General Practice Flashcards

During a laparoscopic procedure, the surgeon requests increasing the insufflation pressure. As the surgical first assistant, what is the primary concern with excessively high intra-abdominal pressure?

Answer: Impaired venous return and decreased cardiac output

High intra-abdominal pressure compresses the vena cava, reducing venous return and decreasing cardiac output, which can cause hemodynamic instability.

When assisting with wound closure, the surgical first assistant is asked to perform an interrupted suture technique. What is the primary advantage of interrupted sutures over a continuous running suture?

Answer: Reduced risk of wound dehiscence if one suture breaks

Interrupted sutures provide security because if one suture fails, the others maintain wound integrity, whereas a continuous suture failure can cause the entire closure to open.

A patient undergoing abdominal surgery suddenly develops bradycardia and hypotension during peritoneal traction. This response is MOST likely caused by:

Answer: Vasovagal reflex stimulation

Peritoneal traction stimulates the vagus nerve, triggering a vasovagal reflex that causes bradycardia and hypotension.

Which retractor is BEST suited for providing self-retaining exposure during an open abdominal procedure?

Answer: Bookwalter retractor

The Bookwalter is a self-retaining retractor system that attaches to the operating table and provides hands-free abdominal exposure without requiring an assistant to hold it.

During a thyroidectomy, the surgical first assistant must be particularly careful to identify and preserve which structure to prevent permanent hoarseness?

Answer: Recurrent laryngeal nerve

The recurrent laryngeal nerve innervates the intrinsic muscles of the larynx; bilateral injury causes permanent voice hoarseness or loss and potential airway compromise.

The surgical first assistant notices a sponge count discrepancy at the time of wound closure. What is the MOST appropriate immediate action?

Answer: Notify the surgeon immediately and halt closure until resolved

A sponge count discrepancy must be immediately reported to the surgeon and closure halted; the patient's body cavity and field must be thoroughly searched before closure.

Which electrosurgical mode uses an interrupted, modulated current that produces a coagulating effect with minimal cutting?

Answer: Coagulation mode

Coagulation mode delivers an interrupted, modulated waveform at a lower duty cycle, producing tissue desiccation and hemostasis rather than vaporization.