Orthopaedic Technologist Certified Surgical Procedure Assistance Questions and Answers — Questions and Answers
Question 1: An Orthopaedic Technologist is assisting in a total hip arthroplasty using a posterior approach. The surgeon places a retractor to expose the posterior acetabulum. The technologist must be aware that this maneuver places which of the following nerves at the greatest risk of injury?
- Femoral nerve
- Sciatic nerve (Correct answer)
- Obturator nerve
- Lateral femoral cutaneous nerve
Correct answer: Sciatic nerve
The sciatic nerve runs directly behind the short external rotators and posterior acetabulum, which are key structures in the posterior approach to the hip. Retractor placement in this area can directly compress or stretch the nerve, leading to injury.
Question 2: What is the primary function of a pneumatic tourniquet when used during surgery on an extremity?
- To reduce the patient's metabolic rate
- To provide regional anesthesia to the limb
- To create a bloodless (hemostatic) surgical field (Correct answer)
- To assist in the reduction of the fracture
Correct answer: To create a bloodless (hemostatic) surgical field
The pneumatic tourniquet is inflated to a pressure sufficient to occlude arterial blood flow into the limb, which creates a 'bloodless' or hemostatic field. This improves visualization of anatomical structures for the surgeon, facilitating a safer and more efficient procedure.
Question 3: A scrubbed Orthopaedic Technologist is assisting in an intramedullary nailing of a femur. Which of the following actions would constitute a break in sterile technique?
- Facing the sterile field at all times
- Passing another scrubbed team member back-to-back
- Clasping hands together and holding them below waist level (Correct answer)
- Adjusting the overhead surgical light with sterile handles
Correct answer: Clasping hands together and holding them below waist level
The sterile field for a gowned and gloved person is considered to exist from the chest to the level of the sterile field, and the sleeves from two inches above the elbow to the cuff. Gowns are considered sterile in front from the shoulder to the waist level. Gloved hands that are dropped below waist or table level are considered contaminated.
Question 4: During an open reduction and internal fixation (ORIF) procedure, the surgeon drills a hole through a bone cortex and then uses a depth gauge. What is the direct purpose of using the depth gauge at this stage?
- To select the correct diameter for the drill bit
- To confirm the fracture has been adequately reduced
- To measure the density of the bone
- To determine the appropriate length of the screw to be used (Correct answer)
Correct answer: To determine the appropriate length of the screw to be used
The depth gauge is a calibrated instrument used to measure the depth of a drilled hole in bone. This measurement allows the surgeon to select a screw of the correct length to ensure optimal purchase and fixation without protruding excessively, which could damage soft tissues.
Question 5: When passing a sharp instrument, such as a #10 blade on a scalpel handle, to the surgeon, what is the MOST accepted safety practice?
- Placing it firmly in a designated 'neutral zone' on the sterile field (Correct answer)
- Handing it to the surgeon with the blade pointed towards them for easy access
- Tapping the surgeon's hand with it to get their attention
- Holding it by the blade and offering the handle to the surgeon
Correct answer: Placing it firmly in a designated 'neutral zone' on the sterile field
Using a hands-free transfer technique, such as placing the sharp instrument in a designated neutral zone (e.g., a small basin or magnetic mat), is the safest method. This prevents hand-to-hand transfer and minimizes the risk of sharps injuries for both the technologist and the surgeon.
Question 6: An Orthopaedic Technologist is preparing a patient's leg for a total knee arthroplasty. Which of the following is most commonly used as the primary antiseptic agent for the surgical skin prep?
- Sterile saline
- Hydrogen peroxide
- Isopropyl alcohol 70% alone
- Chlorhexidine gluconate (CHG) (Correct answer)
Correct answer: Chlorhexidine gluconate (CHG)
Chlorhexidine gluconate (CHG), often in an alcohol-based solution, is a broad-spectrum antiseptic agent commonly used for surgical skin preparation in orthopaedics. It has a rapid onset and persistent antimicrobial effect, making it highly effective at reducing the microbial load on the skin before incision.
Orthopaedic Technologist Certified Surgical Procedure Assistance Questions and Answers
An Orthopaedic Technologist is assisting in a total hip arthroplasty using a posterior approach.
The surgeon places a retractor to expose the posterior acetabulum.
The technologist must be aware that this maneuver places which of the following nerves at the greatest risk of injury?