Surgical Procedures Review Flashcards
***What is the difference between a closed and open reduction?
-Closed reduction – nonsurgical procedure with fractured fragments realigned by manipulation
- Open reduction – surgical procedure that includes using screws, plates and rods
- ORIF {Open reduction internal fixation}
What is operative cholangiography?
-Performed during biliary tract surgery
-Bile is drain and ducts are filled with contrast (6 to 8 ml)
-Common bile duct through a needle, catheter
or T-tube
***What is the purpose for performing an operative cholangiogram?
- Checking for patency of bile ducts
- Functional status of sphincter of hepatopancreatic ampulla
- Stones, neoplasms, strictures or dilation of ducts
***Where is the C-Arm placed during an operative cholangiogram?
- Center C-arm in the PA projection over right side of abdomen below rib line
- Tilt patient to the left or Trendelenburg position for flow of contrast
Where is the C-arm positioned for line placement or for a bronchoscopy?
C-Arm enters sterile field perpendicular to patient or side of patient (PA projection)
What is the purpose of using the C-Arm for line placement or for a chest bronchoscopy?
- Line placement – to determine point of insertion and follow catheter to verify position and identify any kinks
- Bronchscopy – perform biopies, insert stents and for dilation purposes
What does ACDF stand for and what is the purpose of the procedure?
- Anterior Cervical Diskectomy & Fusion
- Treats nerve roots or spinal cord compression by decompressing & stabilizing corresponding vertebrae:
- Disc is completely removed as well as disc material
- Intervertebral foramen is enlarged
- Remaining space filled with bone graft
- Bone graft joining vertebrae = fusion
What is a laminectomy?
-Performed to relieve pressure on spinal cord or nerve roots
-Posterior arch is removed
-Spinal fusion depends on # of vertebrae
removed
-Interbody fusion cage
-Titanium cages filled with bone inserted
between vertebral bodies to maintain space
height & fuse joint
Why is the rainbow position for the C-Arm used when performing a c-spine procedure?
Used for larger patients if unable to raise C-Arm to obtain anatomy in center of beam
How are hip fractures classified?
- According to anatomic location
- Femoral neck, intertrochanteric and subtrochanteric fractures
What is a hip ORIF?
- A long fixator is placed on lateral side of fractured hip and secured with screws through fixator into femoral head and neck
- Smaller screws are placed below trochanters that transverse shaft of femur
What is the procedure for a hip fracture surgery?
- Special fracture or orthopedic table for traction & fluoro during procedure
- Shower curtain
- Fracture is reduced through traction and manipulation
- Patient is supine with legs abducted and affected leg in traction
- Radiographer is positioned between patient’s legs
Explain a total hip replacement.
- Degenerative disease or chronic trauma to femoral head and/or acetabulum
- Prosthetic hip is utilized
- Prosthetic devices vary in composition, design & components
- Postoperative images – include entire device
When a nail or rod is inserted into the intramedullary canal for a femur to reduce a fracture of the shaft, what approaches might the surgeon utilize?
- Antegrade {greater trochanter or proximal end of long bone}
- Retrograde {popliteal notch or distal end of long bone}
Explain the femur nail procedure.
- Fracture table is utilized
- Bone reamer is used to widen intramedullary cavity
- Guidewires inserted
- C-Arm used to verify location of guidewires & fracture alignment along with any screws used
- Center C-Arm over fx site during canal reaming to ensure fx remains reduced
- Holes should appear round and not oblong
- Magnification
- Tilt or rotate C-Arm
