ortho surgical (1)

Question 1

finger clubbing

Answer 1

family trait and harmless

but can be associated w lung disease, liver disease, heart disease, inflammatory bowel disease, and AIDS

Question 2

red lunula associated w

Answer 2

Cardiovascular disease
Cardiac failure
Collagen vascular disease

Cirrhosis
Psoriasis
COPD
Carbon dioxide poisoning

Prednisone use

Question 3

An Absent lunula may indicate

Answer 3

anemia or malnutrition

Question 4

Pale nails may be a sign of:

Answer 4

Anemia
Congestive heart failure
Liver disease
Malnutrition

Question 5

Bluish nails (cyanosis) may indicate

Answer 5

Raynaud’s disease
respiratory disorders
cardiovascular disorders

Question 6

Splinter hemorrhage is associated with the following conditions:

Answer 6

Bacterial endocarditis
Trauma
Mitral stenosis
Vasculitis
Cirrhosis
Scurvy
Chronic glomerulonephritis

Question 7

Painful, red and swollen nail fold, or skin and soft tissue that surrounds the nail, nail infection

Answer 7

Paronychia

Question 8

Paronycha may be…

is most often caused by…

Answer 8

may be acute, where it develops over a few hours
or chronic, where it lasts more than six weeks

most often caused by infection, injury or irritation

or eczema or psoriasis
or diabetes or HIV

Question 9

Crused fingertips:

subungual hematoma

Answer 9

nail bed can bleed, usually after an injury, under the nail creating a hematoma (abnormal collection of blood outside a blood vessel)

Question 10

Crushed fingertips:

Fractures of the fingertip, usually of the type called a

Answer 10

tuft fracture (distal phalanx), usually heal well if given a chance to rest (a splint may be needed)

Question 11

Zone 2

Answer 11

not a a lot of blood (tendon injuries here don’t heal as well because of lack of blood supply to tendon) no man’s land

Question 12

Tendons don’t have what?

Answer 12

Tendons don’t have a good blood supply

Question 13

Finger tip amputations two types?

Answer 13

minor injury or primary closure (revision amputation)

Question 14

Finger tip amputations: minor injury

Answer 14

Minor injury (< 2cm skin loss) 
Indications: adults and children with no bone or tendon exposed 

May close on its own with protective dressing and regular cleansing

Question 15

Finger tip amputations: primary closure (revision amputation)

Answer 15

Indications: finger amputation with exposed bone and the ability to remove bone proximally without compromising bony support to nail bed,
or loss of >50% of distal phalange

Or irreparable damage to the nail matrix

Question 16

Digit amputation surgical options

Answer 16

Full thickness skin grafting

Indication: exposed bone or tendon where rongeuring (snipping) bone proximally is not an option

Reconstructive flap may be necessary to cover the wound with new skin, as well as the fat and blood vessels underneath

Question 17

Ring Avulsion injury (degloving)

Answer 17

Sudden pull on a finger ring (jewelry) results in severe soft tissue injury ranging from circumferential soft tissue laceration to complete amputation skin, nerves, vessels are often damaged

Fingers one of the most sensitive parts of body

Question 18

Ring Avulsion injury: prognosis

Answer 18

extent of injury is greater than what it appears to be

poor prognosis because of associated vascular injury

advances in interposition graft techniques have improved results

Question 19

Common Shoulder Surgical Procedures include the

Answer 19

Arthroscopic Rotator cuff repair

Question 20

Rotator Cuff Repair

Answer 20

Surgical repair of the torn rotator cuff which often involves re-attaching the tendon to the head of humerus

A partial tear, however, may need only a trimming or smoothing procedure

Question 21

Rotator Cuff Repair: Arthroscopy can assess….

Answer 21

Arthroscopy can assess and treat damage to other structures within the joint
Bone spurs are often removed arthroscopically
No need to detach the deltoid muscle with Mini-Open Repair

Question 22

Physician’s order for rehabilitation

Answer 22

Immobilization - Repair needs to be protected (not stressed) while the tendon heals

Cast or splint (non-surgical immobilization)
Instructions to the patient include use a sling and avoid using arm for the first 4 to 6 weeks

Length of time of immobilization depends upon the severity of injury

Question 23

Shoulder Post-op Exercises

Answer 23

Passive Exercise
referral to a PT for passive ROM (PROM) ex.

CPM may be ordered
In most cases, passive ROM is begun within the first 4 to 6 weeks after surgery

After 4 to 6 weeks, progress to doing active exercises

At 8 to 12 weeks, start strengthening exercise program

Complete recovery will take several months

Most patients have a functional range of motion and adequate strength by 4 to 6 months after surgery

Question 24

Cut tendon that means

Answer 24

likely nerve is injured as well!

Question 25

Peripheral nerves can

Answer 25

regenerate, but full cut needs a graft to get to motor endplate!

Question 26

to stabilize a long bone fracture, a plate and screws outside the bone or a rod inside the bone may be used

Answer 26

internal fixation

Question 27

screws are placed into the bone above and below the fracture, and a device is attached to the screw from outside the skin where it may be adjusted to realign the bone

Answer 27

external fixation