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Surgical Assistant Certification Exam with
Complete Solutions | A+ Grade
The surgeon asks you to first gently supinate, then gently pronate the operative wrist of a 14-year old patient in supine position. The operative extremity is positioned at 80 degrees to the torso. Which of the following most accurately describes the movement of the operative thumb (which direction it points) as you carry out the instructions? - ✔✔Thumb inferior, then back to superior With patient in the prone position, the dorsal roots of the spinal nerves are oriented: - ✔✔Superficial to its corresponding ventral roots A choledoco-duodenostomy refers to the surgical anastomosis of which of the following two structures:
- ✔✔Duodenum and common bile duct In knee arthroscopy, the antero-medial portal is placed: - ✔✔Proximal and anterior to the pet anserinus, medial to the patellar ligament. Epidural anesthesia is administered: - ✔✔Into the space between the spinal canal and the dura mater covering the nerve roots. The connective tissue between the patella and the tibial tuberosity in the knee facilitates quadriceps muscle contraction across the knee joint. What is the structure? - ✔✔Patellar Ligament The talus forms an articulation with which of the following lists of bones: - ✔✔Calcaneus, navicular, tibia, and calcaneus
The acetabulum, or hip socket, is comprised of the fusion of which of the three bone chokes below? - ✔✔Pubis, ischium, and ilium The superior mesenteric artery provides primary blood supply for which of the following structures: - ✔✔Pancreas The uterine artery is a most commonly a direct branch of the: - ✔✔Internal iliac artery After what percent of total blood volume may arterial pressure AND cardiac output begin to significantly (and precipitously) drop? - ✔✔More than about 10% Putting a patient into Trendelenberg position has the effect of: - ✔✔Increasing blood flow to the brain A history of crushing would to the chest, a patient exhibits the following symptoms: low blood pressure; chest pain radiating to the neck, shoulders, and back; trouble taking deep breaths and rapid shallow breathing. Which of the following cardio-pulmonary conditions may be responsible and require urgent surgery? - ✔✔Cardiac Tamponade Which of the following may be a cause of acute cyanosis in a patient undergoing a surgical procedure: - ✔✔Lower than normal hemoglobin Direct inadvertent stimulation of the Vagus nerve during carotid endarterectomy may have which of the following transient affects: - ✔✔Bradycardia
Which of the following are true statements regarding the pancreas? - ✔✔2. The pancreas lies in direct relation to the portal vasculature, the biliary tree, the vena cava, the celiac ganglia, and the spleen its vasculature Which of the following are true statements regarding the pancreas? - ✔✔3. Endocrine and exocrine function are distributed throughout the head, neck, body, and tail sections The fold of peritoneum that connects the sides of the uterus to the walls and floor of the pelvis is known as the: - ✔✔Broad ligament Innervation to the external genitalia are supplied by the: - ✔✔Pudendal nerve and its branches The passage of urine from the kidney not the urinary bladder follows which of the following pathways: - ✔✔Bowman`s capsule, collecting ducts, renal calyx, renal pelvis, and ureter Following anesthesia, the speed of emergence is directly related to alveolar ventilation (an excretory function of the lung) and inversely related to blood gas solubility. Which of the following statements is also likely true? - ✔✔Hypoventilation lengthens the time taken to exhale the anesthetic agent and delays recovery A lymph node dissection near a cancerous tumor may confirms may the presence of cancer cells. Removal of the entire downstream chain of lymph nodes may be performed to eliminate further lymphatic spread. Which of the following statement most accurately describes a "Sentinel" lymph node biopsy? - ✔✔Removal and biopsy of successive lymph nodes starting at the known tumor site along the lymphatic pathway until a "negative" node is discovered
Which of the following is cranial nerve #10: - ✔✔Vagus nerve Which anatomical triangle has the following boundaries: Superior: Posterior belly of the digastric muscle. Lateral: Medial border of the sternocleidomastoid muscle. Inferior: Superior belly of the omohyoid muscle. - ✔✔The carotid triangle The external carotid artery may be identified by the: - ✔✔Absence of branches in the neck, superior to the common carotid bifurcation Primary superficial sensation to the cheek and nose derives from: - ✔✔Maxillary branch of Cranial Nerve V (Trigeminal) Contents of the thoracic outlet, which may be affected by thoracic outlet syndrome, include which of the following lists of structures? - ✔✔Subclavian vein and artery, and brachial plexus The tricuspid valve of the heart lies between the: - ✔✔The right atrium and the right ventricle Internal mammary arteries are direct branches of which of the following? - ✔✔Subclavian artery/s Which incision would avoid contact with the posterior rectus sheath? - ✔✔Pfannenstied Which incision would allow a single-layer fascial closure? - ✔✔Midline
Thickening of the ligamentum flavum may provide the cause of which one of the following pathological conditions: - ✔✔Central spinal stenosis Which of the following structures is innervated by a branch/branches of the cervical plexus? - ✔✔Omohyoid muscle Danger to which of the following nerves must be considered during carpal tunnel decompression: - ✔✔Medial nerve Fasciotomy of which compartment in the forearm, will relieve compression on the median and ulnar nerves, and the radial and arteries? - ✔✔Deep and superficial volar Which of the listed muscles originates at the supraglenoid tubercle in the shoulder? - ✔✔Long head of the biceps Which of the following ligaments is used as an important landmark in shoulder arthroscopy: - ✔✔Coracoacromial ligament Which of the following are branches of the sciatic nerve which ultimately supply innervation to the distal lower extremity (foot) flexors? - ✔✔Tibial nerve Difficult access to this artery for control of blood loss make posterior cruciate ligament surgery potentially more perilous: - ✔✔Popliteal artery
What is the surgical significance of the adductor hiatus in the thigh? - ✔✔Its opening marks the location for the distal anastomosis during in femoral-popliteal bypass Where would you locate the posterior tibial pulse? - ✔✔Posterior to the medial malleolus Which two cranial nerves cause through the operative field, and must be preserved? - ✔✔X and XII At several points in the procedure, it is most critical to prevent emboli from entering the: - ✔✔Internal carotid artery The injection of lidocaine into the common carotid body prior to performing the arrteriotomy is done to:
- ✔✔Prevent sinus bradycardia Patient blood perfusion includes the use of cardioplegic solutions. The purpose of this solution is to: - ✔✔Reversibly arrest the heart beat The Greater Saphenous vein may be located distally at which of the following locations? - ✔✔Anterior to the medial malleolus Which of the following represents the facial planes passed through during an open procedure (external to internal) in this region, to reach the peritoneum: - ✔✔Scarpa`s facia, obliques, transverses abdominus, transversalis fascia According to AORN wound classification system, a ruptured appendix with no visual bowel contents represents: - ✔✔Class IV: Dirty Infected
Damage to the long thoracic nerve during axillary node dissection may cause: - ✔✔Paralysis of the serrates anterior Retroperitoneal structures are most at risk of inadvertent damage in which of the following procedures:
- ✔✔Sigmoid Colectomy The right colic artery is a branch for the: - ✔✔Superior Mesenteric Artery Three distinct and visible longitudinal bands of a smooth muscle running the length of the colon are referred to as: - ✔✔Taenia Coli The primary difference between the Cushing and Connell suturing technique for GI anastomosis include which of the following: - ✔✔The Connell stitch penetrates the mucosal layer, while the Cushing does not The ligament encountered just anterior to the dorsal lamina during laminotomy is known as the: - ✔✔Ligamentum flavum The typical suction tip used in lumbar spine surgery is known as the: - ✔✔Frazier suction tip Spinal ganglia and nerve roots are protected by which two tissue layers listed below? - ✔✔Arachnoid mater and dura mater
In the radiographic image above, which of the following fixation strategies has been used - ✔✔Internal fixation Heads of locking screws are machined to make threaded contact with the reciprocal plate. The mechanical advantage of such screws is best described by which of the following: - ✔✔Threaded screw heads facilitated mechanical coupling to the plate for angular screw stability In accordance with AO standards, rigid fixation across the epiphyseal plate is generally considered: - ✔✔Contraindicated in pediatric surgery Which of the following structures inserts into the tibial tubercle and may need some distal and medial release during the arthrotomy phase of knee arthroplasty: - ✔✔Patellar ligament Which of the following locations for collateral ligament release may be required during the tibial trial phase of knee arthroplasty: - ✔✔Medial distal insertion Which one of the following approaches for hip replacement spares the hip abductors and may lead to fewer post-op dislocations, but requires a specialized OR table (Hana) to perform? - ✔✔Anterior Which of the following muscle structures is primarily classified as a hip abductor, and may be considered problematic when transected and reapproximated, or otherwise violated during hip replacement surgery? - ✔✔Gluteus medias A Frazier tip suction held to the back of a Cottonoid Pattie are likely used to clear the operative field in which of the following: - ✔✔Microsurgery
Most drugs, toxins and metabolites are excreted in the - ✔✔Urine One of the most common undesirable effects of insulin administration is - ✔✔Hypoglycemia Parkinson`s Disease is caused by decreased ________ neurotransmission. - ✔✔Dopamine _________ is an acid reducing agent. - ✔✔Axid ___________ is commonly given pre-op to patients to reduce acid in the GI tract. - ✔✔Reglan Corticosteroids _________ prebronchial inflammation - ✔✔Decrease Patients with chronic bronchitis experience chronic _______________ as a result of airway obstruction and inflammation. - ✔✔Dyspnea The term tolerance means ______________ response to a drug. - ✔✔Decreased The peripheral nervous system is divided into the somatic nervous and ____________ system. - ✔✔Autonomic The parasympathetic system _______ energy - ✔✔Expends
The duration of a drug is - ✔✔length of time for which a drug is therapeutic Bronchoconstruction results from the effects of acetylcholine, histamine and ________ mediators released within the bronchial walls. - ✔✔Inflammatory Third generation cephalosporins are effective against many _________ and are not destroyed by cephalosporinases - ✔✔Gram-negatives As a first assistant, what is the first response if a patient has an allergic reaction to a drug? - ✔✔Maintain sterility of the field Pitocin is used typically in which surgical specialty? - ✔✔Obstetrics Medication given by injection in the muscle is termed? - ✔✔IM Which of the following antihypertensives (diuretics) must be u sed cautiously to avoid dehydration and requires potassium levels to be followed closely - ✔✔Loop The last thing to do when forming a story about a drug is to associate, ask, and - ✔✔Predict ________ can cause GI irritation or ulceration when used in high dosage - ✔✔Ibuprofen Which of the following antibiotic prevents the cross-linking of a cell wall components? - ✔✔Penicillin
