO2 or high pressures may suggest improper needle placement.

What is the best alternate site for Veress needle insertion besides the umbilicus?

Answer: Palmer's point

Explanation: Palmer's point, located in the left upper quadrant just below the costal margin, is considered the best alternate site for Veress needle insertion besides the umbilicus. This site provides access to the peritoneal cavity while minimizing the risk of injury to intra-abdominal organs.

Midline (umbilical) Veress needle placement is worrisome for injuring which structure?

Answer: The aorta

Explanation: Midline (umbilical) Veress needle placement poses a risk of injuring the aorta, a major blood vessel located in the abdominal cavity. Proper needle placement and careful technique are essential to avoid such complications during laparoscopic surgery.

Which cardiovascular effect is most likely due to the effects of pneumoperitoneum during laparoscopic surgery?

Answer: Bradycardia

Explanation: Bradycardia, or a decrease in heart rate, is the cardiovascular effect most commonly associated with the effects of pneumoperitoneum during laparoscopic surgery. This response is believed to be mediated by the vagal nerve stimulation caused by the elevated intra-abdominal pressure.

Which of the following is NOT a sign of gas embolus during laparoscopic surgery?

Answer: Bradycardia

Explanation: While hypotension, tachycardia, and a mill wheel murmur are signs of gas embolus during laparoscopic surgery, bradycardia is not typically associated with this complication. Bradycardia is more commonly seen as a response to pneumoperitoneum, rather than gas embolism.