Orthopedic Surgery and Spine Overview

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Questions and Answers

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

To hold bone to bone and provide joint stability (correct)

To cover and protect the surface of bones

To enable the formation of blood cells

To connect muscle to bone

Which type of bone tissue is known as the hard outer shell that supports tissue?

Cartilage

Cancellous bone

Cortical bone (correct)

Compact bone

At what point in development is the epiphyseal plate no longer present?

During puberty

At birth

At skeletal maturity (correct)

In early childhood

What is one of the essential components of a joint?

Articular cartilage Signup and view all the answers

Which vitamin is crucial for the continuous process of bone formation and reabsorption?

Vitamin D Signup and view all the answers

In which part of the body is cancellous bone primarily found?

Ends of long bones and certain flat bones Signup and view all the answers

What defines the periosteum in relation to bone structure?

A membrane that covers all bones Signup and view all the answers

What purpose do tendons serve in the skeletal system?

To connect muscle to bone Signup and view all the answers

How many total phalanges are present in the human foot?

14 Signup and view all the answers

What is the purpose of the cartilage joints connecting the vertebral bodies?

To allow mobility Signup and view all the answers

Which position is NOT typically used for orthopedic surgical patients?

Sitting up Signup and view all the answers

What is the first step in the sequence of instruments used to fixate a bone?

Hold the bone with the bone holder Signup and view all the answers

Which of the following is commonly used to ensure strict aseptic technique in orthopedic surgeries?

Autoclave sterilization Signup and view all the answers

What type of draping is usually used for limb surgeries?

Limb draping Signup and view all the answers

Which instrument is used to make a hole for the screw when fixing a bone?

Drill Signup and view all the answers

How many lumbar vertebrae are there in the human spine?

5 Signup and view all the answers

What kind of positioning aids might be used for patients in the lateral position during orthopedic surgery?

Vac packs and beanbags Signup and view all the answers

Which orthopedic instrument is specifically designed for retracting tissue during surgery?

Hommann retractor Signup and view all the answers

What is the main purpose of 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 Replacements?

Tricompartmental Signup and view all the answers

What is a key consideration when selecting the fixation technique for knee implants?

The predisposition of the bone and the surgeon’s preference Signup and view all the answers

During ACL reconstruction, what is the purpose of inserting a guide pin from the anterior tibial incision?

To guide the placement of the patellar tendon graft Signup and view all the answers

What type of knee prosthesis offers the most stability when there is significant bone loss?

Fully constrained Prostheses Signup and view all the answers

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

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

What is a potential consequence of not using the safety lock on powered surgical instruments?

Injury to the surgical team or patient from accidental activation Signup and view all the answers

How long can a pneumatic tourniquet safely be inflated on a patient's arm?

60 minutes Signup and view all the answers

What inflation pressure should the tourniquet not exceed for the arm?

250-300mmHg Signup and view all the answers

Why are forced-air warming blankets particularly important in orthopedic surgeries?

They reduce the risk of hypothermia due to extensive skin exposure. Signup and view all the answers

What is the primary use of the C-Arm in orthopedic surgery?

Performing fluoroscopy during the procedure Signup and view all the answers

Which statement regarding pneumatic tourniquets is correct?

Documentation of inflation and deflation times is essential. Signup and view all the answers

What are the recommended maximum inflation pressures for a pneumatic tourniquet on the thigh?

300-350mmHg Signup and view all the answers

What is one of the main responsibilities of the perioperative nurse regarding surgical tables?

Secures the patient safely using appropriate positioning devices Signup and view all the answers

Why is traffic control and airflow management critical in the orthopedic operating room?

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

What is the primary purpose of performing an arthroscopy of the knee?

For diagnostic viewing and treatment of knee injuries Signup and view all the answers

What type of anesthesia can be used for knee arthroscopy?

General, spinal, or local anesthesia Signup and view all the answers

Which structure is primarily affected by a meniscus tear?

Meniscus Signup and view all the answers

In repairing a meniscal tear, what is crucial about the vascular zone?

Suturing should only be conducted for vascular zone tears Signup and view all the answers

What is the primary stabilizing function of the anterior cruciate ligament (ACL) in the knee?

To prevent excessive twisting and forward movement of the tibia Signup and view all the answers

What is commonly associated with ACL injuries?

Simultaneous anterior and rotational stresses Signup and view all the answers

What is usually used as a graft for anterior cruciate ligament repair?

Patellar tendon graft Signup and view all the answers

Which of the following is NOT a procedural consideration during meniscal tear repair?

Injecting corticosteroids to reduce inflammation Signup and view all the answers

What should be the focus of treatment for a meniscus tear?

Preserving knee structures Signup and view all the answers

During an arthroscopic procedure, what happens to the meniscal tissue?

It is resected based on the type and location of the tear Signup and view all the answers

Study Notes

Orthopedic and Spine Surgery Overview

Orthopedic surgery involves anatomical understanding, procedural considerations, and safety precautions regarding specialized equipment.
Technological advancements have significantly enhanced patient outcomes in orthopedic procedures.

Anatomy of the Skeletal System

The skeletal system consists of 206 bones, muscles, ligaments, and tendons, supporting soft tissues and enabling movement.
Cortical bone forms the hard outer layer, while cancellous bone is softer and contains red marrow.
Long bones have a diaphysis (shaft) and epiphysis (ends) separated by the epiphyseal plate until skeletal maturity.

Spine Structure

The vertebral column comprises cervical (7), thoracic (12), and lumbar (5) vertebrae, with the sacrum and coccyx fused at the base.
Intervertebral joints enhance mobility through cartilage connections.

Perioperative Nursing Considerations

Strict verification of the operative side and site is crucial through safety checklists and imaging.
Aseptic technique is mandatory due to the use of fixation systems in surgeries.

Patient Positioning Techniques

Positioning is determined by the surgical approach: supine, lateral, Fowler’s, or prone.
Specialized aids (e.g., Vac packs) are utilized to maintain patient safety and comfort during procedures.

Draping and Instrumentation

Draping depends on the procedure, utilizing limb draping techniques and independent drapes.
An orthopedic procedure instrument set includes periosteal elevators, bone rongeurs, and other specialized tools.

Instrumentation Sequence for Bone Fixation

Stabilize the fracture with a bone holder.
Drill and tap the bone to create a channel for screws.
Measure depth with a gauge and insert screws using a screwdriver.

Equipment In Use

Powered surgical instruments, especially drills, streamline orthopedic procedures but pose a risk if not managed properly.
Forced-air warming blankets mitigate hypothermia risks during extensive skin exposure.

Pneumatic Tourniquets

Tourniquets facilitate a bloodless surgical field; inflation pressure is determined by patient-specific metrics.
Recommended maximum inflation time is 60 minutes for upper extremities and 120 minutes for lower extremities.

Airflow and Traffic Control

Maintaining controlled airflow reduces the risk of introducing microorganisms into the surgical field.

Knee Surgery Focus: Arthroscopy

The most frequent arthroscopic procedure allows for diagnostic evaluation and repairs like synovial biopsies and ACL reconstructions.
Torn ACL and meniscus injuries are common, necessitating specific surgical interventions.

Total Knee Arthroplasty (TKA)

TKA is conducted for conditions like arthritis to improve knee function and stability.
Types of knee implants include unicompartmental, bicompartmental, and tricompartmental, with fixation techniques varying based on bone quality and patient factors.

Implants and Fixation Techniques

Knee prostheses are designed to preserve ligaments and maintain stability, with consideration given to age, activity level, and surgeon preference.
Proper identification is crucial as knee prostheses are specific to the left or right knee.

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Description

This quiz explores the fundamentals of orthopedic and spine surgery, covering the anatomy of the skeletal system, the structure of the spine, and important perioperative nursing considerations. Dive into the advancements in surgical techniques and the intricate details of the skeletal framework.