SUR 104 - Ortho
Card Set Information
SUR 104 - Ortho
fusion of a joint
disruption of the blood supply to a bone that causes death and irreversible decay of the osseous bone
cast cut into 2 parts - front and back - for removal and reapplication
adverse physiologic response of patient to placement of bone cement in the medullary canal
bone cement implantation syndrome (BCIS)
swelling between layers of fascia that causes damage to tissue
evacuation of blood from a limb before inflating a tourniquet to create bloodless field
emergency procedure to release pressure on region of compartment syndrome
basophilic cells that synthesize collagen and glycoprotein to form bone matrix
cells in the bone that influence growth and regeneration by breakdown and resorption of existing cellular material
healing process of a bone
failure of bone to align and heal
how many bones does the human skeleton have?
what does axial skeleton consist of?
skull, vertebrae and ribcage
what does appendicular skeleton consist of?
how many bones does each upper extremity consist of?
how many bones does each lower extremity consist of?
examples of long bones
humerus, radius, ulna
femur, thigh, tibia, fibula
end of a long bone
shaft of a long bone
examples of short bones
bones in the hand and foot
examples of flat bones
scapula and patella
examples of irregular bones
outer layer of bone
description of cortex
compact, hard connective tissue that surrounds porous, spongy, cancellous tissue
where is red marrow found?
ends of long bones, porosities of cancellous bone, and flatter bones
what is red marrow responsible for?
erythropoeisis (formation of red blood cells and certain white blood cells)
where is yellow marrow found?
strong, fibrous membrane that covers bone except at joints
lengthwise, lamellar structures that provide weightbearing strength and passage for additional blood supply
how does blood supply enter bones?
penetrates periosteum and enter through Volkmann canals
what is inner aspect of the bone lined with?
steps of bone healing
how soon after injury is a callus visible on radiograph?
within 1 to 2 weeks of injury
how soon after injury is connective tissue completely calcified?
within 6 weeks
how soon can complete remodeling take to complete?
6 months to 1 year
smooth, relatively firm, compressive connective tissue, cusions most articular surfaces at the ends of bones
from what does cartilage derive its nutrition?
what does synovial fluid contain that keep the joint free of debris and bacteria?
macrophages and white blood cells
examples of ball-and-socket joints
hip and shoulder
examples of hinged joints
knee, ankle, elbow and phalangeal joints of the fingers
examples of condyloid joint
examples of saddle joint
bands of flexible, tough fibrous tissue that join the articular surfaces of bones and cartilage
classifications of muscles
largest category of muscle tissue
bands of extremely strong, flexible fibrous tissue that attach muscle bundles to the periosteum of bones
infection in bone
what may acute osteomyelitis cause?
nonunion of fractures
what may chronic osteomyelitis cause?
loss of extremity
what is chronic osteomyelitis often associated with?
peripheral vascular disease
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
protective eyewear with full-face shield when splatter anticipated
semi-sharp instruments used to strip periosteum from bone without destroying its ability to regenerate new bone
clamps needed to hold smaller bones or grasp a joint capsule
how are power-driven instruments powered?
electricity or compressed air or nitrogen
which way is reciprocating movement of power cutting instrument
cutting action from front to back
which way is oscillating movement of power cutting instrument?
cutting action from side to side
instruments used for insertion or extraction of metallic implants versus actual implants
must be of same metal to prevent galvanic reaction
what types of bone grafts are obtained from iliac crest?
autologous cancellous and cortical bone
what types of bone grafts are obtained from fibula?
how long after procurement of bone graft must a living donor be retested for HIV?
devices used to stabilize or immobilize bone
used to permanently replace bone, joints or tendons
what are prosthetic implants made of?
nonmagnetic and electrolytically insert metals (stainless steel, cobalt and titanium)
what is used to reinforce fixation or increase the strength of implant?
methyl methacrylate (bone cement)
should implants such as plates and screws be flash-sterilized?
no, not for any reason
cannot withstand the heat
what method is used to sterilize implants?
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
what device or prosthesis specifics must be recorded in the patient's intraoperative record?
type, size, lot number
vaporizes methyl methacrylate to remove cemented joint implant during revision arthroplasty
laser used primarily in knee, ankle, shoulder, and elbow - all joints except spine
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
laser used primarily in arthroscopy of the knee and shoulder joints on articular cartilage
how does neodymium:YAG laser work?
it vaporizes protein and bonds collagen
used for hemostasis on cut bone
how is bone wax softened for use?
inner sterile foil packet can be placed in warm saline irrigation
used to identify neural tissue during a partial nerve resection to control spastic muscles
what type of materials are used to suture ligaments, tendons and muscles involved in movement of bony skeleton?
nonabsorbable synthetic materials
what type of suture is preferred to suture periosteum?
table used for many surgical procedures requiring traction, x-ray image intensification, and/or cast application
when is the patient anesthetized in regards to the fracture table?
on the transport cart before being positioned on the fracture table
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
amount of blood loss when suction and autotransfusion is performed
signs and symptoms of neurovascular impairment in extremity
6 P's - pallor, pulses, pain, paresthesia, puffiness and paralysis
fracture that runs across bone
fracture that runs in slanting direction across bone
fracture that coils around bone
fracture that protrudes through skin
compound open fracture
who assumes responsibility for supporting the fracture site during transfer of the patient from one bed surface to another?
3 distinct phases of fracture treatment
methods of treating fractures
closed reduction with immobilization
open reduction and internal fixation (ORIF)
pulling force exerted to maintain proper alignment or position
force applied directly on the bone after insertion of pins, wires, or tongs placed through or into the bone
traction is applied by means of?
pulleys and weights
two or more pins or screws, parallel to each other, inserted into cortex of each fragmented bone section, and connected to metal bar
external fixation frame with more than 120 interchangeable components, forming a framing system (weighs about 8 pounds)
anesthesia given for ORIF
IV moderate sedation may be given to dull awareness of drill and mallet sounds
fracture of radial bone in the wrist
slotted plate that permits muscle tone of extremity to keep ends of fragments pressed closely together
plate fitted to contour of the bone