HealthcareOctober 3, 202612 min read

Surgical Tech Mnemonics: 12 Memory Tricks for the CST Exam

12 memory hooks for the lists and sequences the CST keeps testing, each with when to use it and where it lets you down.

  • 12Mnemonics
  • 3Domains covered
  • 175 itemsReal exam
  • 240 minTime limit
  • $230Exam fee
Surgical technology mnemonics and memory tricks for the CST exam

Table of Contents

How to use a mnemonic on exam day

A mnemonic is a retrieval cue, not understanding. It gets a list or a sequence back out of memory under time pressure; it does not tell you which item on the list the question wants. Each card below therefore has two extra lines: Use it when — the kind of CST question where the hook pays off — and Careful — where the shortcut breaks or the exam sets a trap around it.

Learn the meaning first. Read the expansion until it makes sense, then use the hook to recall it. A mnemonic you cannot unpack is worth nothing on a scenario item.

Perioperative Care

Instrument classifications by function

“Can Good Clamps Really Seal Small Defects?”

  1. CCutting and dissecting: scalpels, Metzenbaum and Mayo scissors
  2. GGrasping and holding: Adson and DeBakey forceps, Allis, Babcock, tenacula
  3. CClamping and occluding: hemostats, Kelly, Pean, Kocher (Ochsner), right angle
  4. RRetracting and exposing: Army-Navy, Richardson, Deaver, Weitlaner, Gelpi, Balfour
  5. SSuturing and stapling: needle holders, skin and internal staplers
  6. SSuctioning and aspirating: Yankauer, Frazier, Poole
  7. DDilating and probing: Hegar dilators, Bakes dilators, probes

Use it when: When a stem asks which class a named instrument belongs to (a Gelpi is a self-retaining retractor) or which instrument to hand for a given step.

Careful: Classify by what the instrument does, not by its shape. Some instruments cross classes: a Kocher is a clamp but is used to grasp fascia, and a right-angle clamp is used to dissect. Most textbooks put scopes (viewing) and accessory items outside these seven groups.

Which grasping clamp for which tissue

“Babcock for Bowel, Allis gets Aggressive, Kocher has teeth”

  1. BabcockRounded, fenestrated, atraumatic jaws for delicate tubular tissue: bowel, appendix, fallopian tube
  2. AllisShort interlocking teeth; slightly traumatic, used on fascia, breast tissue or tissue that will be removed
  3. Kocher1x2 teeth at the tip with serrated jaws; holds tough tissue such as fascia, never bowel or vessels you intend to keep

Use it when: When the stem names a tissue and asks for the right grasper, or asks which clamp would injure delicate tissue.

Careful: Kocher and Ochsner are the same clamp in most US sets. Do not confuse the Kocher clamp with the Kocher incision (right subcostal) or the Kocher maneuver (mobilizing the duodenum). Vessels get non-crushing vascular clamps such as DeBakey or bulldog clamps, not any of these.

Nonabsorbable sutures

“Sneaky Ninjas Prefer Permanent Stays”

  1. SSilk: braided, natural fiber
  2. NNylon: monofilament (or braided)
  3. PPolypropylene (Prolene): monofilament, used for vascular anastomoses and hernia repair
  4. PPolyester (Ethibond, Mersilene): braided
  5. SStainless steel: wire, for sternal closure and orthopedic repairs

Use it when: When asked which suture stays permanently (vascular, hernia, tendon) or to sort a list into absorbable and nonabsorbable.

Careful: Monofilament does not mean nonabsorbable: polydioxanone (PDS) and poliglecaprone 25 (Monocryl) are monofilament absorbables. Silk is classed as nonabsorbable but slowly loses strength and degrades in tissue. Surgical gut is the natural absorbable, and chromic gut lasts longer than plain.

When surgical counts are done

“Before A Case Closes, Surgeons Stop”

  1. BBaseline count before the incision
  2. AAdded items, counted and recorded as they come onto the field
  3. CCavity within a cavity, counted before it is closed (for example, the uterus at cesarean)
  4. CClosure of the wound begins
  5. SSkin closure or end of the procedure
  6. SStaff change: permanent relief of the scrub or the circulator

Use it when: When a stem asks whether a count is required at a given moment, or what to do when new sponges or sharps are opened.

Careful: Count in the same order every time (surgical site, Mayo stand, back table, then items off the field), with the scrub and circulator viewing and counting aloud together. If a count is wrong, tell the surgeon, search the field and room, and if it is still unresolved, take and read an imaging study before the patient leaves the room when the patient's condition allows. Counted items are not removed from the room during the case.

Ancillary Duties

Sterilization monitors

“Print, Paint, Proof”

  1. PrintMechanical (physical) monitors: printouts, gauges and recorders of time, temperature and pressure for each cycle
  2. PaintChemical indicators change color: external tape (Class 1) shows exposure; the Bowie-Dick test (Class 2) checks air removal in prevacuum sterilizers; internal indicators and integrators (Classes 3-6) respond to conditions inside the pack
  3. ProofBiological indicators: resistant spores. No growth is the only direct proof of kill; growth means the load failed

Use it when: When asked what a monitor result means for a load, or which monitor must be read before a load is released.

Careful: Steam and hydrogen peroxide gas plasma BIs use Geobacillus stearothermophilus; ethylene oxide and dry heat use Bacillus atrophaeus. Loads containing implants are quarantined until the BI result is known unless an emergency release is documented, and the Bowie-Dick test runs daily in an empty chamber before the first load.

Instrument processing sequence

“Please Take Dirty Instruments Past Sterile Storage”

  1. PPoint-of-use treatment: wipe gross soil with sterile water and keep instruments moist (enzymatic spray or a damp towel)
  2. TTransport in a closed, labeled biohazard container
  3. DDecontaminate: manual or mechanical cleaning (washer-disinfector, ultrasonic) with enzymatic detergent
  4. IInspect and test: function, alignment, sharpness, insulation
  5. PPackage: box locks open, ratchets unlocked, heavy items on the bottom
  6. SSterilize by the method the device manufacturer validates
  7. SStore so packages stay clean, dry and intact (event-related sterility)

Use it when: Sequencing items and what-comes-next items about a used tray leaving the room.

Careful: Cleaning must come before sterilization, because leftover bioburden shields organisms from the sterilant. Never use saline on instruments; it causes pitting and corrosion. The manufacturer's instructions for use (IFU) override any general rule for a specific device.

Spaulding classification

“Cuts, Kisses, Touches”

  1. CutsCritical items enter sterile tissue or the vascular system: sterilize (instruments, implants, needles)
  2. KissesSemicritical items contact mucous membranes or non-intact skin: high-level disinfection at minimum (flexible endoscopes, laryngoscope blades)
  3. TouchesNoncritical items touch only intact skin: low-level disinfection (blood pressure cuffs, positioning devices)

Use it when: When asked what level of processing an item needs before reuse.

Careful: The class follows where the device goes, not what it is called: a scope that enters sterile tissue (arthroscope, laparoscope) is critical and should be sterilized, while a GI endoscope is semicritical. Prion diseases such as CJD need special protocols beyond Spaulding.

Placing the ESU dispersive pad

“Muscles Need Clean Complete Attachment”

  1. MMuscle: over a large, well-perfused muscle mass (thigh, buttock, upper arm)
  2. NNear the surgical site, applied after final positioning
  3. CClean, dry, intact skin; clip hair if needed
  4. CComplete contact: smooth, no tenting, never cut or folded; recheck after any repositioning
  5. AAway from bony prominences, scars, metal implants, tattoos and pooled prep or irrigation fluid

Use it when: Electrosurgical safety questions and burn-prevention scenarios.

Careful: The pad returns current to the generator; it does not ground the patient, despite older items that say so. Return-electrode monitoring systems alarm when contact is poor, and pad-site burns usually come from partial contact. Bipolar electrosurgery needs no dispersive pad because current passes only between the two tips.

Basic Science

Layers of the abdominal wall (lateral incision)

“Surgeons Can Seldom Ever Insert Trocars Through Fat Painlessly”

  1. SSkin
  2. CCamper's fascia (fatty superficial layer)
  3. SScarpa's fascia (membranous layer)
  4. EExternal oblique and its aponeurosis
  5. IInternal oblique
  6. TTransversus abdominis
  7. TTransversalis fascia
  8. FPreperitoneal fat
  9. PPeritoneum

Use it when: When asked which layer is being opened or closed, or the order of layers in a McBurney or flank approach.

Careful: A midline incision crosses no muscle: skin, subcutaneous tissue (Camper's and Scarpa's), linea alba, transversalis fascia, preperitoneal fat, peritoneum. Paramedian and Pfannenstiel incisions go through the anterior rectus sheath and move the rectus aside. Below the arcuate line there is no posterior rectus sheath.

Surgical wound classification (CDC)

“Closed, Controlled, Spilled, Pus”

  1. IClean (closed): no inflammation; respiratory, GI, genital and urinary tracts not entered (hernia repair, breast biopsy)
  2. IIClean-contaminated (controlled): one of those tracts entered under controlled conditions without unusual contamination (cholecystectomy, elective bowel resection)
  3. IIIContaminated (spilled): open fresh accidental wound, major break in sterile technique, gross spillage from the GI tract, or acute non-purulent inflammation
  4. IVDirty-infected (pus): existing clinical infection, perforated viscus, or old traumatic wound with devitalized tissue

Use it when: When asked to classify a wound or to predict which case carries the highest surgical site infection risk.

Careful: The class depends on what actually happened, not the planned operation: an elective colectomy is class II, gross spillage makes it class III, and a perforated appendix is class IV. A major break in sterile technique alone can move a clean case to class III.

Stages of general anesthesia (Guedel)

“Always Expect Some Overdose”

  1. AAnalgesia (stage I): from induction to loss of consciousness
  2. EExcitement (stage II): delirium, irregular breathing, risk of laryngospasm and vomiting; keep the room quiet and do not touch the patient
  3. SSurgical anesthesia (stage III): the depth at which prep and incision proceed
  4. OOverdose (stage IV): medullary depression with respiratory and circulatory collapse

Use it when: When asked why the room must be quiet during induction and emergence, or when positioning and prep can begin.

Careful: Guedel described these stages with ether. Modern IV induction passes through stage II in seconds, but emergence goes back through it, so the quiet-room rule applies again at extubation. Positioning and prep wait until the anesthesia provider says the patient is ready.

Branches of the celiac trunk

“Left Hand Side”

  1. LLeft gastric artery
  2. HCommon hepatic artery
  3. SSplenic artery

Use it when: Anatomy items on gastric, biliary, splenic and aortic procedures, or which vessel arises from where.

Careful: The superior mesenteric, renal and inferior mesenteric arteries come straight off the aorta, not from the celiac trunk. The common hepatic gives off the gastroduodenal and proper hepatic arteries, and the cystic artery usually arises from the right hepatic artery.

Numbers worth memorising

Some surgical technology facts have no shortcut — they are just numbers the exam expects you to know cold. These are the ones that show up most often in the item bank.

FactValueWhy it gets tested
Gravity-displacement steam, wrapped instruments121 C (250 F) for 30 minutes exposureClassic textbook cycle; drying time is extra
Gravity-displacement steam at higher temperature132 C (270 F) for 15 minutes, wrapped instrumentsHigher temperature, shorter exposure
Dynamic-air-removal (prevacuum) steam132 C (270 F) for 4 minutes; 135 C (275 F) for 3 minutesFaster because air is pulled out before steam enters
Immediate-use steam, gravity, unwrapped132 C (270 F): 3 minutes nonporous; 10 minutes porous or lumened itemsImmediate use only, never as a substitute for adequate inventory
Ethylene oxide aeration12 hours at 50 C or 8 hours at 60 CEO residue is toxic; aeration is part of the cycle
Lidocaine maximum dose (adult)4.5 mg/kg, not over 300 mg plain; 7 mg/kg, not over 500 mg with epinephrinePharmacology items test doses and conversions
Bupivacaine maximum dose (adult)175 mg plain; 225 mg with epinephrineMore cardiotoxic than lidocaine
Epinephrine dilutions in local anesthetic1:100,000 = 10 mcg/mL; 1:200,000 = 5 mcg/mLRead the label ratio carefully when confirming a drug on the field
Suture sizingMore zeros means finer: 6-0 is thinner than 2-0Fine sizes for vessels and face, heavy sizes for fascia and bone
CST pass mark98 of 150 scored questions175 questions in 4 hours; 25 are unscored pretest items

Build your own in three steps

The best mnemonic is the one you made, because making it is half the memorising.

  1. 1Pick a list the outline tests as a sequence or a set — steps, signs, contraindications. Single facts do not need a hook.
  2. 2Take the first letter of each item and build a phrase that is vivid or absurd. Odd sticks; sensible fades.
  3. 3Test it cold the next day on practice questions. If you recalled the phrase but missed the item, the hook is fine and the understanding is not.

Now test the hooks on real questions

ExamCert AI has 1,305 CST questions with explanations. Mnemonics stick when you use them to answer something — drill by domain and see which ones hold up.

Practise CST on ExamCert AI

Or start with the 8 free CST practice questions we walked through, answers and distractors explained.

FAQ

What is a good mnemonic for the layers of the abdominal wall?

For a lateral (muscle-splitting) incision, use 'Surgeons Can Seldom Ever Insert Trocars Through Fat Painlessly': skin, Camper's fascia, Scarpa's fascia, external oblique, internal oblique, transversus abdominis, transversalis fascia, preperitoneal fat, peritoneum. A midline incision skips the muscles and goes through the linea alba.

How do surgical techs remember the instrument classifications?

'Can Good Clamps Really Seal Small Defects?' gives cutting, grasping, clamping, retracting, suturing, suctioning and dilating. Classify each instrument by what it does, because some tools cross categories.

When are surgical counts done?

Before the incision, when items are added, before closing a cavity within a cavity, when wound closure begins, at skin closure or end of the procedure, and when the scrub or circulator is permanently relieved. 'Before A Case Closes, Surgeons Stop' covers all six.

Are mnemonics enough to pass the CST exam?

No. NBSTSA's 2023 job analysis rates Perioperative Care, the largest domain, as about 71% application-level, so you must apply a list to a scenario, not just recite it. Use mnemonics to recall lists and sequences, then practice scenario questions.

Sources

Exam facts come from NBSTSA; clinical content was checked against the references below.

Checked October 3, 2026. Outlines, fees and clinical guidance change — confirm with NBSTSA and your program before test day.