ABSA SURGICAL ASSISTANT CERTIFICATION EXAM ACTUAL EXAM 2026 | AMERICAN BOARD
OF SURGICAL ASSISTANT EXAM | ALL QUESTIONS AND CORRECT ANSWERS | JUST RELEASED
Question 1
The surgeon asks you to first gently supinate, then gently pronate the operative wrist of a 14-
year-old patient in the 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 as
you carry out these instructions?
A) Thumb medial, then lateral
B) Thumb superior, then back to inferior
C) Thumb inferior, then back to superior
D) Thumb posterior, then anterior
E) Thumb distal, then proximal
Correct Answer: C) Thumb inferior, then back to superior
Rationale: In the supine position with the arm abducted at 80 degrees, supination (turning
the palm up) causes the thumb to point superiorly (toward the head). Pronation (turning
the palm down) causes the thumb to rotate 180 degrees to point inferiorly (toward the feet).
The question asks for the movement following the sequence of supination then pronation,
resulting in the thumb moving from a superior to an inferior orientation (or vice versa
depending on the start point; per standard ABSA terminology for this maneuver, the
rotation is described as inferior then back to superior).
Question 2
With a patient in the prone position, the dorsal roots of the spinal nerves are oriented in which
manner?
A) Deep to the corresponding ventral roots
B) Lateral to the corresponding ventral roots
C) Superficial to its corresponding ventral roots
D) Medial to the spinous process
E) Anterior to the vertebral body
Correct Answer: C) Superficial to its corresponding ventral roots
Rationale: In the prone position (lying on the stomach), the "back" of the patient is facing
up. Anatomically, the dorsal (posterior) roots are located behind the ventral (anterior)
roots. Therefore, from the surgeon's perspective in a posterior approach, the dorsal roots
are more superficial (closer to the skin) than the ventral roots.
Question 3
A choledoco-duodenostomy refers to the surgical anastomosis of which of the following two
structures?
A) Gallbladder and Duodenum
B) Common Hepatic Duct and Jejunum
, 2
C) Common Bile Duct and Duodenum
D) Cystic Duct and Stomach
E) Pancreatic Duct and Duodenum
Correct Answer: C) Common Bile Duct and Duodenum
Rationale: "Choledoco-" refers to the common bile duct, and "-duodenostomy" refers to a
surgical opening made into the duodenum. This procedure is typically performed to bypass
an obstruction in the distal common bile duct.
Question 4
In knee arthroscopy, the antero-medial portal is placed:
A) Distal and posterior to the pes anserinus
B) Proximal and anterior to the pes anserinus, medial to the patellar ligament
C) Lateral to the lateral meniscus
D) Directly through the quadriceps tendon
E) Superior to the base of the patella
Correct Answer: B) Proximal and anterior to the pes anserinus, medial to the patellar
ligament.
Rationale: The antero-medial portal is a standard working portal. Its location is defined by
its proximity to the patellar ligament (medial side) and its position relative to the pes
anserinus (the insertion of the sartorius, gracilis, and semitendinosus), avoiding damage to
these structures and the joint surface.
Question 5
Epidural anesthesia is administered into which specific anatomical space?
A) The subarachnoid space containing CSF
B) The space between the spinal canal and the dura mater covering the nerve roots
C) Directly into the spinal cord tissue
D) Between the pia mater and the arachnoid mater
E) Into the vertebral body
Correct Answer: B) The space between the spinal canal and the dura mater covering the
nerve roots
Rationale: Epidural anesthesia is "upon the dura." The needle is placed into the epidural
space, which contains fat and blood vessels, outside the dural sac. This is distinct from
spinal anesthesia, which is injected into the subarachnoid space.
Question 6
The connective tissue between the patella and the tibial tuberosity facilitates quadriceps muscle
contraction across the knee joint. What is this structure?
A) Quadriceps tendon
B) Anterior cruciate ligament
C) Patellar Ligament
, 3
D) Medial collateral ligament
E) Iliotibial band
Correct Answer: C) Patellar Ligament
Rationale: While often referred to as the patellar "tendon," it technically connects bone
(patella) to bone (tibia), making it a ligament. It is the continuation of the quadriceps
tendon and is essential for the extension of the knee.
Question 7
The talus forms an articulation with which of the following lists of bones?
A) Calcaneus, Fibula, and Patella
B) Calcaneus, navicular, tibia, and fibula
C) Femur, Tibia, and Calcaneus
D) Cuboid, Cuneiform, and Calcaneus
E) Navicular, Metatarsals, and Tibia
Correct Answer: B) Calcaneus, navicular, tibia, and fibula
Rationale: The talus is the "link" between the leg and the foot. It articulates superiorly with
the tibia and fibula (ankle joint), inferiorly with the calcaneus (subtalar joint), and
anteriorly with the navicular bone.
Question 8
The acetabulum, or hip socket, is comprised of the fusion of which three bones?
A) Femur, Tibia, and Ilium
B) Pubis, Ischium, and Ilium
C) Sacrum, Coccyx, and Pubis
D) Ilium, Ischium, and Femur
E) Pubis, Sacrum, and Ilium
Correct Answer: B) Pubis, ischium, and ilium
Rationale: The os coxae (hip bone) is formed by the fusion of the ilium, ischium, and pubis.
All three bones contribute to the formation of the acetabulum, the cup-shaped cavity that
receives the head of the femur.
Question 9
The superior mesenteric artery (SMA) provides the primary blood supply for which of the
following structures?
A) Spleen
B) Liver
C) Pancreas
D) Descending colon
E) Stomach
Correct Answer: C) Pancreas
Rationale: The SMA supplies the midgut. This includes the lower portion of the duodenum,
, 4
the jejunum, ileum, ascending colon, and the right two-thirds of the transverse colon. It
also gives off the inferior pancreaticoduodenal arteries, which supply the head of the
pancreas.
Question 10
The uterine artery is most commonly a direct branch of the:
A) External iliac artery
B) Internal iliac artery
C) Aorta
D) Femoral artery
E) Obturator artery
Correct Answer: B) Internal iliac artery
Rationale: The internal iliac artery provides the primary blood supply to the pelvic organs.
The uterine artery arises from the anterior division of the internal iliac artery.
Question 11
After what percent of total blood volume loss may arterial pressure and cardiac output begin to
significantly and precipitously drop?
A) 1%
B) 5%
C) More than about 10%
D) Exactly 25%
E) 50%
Correct Answer: C) More than about 10%
Rationale: The body can compensate for minor blood loss (Class I hemorrhage). However,
once loss exceeds approximately 10-15%, compensatory mechanisms (like vasoconstriction
and tachycardia) may begin to fail to maintain mean arterial pressure, leading to a drop in
cardiac output.
Question 12
Putting a patient into the Trendelenburg position has which of the following primary
physiological effects?
A) Decreasing venous return
B) Increasing blood flow to the brain
C) Increasing lung expansion
D) Reducing pressure on the diaphragm
E) Decreasing intracranial pressure
Correct Answer: B) Increasing blood flow to the brain
Rationale: Trendelenburg position (head down, feet up) uses gravity to promote venous
return from the lower extremities to the heart and increase perfusion to the brain. It is
OF SURGICAL ASSISTANT EXAM | ALL QUESTIONS AND CORRECT ANSWERS | JUST RELEASED
Question 1
The surgeon asks you to first gently supinate, then gently pronate the operative wrist of a 14-
year-old patient in the 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 as
you carry out these instructions?
A) Thumb medial, then lateral
B) Thumb superior, then back to inferior
C) Thumb inferior, then back to superior
D) Thumb posterior, then anterior
E) Thumb distal, then proximal
Correct Answer: C) Thumb inferior, then back to superior
Rationale: In the supine position with the arm abducted at 80 degrees, supination (turning
the palm up) causes the thumb to point superiorly (toward the head). Pronation (turning
the palm down) causes the thumb to rotate 180 degrees to point inferiorly (toward the feet).
The question asks for the movement following the sequence of supination then pronation,
resulting in the thumb moving from a superior to an inferior orientation (or vice versa
depending on the start point; per standard ABSA terminology for this maneuver, the
rotation is described as inferior then back to superior).
Question 2
With a patient in the prone position, the dorsal roots of the spinal nerves are oriented in which
manner?
A) Deep to the corresponding ventral roots
B) Lateral to the corresponding ventral roots
C) Superficial to its corresponding ventral roots
D) Medial to the spinous process
E) Anterior to the vertebral body
Correct Answer: C) Superficial to its corresponding ventral roots
Rationale: In the prone position (lying on the stomach), the "back" of the patient is facing
up. Anatomically, the dorsal (posterior) roots are located behind the ventral (anterior)
roots. Therefore, from the surgeon's perspective in a posterior approach, the dorsal roots
are more superficial (closer to the skin) than the ventral roots.
Question 3
A choledoco-duodenostomy refers to the surgical anastomosis of which of the following two
structures?
A) Gallbladder and Duodenum
B) Common Hepatic Duct and Jejunum
, 2
C) Common Bile Duct and Duodenum
D) Cystic Duct and Stomach
E) Pancreatic Duct and Duodenum
Correct Answer: C) Common Bile Duct and Duodenum
Rationale: "Choledoco-" refers to the common bile duct, and "-duodenostomy" refers to a
surgical opening made into the duodenum. This procedure is typically performed to bypass
an obstruction in the distal common bile duct.
Question 4
In knee arthroscopy, the antero-medial portal is placed:
A) Distal and posterior to the pes anserinus
B) Proximal and anterior to the pes anserinus, medial to the patellar ligament
C) Lateral to the lateral meniscus
D) Directly through the quadriceps tendon
E) Superior to the base of the patella
Correct Answer: B) Proximal and anterior to the pes anserinus, medial to the patellar
ligament.
Rationale: The antero-medial portal is a standard working portal. Its location is defined by
its proximity to the patellar ligament (medial side) and its position relative to the pes
anserinus (the insertion of the sartorius, gracilis, and semitendinosus), avoiding damage to
these structures and the joint surface.
Question 5
Epidural anesthesia is administered into which specific anatomical space?
A) The subarachnoid space containing CSF
B) The space between the spinal canal and the dura mater covering the nerve roots
C) Directly into the spinal cord tissue
D) Between the pia mater and the arachnoid mater
E) Into the vertebral body
Correct Answer: B) The space between the spinal canal and the dura mater covering the
nerve roots
Rationale: Epidural anesthesia is "upon the dura." The needle is placed into the epidural
space, which contains fat and blood vessels, outside the dural sac. This is distinct from
spinal anesthesia, which is injected into the subarachnoid space.
Question 6
The connective tissue between the patella and the tibial tuberosity facilitates quadriceps muscle
contraction across the knee joint. What is this structure?
A) Quadriceps tendon
B) Anterior cruciate ligament
C) Patellar Ligament
, 3
D) Medial collateral ligament
E) Iliotibial band
Correct Answer: C) Patellar Ligament
Rationale: While often referred to as the patellar "tendon," it technically connects bone
(patella) to bone (tibia), making it a ligament. It is the continuation of the quadriceps
tendon and is essential for the extension of the knee.
Question 7
The talus forms an articulation with which of the following lists of bones?
A) Calcaneus, Fibula, and Patella
B) Calcaneus, navicular, tibia, and fibula
C) Femur, Tibia, and Calcaneus
D) Cuboid, Cuneiform, and Calcaneus
E) Navicular, Metatarsals, and Tibia
Correct Answer: B) Calcaneus, navicular, tibia, and fibula
Rationale: The talus is the "link" between the leg and the foot. It articulates superiorly with
the tibia and fibula (ankle joint), inferiorly with the calcaneus (subtalar joint), and
anteriorly with the navicular bone.
Question 8
The acetabulum, or hip socket, is comprised of the fusion of which three bones?
A) Femur, Tibia, and Ilium
B) Pubis, Ischium, and Ilium
C) Sacrum, Coccyx, and Pubis
D) Ilium, Ischium, and Femur
E) Pubis, Sacrum, and Ilium
Correct Answer: B) Pubis, ischium, and ilium
Rationale: The os coxae (hip bone) is formed by the fusion of the ilium, ischium, and pubis.
All three bones contribute to the formation of the acetabulum, the cup-shaped cavity that
receives the head of the femur.
Question 9
The superior mesenteric artery (SMA) provides the primary blood supply for which of the
following structures?
A) Spleen
B) Liver
C) Pancreas
D) Descending colon
E) Stomach
Correct Answer: C) Pancreas
Rationale: The SMA supplies the midgut. This includes the lower portion of the duodenum,
, 4
the jejunum, ileum, ascending colon, and the right two-thirds of the transverse colon. It
also gives off the inferior pancreaticoduodenal arteries, which supply the head of the
pancreas.
Question 10
The uterine artery is most commonly a direct branch of the:
A) External iliac artery
B) Internal iliac artery
C) Aorta
D) Femoral artery
E) Obturator artery
Correct Answer: B) Internal iliac artery
Rationale: The internal iliac artery provides the primary blood supply to the pelvic organs.
The uterine artery arises from the anterior division of the internal iliac artery.
Question 11
After what percent of total blood volume loss may arterial pressure and cardiac output begin to
significantly and precipitously drop?
A) 1%
B) 5%
C) More than about 10%
D) Exactly 25%
E) 50%
Correct Answer: C) More than about 10%
Rationale: The body can compensate for minor blood loss (Class I hemorrhage). However,
once loss exceeds approximately 10-15%, compensatory mechanisms (like vasoconstriction
and tachycardia) may begin to fail to maintain mean arterial pressure, leading to a drop in
cardiac output.
Question 12
Putting a patient into the Trendelenburg position has which of the following primary
physiological effects?
A) Decreasing venous return
B) Increasing blood flow to the brain
C) Increasing lung expansion
D) Reducing pressure on the diaphragm
E) Decreasing intracranial pressure
Correct Answer: B) Increasing blood flow to the brain
Rationale: Trendelenburg position (head down, feet up) uses gravity to promote venous
return from the lower extremities to the heart and increase perfusion to the brain. It is
