Surgical Procedures I > Test 4 > Flashcards

Test 4 Flashcards

(95 cards)

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1
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Freer Elevator

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Key elevator

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Cobb Elevator

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Chandler Elevator

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Hohmann Retractor

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Cobra Retractor

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Bennett Retractor

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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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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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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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Chuck Key
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Gigli Saw
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Tenorrhaphy
* Suture/repair of a tendon * No anchoring to bone, no hardware * suture of choice: braided, strong, non- absorbable
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Tenodesis
reattachment of a tendon to the bone need hardware
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Fasciectomy
* 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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Hallux Valgus Repair
Bunionectomy
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Triple Arthrodesis
* Fusion of the talocalcaneal, talonavicular & calcaneocuboid joints * fusing 3 different joints (foot surgery)
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Abduction
Movement of extremity away from midline of bodyabdu
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Adduction
movement of an extremity toward the midline of the body
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circumduciton
Movement of a body part in a circular motion
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Eversion
being turned or rotated outward
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Inversion
being turned inward or inside out
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Extension
extending body parts into a straight line from either side of a joint
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Flexion
bending the parts of a limb on either side of a joint closer together
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Dorsiflexion
Bending the **foot** upward toward the shin
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Plantar Flexion
Bending the **foot** downward away from the shin
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Hyperextension
* Straightening of a body part beyond normal resting extended position * sometimes have to do total knee because of this
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External Rotation
Turning a joint outward or away from center shoulder
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Internal Rotation
Turing a joint inward or nearer to the center shoulder
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Pronation
Turning a part so that it faces downward
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Supination
Turning a part so that it faces upward
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Rotation
the process of turning around an axis
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Varus/Varum and Varus/Valgum
* describes what's happening after a joint * Varus think the pig can run through legs * Valgum think stick of gum stuck between knees
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Osteoporosis
* normal process of losing bone density * lack of use, lack of weight bearing
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Osteomalacia
* softening of bone due to loss of minerals * sometimes diet * sometimes genetics
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Osteogenesis Imperfecta
defective synthisis of Type I colagen. A lot of mineral, bones brittle
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osteomyelitis
* infection in bone * can go systemic quickly
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Chondromalacia
* softening of cartilage * pretty common
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Bone types
* 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
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Joints
* synovial fluid- filtrate of blood helps lubricate. oily greasy * ligaments give strength
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Bone Anatomy
*
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Layers of Bone
* Periosteum- thin layer * cortical bone- shows up more on x-ray * cancellous bone- inner matrix of bone
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Cancellous vs. Cortical Bone Structure
* 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
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Bone Growth
* 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
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Diagnostic Testing
* 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
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* Closed fracture * open fracture * more active bleeding exposed to the outside
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* Impacted * telesopes one peice inside of other * car accident * fall of building * Greenstick * kids break partially
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* Pathologic * disease process--cancer, infection, causes fracture * Transverse-straight across
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Oblique fracture vs. spiral
* oblique at an angle, spiral is a twisted break
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* much longer fracture along length of bone
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Bone Repair Options
* 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
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Purchase?
how well a screw tightens
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Casting vs. Splinting
* Cast is all the way around * Splint is used most of the time in the OR it can allow for swelling
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Factors Affecting Healing
* Nature of injury * Degree of bridge formation * Amount of bone loss * Type of bone injured * Degree of immobilization * Local infection * Local malignancy * Bone necrosis
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Unions
* 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
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Preparation ORIF Radius
* Positioning * Supine * Unsterile tourniquet * Prep * Fingers to just below tourniquet circumferentially. * Draping * 3/4 sheet * Stockinette * Hand and Arm Sheet * Exsanguinated * Tourniquet raised
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ligament of teres runs through the Fovea
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Pathologies for ORIF Hip
* Arthritis * Fractures * Avascular Necrosis-- not accident related * Circumflex artery- feeds femoral head * May occur in other bones as well
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Options for the hip
* 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
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ORIF Hip: Compression Screw
* 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
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chick table
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hana table
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difference between reaming and drilling?
* reaming is a slower speed
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ORIF Hip: Femoral Head Replacement
* 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
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Total Hip Arthroplasty vs. Hemiarthroplasty
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Pathology and Common Procedures of hand
* Trigger Finger * Trigger Finger Release * Game keeper’s Repair * Carpal Tunnel Syndrome * Carpal Tunnel Release * De Quervains /intersection Syndrome * Dupuytren’s Contracture * Ganglion Cyst
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Carpal Tunnel Release
* 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.
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Ulnar Nerve Transposition
* 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
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Triple arthrodesis
* 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
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Bunionectomy
* Hallux Valgus * Structural defect of the foot
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Achilles Tendon Repair
* 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
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Rotator Cuff
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Pathologies and Procedures shoulder
* Rotator Cuff Tear * Open RCR * Arthroscopic RCR * Recurrent Anterior Dislocation * Bankhart * SLAP Repair
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Pathologies of knee
* Injury * Meniscal Tear * ACL tear * Patella Fracture * Osteoarthritis * Varus & Valgus * Chondromalacia
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Common Procedures knees
* 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
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Cuts of a Total Knee
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
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AKA/BKA
* 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.
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Bone Cancer
* Benign Neoplasms * Osteoma * Chondroma * Osteochondroma * Giant Cell Tumor * Malignant * Osteosarcoma * Ewing’s Sarcoma * Chondrosarcoma
Surgical Procedures I
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