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Senior Rotations > Orthopedics > Flashcards

Orthopedics Flashcards

1
Q

describe total knee arthroplasty

A

replace worn surfaces of knee joint

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2
Q

indications for total knee arthroplasty

A

rheumatic/traumatic arthritis

varus/valgus deformity (destroy medial/lateral)

pain, instability

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3
Q

position for total knee replacement

A

supine w/ footrest for flexed leg

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4
Q

2 principle methods of implant fixation for joint arthroplasty

A

cemented

noncemented

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5
Q

ideal candidate for cemented or uncemented/press fit

A

noncemented: younger active people. Biofixation

Cemented: old people

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6
Q

what is bone cement

A

poly methyl methacrylate monomer

IM of cemented arthroplasty prosthesis

adheres to metal/polyethylene but not bone

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7
Q

how is PMMA used to ensure fixation

A

fills cavity and interstices of bone for mechanical bond

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8
Q

adverse reactions to PMMA

A

transitory hypotension

cardiac arrest

CVA, PE

hypersensitivity

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9
Q

osteoarthritis

A

noninflammatory progressive degenerative joint disease-hypertrophic hyaline/subchondral bone

wear and tear after 50

cause of most joint replacements

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10
Q

rheumatoid arthritis

A

autoimmune disease-system attacks synovium and articular surfaces-inflammation

ages 25-50

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11
Q

osteomalacia

A

softening of bones due to lack of vitamin D

inadequate mineralization

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12
Q

osteoporosis

A

excessive loss of calcified matrix-decreased bone mass

metabolic disorder producing porous, brittle, easily fractured bones

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13
Q

continuous passive motion

A

early postop passive ROM

stimulates healing in articular tissue (tendon, cartilage, ligament)

doesn’t interfere with incisional healing over joint

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14
Q

benefits of CPM

A

inhibit adhesions

decrease joint stiffness, swelling, pain

early functional ROM

decreased effects of immobilization

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15
Q

osteomyelitis

A

bone/marrow infection from Staph A.

hard to treat expensive

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16
Q

diarthrotic joint

A

freely moveable/synovial

skull

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17
Q

amphiarthrotic joint

A

slightly moveable-connected by cartilage

symphysis pubis, intervetrebral joints

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18
Q

avulsion fracture

A

ligaments are intact on separated bone fragments

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19
Q

luxation

A

complete dislocation of one surface to another

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20
Q

subluxation

A

partial dislocation (ligament instability)

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21
Q

monteggia fracture

A

proximal ulnar fracture w/ dislocation of radial head

blow to ulna or fall w/ arm hyperextended

not treated with OR in kids

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22
Q

Colles’ fracture

A

distal radius fracture w/ posterior displacement of distal radial fragment

reduce, close, immobilize

fall on outstretched hand

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23
Q

compound fracture

A

bone through skin-extensive tissue damage

significant anatomical displacement

ORIF

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24
Q

comminuted fracture

A

more than 2 pieces

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25
Q

spiral/oblique fracture

A

bone twisted apart

oblique-shorter than spiral

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26
Q

pathologic fracture

A

due to weakened state-osteoporosis

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27
Q

greenstick fracture

A

bending partially ossiated bone

convex side breaks, concave bends and heals

incomplete fracture

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28
Q

stress fracture

A

incomplete fracture from overuse/high impact sports

small crack

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29
Q

5 stages of bone healing

A

hematoma

fibroblasts network formation

osteoblasts invade

calcium callus

remodeling

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30
Q

malunion

A

fracture heals out of anatomical position

impaired function/significant angulation of extemity

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31
Q

nonunion

A

healing ends without connecting bone (hematoma)

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32
Q

delayed union

A

healing hasn’t occurred in normal time

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33
Q

terrible triad

A

torn anterior cruciate ligament, medial meniscus, medial collateral ligament

osteoarthritis if untreated

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34
Q

where is a Baker’s cyst

A

popliteal fossa

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35
Q

cast for complete knee immobilization

A

cylinder

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36
Q

cast for complete hip immobilization

A

spica with abduction pillow

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37
Q

anatomy of knee joint

A

2 articulations

condyle of femur and tibial plateau

femur and patella

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38
Q

supraspinatus syndrome

A

impingement syndrome (shoulder)

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39
Q

why use a tourniquet for appendicular surgery

A

bloodless field

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40
Q

why use Esmarch

A

exsanguinate appendage distal to proximal elevation

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41
Q

3 contraindications for tourniquets

A

compartment syndrome

McArdle disease

hypertension

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42
Q

3 safety rules for tourniquet

A

don’t compress bony/neurovascular structures

place as high as possible, not on skin folds

wrap w/ stockinette w/o wrinkles

cuff overlap min 3in. max 6in.

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43
Q

recommended max time for tourniquet inflation

A

less than 1hr. upper extremity

less than 2hrs. thigh

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44
Q

what is done when tourniquet limit expired

A

take down 5 min for every half hour (rewrap)

minimize effects on muscles/nerves

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45
Q

3 examples of antibiotic therapy

A

IV-cephalosporin, irrigation, ointment

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46
Q

2 antibiotics used

A

polymixin, bacitracen

47
Q

bones in skeletal system

A

206

48
Q

what is appendicular skeleton

A

upper and lower appendages

pelvic/pectoral girdles

49
Q

bones in appendicular skeleton

A

126

50
Q

axial skeleton

A

skull

vertebrae

rib cage

51
Q

bones in axial skeleton

A

80

52
Q

cortical bone

A

hard outer shell

main support

53
Q

cancellous bone

A

soft, spongy, red bone marrow

iliac crest, pelvis, ends of long bones

54
Q

cortical vs. cancellous screws

A

cortical-tight threads, sheet metal screws, transfix

cancellous-wide threads, wood screws

55
Q

allograft vs. autograft bone

A

autograft-from self

allograft-substitute, cadaver

56
Q

where is autogenous bone harvested

A

iliac crest-cortical cancellous
femoral head, patella
fibula-cortical

57
Q

anatomy of hip joint and proximal femur

A

proximal femur –> trochanter

acetabulum and femur

58
Q

3 fused bones of os coaxes (hip bone, innominate)

A

ileum

ischium

pubis

59
Q

acetabulum

A

socket of hip joint

60
Q

total hip arthroplasty

A

removal of ball and socket and replace

61
Q

surfaces replaced in total hip arthroplasty

A

femoral head and neck

acetabulum

62
Q

indications for total hip arthroplasty

A

rheumatoid arthritis

degenerative joint disease

avascular necrosis

63
Q

what is a bunion

A

hallux valgus-soft tissue or bony mass at medial side of first metatarsal head

64
Q

patients frequently experiencing bunions

A

women-shoes

65
Q

goal of bunionectomy

A

cosmesis: correct deformity
reconstruction: resect abnormal bony components
function: ROM

66
Q

Keller procedure

A

proximal 3rd of proximal phalanx of big toe resected

implant in IM canal to stabilize joint

67
Q

Mayo procedure

A

CHECK

68
Q

McBride procedure

A

abductor tendon fixed to lateral metatarsal neck

excise sesamoid bone

69
Q

triple arthrodesis

A

fuse talocalcaneal, talonavicular, calcaneocuboid joints

70
Q

why perform triple arthrodesis

A

inversion or eversion deformity of foot
intraarticular fracture
clubfoot, poliomeylitis, rheumatoid arthritis

71
Q

goal of triple arthrodesis

A

limit motion of foot and ankle to plantar flexion and dorsiflexion-pain relief

72
Q

4 bones and 3 fusions of arthrodesis

A

bones: talus, calcaneous, navicular, cuboid
fusions: talocalcaneal, talonavicular, calcaneocuboid

73
Q

eight carpal bones

A

scaphoid lunate triquetrum pisiform

trapezium trapezius capitate hamate

74
Q

most fractured carpal bone

A

scaphoid

75
Q

internally fixate scaphoid

A

k-wire fixation

76
Q

carpal tunnel syndrome

A

compression of median nerve at wrist

thick synovium, trauma,

77
Q

carpal tunnel release

A

curvilinear longitudinal volar incision

release transverse carpal ligament

78
Q

7 tarsals

A

talus calcaneous navicular cuboid

lateral, medial, intermediate cuneiform

79
Q

shoulder dislocation surgery

A

CHECK

80
Q

goals of shoulder dislocation surgery

A

prevent reoccurrence/complications

stop arthritic changes

maintain ROM/fix pain

81
Q

Putti-Platt

A

joint capsule attached to glenoid rim and lateral advancement of subscapularis

82
Q

Bankart

A

reattach attenuated anterior capsule to rim of glenoid fossa with heavy suture

83
Q

Bristow

A

coracoid process and muscle inserted to neck of glenoid cavity

attachment with screw in subscapularis muscle

84
Q

position for shoulder dislocation surgery

A

supine or semi-sitting with sandbag or sheet under shoulder

85
Q

rotator cuff muscles

A

supraspinatus

infraspinatus

teres minor

subscapularis

86
Q

function of rotator cuff

A

abduction of shoulder

stabilty

87
Q

3 bony articulations of shoulder girdle

A

glenohumeral

sternoclavicular
acromioclavicular

88
Q

anatomy of shoulder joint

A

pectoral girdle-scapula, clavicle

glenohumeral, sternoclavicular, acromioclavicular joints

89
Q

arthroscopy

A

visualization of joint

diagnose, conservative treatment of cartilage, ligament, synovial, bony surface defects

90
Q

frequent joints for arthroscopy

A

knee, shoulder, wrist, ankle, elbow, TMJ

91
Q

3 procedures performed via arthroscopy

A

ACL repair

repair of meniscal tear

patellar tendon graft

92
Q

irrigation for joint distention in arthroscopy

A

lactated ringers

NaCl

93
Q

epi for irrigation in arthroscopy

A

minimize bleeding in joint capsule

94
Q

pros and cons of arthroscpoy

A

pros: short stay, rehab, recovery, pain, inflammation
cons: hard to maneuver, injure articular surfaces

95
Q

ORIF

A

expose fracture to use plate, screws, pins, rods to correct

no skeletal traction

anatomic alignment obtained

96
Q

closed reduction external fixation

A

manual traction to reduce

pins, rods, k-wire to stablilize

97
Q

OR external fixation

A

open surgically to reduce

pins and rods to stabilize

98
Q

indications for external fixation

A

severe open fracture

highly comminuted closed fractures

arthrodesis

infected joint/nonunion

99
Q

intramedullary fixation

A

nails and rods driven into IM canal brings ends together for union

splint, ease pain, align for comminuted

100
Q

benefits of closed reduction IM fixation

A

less infection, soft tissue, vascular injury

prevent rotating or gliding of fragments

prevent short limbs from bone loss

101
Q

dynamic vs. static IM fixation

A

dynamic: screws in proximal OR distal fragments-bring gap close together
static: screws in proximal & distal fragments

102
Q

why use flexible IM rods for healing

A

better fixation, return to function, early ambulation, support

103
Q

what is a fracture table

A

ortho OR bed w/ attachments for positioning, traction, diagnostics (x-ray, casts)

lateral body brace, sacral rest, perineal post

104
Q

benefits of fracture table

A

attachments for position and traction

easy diagnosis

105
Q

traction

A

pulling force to maintain proper alignment

reduce fracture and pain, vascular ability

106
Q

benefits of traction

A

prevent/reduce muscle spasm

reduce fracture/dislocation

immobilize joint/body part

treat joint disorder

107
Q

skeletal vs. skin traction

A

skeletal: sterile supplies, force directly to bone with pins
skin: tape, straps, moleskin, elastic bandage

108
Q

3 common forms of traction

A

skin: Bucks for Hip’s, Russel’s for Cong. Hip dislocation, skeletal for preop long bone fx

skeletal-pin through bone to tong and rope and pulley with weight

manual-operative reduction closed or open

109
Q

lumbar laminectomy

A

remove ruptured disk (nucleus pulposis) to relieve compressed nerve

110
Q

why do lumbar lami

A

compressed nerve

111
Q

position for lami

A

prone

112
Q

spinal fusion

A

fixate pedicles of vertebrae with screws, plates, rods

113
Q

indications for spinal fusion

A

infection

neoplasm

post trauma/surgery rheumatoid arthritis

INSTABILITY

Senior Rotations (8 decks)

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