Physical Therapy Assistant Practice Exam

What bony prominence is particularly susceptible to skin breakdown in a patient positioned in the supine position?

1. Calcaneus

2. Spinous processes

3. Medial malleolus

4. Occiput

The correct answer is: Spinous processes

The correct answer is the occiput, which refers to the back part of the skull. When a patient is positioned supine (lying on their back), certain bony prominences become more vulnerable to pressure ulcers due to the weight of the body pressing against surfaces. The occiput is particularly at risk because it is in direct contact with the hospital bed or any other flat surface the patient may be lying on. In the supine position, the occipital region bears weight and can experience reduced blood flow, especially if the patient's head is not properly aligned or the surface is not adequately cushioning. Prolonged pressure on this area can lead to ischemia and subsequent skin breakdown, resulting in pressure ulcers. While the spinous processes, calcaneus, and medial malleolus are also areas of concern for pressure ulcers in various positions, the occiput is the most directly impacted when a patient is supine, making it critical for healthcare providers to monitor this area closely and implement strategies for prevention, such as regular repositioning and the use of specialized padding or cushions.