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ST > ORTHO test 2 > Flashcards

ORTHO test 2 Flashcards

1
Q

shoulder arthroscopy

A

diagnosis, removal of loose bodies, and rotator cuff repairs

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2
Q

acromioplasty

A

limited painful ROM impingement syndrome

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3
Q

bankart, putti platt, bristow

A

recurrent anterior dislocation of the shoulder

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4
Q

total shoulder arthroplasty

A

painful glenohumeral arthritis with significant loss of ROM or osteonecrosis

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5
Q

arthroscopic bankart procedure

A

shaver, burr, suture hook, MITEK for arthroscopic repair

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6
Q

why type of joint is the shoulder?

A

ball and socket

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7
Q

what bones articulate to form the joint?

A

scapula, humerus, glenoid

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8
Q

the top of the glenoid cavity is formed by the bony point on the top of the shoulder called the acromion process of the

A

scapula

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9
Q

three joints of the shoulder girdle

A

glenoidoclavicle, acromiclavicle, steroclavicular

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10
Q

which tendons are part of the rotator cuff?

A

supraspinatus, infraspinatus, teres minor, subscapularis

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11
Q

main function of the rotator cuff

A

shoulder movement

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12
Q

what landmark is used for orientation during the shoulder arthroscopy? what instrument is used?

A

biceps tendon

switching stick

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13
Q

how is the arm manipulated by the ST during exam of the shoulder?

A

external and internal rotation, slightly flexed position

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14
Q

what are the problems that may commonly be found and treated during the diagnostic shoulder arthroscopy?

A

rotator cuff repair, labral tear, loose bodies

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15
Q

what solution is commonly used for arthroscopy?

A

epi mixed with lactated ringer

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16
Q

bankart lesion

A

anterior part of the glenoid labrum of the shoulder

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17
Q

trocars used for bankart repair? why?

A

threaded to prevent dislodgement

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18
Q

what are the bony landmarks that are marked for an arthroscopic acromioplasty?

A

acromion, acromioclavicalar point, distal clavicle, coracoid process

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19
Q

most common method of reduction for a colles fracture?

A

close method, casted

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20
Q

femoral osteotomy guide

A

determine the point for removal of the femoral head using a saw

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21
Q

acetabular reamers

A

used to remove the articular cartilage

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22
Q

hohman retractors

A

elevate the femoral neck and head into the open wound

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23
Q

charnley

A

self retaining retractor for THA

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24
Q

femoral reamers

A

open up the IM canal

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25
Q

cookie cutter

A

box chisel used to prepare the end of the femur for rasping

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26
Q

femoral rasps

A

last one used is left in place as part of the base trial for the femoral component

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27
Q

cement restrictor

A

prevent entry into the unreamed segments of the IM canal

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28
Q

calcar plane

A

smooth the site around the femoral rasp just prior to the trial components are used

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29
Q

dynamic hip screw

A

hip fractures

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30
Q

trypes of hip fractures

A

interochanteric, subtrochanteric, femoral neck, basilar neck

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31
Q

what type of drape is commonly used with IV poles?

A

large barrier drape

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32
Q

what is the first step for a DHS/DCS procedure? and size?

A

guide pin is handed to the surgeon

38mm barrel plate and 135 degree angle barrel

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33
Q

what is used to prepare the site for the placement of the DHS plate and screw?

A

triple reamer

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34
Q

common reasons for a total hip arthroplasty?

A

osteoarthritis, trauma, over 65 years old

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35
Q

contamination during ortho? how to prevent?

A

when draping, change outer gloves

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36
Q

why should pt for THA include a type and cross?

A

blood loss could be high

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37
Q

3 advantages of laminar airflow in OR? spacesuits?

A

reduce microbial count, filtered air, air exchanges

to prevent contamination

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38
Q

what is placed to immobilize the joint as part of the post op care?

A

triangular split

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39
Q

irrigation during drilling or reaming through bone

A

cool bone-prevent necrosis

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40
Q

use laps when passing ronguer

A

remove tissue

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41
Q

verify sizes when passing reamers, rasps

A

verbalized when used

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42
Q

remove bits of tissue from field

A

prevent contamination

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43
Q

accept implants

A

no dropping

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44
Q

save sm piece of cement

A

so can check piece for hardness

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45
Q

what is the purpose of a lateral post during the knee arthroscopy?

A

placing counteraction on the knee joint to open the medial side

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46
Q

most common injury during arthroscopy? repair?

A

meniscus injury

arthroscopic partial mensciectomy or repair

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47
Q

which ligament of the knee is commonly injury? how?

A

ACL, pivot move in opposite direction

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48
Q

what can be used to repair a ligament?

A

autografts, allografts

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49
Q

where is graft placed for ACL? suture?

A

intercondylar notch

nonabsorbable suture 2 or 5

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50
Q

how is the graft secured in the tunnels?

A

staples, screws

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51
Q

why is it important to save all bone chips and pieces of tissue from the reaming process?

A

may be placed in defect

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52
Q

complications during allograft?

A

infection, disease transmission

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53
Q

additional instruments for amputation?

A

rasp, amputation knife/saw, power saw

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54
Q

why is the femur kept in extension during the suture of the quad muscle?

A

to avoid hip flexion

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55
Q

complication of amputations?

A

phantom limb pain

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56
Q

common reasons for amputation?

A

peripheral vascular disease

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57
Q

most common reasons for total knee arthroplasty?

A

relieve pain and disability

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58
Q

sandbag taped on the OR table for knee

A

allow for the knee to be optimally flexed

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59
Q

what precautions does the ST make to ensure the cuts are completed efficiently?

A

extra sterile saw blade

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60
Q

what should the ST be doing during trial reduction?

A

communicating what size prosthesis will be needed

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61
Q

purpose of triple arthrodesis?

A

relieve pain

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62
Q

what is used to perform the triple arthrodesis?

A

screws, bone graft

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63
Q

instrument for achilles tendon repair? position? foot? suture?

A

tendon pulling forceps
prone
foot is at rest
4-0 nonabsorbable

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64
Q

post op dressing after achilles tendon

A

4x4 dressing sponges

splint

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65
Q

most common cause of a bunion?

A

shoes styles worn, female most common

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66
Q

procedures for bunions

A

bunionectomy, mcbride, chevron

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67
Q

goal of bunion procedure?

A

prevent reoccurence

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68
Q

structures that must be preserved during bunion procedure?

A

metatarsal neck

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69
Q

what nerve is associated with carpal tunnel release?

A

median nerve

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70
Q

instrument sued to bluntly dissect under the carpal ligament for arthroscopic carpal tunnel release?

A

mosquito

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71
Q

when removing ganglion, what might be used to remove the last little core?

A

nibbler

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72
Q

three ways might a carpal or metacarpal fracture be fixated?

A

k wires, plate, screws

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73
Q

bones associated with an elbow fracture?

A

distal humerus, olecranon, proximal ulnar, radius

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74
Q

what position is ulnar nerve transposition done in?

A

supine, Olympic table

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75
Q

suture used to tack down the transposed ulnar nerve?

A

2-0 ethibond

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76
Q

4 things when placing a k wire in a finger

A

k wire, wire driver, pin cutter, pin cover

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77
Q

3 ligaments in acromioclavicular injury?

A

coracoclavicle, coracoacromion, acromiclavicular

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78
Q

mohow are most clavicular fractures treated?

A

immobilization

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79
Q

what tendon of the rotator cuff tear easier?

A

supraspinatus

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80
Q

which procedure for correction of anterior shoulder dislocation carries the most risk?

A

bristow

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81
Q

what positions may be used for acetabular fracture fixation?

A

lateral, supine

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82
Q

what is the reason for fixing hip fractures so quicly?

A

decrease in morbidity and mortality

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83
Q

what are possible complications of mismanaged femoral fractures?

A

immobility, bleeding, infection, atrophy

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84
Q

how can a patellar fracture be treated?

A

wire, screws, patellectomy

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85
Q

steps of IM rod insertion?

A

guide pin placement, reaming of the IM canal, rod placement, locking screw placements

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86
Q

why is it important to form the stump carefully in a lower extremity amputation?

A

allows for tie off, prosthesis fits better

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87
Q

what is considered in deciding if a patient is a candidate for limb or digit reattachment?

A

type of fracture, degree of damage to blood vessels, tissue, nerves

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88
Q

first step in limb/digit reattachment

A

foreign matter and damaged tissue removed

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89
Q

what pathology occurs that leads to total joint replacement?

A

degenerative joint diease

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90
Q

what type of systems are total joints that allow for differences in patient anatomy, component fit and surgeon preference

A

modular

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91
Q

what position is the patient for total hip arthroplasty?

A

lateral

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92
Q

3 components for a total hip arthroplasty

A

femoral head/neck, acetabulam

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93
Q

possible complation of total hip arthroplasty

A

shatter the femur, infection, immobility

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94
Q

who are candidiates for non cemented total joint arthroplasties?

A

young, healthy, no history of bone disease, strong cortical bone

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95
Q

where is PMMA mixed? why?

A

mixevac, the fumes are suctioned away since they are toxic

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96
Q

2 types of drains for total joint arthroplasties?

A

nonreinfusion, reinfusion–not normally used

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97
Q

position for total shoulder arthroplasty

A

semi fowlers

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98
Q

incision for total shoulder arthroplasty

A

deltopectoral groove

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99
Q

what does DJD stand for?

A

degenerative joint disease

100
Q

when all surfaces of a joint are replaced what is it called?

A

total joint arthroplasty

101
Q

3 types of components used for total joints

A

cemented, noncemented, hybrid

102
Q

what is PMMA? and 2 parts

A

bone cement

liquid, powder

103
Q

risk to you when using bone cement

A

respiratory tract problems, eye contact

104
Q

risk to patient when using bone cement

A

cardiac arrest, hemorrhage

105
Q

what is always done prior to cementing and why?

A

irrigation, opens pores of bones, better bonding

106
Q

what is always done before closure of a total joint?

A

ROM, check functioning properly

107
Q

which arthroplasty is done on the upper 1/3 of the leg with the patient in the lateral position?

A

total hip arthroplasty

108
Q

what are the most commonly used hip systems?

A

modular

109
Q

what does it mean to disarticulate the hip and what instrument is it done with?

A

dislocate hip, head from acetabulum

flex gently

110
Q

what type of saw would be used to excise the femoral head?

A

oscillating saw

111
Q

3 instruments used to ream the femur?

A

reamer, broaches, mallet

112
Q

what could happen if the femur is reamed with a femoral broach that’s too big

A

shatter the femur

113
Q

what type of component is slightly rough and has a textured posterior surface?

A

cemented

114
Q

what type of componenent has a porous surface on the posterior side?

A

non cemented

115
Q

what component costs more for cement?

A

noncemented

116
Q

in which total joint arthroplasty is a tourniquet used?

A

knee, ankle, elbow, digits

117
Q

3 components for total knee and what they are made out of

A

femoral: metal
tibial: polyethylene
patellar: polyethylene

118
Q

when using cement for a total joint, what is avoided until the cement has hardened and why?

A

movement, may dislocate prosthesis

119
Q

2 greatest problems after metacarpal arthroplasty?

A

progression of diseases to other joints

weak ability to pinch

120
Q

what is usally mixed in with the irrigation for total joint arthroplasties?

A

antibiotics

121
Q

what nerve is compressed in a carpal tunnel?

A

median nerve

122
Q

2 incisions for closed carpal tunnel

A

wrist, middle of palm

123
Q

excision of benign out pouchings of synovium which present as firm masses

A

excision of ganglion

124
Q

where are ganglions most common?

A

palm of hand, wrist

125
Q

treatment for fractures of the carpals?

A

closed reduction and immobilization

126
Q

3 ways carpals are treated with an open procedure

A

k wires, small screws, mini plates

127
Q

where is carpal fracture bone graft taken from?

A

head of the radius

128
Q

most common wrist fracture?

A

colles

129
Q

where is the colles fracture located?

A

distal end of the radius

130
Q

what is the most common cause of the colles fracture and what could you used to help prevent it?

A

breaking fall with hand

wrist guards

131
Q

what are the 3 common fractures of the elbow?

A

distal humerus, olecranon, proximal ulnar/radius

132
Q

2 causes of ulnar nerve damage

A

trauma to elbow, dislocation of elbow

133
Q

2 things happen when the ulnar nerve is damage?

A

sensory loss to hand, atrophy

134
Q

where is the ulnar nerve usually found?

A

under the fascia flexor carpi ulnaris muscles

135
Q

when an ulnar nerve transposition is done, where is the nerve placed?

A

deep in the brachialis flexor muscle origin

136
Q

3 proximal femur fractures

A

intertrochanteric, femoral neck, subtrochanteric

137
Q

which proximal femur fracture is most common in wisconsin?

A

intertrochanteric

138
Q

what type of traction is used in hip fractures to decreases muscle spasm and pain?

A

bucks

139
Q

if a femoral shaft fixation is not done correctly, what 3 things could the patient suffer from?

A

immobility, skin problems, pneumonia

140
Q

what is the most common tx used for femoral shaft fixation?

A

IM rods

141
Q

another name for popliteal cyst?

A

bakers cyst

142
Q

3 anatomical sites that are affected with ankle fractures

A

medial, lateral, posterior

143
Q

a triple arthrodesis is a fusion of what 3 ankle joints?

A

talocalcaneal, talonavicular, calcaneocubic

144
Q

2 reasons why a triple arthrodesis is done?

A

inversion, eversion of the foot

145
Q

OR table for acetabular fracture fixation

A

lateral

146
Q

fracture table acetabular fracture fixation

A

supine

147
Q

what is compartment syndrome and when does it usually occur?

A

pressure build up from bleeding or swelling of tissues, when blood flow is disrupted

148
Q

how is compartment syndrome treated?

A

fasciotomy

149
Q

Austin moore

A

replace femoral head and neck

150
Q

bipolar

A

only femur is reamed, no acetabulum

replacement of femoral head with prothesis

151
Q

modular

A

femoral, femoral head/neck, acetabular

adjust to the patient size

152
Q

what is a bone hook used for?

A

disarticulate the hip

153
Q

what would you hand after the bone hook?

A

oscilatting saw

154
Q

another name for the femoral reamer

A

femoral broach

155
Q

varus

A

inward angulation, bowlegged

156
Q

valgus

A

angled outward, knock kneed

157
Q

3 planes of motion for the knee

A

abduction, flexion, rotation

158
Q

position for total knee surgery?

A

supine

159
Q

unicompartmental implants

A

either medial or lateral part of knee

160
Q

bicompartmental implants

A

tibiofemoral and patellofemoral joints

161
Q

tricompartmental

A

femur, patella, tibia

162
Q

2 saws for total knee

A

oscillating, reciprocating

163
Q

what would you anticipate handing the surgeon when placing the pins to stabilize the alignment guides?

A

saw and mallet

164
Q

why is the ulnar nerve transposed?

A

causes sensory loss and atrophy

165
Q

what instrument is used to free the ulnar nerve?

A

freer

166
Q

when would bone grafting be used in humeral shaft fixation?

A

if severely communited

167
Q

why is cement used in the case of pathologic fractures?

A

healing potential is poor

168
Q

why is gentle reaming of the medullary canal used when placing an IM nail?

A

to not cause further fracture

169
Q

how do most clavicular fractures occur?

A

direct blow to clavicle

170
Q

most common site of clavicular fracture?

A

middle 1/3 of bone

171
Q

how are most clavicular fractures treated?

A

immobilization

172
Q

when is an open reduction indicated for clavicular fractures?

A

distal fracture, nonunion

173
Q

what are 2 types of fixation devices used with open reduction of the clavicle?

A

tubular plate, pins

174
Q

what would you suppose a semitublar plate is, and why would it be used on a clavicle?

A

curves to bone, contours to bone

175
Q

what is the most difficult part of surgery for open shoulder?

A

exposure

176
Q

partial rotator cuff vs complete tears

A

partial: from use, middle age
complete: extreme force, athletes

177
Q

goal of treatment of rotator cuff tears?

A

alleviate pain, return to normal activities

178
Q

additional itmes for major tear

A

suretac

drill with small bit

179
Q

additional items for minor tear

A

heavy suture, smoothing

180
Q

goals for recurrent shoulder dislocation?

A

complications, correct the problem

181
Q

what step is added to amke a bankart a putti platt?

A

subscalpuris tendon

182
Q

disadvantage of the bristow procedure

A

loss of internal rotation

183
Q

how do acetabular fractures usually occur?

A

severe trauma

184
Q

safety done for lengthy procedures

A

cell saver, warm OR, art line, type and cross

185
Q

why is internal fixation of the trochanter done?

A

to get pt up, little blood loss

186
Q

determinants of procedural success?

A

degree of displacement, early reduction

187
Q

why is blood loss low on hip and lower extremity

A

don’t enter joint capsule

188
Q

what size of instruments are used on hip and lower extremity?

A

large

189
Q

what eents can affect the blood supply to the femoral head?

A

swelling

190
Q

fractures of the epiphyseal growth plate of the femur in a child?

A

slip capitol femoral epipshysis fracture

191
Q

types of pins for epiphyseal growth plate fixation?

A

hag, holls

192
Q

most cost effective prosthesis to replace the femoral head?

A

austin moore

193
Q

when is austin moore selected?

A

when life expectancy is short

194
Q

what condition if present would warrant a total joint arthroplasty?

A

major deficiency of acetabular side of joint

195
Q

if femoral shaft fracture not managed appropriately

A

decrease in mobility, increase in morbidity

196
Q

femur

A

largest in body, supports all body weight

197
Q

possible tx methods for femur

A

im nails/rods

198
Q

disadvantages to using plates and screws for femoral shaft fixation?

A

bend, break

199
Q

advantages for IM fixation?

A

increase in load sharing, rod less likely to bend, less scarring

200
Q

position, prep, drape for tibia

A

supine, circumferential toes to tourniquet, stockinette, towel, extrem. sheet, split sheet

201
Q

most common complication of supracondylar fractures?

A

nonunion

202
Q

when should repair to the menisci and ligaments?

A

same time as joint fixation

203
Q

what do popliteal cysts often indicate in adults?

A

RA, torn meniscus

204
Q

position for popliteal cysts?

A

prone

205
Q

instruments for popliteal cysts

A

soft tissue instruments, ronguer

206
Q

why are tibial shafts difficult to treat?

A

less blood supply

207
Q

what tibial fractures heal better?

A

tortional, less damage to periosteum

208
Q

when is external fixation tx of choice?

A

gross contamination

209
Q

key to successful tx of open tibial fractures?

A

debride and clean out any non viable tissue

210
Q

bones for ankle fracture

A

tibia, fibula

posterior, medial, lateral

211
Q

where can bone be taken from if more is needed for the bone graft?

A

iliac crest

212
Q

hallux valgus

A

bion

213
Q

hammer toe

A

bump in less 4 toes, treated with k wires, plates, screws

214
Q

prep for knee arthroplasty

A

toes to tourniquet

215
Q

tourniquet for shoulder

A

no

216
Q

treatment for hip fractures

A

ASAP

217
Q

how are acetabular fractures fixed?

A

mesh, plates, screws

218
Q

avascular necrosis

A

risk of femoral neck fractures

219
Q

complications of avascular necrosis

A

skin breakdown, pneumonia, DVT

220
Q

treatment for tibial fracture

A

IM rod

221
Q

heel bone

A

calcaneus

222
Q

femoral nailing positioner

A

chick table

223
Q

suture for attaching tendon to bone

A

polyglactin 910

224
Q

acromion process in the AC joint is part of which bone?

A

scapula

225
Q

candidates for THA

A

over 65

226
Q

what tissue does the acetabular reamer remove?

A

cartilage and bone

227
Q

What 3 structures may need a possible resection during a total knee?

A

Patellar fat lad, ACL, meniscus

228
Q

Total shoulder prep

A

Circumferential to wrist

229
Q

What does a total shoulder do for the patient?

A

Gives support so rehab can occur

230
Q

Total elbow position

A

Supine or semi fowlers

231
Q

What nerve is avoided in a total elbow?

A

Ulnar nerve

232
Q

What’s another name for distal humerus?

A

Trochlea

233
Q

Another name for proximal ulnar

A

Olecranon process

234
Q

What 2 medullary canals are teamed for a total elbow?

A

Humerus and ulna

235
Q

Metatarsal

A

Toes

236
Q

Metacarpals

A

Fingers

237
Q

What is the implant for finger and toe surgeries called?

A

Silastic implant

238
Q

What is the silastic implant supported by?

A

Ligaments, muscles, tendons

239
Q

Why would a total shoulder be done?

A

Physically induced or accidental injury

240
Q

Femoral shaft fixation

A

Closed reduction

241
Q

Bones of the shoulder

A

Clavicle, scapula, humerus

242
Q

Detractors used for shoulder surgery

A

Double end richardson, weitlanders, rakes

243
Q

Clavicular fracture fixed with open reduction

A

Tubular plates

244
Q

What shoulder dislocation surgery is easiest to do?

A

Bankart

245
Q

What should dislocation normally doesn’t give good results?

A

Bristow

246
Q

4 types of acetabular fractures

A

Column, t shaped, transverse, isolated posterior wall

ST (35 decks)

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