ORTHO test 2 Flashcards
(246 cards)
1
Q
shoulder arthroscopy
A
diagnosis, removal of loose bodies, and rotator cuff repairs
2
Q
acromioplasty
A
limited painful ROM impingement syndrome
3
Q
bankart, putti platt, bristow
A
recurrent anterior dislocation of the shoulder
4
Q
total shoulder arthroplasty
A
painful glenohumeral arthritis with significant loss of ROM or osteonecrosis
5
Q
arthroscopic bankart procedure
A
shaver, burr, suture hook, MITEK for arthroscopic repair
6
Q
why type of joint is the shoulder?
A
ball and socket
7
Q
what bones articulate to form the joint?
A
scapula, humerus, glenoid
8
Q
the top of the glenoid cavity is formed by the bony point on the top of the shoulder called the acromion process of the
A
scapula
9
Q
three joints of the shoulder girdle
A
glenoidoclavicle, acromiclavicle, steroclavicular
10
Q
which tendons are part of the rotator cuff?
A
supraspinatus, infraspinatus, teres minor, subscapularis
11
Q
main function of the rotator cuff
A
shoulder movement
12
Q
what landmark is used for orientation during the shoulder arthroscopy? what instrument is used?
A
biceps tendon
switching stick
13
Q
how is the arm manipulated by the ST during exam of the shoulder?
A
external and internal rotation, slightly flexed position
14
Q
what are the problems that may commonly be found and treated during the diagnostic shoulder arthroscopy?
A
rotator cuff repair, labral tear, loose bodies
15
Q
what solution is commonly used for arthroscopy?
A
epi mixed with lactated ringer
16
Q
bankart lesion
A
anterior part of the glenoid labrum of the shoulder
17
Q
trocars used for bankart repair? why?
A
threaded to prevent dislodgement
18
Q
what are the bony landmarks that are marked for an arthroscopic acromioplasty?
A
acromion, acromioclavicalar point, distal clavicle, coracoid process
19
Q
most common method of reduction for a colles fracture?
A
close method, casted
20
Q
femoral osteotomy guide
A
determine the point for removal of the femoral head using a saw
21
Q
acetabular reamers
A
used to remove the articular cartilage
22
Q
hohman retractors
A
elevate the femoral neck and head into the open wound
23
Q
charnley
A
self retaining retractor for THA
24
Q
femoral reamers
A
open up the IM canal
25
cookie cutter
box chisel used to prepare the end of the femur for rasping
26
femoral rasps
last one used is left in place as part of the base trial for the femoral component
27
cement restrictor
prevent entry into the unreamed segments of the IM canal
28
calcar plane
smooth the site around the femoral rasp just prior to the trial components are used
29
dynamic hip screw
hip fractures
30
trypes of hip fractures
interochanteric, subtrochanteric, femoral neck, basilar neck
31
what type of drape is commonly used with IV poles?
large barrier drape
32
what is the first step for a DHS/DCS procedure? and size?
guide pin is handed to the surgeon
| 38mm barrel plate and 135 degree angle barrel
33
what is used to prepare the site for the placement of the DHS plate and screw?
triple reamer
34
common reasons for a total hip arthroplasty?
osteoarthritis, trauma, over 65 years old
35
contamination during ortho? how to prevent?
when draping, change outer gloves
36
why should pt for THA include a type and cross?
blood loss could be high
37
3 advantages of laminar airflow in OR? spacesuits?
reduce microbial count, filtered air, air exchanges
| to prevent contamination
38
what is placed to immobilize the joint as part of the post op care?
triangular split
39
irrigation during drilling or reaming through bone
cool bone-prevent necrosis
40
use laps when passing ronguer
remove tissue
41
verify sizes when passing reamers, rasps
verbalized when used
42
remove bits of tissue from field
prevent contamination
43
accept implants
no dropping
44
save sm piece of cement
so can check piece for hardness
45
what is the purpose of a lateral post during the knee arthroscopy?
placing counteraction on the knee joint to open the medial side
46
most common injury during arthroscopy? repair?
meniscus injury
| arthroscopic partial mensciectomy or repair
47
which ligament of the knee is commonly injury? how?
ACL, pivot move in opposite direction
48
what can be used to repair a ligament?
autografts, allografts
49
where is graft placed for ACL? suture?
intercondylar notch
| nonabsorbable suture 2 or 5
50
how is the graft secured in the tunnels?
staples, screws
51
why is it important to save all bone chips and pieces of tissue from the reaming process?
may be placed in defect
52
complications during allograft?
infection, disease transmission
53
additional instruments for amputation?
rasp, amputation knife/saw, power saw
54
why is the femur kept in extension during the suture of the quad muscle?
to avoid hip flexion
55
complication of amputations?
phantom limb pain
56
common reasons for amputation?
peripheral vascular disease
57
most common reasons for total knee arthroplasty?
relieve pain and disability
58
sandbag taped on the OR table for knee
allow for the knee to be optimally flexed
59
what precautions does the ST make to ensure the cuts are completed efficiently?
extra sterile saw blade
60
what should the ST be doing during trial reduction?
communicating what size prosthesis will be needed
61
purpose of triple arthrodesis?
relieve pain
62
what is used to perform the triple arthrodesis?
screws, bone graft
63
instrument for achilles tendon repair? position? foot? suture?
tendon pulling forceps
prone
foot is at rest
4-0 nonabsorbable
64
post op dressing after achilles tendon
4x4 dressing sponges
| splint
65
most common cause of a bunion?
shoes styles worn, female most common
66
procedures for bunions
bunionectomy, mcbride, chevron
67
goal of bunion procedure?
prevent reoccurence
68
structures that must be preserved during bunion procedure?
metatarsal neck
69
what nerve is associated with carpal tunnel release?
median nerve
70
instrument sued to bluntly dissect under the carpal ligament for arthroscopic carpal tunnel release?
mosquito
71
when removing ganglion, what might be used to remove the last little core?
nibbler
72
three ways might a carpal or metacarpal fracture be fixated?
k wires, plate, screws
73
bones associated with an elbow fracture?
distal humerus, olecranon, proximal ulnar, radius
74
what position is ulnar nerve transposition done in?
supine, Olympic table
75
suture used to tack down the transposed ulnar nerve?
2-0 ethibond
76
4 things when placing a k wire in a finger
k wire, wire driver, pin cutter, pin cover
77
3 ligaments in acromioclavicular injury?
coracoclavicle, coracoacromion, acromiclavicular
78
mohow are most clavicular fractures treated?
immobilization
79
what tendon of the rotator cuff tear easier?
supraspinatus
80
which procedure for correction of anterior shoulder dislocation carries the most risk?
bristow
81
what positions may be used for acetabular fracture fixation?
lateral, supine
82
what is the reason for fixing hip fractures so quicly?
decrease in morbidity and mortality
83
what are possible complications of mismanaged femoral fractures?
immobility, bleeding, infection, atrophy
84
how can a patellar fracture be treated?
wire, screws, patellectomy
85
steps of IM rod insertion?
guide pin placement, reaming of the IM canal, rod placement, locking screw placements
86
why is it important to form the stump carefully in a lower extremity amputation?
allows for tie off, prosthesis fits better
87
what is considered in deciding if a patient is a candidate for limb or digit reattachment?
type of fracture, degree of damage to blood vessels, tissue, nerves
88
first step in limb/digit reattachment
foreign matter and damaged tissue removed
89
what pathology occurs that leads to total joint replacement?
degenerative joint diease
90
what type of systems are total joints that allow for differences in patient anatomy, component fit and surgeon preference
modular
91
what position is the patient for total hip arthroplasty?
lateral
92
3 components for a total hip arthroplasty
femoral head/neck, acetabulam
93
possible complation of total hip arthroplasty
shatter the femur, infection, immobility
94
who are candidiates for non cemented total joint arthroplasties?
young, healthy, no history of bone disease, strong cortical bone
95
where is PMMA mixed? why?
mixevac, the fumes are suctioned away since they are toxic
96
2 types of drains for total joint arthroplasties?
nonreinfusion, reinfusion--not normally used
97
position for total shoulder arthroplasty
semi fowlers
98
incision for total shoulder arthroplasty
deltopectoral groove
99
what does DJD stand for?
degenerative joint disease
100
when all surfaces of a joint are replaced what is it called?
total joint arthroplasty
101
3 types of components used for total joints
cemented, noncemented, hybrid
102
what is PMMA? and 2 parts
bone cement
| liquid, powder
103
risk to you when using bone cement
respiratory tract problems, eye contact
104
risk to patient when using bone cement
cardiac arrest, hemorrhage
105
what is always done prior to cementing and why?
irrigation, opens pores of bones, better bonding
106
what is always done before closure of a total joint?
ROM, check functioning properly
107
which arthroplasty is done on the upper 1/3 of the leg with the patient in the lateral position?
total hip arthroplasty
108
what are the most commonly used hip systems?
modular
109
what does it mean to disarticulate the hip and what instrument is it done with?
dislocate hip, head from acetabulum
| flex gently
110
what type of saw would be used to excise the femoral head?
oscillating saw
111
3 instruments used to ream the femur?
reamer, broaches, mallet
112
what could happen if the femur is reamed with a femoral broach that's too big
shatter the femur
113
what type of component is slightly rough and has a textured posterior surface?
cemented
114
what type of componenent has a porous surface on the posterior side?
non cemented
115
what component costs more for cement?
noncemented
116
in which total joint arthroplasty is a tourniquet used?
knee, ankle, elbow, digits
117
3 components for total knee and what they are made out of
femoral: metal
tibial: polyethylene
patellar: polyethylene
118
when using cement for a total joint, what is avoided until the cement has hardened and why?
movement, may dislocate prosthesis
119
2 greatest problems after metacarpal arthroplasty?
progression of diseases to other joints
| weak ability to pinch
120
what is usally mixed in with the irrigation for total joint arthroplasties?
antibiotics
121
what nerve is compressed in a carpal tunnel?
median nerve
122
2 incisions for closed carpal tunnel
wrist, middle of palm
123
excision of benign out pouchings of synovium which present as firm masses
excision of ganglion
124
where are ganglions most common?
palm of hand, wrist
125
treatment for fractures of the carpals?
closed reduction and immobilization
126
3 ways carpals are treated with an open procedure
k wires, small screws, mini plates
127
where is carpal fracture bone graft taken from?
head of the radius
128
most common wrist fracture?
colles
129
where is the colles fracture located?
distal end of the radius
130
what is the most common cause of the colles fracture and what could you used to help prevent it?
breaking fall with hand
| wrist guards
131
what are the 3 common fractures of the elbow?
distal humerus, olecranon, proximal ulnar/radius
132
2 causes of ulnar nerve damage
trauma to elbow, dislocation of elbow
133
2 things happen when the ulnar nerve is damage?
sensory loss to hand, atrophy
134
where is the ulnar nerve usually found?
under the fascia flexor carpi ulnaris muscles
135
when an ulnar nerve transposition is done, where is the nerve placed?
deep in the brachialis flexor muscle origin
136
3 proximal femur fractures
intertrochanteric, femoral neck, subtrochanteric
137
which proximal femur fracture is most common in wisconsin?
intertrochanteric
138
what type of traction is used in hip fractures to decreases muscle spasm and pain?
bucks
139
if a femoral shaft fixation is not done correctly, what 3 things could the patient suffer from?
immobility, skin problems, pneumonia
140
what is the most common tx used for femoral shaft fixation?
IM rods
141
another name for popliteal cyst?
bakers cyst
142
3 anatomical sites that are affected with ankle fractures
medial, lateral, posterior
143
a triple arthrodesis is a fusion of what 3 ankle joints?
talocalcaneal, talonavicular, calcaneocubic
144
2 reasons why a triple arthrodesis is done?
inversion, eversion of the foot
145
OR table for acetabular fracture fixation
lateral
146
fracture table acetabular fracture fixation
supine
147
what is compartment syndrome and when does it usually occur?
pressure build up from bleeding or swelling of tissues, when blood flow is disrupted
148
how is compartment syndrome treated?
fasciotomy
149
Austin moore
replace femoral head and neck
150
bipolar
only femur is reamed, no acetabulum
| replacement of femoral head with prothesis
151
modular
femoral, femoral head/neck, acetabular
| adjust to the patient size
152
what is a bone hook used for?
disarticulate the hip
153
what would you hand after the bone hook?
oscilatting saw
154
another name for the femoral reamer
femoral broach
155
varus
inward angulation, bowlegged
156
valgus
angled outward, knock kneed
157
3 planes of motion for the knee
abduction, flexion, rotation
158
position for total knee surgery?
supine
159
unicompartmental implants
either medial or lateral part of knee
160
bicompartmental implants
tibiofemoral and patellofemoral joints
161
tricompartmental
femur, patella, tibia
162
2 saws for total knee
oscillating, reciprocating
163
what would you anticipate handing the surgeon when placing the pins to stabilize the alignment guides?
saw and mallet
164
why is the ulnar nerve transposed?
causes sensory loss and atrophy
165
what instrument is used to free the ulnar nerve?
freer
166
when would bone grafting be used in humeral shaft fixation?
if severely communited
167
why is cement used in the case of pathologic fractures?
healing potential is poor
168
why is gentle reaming of the medullary canal used when placing an IM nail?
to not cause further fracture
169
how do most clavicular fractures occur?
direct blow to clavicle
170
most common site of clavicular fracture?
middle 1/3 of bone
171
how are most clavicular fractures treated?
immobilization
172
when is an open reduction indicated for clavicular fractures?
distal fracture, nonunion
173
what are 2 types of fixation devices used with open reduction of the clavicle?
tubular plate, pins
174
what would you suppose a semitublar plate is, and why would it be used on a clavicle?
curves to bone, contours to bone
175
what is the most difficult part of surgery for open shoulder?
exposure
176
partial rotator cuff vs complete tears
partial: from use, middle age
complete: extreme force, athletes
177
goal of treatment of rotator cuff tears?
alleviate pain, return to normal activities
178
additional itmes for major tear
suretac
| drill with small bit
179
additional items for minor tear
heavy suture, smoothing
180
goals for recurrent shoulder dislocation?
complications, correct the problem
181
what step is added to amke a bankart a putti platt?
subscalpuris tendon
182
disadvantage of the bristow procedure
loss of internal rotation
183
how do acetabular fractures usually occur?
severe trauma
184
safety done for lengthy procedures
cell saver, warm OR, art line, type and cross
185
why is internal fixation of the trochanter done?
to get pt up, little blood loss
186
determinants of procedural success?
degree of displacement, early reduction
187
why is blood loss low on hip and lower extremity
don't enter joint capsule
188
what size of instruments are used on hip and lower extremity?
large
189
what eents can affect the blood supply to the femoral head?
swelling
190
fractures of the epiphyseal growth plate of the femur in a child?
slip capitol femoral epipshysis fracture
191
types of pins for epiphyseal growth plate fixation?
hag, holls
192
most cost effective prosthesis to replace the femoral head?
austin moore
193
when is austin moore selected?
when life expectancy is short
194
what condition if present would warrant a total joint arthroplasty?
major deficiency of acetabular side of joint
195
if femoral shaft fracture not managed appropriately
decrease in mobility, increase in morbidity
196
femur
largest in body, supports all body weight
197
possible tx methods for femur
im nails/rods
198
disadvantages to using plates and screws for femoral shaft fixation?
bend, break
199
advantages for IM fixation?
increase in load sharing, rod less likely to bend, less scarring
200
position, prep, drape for tibia
supine, circumferential toes to tourniquet, stockinette, towel, extrem. sheet, split sheet
201
most common complication of supracondylar fractures?
nonunion
202
when should repair to the menisci and ligaments?
same time as joint fixation
203
what do popliteal cysts often indicate in adults?
RA, torn meniscus
204
position for popliteal cysts?
prone
205
instruments for popliteal cysts
soft tissue instruments, ronguer
206
why are tibial shafts difficult to treat?
less blood supply
207
what tibial fractures heal better?
tortional, less damage to periosteum
208
when is external fixation tx of choice?
gross contamination
209
key to successful tx of open tibial fractures?
debride and clean out any non viable tissue
210
bones for ankle fracture
tibia, fibula
| posterior, medial, lateral
211
where can bone be taken from if more is needed for the bone graft?
iliac crest
212
hallux valgus
bion
213
hammer toe
bump in less 4 toes, treated with k wires, plates, screws
214
prep for knee arthroplasty
toes to tourniquet
215
tourniquet for shoulder
no
216
treatment for hip fractures
ASAP
217
how are acetabular fractures fixed?
mesh, plates, screws
218
avascular necrosis
risk of femoral neck fractures
219
complications of avascular necrosis
skin breakdown, pneumonia, DVT
220
treatment for tibial fracture
IM rod
221
heel bone
calcaneus
222
femoral nailing positioner
chick table
223
suture for attaching tendon to bone
polyglactin 910
224
acromion process in the AC joint is part of which bone?
scapula
225
candidates for THA
over 65
226
what tissue does the acetabular reamer remove?
cartilage and bone
227
What 3 structures may need a possible resection during a total knee?
Patellar fat lad, ACL, meniscus
228
Total shoulder prep
Circumferential to wrist
229
What does a total shoulder do for the patient?
Gives support so rehab can occur
230
Total elbow position
Supine or semi fowlers
231
What nerve is avoided in a total elbow?
Ulnar nerve
232
What’s another name for distal humerus?
Trochlea
233
Another name for proximal ulnar
Olecranon process
234
What 2 medullary canals are teamed for a total elbow?
Humerus and ulna
235
Metatarsal
Toes
236
Metacarpals
Fingers
237
What is the implant for finger and toe surgeries called?
Silastic implant
238
What is the silastic implant supported by?
Ligaments, muscles, tendons
239
Why would a total shoulder be done?
Physically induced or accidental injury
240
Femoral shaft fixation
Closed reduction
241
Bones of the shoulder
Clavicle, scapula, humerus
242
Detractors used for shoulder surgery
Double end richardson, weitlanders, rakes
243
Clavicular fracture fixed with open reduction
Tubular plates
244
What shoulder dislocation surgery is easiest to do?
Bankart
245
What should dislocation normally doesn’t give good results?
Bristow
246
4 types of acetabular fractures
Column, t shaped, transverse, isolated posterior wall
