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Flashcards in Surgical Procedures Review Deck (17)

***What is the difference between a closed and open reduction?

-Closed reduction – nonsurgical procedure with fractured fragments realigned by manipulation

-Open reduction – surgical procedure that includes using screws, plates and rods
-ORIF {Open reduction internal fixation}


What is operative cholangiography?

-Performed during biliary tract surgery
-Bile is drain and ducts are filled with contrast (6 to 8 ml)
-Common bile duct through a needle, catheter
or T-tube


***What is the purpose for performing an operative cholangiogram?

-Checking for patency of bile ducts

-Functional status of sphincter of hepatopancreatic ampulla

-Stones, neoplasms, strictures or dilation of ducts


***Where is the C-Arm placed during an operative cholangiogram?

-Center C-arm in the PA projection over right side of abdomen below rib line

-Tilt patient to the left or Trendelenburg position for flow of contrast


Where is the C-arm positioned for line placement or for a bronchoscopy?

C-Arm enters sterile field perpendicular to patient or side of patient (PA projection)


What is the purpose of using the C-Arm for line placement or for a chest bronchoscopy?

-Line placement – to determine point of insertion and follow catheter to verify position and identify any kinks

-Bronchscopy – perform biopies, insert stents and for dilation purposes


What does ACDF stand for and what is the purpose of the procedure?

-Anterior Cervical Diskectomy & Fusion
-Treats nerve roots or spinal cord compression by decompressing & stabilizing corresponding vertebrae:
-Disc is completely removed as well as disc material
-Intervertebral foramen is enlarged
-Remaining space filled with bone graft
-Bone graft joining vertebrae = fusion


What is a laminectomy?

-Performed to relieve pressure on spinal cord or nerve roots
-Posterior arch is removed
-Spinal fusion depends on # of vertebrae
-Interbody fusion cage
-Titanium cages filled with bone inserted
between vertebral bodies to maintain space
height & fuse joint


Why is the rainbow position for the C-Arm used when performing a c-spine procedure?

Used for larger patients if unable to raise C-Arm to obtain anatomy in center of beam


How are hip fractures classified?

-According to anatomic location
-Femoral neck, intertrochanteric and subtrochanteric fractures


What is a hip ORIF?

-A long fixator is placed on lateral side of fractured hip and secured with screws through fixator into femoral head and neck

-Smaller screws are placed below trochanters that transverse shaft of femur


What is the procedure for a hip fracture surgery?

-Special fracture or orthopedic table for traction & fluoro during procedure

-Shower curtain

-Fracture is reduced through traction and manipulation

-Patient is supine with legs abducted and affected leg in traction

-Radiographer is positioned between patient’s legs


Explain a total hip replacement.

-Degenerative disease or chronic trauma to femoral head and/or acetabulum

-Prosthetic hip is utilized

-Prosthetic devices vary in composition, design & components

-Postoperative images – include entire device


When a nail or rod is inserted into the intramedullary canal for a femur to reduce a fracture of the shaft, what approaches might the surgeon utilize?

-Antegrade {greater trochanter or proximal end of long bone}

-Retrograde {popliteal notch or distal end of long bone}


Explain the femur nail procedure.

-Fracture table is utilized

-Bone reamer is used to widen intramedullary cavity

-Guidewires inserted

-C-Arm used to verify location of guidewires & fracture alignment along with any screws used

-Center C-Arm over fx site during canal reaming to ensure fx remains reduced

-Holes should appear round and not oblong
-Tilt or rotate C-Arm


Explain the procedure for a humerus.

-Supine or in a reclining beach chair

-Shoulder off side of table to prevent humerus from being blocked by table

-Arm will be rotated medially with elbow @ 90 degrees

-C-Arm enters parallel to patient or @ a 45 degree angle


What is the procedure when using the portable machine for surgical procedures?

-Portable machine approaches patient perpendicular

-Cover sterile field

-Angle tube if necessary to match IR

-Surgeon may hold extremity in position during exposure - shield