Chapter 15: Obstetric and Gynecology Surgery

Which paired ligaments are encountered and ligated last in an abdominal hysterectomy and first in a vaginal hysterectomy?

Select one:

a. infundibulopelvic

b. uterosacral

c. round

d. cardinal

uterosacral

Radionuclide seeds are placed in infected Bartholin's gland cysts to treat the infected contents.

Select one:

True

False

False

Which of the following types of stirrups would likely be used for a laparoscopically assisted vaginal hysterectomy (LAVH)?

Select one:

a. posterior knee support

b. fiberglass hanging

c. Allen low lithotomy

d. candy cane hanging

Allen low lithotomy

Which instrument should the surgical technologist have ready to provide exposure during cesarean section procedures when the uterine incision is made?

Select one:

a. bladder blade

b. Auvard

c. Gelpi

d. Graves

bladder blade

Laparoscopic linear stapling devices are often used to ligate and cut the uterine ligaments and vessels during LAVH.

Select one:

True

False

True

Which of the following is routinely done first in a basic gynecologic laparoscopy that may require a small separate setup and glove change before proceeding?

Select one:

a. injection of methylene blue into IV

b. cervical conization

c. insertion of uterine manipulator

d. pelvic ultrasonography

insertion of uterine manipulator

Cherney, Maylard, and Pfannenstiel are examples of gynecologic:

Select one:

a. transverse abdominal incisions

b. urinary drainage catheters

c. self-retaining retractors

d. fenestrated drape sheets

transverse abdominal incisions

Which radiological study might be ordered preoperatively for a patient scheduled for tuboplasty?

Select one:

a. hysterosalpingogram

b. angiography

c. cholangiogram

d. retrograde urography

hysterosalpingogram

What color is the abnormal tissue after staining with Lugol's solution in a cervical biopsy?

Select one:

a. no color change

b. blue

c. white

d. brown

no color change

Which of the following is the largest supporting ligament in the female pelvis that has anterior and posterior leaves?

Select one:

a. round

b. broad

c. suspensory

d. cardinal

broad

What is used to achieve tissue destruction in an endometrial balloon ablation?

Select one:

a. hot dextrose water

b. electrical energy

c. laser light energy

d. ultrasonic friction

hot dextrose water

For a dilation and curettage (D&C), which of the following orders of instrument use is CORRECT for endometrial biopsy?

Select one:

a. weighted vaginal speculum, tenaculum, uterine sound, cervical dilators, endometrial curettes

b. uterine sound, weighted vaginal speculum, tenaculum, cervical dilators, endometrial curettes

c. cervical dilators, uterine sound, weighted vaginal speculum, tenaculum, endometrial curettes

d. tenaculum, uterine sound, weighted vaginal speculum, cervical dilators, endometrial curettes

weighted vaginal speculum, tenaculum, uterine sound, cervical dilators, endometrial curettes

For which procedure would the surgical technologist want to be sure to have adequate numbers of Allis or Allis-Adair tissue forceps?

Select one:

a. A&P repair

b. D&C

c. LAVH

d. TAH-BSO

A&P repair

What is a Veress needle used for?

Select one:

a. epidural anesthesia

b. suprapubic catheter placement

c. amniocentesis

d. laparoscopic insufflation

laparoscopic insufflation

Which method of tubal ligation is less frequently performed and requires use of long instruments, but may pose a higher risk of postoperative surgical site infection due to the approach?

Select one:

a. open, combined with cesarean section

b. colpotomy

c. minilaparotomy

d. laparoscopic

colpotomy

Which of the following procedures would likely be assigned a Class III or Class IV wound and may require aerobic and anaerobic culture tubes?

Select one:

a. radical hysterectomy

b. marsupialization of Bartholin's cyst

c. dilation and curettage

d. cesarean section delivery

marsupialization of Bartholin's cyst

Which incision is MOST frequently used for cesarean sections?

Select one:

a. Pfannenstiel

b. epigastric

c. paramedian

d. vertical midline

Pfannenstiel

The term adnexa refers to which gynecologic anatomical structures?

Select one:

a. labia minora, labia majora, urinary orifice, and clitoris

b. endometrium, myometrium, and peritoneum

c. fallopian tubes, ovaries, and infundibulum

d. isthmus, internal os, cervix, and external os

fallopian tubes, ovaries, and infundibulum

Which anatomical area is located between the posterior vaginal opening and the anus?

Select one:

a. perineum

b. labia majora

c. mons pubis

d. urethral orifice

perineum

Which instrument is used to grasp the cervix and provide traction during cervical dilation?

Select one:

a. Babcock tissue forceps

b. perforating Backhaus clip

c. single-tooth tenaculum

d. Allis-Adair tissue forceps

single-tooth tenaculum

Bulb syringes are used in obstetrical delivery procedures to:

Select one:

a. suction amniotic fluid from the field

b. suction the mouth and nares of the neonate

c. collect cord blood gas specimens

d. collect pelvic washings for cytology

suction the mouth and nares of the neonate

Adhesion formation is a normal physiologic inflammatory response to abdominal surgery that cannot be prevented or minimized.

Select one:

True

False

False

Which self-retaining retractor has the shape of a figure-of-eight (8) when in the closed position?

Select one:

a. Franz

b. Balfour

c. Gelpi

d. O'Sullivan-O'Connor

O'Sullivan-O'Connor

Which type of needle holder is curved and frequently used for hysterectomy procedures?

Select one:

a. Castroviejo

b. Heaney

c. Mayo-Hegar

d. Webster

Heaney

Which medication may be injected into the uterus for hemostasis, before closure of the uterus in a cesarean section?

Select one:

a. Hyskon

b. Lugol's

c. dextran

d. oxytocin

oxytocin

Which procedure involves an en bloc removal of the uterus, bilateral ovaries and fallopian tubes, supporting ligaments, upper third of the vagina, and pelvic lymph nodes?

Select one:

a. suprapubic hysterectomy

b. anterior and posterior colporrhaphy

c. bilateral laparoscopic tubal ligation

d. radical hysterectomy

radical hysterectomy

When is the first closing count performed in a cesarean section?

Select one:

a. as the fascial or muscle layer is being sutured

b. immediately prior to delivery of the placenta

c. when the umbilical cord is clamped and cord blood is collected

d. when the first suture is given for closure of the uterus

when the first suture is given for closure of the uterus

Which instrument is used to test the patency of the fallopian tube during tuboplasty?

Select one:

a. lacrimal probe

b. Hegar dilator

c. Veress needle

d. uterine sound

lacrimal probe

What is the preferred method of anesthesia for a cesarean section delivery?

Select one:

a. Bier block

b. general

c. epidural

d. spinal

epidural

Which pistol-grip type of instrument might be found in a D&C tray for cervical biopsy?

Select one:

a. Tischler

b. pituitary

c. Kerrison

d. Takahashi

Tischler

Which maneuver might be performed by the surgical technologist during a cesarean section to aid in the delivery as the surgeon gently manipulates the head of the fetus out of the uterus?

Select one:

a. insertion of the surgical technologist's hand into the uterus to pull the legs of the fetus out

b. use of two Balfour bladder blades to widen the uterine opening

c. application of external pressure over the fundus of the uterus

d. application of external pressure over the bladder

application of external pressure over the fundus of the uterus

What is the name of the routine surgical treatment of infected Bartholin's gland cysts?

Select one:

a. cerclage

b. episiotomy

c. marsupialization

d. labioplasty

marsupialization

What is the general term for the treatment method that destroys genital condylomata with a carbon dioxide laser?

Select one:

a. ablation

b. curettage

c. exenteration

d. suspension

ablation

Total abdominal hysterectomy is assigned which wound classification?

Select one:

a. Class IV

b. Class III

c. Class I

d. Class II

Class II

Which muscle is incised in transverse abdominal approaches for gynecologic procedures?

Select one:

a. internal oblique

b. external oblique

c. anterior rectus

d. serratus anterior

anterior rectus

Which anatomical structure is located anterior to the symphysis pubis and superior to the vaginal opening?

Select one:

a. urethral orifice

b. mons pubis

c. labia majora

d. perineum

mons pubis

Instruments used for closure of the vaginal cuff in total abdominal hysterectomy are:

Select one:

a. discarded in the trash

b. flash sterilized by the circulator

c. used to elevate the fascia during closure

d. isolated as contaminated

isolated as contaminated

Which gynecologic procedure is performed for treatment of urinary incontinence or cystocele?

Select one:

a. Wertheim's procedure

b. posterior colporrhaphy

c. Shirodkar procedure

d. anterior colporrhaphy

anterior colporrhaphy

Which term means the number of times a woman has been pregnant?

Select one:

a. gravida

b. rotation

c. menarche

d. parity

gravida

Which of the following procedures does NOT require an incision, use of trocars, or distention with gas or fluid?

Select one:

a. colposcopy

b. pelviscopy

c. laparoscopy

d. hysteroscopy

colposcopy

The fallopian tubes are located bilaterally in the mesosalpinx of which uterine-pelvic ligaments?

Select one:

a. round

b. broad

c. uterosacral

d. cardinal

broad

In which procedure would the surgeon likely request 8-0 or 9-0 suture?

Select one:

a. tuboplasty

b. tubal ligation

c. cervical cerclage

d. cesarean section

tuboplasty

Radionuclide seeds are used to treat:

Select one:

a. dysmenorrhea/menorrhalgia

b. uterine/cervical carcinoma

c. vulvar condylomata

d. endometriosis

uterine/cervical carcinoma

What is the name of the heavy, right-angle scissors frequently used to dissect around the cervix during hysterectomy?

Select one:

a. Jorgenson

b. Metzenbaum

c. tenotomy

d. Braun

Jorgenson

What color is the abnormal tissue after staining with acetic acid in a cervical biopsy?

Select one:

a. white

b. brown

c. blue

d. no color change

white

What is the procedure name for the removal of fibroid tumors of the uterus with the preservation of fertility?

Select one:

a. myomectomy

b. endometrial ablation

c. oophorectomy

d. pelvic exenteration

myomectomy

All of the following are paired ligaments that support the uterus in the lower abdomen and attach it to the pelvis, EXCEPT:

Select one:

a. broad

b. round

c. cardinal

d. Cooper's

Cooper's

Which of the following is used for creating pneumoperitoneum in laparoscopy?

Select one:

a. helium

b. nitrogen

c. carbon dioxide

d. oxygen

carbon dioxide

In which of the following procedures would the patient be left without a vagina or any of the female reproductive organs and have a permanent colostomy and ileostomy?

Select one:

a. cerclage

b. colporrhaphy

c. marsupialization

d. exenteration

exenteration

Cephalopelvic disproportion is a component of which of the following indications for a cesarean section delivery?

Select one:

a. dystocia

b. uterine rupture

c. placenta previa

d. preeclampsia

dystocia

Which of the following is a weighted vaginal speculum?

Select one:

a. Auvard

b. Graves

c. Heaney

d. Sims

Auvard

Which gynecologic procedure is used for visualization of the endometrium and may be used to treat polyps or myomas?

Select one:

a. cervical cerclage

b. laparoscopy

c. hysteroscopy

d. dilation and curettage

hysteroscopy

What is the name of a bivalve speculum frequently found in a vaginal procedure tray?

Select one:

a. Hegar

b. Graves

c. Goelet

d. Heaney

Graves

Delivery of the placenta is the conclusion of which stage of labor?

Select one:

a. fourth

b. second

c. third

d. first

third

Tubal ligation is performed for:

Select one:

a. unruptured tubal pregnancy

b. blood gas collection

c. elective sterilization

d. urinary incontinence treatment

elective sterilization

In a robotically assisted hysterectomy, the surgical technologist may be responsible for removing the specimen from the vagina after the vaginal cuff closure has been completed.

Select one:

True

False

True

What is the main purpose of putting a bolster sheet or roll under the right hip of a patient just prior to C-section?

Select one:

a. It reduces low back strain while in the supine position.

b. It keeps the epidural catheter from being kinked.

c. It reduces the pressure of the gravid uterus on the vena cava.

d. It prevents sacral decubitus ulcer formation.

It reduces the pressure of the gravid uterus on the vena cava.

What is the name of the fingerlike projections at the terminal end of the fallopian tube that guides oocytes into the lumen?

Select one:

a. external os

b. fimbria

c. ampulla

d. isthmus

fimbria

Which instrument is used to manipulate the fallopian tubes without compression or damage?

Select one:

a. Ferris-Smith tissue forceps

b. Babcock tissue forceps

c. Kocher clamp

d. Heaney clamp

Babcock tissue forceps

Which of the following statements is CORRECT regarding anatomical changes following pelvic exenteration?

Select one:

a. Colostomy and ileostomy will both exit on the left side of the abdomen.

b. Colostomy will exit on the right and ileostomy on the left side of the abdomen.

c. Colostomy will exit on the left and ileostomy on the right side of the abdomen.

d. Colostomy and ileostomy will both exit on the right side of the abdomen.

Colostomy will exit on the left and ileostomy on the right side of the abdomen.

What is the name of the anatomical area where the fallopian tubes are attached and enter the uterus?

Select one:

a. cervix

b. isthmus

c. cornu

d. infundibulum

cornu

Which of the following structures is NOT part of the anatomy of the vulva?

Select one:

a. clitoris

b. labia

c. mons pubis

d. cervix

cervix

What is another name for the ovarian suspensory ligament?

Select one:

a. uterosacral

b. cardinal

c. infundibulopelvic

d. round

infundibulopelvic

For which procedure would the gynecologist likely wear surgical loupes?

Select one:

a. robotically assisted hysterectomy

b. tubal reanastomosis

c. cesarean section

d. endometrial ablation

tubal reanastomosis

Cervical cerclage is performed to:

Select one:

a. prevent spontaneous abortion

b. repair a cystocele

c. biopsy the areas of dysplasia

d. vaporize vaginal condylomata

prevent spontaneous abortion

How many stages of labor and delivery does the patient go through?

Select one:

a. three

b. five

c. four

d. two

four

Which of the following is a serum analysis done to detect ovarian carcinoma?

Select one:

a. CBC

b. CA-125

c. KUB

d. FSH

CA-125

Clamp, clamp, cut, tie (CCCT) is a way to anticipate routine dissection steps during hysterectomy procedures.

Select one:

True

False

True

Which piece of operating room furniture would likely be unnecessary for many vaginal surgical procedures?

Select one:

a. ESU

b. back table

c. Mayo stand

d. kick bucket

Mayo stand

What is the MOST common surgical intervention for a vaginal delivery?

Select one:

a. cerclage

b. marsupialization

c. labioplasty

d. episiotomy

episiotomy