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Orthopedic Surgery
Surg Tech Orthopedic
| Question | Answer |
|---|---|
| Compact bone | "cortical bone - hard, dense tissue of bne that surrounds the marrow cavity |
| Cancellous bone | "spongy bone" - found at ends of bone and lining the medullary marrow canal |
| When the body detects low Ca, _______ are stimulated by _______ _______ to break down bone tissue and increase reabsorption of Ca from bones into blood | osteoclasts; parathyroid hormone |
| Long bones | bones of arm (humerus), legs (femur), hands, and feet (phalanges) |
| A partial fracture in a pediatric patient would be termed a ______ fracture | greenstick |
| A complete fracture that penetrates the skin is a(n) _____ or open fracture. | compound |
| If a fracture has more than two pieces, it usually occurs due to a direct crushing force and is called a _______ fracture. | comminuted |
| The patient slid off the roof, compressing the ends of the tibia into each other, creating a(n) ________ fracture. | impacted |
| Sacs that contain synovial fluid and act as lubrication to aid in joint movement | bursa |
| Epiphyseal plate is aka the _____ _____ | growth plate |
| Examples a flat bones | ribs, scapula, sternum, cranial bones |
| Examples of irregular bones | bones of skull and face and vertebrae |
| Sesamoid bones | "round bones" - found within tendons ex: patella |
| 3 general groups of joints | immovable, slightly movable, freely movable |
| Immovable joints | "synarthrosis" ex: suture lines of cranial bones |
| Slightly movable joints | "amphiarthrosis" ex: cartilage that connects vertebrae and disk of cartilage (symphysis pubis) |
| Freely movable joints | "diarthrosis" "synovial joints" ex: knee, elbow |
| Ball-and-socket joints | widest ROM; movement in all planes ex: shoulder, hip |
| Condyloid joints | allows for movement in only one plane with some lateral movement ex: TMJ |
| Gliding joints | allow side-to-side and twisting movements ex: carpals of wrist |
| Hinge joints | allows movement in only one plane ex: elbow |
| Pivot joints | allow only a rotational movement around a central axis ex: proximal end of radius |
| Saddle joints | allow movement in a variety of planes ex: trapezium of wrist with metacarpal of thumb |
| Osteochondritis dissecans | "joint mice" small piece of cartilage and bone separate from end of a bone due to a loss of blood supply, and the pieces become lodged within the joint space, causing instability |
| Valgus | outward turning |
| Varus | inward turning |
| Genu valgum | "knock-kneed" knees are in close position and space between ankles is inc |
| Genu varum | "bow-legged" space between knees is abnormally inc and lower legs bow inwardly |
| Normal process of bone healing | 1. inflammation 2. cellular proliferation 3. callus formation 4. ossification 5. remodeling |
| Inflammatory stage | begins at time of injury and lasts about 2 days - hematoma is formed |
| Cellular proliferation | begins approx 2nd day - macrophages debride area and allow for formation of a fibrin mesh that seals the approximated edges of fracture site |
| Callus formation | lasts 3-4 weeks - soft tissue growth continues and bone fragments grow toward one another osteoblasts form a matrix of collagen that invades the periosteal callus, bridging the fracture site and uniting the two ends of bone |
| Ossification stage | beings after 2-3 weeks and can last 3-4 months - matrix of osteoblasts calcifies |
| Remodeling stage | maintenance state of normal bone |
| Distraction | bone fragments that are separated so that bone contact does not occur |
| Delayed union | inc in healing time for fractures |
| Nounion | when fractured bone ends do not unite |
| Malunion | when the fracture heals in a position that does not resemble the original anatomical form of the bone and alters the mechanical function of the bone |
| 2 most frequently used types of casting material | fiberglass and plaster |
| When is a fracture table used | hip fracture, femoral nailing |
| Unaffected leg is placed in a boot that's (abducted/adducted) to allow for c-arm to be positioned over the injured site | abducted |
| What is used to exsanguinate an extremity? | Ace or Esmarch bandage |
| Tourniquets should not be applied for longer than ______ for upper extremities or ________ for lower extremities | 1 hr; 1.5 hrs |
| 3 types of traction | manual, skin, or skeletal |
| CPM | continuous passive ROM machine |
| What is a CPM used for? | aids in dec pain and swelling at operative site |
| Type of suture used to repair ligaments, tendons, muscles, and bone | nonabsorbable |
| Type of suture used to close periosteum | absorbable |
| Polymethyl methacrylate (PMMA) | bone cement - used during total joint arthroplasty |
| Doubly curved bone that acts as a brace for scapula | clavicle |
| Where does the clavicle articulate? | medially with manubrium and laterally with acromion process of scapula |
| AC joint | acromioclavicular joint - articulation between lateral end of clavicle and flattened, small process at border of acromion |
| Why is a shoulder scope performed? | removal of loose bodies, bursectomy, rotator cuff repairs, labral tear repair, and repair of impingement syndrome (dec ROM) |
| What tendon is examined for injury during a shoulder scope? | biceps tendon |
| Biggest complication of acromioplasty | loss of anterior deltoid function caused by axillary nerve injury or detachment of deltoid from acromion (biceps tendon rupture) |
| Primary reason for shoulder arthroplasty | chronic pain from glenohumeral arthritis with significant loss of ROM and joint function |
| Complications of arthropalsty | narrowing of joint space, osteophyte formation, and cysts |
| Screw with a wider thread and wider-spaced threads used in epiphyseal bone | cancellous screw |
| Screw with closely spaced shallow threads for dense bone found in the diaphysis | cortical screw |
| Screw that is partially threaded to compress bone between the screw head and the distal threads | lag screw |
| Screw with hollow central shaft, usually inserted over a guide wire or pin | cannulated screw |
| Pin segments in larger diameters used for skeletal traction or as guide pin for screws | Steinmen |
| Placed in the intramedullary shaft for fractures of long bones—early ambulation | pins or rods |
| Characterizations of total knee arthroscopy | unicompartmental, bicompartmental, tricompartmental |
| 3 bones of pelvis | ilium, ischium, pubis |
| Which nerve is identified and protected during a THA? | sciatic |
| Antegrade | come from above (periformus muscle entry) |
| Retrograde | come from below ( intercondylar notch entry) |
| Instrument required when using cannulated nails | guide rod |
| What tendon passes down bilaterally to the patella and inserts on the upper tibia? | proximal quadriceps femoris |
| Posterior cruciate ligament (PCL) | attached to posterior midline surface of tibia and passes anteriorly, attaching to medial condyle of femur |
| Purpose of PCL | prevents femur from sliding anteriorly on tibia |
| Anterior cruciate ligament (ACL) | attached to posterior lateral condyle of femur and to a notch in the midline of tibia between tibial condyles |
| Purpose of ACL | prevents hyperextension of knee, limits the medial rotation of femur |
| Larger and stronger bone of lower leg that holds body weight | tibia "shinbone" |
| Distally, the tibia articulates with the _____ bone to form part of the ankle joint | talus |
| Laterally, the tibia articulates with ____ | fibula |
| Arthrodesis is the fusion of which joints? | subtalar, calcaneocuboid, talonavicular joints |
| The Achilles' tendon connects the _____, _____, and _____ muscles to the ______. | gastrocnemius, soleus, plantaris; calcaneus |
| Thompson "squeeze test" | calf is squeezed just distal to its maximal diameter while pt is prone to cause plantar flexion of ankle joint - test is + for tendon rupture when no flexion occurs |
| Hallux valgus | bunion |
| Techniques used to treat hallux valgus | Aken, Chevron, McKeever, Keller, McBride |
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