4: Musculoskeletal System > Chapter 71 Arthroscopy > Flashcards

Chapter 71 Arthroscopy Flashcards

(50 cards)

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1
Q

List 5 advantages of arthroscopy over open sx

A
  1. Decreased morbidity
  2. Faster recovery
  3. Reduced complication rate
  4. Improved functional outcome
  5. Reduced GA/sx time
  6. Reduced hospitalization time
  7. Improved client perception
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2
Q

What three factros should be included of arthroscope used?

A
  • Diameter
  • Distal lens angle
  • Long vs short
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3
Q

Label the diagram

A

a) Eyepiece
b) Light post
c) Telescope

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4
Q

What 3 bulbs are used in arthroscopy?

Which is preferred and why/

What is the disadantage of this bulb

A
  • Xenon, Halogen, metal halide
  • Xenon preferred as better light intensity and colour temperature. Also more economical.
  • Downside of Xenon is that they fail suddeny i.e. no dimming.
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5
Q

3 benefits of joint irrigation during arthroscopy

A
  1. Joint distension –> bigger working space
  2. Tamponade of bleeding vessels
  3. Flushed out debris
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6
Q

What is recommended irrigation pressure in joint

A

60 mmHg

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7
Q

Name the instruments

A

a) locking arthroscopic grasping forceps
b) non-locking arthroscopic grasping forceps

(ideally without teeth)

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8
Q

Name the instrument

A

Arthroscopic punch forceps

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9
Q

Name the instruments

A

a) Hook knife
b) Meniscal push knife
c) Bayonet knift
d) Handle

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10
Q

What are these instruments?

Name the types

A

Arthroscopic power shavers

a) Radial shaver
b) Burr
c) Aggressive cutter

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11
Q

For stifle fat pad removal, what mode and speed should aggressive shaver be used?

A

Oscillating

1500 rpm

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12
Q

What is primary collagen type of joint capsule

A

Type 1

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13
Q

What is optimal temperature range of radiofrequency probe?

A

65 - 75ºC

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14
Q

Radiofrequency ablation leads to initial weakening of tissues. How long for?

What % shrinkage is usually seen clinically?

A

6 - 12 weeks

25%

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15
Q

What effect do local anaesthetics have on chondrocytes?

A

Chondrotoxic

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16
Q

What is infection rate post-arthroscopy?

A

<1%

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17
Q

What type of scope is used in the shoulder?

A

2.7mm, 30º, long

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18
Q

Mark portal positions for shoulder arthroscopy

What 2 vessels and 2 nerves have to be avoided

A
  1. Egress
  2. Arthroscopy
  3. Instrument
  4. Instrument for biceps tendon access
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19
Q

Describe the landmarks for shoulder portals

A

Arthroscope portal: Directly distal to actomion (and 2 mm cranial)

Egress: Midway along craniocaudal margin of greater tubercle

Instrument portal: Typically 2cm caudal and slightly distal to arthroscope portal

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20
Q

Label the diagram

A
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21
Q

Label the anatomic structures (shoulder arthroscopy)

22
Q

What structures should be inspected when performing shoulder arthroscopy (from lateral approach)

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A
  • Medial glenohumeral (collateral) ligament
  • Subscapularis tendon
  • Joint capsule
  • Biceps tendon
  • Supraglenoid tubercle
  • Glenoid
  • Humeral head
  • Caudal joint pouch
23
Q

Comment on this structure at origin of biceps brachii tendon

Study These Flashcards
A

Normal fibrous cuff

24
Q

Describe the landmarks for portal insertion in elbow arthroscopy

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A

Arthroscope portal: 1-2cm distal to medial epicondyle, and slightly caudal

Egress portal: Parallel with olecranon, angled distomedially

Instrument portal: Just caudal to medial collateral ligament

25
Label the diagram
26
List anatomic structures that should be evaluated during elbow arthroscopy
* Medial and lateral coronoid * Radial head * Humeral condyles * Trochlear notch * Anconeus * Medial collateral * Annular and oblique ligaments
27
Name the anatomic structures (elbow arthroscopy)
28
Comment on the image (elbow)
Normal trochlear notch with absence of cartilage (think image is a funny angle)
29
What scope is used in the carpus?
1.9mm, 30º (whatever length)
30
Label the diagram
(can place either dorsolateral or dorsomedail arthroscope portal)
31
What anatomic structures can be visualised during carpus arthroscopy?
* Distal articular surface of radius * Intermedioradial carpal bone * Palmar radiocarpal ligament * Accessory carpal bone * Distal articular surface of ulna * Ulnar carpal bone * Palmart ulnocarpal ligament * Synovium
32
Label the anatomic structures (carpus arthroscopy)
33
What scope is used for hip arthroscopy?
2.7mm, 30º, long
34
Label the diagram and scope portals
1. Arthroscope portal 2. Instrument portal (text actually described 3 o'clock position - they say use egress position) 3. Egress
35
What anatomic structures should be visualised during hip arthroscopy?
* Acetabulum * Teres ligament * Femoral head * Acetabular labrum * Transacetabular ligament * Joint capsule
36
Name anatomic structures visualised (hip arthroscopy)
37
What scope is used in stifle joint?
2.7mm, 30º, short
38
Label the diagram and portal sites
1. Arthroscope portal 2. Egress 3. Instrument portal (N.B. can do 2 portal technique without egress portal)
39
What structures should be viewed during stifle arthroscopy?
* Cranial and caudal cruciate ligaments * Medial and lateral menisci * Medial and lateral collaterals * Tendon of origin of long digital extensor * Underside of patella and trochlear groove * Medial and lateral femoral condyles * Intercondylar eminence
40
Label the anatomic structures (stifle arthroscopy)
41
List 3 methods to improve visualisation in stifle arthroscopy
* Manually (induce cranial tibial translation and varus/valgus) * Intra-articular stifle distractor * Extra-articular stifle distractor
42
List 4 types of intra-articular stifle distractor
* Ventura stifle thrust level * Canine stifle distractor * Wallace knee retractor * Gelpi-like stifle distractor (VI - our TPLO one)
43
Name the instruments
44
What are the landmarks for pin insertion using Leipzig stifle distractor?
* Tibia: Caudal point on line perpendicular to long axis of tibia * Femur: Mid-way on line connecting patella apex and fabella Increase likelihood of diagnosis meniscal tear x1.9
45
What scope is used in tarsus?
1.9mm, 30º
46
Through what approaches can tarsal arthroscopy be performed? Which is usually used?
Dorsal or plantar Plantar used most commonly
47
Label the diagram
48
What structures can be evaluated during tarsal arthroscopy?
* Distal articular surface of tibia * Articulation of tibia, fibual, talus * Trochlea of talus * Medial and lateral collaterals * Synovium * Tendon of lateral digital extensor
49
What % of ROM comes from the tibiotalar joint?
95%
50
Name the anatomic structures (tarsal arthroscopy)
4: Musculoskeletal System
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