Surgical Patient Positioning Flashcards

Which surgical position places the patient flat on their back with arms extended on armboards no greater than 90 degrees?

Answer: Supine

The supine (dorsal recumbent) position places the patient flat on the back. Arms must not be extended beyond 90 degrees to prevent brachial plexus stretch injury. It is the most common surgical position.

A patient is positioned in lithotomy for a vaginal hysterectomy. Which complication is the surgical technologist most concerned about preventing?

Answer: Compartment syndrome of the lower extremities

In lithotomy, legs are elevated in stirrups. Prolonged elevation can reduce blood flow to the lower extremities, leading to compartment syndrome — a potentially limb-threatening complication unique to this position. Both legs must be raised and lowered simultaneously.

When positioning a patient in the lateral position for a thoracotomy, what device is placed beneath the chest wall just below the dependent axilla?

Answer: Axillary roll

An axillary roll is placed under the chest wall just inferior to the dependent axilla (NOT inside it) to shift body weight off the arm and prevent compression of the brachial plexus and axillary vessels of the down-side arm.

Which position is most commonly used for procedures on the posterior spine and posterior thorax?

Answer: Prone

The prone position (patient lying face down) provides direct posterior access, making it the standard position for laminectomies, posterior spinal fusions, and posterior thoracic procedures. Chest rolls or a Wilson frame are used to support the body.

Trendelenburg position (head-down tilt) is most commonly indicated for which type of procedure?

Answer: Pelvic laparoscopy

Trendelenburg causes abdominal viscera to shift superiorly away from the pelvis, improving visualization of pelvic structures. It is routinely used for laparoscopic pelvic procedures such as hysterectomy, myomectomy, and tubal ligation.

When transferring a patient from lithotomy back to supine, both legs must be lowered simultaneously. What is the primary reason for this requirement?

Answer: To avoid sudden hemodynamic instability

Lowering one leg at a time causes unequal redistribution of blood volume, which can trigger rapid hypotension and cardiovascular compromise. Simultaneous, slow bilateral lowering prevents sudden hemodynamic shifts and also avoids pelvic ligament strain.