Orthopedic Anatomy Module 19: Ortho Spine

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Questions and Answers

What is the primary goal of Total Knee Arthroplasty (TKA)?

To completely remove the knee joint

To increase the degree of knee flexion beyond normal limits

To create a permanent fusion of the knee bones

To replace the worn surfaces of the knee and improve mobility (correct)

Which type of knee implant is most commonly used for Total Knee Replacement?

Tricompartmental implant (correct)

Unicompartmental implant

Fully constrained prosthesis

Bicompartmental implant

Which statement accurately describes the types of knee implants?

Semiconstrained implants provide little to no support when there is significant soft tissue deformity.

Fully constrained prostheses are ideal for cases of high bone loss and instability. (correct)

Unconstrained prostheses allow for maximum mobility without any connection between components.

Bicompartmental implants are widely preferred due to their effectiveness.

What is an important consideration when choosing fixation techniques for knee implants?

Patient's age, activity level, and bone predisposition are vital factors. Signup and view all the answers

In an ACL reconstruction procedure, what is the first step in preparing for the graft?

Inserting the guide pin into the intercondylar notch Signup and view all the answers

Which muscles comprise the rotator cuff in the shoulder joint?

Supraspinatus, infraspinatus, teres minor, subscapularis Signup and view all the answers

What structure is formed by the fusion of the ilium, pubis, and ischium in the hip bone?

Acetabulum Signup and view all the answers

Which ligaments are known to reinforce the knee capsule?

Medial collateral ligament (MCL), lateral collateral ligament (LCL) Signup and view all the answers

Which part of the humerus connects to the joint capsule of the shoulder?

Proximal end Signup and view all the answers

What are the two main components of the knee joint's articulations?

Femur and tibial plateau, patella and femur Signup and view all the answers

What is the primary function of the synovial membrane in joints?

Cover all articulating surfaces Signup and view all the answers

Which structures are associated with the insertion points in the femur?

Greater trochanter for abductor muscle Signup and view all the answers

What type of joint is formed by the end of the tibia and fibula at the ankle?

Hinge joint Signup and view all the answers

Which material is NOT typically used for suturing tendons or ligaments?

Catgut Signup and view all the answers

What is a known effect of prolonged exposure to the liquid component of PMMA?

Irritation of the respiratory tract and eyes Signup and view all the answers

Which agent is applied topically to control bleeding from the bone surfaces?

Bone Wax Signup and view all the answers

What is the primary purpose of a prosthesis in joint replacement surgery?

To replace a damaged joint capsule Signup and view all the answers

In orthopedic surgeries, when is it important to use double or triple gloves?

Due to the sharpness of bone being handled Signup and view all the answers

Which of the following best describes the purpose of plates and screws in fracture fixation?

To hold fractured pieces of bone in place Signup and view all the answers

What is the purpose of mixing Bacitracin with sterile saline in orthopedic procedures?

For pulsed irrigation of contaminated tissues Signup and view all the answers

What is the significance of the Association for the Study of Internal Fixation (ASIF) in orthopedic surgery?

It offers a range of instruments used for the fixation of fractures Signup and view all the answers

Which protective measure is NOT typically required for orthopedic surgeries?

Single layer of gloves Signup and view all the answers

During the fixation of a fracture, what is the correct sequence of using instruments?

Hold, Drill, Tap, Measure, Screw Signup and view all the answers

What is the primary benefit of using PMMA impregnated with antibiotics?

Reduces infection rates Signup and view all the answers

What should always be done when mixing PMMA to minimize staff exposure?

Use special hoods and mixing devices Signup and view all the answers

Which joints are most commonly involved in arthroscopic procedures?

Knee, shoulder, and wrist Signup and view all the answers

Which statement about absorbable sutures is correct?

They are suitable for use with tissues that heal quickly. Signup and view all the answers

What advantage does arthroscopic surgery provide compared to traditional methods?

Leads to less post-operative inflammation and pain Signup and view all the answers

What is the primary function of saline irrigation during knee arthroscopy?

To enhance visualization of the joint Signup and view all the answers

Why is maintaining strict air flow control important during surgeries?

To reduce the risk of surgical site infections Signup and view all the answers

What is a common reason for performing hip replacement surgery?

Sub-capital fracture of the femoral neck Signup and view all the answers

Which statement is true regarding fractures treated by plastic/oral maxillofacial and ENT surgeons?

They repair fractures of the jaw, nose, and orbits Signup and view all the answers

What type of screws can be used in fracture fixation?

Both threaded and smooth screws Signup and view all the answers

What is the primary goal of fracture surgery?

To reestablish the length, shape, and alignment of bones Signup and view all the answers

Which statement about Closed Reduction is true?

It allows manipulation of bone fragments without skin incision. Signup and view all the answers

When is External Fixation typically used?

In cases of severe open fractures and highly comminuted closed fractures. Signup and view all the answers

What is a notable advantage of Open Reduction and Internal Fixation (ORIF)?

The surgeon can ensure anatomic alignment through direct view. Signup and view all the answers

What materials are commonly used in internal fixation during ORIF?

Metal plates, screws, rods, and nails Signup and view all the answers

What type of fracture treatment uses K-wires or Steinman Pins?

Open Reduction and Internal Fixation (ORIF) Signup and view all the answers

Which option correctly describes the use of Intramedullary (IM) rods?

They distribute weight-bearing stresses across the length of the bone. Signup and view all the answers

What is a major benefit of using IM rods over traditional fixation methods?

Reduced risk of infection and lower blood loss Signup and view all the answers

In which case would Internal Fixation be the treatment of choice?

When the closed method fails to realign the fracture Signup and view all the answers

Which of the following is NOT an example of ORIF procedures?

Application of a splint for a fractured wrist Signup and view all the answers

Study Notes

Bone Repair and Anatomy

Periosteal elevators are used to strip away the periosteal layer during fracture repair.
The synovial membrane covers all articulating surfaces of joints.
Cortical (hard) bone is contrasted with cancellous (spongy) bone in anatomy.

Shoulder and Upper Extremity

The shoulder features a ball-and-socket joint, supported by four rotator cuff muscles: supraspinatus, infraspinatus, teres minor, and subscapularis.
Humerus is the longest bone in the upper arm, connecting to the shoulder capsule at the proximal end and the ulna and radius at the distal end.

Wrist and Hand Structure

The wrist and hand consist of three parts: 8 carpals, 14 metacarpals, and phalanges.
There are two sides: radial and ulnar; the median nerve travels through the palm and wrist.

Hip Joint Components

The hip joint is stabilized by a capsule, ligaments, and muscles.
Comprised of ilium, pubis, and ischium, the acetabulum connects with the head of the femur.
The greater and lesser trochanters on the femur serve as insertion points for hip muscles.

Knee Anatomy and Function

The knee contains two articulations: one between the femur and tibia, and another between the patella and femur.
Key stabilizing structures include the medial (MCL) and lateral collateral ligaments (LCL), as well as the anterior and posterior cruciate ligaments.
Two menisci (medial and lateral) provide cushioning and stability between femur and tibia.

Ankle Joint Characteristics

The ankle is a hinge joint formed by the tibia and fibula, contributing to movements of the foot.
Surgical site infections (SSI) may occur due to airborne bacteria; maintaining sterile techniques is crucial.

Suture Material and Bone Cement

Suture materials are selected for tensile strength and minimal degradability; absorbable sutures are utilized for softer tissues while non-absorbable sutures are used for tougher tissues.
Bone cement (PMMA) combines a powder and liquid to create a radiopaque substance, with precautions in handling to avoid flammability and respiratory irritation.

Medications in Orthopedic Surgery

Use of antibiotics, hemostatics, and antibacterial agents is common; antibiotics can be applied intravenously or locally.
Bone wax and topical thrombin aid in controlling bleeding during procedures.

Protective Measures in Surgery

Extra precautions in orthopedic cases include double or triple gloving, face shields, and care to avoid strike-through contamination.
X-ray gowns are required for personnel if imaging equipment is being used.

Prosthesis Handling and Fracture Surgery Goals

Careful handling of prostheses is essential to avoid damage or contamination.
The primary objective of fracture surgery is to restore bone alignment, length, and functionality.

Techniques for Fracture Fixation

Closed reduction involves non-surgical manipulation with radiographic confirmation; splints or casts are used for immobilization.
External fixation offers rigid stabilization without the need for a cast, useful in severe fractures or soft tissue injuries.
Open reduction and internal fixation (ORIF) involves surgical exposure and application of devices like plates and screws to align broken bones.

Arthroscopy Overview

Arthroscopies are utilized for diagnosis and treatment of joint injuries, commonly performed in the knee, shoulder, and wrist.
Normal saline is used for irrigation, and multiple small incisions allow for insertion of arthroscopic instruments.

Total Knee Arthroplasty (TKA)

Total knee replacements primarily address degenerative, rheumatoid, or traumatic arthritis to enhance joint mobility.
Types of knee implants include unicompartmental, bicompartmental, and tricompartmental; the latter is the most commonly used.
Constraint levels of implants vary and implantation techniques can be cemented or non-cemented, influenced by bone condition and patient factors.

Summary of Instrumentation for Fixation

Hold bone with a holder for stabilization.
Drill to create holes for screws, followed by tapping for threaded stability.
Depth gauging ensures appropriate screw length before insertion with a screwdriver.

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Description

This quiz covers the key concepts in orthopedic anatomy as discussed in Module 19. Topics include the structure of the periosteal layer, synovial membrane functions, blood supply in bone types, and the anatomy of the shoulder joint and its muscles. Test your knowledge on fracture repair and upper extremity anatomy.