OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 4 — Questions and Answers
Question 1: The primary purpose of pulsed lavage (high-pressure irrigation) during orthopaedic surgery is to:
- Hydrate exposed bone to prevent necrosis
- Remove debris, devitalized tissue, and bacteria to reduce infection risk (Correct answer)
- Activate bone morphogenetic proteins in the surgical site
- Lubricate power tool cutting surfaces
Correct answer: Remove debris, devitalized tissue, and bacteria to reduce infection risk
Pulsed lavage mechanically removes contaminants, devitalized tissue, and bacterial load from the surgical site to reduce infection risk.
Question 2: During a spine surgery in the prone position, which complication must the OT monitor for related to eye positioning?
- Corneal abrasion and vision loss from direct pressure on the globes (Correct answer)
- Increased intraocular pressure from head-up tilt
- Dry eye syndrome from prolonged blinking
- Pupillary dilation from surgical lighting
Correct answer: Corneal abrasion and vision loss from direct pressure on the globes
Direct pressure on the orbits during prone positioning can cause central retinal artery occlusion or corneal abrasion, making proper head/eye support critical.
Question 3: An OT notes the tourniquet has been inflated for 115 minutes during a lower extremity case. The appropriate action is to:
- Continue without concern as long as the patient remains hemodynamically stable
- Alert the surgeon immediately so the tourniquet can be deflated and the limb reperfused (Correct answer)
- Increase tourniquet pressure to maintain an adequate seal
- Document the time but wait until 150 minutes to notify
Correct answer: Alert the surgeon immediately so the tourniquet can be deflated and the limb reperfused
Tourniquet time beyond 90-120 minutes dramatically increases risk of nerve injury and ischemic damage; the surgeon must be alerted to consider deflation.
Question 4: Which of the following describes correct technique when using a mallet and chisel during orthopaedic surgery?
- The OT holds the chisel while the surgeon strikes the mallet
- The surgeon controls both the chisel and mallet; the OT provides retraction only (Correct answer)
- The OT strikes the mallet while stabilizing the chisel handle
- Either the surgeon or OT may hold the chisel, with no established protocol
Correct answer: The surgeon controls both the chisel and mallet; the OT provides retraction only
The surgeon maintains full control of both the chisel and the mallet to ensure precise force application; the OT assists with exposure and retraction.
Question 5: During a total hip replacement, the OT is asked to apply traction to the leg. The purpose is to:
- Test the stability of the trial implant components
- Distract the hip joint to facilitate femoral head dislocation and acetabular exposure (Correct answer)
- Stretch the sciatic nerve to allow posterior capsule access
- Measure leg length discrepancy intraoperatively
Correct answer: Distract the hip joint to facilitate femoral head dislocation and acetabular exposure
Axial traction and rotation of the leg facilitates dislocation of the femoral head, exposing both the acetabulum and proximal femur for implant preparation.
Question 6: What is the correct sequence when preparing a sterile implant for delivery to the surgical field?
- Open inner packaging with sterile technique and hand directly to the scrub tech, then document lot/serial number
- Document lot number first, then open outer packaging with bare hands and drop inner package onto field
- Open outer packaging with clean hands, then open inner sterile packaging and drop or transfer to the sterile field, then document lot/serial number (Correct answer)
- Soak implant in betadine for 30 seconds before transferring to the sterile field
Correct answer: Open outer packaging with clean hands, then open inner sterile packaging and drop or transfer to the sterile field, then document lot/serial number
The outer packaging is opened by non-sterile personnel, the sterile inner packaging is presented to the scrub tech or dropped onto the field, and the lot/serial number is documented for the implant log.
Question 7: When assisting during arthroscopic ACL reconstruction, the OT's role in graft preparation typically involves:
- Fashioning the tendon graft, whipstitching the ends, and sizing it on the graft preparation board (Correct answer)
- Only labeling the graft specimen and sending it to pathology
- Cutting the graft to bone-length with a saw
- Soaking the graft in antibiotic solution for a minimum of 60 minutes
Correct answer: Fashioning the tendon graft, whipstitching the ends, and sizing it on the graft preparation board
The OT prepares the tendon graft by trimming, whipstitching the ends for secure fixation, and sizing it through the appropriate tibial tunnel sizer on the back table.
OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 4
The primary purpose of pulsed lavage (high-pressure irrigation) during orthopaedic surgery is to: