CERTIFIED SURGICAL ASSISTANT EXAM
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?
o Thumb lateral, then back to medial.
o Thumb medial, then back to lateral.
o Thumb superior, then back inferior
o Thumb inferior, then back to superior - Answers - Thumb inferior, then back to
superior
With patient in the prone position, the dorsal roots of the spinal nerves are oriented:
o Deep to its corresponding ventral roots
o Superficial to its corresponding ventral roots
o Cranial to its corresponding ventral roots
o Caudal to its corresponding medial roots - Answers - Superficial to its corresponding
ventral roots
The connective tissue between the patella and the tibial tuberosity in the knee facilitates
quadriceps muscle contraction across the knee joint. What is this structure?
o Patellar Ligament
o Quadriceps Tendon
o Vastis Lateralis
o Vastis Medialis - Answers - Patellar Ligament
The talus forms an articulation with which of the following lists of bones:
o Navicular, cuneiform, fibula and calcaneus
o Tibia, cuboid, fibula, and cuneiform
o Calcaneus, navicular, tibia, and calcaneus
o Fibula, cuneiform, calcaneus, and tibia - Answers - Calcaneus, navicular, tibia, and
calcaneus
The acetabulum, or hip socket, is comprised of the fusion of which of the three bone
choices below?
o Ilium, sacrum, and pubis.
o Pubis, sacrum, and ischium.
o Pubis, ischium, and ilium.
o Sacrum, ischium, and ilium. - Answers - Pubis, ischium, and ilium.
A large bolus of potassium given intravenously to a patient may have catastrophic
effects on cardiac muscle and ultimately arrest cardiac function. The mechanism for this
problem is described in which of the following statements:
• Potassium in the intracellular space blocks repolarization of the muscle cell membrane
• Calcium and potassium inside the cell reach toxic levels
• Potassium displaces calcium across the nuclear membrane
,• Calcium displaces sodium across the nuclear membrane - Answers - Potassium in
the intracellular space blocks repolarization of the muscle cell membrane
The superior mesenteric artery provides primary blood supply for which of the following
structures:
o Esophagus
o Pancreas
o Stomach
o Spleen - Answers - o Pancreas
The uterine artery is a most commonly a direct branch of the:
o Internal iliac artery
o External iliac artery
o Common iliac artery
o Gonadal artery - Answers - o Internal iliac artery
After what percent of total blood volume may arterial pressure AND cardiac output begin
to significantly (and precipitously) drop?
o More than about 5%
o More than about 10%
o More than about 20%
o More than about 25% - Answers - o More than about 10%
Putting a patient into Trendelenberg position has the effect of:
o Decreasing blood flow to the brain
o Decreasing blood flow to the coronary arteries
o Increasing blood flow to the brain
o Increasing blood flow to the coronary arteries - Answers - o Increasing blood flow to
the brain
A history of crushing wound 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 responsible and require urgent surgery?
o Pericarditis
o Cardiac Asynchrony
o Cardiac Tamponade
o Pericardial Effusion - Answers - o Cardiac Tamponade
Which of the following may be a cause of acute cyanosis in a patient undergoing a
surgical procedure:
o Lower than normal hemoglobin
o Higher than normal hemoglobin
o Lower than normal hematocrit
o Higher than normal hematocrit - Answers - o Lower than normal hemoglobin
, Direct inadvertent stimulation of the Vagus nerve during carotid endarterectomy may
have which of the following transient affects:
• Bradycardia
• Tachycardia
• Alkalosis
• Acidosis - Answers - • Bradycardia
A choledoco-duodenostomy refers to the surgical anastomosis of which of the following
two structures:
o Gall bladder with the common bile duct
o Common bile duct and fundus of the stomach
o Duodenum and common bile duct
o Pancreatic duct and antrum of the stomach - Answers - Duodenum and common
bile duct
In knee arthroscopy, the antero-medial portal is placed:
o on the same side of the patella as the Ilio-tibial band.
o on the opposite side of the patella from the pes anserinus.
o superior to the quadriceps insertion on the patella.
o proximal and anterior to the pes anserinus, medial to the patellar ligament. - Answers
- proximal and anterior to the pes anserinus, medial to the patellar ligament
Epidural anesthesia is administered:
o Anterior (deep to) to the lumbar or sacral nerve roots.
o Into the space between the spinal canal and the dura mater covering the nerve roots.
o Into precisely the same subarachnoid space as spinal anesthesia, but in the sacral
area.
o Directly into the cerebral spinal fluid at any point from the ventricles in the brain, to the
cauda equina. - Answers - Into the space between the spinal canal and the dura mater
covering the nerve roots
A "foot drop" results from insufficiency of the extensor muscles in the foot, and may be
caused by lumbar disc herniation (damage to a nerve root in the lumbar spine), or
damage to/compression of the ________ nerve as it courses superficial to the fibular
head.
• peroneal
• pudendal
• posterior tibial
• sural - Answers - • peroneal
The recurrent laryngeal nerve is a branch of the:
• Phrenic Nerve
• Facial Nerve
• Brachial Plexus
• Vagus Nerve - Answers - • Vagus Nerve
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?
o Thumb lateral, then back to medial.
o Thumb medial, then back to lateral.
o Thumb superior, then back inferior
o Thumb inferior, then back to superior - Answers - Thumb inferior, then back to
superior
With patient in the prone position, the dorsal roots of the spinal nerves are oriented:
o Deep to its corresponding ventral roots
o Superficial to its corresponding ventral roots
o Cranial to its corresponding ventral roots
o Caudal to its corresponding medial roots - Answers - Superficial to its corresponding
ventral roots
The connective tissue between the patella and the tibial tuberosity in the knee facilitates
quadriceps muscle contraction across the knee joint. What is this structure?
o Patellar Ligament
o Quadriceps Tendon
o Vastis Lateralis
o Vastis Medialis - Answers - Patellar Ligament
The talus forms an articulation with which of the following lists of bones:
o Navicular, cuneiform, fibula and calcaneus
o Tibia, cuboid, fibula, and cuneiform
o Calcaneus, navicular, tibia, and calcaneus
o Fibula, cuneiform, calcaneus, and tibia - Answers - Calcaneus, navicular, tibia, and
calcaneus
The acetabulum, or hip socket, is comprised of the fusion of which of the three bone
choices below?
o Ilium, sacrum, and pubis.
o Pubis, sacrum, and ischium.
o Pubis, ischium, and ilium.
o Sacrum, ischium, and ilium. - Answers - Pubis, ischium, and ilium.
A large bolus of potassium given intravenously to a patient may have catastrophic
effects on cardiac muscle and ultimately arrest cardiac function. The mechanism for this
problem is described in which of the following statements:
• Potassium in the intracellular space blocks repolarization of the muscle cell membrane
• Calcium and potassium inside the cell reach toxic levels
• Potassium displaces calcium across the nuclear membrane
,• Calcium displaces sodium across the nuclear membrane - Answers - Potassium in
the intracellular space blocks repolarization of the muscle cell membrane
The superior mesenteric artery provides primary blood supply for which of the following
structures:
o Esophagus
o Pancreas
o Stomach
o Spleen - Answers - o Pancreas
The uterine artery is a most commonly a direct branch of the:
o Internal iliac artery
o External iliac artery
o Common iliac artery
o Gonadal artery - Answers - o Internal iliac artery
After what percent of total blood volume may arterial pressure AND cardiac output begin
to significantly (and precipitously) drop?
o More than about 5%
o More than about 10%
o More than about 20%
o More than about 25% - Answers - o More than about 10%
Putting a patient into Trendelenberg position has the effect of:
o Decreasing blood flow to the brain
o Decreasing blood flow to the coronary arteries
o Increasing blood flow to the brain
o Increasing blood flow to the coronary arteries - Answers - o Increasing blood flow to
the brain
A history of crushing wound 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 responsible and require urgent surgery?
o Pericarditis
o Cardiac Asynchrony
o Cardiac Tamponade
o Pericardial Effusion - Answers - o Cardiac Tamponade
Which of the following may be a cause of acute cyanosis in a patient undergoing a
surgical procedure:
o Lower than normal hemoglobin
o Higher than normal hemoglobin
o Lower than normal hematocrit
o Higher than normal hematocrit - Answers - o Lower than normal hemoglobin
, Direct inadvertent stimulation of the Vagus nerve during carotid endarterectomy may
have which of the following transient affects:
• Bradycardia
• Tachycardia
• Alkalosis
• Acidosis - Answers - • Bradycardia
A choledoco-duodenostomy refers to the surgical anastomosis of which of the following
two structures:
o Gall bladder with the common bile duct
o Common bile duct and fundus of the stomach
o Duodenum and common bile duct
o Pancreatic duct and antrum of the stomach - Answers - Duodenum and common
bile duct
In knee arthroscopy, the antero-medial portal is placed:
o on the same side of the patella as the Ilio-tibial band.
o on the opposite side of the patella from the pes anserinus.
o superior to the quadriceps insertion on the patella.
o proximal and anterior to the pes anserinus, medial to the patellar ligament. - Answers
- proximal and anterior to the pes anserinus, medial to the patellar ligament
Epidural anesthesia is administered:
o Anterior (deep to) to the lumbar or sacral nerve roots.
o Into the space between the spinal canal and the dura mater covering the nerve roots.
o Into precisely the same subarachnoid space as spinal anesthesia, but in the sacral
area.
o Directly into the cerebral spinal fluid at any point from the ventricles in the brain, to the
cauda equina. - Answers - Into the space between the spinal canal and the dura mater
covering the nerve roots
A "foot drop" results from insufficiency of the extensor muscles in the foot, and may be
caused by lumbar disc herniation (damage to a nerve root in the lumbar spine), or
damage to/compression of the ________ nerve as it courses superficial to the fibular
head.
• peroneal
• pudendal
• posterior tibial
• sural - Answers - • peroneal
The recurrent laryngeal nerve is a branch of the:
• Phrenic Nerve
• Facial Nerve
• Brachial Plexus
• Vagus Nerve - Answers - • Vagus Nerve
