Dave SG - Questions Flashcards
What are the 3 red flags for suture station?
- Losing control of your sharp (needle)
- Picking up an instrument after putting in down (DONT PUT ANYTHING DOWN)
- Grasping the needle tip w/ your fingers or the needle driver (use the pickups)
Classify Vicryl suture
- Absorbable
- Synthetic
- Braided multifilament
Name 5 different types of synthetic suture
- Dexon
- PDS (Polydiaxonone)
- Maxon
- Monocril
- Vicryl
“DPM Motor Vehicle” - Vanity Plate, Fake? Synthetic
What type of Suture has the longest absorption rate?
Maxon→ Hydrolyzed in 180 days (Maximum)
What types of suture are best for closure of infected skin wounds?
-
Polypropylene → can be used in contaminated/infected wounds
- Non-absorbable, synthetic, monofilaments are best in infected skin wounds
Name a specific brand of suture and type of suture technique that would be appropriate for closure of a joint capsule
Capsule closure → 2-0 or 3-0 Vicryl
Arrange the following in terms of size from thinnest to thickest:
fiberwire, nylon, vicryl
0 Fiberwire > 2-0 Vicryl > 4-0 Nylon
Is PDS suture monofilament or multifilament?
MONOFILAMENT
Identify the suture(s) technique used:
- Left = Vertical mattress
- Right = Interrupted Cruciate
Order of screw placement
- Overdrill→ only through proximal cortex, Glide Hole
- Underdrill→ both cortices, Thread Hole
- Countersink→ prepare near cortex for screw head
- Measure → w/ depth gauge
- Tap→ cuts thread pattern for screw
- Screw → “two-finger tightness”
Interfragmentary Compression Station - Objectives
- Load each of the instruments into the hand piece using the quick-release technique
- Identify each of the instruments needed to generate interfragmentary compression
- Perform interfragmentary compression using the correct instruments, in the correct order
Identify 2 reasons for countersinking
- Increase the surface contact area of the screw head
- Make the screw head less prominent
Why do we always measure after countersinking?
Because countersinking physically removes bone and will shorten the size of screw needed→ measuring before countersinking will lead to using a screw that is too long
You are in a surgical case and plan on using a 2.0mm screw to fixate an osteotomy, but accidentally overdrill through both the near and far cortex. What options do you now have to generate interfragmentary compression through this hole?
Switch to a 2.7mm screw, as the thread hole for that screw is 2.0mm
What is the pitch of a cortical screw?
- Cortical screw = 1.25mm
- Cancellous screw = 1.75mm
Anatomic boundaries of the nail matrix?
- Distally to the LUNULA
- Proximally to the DISTAL PORTION OF THE EXTENSOR RIDGE
- Marginally from LATERAL CONDYLE to LATERAL CONDYLE
What is the difference between eponychium and hyponychium?
- Hyponychium= distal free edge of the nail
- Eponychium = proximal skin fold, NOT part of the nail matrix
In what clinical situations would the Winograd procedure be appropriate to perform?
Pediatrics and cases w/ hypergranular tissue
Steps of applying a tourniquet
- 4” Webril – 3-5 loops
- Apply tourniquet – Red for ankle, Brown for thigh
- Hook to machine
- Add 10-10 Drape for defining sterile/unsterile junction
- Scrub in
- Surgical Prep of the foot
- Blue towel to indicate sterile/ unsterile and towel clamp
- Esmarch to drain blood
5 layers of surgical dissection
- skin
- superficial fascia
- deep fascia
- periosteum
- bone