Certified Surgical Technologist Surgical Positioning 2 — Questions and Answers
Question 1: Which surgical position is used for retroperitoneal flank access during kidney (nephrectomy) surgery?
- Supine with arm extended
- Lateral (kidney) position (Correct answer)
- Prone with Wilson frame
- Fowler's position
Correct answer: Lateral (kidney) position
The lateral position with the patient's flank over the kidney rest and table flexed provides direct retroperitoneal access for nephrectomy and other kidney procedures.
Question 2: The 'beach chair' (modified sitting) position is most commonly associated with which surgical procedure?
- Lumbar laminectomy
- Shoulder arthroscopy (Correct answer)
- Total knee replacement
- Appendectomy
Correct answer: Shoulder arthroscopy
The beach chair position keeps the patient semi-upright, providing excellent glenohumeral joint access and reducing venous oozing during shoulder arthroscopy.
Question 3: What is the primary life-threatening risk of the sitting (Fowler's) position during posterior fossa neurosurgery?
- Pressure ulcers on the sacrum
- Venous air embolism (Correct answer)
- Brachial plexus injury
- Corneal abrasion
Correct answer: Venous air embolism
The upright sitting position creates sub-atmospheric venous pressure in the cerebral venous sinuses; if a vessel is opened, air can be entrained causing a potentially fatal air embolism.
Question 4: Brachial plexus stretch injury in the supine position is most commonly caused by:
- Arm abduction greater than 90 degrees (Correct answer)
- Arm tucked securely at the patient's side
- Neutral head positioning
- Padding the elbow
Correct answer: Arm abduction greater than 90 degrees
Abducting the arm beyond 90 degrees on an arm board overstretches the brachial plexus between the clavicle and first rib, causing neuropraxia.
Question 5: Which device is primarily used to stabilize a patient in the lateral position during flank surgery?
- Allen stirrups
- Beanbag positioner and kidney rest (Correct answer)
- Mayfield headrest
- Wilson frame
Correct answer: Beanbag positioner and kidney rest
A beanbag positioner conforms to the patient's body contours to prevent rolling, while the kidney rest supports the flank at the operative site.
Question 6: Which bony prominences must be padded to prevent pressure injuries during all surgical positions?
- Heels only
- All bony prominences including heels, sacrum, elbows, and occiput (Correct answer)
- Sacrum only
- Elbows only
Correct answer: All bony prominences including heels, sacrum, elbows, and occiput
All bony prominences with minimal overlying soft tissue are susceptible to ischemic pressure injury during prolonged immobility on the OR table.
Question 7: The semi-Fowler's position elevates the head of the bed to approximately:
- 90 degrees
- 15–30 degrees (Correct answer)
- 45–60 degrees
- 5 degrees
Correct answer: 15–30 degrees
Semi-Fowler's raises the head 15–30 degrees, reducing venous pressure in the head and neck while maintaining patient comfort for head, neck, and nasal procedures.
Certified Surgical Technologist Surgical Positioning 2
Which surgical position is used for retroperitoneal flank access during kidney (nephrectomy) surgery?