Orthopedic Surgery Basics

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Questions and Answers

What type of acetabulum fixation is most likely to be used for young, active patients during a hip procedure?

Adjustable cemented design

Hybrid with one component cemented and one non-cemented

Cemented acetabulum

Totally non-cemented (correct)

Which instrument is specifically used to remove the lamina bone during a laminectomy?

Bayonet forceps

Cobb periosteal elevator

Kerrison rongeur (correct)

Pituitary rongeur

What is a critical consideration for the position of a patient undergoing spinal surgery?

Seated position for better access

Reclined position to minimize pain

Prone position for direct exposure (correct)

Supine position to avoid pressure on spine

What are the primary reasons for performing surgery on the spine?

Degenerative changes and post-surgical defects Signup and view all the answers

Which step is involved in the preparation of the femur for hip prosthesis insertion?

Trialing the femoral component with plastic models Signup and view all the answers

What bones contribute to the formation of the acetabulum?

Ilium, Pubis, Ischium Signup and view all the answers

Which ligament is responsible for providing stability to the inner part of the knee joint?

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

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

Hinge joint Signup and view all the answers

Which of the following statements about the vertebrae in the spine is correct?

There are 7 cervical and 12 thoracic vertebrae Signup and view all the answers

What is the role of bone cement (PMMA) in orthopedic surgery?

To fixate an implant system in bone Signup and view all the answers

What is used to ensure a bloodless surgical field during extremity surgery?

Tourniquet Signup and view all the answers

Which of the following represents a safety measure for power surgical instruments?

Ensure safety lock is on when not in use Signup and view all the answers

What is the purpose of C-Arm radiography during surgical procedures?

To offer fluoroscopy for real-time imaging Signup and view all the answers

Which of the following best describes the role of the Greater Trochanter in the femur?

Provides connection for muscles and ligaments Signup and view all the answers

Which of the following types of bones are found in the human foot?

Tarsal, Metatarsal, Phalanges Signup and view all the answers

Which type of bone graft requires stabilization with orthopedic hardware due to its inability to fuse on its own?

Cortical bone graft Signup and view all the answers

What is a significant advantage of using external fixation in fracture surgery?

Facilitates earlier mobilization with less chance of infection Signup and view all the answers

Which intervention is primarily used to fill defects and promote union of fractures in the skeletal system?

Bone grafting Signup and view all the answers

What is the primary goal of performing a closed reduction in fracture treatment?

To manipulate bone fragments without surgery Signup and view all the answers

Which type of harvest is classified as an autograft?

Bone harvested from the patient's own body Signup and view all the answers

What is a critical component of the sterilization process for implants before surgery?

Presence of a biological indicator Signup and view all the answers

What is the primary purpose of fracture surgery?

To stabilize the fracture to allow healing Signup and view all the answers

What advantage does ORIF (Open Reduction Internal Fixation) provide in fracture treatment?

It provides direct visualization of the fracture for better alignment. Signup and view all the answers

Which instrument would primarily be used for a cancellous bone graft?

Bone curette Signup and view all the answers

In perioperative nursing considerations, what is NOT recommended as part of infection control?

Using single gloves only Signup and view all the answers

What structure separates the epiphysis from the diaphysis in long bones?

Epiphyseal plate Signup and view all the answers

Which muscle group forms the rotator cuff in the shoulder?

Four specific muscles Signup and view all the answers

Which layer must be stripped away to repair a fractured bone?

Periosteum Signup and view all the answers

What type of bone graft consists of the hard, dense outer layer of bone?

Cortical bone graft Signup and view all the answers

What type of bone is characterized as soft and spongy, containing bone marrow?

Cancellous bone Signup and view all the answers

How many bones are there in the carpal region of the wrist?

8 Signup and view all the answers

Which of the following structures is responsible for holding bone to bone in joints?

Ligaments Signup and view all the answers

What is the primary function of the periosteum?

Cover and protect the bone Signup and view all the answers

What is the most common graft used for ACL repair?

Patellar tendon graft Signup and view all the answers

What surgical approach is preferred for Anterior Cruciate Ligament repair?

Arthroscopic repair Signup and view all the answers

Which type of fixation is commonly used for an intertrochanteric fracture?

Dynamic Hip Screw Signup and view all the answers

In which scenario would total hip arthroplasty generally be considered?

Unstable femoral neck fracture Signup and view all the answers

What are the three types of hip fractures classified by location?

Femoral neck, Intertrochanteric, Subtrochanteric Signup and view all the answers

What type of fixation is associated with femoral neck fractures in elderly women?

Internal fixation with cannulated screws Signup and view all the answers

What does a hybrid fixation technique in total knee arthroplasty involve?

Combination of cemented and uncemented components Signup and view all the answers

Which of the following statements is true regarding bipolar prosthetics?

They are designed to minimize wear and friction. Signup and view all the answers

What is the primary goal of total knee arthroplasty?

To preserve normal ligaments and maintain range of motion. Signup and view all the answers

What is a key consideration when performing closed reduction for a fracture?

X-ray confirmation is required post-reduction. Signup and view all the answers

Study Notes

Orthopedic Surgery Overview

The skeletal system consists of 206 bones, providing support, enabling locomotion, and connecting ligaments and tendons.
Muscles cover bones and facilitate movement; ligaments connect bone to bone for stability, and tendons transmit forces from muscles to bones.
Cartilage supports bones at joints; joints are where two or more bones articulate.

Long Bone Anatomy

Diaphysis: central shaft of the long bone.
Epiphysis: ends of long bones made of cancellous bone; contains the growth plate (epiphyseal plate) until skeletal maturity.
Periosteum: connective tissue layer surrounding bones; essential for repair after fractures, requiring periosteal elevators for removal.

Bone Types and Structures

Cortical Bone: dense outer shell capable of supporting large forces.
Cancellous Bone: spongy tissue containing bone marrow, found in locations such as the iliac crest and ends of long bones.

Joint Anatomy

Shoulder: ball and socket joint featuring the rotator cuff's four muscles; the humerus connects to the shoulder joint and forearm bones.
Knee: hinge joint with collateral ligaments (MCL, LCL), menisci, and cruciate ligaments (anterior and posterior).
Hip: ball and socket joint vital for stability, formed by ilium, pubis, and ischium.
Foot: hinge joint formed by tibia and fibula; includes tarsal, metatarsal, and phalange bones.
Spine: comprised of cervical (7), thoracic (12), lumbar (5), sacrum, and coccyx bones.

Orthopedic Surgical Equipment

Essential tools include surgical tables (Jackson spinal top, fracture table), power surgical instruments, C-arm for imaging, pneumatic tourniquets, and bone cement (PMMA).
Safety precautions for equipment: test air-driven instruments before use, ensure safety locks, and confirm correct connections.

Surgical Interventions

Types of interventions include bone grafts (allografts and autografts), fracture surgeries (closed, external fixation, ORIF), arthroscopy, total knee and hip surgeries, and spinal surgeries.
Bone grafts are grafted to fill defects; cancellous bone promotes healing due to its vascularity, while cortical bone requires stabilization.

Fracture Repair Techniques

Closed Reduction: non-surgical manipulation; reduces infection risks and improves healing.
External Fixation: rigid stabilization with a device external to the skin.
Open Reduction Internal Fixation (ORIF): direct visualization and internal hardware fixation for complicated fractures.

Total Knee Arthroplasty (TKA)

Aims to replace worn knee surfaces due to arthritis while preserving ligaments for normal range of motion, using various fixation methods (uncemented, cemented, hybrid).

Hip Surgery Considerations

Three types of hip fractures include femoral neck, intertrochanteric, and subtrochanteric.
Internal fixation with screws or total hip replacements is utilized depending on fracture type and stability.
Special procedures involve the use of dynamic hip screws for intertrochanteric fractures.

Spine Surgery

Procedures commonly target lumbar and cervical regions due to high mobility and injury susceptibility.
Laminectomy is performed to relieve spinal cord pressure, typically using Kerrison and pituitary rongeurs for lamina removal.

Perioperative Nursing Considerations

Use of PPE, traffic control, positioning, and surgical counts are essential for ensuring patient safety.
Blood replacement and patient warming are critical during procedures; neuro patties assist with hemostasis.

Key Medications and Safety

Bone wax promotes hemostasis; bacitracin is used for irrigation of contaminated areas.
Bone cement must be mixed safely and can secure prosthetic implants; handling protocols are crucial due to toxicity.

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Description

This quiz covers fundamental concepts in orthopedic surgery, including the anatomy of the skeletal system, types of surgical equipment, and procedures for fixing fractures. Additionally, it delves into the differences between cancellous and cortical bone grafts and procedural considerations for surgeries involving the knee, hip, and spine.