ORTHO test 1 Flashcards
where is the ideal location and time to shave the ortho patient?
right before surgery, in the pre op area
what type of treatment is used when the fracture needs to have continuous traction?
closed reduction with external fixator
oscillating saw
side to side
what complication can occur from excessive weights on the traction or inadequate immobilization with casting?
delayed union due to mechnical reason
five stages of osteogenesis
inflammation, cellular proliferation, cellular formation, ossification, remodeling
what do muscles interact with?
nerves, minerals, skin
where does an autograft come from-what is its opposite?
comes from patient-opposite is allograft
total knee patellar component
replace patellar surface
Two instruments used on a shoulder scope to make incisions opposite of one another?
Wisinger rod, switching stick
blades
cut/saw bone
what type of traction is applied with closed reduction?
manual or skin
when is ORIF used?
cant be reduced with closed method
extension
a joint
coxa
hip
plantar flexion
specifically to bend foot downward at toward sole
nerve hook
retract nerves and blood vessels
synarthrotic
nonmovable
what is important to remember in the care of arthroscopy instruments?
handle gently, don’t kink
finger rasp
smooth bone
osteomalacia
softening of bones
what are the goals of fracture treatment?
reestablish length, shape, alignment, anatomic function
total knee femoral component
replace femoral surface of knee joint
pathological fracture
caused by disease
how many prep kits if prepping for a graft site?
two
acromioplasty
used to treat limited painful ROM impingement syndrome
shaft of bones
diaphysis
posterior
toward the back
irregular bones
vertebrae, facial bones
rotation
moving a body part around a central axis
freer
free tissue
two types of devices used for fractures of the tibia, femur, humerus and where are they placed?
robs, nails
IM canal
what type of water is used for fiberglass and plaster casts?
cool and tepid
cylinder cast
knee immobilization
Vascular meniscus
Outer edge 10-25%
regular screwdriver
insert or remove screws
If a tear occurs in the vascular what will be used to repair it?
Suture 0, 2-0 vicryl, PDS or proline
When doing an ACL reconstruction what is always done first?
Correct any other pathologies first
lane bone holder
hold bone in place
femur, self retaining-usually used in pairs
position of a shoulder arthroscopy
semi fowlers/lateral
periosteum
covers bones, provides attachment for tendons, muscles, ligaments
de quervans
inflmmation of the tendon sheath of the thumb
another name for diarthrosis joints
synovial joint
yellow bone marrow
fat center of shaft in adults
common graft used for acl reconstruction
patellar tendon graft
the______ are stimulated by the ________ to dissolve bone and release _____into the vascular system for important functions such as the actions of muscle?
osteoclasts, parathyroid gland, calcium
test used to test joint stability of knee
lachman and drawer
long leg cast
femur, tibia, fibular, ankle fracture
spinal column
cervical 1-7 thoracic 1-12 lumbar 1-5 sacrum 5 coccyx 4
what tissue are diarthrotic joints line with?
synovial membrane
what part is slightly larger on the meniscus?
medial
PMMA
bone cement to hold prosthesis in place
punches/biter
remove tissue from joints
why is exercise important for bone formation?
to prevent bone loss
talipes
foot
short bones
carpal and tarsal bones
lateral
toward the side
CMTS
color, motion, temperature, sensation
hip screw
bridge to promote bone healing
used with hip plate
five steps of bone healing
begins at the time of fracture and lasts about two days
begins on day two and fibrin mesh forms
lasts three to four weeks
begins two-three weeks after injury and lasts 3-4 months
maintenance state of normal bone
compound fracture
bone pierces skin
cannulas
allow for passage of arthroscope and instruments
circumduction
moving a body part in a circular path without moving the entire body
strain
injury to muscle or tendon due to overstretching
blount knee retractor
hold back structures,
ACL, patella
seven steps of inserting a lag screw
guide pin is placed across the fracture
an angle guide is used to measure the degree of angle from the pin down the side of the femur
a reaming device is used to make the path for the lag screw to follow
tap is used to make a path for the threads of the lag screw
lag screw is placed
side plate is attached to the lag screw and screws are used to hold it in place
compression screw placed to hold the lag and plate together
rickets
disease of children caused by vitamin d deficiency
Three things a meniscal tear presents with?
Locking, clicking, fluid accumulation
cannulated screw
screw with hollow central shaft, usually inserted over a guide wire or pin
three joints that can be scoped
knee, shoulder, elbow
key elevator
separate periosteum from bone
flexion
any joint, decreasing a joint angle
when is external fixation most often used?
severe fracture, many fragments, infected
2 advantages/disadvantages of ORIF
direct observation, increase effectiveness with communited fractures
d: increase infection and risk of nonunion
what is the segment of vertebrae closet to the head?
cervical
knuckle like projection of bone
condly
anterior
toward the front
What is the ma for electrical current?
18-22
the hormone ____ from the ___ gland activates ___ to build more osteocytes when the ____ level is stable
calcitonin, thyroid, osteoblasts, calcium
bursa
small sac lubricates for joint movement
threaded pin
stabilize fractures, large bone surfaces
the top of the glenoid cavity is formed by the bony point on the top of the shoulder called the acromion process of the _____
spula
osteochondritis
inflammation of bone or cartilage
total shoulder arthroplasty
used to treat painful glenohumeral arthritis with significant loss of ROM or osteonecrosis
what is a joint irrigation pump not needed for?
ankle/elbow
exothermic
accompanied by the release of heat
what is lagging?
fracture fixation technique
hallux
great toe
valgus
turns outward away from midline
what does ORIF stand for?
open reduction with internal fixation
guide pin
guide reamers for insertion of rods
three types of joint immobilzation devices
cast, splint, brace
describe cancellous bone
soft, spongy, found at iliac crest
contains red bone marrow, in center of long bones
who can apply tourniquets?
rn, md, stfa
body jacket
spine immobilization
ganglion
tendon sheath cyst
what type of treatment doesn’t use a cast?
closed recution with external fixator
what is routinely done in donor sites because of the difficulty in achieving hemostasis?
drains placed
internal rotation
point the toes or flex arm inward or rotate toward the midline
what is used to smooth out fiberglass casts after application?
lotion
cortical bone
hard bone, found in diaphysis or shafts of long bones
two types of amphiarthrosis joints
pubic symphysis, intervertabral joints
two terms that describe a hollow or depression in the bone
fossa and fovea
What type of anesthesia would be used on an elbow scope?
General for total relaxation
adduction
bring toward the middle; toward the midline
steinman
pin segments in large diameters used for skeletal traction
supinate
turn upward
if implants are different alloys or reused
corrode, causing breakdown of implant, can causes irriation
lag screw
used with side plate held in place with a compression screw
stimulator
low level current treatment of nonunion or delayed union
small gouge
gouge out bone
sesamoid bone
found within tendons
bunion
bony growth (exostosis) medical aspect first toe
what type of procedure can be useful in finding tumors>
bone scan, with injection of substance
smiley retractor
hold back structures
knees
long arm cast
ulnar/radius or elbow fracture
polyester, braided nylon
attach tendon to bone
plaster rool
protection of an extremity during the healing process
four steps to fracture treatment
reduction, stabilize, confirm with xray, immobilize
rounded protuberance that forms a joint articulation, is covered by cartilage and is found at the ends of bone?
condyls
shoulder arthroscopy
used for diagnosis, removal of loose bodies, rotator cuff repiars
arthrography
joints
the malignant tumor osteosarcoma primarliy affects the ____ bones and commonly metastasizes to the lungs
long
inversion
turning the foot inward at the ankle joint
reamer
giving the finishing touch to the hole
what do you utilize for shoulder arthroscopy positioning?
beach chair/ trapezee
dorsiflexion
specifically to bend foot upward at ankle
arthritis
inflammation of a joint
hibbs retractor
hold back structures for hip surgery
what should be used when bending plates?
plate benders from specific manufacturer
four steps in the routine for inserting a screw
drill, measure, tap, screw
a benign tumor of the cartilage is called a ____ whereas a benign tumor of the bone is called an _____
chrondoma, osteoma
greenstick fracture
bent but not broken all the way, occurs in children
flat bones
ribs, sternum, cranial bones
small elevation of bone
tubercle
three goals of positioning
exposure,alignment, nerve safety
pin cutter
cut large pins
burrs
remove unwanted bone
another name for manmade fracture
fixation device used? and why?
osteotomy
staples- gradually push apart the two bones
rod or nail
placed in the IM shaft of long bones
distraction
pulling apart
what is the tissue that covers the ends of the long bones (the condyles)?
cartilage
smooth pin
stabilize fractures
what does diagnostic arthroscopy mean?
to look
which sesamoid bone is found in the knee?
patella
test used to test joint stability of shoulder
spirling and hawkins
fiber optic light cord
provide light
What is it called when you take a piece of bone from the femoral condyle when doing an ACL?
Notchplasty
ankylosis
abnormal stiffness or fixation of a joint
artificial knee joint components
femoral/tibial and patellar components
box chisel
take out square of bone- make window
total hips
what areas should be isolated when the surgical site is on the upper third of the leg?
groin/anal
operative arthroscopy
meants to work
list 3 types of tractiion
skin, manual, skeletal
why would a surgeon choose to do a closed reduction with cast?
lower infection, improve results
bucket handle tear
meniscus is torn, most common knee injury
two extra equipment in the room for ortho case
TV tower, implant carts, distraction devices
five types of diarthrosis joints
gliding-carpals of the wrist hinge-elbow, knee pivot-wrist condyloid-TMJ saddle-metacarpal of thumb
bankwart, putti platt, bristow
used for a recurrent anterior dislocation of the shoulder
orthopediic plates
used with screws and bent to fit the bone to hold the fragments in place during healing
wire scissors
cut finge gauge wire
varus
turns inward toward midline
three main components of external fixators?
bone anchoring device, longitudional supports, connecting elements
steps for closed reduction
prepare a bucket of lukewarm water
use scissors to prepare the stockinette of approp. length
pass the webril/plaster
drop the plaster or fiberglass vertically
wait for all bubbles to ceases; compress to remove excess water
pass plaster roll or fiber glass
elevate on pillow using flat of hand
air dry or use the cast drier
the malignant tumor occurring in the bone marrow is called _____
multiple myeloma
what is the difference between a ligament and a tendon?
ligament: stability, dense, hold bone to bone
tendon: transmits force, tough, form end s of muscles
three types of joint immobilization devices
collar, bunion, shoe
hand drill with key
insert or remove traction key
not often used in OR
cortical screw
used in cortical bone, narrow threads, go across whole width of bone
short leg cast
ankle and foot fractures, triple arthrodesis
arthrodesis
surgical fusion of a joint
four types of devices used for oRIF
pin, wire,- most common screw, rod
Four reasons why a shoulder scope would be done?
Loose bodies, lysis of adhesions, synovial bx, bursectomy
osteogenesis
formation of bone
subluxation
partial dislocation of a joint
esmark
exsanguinate extremity
type of alloys used in the manufacturing process?
stainless steel
avascular necrosis
disruption of the blood supply due to trauma, diease, or medications
will the surgeon need a tap if the screw is a pretapped screw?
yes to make a path for the threads to follow
hammer toe
also known as claw or mallet due to position of joints
three types of synovial joints
elbow, knee, shoulder
main complication of osteoporosis
break
spica cast
immobilization of hip/leg of affected side to the mid thigh of unaffected leg
total hip acetabular component
replace arthritic acetabulum
if an arm is moved away from the body and the fingertips are made to touch the shoulder, what 2 motion words describe these movements?
abduction, flexion
femoral broach/reamer
open up femoral canal
the appendicular skeleton refers to the ___ and ___ the axial skeleton refers to the ___,___,___ and ___
upper, lower, cranium, vertabrae, ribs, sternum
complication fro cast being placed too tight?
compartmental snydrome, ishechemia
nonunion
bone healing is interrupted
sprain
stretched or torn ligament
______ is an inflammation and infection of the bone and bone marrow. it is a danger with any kind of ortho surgery. the genus _____ bacteria are the most common causative organisms
osteomyelitis, staphylcocci
preparation of plaster rolls
submerge in tepid water, don’t ring out
how many bones are in the body?
206
ACL reconstruction is done after what 3 things are tried first?
Rehab, exercise, brace
What is the most common graft used for ACL?
Patellar tendon graft
rasp
smooth bone
used on larger bone
lewin bone clamp
hold bone in place
total joint
comminuted fracture
several pieces
wire nips
cut small wire
arthroscopic bankart procedure
uses a shaver, burr, suture hook, and MITEK anchors for an arthroscopic repair
total knee tibial component
replace tibial surface of knee joint
nibbler, single action ronguer, double action ronguer
bite off tissue
what is the purose of a notchplasty during an acl reconstruction?
to make avaible space for graft
where is the medullary canal found?
shaft of long bones
Synovitis
Inflammation of synovial lining
amphiarthrotic
slightly movable
joint
articulation
what should the extremity be padded with?
webril
eversion
turning the foot outward at the ankle joint
what should you think of when inserting wire?
hot is will be secured, if it will be passed through bone
if a fracture is treated with closed reduction and hardware is inserted under what type of xray?
fluoroscopy
what are the differences between standard xray and fluoroscopy?
f: live and immediate
xray: still
how many bones are in the appendicular skeleton? axial skeleton?
126,80
metatarsal arthroplasty component
replace metatarsal joint
rheumatoid joints-plastic not cemented
osteoarthritis
when flexible tissue at end of bones wear down
curette
scrape out small amounts of bone
projection on the surface of the bone above it si the
epicondyl
drill bits
drill holes in bones
makes path for screw to be inserted
bone cutter
cut away bone
amputate fingers
the _____ tumor is a malignant tumor primarily affecting young boys
ewings
abduction
moving a body part away from the midline of the body
total hip femoral component
replace femoral head and neck
what bones articulate to form the shoulder joint?
scapula, humerus, glenoid
chisel
cut bone
what are used when using rods and nails and removing them?
impactors, extractors
three joints of the shoulder girdle
glenoidoclavicle, acromicalavior, steroclavicular
rheumatoid arthritis
chronic inflammation affecting may joints
periosteal elevator
separate periosteum from bone
mice
locking or pain in joint due to loose particles
avulsion
tissue torn away from normal attachments
tendon
connects muscle to bone
bone file
smooth bone
used in totals
what type of fracture treatment builds an external frame to support the fracture?
external fixation
as susie fell when she was pushed, she fell onto her outstretched hand, fracturing the distal radius, this is called a ____ fracture
colles
exsanguination
bloodless field
what is the part of the humerus closest to the heart?
proximal, medial
plates
bridge to promote bone healing
why is continuous irrigation used in arthroscopy?
easier to move
staples
staple bone together
may need several at one time
reciprocating saw
back and forth
joint of shoulder
ball and socket joint
hemopoesis
bones are a site for blood cell formation, found in bone marrow
an elevation or protruderence of bone
tuberosity
cobra retractor
hold back structures
hips
what are the three reasons why open reduction with external fixation is done?
to avoid cast, allow skin graft, maintain alignment
cancellous screw
wider spaced threads
condylar ends of the shaft, doesn’t cross whole bone
wire twist
twist wire
3 safety precautions taken when using tourniquets
1hr upper, 2 hr lower, make sure padded
dupuytrens
abnormal formation cuasing ring and little fingers to bend
proximal
nearest, near to point of attachment of origin
why is draping the ortho patient more of a challenge than draping an abd procedure?
more to drape around, can contaminate on more items, infection higher
4 advantages of arthroscopy
1 disadvantage
less invasive, less risk of infection, less recovery time
D: less maneuverability
what do all arthroscopies involve to facilitate opening the joint space for viewing and treatment?
distraction device
three categories of fracture treatment
ORIF, closed, external fixation
pronate
turn downward
bennett retractor
hold back structures, dull
depth gauge
measure hold for screw length needed
four areas where cancellous grafts can be taken from?
ilium, olecranon, distal radius, iliac crest
What does ACL stand for?
Anterior cruciate ligament
hohmann retractor
hold back structures for hip surgery
end of bones
epiphysis
three steps to placing cancellous screws
drill, tap, screw
lowman bone clamp
hold bone in place
self retaining
chief diagnostic tool for ortho?
xray
impacted fracture
broken ends are jammed together
what is the purpose of bones?
provide framework to support soft tissue
israel retractor
hold back structures
dull
four places where cortical grafts can be taken form?
tibia, fibula, ribs, iliac crest
purpose of traction, types
align body parts, skin manual skeletal
self retaining screwdriver
insert or remove screws
red bone marrow
produces RBCs, platelets and wBCs
phillips screwdriver
insert or remove screws
what happens when the epiphyseal plate is fractured on a child?
affects the childs growth
external rotation
turn or flex/rotate the toes or arm away from the midline
addition of healthy bone to an area to promote bone growth and what is it used for?
bone grafting
fill cavities, fill defects, promote fracture union
medial
nearer to the midline of the body
tap
created the threads in the bone
elastic, resilient supporting tissue found at the ends of bone?
cartilage
what method of immobilization is commonly used after closed reduction?
splint
wire cutter/pliers
cut large gauge wire
why are splints used in casting?
swelling
when closing the periosteum, use ______ suture such as ___ and ___ and for bone use ___ suture such as _____
absorable, vicryl, chromic, nonabsorbable, surgical steel
two considerations for the prone position
airway, range of motion
gooseneck ronguer
bite off tissue
back procedures
stainless steel
used to secure bone to bone
genu valgum
knees close to the midline increasing the space between the ankles
example of round bone
kneecap
which category of fracture treatment is the treatment of choice when possible?
closed reduction
info required regarding implant documentation
number of implants, type, size, serial numbers
leksell rongue
bite off tissue
back procedures
what is contained within the medullary canal?
yellow bone marrow
diarthrotic
Freely movable most common
drill
high concentrated power, making brand new hold
what basic ortho instruments would you have available to work on a medium sized bone like the tibia?
ferris smith, kelly, pean, kocher, ronguer, #3 with #10
hip prosthesis austin moore
replace fractured femoral head/neck
masses of tissue that cover bones and provide movement to the skeletal system
muscles
arthroscope and camera
allow to view inside of joint
distal
farther fromm the origin of a structure or from a given reference
long bones
humerus, femur, tibia, fibula
what does the bones serve as a storage site and reservoir for?
minerals
femoral impactor
drive component into place on total hip arthroplasty
where are lag screws used to stablizie fractures?
greater trochanter of the hip
four steps to placing cortical screws
drill, measure, tap, screw
basic instruments needed for an arthroscopy
trocar, scope, camera, irrigation, shaver, biter, hook, debrider
bone hook
hook and manipulate bone
total hip arthroplasty
