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Orthopedic Test review Surgical Technology
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1.
Fracture classifications: Open and closed
2.
Causes of fractures: trauma and pathological
3.
types of fractures: know what each are
Greenstick/stress: barely fractured
Potts: @ fibula near ankle
Colles: Fall on outsretched hand (FOOSH)
Compound: penetrates skin
Comminuted: more than 2 pieces of bone fragments
Transverse: horizontal fracture
Oblique: angled across cortices
Spiral: curves around bone
Impacted: end of bones forced into each other
4.
External Fixation: outside of skin; bone anchoring devices, cast,
skeletal tractions, splints
5.
Internal Fixation: inside of skin; rods on bone, screws, plates,
nails
6.
basic steps of instruments used in an ORIF procedure.: Drill,
Measure (depth guage), insert screw
7.
Procedure steps ORIF: Open incision
Reduction of fracture
Internal Fixation
8.
casting: handle with palms
luke warm water
not too tight
cast is removed before entering OR
9.
bones are repaired by a closed intramedullary nail: femur,
humerus, and tibia
16.
complications of fractures: Fat embolism
Thrombophebitis
Nerve compression
Compartment syndrome
Infection
17.
Intertrochanteric fracture of the hip: Internal fixation; unite
w/out difficulty; occurs in older pts (pg. 473-475 Alexander)
18.
Femoral neck fracture of hip: cannulated screw; reduction is
necessary before internal fixation of femoral neck b/c of high
incidence of complications
19.
Femoral Head fracture: prosthesis; unipolar vs bipolar
20.
knee ligaments: To stabilize the knee
Cruciate: anterior/posterior
Collateral: medial/lateral
21.
How are meniscus tears fixed?: meniscectomy
22.
total joint Arthroplasty: restore motion of joint and function to
muscles and ligaments
23.
Compositions of the rotator cuff: supraspinatus
infraspinatus
teres minor
subscapularis
24.
Laminectomy: removes portion of posterior vertebral arch; in
conjuntion with spinal fusion procedures
25.
Bunion (Hallux valgus) procedures: Keller, mayo, or McBride
26.
Developmental dislocation of hip and procedures:
progressive condition when hip structures fail; DDH reduction,
derotational osteotomy, and pelvic osteotomy
10.
steps in a closed intramedullary nail surgery: Incision, AWL
to create hole in bone, reaming, then insert nail
27.
11.
anatomical landmarks and where: Trochanter: head of femur
Medial malleolus: tibia distal end
Lateral malleolus: fibula.
Olecranon: elbow (ulna)
Condyles: femur
Epicondyles: above condyles
Orthopedic pathologies: Rheumatoid arthritis: inflammation of
joints, cartilage degenerates; most severe
Osteoarthritis: wear and tear on joints
Ostomyelitis: inflammation of bone marrow
28.
Joint movement terminology: Abduction: away
Adduction: towards
Circumduction: around
Rotation: back and forth
Flexion: plantar and dorsiflexion
Extension: straight out
Eversion: turn foot out (ballet dancer)
Inversion: turn foot in
Pronation: face down
Supination: face up
29.
Preparing for orthopedic surgery: Aseptic technique
Meticulous prepping and draping
minimal room traffic
30.
Positioning: Equipment: fracture table, bean bag, McGuire
positioner, Andrews frame
12.
bone graft site: iliac crest (pg. 451-452 alexander's)
13.
instruments used to retrieve bone: lambotte osteotomes,
mallet, ronguers, currettes, russian pickups
14.
5 stages of bone healing: Inflammation- bleeding, fibrin
meshwork
Cellular Proliferation- osteoblast invade fibrin meshwork
Callus Formation- granulation, cartilage developes semigrid
Ossification- 2-3wks after injury, last 3mths, osteoblast calcify
Remodeling- new CT cells; osteoblast of periosteum
PG 453 Alexanders
15.
complications to fracture healing: Delayed Union: doesn't heal
w/in avg time
Malunion: doesn't heal correctly (deformed)
Nonunion: doesn't heal together
31.
Preparing for Ortho case: Casts are removed before OR
Pneumatic tourniquets
Anesthesia
Hemostatic agents
irrigations
special instruments
biological indicator
32.
What are the tourniquet pressures?: 250-300 mm Hg for
upper extremity
300-350 mm Hg for lower extremity
33.
what are the tourniquet pressure times?: upper extremity: 1hr
lower extremity: 2hrs
34.
Sutures: Surgical steel- bone to bone, most inert, sternum
Polyester- ethibond, tendons
Prolene
Nylon- min tissue reaction
Chromic- periosteum, slow absorbtion
Vicryl- tendons, muscle
35.
Powered instruments
(look at pictures): SawsReciprocating: back and forth motion
Oscillation: side to side (safety on when not in use)
36.
Fracture treatment: Closed reduction
External fixationBone-anchoring device
longitudinal supporting devices
Connecting devices (pins, clamps, rods)
37.
38.
39.
Risks factors for proximal femur fractures: Osteoporosis
Previous fracture
Excessive caffine
Increased drinking
Psychotropic meds
Visual impairment
Types of hip fractures: Femoral neck fracture
Intertrochanteric fracture
Subtrochanteric fracture
Femoral Head- needs replacing
Intertrochanteric fracture: Dynamic Hip Screw plate; guide
pin, then drill out core in femoral head, and depth gauge, then
plate will be added
43.
Tibial Plateu fractures (look at pictures): Pg 478
1) pure cleavage unicondylar fracture
2) cleavage with depression
3) central depression
4) medial condylar wedge w/depression/comminution
5) bicondylar w/continuity of diaphysis and metaphysis from
diaphysis
6) comminution w/dissociation of metaphyis and diaphysis
44.
Bone holding forceps: verbrugge, lowman, lewin
45.
tibial plateau fracture and treatment: -joint surfaces- lateral
condyles are compressed
-alignment immobilization
-ORIF
46.
Knee fracture treatment (patella): Patellectomy or preferably
fixation including suturing and tension band wiring or a screw
47.
Foot fractures: Fractured heel- calcaneus
Fractured Talus
Metatarsal fractures
48.
Malleolar ankle fracture: Distal ankle fracture
Medial Malleolus (tibia) and posterior malleolus
Lateral Malleolus (fibula)
Requires open reduction w/plates and screws
49.
Shoulder dislocation procedures: Bankart, Putti-Platt, Bristow
Semi-fowler position
Subluxation-partial displacement
50.
Humerus fracture: Humeral head
Humeral Shaft
Distal fractures-supracondylar, transcondylar, intercondylar
51.
olecranon fracture repair: small fractures can be excised and
triceps tendon reattached to the ulnar shaft. Larger fractures
must be reduced and held with internal fixation
52.
Arm fracture: radius and ulna
colle's fracture
carpal bones
53.
Carpal tunnel syndrome: Results from compression medial
nerve caused by thickened synovium, trauma, or aberrant
muscles.
Surgery involves releasing or excising carpal ligament
54.
cyst conditions: Ganglion cyst- lesion arises from a joint or
tendon sheath and contains glassy, clear fluid. HAND
Popliteal (Baker) cyst- occur in joints affecting popliteal fossa;
painful and large. KNEE
40.
Retractors: Cobra, belly cobra, femoral, hohman, hibbs,
bennett, adson beckman, iliac crest
41.
Balanced suspension traction: skeletal traction; pulley sys with
constant traction
55.
42.
Tibia fracture: most common site for open fracture
treated with External fixator 1st, followed by ORIF
Wrist fracture treatment: closed reduction with external
fixation
56.
Arthroscopy: diagnostic
operative
57.
arthroscopic positioning: Knee- bent @90 degrees and
stabilized. Full ROM during procedure
Shoulder- semi fowler position
58.
59.
60.
Knee arthroscopy repairs: Menisectomy- resection and repair
of meniscal tear; partial or complete.
ACL Reconstruction- for instability of knee w/activities pg 515
PCL Reconstruction- for tears of PCL
Herniated disc: intervertebral disc wears out causing pain,
inflammation, and nerve impingement.
Artificial Disc Replacement
Vertebrae fracture surgery: Vertebroplasty- bone cement is
injected into the vertebral body to prevent pain and further
vertebral body height loss
61.
Spine Deformities: Kyphosis
Lordosis
Scoliosis
62.
Treatment of scoliosis: Luque Segmental Spinal Rod
procedure
Cotrel-Dubousset sys procedure
Texas Scottish Rite Hospital-crosslink spinal sys
Anterior Spinal Fusion with Isola instrumentation
63.
Pediatric Procedures: Club foot repair
Developmental dislocation of hip
Repair of slipped capital femoral epiphysis
Pelvic osteotomy for spastic hip/dislocation
64.
Talipes Equinovarus (clubfoot ): Nonsurgical- taping, bracing,
physical therapy, or continuous passive movement.
Surgical- release of soft tissue and joint contractures, tendon
lengthening, temporary pin fixation of the joints
65.
Developmental dislocation of Hip: DDH or Dysplasia of Hip
or Coxa Vara
Treatment- harness device, spica cast, surgery
66.
Slipped Capital Femoral Epiphysis: Occurs in adolescents
The femoral head slips off in a backward direction
Treatment- insertion of screw
67.
Pelvic Osteotomy for spastic Hip dislocation: Portion of
Proximal femur and portions of ilium removed.
Surgery to release hamstrings and other muscles that become
too tight due to spasticity.
68.
Fracture treatments: TractionManuel
Skin
Skeletal
69.
Instruments: Lambotte ostetomes
Stille bone gouge
Liston Bone cutting forceps
70.
Elevators: Freer
Periosteal
Cobb
Woodson
71.
Triple Arthrodesis: Talocalcaneal, talonavicular, and
calcaneocuboid joints must be fused with pronounced
inversion or eversion deformities.
72.
Aseptic technique is critical in ortho surgery since soft
tissue infections can lead to...: Osteomyelitis
73.
In a total hip replacement which structure is reamed?:
Acetabulum surface
74.
K wires are inserted by: Drill
75.
Swayback: Lordosis
76.
Suture lines of the skull are what type of joint?: Synarthrosis
77.
Frequent site of cartilage tears in knee: Medial meniscus
78.
Total knee arthroplasty requires resurfacing of...: Femur and
tibia
79.
When one component is cemented and the other is none
cemented?: Hybrid
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