Deck 28: Surgical Incisions, implants, and Wound Closure

Question 1

Which term is also known as bone cement?

A) Dermabond
B) Cyanoacrylate
C) Polydiaxanone
D) Methyl methacrylate

Answer 1

D
Methyl methacrylate is used to augment fixation of pathologic fractures and to stabilize prosthetic devices in bone.It is an acrylic,cement-like substance whose powder and liquid must be mixed just prior to being used.

Question 2

Which is the outermost,top layer of skin?

A) Stratus layer
B) Cuticular layer
C) Epidermis layer
D) Subcutaneous layer

Answer 2

C
The epidermis is the outermost layer and is organized into five levels of stratified squamous epithelium and contains no organs,glands,nerve endings,or blood vessels.

Question 3

What is one necessary specification of all suture materials?

A) Must be sterile when placed in tissue
B) As large a diameter as possible must be used to ensure proper hold
C) Removal must occur within 7 to 10 days postoperatively
D) Must be greatly reactive to skin and tissue to be effective

Answer 3

A
Suture material must be sterile when placed in tissue.Sterile techniques must be rigidly followed in handling suture material.Almost all postoperative wound infections are initiated along or adjacent to suture lines.Affinity for bacterial contamination varies with the physical characteristics of the material.

Question 4

What type of needle has a slit from inside the eye to the end of the needle through which the suture strand is drawn?

A) Single-armed needle
B) Permanently swaged needle
C) French eye needle
D) Cutting needle

Question 5

What type of suture is typically used on facial procedures?

A) Chromic surgical gut
B) PDS
C) Surgical stainless steel
D) Plain surgical gut

Question 6

What type of stitch is used for skin edges primarily?

A) Everting
B) Inverting
C) Diverting
D) Overting

Question 7

What is one disadvantage of using staples on tissues?

A) Produces an air-tight closure,that may leak
B) Staples used on skin cannot be removed sooner than 3 weeks postoperatively
C) Produces an uneven surface
D) Cannot be placed through an endoscope

Question 8

A _____ stitch is one in which each individual stitch is placed,tied,and cut in succession from one suture.

A) Horizontal mattress
B) Simple interrupted
C) Connell suture
D) Continuous running

Question 9

What type of incision is typically used for an open appendectomy procedure?

A) Thoracoabdominal incision
B) Pfannenstiel incision
C) Inguinal incision
D) McBurney's incision

Question 10

Which statement is true regarding suture knot tying?

A) Place the knot in a noticeable spot.
B) Tie the knot toward a weak blood supply.
C) Tie the knot toward a vital structure.
D) Tie the knot away from a potential irritant such as the nares.

Question 11

Which is an organ or structure that lies within the peritoneal cavity?

A) Kidney
B) Small bowel
C) Bladder
D) Aorta

Question 12

When incisions are made along Langer lines,the resulting closure is more cosmetically pleasing.

Question 13

When handling synthetic absorbable sutures,soak them in saline before using to allow better pliability.

Question 14

Which statement is true regarding a stainless steel suture?

A) A stainless steel suture is very elastic.
B) Stainless steel may not be used when an infection is present.
C) Stainless steel is used in the respiratory tract.
D) Stainless steel is cut only with Mayo suture scissors.

Question 15

Which is a feature that does not apply to the Halsted suture technique?

A) When there is an infection present,silk suture is the preferred stitch.
B) Sutures are cut close to the knot.
C) A suture that is stronger than the tissue it holds should not be used.
D) Each skin stitch requires a separate needle.

Question 16

What type of device is used to span an incision?

A) Bumper
B) Bolster
C) Bridge
D) Buttons or beads

Question 17

What type of suture does not separate from the needle unless pulled off intentionally?

A) Double-armed attachment
B) Permanently swaged needle attachment
C) Controlled-release needle attachment
D) Halsted needle

Question 18

Which layer of the epidermis creates cells that reproduce and multiply to form new epidermal layers?

A) Stratum corneum
B) Stratum lucidum
C) Stratum granulosum
D) Stratum spinosum

Question 19

After an EEA stapler is used to anastomose two edges of tissue together,a doughnut-shaped ring is sent to pathology as a specimen.

Question 20

Which is an example of a synthetic nonabsorbable polymer?

A) Dermal silk
B) Surgical cotton
C) Stainless steel suture
D) Surgical nylon

Question 21

What is the standard length of absorbable suture material?

A) 60 inches
B) 54 inches
C) 10 inches
D) 5 inches

Question 22

Which is a disadvantage of synthetic mesh material?

A) Very few pores to allow drainage
B) Limited pre-cut patch sizes
C) Difficulty with suturing underneath the edges of tissue
D) Not an inert material

Question 23

Which is a disadvantage of skin closure strips?

A) They can cause foreign body tissue reaction.
B) They curl up and fall off easily.
C) Visibility of the healing wound is limited.
D) Application can be time consuming.

Question 24

Which is the top,outermost layer of abdominal closure underneath the skin layer?

A) Peritoneal tissue
B) Fascia
C) Subcuticular tissue
D) Muscle

Question 25

What type of material can be used to retract skin or a vessel?

A) Cotton towel
B) Thyroid shield
C) Balfour retractor
D) Umbilical tape

Question 26

What main precaution must be taken when handling any implants,especially silicone implants?

A) Always rinse an implant in saline before using.
B) Use a nonsterile marker to write down the size of the implant.
C) The implant should always be handled with bare hands only.
D) Gloves that are free of lint,dust,powder,and surface contaminants should be worn.

Question 27

Which of the following is a suture cover?

A) Primary packet
B) Peel pack
C) Chemguard wrap
D) Dust cover

Question 28

Which is a requirement of prosthetic materials that are to be implanted into the body?

A) Will degenerate within 2 to 3 years
B) Produce little or no tissue reaction
C) Maintain marginal tissue coverage
D) Maintain degenerative qualities within the body

Question 29

Which is a component of fibrin glue?

A) Platelets
B) Potassium gluconate
C) Fibrinogen
D) Gelfoam

Question 30

What is another name for a suture ligature?

A) Tie on a passer
B) Stick tie
C) Free tie
D) Kittner

Question 31

What type of bone can be taken from a patient's own tibia?

A) Allogenous cortical bone
B) Autologous cancellous bone
C) Autologous cortical
D) Allogenous cancellous

Question 32

Which is not a biologic tissue replacement material?

A) Cryopreserved skin
B) Silicone
C) Amniotic membrane
D) Artificial skin

Question 33

Which is a handling consideration when working with surgical gut and collagen sutures?

A) Prior to use,allow the alcohol in the packet to evaporate.
B) Do not unwind the suture before handing it up on a needle holder.
C) Be careful to not soak suture in saline prior to use.
D) Avoid spilling the fluid within the suture packet onto the sterile field.

Question 34

Which is a strand used to make suture materials?

A) Monofilament
B) Polyfilament
C) Unafilament
D) Bifilament

Question 35

Which is a component used to classify surgical needles?

A) Color
B) Length
C) Point
D) Neck

Question 36

Which is a classification of suture?

A) Disposable
B) Absorbable
C) Reusable
D) Resorbable

Question 37

What type of stitch is more likely to be used on stomach,colon,or bladder?

A) Absorbable
B) Nonabsorbable
C) Disposable
D) Resorbable

Question 38

Which is a principle to be followed when handling needles and needle holders at the serial field?

A) Clamp the needle one quarter the distance from the eye to the point.
B) Close the ratchet of the needle holder on the first or second ratchet.
C) Never touch the free end of the suture material when handing it up at the sterile field.
D) Pass the needle holder with the needle point down toward the sterile wound.