SUR 104 - Ortho

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Author:
jb124
ID:
180546
Filename:
SUR 104 - Ortho
Updated:
2012-11-02 02:48:15
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Orthopedic surgery
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Description:
Orthopedic surgery
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  1. fusion of a joint
    arthrodesis
  2. disruption of the blood supply to a bone that causes death and irreversible decay of the osseous bone
    avascular necrosis
  3. cast cut into 2 parts - front and back - for removal and reapplication
    bi-valve cast
  4. adverse physiologic response of patient to placement of bone cement in the medullary canal
    bone cement implantation syndrome (BCIS)
  5. swelling between layers of fascia that causes damage to tissue
    compartment syndrome
  6. generating heat
    exothermic
  7. evacuation of blood from a limb before inflating a tourniquet to create bloodless field
    exsanguinate
  8. emergency procedure to release pressure on region of compartment syndrome
    fasciotomy
  9. basophilic cells that synthesize collagen and glycoprotein to form bone matrix
    osteoblast
  10. cells in the bone that influence growth and regeneration by breakdown and resorption of existing cellular material
    osteoclasts
  11. bone infection
    osteomyelitis
  12. healing process of a bone
    union
  13. failure of bone to align and heal
    nonunion
  14. how many bones does the human skeleton have?
    206
  15. what does axial skeleton consist of?
    • skull, vertebrae and ribcage
    • 80 bones
  16. what does appendicular skeleton consist of?
    • limbs
    • 126 bones
  17. how many bones does each upper extremity consist of?
    32
  18. how many bones does each lower extremity consist of?
    31
  19. bone classifications
    • long
    • short
    • flat
    • irregular
  20. examples of long bones
    • humerus, radius, ulna
    • femur, thigh, tibia, fibula
  21. end of a long bone
    epiphysis
  22. shaft of a long bone
    diaphysis
  23. examples of short bones
    bones in the hand and foot
  24. examples of flat bones
    scapula and patella
  25. examples of irregular bones
    vertebrae
  26. outer layer of bone
    cortex
  27. description of cortex
    compact, hard connective tissue that surrounds porous, spongy, cancellous tissue
  28. where is red marrow found?
    ends of long bones, porosities of cancellous bone, and flatter bones
  29. what is red marrow responsible for?
    erythropoeisis (formation of red blood cells and certain white blood cells)
  30. where is yellow marrow found?
    medullary canals
  31. strong, fibrous membrane that covers bone except at joints
    periosteum
  32. lengthwise, lamellar structures that provide weightbearing strength and passage for additional blood supply
    haversian canals
  33. how does blood supply enter bones?
    penetrates periosteum and enter through Volkmann canals
  34. what is inner aspect of the bone lined with?
    endosteum
  35. steps of bone healing
    • hematoma formation
    • callus formation
    • calcification process
    • remodeling phase
  36. how soon after injury is a callus visible on radiograph?
    within 1 to 2 weeks of injury
  37. how soon after injury is connective tissue completely calcified?
    within 6 weeks
  38. how soon can complete remodeling take to complete?
    6 months to 1 year
  39. smooth, relatively firm, compressive connective tissue, cusions most articular surfaces at the ends of bones
    cartilage
  40. from what does cartilage derive its nutrition?
    synovial fluid
  41. what does synovial fluid contain that keep the joint free of debris and bacteria?
    macrophages and white blood cells
  42. examples of ball-and-socket joints
    hip and shoulder
  43. examples of hinged joints
    knee, ankle, elbow and phalangeal joints of the fingers
  44. examples of condyloid joint
    wrist
  45. examples of saddle joint
    thumb
  46. bands of flexible, tough fibrous tissue that join the articular surfaces of bones and cartilage
    ligaments
  47. classifications of muscles
    • cardiac (branching)
    • smooth (involuntary)
    • skeletal (voluntary)
  48. largest category of muscle tissue
    skeletal muscle
  49. bands of extremely strong, flexible fibrous tissue that attach muscle bundles to the periosteum of bones
    tendons
  50. infection in bone
    osteomyelitis
  51. what may acute osteomyelitis cause?
    nonunion of fractures
  52. what may chronic osteomyelitis cause?
    loss of extremity
  53. what is chronic osteomyelitis often associated with?
    peripheral vascular disease
  54. what types of protective attire is needed for orthopedic surgery?
    • knee-high, waterproof shoe covers
    • fluid-impervious gown and/or waterproof apron under the gown
    • double-glove
    • protective eyewear with full-face shield when splatter anticipated
  55. semi-sharp instruments used to strip periosteum from bone without destroying its ability to regenerate new bone
    periosteal elevators
  56. clamps needed to hold smaller bones or grasp a joint capsule
    heavy clamps
  57. how are power-driven instruments powered?
    electricity or compressed air or nitrogen
  58. which way is reciprocating movement of power cutting instrument
    cutting action from front to back
  59. which way is oscillating movement of power cutting instrument?
    cutting action from side to side
  60. instruments used for insertion or extraction of metallic implants versus actual implants
    must be of same metal to prevent galvanic reaction
  61. what types of bone grafts are obtained from iliac crest?
    autologous cancellous and cortical bone
  62. what types of bone grafts are obtained from fibula?
    cortical bone
  63. how long after procurement of bone graft must a living donor be retested for HIV?
    90 days
  64. devices used to stabilize or immobilize bone
    fixation devices
  65. used to permanently replace bone, joints or tendons
    prosthetic implants
  66. what are prosthetic implants made of?
    nonmagnetic and electrolytically insert metals (stainless steel, cobalt and titanium)
  67. what is used to reinforce fixation or increase the strength of implant?
    methyl methacrylate (bone cement)
  68. should implants such as plates and screws be flash-sterilized?
    • no, not for any reason
    • cannot withstand the heat
  69. what method is used to sterilize implants?
    ethylene oxide
  70. how should a metal implant be handled when removing from the package?
    • no instruments should be used (could get scratched)
    • powder-free gloves should be worn when handling
  71. what device or prosthesis specifics must be recorded in the patient's intraoperative record?
    type, size, lot number
  72. vaporizes methyl methacrylate to remove cemented joint implant during revision arthroplasty
    CO2 laser
  73. laser used primarily in knee, ankle, shoulder, and elbow - all joints except spine
    Holmium:YAG laser
  74. how does Holmium:YAG laser work?
    • it can ablate dense cartilage, bone and soft tissue
    • used through arthroscope to cut, shape, smooth and sculpt cartilage and tissues in joints
  75. laser used primarily in arthroscopy of the knee and shoulder joints on articular cartilage
    neodymium:YAG laser
  76. how does neodymium:YAG laser work?
    it vaporizes protein and bonds collagen
  77. used for hemostasis on cut bone
    bone wax
  78. how is bone wax softened for use?
    inner sterile foil packet can be placed in warm saline irrigation
  79. used to identify neural tissue during a partial nerve resection to control spastic muscles
    nerve stimulator
  80. what type of materials are used to suture ligaments, tendons and muscles involved in movement of bony skeleton?
    nonabsorbable synthetic materials
  81. what type of suture is preferred to suture periosteum?
    absorbable suture
  82. table used for many surgical procedures requiring traction, x-ray image intensification, and/or cast application
    fracture table
  83. when is the patient anesthetized in regards to the fracture table?
    on the transport cart before being positioned on the fracture table
  84. preparations for lifting patient from transport cart to fracture table
    • patient will be full lift whether general or regional anesthesia used
    • table is very narrow
  85. amount of blood loss when suction and autotransfusion is performed
    400 mL
  86. signs and symptoms of neurovascular impairment in extremity
    6 P's - pallor, pulses, pain, paresthesia, puffiness and paralysis
  87. fracture that runs across bone
    transverse fracture
  88. fracture that runs in slanting direction across bone
    oblique fracture
  89. fracture that coils around bone
    spiral fracture
  90. fracture that protrudes through skin
    compound open fracture
  91. who assumes responsibility for supporting the fracture site during transfer of the patient from one bed surface to another?
    surgeon
  92. 3 distinct phases of fracture treatment
    • reduction
    • immobilization
    • rehabilitation
  93. methods of treating fractures
    • closed reduction with immobilization
    • skeletal traction
    • external fixation
    • open reduction and internal fixation (ORIF)
    • electrostimulation
  94. pulling force exerted to maintain proper alignment or position
    traction
  95. force applied directly on the bone after insertion of pins, wires, or tongs placed through or into the bone
    skeletal traction
  96. traction is applied by means of?
    pulleys and weights
  97. two or more pins or screws, parallel to each other, inserted into cortex of each fragmented bone section, and connected to metal bar
    stabilization bar
  98. external fixation frame with more than 120 interchangeable components, forming a framing system (weighs about 8 pounds)
    Ilizarov technique
  99. anesthesia given for ORIF
    • regional block
    • IV moderate sedation may be given to dull awareness of drill and mallet sounds
  100. fracture of radial bone in the wrist
    Colles fracture
  101. slotted plate that permits muscle tone of extremity to keep ends of fragments pressed closely together
    Eggers plate
  102. plate fitted to contour of the bone
    Sherman plate

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