Electrosurgery Quiz Meant For Every Aspiring Surgeon
Electrosurgery is the application of a high-frequency alternating polarity, electrical current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. Its benefits include the ability to make precise cuts with limited blood loss.
This is an Electrosurgery Quiz meant for every aspiring Surgeon!
- 1.
You are performing a total abdominal hysterectomy. At the lateral vaginal cuff you notice a small artery pumping bright red arterial blood. How should you employ electrocautery to control the bleeding?
- A.
Grasp it with a tonsil clamp and touch the bovie tip to the clamp and activate “cut” or “Coag” until the tissue desiccates.
- B.
Apply the bovie tip directly to the pumping artery use “Coag” and increase the power until the bleeding stops.
- C.
Apply the bovie tip directly to the pumping artery use “Cut” and increase the power until the bleeding stops.
- D.
Use a suture as electrocautery cannot control arterial bleeding.
Correct Answer
A. Grasp it with a tonsil clamp and touch the bovie tip to the clamp and activate “cut” or “Coag” until the tissue desiccates.Explanation
The correct answer suggests using a tonsil clamp to grasp the bleeding artery and then applying the bovie tip to the clamp. By activating the "cut" or "Coag" function, the electrocautery will desiccate the tissue and control the bleeding. This method is effective because it allows for precise control and targeting of the bleeding artery while minimizing damage to surrounding tissues.Rate this question:
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- 2.
You have just completed a Cold Knife Cone in the operating room and you notice the cone bed as some generalized oozing. How should you use electrocautery?
- A.
Set the bovie on “Coag” and move across the oozing surface of the cone bed just above the tissue arcing the electricity
- B.
Use a tonsil clamp to grasp as much tissue as possible and setting the bovie on “Coag” and touch the bovie tip to the tonsil clamp
- C.
Use the bovie on “Cut” and plunge the bovie tip into the cervical stroma near the bleeding points.
- D.
Get a larger bovie tip and hold it against the bleeding surface with a large area of contact then use the “Coag” setting and as much power as necessary to stop bleeding.
Correct Answer
A. Set the bovie on “Coag” and move across the oozing surface of the cone bed just above the tissue arcing the electricityExplanation
When there is generalized oozing on the cone bed after a Cold Knife Cone procedure, the appropriate technique to use electrocautery is to set the bovie on "Coag" and move across the oozing surface of the cone bed just above the tissue, arcing the electricity. This technique allows for controlled cauterization of the bleeding points and helps to stop the bleeding effectively.Rate this question:
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- 3.
If the bovie electrode, while active, touches the surgeon’s skin accidentally (through a hole in the glove) will the surgeon be “electrocuted” or “burned”?
- A.
“Electrocuted” because the bovie uses current out of the wall outlet.
- B.
“Burned” because the bovie amplifies the Hertz (cycles per second) of the electricity from the wall outlet beyond the range of electrocuting tissue.
- C.
“Electrocuted” because electricity at any Hertz (Cycles per second) will cause tissue to depolarize
- D.
“Burned” because electricity at any Hertz only burns tissue.
Correct Answer
B. “Burned” because the bovie amplifies the Hertz (cycles per second) of the electricity from the wall outlet beyond the range of electrocuting tissue.Explanation
The correct answer is "Burned" because the bovie amplifies the Hertz (cycles per second) of the electricity from the wall outlet beyond the range of electrocuting tissue. This means that the bovie electrode, even if it accidentally touches the surgeon's skin, will not cause electrocution but rather burn the tissue due to the amplified electricity.Rate this question:
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- 4.
Alternating current electrosurgery (the bovie) brings about its effect by which of the following?
- A.
It produces an flow of electrons that become focused at the bovie electrode and arc to the patient producing heat and a thermal burn.
- B.
It sends an electrical current that causes the tissue to rapidly contract which brings about surface coagulation.
- C.
It produces heat by circulating electrons through the bovie electrode which heats up and acts as hot cautery.
- D.
It focuses electricity into the patient which causes massive tissue depolarization and coagulum to be formed.
Correct Answer
A. It produces an flow of electrons that become focused at the bovie electrode and arc to the patient producing heat and a thermal burn.Explanation
Alternating current electrosurgery, commonly known as the bovie, works by producing a flow of electrons that are concentrated at the bovie electrode. These electrons then arc or jump to the patient, resulting in the generation of heat. This heat can cause a thermal burn on the patient's tissue.Rate this question:
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- 5.
Monopolar electrosurgery requires which of the following?
- A.
Nothing except a bovie electrode as the alternating current pushes electrons into the patient but pulls them out again as the current cycle reverses.
- B.
The pt has to be touching a metal object to allow the electrons to pass out of the patient and go to ground or the earth.
- C.
A grounding pad to complete the circuit and allow excess electrons to flow out of the patient.
- D.
Two electrodes to allow the electrons to pass between them.
Correct Answer
C. A grounding pad to complete the circuit and allow excess electrons to flow out of the patient.Explanation
Monopolar electrosurgery requires a grounding pad to complete the circuit and allow excess electrons to flow out of the patient. This is necessary because the alternating current used in monopolar electrosurgery pushes electrons into the patient but then pulls them out again as the current cycle reverses. The grounding pad provides a path for the electrons to flow out of the patient and go to ground or the earth. Without the grounding pad, the excess electrons would not have a way to exit the patient's body, which could lead to complications or damage.Rate this question:
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- 6.
Placement of the grounding pad:
- A.
Is not important as the electrons will flow through the patient regardless.
- B.
Is an unnecessary precaution as newer electrosurgery generators are self regulating and burns are mostly of historic significance.
- C.
Should always be on the leg so nursing can monitor if it is working properly and report on its safety.
- D.
Should be as close to the surgical site as possible over a large muscle to reduce the amount of resistance and allow lower power settings.
Correct Answer
D. Should be as close to the surgical site as possible over a large muscle to reduce the amount of resistance and allow lower power settings.Explanation
The grounding pad should be placed as close to the surgical site as possible over a large muscle to reduce the amount of resistance and allow lower power settings. This is important because it helps to ensure that the electrical current flows efficiently through the patient's body, minimizing the risk of burns and other complications. Placing the grounding pad in this location also allows for better monitoring of its effectiveness during the procedure.Rate this question:
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- 7.
Bipolar cautery requires which of the following?
- A.
Two active electrodes in close proximity to allow electricity to flow between them.
- B.
A grounding pad to collect extra electrons that flow into the patient.
- C.
A hysteroscopic or laparoscopic trocar to allow for direct coupling.
- D.
Interruptions in the insulator to allow for direct coupling.
Correct Answer
A. Two active electrodes in close proximity to allow electricity to flow between them.Explanation
Bipolar cautery requires two active electrodes in close proximity to allow electricity to flow between them. This is because bipolar cautery uses a localized electrical current between two electrodes to coagulate tissue and control bleeding. The close proximity of the electrodes ensures that the electrical current is focused and limited to the desired area, minimizing damage to surrounding tissue. The other options mentioned, such as a grounding pad, hysteroscopic or laparoscopic trocar, and interruptions in the insulator, are not necessary for bipolar cautery.Rate this question:
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- 8.
Use of monopolar cautery during laparoscopic surgery carries which of the following risks?
- A.
Risk of insulation failure allowing the electricity to flow through an area of the instrument outside of the surgeons view and cause unrecognized damage to other internal organs.
- B.
Tissue damage from having to use undersized surgical equipment.
- C.
Risk of inadvertent injury to the surgeon as the longer instruments have greater resistance which can cause them to heat up and burn the surgeons hand.
- D.
The need for increased power settings (and therefore more potential for uncontrolled burn) are required as the instruments are longer and the electricity has farther to flow.
Correct Answer
A. Risk of insulation failure allowing the electricity to flow through an area of the instrument outside of the surgeons view and cause unrecognized damage to other internal organs.Explanation
The use of monopolar cautery during laparoscopic surgery carries the risk of insulation failure. This can cause the electricity to flow through an area of the instrument outside of the surgeon's view, leading to unrecognized damage to other internal organs. This risk is significant because the surgeon may not be aware of the damage being caused, which can have serious consequences for the patient.Rate this question:
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- 9.
The difference settings of “cut”, “coag” and “blend” are characterized by which of the following statements?
- A.
“Cut” is continuous flow and higher heat generation while “coag” is interrupted flow and less heat production.
- B.
“Coag” causes more tissue destruction and more steam while “cut” is more focused and cooler with less vapor production.
- C.
“Blend” is the perfect combination of “cut” and “coag” as it focuses the electricity which produces less heat and more pinpoint control.
- D.
“Coag” causes more widespread tissue damage deeper in the tissue while “cut” and “blend” provide for focused energy that has more pinpoint accuracy.
Correct Answer
A. “Cut” is continuous flow and higher heat generation while “coag” is interrupted flow and less heat production.Explanation
The statement "Cut" is continuous flow and higher heat generation while "coag" is interrupted flow and less heat production accurately characterizes the difference settings of "cut" and "coag". This means that when the "cut" setting is used, there is a continuous flow of electricity which generates higher heat. On the other hand, when the "coag" setting is used, the flow of electricity is interrupted, resulting in less heat production. This information helps to differentiate between the two settings and understand their effects on tissue during surgical procedures.Rate this question:
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- 10.
Which of the following is not correct?
- A.
“Cut” has continuous flow of electricity which produces higher heat at the tissue and vaporization of cells..
- B.
To coagulate a blood vessel you need to grasp it in an instrument and can then apply either “cut” or “coag” settings until tissue dessication and coagulation occurs.
- C.
“Coag” uses intermittent (or damped) flow of electricity to heat and then cool tissue to produce lower heat and coagulum of superficial tissue.
- D.
“Coag” uses intermittent flow of electrons which produces blast of electricity and higher heat with vaporization of tissue.
Correct Answer
D. “Coag” uses intermittent flow of electrons which produces blast of electricity and higher heat with vaporization of tissue.Explanation
The given correct answer is explaining that "Coag" uses intermittent flow of electrons which produces a blast of electricity and higher heat with vaporization of tissue. This means that "Coag" setting does not produce lower heat and coagulum of superficial tissue as mentioned in the other statement.Rate this question:
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