Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

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During ligation of the vena cava for pulmonary embolism, which structure must be protected?

  1. Left renal artery

  2. Lumbar veins

  3. Right ureter

  4. Inferior mesenteric vein

The correct answer is: Lumbar veins

In the context of ligation of the vena cava for pulmonary embolism, protecting the lumbar veins is crucial due to their anatomical position and the role they play in venous drainage. The lumbar veins are located in close proximity to the inferior vena cava, and during surgical manipulation, there is a significant risk of inadvertently injuring these veins. Such an injury can lead to complications, including significant bleeding and disruption of venous return from the lower body. While the other structures listed, such as the left renal artery, right ureter, and inferior mesenteric vein, are also important anatomical considerations during abdominal surgery, their proximity and relevance during vena caval ligation do not pose the same level of immediate concern as the lumbar veins. The lumbar veins’ close association with the inferior vena cava makes their safeguarding critical during this specific surgical intervention.