QUIZ Ch. 11 - Hemostasis, Wound Healing, and Wound Closure Flashcards by Unknown Unknown

What is used to close the epidermal layer when a subcuticular wound closure has been done for good cosmesis?

a.
suture anchors

b.
suture bridge

c.
split lead shots

d.
skin closure tapes

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Which type of suture ties has an attached needle?

a.
free tie

b.
ligature reel

c.
tie-on-a-passer

d.
suture ligature

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If tissue is approximated too tightly, it can result in:

a.
keloids

b.
adhesions

c.
ischemia

d.
granulation

c.
ischemia

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What is the chemical name of Gore-Tex suture?

a.
polyglactin 910

b.
polybutester

c.
polytetrafluoroethylene

d.
polypropylene

c.
polytetrafluoroethylene

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Which layer of the abdominal wall must be approximated securely, even if the other layers are not?

a.
subcutaneous fat

b.
fascia

c.
peritoneum

d.
skin

b.
fascia

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Another name for a suture ligature is a:

a.
free tie

b.
ligature reel

c.
tie-on-a-passer

d.
stick tie

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What kind of wound is a sacral decubitus ulcer?

a.
closed

b.
clean

c.
contusion

d.
chronic

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A continuous suturing technique that places sutures in the endothelial layer of the skin in short, lateral throws is called a:

a.
purse-string suture

b.
mattress suture

c.
subcuticular suture

d.
traction suture

c.
subcuticular suture

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In general, a monofilament suture would require ____________ knot throws for security than a multifilament suture.

a.
more

b.
the same number of

c.
fewer

d.
more, but only if coated

a.
more

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Which historic figure in medicine is credited with creating principles of proper tissue handling and suturing?

a.
DeBakey

b.
Cushing

c.
Kocher

d.
Halsted

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The tensile strength of suture material should equal the tensile strength of the tissue into which suture is placed.

True
False

True

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What is the term for the blood products donated by another person?

a.
hemolytic

b.
homologous

c.
homeostasis

d.
hemostat

b.
homologous

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A surgeon’s choice of suture to be used is based on the surgeon’s training, the condition of the patient, the type of wound, and the conditions surrounding the surgical intervention.

True
False

True

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Which phase of healing for wounds closed by first intention begins within minutes of the incision or injury?

a.
maturation

b.
inflammatory

c.
granulation

d.
proliferation

b.
inflammatory

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Which type of needle is preferred for suturing of skin?

a.
spatula

b.
taper

c.
cutting

d.
blun

c.
cutting

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What is the term for a type of suture that has the strand of suture material inserted into the hollowed-out needle end?

a.
closed eye

b.
crimped

c.
French-eye

d.
swaged

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Which of the following sutures has comparatively inconsistent tensile strength and rapid absorption rate in vivo with moderate tissue reaction?

a.
plain surgical gut

b.
polydioxanone

c.
poliglecaprone

d.
polyglyconate

a.
plain surgical gut

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Which of the following is synthetic, monofilament, nonabsorbable, and the most inert synthetic suture used frequently in cardiovascular and ophthalmology procedures?

a.
polypropylene

b.
polybutester

c.
polyterephthalate

d.
polytetrafluoroethylene

a.
polypropylene

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Which of the following surgical needles is a solid bore (not hollow) type of needle?

a.
Tru-cut

b.
Dorsey

c.
Keith

d.
heparin

c.
Keith

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A way in which the surgical technologist can assist the surgeon by keeping the suture strand out of the way during a continuous running closure is by:

a.
following

b.
tracking

c.
tagging

d.
pulling

a.
following

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Which suture gauge would be MOST appropriate for ophthalmic surgery?

a.
0

b.
3-0

c.
8-0

d.
#5

c.
8-0

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To achieve the goal of leaving as little foreign material in a wound, the ideal suture selected should have:

a.
high-tensile strength and small diameter

b.
a large diameter gauge

c.
an antibacterial coating over it

d.
tightly braided fibers with capillarit

a.
high-tensile strength and small diameter

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The suturing technique MOST appropriate for wounds likely to become infected or suffer potential stress is:

a.
blanket

b.
interrupted

c.
purse-string

d.
simple continuous

b.
interrupted

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Tourniquets provide permanent mechanical hemostasis and enhance visualization by creating a bloodless field.

True
False

False

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Which organization specifies diameter ranges for sutures? a. Brown and Sharpe (B&S) b. American National Standards Institute (ANSI) c. U.S. Pharmacopeia (USP) d. U.S. Food and Drug Administration (FDA)

c. U.S. Pharmacopeia (USP)

What is the chemical name for Dermabond™ or Indermil™? a. polymethyl methacrylate b. cryoprecipitate c. cyanoacrylate d. fibrin glue

c. cyanoacrylate

Kitners, Cottonoids, and laps are surgical: a. clamps b. sponges c. tourniquets d. ligatures

b. sponges

Which wound classification would be assigned to a vaginal hysterectomy with anterior and posterior colporrhaphy? a. Class IV b. Class I c. Class II d. Class III

c. Class II

Which of the following is a genetic clotting deficiency? . anaphylaxis b. hyperthermia c. aplastic anemia d. hemophilia

d. hemophilia

By which intention would a purulent wound treated by debridement and placement of medicated packing, then sutured after resolution of the infection heal? a. primary union b. first intention c. second intention d. third intention

d. third intention

Which blood type is considered the universal recipient? a. AB b. A c. O d. B

a. AB

What is the name of a raised, hypertrophic scar due to excessive collagen formation in some darker-skinned individuals? a. granuloma b. seroma c. keloid d. cicatrix

c. keloid

What would be the type of suture placed temporarily in the tongue to hold it out of the way in a maxillofacial procedure? a. suture ligature b. traction c. retention d. purse-strin

b. traction

Which type of synthetic mesh is absorbable? . polyester fiber b. PTFE c. polypropylene d. polyglactin 910

d. polyglactin 910

Which of the following is NOT a method of achieving hemostasis? a. thermal b. mechanical c. chemical d. apportional

d. apportional

Which suturing technique would be used to close the stump of the appendix in an open appendectomy? a. retention b. purse-string c. horizontal mattress d. vertical mattress

b. purse-string

What is the term for tissue that is easily torn or shredded? a. adhesive b. eviscerated c. friable d. dehisced

c. friable

Which suture is MOST inert in tissue? a. chromic gut b. surgical silk c. plain gut d. stainless steel

d. stainless steel

Which tissue layer of the abdominal wall provides the greatest strength and support of the wound? a. fascia b. peritoneum c. skin d. subcutaneous fa

a. fascia

Avitene®, Gelfoam®, and Surgicel® are examples of mechanical methods of hemostasis. True False

False

Which of the following is NOT correct about the structure/design of suture needles? a. They are classified according to the eye, point, and body. b. They may be eyed or eyeless. c. They may be straight or curved. d. They range from 1/2 circle curvature to 5/8 circle curvature.

They range from 1/2 circle curvature to 5/8 circle curvature.

Evisceration of an abdominal wound is: a. filling in of a wound from bottom up b. protrusion of viscera through all tissue layers c. excessive scar formation after surgery d. single- or multi-layer separation of wound edges

b. protrusion of viscera through all tissue layers

Which type of suture needle is used on friable tissue such as liver or kidney? a. taper b. cutting c. blunt d. trocar

c. blunt

Tissue trauma is minimized by using which type of suture-needle combination? a. threaded suture on a closed-eye Keith needle b. suture loaded on a French-eyed taper needle c. suture permanently swaged on an eyeless needle d. threaded suture on a closed-eye taper needle

c. suture permanently swaged on an eyeless needle

Which nonsuture needle is used for insufflation of carbon dioxide into the abdomen for laparoscopy? a. arterial b. Veress c. spinal d. hypodermic

b. Veress

Which statement is CORRECT regarding monofilament sutures? a. They may be used in infected wounds. b. They have high capillarity. c. They cause increased tissue drag. d. They are braided, twisted, and coated.

a. They may be used in infected wounds.

Primary union wound healing occurs: a. bottom to top b. end to end c. top to bottom d. side to side

d. side to side

Ligatures are use to: a. prevent evisceration b. occlude the lumen of a blood vessel c. eliminate dead space d. approximate tissue layers

b. occlude the lumen of a blood vessel

What is the primary reason bolsters are used with retention sutures? a. to prevent sutures from cutting into the skin b. to stabilize heavy dressings without use of tape c. to prevent dressings from touching the suture line d. to facilitate easy postop suture removal

a. to prevent sutures from cutting into the skin

Natural absorbable sutures are broken down in the body by: a. enzymatic digestion b. capillarity c. metabolic factors d. granulation

a. enzymatic digestion

Ethicon sutures may be available with a designation of "plus" for some sutures, which means they: a. are impregnated with an antibacterial coating b. have a heavier gauge needle for thicker tissues c. are longer strands than the original versions d. have more than one needle in the package

a. are impregnated with an antibacterial coating

Which of the following is an example of acceptable and safe intraoperative autotransfusion blood collection? a. bloody ascites fluid drained from the peritoneal cavity during surgery for ovarian cancer b. blood collected during a major abdominal trauma procedure with small bowel perforation c. blood collected from sponges into a basin of sterile saline during repair of ruptured abdominal aortic aneurysm d. bloody fluid suctioned during liver resection with use of reconstituted topical thrombin spray on oozing bleeders

c. blood collected from sponges into a basin of sterile saline during repair of ruptured abdominal aortic aneurysm

Which of the following is a natural, multifilament suture classified as nonabsorbable but loses much of its tensile strength in a year and is undetectable in tissues after 2 years? a. stainless steel b. surgical silk c. polyester d. polypropylene

b. surgical silk

Which of the following tissues is NOT part of the abdominal wall closure when retention sutures are placed? a. subcutaneous fat b. fascia lata c. mesentery d. peritoneum

c. mesentery

Two members of the surgical team must perform the checks of identification information: patient armband, blood and Rh type, unit number, and expiration date prior to administration of any blood products to a patient. True False

True

Which type of suture is often used to create a vascular anastomosis? a. synthetic, nonabsorbable, monofilament with double-armed taper needles b. synthetic, absorbable, monofilament on a Keith straight needle c. synthetic, absorbable, multifilament on a 3/8 circle cutting needle d. synthetic, nonabsorbable, multifilament on a 1/2 circle taper needle

a. synthetic, nonabsorbable, monofilament with double-armed taper needles

Which internal stapling device fires a circular double row of staples to reanastomose the colon? a. ligating clip applier b. intraluminal stapler c. linear cutter d. linear stapler

b. intraluminal stapler

Which needle has the cutting edge on the outside curvature of the needle body? a. reverse b. Keith straight c. spatula d. conventiona

a. reverse

Which type of healing occurs in an aseptic wound with good approximation and ideal surgical conditions? a. second intention b. third intention c. first intention d. fourth intention

c. first intention

All of the following are techniques for eliminating dead space in a wound EXCEPT: a. electrical nerve stimulation b. careful approximation of tissues c. pressure dressings d. placement of wound drain

a. electrical nerve stimulation

A patient undergoing chemotherapy and radiation therapy for cancer might experience prolonged wound healing due to: a. vascular proliferation b. Class I, primary union wound c. immunosuppressed status d. hyperactive immune response

c. immunosuppressed status

Which suture technique involves making a knot in the suture outside of the body and then pushing it inside through a cannula? a. secondary suture line b. extracorporeal method c. figure-of-eight stick tie d. intracorporeal method

b. extracorporeal method

Which of the following wounds would be assigned a Class I? a. appendectomy with no major intestinal spillage b. gunshot wound to the abdomen c. inguinal hernia repair with no breaks in technique d. compound femoral fracture

c. inguinal hernia repair with no breaks in technique

Which postoperative wound complication would require immediate surgical treatment? a. infection b. fistula c. evisceration d. adhesions

c. evisceration

What is the term for removal of foreign material or contaminated debris from a wound? a. denuding b. debridement c. desiccation d. dehiscence

b. debridement

Sutures with memory, such as chromic, plain, nylon, or other monofilaments, should be stretched tightly to remove any kinks in the strand before being handed to the surgeon. True False

False

Which of the following interweaves its fibers during the maturation phase of wound healing and increases its tensile strength? a. protein b. collagen c. fibrin d. enzymes

b. collagen

Approximation is bringing two sides of a wound together closely with sutures, wound zippers, or special adhesives so that the wound can heal from side to side. True False

True

Elective surgery patients may be asked to discontinue use of which medication to prevent drug-therapy-induced platelet dysfunctions? a. anticonvulsants b. aspirin c. antacids d. antibiotics

b. aspirin

Which of the following statements is TRUE regarding natural absorbable sutures? a. They are packaged dry. b. They are braided multifilament strands. c. They have less tissue reaction than synthetics. d. They are packaged wet.

d. They are packaged wet

What is the term that describes the measure of how much a suture strand can be stretched before breaking? a. tensile strength b. gauge c. drag coefficient d. capillarity

a. tensile strength

How will the surgeon manipulate skin edges of a wound before the surgical technologist places an approximating skin staple? a. invert the edges inward b. overlap the edges tightly c. evert the edges outward d. rotate the edges slightly

c. evert the edges outward

Which absorbable suture provides for the MOST extended wound support? a. Monocryl b. Polysorb c. PDS Plus d. Vicryl

c. PDS Plus

Some multifilament sutures are coated to: a. decrease the absorption rate b. prevent knot slippage c. increase the capillarity d. provide smooth passage through tissue

d. provide smooth passage through tissue

Suture gauge can range from #5 (being the smallest) to 11-0 (being the heaviest) diameter. True False

False

A wound that is not sutured and that gradually fills in by granulation heals by which intention? a. fourth b. second c. first d. third

b. second

Inflammation can BEST be described as: a. a disease process accompanied by fever b. a normal protective response to tissue injury c. an abnormal physiologic response to tissue injury d. an exaggerated immune system response

b. a normal protective response to tissue injury

Which of the following types of vessel loops are NOT available for use? a. green colored for bile ducts b. yellow colored for nerves c. red colored for arteries d. blue colored for veins

a. green colored for bile ducts