OR Comp Flashcards
What is a cannulated screw used for?
-subcapital femoral neck fracture (femoral head/neck junction)
What is a DHS? What it is used for?
Dynamic Hip Screw
Used for intertrochanteric fracture
-fractures outside of the capsule, subcapsular, intertrochanteric, (fractures where blood vessels are left unharmed)
What is a DHS interchangable with?
Short gamma nail
What does a DHS require?
Intact lateral cortex
Short Gamma Nail is also known as?
Trochanteric Fixation Nail
What is a short gamma nail used for?
- fractures located outside the capsule (sub/inter trochanteric)
- interchangeable with the DHS
- also used for further down the neck
Birmingham?
- used on younger/active patients
- femoral neck maintained for potential future replacement
- patient likely to need total hip replacement in the future
Hemi Arthroplasty?
- replacement of femoral head/neck OR acetabulum, but not both
- cap and stem = single unit
- younger patients
- for fractures around stem: can occur during surgery or from trauma
What is the capsule of the hip?
Where the blood vessels are located
What is a THR/THA?
Total Hip Replacement/Arthroplasty
THR
- stem inserts into femur, ball that replaced head of femur, shell that linens acetabulum
- generally not applicable in trauma situations (patient have chronic pain and mobility issues after surgery)
What is a gamma nail used for?
- subtrochanteric or diaphyseal fracture
- intertrochanteric fractures with loss of bony cortex integrity
Components of gamma nail
- screw in neck, IM nail in femur, locking screw at knee
- may be performed antegrade or retrograde
- may use circlage wire as well (wraps and tightens bone)
TKR/TKA
Total Knee Replacement/Arthroplasty
- indications include pain, joint deformity, primarily from arthritis
- x-ray not required during OR procedure, but pre-op and 2 day post-op required
What does IM nail stand for?
Intramedullary
Tibial IM nail?
- tibial diaphyseal fracture
- fibula is non-weightbearing and is often not plated unless the integrity of the ankle joint is compromised
- may use circlage wire as well
Plate and Screw fixation
-used for absolute fixation on anatomy where callus formation would limit mobility, such as ankles, wrists, and spines
K-Wires
- used for finicky fractures (phalanges, metatarsals/carpals, calcaneus, wrists, etc.)
- fixates bone until the healing takes place, the wire is then removed
External fixation (ExFix)
- commonly used when swelling in the limb is an issue but fixation is still necessary
- surgeon will perform an ORIF 7-10 days later once the swelling has subsided
Pacemaker
- pt with inadequate cardiac pacing
- consists of 1 single chamber, 2 dual chamber, or 3 CRT levels with a greater generator, up at the left or right shoulder
- vascular (cine) runs are common
- always use cardiac appropriate C-arm
Total Hip Replacement (Dr. Burkart)
- X-table lateral pelvis done in OR
- patient positioned with affected side up
- increase technique to compensate for increased soft tissue density on the side down
- lines drawn on image post exam for measurement
X-table spines
- used to localize ROI and confirm hardware placement
- L-spine and C-spines
Why is I.I below table not recommended?
Increased dose due to scatter and increased OID (decreased image resolution, increase scatter)
Common uses of the C-arm
- hip pinnings
- open/closed fracture reduction
- cholangiography
What is a snapshot/digital image?
-higher quality, computer enhanced image
What is subtraction?
- initial image is captured
- used as filter-stationary structures removed from image
What is roadmapping?
-specific image held on screen during continuous fluoro
Min C-arm tilt that increases dose? By how much?
30 degrees, increases dose to face and neck by a factor of 4
Which end should you stand by (tube or I.I)?
I.I
Less dose due to patient scattering back to tube
How much can the tube above the table increase dose?
100 times higher dose to operator
Minimum distance you should be from the tube?
6 feet
What do nearby radiation levels depend on?
- C-arm orientation
- Technique
- Patient size
What lead equivalent must we wear?
0.5mm
What is closed reduction?
Non surgical: realignment and manipulation
Arthrodesis?
Stiffening of a joint by OR
Arthropathy?
Disease affecting a joint
Asepsis?
All living things are absent
Cancellous screw?
Screw for ORIF for spongey bone
Cerclage wire?
Wire tightening around fracture to reduce limb shortening
Dynamic compression plate?
-screw and plate combo to apply forces through a fracture
Ilizarov technique?
-ex fix used to lengthen bone
Surgical team?
- surgeon
- anesthesiologist
- assistant
- surgical tech (surgical assistant?)
- circulating nurse
- scrub nurse
3 ways for C-arm to be sterile?
- drape C-arm
- drape patient
- shower curtain
Surgical asepsis?
Minimize infectious agents
Surgical attire?
- scrubs
- hair cover
- shoe cover
- shoes
- mask
- gloves
- eyewear
Common hip fractures?
- neck
- intertrochanteric
- subtrochanteric
Reasons for THR?
Degenerative disease
Trauma
Which device for THR for patients with decreased mobility?
Austin moore
Bone reamer is for?
Widening medullary canal
Laminectomy for C-spine?
- removes osteophytes
- herniated disc material
Laminectomy for L-spine?
- obstruction
- impingement
- stenosis
Vertebroplasty vs Kyphoplasty
V: older, cement into spine
K: balloon filled with cement
What ventricle for pacemaker?
Right ventricle
