Orthopedic and Spine Surgery Module 19

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary design feature that differentiates bipolar endoprostheses from unipolar models?

Unipolar models provide better rotational movement.

Bipolar models have an inner head to reduce friction.

Unipolar models utilize a plastic-lined cup.

Bipolar models allow for reduced shear stresses on the acetabular surface. (correct)

During the process of total hip replacement, what is the correct sequence of steps for preparing the femur and acetabulum?

Excise femoral head, prepare femur, then prepare acetabulum.

Prepare both femur and acetabulum simultaneously.

Prepare acetabulum, excise femoral head, then prepare femur. (correct)

Prepare femur, excise femoral head, then prepare acetabulum.

What is the purpose of using a guidewire during the cannulated screw insertion procedure?

To provide a stable pathway for precise screw placement. (correct)

To confirm the placement of screws using fluoroscopy.

To aid in the measurement of screw length.

To irrigate the wound before inserting screws.

What can be used to secure the femoral head prosthesis during a total hip replacement?

Bone cement or screws, depending on the patient. Signup and view all the answers

What type of instruments are typically included in the basic orthopedic instrument set for total hip replacement surgery?

Soft tissue instruments along with fixation instrumentation. Signup and view all the answers

What is the primary function of ligaments in the skeletal system?

Holding bone to bone and providing joint stability Signup and view all the answers

Which of the following statements about cancellous bone is correct?

It contains red bone marrow and is spongy in nature. Signup and view all the answers

What role do muscles play in relation to the skeletal system?

They cover bones and provide movement. Signup and view all the answers

What is the epiphyseal plate's significance in long bones?

It indicates skeletal maturity and growth cessation. Signup and view all the answers

Which type of bone tissue primarily supports weight-bearing activities?

Cortical bone because of its density and strength. Signup and view all the answers

What mineral is NOT typically involved in the continuous formation and reabsorption by bone?

Iron Signup and view all the answers

What type of connective tissue covers all bones in the body?

Periosteum Signup and view all the answers

Which is NOT a role of bones within the skeletal system?

Transmit forces from muscles to joints Signup and view all the answers

What is the primary purpose of using powered surgical instruments in orthopedic procedures?

To reduce the need for handheld instruments Signup and view all the answers

What is a critical precaution when using powered surgical drills?

They must not rest on the patient or drapes Signup and view all the answers

What is a potential consequence of accidental activation of a surgical drill?

Creation of a 'strike through' leading to contamination Signup and view all the answers

Why are forced-air warming blankets important in orthopedic surgery?

To maintain patient warmth due to large skin exposure Signup and view all the answers

What should the inflation pressure of a pneumatic tourniquet not exceed for the upper extremity?

250-300 mmHg Signup and view all the answers

How should inflation time for a pneumatic tourniquet be documented?

On the patient's chart with specific time intervals Signup and view all the answers

What role does the C-Arm play in orthopedic surgery?

It provides fluoroscopic imaging during the procedure Signup and view all the answers

What is the recommended action when the maximum time limit for tourniquet inflation is reached?

The surgeon may request additional time at 15-minute intervals Signup and view all the answers

What is a fundamental reason for airflow control in an orthopedic operating room?

To prevent the introduction of microorganisms Signup and view all the answers

What is the appropriate overlap for cuffs when applying pneumatic tourniquets?

3-6 inches Signup and view all the answers

What is the role of the periosteal elevators in bone repair?

To strip the periosteal layer away from the bone 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 forms the socket for the head of the femur in the hip joint?

Acetabulum Signup and view all the answers

Which statement about the knee joint is accurate?

The knee joint has two articulations involving the femur, tibia and patella. Signup and view all the answers

Which structure serves as a point of insertion for the iliopsoas muscle in the femur?

Lesser trochanter Signup and view all the answers

How many carpal bones are present in the wrist?

8 Signup and view all the answers

Which ligament helps reinforce the medial side of the knee capsule?

Medial collateral ligament Signup and view all the answers

What type of joint is the ankle classified as?

Hinge joint Signup and view all the answers

What structure covers all articulating surfaces of joints?

Synovial membrane Signup and view all the answers

Which nerve extends under the wrist and is located in the palm of the hand?

Median nerve Signup and view all the answers

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

To replace the worn surfaces of the knee Signup and view all the answers

Which type of knee implant is most commonly used in Total Knee Arthroplasty?

Tricompartmental implant Signup and view all the answers

Which component is NOT typically required in the ACL reconstruction procedure?

Bicompartmental prosthesis Signup and view all the answers

What type of constraint does an unconstrained prosthesis have in knee replacement?

Little constraint Signup and view all the answers

What surgical technique may be employed when there is high bone loss and instability?

Fully constrained prosthesis Signup and view all the answers

Which incision is necessary for harvesting the patellar tendon during ACL reconstruction?

Patellar incision Signup and view all the answers

Which fixation technique is commonly used for knee implants?

Cemented and noncemented techniques Signup and view all the answers

What is the primary function of the guide pin during ACL reconstruction?

To assist in pin placement in the intercondylar notch Signup and view all the answers

What is the main reason for the limitation of bicompartmental implants in knee surgeries?

They are not designed for patellofemoral replacement Signup and view all the answers

What aspect of knee prostheses is crucial to remember regarding their application?

They are left and right specific Signup and view all the answers

Study Notes

Orthopedic Surgery Overview

Orthopedic surgery focuses on disorders of the musculoskeletal system, utilizing technology to improve patient outcomes.
Knowledge of bone and tissue fixation principles is essential for perioperative nurses.

Anatomy of the Skeletal System

Comprises 206 bones forming the axial and appendicular skeleton, providing structural support, movement, and blood cell formation.
Bone continuously remodels, absorbing calcium, Vitamin D, and phosphorus.
Key structures include muscles (movement), ligaments (bone connection and joint stability), tendons (force transmission), cartilage (support), and joints (bone articulation).

Bone Tissue Types

Cortical Bone: Dense outer layer providing structural integrity.
Cancellous Bone: Soft, spongy tissue found in specific areas such as the iliac crest and ends of long bones, housing red bone marrow.

Joint Anatomy

Shoulder: Ball and socket joint formed by the rotator cuff muscles (supraspinatus, infraspinatus, teres minor, subscapularis).
Wrist and Hand: Comprise 8 carpals, 14 metacarpals, and phalanges; median nerve runs through the palm.
Hip: Formed by the ilium, pubis, ischium, and acetabulum, connecting to the femur; features greater and lesser trochanters.
Knee: Contains two primary articulations; reinforced by collateral ligaments (MCL, LCL) and cruciate ligaments (ACL, PCL).
Ankle: Hinge joint formed by tibia and fibula.

Orthopedic Surgical Equipment

Powered Surgical Instruments: Reduce manual effort; must be secured to prevent accidental activation.
Forced-Air Warming Blankets: Prevent hypothermia due to exposure.
Operating Room Tables: Specialized for various orthopedic procedures, e.g., fracture tables.
Radiography: Used for imaging during surgery; C-Arm facilitates real-time visualization.
Pneumatic Tourniquets: Used to establish a bloodless field, with careful attention to inflation pressures and duration.

Surgical Procedures Considerations

Diagnostic Arthroscopy: For meniscal tears and ACL reconstruction; involves inserting guide pins and sutures to repair ligaments.
Total Knee Arthroplasty (TKA): Replaces worn knee surfaces due to arthritis, improving joint mobility; types of implants include unicompartmental, bicompartmental, and tricompartmental.
Total Hip Replacement (THR): Replaces the femoral head using unipolar or bipolar designs; emphasizes symmetrical leg length during bilateral replacements.

Specific Surgical Techniques

Knee Surgery: Involves guidewire placement, cannulated screws, and confirmation via fluoroscopy.
Hip Surgery: First prepares the acetabulum, followed by the femur, ensuring proper fit and stability with or without bone cement.

Spine Surgery

Common in the lumbar and cervical regions, addressing injuries and degenerative conditions.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge of orthopedic and spine surgery with this quiz based on Module 19. Each question covers essential anatomy, procedural considerations, and specific equipment critical to orthopedic practices. Prepare to reinforce your understanding of the surgical principles outlined in your readings.