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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?
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?
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?
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?
What are the primary reasons for performing surgery on the spine?
Which step is involved in the preparation of the femur for hip prosthesis insertion?
Which step is involved in the preparation of the femur for hip prosthesis insertion?
What bones contribute to the formation of the acetabulum?
What bones contribute to the formation of the acetabulum?
Which ligament is responsible for providing stability to the inner part of the knee joint?
Which ligament is responsible for providing stability to the inner part of the knee joint?
What type of joint is formed by the connection of the tibia and fibula at the ankle?
What type of joint is formed by the connection of the tibia and fibula at the ankle?
Which of the following statements about the vertebrae in the spine is correct?
Which of the following statements about the vertebrae in the spine is correct?
What is the role of bone cement (PMMA) in orthopedic surgery?
What is the role of bone cement (PMMA) in orthopedic surgery?
What is used to ensure a bloodless surgical field during extremity surgery?
What is used to ensure a bloodless surgical field during extremity surgery?
Which of the following represents a safety measure for power surgical instruments?
Which of the following represents a safety measure for power surgical instruments?
What is the purpose of C-Arm radiography during surgical procedures?
What is the purpose of C-Arm radiography during surgical procedures?
Which of the following best describes the role of the Greater Trochanter in the femur?
Which of the following best describes the role of the Greater Trochanter in the femur?
Which of the following types of bones are found in the human foot?
Which of the following types of bones are found in the human foot?
Which type of bone graft requires stabilization with orthopedic hardware due to its inability to fuse on its own?
Which type of bone graft requires stabilization with orthopedic hardware due to its inability to fuse on its own?
What is a significant advantage of using external fixation in fracture surgery?
What is a significant advantage of using external fixation in fracture surgery?
Which intervention is primarily used to fill defects and promote union of fractures in the skeletal system?
Which intervention is primarily used to fill defects and promote union of fractures in the skeletal system?
What is the primary goal of performing a closed reduction in fracture treatment?
What is the primary goal of performing a closed reduction in fracture treatment?
Which type of harvest is classified as an autograft?
Which type of harvest is classified as an autograft?
What is a critical component of the sterilization process for implants before surgery?
What is a critical component of the sterilization process for implants before surgery?
What is the primary purpose of fracture surgery?
What is the primary purpose of fracture surgery?
What advantage does ORIF (Open Reduction Internal Fixation) provide in fracture treatment?
What advantage does ORIF (Open Reduction Internal Fixation) provide in fracture treatment?
Which instrument would primarily be used for a cancellous bone graft?
Which instrument would primarily be used for a cancellous bone graft?
In perioperative nursing considerations, what is NOT recommended as part of infection control?
In perioperative nursing considerations, what is NOT recommended as part of infection control?
What structure separates the epiphysis from the diaphysis in long bones?
What structure separates the epiphysis from the diaphysis in long bones?
Which muscle group forms the rotator cuff in the shoulder?
Which muscle group forms the rotator cuff in the shoulder?
Which layer must be stripped away to repair a fractured bone?
Which layer must be stripped away to repair a fractured bone?
What type of bone graft consists of the hard, dense outer layer of bone?
What type of bone graft consists of the hard, dense outer layer of bone?
What type of bone is characterized as soft and spongy, containing bone marrow?
What type of bone is characterized as soft and spongy, containing bone marrow?
How many bones are there in the carpal region of the wrist?
How many bones are there in the carpal region of the wrist?
Which of the following structures is responsible for holding bone to bone in joints?
Which of the following structures is responsible for holding bone to bone in joints?
What is the primary function of the periosteum?
What is the primary function of the periosteum?
What is the most common graft used for ACL repair?
What is the most common graft used for ACL repair?
What surgical approach is preferred for Anterior Cruciate Ligament repair?
What surgical approach is preferred for Anterior Cruciate Ligament repair?
Which type of fixation is commonly used for an intertrochanteric fracture?
Which type of fixation is commonly used for an intertrochanteric fracture?
In which scenario would total hip arthroplasty generally be considered?
In which scenario would total hip arthroplasty generally be considered?
What are the three types of hip fractures classified by location?
What are the three types of hip fractures classified by location?
What type of fixation is associated with femoral neck fractures in elderly women?
What type of fixation is associated with femoral neck fractures in elderly women?
What does a hybrid fixation technique in total knee arthroplasty involve?
What does a hybrid fixation technique in total knee arthroplasty involve?
Which of the following statements is true regarding bipolar prosthetics?
Which of the following statements is true regarding bipolar prosthetics?
What is the primary goal of total knee arthroplasty?
What is the primary goal of total knee arthroplasty?
What is a key consideration when performing closed reduction for a fracture?
What is a key consideration when performing closed reduction for a fracture?
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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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