Science Of Energy

Question 1

Advanced bipolar instruments incorporate the following improvements over traditional bipolar instruments:

Answer 1

Impedance sensing, increased compression, mechanical cutting, 7mm vessel seal

Question 2

“Energy always seeks the path of least resistance.” This principle relates to which important tissue effect?

Answer 2

Lateral thermal spread

Question 3

What are the controllable factors that impact tissue sealing? (Select all that apply)

Answer 3

Heat, time, compression

Question 4

What surgeons sometimes do to coagulate vessels> 1mm with a monopolar pencil?

Answer 4

Use a metal instrument (forceps or hemostat) to apply compression while using intentional direct coupling

Question 5

Which of the following is NOT benefit of harmonic technology?

Answer 5

Faster than monopolar

Question 6

Vessel Sealing up to and including 7mm is a benefit of increasing the physical factor in advanced bipolar devices.

Answer 6

Compression

Question 7

Ohm’s law states that voltage is equal to current times _____.

Answer 7

Resistance

Question 8

As tissue dedicates (dries out), the ____ within the tissue ______, causing energy to move to a new path outside of the intended area.

Answer 8

Resistance, increases

Question 9

What is NOT true about monopolar devices?

Answer 9

Monopolar devices require longer time on tissue, compared to bipolar or ultrasonic devices

Question 10

When using monopolar pencils, which action below may decrease the risk of a surgeon getting burned when intentionally using direct coupling (“buzzing” a metal instrument to add compression”)

Answer 10

Holding the instrument in a way that provides more surface area and contact, to minimize concentration

Question 11

Nerve and muscle stimulation ceases at ____ kHz, because the _____ is so rapid across the body’s neurons that the brain doesn’t recognize it.

Answer 11

100 kHz, frequency

Question 12

Which statement below is FALSE?

Answer 12

Monopolar devices use direct current and bipolar devices use alternating current

Question 13

Which of the following energy modalities requires a return pad?

Answer 13

Monopolar

Question 14

The smaller the area of contact, the greater the current concentration, resulting in greater tissue effect. TRUE OR FALSE

Answer 14

TRUE

Question 15

What is the relationship between current concentration and time on the tissue?

Answer 15

Higher current concentration and longer time on tissue means more thermal tissue damage

Question 16

What is the relationship between voltage and power?

Answer 16

Voltage and power are directly related, meaning if the voltage is lower , the power is less

Question 17

In terms of electrical current, smaller areas of contact result in _____ higher current density (or current concentration), creating a ____ substantial tissue effect (tissue damage)

Answer 17

Higher, more

Question 18

What is NOT a basic principle of electricity?

Answer 18

Follows the path of greatest resistance

Question 19

This monopolar waveform has higher volatiles and is only approx. 6% of the time.

Answer 19

Coagulation

Question 20

Patients don’t get electrocuted during the electrosurgery because electro surgical generators operate safely at frequencies of 200kHz or above, which is too high to cause neuromuscular stimulation. TRUE OR FALSE

Answer 20

True

Question 21

In what way could the PURE CUT setting be beneficial to the patient?

Answer 21

Lower voltages can minimize lateral thermal damage

Question 22

Potential risks of monopolar electrosurgery are:

Answer 22

All of the above

Question 23

Which monopolar waveform produces the least lateral thermal damage?

Answer 23

Pure cut

Question 24

Which statement below is FALSE?

Answer 24

Power is the driving force that pushes electrons, measured in watts

Question 25

______ _______ and _____ are uncontrollable factors that impact tissue sealing.

Answer 25

Collagen, elastin, water

Question 26

Which is NOT a reason why surgeons may choose to use Monopolar devices?

Answer 26

Large vessel sealing