Orthopedic Quiz on Bone Structure and Repair

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Questions and Answers

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

To facilitate muscle movement around joints.

To protect against joint instability.

To connect bone to bone and provide joint stability. (correct)

To transmit forces to bone or cartilage.

Which type of bone tissue is found at the ends of long bones and contains red bone marrow?

Compact bone

Trabecular bone

Cancellous bone (correct)

Cortical bone

Where is the periosteal layer located and what is its significance during bone repair?

It covers all joints and stabilizes them during movement.

It covers all bones and must be stripped away during fracture repair. (correct)

It is a dense layer found only in long bones, preventing fracture.

It covers the entire skeletal system and provides immunity.

What is the order of instruments used for fixing a bone fracture?

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

What distinguishes autografts from allografts in orthopedic procedures?

Autografts are sourced from donor tissue banks, while allografts come from the patient. Signup and view all the answers

Which tool is specifically used for measuring the depth of a drilled hole in bone?

Depth gauge Signup and view all the answers

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

To cover and protect all articulating surfaces of the joint. Signup and view all the answers

How does cancellous bone contribute to the process of healing after a bone graft?

By promoting a faster integration into host bones. Signup and view all the answers

What is the primary purpose of using ortho hardware with bone grafts?

To stabilize the grafts until they fuse Signup and view all the answers

Which instrument is specifically designed to grasp and remove the intervertebral disc?

Pituitary Rongeur Signup and view all the answers

What is the maximum recommended inflation pressure for a pneumatic tourniquet used on the arm?

250-300 mmHg Signup and view all the answers

What is the risk associated with powered surgical instruments if not properly managed?

False activation leading to potential injury Signup and view all the answers

What best practice should be followed regarding tourniquet inflation time in surgical procedures?

Inflation should not exceed 60 minutes for the upper extremity Signup and view all the answers

Which of the following surgical procedures is least likely to utilize a pneumatic tourniquet?

Total Knee Arthroplasty (TKA) Signup and view all the answers

What is a significant nursing consideration when using powered surgical instruments?

The safety lock must be engaged when not in use Signup and view all the answers

How long can a pneumatic tourniquet be safely inflated on the lower extremity before potential risks arise?

120 minutes Signup and view all the answers

Which of the following describes a common consequence of drill activation on sterile drapes during surgery?

Contamination of the surgical field Signup and view all the answers

In which situation should additional inflation time for a pneumatic tourniquet be requested?

At 15-minute intervals post-inflation time Signup and view all the answers

Which virtue emphasizes the focus on the best interests of the patient in perioperative nursing?

Compassion Signup and view all the answers

What aspect does conscientiousness in nursing primarily address?

Ensuring decisions are made without bias Signup and view all the answers

Which CNO ethical value specifically deals with how a nurse should respect the individual dignity of patients?

Respect for Life Signup and view all the answers

When considering the goals and purpose of treatment, what is the role of the Perioperative Nursing Data System (PNDS)?

To help identify treatment goals and effective means of achieving them Signup and view all the answers

Which of the following standards is NOT included in the Perioperative Nurse Practice Standards?

Effective patient communication Signup and view all the answers

What is one of the primary reasons for using PMMA in orthopedic surgery?

To serve as a radiopaque marker Signup and view all the answers

What safety measure is essential when working with the liquid component of PMMA in the operating room?

The OR must be well-ventilated Signup and view all the answers

How should prostheses be handled to avoid contamination during surgery?

Kept on a lint-free surface Signup and view all the answers

In closed reduction of a fracture, what is primarily confirmed through radiography?

The alignment of the bone fragments Signup and view all the answers

What is the role of Bacitracin during orthopedic procedures?

To irrigate contaminated tissue Signup and view all the answers

What condition is primarily associated with causing osteomyelitis, an infectious process?

Fractures due to trauma Signup and view all the answers

What is a significant advantage of external fixation in orthopedic surgery?

It manages soft tissue wounds effectively Signup and view all the answers

Which of the following is NOT a goal of fracture surgery?

To increase the bone density Signup and view all the answers

What essential documentation must be completed for a prosthesis used in surgery?

Implant information including serial number and expiry date Signup and view all the answers

What is the primary risk associated with an open fracture that differentiates it from a closed fracture?

Increased risk of infection Signup and view all the answers

What distinguishes a unipolar prosthetic from a bipolar prosthetic in hip replacement?

Includes an inner ball component Signup and view all the answers

What is the primary benefit of using intramedullary (IM) rods for fracture fixation?

Less scarring due to the closed reduction nature Signup and view all the answers

Which ligaments are primarily involved in reinforcing the knee capsule?

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

During a bilateral total hip replacement using the modular method, what is the main purpose of this approach?

To ensure both legs are symmetrical in length Signup and view all the answers

What material is primarily used to irrigate the joint during an arthroscopy?

Normal Saline Signup and view all the answers

Which statement is true regarding arthroscopic procedures compared to traditional surgery?

Promote less inflammation and scarring Signup and view all the answers

What is a common system name used for intramedullary nail fixation in femur fractures?

Nancy Signup and view all the answers

What are the two primary articulations that make up the knee joint?

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

What type of incision is associated with intramedullary fixation procedures?

Small incision sites characteristic of closed reduction Signup and view all the answers

Which of the following is NOT a characteristic of arthroscopy?

Involves larger incisions for viewing Signup and view all the answers

Study Notes

Anatomy of Orthopedics

Muscles provide movement to the skeletal system by covering bones.
Ligaments connect bone to bone, ensuring joint stability.
Tendons transmit forces from muscles to bones or cartilage at their endpoints.
Cartilage, an elastic tissue, supports and stabilizes the ends of bones.
Joints are formed by the articulations where bones meet.

Bone Tissue and Blood Supply

Two types of bone tissue: cortical (hard outer shell) and cancellous (soft spongy tissue).
Cancellous bone is found in areas like the iliac crest, tibia, and ends of long bones, housing red marrow.
Long bones consist of a shaft (diaphysis) and two ends (epiphyses), separated by the epiphyseal plate until skeletal maturity.
Periosteum is a connective tissue covering over bones, crucial for fracture repair.
The synovial membrane covers articulating surfaces of joints.

Surgical Instruments Sequence for Bone Fixation

Stabilize the fracture with a bone holder.
Drill a hole in the bone for the screw.
Tap the hole to create a stable canal for screw insertion.
Use a depth gauge to measure screw length.
Insert the screw with a screwdriver.

Minor Count in Orthopedic Surgery

A minor count includes initial count, closing count, and final count for all orthopedic procedures.

Bone Grafts

Bone grafts fill cavities from bone removal, promote union of fractures, and fill defects.
Allografts are from tissue banks, while autografts use the patient’s bone, typically from the iliac crest.
Cancellous bone from the iliac crest grows into the host bone.
Cortical bone grafts require stabilization with orthopedic hardware.

Instrument Identification

Kerrison Rongeur: used to grasp and resect the lamina of the bone.
Pituitary Rongeur: used for grasping and removing intervertebral discs.

Equipment and Nursing Considerations

Ensure powered surgical instruments (drills) are properly secured and tested before use to prevent accidental activation.
C-Arm provides fluoroscopy during orthopedic surgeries; all OR personnel must wear protective lead gowns.

Pneumatic Tourniquets

Used to create a bloodless surgical field in extremity procedures.
Inflation pressure determined by patient’s blood pressure and extremity size (max 250-300 mmHg for arms, 300-350 mmHg for thighs).
Cuff inflation limited to 60 minutes for upper extremities and 120 minutes for lower, with documentation of usage times.

Bone Cement (PMMA)

Created by mixing powder with liquid to form a radiopaque cement.
Liquid is flammable; proper ventilation is needed, and exposure should be minimized.
PMMA mixed with antibiotics has been shown to reduce infection rates.

Handling Prosthesis

Prosthesis must be handled carefully to prevent damage or contamination.
Document implant details like serial number and expiration date.
Sterilization must include a biological indicator for implants.

Fracture Surgery Overview

Fractures result from trauma, infection, or conditions like osteoporosis.
Surgery aims to align fractured bones and restore function.
Techniques include closed reduction (non-surgical alignment confirmed by radiography), external fixation (rigid fixation for severe fractures), and IM rods/nails for internal fixation.

Arthroscopy Surgery

Arthroscopies allow for visualization and treatment of joint issues using scopes.
Common in knee, shoulder, and wrist surgeries; offers reduced recovery time and less pain.
Normal saline is used for irrigation to maintain joint distention.

Focal Virtues in Nursing

Compassion: prioritizing patient well-being.
Discernment: applying insightful judgment in care.
Trustworthiness: building strong relationships with patients.
Integrity: maintaining dignity and respect.
Conscientiousness: focusing on patient-centered care.

CNO Ethical Values

Emphasis on client well-being, choice, privacy, respect for life, and truthfulness.
Commitments to fairness and maintaining trust in healthcare practices.

Perioperative Nurse Practice Standards

Utilize interdisciplinary knowledge for effective clinical decision-making.
Ensure patient safety through collaboration and accountability in care delivery.

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Description

Test your knowledge on the skeletal system with this quiz focused on ligaments, bone tissue, and repair processes. Learn about critical concepts like the significance of the periosteal layer, the types of bone grafts, and instruments used for fracture fixing. Perfect for students and professionals in orthopedics.