Surgical Technology Level 3 FINAL

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1

Which of the following is NOT one of the five stages of normal bone healing?

Consolidation

2

Which of the following are types of Fractures?

Pathological, stellate, Pott's

3

Which of the following is the largest and most complex of the synovial joints?

Knee

4

Which ligament originates from the anterior intercondylar area of the tibia and extends to the lateral condyle of the femur?

Anterior cruciate

5

An example of an amphiarthrosis is/are the?

Vertebrae

6

Which cells have the ability to synthesize and resorb bone matrix?

Osteocytes

7

A fracture at the distal end of the radius in which the smaller fragment is displaced posteriorly is called a ?

Colle's fracture

8

At its distal end, the tibia expands to form a prominence on the inner ankle called the?

Medial malleolus

9

What semisolid tissue, found in the spaces of cancellous bone does not typically produce red blood cells?

Yellow marrow

10

Which of the following is the method used for the repair of a ruptured Achilles tendon?

Krackow whip stitch

11

Which of the following articulates with the head of the femur?

Acetabulum

12

Which bone articulates with the glenoid cavity to form the shoulder joint?

Humerus

13

The end of which bone articulates with the manubrium?

Clavicle

14

Which of the following articulates with the distal clavicle and provides attachments for the muscles of the arms and chest?

Acromion process

15

Which of the following statements is NOT an indication for ORIF?

Closed reduction with immobilization of the fracture

16

Which of the following bones is/are considered flat bones?

Ribs

17

The initial step in the body's normal repair of a fracture involves?

Blood clot

18

Which type of fracture is complete and results in several bony fragments?

Comminuted

19

Which of the following is NOT an indication for pathological bone growth?

Cellular proliferation

20

Cortical bone is a hard, dense bone that is composed of circular rings of bone matrix is called

Haversian units

21

What is the standard method of treatment for a femoral shaft fracture?

Intramedullary nails

22

Which type of joint only allows movement in one plane?

Hinge

23

Bone grafts are usually taken from the?

Iliac crest

24

Which of the following instruments would NOT commonly be used to harvest a bone graft?

Drill

25

Manipulating bone fracture fragments into alignment without incising the skin is called?

Closed reduction

26

Which of the following is a clinical sign and symptom of carpal tunnel syndrome?

Paresthesia of the fingers

27

Which of the following is the correct sequence of surgical instruments for the insertion of a bone screw?

Drill, measure, tap, screw

28

Which type of casting material is durable, lightweight, and strong?

Fiberglass

29

Which of the following statements is true?

Surgical implant information including number, type, and size is recorded

30

Which of the following muscles is NOT a part of the rotator cuff?

Glenohumerus

31

What is the primary reason for performing a total joint arthroplasty?

Degenerative joint disease

32

Which of the following is NOT a form of traction?

CPM

33

How many components are implanted during a total knee arthroplasty?

Four

34

A patient is scheduled for an anterior cruciate ligament repair. The surgeon plans to use the patient's patellar tendon. This is an example of which type of graft?

Autograft

35

What is the correct surgical position for a total hip arthroplasty?

Lateral

36

Which of the following best describes the skin prep for a rotator cuff repair?

Entire arm circumferentially and shoulder to mandibular border and bilateral as far as possible

37

Which of the following pieces of equipment would NOT typically be used during a total knee arthroscopy?

Insufflator

38

Supination

To turn the palm of the hand upward

39

Periosteum

The dense membrane that surrounds the bone, outer layer, must be removed to saw

40

Flexion

Act of bending a joint

41

Rheumatoid arthritis

A painful, inflammatory joint disease that involves the synovium in the joint

42

Adduction

Movement of a body part towards the midline

43

Arthrodesis

Surgical fixation or fusion of a joint of bone with graft material

44

Pronation

To turn the palm of the hand downward

45

Endosteum

Lining inside of the medullary canal

46

Osteoarthritis

Degenerative joint disease that is from wear and tear of repetitive motion

47

Diaphysis

Shaft of the long bone

48

Cancellous bone

Spongy type of bone found at the end of long bones that contain marrow

49

Distal

Portion of an extremity or vessel that is farthest from the center of the body

50

Epiphysis

Area of the bone that is the growth plate

51

Osteomyelitis

Inflammation of the bone caused by infectious organisms

52

Proximal

Portion of an extremity or vessel that is closest to the center of the body

53

Cortical bone

Hard dense bone that is on the outer and central part of a long bone

54

Articular cartilage

Dense connective tissue that is particularly at the joint surfaces

55

Abduction

Moving a body part away from the midline

56

A closed system of blood vessels that transports blood away from the heart to the body's tissues and back to the heart refers to the

Peripheral vascular system

57

Microscopic vessels designed to exchange nutrients and waste between blood and tissue fluid around the cells are known as?

Capillaries

58

Which of the following accurately describes the layers of an artery from inner to outer layers?

Tunica intima, tunica media, tunica adventitia

59

All of the following statements accurately describes the characteristics of a vein EXCEPT:

Veins carry oxygenated blood away from the heart

60

Which blood vessel(s) provide(s) the myocardium with oxygenated blood?

Coronary arteries

61

Of the following, which is NOT one of the three major branches of the aortic arch?

Right subclavian artery

62

The abdominal aorta bifurcates at the level of the fourth lumbar vertebrae into the

Right and left common iliac arteries

63

Which arteries supply the pelvis and perineum with blood?

Internal iliac

64

Which blood vessels supply the neck and head outside of the skull with blood?

External carotid

65

Which blood vessels communicate with the basilar artery to form the circle of Willis?

Internal carotid

66

Which blood vessels supply blood to the spinal cord and its meninges?

Lumbar

67

Which veins receive blood from the brain, meninges, and deeper regions of the face and neck?

Internal jugular

68

Which veins travel along the lateral side of the arm from the hand to the shoulder, eventually emptying into the axillary veins?

Brachiocephalic

69

Which is the longest vein in the body?

Greater saphenous

70

Claudication refers to

Cramping

71

Which of the following statements regarding arterial embolism is FALSE?

The formation of emboli may result from underlying peripheral vascular disease

72

All of the following statements regarding abdominal aneurysms are false EXCEPT?

Aneurysms are generally fusiform and involve the circumference of the artery

73

All of the following statements regarding endarterectomy are false EXCEPT:

Transient cerebral ischemia is the primary indication of stenosis

74

Which graft requires pre-clotting by the surgical team?

Dacron graft

75

For an aortofemoral bypass. which statement would be FALSE?

The patient will be prepped from the axilla to mid-thigh

76

Delicate polypropylene sutures should be tagged with

Rubber shods

77

Vascular clamps may include all of the following EXCEPT:

Doppler

78

Typical suture gauge for a femoral vascular anastomosis is

6-0

79

Which procedure would include prepping from mid-abdomen to the toes, with the affected leg prepped circumferentially?

Femoropopliteal bypass

80

Considering acute arterial occlusion, which of the following is NOT one of the 4 P's considered in diagnosis?

Peripheral

81

Which choice indicates the correct sequence of events for clamping of vessels prior to an arteriotomy?

Heparinize pt, apply proximal clamps, apply distal clamp, incise vessel

82

Which procedure could possibly necessitate the use of a Javid shunt?

Carotid endarterectomy

83

Which vessels must be clamped during a carotid endarterectomy?

Common carotid, external carotid, and internal carotid arteries

84

Which instrument is an arteriotomy initiated?

#11 blade on #7 handle

85

All of the following statements are TRUE regarding peripheral vessel angioplasty EXCEPT?

The most common approach is via the common iliac arteries

86

Which graft material CAN be safely used in the popliteal space?

Gore-tex graft

87

Which incisional approach would be best for the repair of AAA?

Abdominal

88

The surgical excision of a dilated portion of the aortic wall with immediate reconstruction using a synthetic graft is known as a/an?

Aortic aneurysmectomy

89

Total absence of myocardial contraction is known as

Asystole

90

Among the drugs commonly used during vascular surgery, the drug that nutralizes, or acts as an antagonist against, the action of heparin is?

Protamine sulfate

91

The purpose of femoropopliteal bypass is to?

Restore blood flow in the distal femoral artery

92

All of the following statements are false regarding the positioning of the patient about to undergo a carotid endarterectomy EXCEPT:

The patient should be placed in supine position with the head turned away from the operative side

93

From which vessel is the clamp removed LAST during a carotid endarterectomy?

Internal carotid artery

94

Which suture type is appropriate for closing an arteriotomy?

Polypropylene

95

All of the following statements are true regarding supplies required for peripheral vascular surgery EXCEPT:

A Doppler probe can be used to dilate vessels

96

All of the following statements are true regarding supplies required for peripheral vascular surgery EXCEPT:

A Doppler probe can be used to dilate vessels

97

All of the following statements regarding diagnostic evaluation of peripheral vascular patients are true EXCEPT:

Doppler probe evaluates the severity of vascular disease

98

Which artery supplies the upper portion of the digestive tube. the spleen, and the liver?

Celiac

99

Considering the surgical procedure for repair of AAA, on which vessel(s) is an arteriotomy performed to facilitate anastomosis of the graft?

Common iliac arteries

100

A Fogarty balloon catheter is used for

Arterial embolectomy/thrombectomy

101

Which medication is added in injectable saline for intra-arterial irrigation during vascular procedures?

Heparin

102

Considering a carotid endarterectomy procedure, after the vessel is dissected free from surrounding tissue, the surgeon will want to ____ the artery and will ask for a _____.

Identify, right angle

103

An iliac artery obstruction is most commonly bypassed with a/an?

Femorofemoral bypass

104

The angioplasty catheter with a balloon is inserted into which vessel for peripheral vessel angioplasty?

Femoral artery

105

All of the following statements are true concerning arteriovenous shunt and fistula EXCEPT?

Levels are monitored to measure if the shunt is clearing creatinine from the blood

106

All of the following statements concerning IVC filter placement are true EXCEPT?

Filter is placed secondary to varicose veins that have become dilated

107

Which structure is referred to as the "pacemaker of the heart?"

Sinoatrial (SA) node

108

Which portion of the heart receives the unoxygenated blood?

Right atrium

109

Which portion of the heart is responsible for pumping blood into the pulmonary artery?

Right ventricle

110

Which portion of the heart is responsible for pumping blood into the aorta?

Left ventricle

111

Dysrhythmia can result in all of the following pathologic conditions EXCEPT:

Aortic stenosis

112

The pulmonary veins empty into the?

Left atrium

113

The valve between the left atrium and ventricles is the?

Bicuspid (mitral)

114

The valve between the right atrium and ventricle is the?

Tricuspid

115

Which structure is attached to the valvular cusps and prevents valves from swinging back into the artia?

Chordae tendinea

116

With the body at rest, the average heart rate is approximately 72 BPM and the parasympathetic nervous system is in control describes what?

Cardiac conduction

117

Which structure prevents the trachea from collapsing and blocking the airway?

Hayline cartilage

118

What is the name of the area between the visceral and parietal pleura that contains serous fluid?

Pleural space

119

Which of the following is NOT a complication of MI, as a result of CAD?

Flail chest

120

The primary bronchus divides into

Secondary bronchi

121

The microscopic air sacs clustered at the ends of the bronchiole, which provides surface area for the exchange of 02 and c02 are the?

Alveoli

122

The main bronchi, pulmonary arteries, veins, and lymphatic vessels enter the lungs on the medial surface through the?

Hilum

123

The right lung is divided into how many lobes?

Three

124

The heart is surrounded by the?

pericardium

125

The cardiac cycle refers to the events taking place during a?

Single heartbeat

126

Which of the following defines the term systole?

Contraction phase

127

Which division of the nervous system is responsible for slowing the heart rate?

Parasympathetic

128

What is the most common congenital deformity of the chest wall?

Pectus excavatum

129

What medial term refers to the abnormal accumulation of air in the pleural cavity?

Pneumothorax

130

Which of the following statements, regarding types of aneurysms, is FALSE?

Saccular aneurysms involve the entire circumference of an artery

131

An abnormal opening in the wall between the right and left ventricles of the heart is known as a/an?

ventricular septal defect

132

Which of the following pediatric procedures requires the use of cardiopulmonary bypass?

Atrial septal defect repair

133

Which of the following is NOT considered a sterile procedure?

bronchoscopy

134

Which of the following statements is TRUE for a thoracoscopy?

Biopsy of the mediastinal lymph node can be achieved

135

Which patient position is used most often for intrathoracic procedures, for example, a lobectomy?

Lateral

136

Which intercostal space is typically entered for a thoracotomy?

5th

137

Which piece of equipment assumes the role of the heart and lungs while undergoing cardiopulmonary bypass?

Pump oxygenator

138

Which of the following statements is FALSE regarding a venting cannula placed during a cardiopulmonary bypass?

A cannula is placed in the right ventricle

139

Which of the following techniques does NOT protect the heart from damage during a cardiopulmonary bypass?

Ventricular fibrillation

140

Which mechanical device is NOT designed for circulatory support after cardiac procedures?

Cardiopulmonary bypass

141

Into which portion of the heart is the cannula placed to achieve venous cannulation for cardiopulmonary bypass?

Right atrium

142

Which solution or drug is NOT to be used during a coronary artery bypass grafting?

water

143

Which of the following procedures is NOT a treatment method for the repair of the mitral valve?

De Vega annuloplasty

144

Which of the following statements is FALSE for tetralogy of Fallot?

Patient does not undergo cardiopulmonary bypass

145

Which of the following is NOT the result of atherosclerosis?

Valvular disease

146

Which of the following statements is FALSE regarding dysrhythmia?

Maybe the result of alteration of circulation

147

Which primary muscles are associated with inspiration?

Diaphragm and external intercostals

148

Which covering is not attached to the heart itself?

Fibrous pericardium

149

Which of the following is the procedure in which a prosthetic ring is implanted to correct a mitral valve whose leaflet edges do not properly come together?

Annuloplasty

150

Which of the following is a cyanotic congenital heart defect?

tetralogy of Gallot

151

Which of the following is NOT a type of aortic valve replacement?

Annulus ring

152

Which of the following is not a part of the renal tubule?

Bowman's capsule

153

The functional unit of the kidney, or nephron is composed of which two basic units?

Renal tubules and renal corpuscles

154

The medial border of the kidney, where the renal blood vessels, is called the?

Hilum

155

Which outer portion of the kidney contains the glomeruli?

Cortex

156

What is the name of the fibrous capsule that surrounds both the suprarenal glands and the kidneys?

Gerota's fascia

157

Which muscle is responsible for emptying the bladder and closing the bladder orifice?

Detrusor muscle

158

Which important clinical landmark is marked by the ureteral and urethral orifices?

Vesical trigone

159

The portion of the skin covering the distal base of the penis that forms a free fold is the?

Prepuce

160

The proximal portion of the male urethra is the?

Prostatic urethra

161

Which portion of the male reproductive system can be found passing through the spermatic cord and eventually conducting semen into the prostatic urethra?

Ductus (vas) deferens

162

Which disorder is marked by multiple fluid-filled benign cysts in the parenchyma of the kidneys?

Polycystic kidney disease

163

Which congenital condition is marked by the absence of the anterior wall of the urethra?

Epispadias

164

Which blood test can indicate the possibility of prostatic cancer?

PSA

165

Which diagnostic tool involves the use of an intravenous contrast medium and radiological films to view the urological system?

IVP (IVU)

166

Which extraperitoneal incision option can be used to access the lower portion of the ureter?

Flank

167

Which incision option required the patient to be placed in the lateral position?

Lumbar

168

Which of the following statements regarding nephrectomy is FALSE?

Radical nephrectomy involves excision of the kidney only

169

Which surgical procedure involves diverting urine flow through an isolated loop of bowel?

Ileal conduit

170

Which of the following statements regarding instrumentation for transurethral procedures is FALSE?

The scope is introduced through the male or female ureter

171

Which incisional approach is preferred for a radical orchiectomy?

Inguinal

172

Which statement regarding radioactive seed implantation in the prostate gland is FALSE?

Seed implantation utilizes a resectoscope with loop electrode

173

Which of the following sutures would be appropriate to secure the catheter during suprapubic cystostomy?

3-0 non-absorbable

174

Mild stress incontinence in women can be reduced or eliminated with which of the following treatment options?

Colporrhaphy, MMK procedure, and pubovaginal sling

175

The procedure involving the removal of only the testis and the epididymis is?

Simple orchiectomy

176

Which of the following surgical procedures utilizes sutures placed in the anterior vaginal wall and secured to the posterior symphysis or Cooper's ligament?

Marshall-Marchetti-Krantz (MMK)

177

What surgical instrument is used for dissection of enlarged prostate tissue during a transurethral resection of the prostate (TURP)?

Loop electrode

178

Why is the left kidney sometimes preferred for donation for transplantation?

The renal vein is longer than the right kidney

179

Which of the following statements regarding the female urethra is FALSE?

Urethra is approximately 20 cm in length

180

Which of the following statements regarding bladder tumors is FALSE?

Malignant tumors may be removed transurethrally

181

Which of the following statements for circumcision is FALSE?

Can lead to infection or pain during erection

182

Which of the following statements for an orchiectomy is FALSE?

The scrotum can be closed with staples

183

Which of the following statements is FALSE for a prostatectomy?

Open prostatectomy may be used for small adenomas

184

Which is the medical term for having the condition of kidney stones?

Nephrolithiasis

185

Kidney transplant surgery may entail all of the following procedural steps EXCEPT?

Procedure similar to radical nephrectomy

186

Which of the following statements regarding prostate-specific antigen (PSA) is FALSE?

Used in conjunction with retrograde pyelogram for diagnosis

187

Hematuria

Presence of blood in urine

188

Cryptorchidism

Undescended testicles

189

Hydrocele

Enlarged fluid-filled sac within the scrotum

190

Hypospadias

Developmental anomaly where male urethra opens on the ventral side of the penis

191

Phimosis

Retraction of prepuce which causes painful swelling of the glans

192

Testicular torsion

Twisting of testes; painful emergency

193

Varicocele

Enlarged veins of the spermatic cord

194

Epispadias

Congenital condition of absence of anterior wall of the urethra

195

What is the definition of co-morbidity?

Disease or disorder in addition to the primary reason the patient is being treated

196

Name three things the surgical technologist can do in an attempt to meet surgical patient needs?

  • introduce yourself in a professional way
  • Explain everything you are going to do to the patient
  • Speak calmly to surgical staff and patient
197

What type of diabetes would a patient be diagnosed with if the patient's pancreas produced little or no insulin and as a result, the patient requires daily doses of insulin?

Type 1 diabetes

198

Describe three methods of monitoring specific to pediatric patients in the OR?

  • Temperature can be done rectally or tympanically
  • Monitoring urine output this is done by a collection bag
  • Oxygen this can be done by pulse oximetry
199

Tetracycline

Should not be administered to newborns because there is an increased risk of staining and hypoplasia of tooth enamel

200

What is the number 1 cause of death in children and give two examples?

Trauma is the # 1 cause of death this can occur from MVAs and drowning accidents

201

Name two special consideration specific to obese surgical patients?

  • There is an increased risk of degenerative osteoarthritis of the back, hips, and knees
  • There is an increased risk of wound infections
202

Name two special considerations to pregnant surgical patients?

  • The vital signs can be altered with an increase in heart rate and decrease in blood pressure
  • Abdominal organs can be displaced
203

Patient self-determination act

This act started in 1990, it states that patients have the opportunity to participate in any decision making an advance of a procedure. Patients must be informed of their rights to choose the type of care and how much care the patient gets. They get to choose who they want to have as their power of attorney and what they put in their living will

204

Name the 5 stages of grief and explain how these reaction apply to any form of personal loss

  • denial
  • anger
  • bargaining
  • depression
  • acceptance
  • These steps do not necessarily come in a specific order but patients will experience at least two of these 5 reactions
205

Name and contrast the 2 classifications of death

Clinical death is the cessation of the heartbeat and breathing while biological death is the cessation of brain activity

206

euthanasia

The Practice of terminating life in a painless way in order to prevent the patient from suffering in life

207

Active euthanasia

The dr speeds up the process of dying, there is

  • Voluntary: the patient initiates death and involuntary which means the patients rights were violated
208

Passive euthanasia

Act of withholding any life-preserving treatments from the patient

209

Name two situations in which a pregnant patient would undergo an immediate operative intervention for an emergency?

Ectopic pregnancy and incompetent cervix

210

Name two patient co-morbidities in which the patient would be considered immunocompromised?

  • Someone who as an autoimmune disease such as lupus, multiple sclerosis or RA
  • Someone who has AIDS
211

First trimester of pregnancy

Increased risk of spontaneous abortion

212

Two intraoperative patient care considerations that would be given specifically to a diabetic surgical patient ?

  • IV access to administer fluids to the patient and insulin, monitoring the blood sugar with a glucometer and providing TEDS and SCDS to the patient
213

Septic Shock

The most common type of shock know for pediatric patients it is usually caused by a gram-negative bacteria. It is caused by reduced circulating blood volume. The treatment consists of fluid replacement, colloid solutions and broad-spectrum antibiotics

214

Hypovolemic Shock

The most common cause if dehydration the most common symptom is bradycardia and results in decreased venous return decreased cardiac output lactic acidosis and bad tissue perfusion. Treatment consists of fluid and blood replacement with hypotonic NACL solutions

215

What is Maslow's hierarchy of needs?

All needs must be met in the order they come in the order is, psychological needs, safety needs, love and belonging needs, esteem needs, and self-actualization

216

Advanced directive

Written instructions telling the patients wishes about the type and amount of medical treatment to be used in the event that the patient can no longer make decisions for themselves.