General Surgery Board Review General Surgery Board Review Anatomy & Surgical Procedures 2 — Questions and Answers
Question 1: Which bowel anastomosis technique is preferred to minimize ischemia at the anastomotic line?
- Continuous locked suture
- Interrupted single-layer technique (Correct answer)
- Continuous Connell suture
- Running horizontal mattress
Correct answer: Interrupted single-layer technique
A single-layer interrupted technique preserves mucosal blood supply better than multi-layer or locked continuous techniques, reducing ischemia at the anastomosis.
Question 2: During inguinal hernia repair, the ilioinguinal nerve travels through which structure?
- Femoral canal
- Inguinal canal (Correct answer)
- Obturator foramen
- Sciatic notch
Correct answer: Inguinal canal
The ilioinguinal nerve traverses the inguinal canal and exits through the superficial inguinal ring, providing sensory innervation to the medial thigh and scrotum/labia.
Question 3: The Kocher maneuver (mobilization) provides surgical access to which structure?
- Splenic hilum
- Left lobe of the liver
- Duodenum and head of pancreas (Correct answer)
- Descending colon
Correct answer: Duodenum and head of pancreas
The Kocher maneuver involves mobilizing the duodenum and head of the pancreas by incising the lateral peritoneal reflection, providing access to the retroduodenal and retropancreatic areas.
Question 4: During a standard Whipple procedure (pancreaticoduodenectomy), which structure is NOT routinely resected?
- Head of pancreas
- Duodenum
- Gallbladder
- Body and tail of pancreas (Correct answer)
Correct answer: Body and tail of pancreas
The standard Whipple removes the pancreatic head, duodenum, gallbladder, distal common bile duct, and sometimes the distal stomach; the body and tail of the pancreas are preserved.
Question 5: Which port placement is standard for the camera during laparoscopic appendectomy?
- Right lower quadrant
- Left lower quadrant
- Umbilical (Correct answer)
- Epigastric
Correct answer: Umbilical
The camera port is placed at the umbilicus to provide a central view of the right lower quadrant; working ports are placed in the suprapubic and left lower quadrant positions.
Question 6: The Pfannenstiel incision primarily provides access to which anatomical region?
- Upper abdomen and liver
- Retroperitoneum
- Pelvis and lower abdomen (Correct answer)
- Right upper quadrant
Correct answer: Pelvis and lower abdomen
The Pfannenstiel incision, made transversely above the pubic symphysis, provides excellent exposure of pelvic structures and is commonly used for cesarean sections and pelvic operations.
General Surgery Board Review General Surgery Board Review Anatomy & Surgical Procedures 2
Which bowel anastomosis technique is preferred to minimize ischemia at the anastomotic line?