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Surgical Procedures I > Test 4 > Flashcards

Test 4 Flashcards

1
Q
A

Freer Elevator

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2
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Key elevator

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3
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Cobb Elevator

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4
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Chandler Elevator

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5
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Hohmann Retractor

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6
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Cobra Retractor

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7
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Bennett Retractor

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8
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Charnley Retractor

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9
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Bone Hook

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10
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Lambotte Osteotome

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11
Q

What is the difference between and osteotome and a Chisel?

A
  • Osteotome has a tapered tip
  • Chisel angles only on one side
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12
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Spinal Gouge

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13
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Leksell Rongeur

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14
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Stille Rongeur

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15
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Bone Cutter

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16
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Wire Cutter

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17
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Lane Bone Holding Clamp

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18
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Verbrugge

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19
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Lowman Bone Holding Clamp

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20
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Brun Curette

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21
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Rasp (Putti-Platt)

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22
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Rasp

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23
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Mallet

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24
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Bone Tamp

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25
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Chuck Key

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26
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Gigli Saw

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27
Q

Tenorrhaphy

A
  • Suture/repair of a tendon
  • No anchoring to bone, no hardware
  • suture of choice: braided, strong, non- absorbable
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28
Q

Tenodesis

A

reattachment of a tendon to the bone

need hardware

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29
Q

Fasciectomy

A
  • removal of fascial tissue to relieve pressure in an extremity
  • compartment syndrome–A painful and dangerous condition caused by pressure buildup from internal bleeding or swelling of tissues– True emergency
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30
Q

Hallux Valgus Repair

A

Bunionectomy

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31
Q

Triple Arthrodesis

A
  • Fusion of the talocalcaneal, talonavicular & calcaneocuboid joints
  • fusing 3 different joints (foot surgery)
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32
Q

Abduction

A

Movement of extremity away from midline of bodyabdu

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33
Q

Adduction

A

movement of an extremity toward the midline of the body

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34
Q

circumduciton

A

Movement of a body part in a circular motion

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35
Q

Eversion

A

being turned or rotated outward

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36
Q

Inversion

A

being turned inward or inside out

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37
Q

Extension

A

extending body parts into a straight line from either side of a joint

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38
Q

Flexion

A

bending the parts of a limb on either side of a joint closer together

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39
Q

Dorsiflexion

A

Bending the foot upward toward the shin

40
Q

Plantar Flexion

A

Bending the foot downward away from the shin

41
Q

Hyperextension

A
  • Straightening of a body part beyond normal resting extended position
  • sometimes have to do total knee because of this
42
Q

External Rotation

A

Turning a joint outward or away from center

shoulder

43
Q

Internal Rotation

A

Turing a joint inward or nearer to the center

shoulder

44
Q

Pronation

A

Turning a part so that it faces downward

45
Q

Supination

A

Turning a part so that it faces upward

46
Q

Rotation

A

the process of turning around an axis

47
Q

Varus/Varum

and

Varus/Valgum

A
  • describes what’s happening after a joint
  • Varus think the pig can run through legs
  • Valgum think stick of gum stuck between knees
48
Q

Osteoporosis

A
  • normal process of losing bone density
    • lack of use, lack of weight bearing
49
Q

Osteomalacia

A
  • softening of bone due to loss of minerals
    • sometimes diet
    • sometimes genetics
50
Q

Osteogenesis Imperfecta

A

defective synthisis of Type I colagen. A lot of mineral, bones brittle

51
Q

osteomyelitis

A
  • infection in bone
  • can go systemic quickly
52
Q

Chondromalacia

A
  • softening of cartilage
  • pretty common
53
Q

Bone types

A
  • Long
    • Humerus
    • Tibia
  • Short
    • Carpals
    • Sesamoid-special type that forms within a tendon. Vary in number per person.
    • Patella
  • Flat
    • Parietal
    • Sternum
    • Illium- like for bone grafts
  • Irregular
    • Vertebra
54
Q

Joints

A
  • synovial fluid- filtrate of blood helps lubricate. oily greasy
  • ligaments give strength
55
Q

Bone Anatomy

56
Q

Layers of Bone

A
  • Periosteum- thin layer
  • cortical bone- shows up more on x-ray
  • cancellous bone- inner matrix of bone
57
Q

Cancellous vs. Cortical Bone Structure

A
  • Cancellous
    • More Organic material
    • Matrix (putty)-morter for bricks
    • Blood cells made in this bone
      • Younger-long and flat
      • Older-replaced with fat (yellow marrow)
      • Flat bones continue to create blood
    • curette
  • Cortical
    • More inorganic material
    • Hydroxyapatite
      • Makes bone hard
      • Sea coral-bone graft fillers
    • Minerals
    • Major collection of tightly gathered cells on outer bone.
    • rounguer
58
Q

Bone Growth

A
  • How is bone stock determined?
    • Amount of load
    • Form and mass follow function
  • Osteocytes- immature bone cells wait for something to happen
    • mature into osteoblast or clasts
  • Osteoblasts
    • Need bone
    • Blasts grow and mature
  • Osteoclasts
    • Excess bone
      • bone spurs that irritate, body tries to heal itself
    • Clasts reabsorb bone
59
Q

Diagnostic Testing

A
  • X-ray- most common with MRI
  • CT
  • MRI- good image of soft tissue
  • Bone Scan- radioactive isotope injected into pt. fast multiplying cells light up- cancer, bone healing, fracture that should be healing but has stalled
  • Arthography
    • simple x-ray with contrast, radiopaque dye into joint space
60
Q
A
  • Closed fracture
  • open fracture
    • more active bleeding exposed to the outside
61
Q
A
  • Impacted
    • telesopes one peice inside of other
    • car accident
    • fall of building
  • Greenstick
    • kids break partially
62
Q
A
  • Pathologic
    • disease process–cancer, infection, causes fracture
  • Transverse-straight across
63
Q

Oblique fracture vs. spiral

A
  • oblique at an angle, spiral is a twisted break
64
Q
A
  • much longer fracture along length of bone
66
Q

Bone Repair Options

A
  • Depends on:
    • Type of bone
      • Cortical
      • Cancellous
  • Casting
  • Splinting
  • Closed Reduction/Percutaneous pinning
  • Plating techniques
    • Screw types
    • 1/3 Tubular
    • DCP
    • Locking
  • IM Rodding
  • External Fixation– stab pins through skin
67
Q

Purchase?

A

how well a screw tightens

68
Q

Casting vs. Splinting

A
  • Cast is all the way around
  • Splint is used most of the time in the OR it can allow for swelling
69
Q

Factors Affecting Healing

A
  • Nature of injury
  • Degree of bridge formation
  • Amount of bone loss
  • Type of bone injured
  • Degree of immobilization
  • Local infection
  • Local malignancy
  • Bone necrosis
70
Q

Unions

A
  • Primary
    • everything happens as it should
  • Malunion
    • healing happened in the right timeline except something might be in wrong with direction could be pt. non compliance
  • Delayed Union
    • took a longer time to heal, maybe infection, disease, not as healthy pt.
  • Nonunion
    • keeps moving, won’t heal, body gives up
71
Q

Preparation ORIF Radius

A
  • Positioning
    • Supine
    • Unsterile tourniquet
  • Prep
    • Fingers to just below tourniquet circumferentially.
  • Draping
    • 3/4 sheet
    • Stockinette
    • Hand and Arm Sheet
    • Exsanguinated
    • Tourniquet raised
72
Q
A

ligament of teres runs through the Fovea

73
Q

Pathologies for ORIF Hip

A
  • Arthritis
  • Fractures
  • Avascular Necrosis– not accident related
    • Circumflex artery- feeds femoral head
    • May occur in other bones as well
74
Q

Options for the hip

A
  • Compression Hip
  • Femoral Head Replacement
  • IM Nailing
    • Antegrade- come in from the top– fracture table
    • Retrograde– fracture more distal, go through knee on regular table
  • Percutaneous pinning
    • for someone whos not as weight bearing or fracture not as bad
75
Q

ORIF Hip: Compression Screw

A
  • Position
    • Supine on Fracture table
  • Prep
    • Iliac Crest to knee; umbilicus down to groin, medially and tableside laterally.
  • Instrumentation
    • Bone Set
    • Compression Hip instruments and implants
    • Large Drill
  • Shower curtain drape
76
Q
A

chick table

77
Q
A

hana table

78
Q

difference between reaming and drilling?

A
  • reaming is a slower speed
79
Q

ORIF Hip: Femoral Head Replacement

A
  • Position
    • Lateral/Supine
  • Prep
    • Umbilicus down to foot
  • Instrumentation
    • Large Bone Set
    • Hip Set
    • Endoprosthesis instruments
      • Trials
      • Templates for Head
    • Large Saw and Drill Set
80
Q

Total Hip Arthroplasty vs. Hemiarthroplasty

81
Q

Pathology and Common Procedures of hand

A
  • Trigger Finger
    • Trigger Finger Release
  • Game keeper’s Repair
  • Carpal Tunnel Syndrome
    • Carpal Tunnel Release
  • De Quervains /intersection Syndrome
  • Dupuytren’s Contracture
  • Ganglion Cyst
82
Q

Carpal Tunnel Release

A
  • Volar incision from proximal palm to the crease of the wrist across the wrist joint
  • Deep transverse carpal ligament is divided
  • Median nerve is visualized
  • Wound is closed.
83
Q

Ulnar Nerve Transposition

A
  • Unlar nerve can be damaged after trauma
    • Neuritis
  • Procedure
    • Incision on lateral aspect of elbow
    • Fascia and flexor carpi ulnaris muscle are divided
    • Nerve is freed
    • Nerve is drawn anteriorly and placed deep into brachialis flexor muscle origin
    • Wound is irrigated and closed
84
Q

Triple arthrodesis

A
  • Pathology
    • Clubfoot
    • Poliomyelitis
    • Rheumatoid arthritis
  • Procedure
    • Capsules incised to obtain mobility
    • Osteotome, saw or rasp used to remove articular surfaces
    • Steinmann pins, staples or screws are used for fixation
    • Wound is closed
85
Q

Bunionectomy

A
  • Hallux Valgus
  • Structural defect of the foot
86
Q

Achilles Tendon Repair

A
  • Prone
  • if the tear is in the tendon
    • various suture techniques will be used according to surgeons preference
    • Most likely a non-absorbale, braided suture
      • ethibond
      • fiberwire
      • orthocord
  • if tenson is torn from bone
    • anchos will be needed
89
Q

Rotator Cuff

90
Q

Pathologies and Procedures shoulder

A
  • Rotator Cuff Tear
    • Open RCR
    • Arthroscopic RCR
  • Recurrent Anterior Dislocation
    • Bankhart
    • SLAP Repair
91
Q

Pathologies of knee

A
  • Injury
    • Meniscal Tear
    • ACL tear
    • Patella Fracture
  • Osteoarthritis
  • Varus & Valgus
  • Chondromalacia
92
Q

Common Procedures knees

A
  • Arthroscopy
    • Menisectomy / Meniscal Repair
    • Chondroplasty
    • Lateral Release– patella pulled too far
  • Arthroscopic ACL Repair
  • Patella tendon graft- pt. or cadaver
    • Autologus
    • Cadavaric- dont thaw until you know for sure
  • Hamstring Graft- from pt.
  • Patellar Repair / Patellectomy
  • Tibial Osteotomy with Plating
  • Arthroplasty
    • Total Knee Artroplasty
      • Distal Femoral Resurfacing
      • Anterior Femoral Cut
      • Posterior Femoral Cut
      • Anterior Femoral Chamfer
      • Posterior Femoral Chamfer
      • Proximal Tibial Resurfacing
      • Patellar Resurfacing
  • Unicompartmental Knee Replacement
93
Q

Cuts of a Total Knee

A
  1. Distal Femoral Resurfacing
  2. Anterior Femoral Resurfacing
  3. Posterior Femoral Resurfacing
  4. Anterior Femoral Chamfer
  5. Posterior Femoral Chamfer
  6. Proximal Tibial Resurfacing
  7. Patellar Resurfacing
94
Q

AKA/BKA

A
  • Determine level of amputation
  • Incisions marked
    • Long posterior flap for BKA
    • Equal flaps for AKA
  • Incision is made through skin, muscle and soft tissue
  • Bone is cut with saw.
    • Beveled with rongeur, rasp or saw
  • Stump is irrigated
  • Fascia is closed
  • Skin is closed.
95
Q

Bone Cancer

A
  • Benign Neoplasms
    • Osteoma
    • Chondroma
    • Osteochondroma
    • Giant Cell Tumor
  • Malignant
    • Osteosarcoma
    • Ewing’s Sarcoma
    • Chondrosarcoma

Surgical Procedures I (5 decks)

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