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Senior Rotations > Orthopedics > Flashcards

Orthopedics Flashcards

(113 cards)

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1
Q

describe total knee arthroplasty

A

replace worn surfaces of knee joint

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2
Q

indications for total knee arthroplasty

A

rheumatic/traumatic arthritis

varus/valgus deformity (destroy medial/lateral)

pain, instability

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3
Q

position for total knee replacement

A

supine w/ footrest for flexed leg

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4
Q

2 principle methods of implant fixation for joint arthroplasty

A

cemented

noncemented

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5
Q

ideal candidate for cemented or uncemented/press fit

A

noncemented: younger active people. Biofixation

Cemented: old people

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6
Q

what is bone cement

A

poly methyl methacrylate monomer

IM of cemented arthroplasty prosthesis

adheres to metal/polyethylene but not bone

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7
Q

how is PMMA used to ensure fixation

A

fills cavity and interstices of bone for mechanical bond

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8
Q

adverse reactions to PMMA

A

transitory hypotension

cardiac arrest

CVA, PE

hypersensitivity

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9
Q

osteoarthritis

A

noninflammatory progressive degenerative joint disease-hypertrophic hyaline/subchondral bone

wear and tear after 50

cause of most joint replacements

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10
Q

rheumatoid arthritis

A

autoimmune disease-system attacks synovium and articular surfaces-inflammation

ages 25-50

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11
Q

osteomalacia

A

softening of bones due to lack of vitamin D

inadequate mineralization

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12
Q

osteoporosis

A

excessive loss of calcified matrix-decreased bone mass

metabolic disorder producing porous, brittle, easily fractured bones

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13
Q

continuous passive motion

A

early postop passive ROM

stimulates healing in articular tissue (tendon, cartilage, ligament)

doesn’t interfere with incisional healing over joint

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14
Q

benefits of CPM

A

inhibit adhesions

decrease joint stiffness, swelling, pain

early functional ROM

decreased effects of immobilization

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15
Q

osteomyelitis

A

bone/marrow infection from Staph A.

hard to treat expensive

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16
Q

diarthrotic joint

A

freely moveable/synovial

skull

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17
Q

amphiarthrotic joint

A

slightly moveable-connected by cartilage

symphysis pubis, intervetrebral joints

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18
Q

avulsion fracture

A

ligaments are intact on separated bone fragments

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19
Q

luxation

A

complete dislocation of one surface to another

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20
Q

subluxation

A

partial dislocation (ligament instability)

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21
Q

monteggia fracture

A

proximal ulnar fracture w/ dislocation of radial head

blow to ulna or fall w/ arm hyperextended

not treated with OR in kids

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22
Q

Colles’ fracture

A

distal radius fracture w/ posterior displacement of distal radial fragment

reduce, close, immobilize

fall on outstretched hand

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23
Q

compound fracture

A

bone through skin-extensive tissue damage

significant anatomical displacement

ORIF

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24
Q

comminuted fracture

A

more than 2 pieces

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25
spiral/oblique fracture
bone twisted apart oblique-shorter than spiral
26
pathologic fracture
due to weakened state-osteoporosis
27
greenstick fracture
bending partially ossiated bone convex side breaks, concave bends and heals incomplete fracture
28
stress fracture
incomplete fracture from overuse/high impact sports small crack
29
5 stages of bone healing
hematoma fibroblasts network formation osteoblasts invade calcium callus remodeling
30
malunion
fracture heals out of anatomical position impaired function/significant angulation of extemity
31
nonunion
healing ends without connecting bone (hematoma)
32
delayed union
healing hasn't occurred in normal time
33
terrible triad
torn anterior cruciate ligament, medial meniscus, medial collateral ligament osteoarthritis if untreated
34
where is a Baker's cyst
popliteal fossa
35
cast for complete knee immobilization
cylinder
36
cast for complete hip immobilization
spica with abduction pillow
37
anatomy of knee joint
2 articulations condyle of femur and tibial plateau femur and patella
38
supraspinatus syndrome
impingement syndrome (shoulder)
39
why use a tourniquet for appendicular surgery
bloodless field
40
why use Esmarch
exsanguinate appendage distal to proximal elevation
41
3 contraindications for tourniquets
compartment syndrome McArdle disease hypertension
42
3 safety rules for tourniquet
don't compress bony/neurovascular structures place as high as possible, not on skin folds wrap w/ stockinette w/o wrinkles cuff overlap min 3in. max 6in.
43
recommended max time for tourniquet inflation
less than 1hr. upper extremity less than 2hrs. thigh
44
what is done when tourniquet limit expired
take down 5 min for every half hour (rewrap) minimize effects on muscles/nerves
45
3 examples of antibiotic therapy
IV-cephalosporin, irrigation, ointment
46
2 antibiotics used
polymixin, bacitracen
47
bones in skeletal system
206
48
what is appendicular skeleton
upper and lower appendages pelvic/pectoral girdles
49
bones in appendicular skeleton
126
50
axial skeleton
skull vertebrae rib cage
51
bones in axial skeleton
80
52
cortical bone
hard outer shell main support
53
cancellous bone
soft, spongy, red bone marrow iliac crest, pelvis, ends of long bones
54
cortical vs. cancellous screws
cortical-tight threads, sheet metal screws, transfix cancellous-wide threads, wood screws
55
allograft vs. autograft bone
autograft-from self allograft-substitute, cadaver
56
where is autogenous bone harvested
iliac crest-cortical cancellous femoral head, patella fibula-cortical
57
anatomy of hip joint and proximal femur
proximal femur --> trochanter acetabulum and femur
58
3 fused bones of os coaxes (hip bone, innominate)
ileum ischium pubis
59
acetabulum
socket of hip joint
60
total hip arthroplasty
removal of ball and socket and replace
61
surfaces replaced in total hip arthroplasty
femoral head and neck acetabulum
62
indications for total hip arthroplasty
rheumatoid arthritis degenerative joint disease avascular necrosis
63
what is a bunion
hallux valgus-soft tissue or bony mass at medial side of first metatarsal head
64
patients frequently experiencing bunions
women-shoes
65
goal of bunionectomy
cosmesis: correct deformity reconstruction: resect abnormal bony components function: ROM
66
Keller procedure
proximal 3rd of proximal phalanx of big toe resected implant in IM canal to stabilize joint
67
Mayo procedure
CHECK
68
McBride procedure
abductor tendon fixed to lateral metatarsal neck excise sesamoid bone
69
triple arthrodesis
fuse talocalcaneal, talonavicular, calcaneocuboid joints
70
why perform triple arthrodesis
inversion or eversion deformity of foot intraarticular fracture clubfoot, poliomeylitis, rheumatoid arthritis
71
goal of triple arthrodesis
limit motion of foot and ankle to plantar flexion and dorsiflexion-pain relief
72
4 bones and 3 fusions of arthrodesis
bones: talus, calcaneous, navicular, cuboid fusions: talocalcaneal, talonavicular, calcaneocuboid
73
eight carpal bones
scaphoid lunate triquetrum pisiform trapezium trapezius capitate hamate
74
most fractured carpal bone
scaphoid
75
internally fixate scaphoid
k-wire fixation
76
carpal tunnel syndrome
compression of median nerve at wrist thick synovium, trauma,
77
carpal tunnel release
curvilinear longitudinal volar incision release transverse carpal ligament
78
7 tarsals
talus calcaneous navicular cuboid lateral, medial, intermediate cuneiform
79
shoulder dislocation surgery
CHECK
80
goals of shoulder dislocation surgery
prevent reoccurrence/complications stop arthritic changes maintain ROM/fix pain
81
Putti-Platt
joint capsule attached to glenoid rim and lateral advancement of subscapularis
82
Bankart
reattach attenuated anterior capsule to rim of glenoid fossa with heavy suture
83
Bristow
coracoid process and muscle inserted to neck of glenoid cavity attachment with screw in subscapularis muscle
84
position for shoulder dislocation surgery
supine or semi-sitting with sandbag or sheet under shoulder
85
rotator cuff muscles
supraspinatus infraspinatus teres minor subscapularis
86
function of rotator cuff
abduction of shoulder stabilty
87
3 bony articulations of shoulder girdle
glenohumeral sternoclavicular acromioclavicular
88
anatomy of shoulder joint
pectoral girdle-scapula, clavicle glenohumeral, sternoclavicular, acromioclavicular joints
89
arthroscopy
visualization of joint diagnose, conservative treatment of cartilage, ligament, synovial, bony surface defects
90
frequent joints for arthroscopy
knee, shoulder, wrist, ankle, elbow, TMJ
91
3 procedures performed via arthroscopy
ACL repair repair of meniscal tear patellar tendon graft
92
irrigation for joint distention in arthroscopy
lactated ringers NaCl
93
epi for irrigation in arthroscopy
minimize bleeding in joint capsule
94
pros and cons of arthroscpoy
pros: short stay, rehab, recovery, pain, inflammation cons: hard to maneuver, injure articular surfaces
95
ORIF
expose fracture to use plate, screws, pins, rods to correct no skeletal traction anatomic alignment obtained
96
closed reduction external fixation
manual traction to reduce pins, rods, k-wire to stablilize
97
OR external fixation
open surgically to reduce pins and rods to stabilize
98
indications for external fixation
severe open fracture highly comminuted closed fractures arthrodesis infected joint/nonunion
99
intramedullary fixation
nails and rods driven into IM canal brings ends together for union splint, ease pain, align for comminuted
100
benefits of closed reduction IM fixation
less infection, soft tissue, vascular injury prevent rotating or gliding of fragments prevent short limbs from bone loss
101
dynamic vs. static IM fixation
dynamic: screws in proximal OR distal fragments-bring gap close together static: screws in proximal & distal fragments
102
why use flexible IM rods for healing
better fixation, return to function, early ambulation, support
103
what is a fracture table
ortho OR bed w/ attachments for positioning, traction, diagnostics (x-ray, casts) lateral body brace, sacral rest, perineal post
104
benefits of fracture table
attachments for position and traction easy diagnosis
105
traction
pulling force to maintain proper alignment reduce fracture and pain, vascular ability
106
benefits of traction
prevent/reduce muscle spasm reduce fracture/dislocation immobilize joint/body part treat joint disorder
107
skeletal vs. skin traction
skeletal: sterile supplies, force directly to bone with pins skin: tape, straps, moleskin, elastic bandage
108
3 common forms of traction
skin: Bucks for Hip's, Russel's for Cong. Hip dislocation, skeletal for preop long bone fx skeletal-pin through bone to tong and rope and pulley with weight manual-operative reduction closed or open
109
lumbar laminectomy
remove ruptured disk (nucleus pulposis) to relieve compressed nerve
110
why do lumbar lami
compressed nerve
111
position for lami
prone
112
spinal fusion
fixate pedicles of vertebrae with screws, plates, rods
113
indications for spinal fusion
infection neoplasm post trauma/surgery rheumatoid arthritis INSTABILITY

Senior Rotations (8 decks)

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