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.
