Orthopaedic Technologist Certified Neurovascular Assessment Flashcards

The posterior tibial pulse is most accurately palpated at which anatomical location?

Answer: Posterior to the medial malleolus

The posterior tibial pulse is found just posterior and inferior to the medial malleolus and is essential in assessing distal lower extremity perfusion.

Which of the following is the most appropriate initial action when an orthopaedic technologist identifies signs of acute neurovascular compromise in a casted extremity?

Answer: Immediately notify the supervising physician and prepare for cast bivalving or removal

Neurovascular compromise is a surgical emergency; the orthopaedic technologist must notify the physician immediately and prepare to bivalve or remove the cast to relieve pressure.

Compartment pressures are considered critical and typically warrant emergency fasciotomy when they reach within how many mmHg of the patient's diastolic blood pressure?

Answer: 30 mmHg

Fasciotomy is indicated when compartment pressure is within 30 mmHg of the diastolic blood pressure (delta-p ≤ 30 mmHg), as perfusion becomes critically compromised.

Testing the ability to abduct and adduct the fingers assesses function of which nerve in the upper extremity?

Answer: Ulnar nerve

The ulnar nerve innervates the intrinsic hand muscles (interossei and hypothenar muscles) responsible for finger abduction and adduction.

An orthopaedic technologist is assessing a patient with a distal radius fracture and notices the patient cannot oppose the thumb to the little finger. Which nerve is most likely compromised?

Answer: Median nerve

Thumb opposition (opponens pollicis) is controlled by the recurrent branch of the median nerve; loss of opposition is a hallmark of median nerve injury at the wrist.

Which color change in the skin most strongly suggests arterial occlusion in a limb with an orthopaedic injury?

Answer: Pallor (white/pale)

Pallor indicates loss of arterial blood supply; while cyanosis suggests venous congestion, pallor with pulselessness is the classic sign of arterial occlusion.

How frequently should neurovascular checks be performed immediately following cast or splint application in an acute fracture patient?

Answer: Every 30 to 60 minutes for the first few hours, then per protocol

Frequent neurovascular monitoring (every 30–60 minutes initially) is critical in the acute post-application period when swelling peaks and compartment syndrome risk is highest.