5: OR SETUP AND POSITIONING

Question 1

Motor, sensory, or both?: Femoral nerve

Answer 1

Both

Question 2

Motor, sensory, or both?: Sciatic nerve

Answer 2

Both

Question 3

Motor, sensory, or both?: Obturator nerve

Answer 3

Both

Question 4

Motor, sensory, or both?: Lateral cutaneous nerve

Answer 4

Sensory

Question 5

Motor, sensory, or both?: Common peroneal nerve

Answer 5

Both

Question 6

Most commonly injured nerve GYN surgery

Answer 6

Femoral

Question 7

Deficits: Femoral Nerve

Answer 7

M: Impaired hip flexion, knee extension
S: Anterior thigh, medial calf

Question 8

Injury: Femoral nerve

Answer 8

Excessive hip flexion, abduction, external rotation
(Essentially like excessive McRoberts)

Question 9

Deficits: Sciatic nerve

Answer 9

M: Inability to flex knee, foot drop
S: Calf, dorsolateral foot

Question 10

Injury: Sciatic nerve

Answer 10

Excessive abduction, external rotation

Question 11

Deficits: Obturator nerve

Answer 11

M: Weakness with thigh adduction
S: Medial thigh

Question 12

Injury: Obturator nerve

Answer 12

Prolonged hip flexion, abduction

Question 13

Deficit: Lateral femoral cutaneous nerve

Answer 13

S: Proximal aspect of thigh

Question 14

Injury: Lateral femoral cutaneous nerve

Answer 14

Excessive hip flexion, abduction, external rotation

Question 15

Deficit: Common peroneal nerve

Answer 15

M: Foot drop
S: Lateral/anterior part of lower leg

Question 16

Injury: Common peroneal nerve

Answer 16

Direct pressure on lateral aspect of knee with prolonged flexion

Question 17

Where should fulcrum of boot be

Answer 17

At hips

Question 18

High lithotomy lowest acceptable degree

Answer 18

60deg between abdomen and thigh

Question 19

Low lithotomy appropriate degrees between abdomen and thigh

Answer 19

60-170

Question 20

Appropriate degree hip abduction

Answer 20

90deg or less

Question 21

Appropriate degree knee flexion

Answer 21

90-120deg

Question 22

Bar supporting the boot should be __

Answer 22

Parallel to floor

Question 23

Upper brachial plexus injury AKA

Answer 23

Erb’s

Question 24

Lower brachial plexus injury AKA

Answer 24

Klumpke’s

Question 25

MOA Brachial Plexus injury

Answer 25

Outstretched arms on armboard (esp >90deg), steep Trendelenberg

Question 26

Appropriate positioning on arm board

Answer 26

Abduction <90 degrees
Thumbs up
Padding to decrease pressure injury

Question 27

Appropriate UE surgeon ergonomics

Answer 27

Shoulders down and relaxed
Arms relaxed by side
Elbows 90 deg
Instruments at elbow level (to minimize risk to shoulder and arm)
Lower table or use surgical step

Question 28

Appropriate spine surgeon ergonomics

Answer 28

Avoid rotation
Avoid extension
Neck flexion 15 deg (ideally 15deg downward gaze)
Monitors should be directly in line with shoulders and below eye level

Question 29

Appropriate surgeon LE ergonomics

Answer 29

Flat feet
Hips level
Avoid tilting/leaning