General Surgery Board Review General Surgery Board Review Anatomy & Surgical Procedures 1 — Questions and Answers
Question 1: The critical view of safety (CVS) in laparoscopic cholecystectomy requires identification of which two structures entering the gallbladder?
- Common hepatic duct and cystic vein
- Cystic duct and cystic artery (Correct answer)
- Common bile duct and right hepatic artery
- Cystic duct and common bile duct
Correct answer: Cystic duct and cystic artery
The critical view of safety requires clear identification of the cystic duct and cystic artery, with the hepatocystic triangle dissected free of fat and fibrous tissue.
Question 2: The triangle of Calot is bounded by the cystic duct, common hepatic duct, and which third structure?
- Inferior surface of the liver (Correct answer)
- Gallbladder neck
- Right hepatic artery
- Portal vein
Correct answer: Inferior surface of the liver
Calot's triangle is bounded superiorly by the inferior surface of the liver, medially by the common hepatic duct, and inferiorly by the cystic duct.
Question 3: Which nerve is at greatest risk during thyroidectomy, and its unilateral injury causes hoarseness?
- External branch of the superior laryngeal nerve
- Recurrent laryngeal nerve (Correct answer)
- Hypoglossal nerve
- Vagus nerve trunk
Correct answer: Recurrent laryngeal nerve
The recurrent laryngeal nerve innervates all intrinsic laryngeal muscles except the cricothyroid; its injury results in ipsilateral vocal cord paralysis and hoarseness.
Question 4: McBurney's point, used to locate the appendix, is located at which anatomical position?
- One-third the distance from the right ASIS to the umbilicus
- Two-thirds the distance from the right ASIS to the umbilicus (Correct answer)
- One-third the distance from the left ASIS to the umbilicus
- Midpoint between the right ASIS and pubic symphysis
Correct answer: Two-thirds the distance from the right ASIS to the umbilicus
McBurney's point is located two-thirds of the distance from the right anterior superior iliac spine (ASIS) to the umbilicus, corresponding to the typical appendix base.
Question 5: During a midline laparotomy, which layer is encountered immediately before entering the peritoneal cavity?
- External oblique fascia
- Internal oblique fascia
- Transversalis fascia (Correct answer)
- Linea alba
Correct answer: Transversalis fascia
The transversalis fascia lines the internal aspect of the abdominal wall and is the last fascial layer encountered before the peritoneum during a midline approach.
Question 6: Within the femoral triangle, structures are arranged from lateral to medial in which order?
- Nerve, artery, vein (Correct answer)
- Vein, artery, nerve
- Artery, vein, nerve
- Nerve, vein, artery
Correct answer: Nerve, artery, vein
The mnemonic 'NAVY' (Nerve, Artery, Vein, Y-front/empty space) describes the lateral-to-medial arrangement within the femoral triangle.
General Surgery Board Review General Surgery Board Review Anatomy & Surgical Procedures 1
The critical view of safety (CVS) in laparoscopic cholecystectomy requires identification of which two structures entering the gallbladder?