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Orthopedics > Intro to surgery > Flashcards

Intro to surgery Flashcards

1
Q

Involves incision of adequte length and depth through superficial and deep layers of skin, fascia and joint capsule

A

Open procedure

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2
Q

used to descrive an open procedure to expose joit stracture

A

Arthotomy

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3
Q

uses arthroscope. Small incisions on the skin

A

Arthroscopic procedure

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4
Q

dx tool where there is line c camera to visualize the loob ng joint

A

arthroscope

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5
Q

Small incisions on the skin

A

portals

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6
Q

Common in shoulder knee and hip, ligament repairs

A

Arthroscopic procedure

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7
Q

Malaki incision in Open

A

bigger Soft tissue disruption

longer recovery time

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8
Q

Uses arthroscopy for a portion of the procedure but also requires and open surgical field

A

Arthroscopically assisted procedure

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9
Q

Autograft

A

self

harvest from donors side

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10
Q

Allograft

A

same specie

uses cadaveric donor

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11
Q

Synthetic graft

A

gore tex and dacron

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12
Q

disadvantages Autograft

A

needs 2 surgical procedure because it needs to harvest the skin then replace it

damage to weakening of otherwise healthy tissue at the donor site

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13
Q

disadvantages allografts

A

potential disease transmission from the donor

dec graft streth
risk of graft failure to immuno rejection

usually tendon lng, d pwede cartillage

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14
Q

disadvantages allografts

A

potential disease transmission from the donor

dec graft streth
risk of graft failure to immuno rejection

usually tendon lng, d pwede cartillage

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15
Q

done after complete muscle tear

A

muscle repair

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16
Q

Full contracting mm is stretched or receive a complere bkie

A

moi of full muscle tear

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17
Q

Repair after ___ hrs when inflammaroty signs are minimal in mm repair

A

48-72 hrs

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18
Q

Mx guidliens for muscle repair

A

Mm sets may be done immediately after rugery

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19
Q

WB for muscle repair

A

partially restrcited until pt achieves fxnal level of strenght and flexibility in the repaired mm

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20
Q

Post immob in muscle repair

A

AROM’S IN TOLERATED RANGE gradual progression of low load high reps resistance para makit tolerance ng mm

AROM’S will tell us how
willing the patient is to
move. Ano lang ka
nyang ROM.

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21
Q

Precautions for muscle repair

A

no strethching and vigorous mm contraction until soft tissue healing is completed (6-8 wks)

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22
Q

Tendon repair result of macrotrauma

A

Young person

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23
Q

Tendon repair
Deteration
repetitive macrotrauma

A

Elderly

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24
Q

Full tear

A

low strenght

little to no pain

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25
Q

bat may pain sa partial tear

A

napupull ang injured area

26
Q

partial tear

A

Strenght 3-2+

27
Q

Tendon repair should be done ___ and why

A

immediately

umuurong agad tendon

28
Q

stretched beyond normal units

A

Dilation:

29
Q

fibrous band or structure that abnormally attached body parts

A

Adhesion:

30
Q

removal of a structure

A

Excision

31
Q

cut or wound produced by a sharp object

A

Incision:

32
Q

subjective evidence of a pt’s dse

A

Symptom

33
Q

prediction of a probable outcome of a dse

A

Prognosis

34
Q

closing an opening by stitches

A

Suture

35
Q

artificially produced opening in a body structure

A

Stoma

36
Q

sudden, involuntary contraction of a mm

A

Spasm

37
Q

drooping or sagging of a body structure

A

Prolapse

38
Q

INDICATION FOR SX INTERVENTION

A
  • Incapacitating pain at rest or c fuc. Act.
  • Marked limitation of arom or prom
  • Gross instability of a joint alignment
  • Significant structural degeneration
  • Chronic jt swelling
  • Failed conservative (non-sx) pr prior sx mx
  • Significant loss of func. Leading to disability as the result of any of the preceding factors.
39
Q

MX GUIDELINES

A

Rehab begins c pt education & pre-rehab exercises or func. Skill dev’t before sx and continues c direct intervention from a therapist and long-term self-mx by the pt after sx

40
Q

. PRE-OP EXAMINATION AND EVALUATION

A 
● Pain
● ROM and Jt. Integrity
● Skin integrity
● MM Performance
● Posture
● Gait Analysis
● Functional Status
41
Q

PRE-OP PT EDUC: METHODS AND RATIONALE

A

● Pt educ begins pre-operatively
● Pre-op instruction gives a pt an idea
regarding the factors assoc. c sx such as
wound care, precautions following sx, use
of asst. devices or immobilizer

42
Q

COMPONENTS OF PRE-OP PT EDUCATION

A 
● Overview of plan of care
● Post-op precautions
● Bed mobility and transfers
● Initial post-op exercises
➔ Deep breathing and coughing exercises
➔ Active ankle exercises
➔ Gentle mm-setting exercises of
immobilized jts
● Gait training
● Wound care
● Pain mx
NOTE: PRE-OP EXERCISE PROG MAY BE
PARTICULARLY BENEFICIAL IF A PROLONGED
PERIOD OF IMMOBILIZATION OR REDUCED
WEIGHT BEARING IS NECESSARY AFTER SX.
43
Q

POST-OP EXAMINATION AND

EVALUATION

A 
● Pain
● Swelling
● Potential Circulatory and Pulmonary
complications
● MM weakness and/or atrophy
● WB
● Weakness and LOM of other non-affected
jts
44
Q

FACTORS THAT INFLUENCES THE
COMPONENTS, PROGRESSION, AND
OUTCOMES OF A POST-OP REHAB
PROG.

A 
● Extent of tissue pathology or damage
❖ Size of severity of the lesion
● Type and unique characteristics of the sx
procedure
● Pt-related factors
❖ Age, extent of pre-op
impairments, and functional
limitations
❖ Health Hx, particularly use of
meds and for DM pts
❖ Lifestyle Hx, inc. tobacco use
❖ Needs goals, expectations, and
social support
 Level of motivation and ability to
adhere to an exercise prog
● Stage of healing of involved tissues
● Characteristics of types of tissues involved
❖ Response to immobilization and
remobilization
● Integrity of structures adjacent to involved
tissues
● Philosophy of the surgeon
45
Q

how long MAXIMUM PROTECTION PHASE lasts

A

(FEW DAYS - 6 WEEKS)

46
Q

how long MODERATE PROTECTION PHASE

A

( 4 to 6 weeks- 12 weeks)

47
Q

how long MINIMUM PROTECTION PHASE

A

(6 TO 12 WEEKS- 6 MONS OR BEYOND)

48
Q

POTENTIAL POST-OP COMPLICATIONS & RISK REDUCTION

A 
A. PULMONARY COMPLICATIONS
B. DVT AND PULMONARY EMBOLISM
C, JOINT SUBLUXATION OR DISLOCATION
D. RESTRICTED MOTION FROM ADHESIONS
AND SCAR FORMATION
E. FAILURE, DISPLACEMENT OR LOOSENING
OF INTERNAL FIXATION DEVICE
F. DEEP VEIN THROMBOSIS AND PULMONARY
EMBOLISM: A CLOSER LOOK
49
Q

Necessary for surgeries such as joint replacement, arthrodesis, or
internal fixation of fractures & reconstruction procedure

A

ARTHROTOMY/open procedure

50
Q

Requires a lengthy period of
rehabilitation for soft tissue
healing.

A

ARTHROTOMY/open procedure

51
Q

Increase soft tissue

disruption

A

OPEN PROCEDURE

52
Q

decrease soft tissue

disruption

A

ARTHROSCOPICALLY

ASSISTED PROCEDURE

53
Q

how long before mm tear is repaired

A

48-72hrs where inflammatory signs

are minimal

54
Q

Muscle is reopposed sutured and immobilization in a ____position

A

because we don’t want
to stretch the muscle or
tendon

55
Q

MM sets for Muscle tear

A

low level contraction: to increase the circulation
of the muscle and lessen
the atrophy

56
Q

MC site for tendon repair

A

bicipital tendon and

achilles tendon

57
Q

Post-op Management for tendon tear

A 
Muscle setting is begun
immediately after sx
● Remove immobilization for brief
periods of exercise
● PROMS or active cxn of
antagonistic muscle group written
a protected range
● Controlled antigravity motions are
initiated after tendon had several
weeks to heal (subacute)
● WB: may be restricted and heavy
weight lifting are contraindicated
(6 - 8 weeks)
● Vigorous stretching and high
intensity resistance exercise can
be initiated at 8 weeks
58
Q

Vigorous stretching and high
intensity resistance exercise can
be initiated at ___ for tendon repair

A

8 weeks

59
Q

CAPSULE STABILIZATION AND RECONSTRUCTION

is indicated for

A 
● Traumatic dislocation with
associated capsular, labral
avulsion or fracture
● Recurrent dislocation
● Subluxation despite conservative
management
● Irreducible dislocation
60
Q

A specific portion of capsule is incised and
tightened by overlapping and then suturing
the redundant tissue

A

Capsulorrhaphy (Capsular shift)

61
Q

Repair of capsule and labral lesion by
reattaching the labrum to the rim of the
glenoid combined with stabilization of the
capsule

A

Capsulolabral Reconstruction

62
Q

Arthroscopic approach that uses laser to

shrink selective portions

A

Electrothermally Assisted Capsulorrhaphy

Orthopedics (5 decks)

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