71. arthroscopy Flashcards Preview

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Flashcards in 71. arthroscopy Deck (25):
1

how are arthroscopes described

1. diameter (1.9, 2.3, 2.7)2. length (short 8 cm, long 12.5 cm)3. lens angle (0, 30, 70 degrees)

2

bending of the athroscopic shows up as how on the field of view

black crescent at the periphery of the field of view or migration of the arthroscopic image across the monitor screen

3

advantage of high definition cameras

more pixel lines per screensharper image

4

3 chip camera

1. zoom2. white balance3. image captureusually clip on, but also direct coupling systems

5

what resolution setting is recommended for arthroscopy

high horizontal resolution

6

light sources for arthroscopy

1. Halogen--more yellow color2. Xenon--MOST COMMON, increased light intensity and higher color temperature with greater visual clarity and color rendition

7

T/F fiberoptic light cables heat up significantly and should NOT be placed directly against the patient

TRUEmay cause thermal injury if too close to the patient

8

benefits and optimal irrigation pressure for arthroscopy

1. increases field of vision2. removes debris3. distends/expands jointSaline or LRS (no diff but LRS may be more physiologic)60 mm Hgdelivered with gravity flow or fluid pump (better when using shaver)

9

a 30 degree arthroscope allows for the equivalent of how many degrees of view

60 degrees

10

how to obtain a higher flow rate with gravity fluid pumping

--increase diameter of tubing--elevation of the bad 8-9 feet --using a pressure bag--3-5 L bags-- Y adapters

11

T/Fflexion of a distended joint will increase intraarticular pressure

TRUE

12

what is the major advantage of working through a cannula

ease of instrument insertion

13

what is the most common reason for failing to locate the appropriate instrument portal site

entering the skin at too oblique of an angle and crossing over the arthroscopeor having the arthroscope too close

14

Where is the typical location of the scope portal for stifle arthroscopy

SCOPE portal LATERALLY (parapatellar)INSTRUMENT portal MEDIALLY (parapatellar)egress is advanced under the patellar tendon

15

the absence of articular carriage at the center of the trochlear notch is indicative of what

NORMAL--frequent finding in normal joints

16

According to Jardel VCOT 2010 what is the approximate relationship btwn a typical arthroscopic portal, instrument portal, and egress portal to pertinent neuro vascular structures on the medial elbow

SCOPE: 23.1 mm caudal to brachial artery, 21 mm caudal to median nerve, 4 mm cranial to ulnar nerveINSTRUMENT: 16.3 mm caudal to brachial artery ,13.5 mm caudal to median nerve, 12 mm cranial to ulnar nerveEGRESS: 21.4 mm caudal to ulnar nerve

17

according to Werner VCOT 2009 what is the SN and SP of arthroscopy for estimating RUI in dogs

SN 98%SP 89%

18

what is triangulation

instrumentation of the joint such that the instrument and the scope angle together to form the apex of a triangle

19

indications of shoulder arthroscopy

--OC/OCD fragment removal and/or debridement--disease of biceps brachia tendon--assess OA--synovial bx ---synovial culture and lavage

20

lateral shoulder arthroscopy portals for OCD

1. camera portal: craniodistal to acromion2. instrument portal: caudally in triangulation with scope 2 cm caudal to acromion3. egress: directed craniocaudal and medially at the level of the greater tubercleaxillary artery and nerve caudallysuprascapular artery and nerve cranially

21

lateral shoulder arthroscopy portals for biceps brachii tendon

1. camera portal: craniodistal to acromion further caudal than with OCD lesion2. instrument portal: cranially in triangulation with scope 2 cm cranial to acromion can be medial to biceps brachia3. egress: caudally to acromionaxillary artery and nerve caudallysuprascapular artery and nerve cranially

22

surgical anatomy to view in shoulder arthroscopy

MCL (medial glenohumeral lig Y)Subscapularis tendonbiceps brachii tendon (has normal labrum or fibrous cuff)Glenoidsupraglenoid tuberclehumeral headcaudal joint pouchjoint capsule

23

medial elbow joint portals

camera: distocaudal to medial epicondyleegress: palpate olecranon process and insert needle on the medial side of process instrument: cranially to triangulate with scopeulnar nerve btwn egress and cameramedian artery and nerve cranially

24

hip arthroscopic portals

camera: perpendicular to limb just dorsal to greater trochanteregress: right hip 3 o'clock to greater trochanter 5 o'clock if left hipcaution ischiatic/sciatic nerve and caudal gluteal artery caudallyvisualize: round ligament, femoral head, acetabulum/acetabular labrum, transacetabular ligament

25

stifle arthroscopy

2.7 mm 30 degree short arthroscopeneed shaver for infra patellar fat pad (with aggressive cutter) on oscillation modestifle distractorsvarious knifes

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