OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 3 — Questions and Answers
Question 1: During a hip arthroplasty, the patient is positioned in a lateral decubitus position. Which anatomical landmark is most critical to pad to prevent a pressure injury?
- Sacrum
- Lateral knee (fibular head/peroneal nerve) (Correct answer)
- Calcaneus
- Anterior superior iliac spine
Correct answer: Lateral knee (fibular head/peroneal nerve)
The common peroneal nerve at the fibular head is highly vulnerable to compression injury in the lateral position and requires careful padding.
Question 2: An Esmarch bandage is used in orthopaedic surgery to:
- Stabilize fractures post-operatively
- Exsanguinate the extremity before tourniquet inflation (Correct answer)
- Compress wound dressings after closure
- Wrap instruments on the back table
Correct answer: Exsanguinate the extremity before tourniquet inflation
An Esmarch bandage wraps the limb distally to proximally to exsanguinate it before tourniquet inflation, creating a bloodless surgical field.
Question 3: When setting up the back table for a shoulder rotator cuff repair, which instrument is essential for suture anchor placement?
- Bone hook
- Tap and drill set
- Awl and mallet (Correct answer)
- Rongeur
Correct answer: Awl and mallet
Suture anchors require an awl to create a pilot hole and a mallet to drive the anchor into bone during rotator cuff repair.
Question 4: During an external fixator application for a tibia fracture, the OT's role when handling Schanz pins includes:
- Pre-bending pins to match limb contour
- Ensuring pins remain sterile and loading them into the drill chuck without contaminating threads (Correct answer)
- Boiling pins in sterile water immediately before insertion
- Selecting pin diameter based on patient age alone
Correct answer: Ensuring pins remain sterile and loading them into the drill chuck without contaminating threads
Schanz pins must remain sterile throughout; the OT loads them into the chuck carefully to avoid contaminating the bone-contact threads.
Question 5: Bone cement (PMMA) preparation in orthopaedic surgery requires the OT to:
- Mix cement under a fume hood or in a vacuum mixing system and monitor working time (Correct answer)
- Prepare cement 30 minutes before use to allow full curing
- Add sterile water instead of the supplied liquid monomer to reduce toxicity
- Mix rapidly at high temperature to accelerate setting
Correct answer: Mix cement under a fume hood or in a vacuum mixing system and monitor working time
PMMA cement produces toxic methyl methacrylate fumes; vacuum mixing or fume management is required, and the OT must track working time as it sets quickly.
Question 6: Which of the following correctly describes the purpose of a bone graft harvested from the iliac crest?
- It serves as a rigid internal fixation device
- It provides osteogenic, osteoinductive, and osteoconductive properties to support healing (Correct answer)
- It is used exclusively as a spacer to maintain limb length
- It replaces metallic implants in pediatric fractures
Correct answer: It provides osteogenic, osteoinductive, and osteoconductive properties to support healing
Autogenous iliac crest bone graft provides all three bone healing properties: osteogenic cells, osteoinductive growth factors, and an osteoconductive scaffold.
Question 7: When a surgeon requests a 'lag screw technique' during fracture fixation, the OT should prepare:
- A fully threaded cortical screw equal in length to the fracture gap
- A drill bit matching the screw's outer diameter for the near cortex and inner diameter for the far cortex (Correct answer)
- A cannulated screw over a guide wire only
- A locking screw with a torque-limiting screwdriver
Correct answer: A drill bit matching the screw's outer diameter for the near cortex and inner diameter for the far cortex
A lag screw requires over-drilling the near cortex (gliding hole = outer diameter) and under-drilling the far cortex (pilot hole = inner diameter) to generate compression across the fracture.
OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 3
During a hip arthroplasty, the patient is positioned in a lateral decubitus position.
Which anatomical landmark is most critical to pad to prevent a pressure injury?