Elective surgery and General trauma

Question 1

surgical strategies to manage an arthritic joint

Answer 1

arthoplasty/replacement, excision/resection, arthrodesis, osteotomy

Question 2

replacing one half of a joint is known as?

Answer 2

hemiarthroplasty

Question 3

materials which can be used to replace a joint

Answer 3

stainless steel, cobalt chrome, titanium alloy, polyethylene and ceramic

Question 4

best procedures for smaller joints

Answer 4

excision or resection arthroplasty

Question 5

when is arthrodesis a good treatment option

Answer 5

end stage ankle arthritis, wrist arthritis, hallux rigidus

Question 6

what does osetomyelitis effect

Answer 6

the bone, including compact and spongy bone. bone marrow as well

Question 7

what makes infection in bone hard to eradicate

Answer 7

leucocytes cause local osteolysis and pus forms, this impairs local blood flow.

Question 8

what is a dead fragment of bone called

Answer 8

sequestrum

Question 9

new bone forming around an area of necrosis is called

Answer 9

involucrum

Question 10

what bacteria can infect osteocytes intra cellularly

Answer 10

staph aureus

Question 11

who is more likely to suffer from acute osteomyelitis

Answer 11

children, immunocompromised adults, recent surgery

Question 12

what part of the skeleton is chronic osteomyelitis more likely to develop in

Answer 12

axial skeleton

Question 13

osteomyelitis: infecting organismS NEWBORNS (4months)

Answer 13

S.aureus, enterobacter, group A/B strep

Question 14

osteomyelitis: infecting organism CHILDREN

Answer 14

s.aureus, A strep, H.influenza, enterobacter

Question 15

osteomyelitis: infecting organism 4 YEARS TO ADULT

Answer 15

s.aureus, A strep, H.influenza, enterobacter

Question 16

osteomyelitis: infecting organism ADULT

Answer 16

s.aureus, rarely enterobacter or Strep

Question 17

osteomyelitis: infecting organism SICKLE CELL PATIENTS

Answer 17

S.aureus, salmonella

Question 18

classification of osteomyelitis

Answer 18

superficial, medullary, localised, diffuse

Question 19

what is the primary survey

Answer 19

ABCDE

Question 20

what score on the GCS would indicate loss of airway control

Answer 20

8 or less

Question 21

what is the maximum GCS score

Answer 21

15

Question 22

minimum GCS score

Answer 22

3

Question 23

describe secondary bone healing

Answer 23

1 fracture occurs,

2 haematoma and inflammation,
3 macrophages and osteoclasts remove debris and reabsorb bone ends,

4 granulation tissue forms from fibroblasts,
5 chondroblasts from cartillage (soft callus)
6 osteoblasts lay bone the matrix (collagen type 1)
7 calcium mineralisation produces woven bone (hard callus)
8 remodelling

Question 24

how long does it take the soft callus to form

Answer 24

2-3 weeks

Question 25

how long does it take the hard callus to form

Answer 25

6-12 weeks

Question 26

what are the five basic fracture patterns

Answer 26

transverse, oblique, spiral, comminuted, segmental

Question 27

describe a transverse fracture

Answer 27

pure bending force (cortex on one side fails in compression and the other side in tension) might not shorten (unless totally displaced) may angulate

Question 28

describe an oblique fracture

Answer 28

shearing force, can shorten and angulate

Question 29

describe a spiral fracture

Answer 29

torsional force, unstable to rotational force

Question 30

describe a comminuted fracture

Answer 30

2 or more fragments, high energy injury, very unstable

Question 31

describe a segmental fracture

Answer 31

fractured in two separate places

Question 32

what is displacement

Answer 32

describes the direction of translation of the distal fragment

Question 33

what is angulation

Answer 33

describes the direction in which the distal fragment points towards the degree of deformity

Question 34

assessment of an injured limb must include

Answer 34

open/closed?, distal neurovascular status, compartment syndrome? status of skin and soft tissue envelope

Question 35

what nerve injuries are associated with a fracture

Answer 35

neurapraxia or axonotmesis

Question 36

what is neurapraxia

Answer 36

temporary conduction defect

Question 37

what is axonetmesis

Answer 37

sustained compression of a nerve. nerves die past the point of injury

Question 38

what is a neurotmesis

Answer 38

complete transection of a nerve, rare in closed injuries

Question 39

most common cause of septic arthritis

Answer 39

staph aureus

Question 40

second most common cause of septic arthritis

Answer 40

streptococci