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Crozer Surgery > Surgery > Flashcards

Surgery Flashcards

1
Q

Indications for use of prophylactic antibiotic use (8)

A

1) Implants
2) Prolonged surgery
3) Trauma surgery
4) Revisional surgery
5) Immunocompromised patient
6) Extensive dissection
7) intra-operative contamination
8) endocarditis

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2
Q

Most commonly used antibiotics (3)

A

Ancef
Clindamycin (if PCN allergy)
Vancomycin (MRSA worry)

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3
Q

Indications for chest Xray (4)

A

40 years of age, smoker, any history of cardiac disease, any history of pulmonary disease

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4
Q

Indications for ordering an ECG (2)

A

> 40 years of age, any history of cardiac disease

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5
Q

Most common time post op for myocardial infarction

A

Day 3

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6
Q

How long should elective surgery be delayed following an MI or CABG

A

6 months

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7
Q

What should be obtained prior to surgery on a patient with Rheumatoid

A

cervical spine x-ray

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8
Q

When should aspirin be d/c prior to surgery

A

7 days due to irreversible binding to platelets

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9
Q

When should NSAIDs be d/c prior to surgery

A

3 days due to reversible binding to platelys

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10
Q

When should heparin be d/c prior to surgery

A

8 hours

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11
Q

When to d/c coumadin prior to surgery

A

3-4 days

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12
Q

What should INR be for elective surgeries

A

<1.4

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13
Q

Order of wound graft closure (4)

A

1) direct closure
2) graft
3) local flap
4) distant flap

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14
Q

Stages of skin graft healing (4)

A

1) Plasmatic
2) Inosculation of blood vessels
3) Re-organization
4) re-innervation

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15
Q

AO principles

A

1) anatomic reduction
2) rigid internal fixation
3) preservation of blood supply
4) early ROM

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16
Q

What are steps necessary for inserting a fully threaded screw (6)

A

1) overdrill near cortex
2) underdrill through far cortex
3) countersink
4) measure
5) tap
6) screw

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17
Q

Amount of screw to pass the far cortex

A

1.5 threads

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18
Q

Purpose of tapping

A

to create a path for the screw threads

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19
Q

Why countersink screw

A

Prevents stress risers and soft tissue irritation .

Provides even compression from screw head

20
Q

Describe a mini fragment screw

A

Screw sizes of: 1.5, 2.0, 2.7

All fully threaded cortical screws

21
Q

What are the differences between cortical and cancellous screws

A

Cortical has smaller pitch

Cortical has smaller rake angle

Cortical has smaller difference between thread diameter and core diameter

22
Q

Describe a Malleolar screw

A

For fixation of medial malleolus, partially threaded, same thread profile and pitch as cortical screw, trephedine self cutting tipping

23
Q

What screw has a fluted tip

A

self-tapping

24
Q

Overdrill, underdrill and countersink for 1.5 mini fragment(fully threaded)

A

overdrill- 1.5
Underdrill- 1.1
Countersink 1.5

25
Q

Overdrill, underdrill and countersink for 2.0 mini fragment (fully threaded)

A

Overdrill- 2.0
Underdrill- 1.5
Countersink- 2.0

26
Q

Overdrill, underdrill and countersink for 2.7 mini fragment (fully threaded_

A

Overdrill- 2.7
Underdrill- 2.0
Countersink- 2.7

27
Q

Overdrill, underdrill and countersink for 3.5 small fragment

A

overdrill 3.5
underdrill 2.5
countersink- 3.5

28
Q

Overdrill, underdrill and countersink for 4.0 small fragment (fully thread)

A

overdrill 4.0
underdrill 2.5
countersink 4.0

29
Q

Overdrill, underdrill and countersink for 4.0 small fragment (partial thread)

A

overdrill- 4.0
underdrill- 2.5
countersink 4.0

30
Q

Overdrill, underdrill and countersink for 4.5 large fragment. Malleolar or non (same measurements )

A

Overdrill 4.5
underdrill 3.2
countersink 4.5

31
Q

Overdrill, underdrill and countersink for 6.5 large fragment (partial or fully threaded)

A

overdrill 6.5
underdrill 3.2
countersink 6.5

32
Q

What are steps for inserting a 4.0 cannulated screw (7 steps)

A

1) insert 1.3mm guide pin to far cortex
2) Measure
3) drill near cortex with 4.0 cannulated bit
4) Drill far cortex with 2.7 cannulated bit
5) tap
6) countersink
7) screw

33
Q

What is a herbert screw

A

Headless screw- can be inserted through articular cartilage.

Threaded portion proximally and distally with smooth portion in between.

Proximal portion has tighter pitch for compression

34
Q

Reese screw

A

Headless- create compression through arthrodesis.

Proximal threads run clockwise, and distal threads run counterclockwise.

35
Q

What are K-wire sizes and widths in millimeters

A

.028 size- .6 width
.035 size- .9 width
.045 size- 1.2 width
.062 size- 1.6 width

36
Q

What are the K-wire sizes and their appropriate caps

A 
Young Boys Wear Green
.028-yellow
.035-blue
.045-white
.062-green
37
Q

What are sizes for Steinman pins

A

5/64-12/64 (11/64 is skipped)

38
Q

Different types of plate fixation (4)

A

Compression, Neutralization, Anti-glide, Buttress

39
Q

Characteristics of compression plate (4)

A

1) Provides axial compression of fracture
2) Pre-bend plate
3) Eccentric drilling of hole adjacent to fracture, remaining holes drilled centrally
4) Place plate on tension side of bone

40
Q

Characteristics of Neutralization plate (3)

A

1) Protects against shearing, bending and torsional forces at the fracture site
2) interfragmental compression obtained by lag screws
3) all holes drilled centrally

41
Q

Characteristics of Anti- glide

A

neutralization plate placed on the posterior aspect of the fibula

42
Q

Characteristic of Buttress plate (2)

A

1) Maintains alignment of unstable fracture fragments

2) no interfragmental compression

43
Q

Which side of a fracture should the plate be placed

A

tension side

44
Q

Is tension side of a met on the dorsal or plantar aspect?

A

Plantar aspect

45
Q

What is a locking plate

A

Plate in which threaded screws are secured into threaded plate holes

Does not rely on bone for stability, but rather forms a fixed- angle construct

Good for osteoporotic, comminuted fractures, or revision surgeries

46
Q

Define Hooke law

A

For a material under load, strain is proportional to stress

47
Q

What is Young Modulus

A

after a load is removed, the material springs back to its original shape.

The resulting slope represents the stiffness of a material

Crozer Surgery (16 decks)

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