CSFA Test #1 Principles Surgical
Assisting SUR 284
The two-hand tie - ANSgives the best knot security
Which of the following methods of suturing should be used to close a deep layer located on the
medial edge of a myocutaneous flap closure of a sacral decubitus ulcer? - ANShalf-buried
mattress suture with 0 PDS FS
A. The simple running stitch would lend itself to wound dehiscence. Although the 0 gauge is an
appropriate gauge suture, the SH needle is not the optimal needle for closing muscle. Vicryl is a
braided stitch that would lead to wicking of postoperative SSI should it occur.
B. The Cushing suture is a continuous vertical mattress stitch that closes lumens. The Prolene
stitch is not the best choice on muscle because it is non-absorbable. However, the FS needle is
an appropriate needle selection for closing this layer.
C. The Halstead suture technique is a double-layer closure used on friable tissue, which muscle
is not. The 0 gauge suture is an appropriate gauge suture. Vicryl is a braided stitch, which would
lead to wicking of postoperative SSI should it occur. The CTX needle is not an appropriate
needle selection for closing this layer because the curve is too large for the proximity of the
edges of the wound.
D. The half-buried mattress (Grey-Turner) method of suture is a series of inverted interrupted
horizontal or vertical mattress stitches. In this method, the knot is tied deep to avoid the incision
line and prevent irritation. The interrupted status helps to avoid wound dehiscence should a
suture fail. PDS has the same qualities of Vicryl, but it is monofilament so it does not lend itself
to wicking of possible SSI. The 0 gauge is an appropriate gauge suture. The FS needle is an
appropriate needle selection for closing this layer.
keloids are - ANSenlarged scar due to formation of excessive amounts of collagen
True or False: All of the following are correct tips for holding retractors
1.When holding retractors only use the amount of force necessary for visualization
2.Focus on holding the retractor even if you are holding it for hours- lack of focus will cause the
retractor to move and block visualization
3.When holding an Army-Navy type retractor tow-in with the retractor - term refers to placing
pressure on the end of the retractor keeping it slightly down while slightly lifting in/up-wards this
motion will help keep a blunt retractor from slipping out
4.When holding two retractors you will need to use counter and counter-traction to maintain
proper visualization - ANStrue
, If during the course of an operation in which an initially clean wound was made and the
pharyngeal cavity was entered, the wound is now: - ANSa clean, contaminated wound
Lithotomy position is another modification of the supine position with the patient lying on their
back with their legs in stirrups or on leg braces exposing the perineum, vagina, and rectum.
Care must always be taken to prevent injury to the Obturator nerve. - ANStrue
All of the following statements concerning Trendelenburg position are true Except -
ANSTrendelburg position is used for procedures of the head and neck
Primary intention or First intention wound healing: Refers to the healing process following
closure of a clean surgical incision closed with suture material - ANStrue
Granulation or Second Intention wound healing the Wound is irrigated, nonviable tissue
removed and the wound is closed 4 to 7 days latter - ANSfalse
Which of the following physical characteristics of sutures is described as the amount of force
necessary to break the suture? - ANStensile strength
EXPLANATIONS:
A. Knot strength describes the force necessary to cause a given type of knot to slip.
B. Memory describes the capacity of a suture to retain its former shape after being reformed.
C. Elasticity describes the inherent ability to regain the original form and length after being
restructured.
D. Tensile strength describes the amount of force or breaking load necessary to break a suture
(breaking strength).
Reverse Trendelenburg position is a modification of the supine position with the patient lying on
their back with the entire bed tilted with head up and feet down. To prevent the patient from
sliding downward, a padded foot board is used. Steep reverse can decrease venous return,
Since blood may pool in the lower extremities, sequential compression devices (SCD) or
antiembolic stockings should be applied to the legs. - ANStrue
Factors which affect wound healing include - ANSage, weight, steroids, ALL THE ABOVE
True or False: Armboards can be positioned at various angles and must never be abducted
greater than 90 degrees to avoid injury to the Axillary nerve plexus. - ANSfalse
Taper point needles are generally used in which of the following tissue types?
1. gastrointestinal
2. tendons
3. adipose
4. vascular - ANS1, 3 and 4
Assisting SUR 284
The two-hand tie - ANSgives the best knot security
Which of the following methods of suturing should be used to close a deep layer located on the
medial edge of a myocutaneous flap closure of a sacral decubitus ulcer? - ANShalf-buried
mattress suture with 0 PDS FS
A. The simple running stitch would lend itself to wound dehiscence. Although the 0 gauge is an
appropriate gauge suture, the SH needle is not the optimal needle for closing muscle. Vicryl is a
braided stitch that would lead to wicking of postoperative SSI should it occur.
B. The Cushing suture is a continuous vertical mattress stitch that closes lumens. The Prolene
stitch is not the best choice on muscle because it is non-absorbable. However, the FS needle is
an appropriate needle selection for closing this layer.
C. The Halstead suture technique is a double-layer closure used on friable tissue, which muscle
is not. The 0 gauge suture is an appropriate gauge suture. Vicryl is a braided stitch, which would
lead to wicking of postoperative SSI should it occur. The CTX needle is not an appropriate
needle selection for closing this layer because the curve is too large for the proximity of the
edges of the wound.
D. The half-buried mattress (Grey-Turner) method of suture is a series of inverted interrupted
horizontal or vertical mattress stitches. In this method, the knot is tied deep to avoid the incision
line and prevent irritation. The interrupted status helps to avoid wound dehiscence should a
suture fail. PDS has the same qualities of Vicryl, but it is monofilament so it does not lend itself
to wicking of possible SSI. The 0 gauge is an appropriate gauge suture. The FS needle is an
appropriate needle selection for closing this layer.
keloids are - ANSenlarged scar due to formation of excessive amounts of collagen
True or False: All of the following are correct tips for holding retractors
1.When holding retractors only use the amount of force necessary for visualization
2.Focus on holding the retractor even if you are holding it for hours- lack of focus will cause the
retractor to move and block visualization
3.When holding an Army-Navy type retractor tow-in with the retractor - term refers to placing
pressure on the end of the retractor keeping it slightly down while slightly lifting in/up-wards this
motion will help keep a blunt retractor from slipping out
4.When holding two retractors you will need to use counter and counter-traction to maintain
proper visualization - ANStrue
, If during the course of an operation in which an initially clean wound was made and the
pharyngeal cavity was entered, the wound is now: - ANSa clean, contaminated wound
Lithotomy position is another modification of the supine position with the patient lying on their
back with their legs in stirrups or on leg braces exposing the perineum, vagina, and rectum.
Care must always be taken to prevent injury to the Obturator nerve. - ANStrue
All of the following statements concerning Trendelenburg position are true Except -
ANSTrendelburg position is used for procedures of the head and neck
Primary intention or First intention wound healing: Refers to the healing process following
closure of a clean surgical incision closed with suture material - ANStrue
Granulation or Second Intention wound healing the Wound is irrigated, nonviable tissue
removed and the wound is closed 4 to 7 days latter - ANSfalse
Which of the following physical characteristics of sutures is described as the amount of force
necessary to break the suture? - ANStensile strength
EXPLANATIONS:
A. Knot strength describes the force necessary to cause a given type of knot to slip.
B. Memory describes the capacity of a suture to retain its former shape after being reformed.
C. Elasticity describes the inherent ability to regain the original form and length after being
restructured.
D. Tensile strength describes the amount of force or breaking load necessary to break a suture
(breaking strength).
Reverse Trendelenburg position is a modification of the supine position with the patient lying on
their back with the entire bed tilted with head up and feet down. To prevent the patient from
sliding downward, a padded foot board is used. Steep reverse can decrease venous return,
Since blood may pool in the lower extremities, sequential compression devices (SCD) or
antiembolic stockings should be applied to the legs. - ANStrue
Factors which affect wound healing include - ANSage, weight, steroids, ALL THE ABOVE
True or False: Armboards can be positioned at various angles and must never be abducted
greater than 90 degrees to avoid injury to the Axillary nerve plexus. - ANSfalse
Taper point needles are generally used in which of the following tissue types?
1. gastrointestinal
2. tendons
3. adipose
4. vascular - ANS1, 3 and 4
