OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 2 — Questions and Answers
Question 1: When passing a scalpel to the surgeon during an orthopaedic procedure, the OT should hand it with the blade:
- Pointing toward the surgeon's palm
- Pointing away from both individuals in a neutral zone
- Resting flat on a sterile towel for the surgeon to pick up (Correct answer)
- Pointing upward to allow visual confirmation
Correct answer: Resting flat on a sterile towel for the surgeon to pick up
The safest scalpel-passing technique uses a neutral zone (kidney basin or sterile towel) to avoid sharps injuries to either party.
Question 2: During an open reduction internal fixation (ORIF) of a distal radius fracture, the OT is asked to hold retractors. The correct technique is to:
- Apply maximum force to keep the wound open as wide as possible
- Maintain steady, firm retraction only as directed and release periodically to prevent ischemia (Correct answer)
- Hand the retractors to the scrub tech and step back
- Hold retractors at the most proximal position to improve leverage
Correct answer: Maintain steady, firm retraction only as directed and release periodically to prevent ischemia
Sustained excessive retractor pressure causes tissue ischemia; the OT should maintain gentle steady traction and release as directed by the surgeon.
Question 3: Which power tool is most commonly used in orthopaedic surgery to ream the medullary canal during intramedullary nail placement?
- Oscillating saw
- Reciprocating saw
- Flexible intramedullary reamer (Correct answer)
- High-speed burr
Correct answer: Flexible intramedullary reamer
A flexible intramedullary reamer sequentially enlarges the medullary canal to accept the nail while following the canal's natural curve.
Question 4: A pneumatic tourniquet cuff pressure for an adult lower extremity procedure is typically set at:
- 50 mmHg above systolic blood pressure
- 100 mmHg above systolic blood pressure (Correct answer)
- 250 mmHg regardless of blood pressure
- Equal to diastolic blood pressure
Correct answer: 100 mmHg above systolic blood pressure
Standard lower extremity tourniquet pressure is set at 100 mmHg above the patient's systolic blood pressure to ensure adequate occlusion without excessive tissue injury.
Question 5: During arthroscopic knee surgery, the OT's primary responsibility when managing the irrigation system is to:
- Keep fluid flowing continuously at maximum pressure to ensure clear visualization
- Monitor fluid inflow and outflow to maintain joint distension without extravasation (Correct answer)
- Switch to normal saline only after the procedure begins
- Allow the scrub technician to manage all fluid decisions independently
Correct answer: Monitor fluid inflow and outflow to maintain joint distension without extravasation
The OT monitors arthroscopic irrigation to maintain adequate joint distension while preventing compartment syndrome from fluid extravasation.
Question 6: Intraoperative fluoroscopy is used during orthopaedic surgery primarily to:
- Provide real-time imaging for implant placement and fracture reduction confirmation (Correct answer)
- Replace pre-operative X-rays for fracture diagnosis
- Monitor blood flow in the surgical field
- Sterilize implants before insertion
Correct answer: Provide real-time imaging for implant placement and fracture reduction confirmation
Fluoroscopy provides real-time X-ray imaging that guides the surgeon in confirming accurate implant placement and adequate fracture reduction.
Question 7: When assisting with a total knee arthroplasty, the OT should handle trial implants by:
- Touching only the articular surfaces to check smoothness
- Handling only non-articular surfaces and maintaining sterility (Correct answer)
- Removing them from sterile packaging with bare hands for speed
- Soaking them in saline before passing to the surgeon
Correct answer: Handling only non-articular surfaces and maintaining sterility
Trial implants must remain sterile and their articular surfaces must not be contaminated; handle only non-articular areas with sterile gloves.
OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 2
When passing a scalpel to the surgeon during an orthopaedic procedure, the OT should hand it with the blade: