FREE FLS Instrumentation and Physiologic Principles Questions and Answers
What is the recommended initial trocar location for laparoscopic surgery?
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?
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.
Which cardiovascular effect is most likely due to the effects of pneumoperitoneum during laparoscopic surgery?
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.
What should you do with the harmonic scalpel to avoid inadvertent injury?
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?
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 best alternate site for Veress needle insertion besides the umbilicus?
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.
What does ASA class 3 indicate?
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.
During monopolar cautery, which method involves quickly turning cell water to steam, causing the cell to explode?
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.
The use of all-plastic or all-metal trocars can avoid which problem?
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.
Which of the following is NOT a sign of gas embolus during laparoscopic surgery?
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.
Midline (umbilical) Veress needle placement is worrisome for injuring which structure?
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.