National Physical Therapy Examination (NPTE) Practice Exam

In which position is a person with quadriplegia LEAST likely to develop pressure ulcers?

1. Scapulae

2. Medial malleoli

3. Lateral malleoli

4. Posterior pelvis

The correct answer is: Scapulae

A person with quadriplegia is least likely to develop pressure ulcers in the scapulae position due to the way pressure is distributed across the body during positioning. When individuals are in a supine position, the scapulae are well-designed to handle some pressure as they are supported by the back and have less bony prominence. This area does not bear the same level of pressure as other bony landmarks, especially when proper positioning and support techniques are employed, such as using cushions and positioning devices that relieve pressure. In contrast, areas like the medial malleoli, lateral malleoli, and posterior pelvis are more prone to developing pressure ulcers. These areas have less muscle and fat padding to protect against pressure-related injuries, and they are located over bony prominences that can easily become ischemic when subjected to sustained pressure. By understanding these positioning mechanics and the anatomic structures involved, it helps in developing effective strategies to prevent pressure ulcers in individuals with limited mobility, such as those with quadriplegia.