OTC Orthopaedic Technologist Certified Neurovascular Assessment 1 — Questions and Answers
Question 1: Which mnemonic is commonly used to remember the key components of neurovascular assessment in orthopaedic patients?
- The 5 Ps: Pain, Pallor, Pulselessness, Paresthesia, Paralysis (Correct answer)
- The 4 Ds: Discoloration, Dysfunction, Drainage, Deformity
- The 3 Cs: Circulation, Capillary refill, Color
- The 6 Ss: Swelling, Stiffness, Sensation, Spasm, Strength, Skin
Correct answer: The 5 Ps: Pain, Pallor, Pulselessness, Paresthesia, Paralysis
The 5 Ps (Pain, Pallor, Pulselessness, Paresthesia, Paralysis) are the classic signs used to assess neurovascular compromise in orthopaedic injuries.
Question 2: What is considered a normal capillary refill time (CRT) in an adult orthopaedic patient?
- Less than 2 seconds (Correct answer)
- 2 to 4 seconds
- 4 to 6 seconds
- Less than 1 second
Correct answer: Less than 2 seconds
Capillary refill time less than 2 seconds is considered normal in adults; a CRT greater than 2 seconds may indicate impaired peripheral circulation.
Question 3: When assessing radial nerve function after a humeral shaft fracture, which specific motor action should the orthopaedic technologist evaluate?
- Wrist and finger extension (Correct answer)
- Thumb opposition
- Finger abduction
- Wrist flexion
Correct answer: Wrist and finger extension
The radial nerve innervates the wrist and finger extensors; inability to extend the wrist (wrist drop) is the classic sign of radial nerve injury associated with humeral shaft fractures.
Question 4: Sensation over the web space between the first and second toes is used to assess which nerve?
- Deep peroneal nerve (Correct answer)
- Superficial peroneal nerve
- Sural nerve
- Saphenous nerve
Correct answer: Deep peroneal nerve
The deep peroneal nerve supplies sensation to the first dorsal web space between the great toe and second toe and is assessed with lower extremity injuries.
Question 5: When performing a neurovascular check after cast application, the orthopaedic technologist notes the patient has increased pain with passive stretch of the fingers. This finding most likely indicates:
- Developing compartment syndrome (Correct answer)
- Normal post-casting discomfort
- Peripheral neuropathy
- Arterial spasm only
Correct answer: Developing compartment syndrome
Pain with passive stretch of muscles within a compartment is an early and reliable sign of developing compartment syndrome, which requires immediate evaluation.
Question 6: Which pulse is assessed at the dorsum of the foot to evaluate vascular integrity of the lower extremity distal to a tibial fracture?
- Dorsalis pedis pulse (Correct answer)
- Posterior tibial pulse
- Popliteal pulse
- Femoral pulse
Correct answer: Dorsalis pedis pulse
The dorsalis pedis pulse, located on the dorsum of the foot between the first and second extensor tendons, is a primary distal pulse assessed after tibial fractures.
Question 7: In a neurovascular assessment, 'paresthesia' refers to:
- Abnormal sensations such as tingling, numbness, or burning (Correct answer)
- Complete loss of motor function
- Skin color changes indicating poor perfusion
- Increased pain at the fracture site
Correct answer: Abnormal sensations such as tingling, numbness, or burning
Paresthesia describes abnormal nerve sensations including tingling, numbness, or burning, and is an early indicator of nerve compression or ischemia.
OTC Orthopaedic Technologist Certified Neurovascular Assessment 1
Which mnemonic is commonly used to remember the key components of neurovascular assessment in orthopaedic patients?