Mixed Deck — All OTC Topics Flashcards

During a spine surgery in the prone position, which complication must the OT monitor for related to eye positioning?

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.

Which position places the knee in approximately 20–30 degrees of flexion and is recommended for a long leg posterior splint?

Answer: Slight flexion (20–30 degrees)

A long leg posterior splint positions the knee in 20–30 degrees of flexion, which is the functional resting position and reduces tension on posterior structures.

Which of the following best describes a greenstick fracture?

Answer: An incomplete fracture where one cortex is broken and the other is bent

A greenstick fracture is an incomplete fracture typically seen in children where one cortex breaks and the opposite cortex bends, analogous to breaking a green stick.

How many layers of cotton padding should be applied over bony prominences when splinting the lower extremity?

Answer: Extra padding — double or more layers

Bony prominences require extra padding to prevent pressure sores and skin breakdown under the rigid splint material.

Which of the following is the MOST significant factor contributing to thermal injury (burns) to the patient's skin during the application of a plaster cast?

Answer: Using water that is too hot to dip the plaster

The chemical reaction between plaster of Paris and water is exothermic, meaning it releases heat as it cures. Using water with a temperature greater than 24°C (75°F) dramatically increases the peak temperature of this reaction, significantly raising the risk of causing a thermal burn to the patient's underlying skin.

A patient with a proximal tibia fracture being splinted with a long leg posterior splint should have the knee positioned in:

Answer: 5–10 degrees of flexion

5–10 degrees of knee flexion relaxes the posterior capsule and prevents hyperextension while keeping the limb in a functional position.

When removing a cast, the cast saw should be held at what angle relative to the cast surface to minimize injury risk?

Answer: Perpendicular (90 degrees) to the cast surface

Holding the saw blade perpendicular to the cast surface and using a plunge-and-lift technique minimizes skin contact and reduces injury risk.

The CROW (Charcot Restraint Orthotic Walker) boot is primarily indicated for which patient population?

Answer: Charcot neuroarthropathy in diabetic patients

The CROW boot immobilizes and offloads the foot in patients with Charcot neuroarthropathy to prevent progressive bony collapse and ulceration.

A wound left open to heal from the base upward through granulation tissue formation is healing by which method?

Answer: Secondary intention

Secondary intention healing allows a wound to fill with granulation tissue from the bottom up when primary closure is not possible, such as in infected or contaminated wounds.

What is the recommended frequency for neurovascular checks in a newly admitted traction patient?

Answer: Every hour for the first 24 hours

Newly applied traction demands hourly neurovascular checks for the first 24 hours to detect early vascular compromise or compartment syndrome.

When assessing a pediatric patient with a suspected supracondylar humerus fracture, which neurovascular structure is at greatest risk of injury?

Answer: Anterior interosseous nerve and brachial artery

Supracondylar fractures in children most commonly injure the anterior interosseous nerve and brachial artery due to their proximity to the fracture site.

Which traction type applies a pulling force directly through a pin or wire inserted into bone?

Answer: Skeletal traction

Skeletal traction uses a pin, wire, or tong inserted into bone to apply a direct longitudinal pulling force for fracture reduction or immobilization.

Which of the following is the correct sequence for donning personal protective equipment (PPE)?

Answer: Gown → mask → eye protection → gloves

CDC guidelines recommend donning PPE in the order: gown first, then mask or respirator, eye protection, and finally gloves so that the gloves cover the gown cuffs.

When applying skin traction to a patient's lower leg, which of the following areas requires careful padding to prevent a common nerve injury?

Answer: The head of the fibula

The head of the fibula, located on the outer side of the leg just below the knee, is where the common peroneal nerve is most superficial. Applying pressure here with traction straps or bandages can lead to nerve compression, resulting in foot drop and sensory deficits. Therefore, this area must be well-padded and the straps applied carefully to avoid this complication.

A patient in traction reports burning and itching under the foam boot. The FIRST action should be to:

Answer: Remove the boot, inspect the skin, and reapply if intact

Burning and itching suggest skin irritation or early breakdown; the boot must be removed for skin inspection before any further intervention.

A patient in a hip spica cast for a femur fracture develops severe, cramping abdominal pain, persistent nausea, and bilious vomiting several days after application. These symptoms are MOST indicative of which serious complication?

Answer: Cast Syndrome (SMA Syndrome)

Cast syndrome, or Superior Mesenteric Artery (SMA) syndrome, is a rare complication where a large body or spica cast compresses the third portion of the duodenum between the SMA and the aorta. This creates a functional bowel obstruction, leading to symptoms of severe nausea, vomiting, and abdominal pain.

An Orthopaedic Technologist is preparing materials for a lower extremity splint on an average-sized adult. Which of the following represents the recommended number of plaster layers for adequate strength?

Answer: 12 to 15 layers

For a lower extremity splint on an average-sized adult, 12 to 15 layers of plaster are typically required to provide sufficient strength and support. Upper extremities generally require fewer layers (6-10), while using too few on a lower extremity would compromise stability.

An OT documents '3/5' on a manual muscle test for knee extension. This finding means the patient can:

Answer: Move through full range of motion against gravity but not against added resistance

MRC grade 3/5 means the muscle can move the joint through full range of motion against gravity alone, with no additional resistance applied.

Bone cement (PMMA) preparation in orthopaedic surgery requires the OT to:

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.

Intraoperative cell salvage (autotransfusion) during major orthopaedic surgery is contraindicated when:

Answer: The surgical field is contaminated with infection or malignant cells

Cell salvage is contraindicated if the surgical field is contaminated by infection or tumor cells, as reinfusing this blood could spread sepsis or malignancy.