Orthopedic Surgery on Hip Fractures

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Questions and Answers

Which component is specifically absent in a unipolar hip replacement?

Inner head (correct)

Bipolar support

Acetabulum

Femoral component

What is the primary purpose of using intramedullary (IM) rods in fracture fixation?

To distribute weight-bearing stresses across the bone length (correct)

To provide permanent immobilization of the fracture

To enhance the aesthetic outcome of the limb

To allow for quicker surgery and reduced costs

Which ligaments are considered collateral ligaments of the knee joint?

Medial and lateral menisci

Medial and lateral collateral ligaments (correct)

Anterior and posterior cruciate ligaments

Patellar and femoral ligaments

Which statement best describes the difference between arthroscopy and open surgery?

Arthroscopy uses a scope for visualization while minimizing incisions Signup and view all the answers

During a bilateral total hip replacement, what employs the modular method?

Aligning legs symmetrically in length Signup and view all the answers

What is considered the gold standard for treating intramedullary fractures?

Intramedullary (IM) rods Signup and view all the answers

What is a common advantage of arthroscopic procedures?

Reduced post-operative pain and scarring Signup and view all the answers

In which type of fractures can the IM nailing technique be effectively utilized?

Subtrochanteric fractures Signup and view all the answers

What method is commonly used to ensure proper visualization during an arthroscopic procedure?

Normal saline irrigation Signup and view all the answers

Which method emphasizes stress at the fracture site rather than distributing it?

Plate/screw fixation Signup and view all the answers

Which of the following statements about external fixation is true?

It allows for additional procedures for soft tissue injuries. Signup and view all the answers

What is the primary advantage of Open Reduction and Internal Fixation (ORIF) compared to closed methods?

It offers direct visualization of the fracture site. Signup and view all the answers

Which type of fracture is most common in elderly women due to osteoporosis?

Intertrochanteric Fractures Signup and view all the answers

What is a critical factor in the management of femoral neck fractures?

Ensuring proper blood supply is maintained. Signup and view all the answers

What type of instrumentation is typically used for stable femoral neck fracture fixation?

Cannulated Screws Signup and view all the answers

Which of the following procedures is indicated for unstable femoral neck fractures?

Total Hip Arthroplasty Signup and view all the answers

What is the function of the guide pin in the Dynamic Hip Screw instrumentation?

To create a channel for the lag screw. Signup and view all the answers

What must be done prior to internal fixation of the femoral neck to prevent complications?

Reduction of the fracture. Signup and view all the answers

Which focal virtue relates to the active regard for the patient's best interests?

Compassion Signup and view all the answers

What is a key element that the perioperative nurse must respect when planning treatment?

Patient and family values Signup and view all the answers

Which ethical value emphasizes the need for maintaining commitments in perioperative nursing?

Client well-being Signup and view all the answers

Which standard is crucial for effective clinical decision-making in perioperative nursing practice?

Effective use of the nursing process Signup and view all the answers

Which focal virtue is primarily concerned with building a trustworthy relationship with the patient?

Trustworthiness Signup and view all the answers

What is the primary purpose of using a vasoconstrictor solution in rhinologic surgeries?

To prevent bleeding during the surgery Signup and view all the answers

Which surgical procedure might require a tracheostomy prior to commencement?

Radical neck dissection Signup and view all the answers

Which of the following instruments is NOT typically used in head and neck surgeries?

Cardiac stethoscope Signup and view all the answers

In tympanoplasty, what is the main indication for performing this procedure?

Conductive hearing loss Signup and view all the answers

The use of which antiseptic is avoided during laryngeal surgeries due to its ototoxic nature?

Chlorhexidine Signup and view all the answers

What is the goal of Functional Endoscopic Sinus Surgery (FESS)?

To improve drainage of the sinuses Signup and view all the answers

What is the initial position of the patient for most head and neck surgeries?

Supine with a shoulder roll Signup and view all the answers

What does the term 'commando procedure' refer to in surgical context?

Oral resection coupled with radical neck dissection Signup and view all the answers

Before passing a tracheostomy tube to the surgeon, what must be tested for leaks?

Cuff with sterile water Signup and view all the answers

What is the main objective of applying topical lidocaine in laryngeal surgeries?

To provide local anesthesia to the vocal cords Signup and view all the answers

What is a significant risk associated with burn surgery due to large tissue exposure?

Hypothermia from tissue loss Signup and view all the answers

What is one of the goals of dressings used in burn surgery?

Collect drainage Signup and view all the answers

Which type of skin graft can be meshed to cover a larger burn area?

Split Thickness Skin Graft (STSG) Signup and view all the answers

What is a long-term risk associated with Split Thickness Skin Grafts (STSG)?

Development of skin contractures Signup and view all the answers

Which procedure involves the removal of the lens within its capsule?

Intra Capsular Cataract Extraction (ICCE) Signup and view all the answers

What part of the skin does a Full Thickness Skin Graft (FTSG) include?

Epidermis and dermis Signup and view all the answers

Which of the following statements about the donor site healing of STSG is true?

It can regenerate epithelium quickly Signup and view all the answers

Why is warmth important in the surgical room for burn surgery?

To prevent hypothermia in the patient Signup and view all the answers

What must be maintained for a graft to survive on the recipient site?

Adequate vascularity Signup and view all the answers

What is the main purpose of the dressings applied during burn surgery?

To immobilize the surgical part Signup and view all the answers

Study Notes

External Fixation and ORIF

External fixation stabilizes fractures without a cast, allowing for soft tissue procedures like skin grafts.
Open Reduction and Internal Fixation (ORIF) corrects fractures when closed methods are insufficient, using internal devices like plates and screws.
ORIF provides direct exposure to the fracture for anatomical alignment.

Hip Fractures

Intertrochanteric Fractures
- Common in elderly women due to osteoporosis; occur between greater and lesser trochanters.
- Extracapsular fractures; blood supply intact allows fixation with plates and screws.
- Typically utilizes Dynamic Hip Screw (DHS) instrumentation.
Femoral Neck Fractures
- Requires reduction before fixation to prevent nonunion and avascular necrosis; blood supply compromised.
- Two fixation types:
  - Stable fractures fixed using cannulated screws.
  - Unstable fractures require Total Hip Arthroplasty (THA), using either unipolar or bipolar components.
Subtrochanteric Fractures
- Treated with Intramedullary (IM) Nails; utilizes fluoroscopy for precision.
- IM Rods distribute weight-bearing stresses effectively, minimizing complications.

Arthroscopy

Common for knee, shoulder, and wrist joints; used for diagnostic and operative purposes.
Utilizes a scope for visualization and normal saline for joint distention.
Benefits include decreased recovery time, smaller incisions, and less postoperative pain.

Nursing Process Considerations

Facial nerve monitoring necessary during surgeries.
Rhinologic surgeries involve vasoconstrictor use to prevent bleeding.
Laryngeal surgeries may use topical anesthetics like lidocaine.
Surgical positioning generally supine with consideration for visualization.

Tympanoplasty

Surgical repair of the tympanic membrane and reconstruction of ossicles.
Indicated for conductive hearing loss.

Functional Endoscopic Sinus Surgery (FESS)

Involves inserting an endoscope to address sinus issues.
Indicated for conditions like polyps and severe allergies.

Radical Neck Dissection

Removal of malignant tissues including nodes and major blood vessels.
Supine position with a tracheostomy often required pre-surgery.

Tracheostomy

Performed for prolonged intubation or airway obstruction.
Includes insertion of a cannula through the trachea.

Neuro Surgery

Involves careful dissection with attention to local infiltration and incision techniques.

Burn Surgery and Skin Grafts

Warm operating room necessary to prevent hypothermia due to extensive tissue exposure.
Vascular integrity is crucial for graft survival; immobilization is necessary.
Split Thickness Skin Graft (STSG)
- Involves epidermis and part of the dermis; heals quickly and can be meshed.
- Aesthetic concerns as contractures may develop over time.
Full Thickness Skin Graft (FTSG)
- Includes both layers of the skin; minimizes contracture and enhances aesthetics.
- Donor site closed primarily and cannot be reused.

Ophthalmology - Cataracts

Cataracts refer to the clouding of the eye's lens.
Cataract Surgery removes the opaque lens:
- External methods like Extra Capsular Cataract Extraction (ECCE) and Intra Capsular Cataract Extraction (ICCE) are available.

Focal Virtues in Nursing

Compassion: Focus on patient best interests.
Discernment: Insightful judgment to benefit patient care.
Trustworthiness: Foster relationships with patients and families.
Integrity: Maintain dignity and ethical practice.
Conscientiousness: Prioritize patient welfare in decision-making.

CNO Ethical Values

Values like client well-being, privacy, truthfulness, and fairness guide perioperative nursing practices.
Emphasis on safe patient care through collaborative multi-disciplinary approaches.

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Description

This quiz covers essential concepts in orthopedic surgery, focusing on external fixation techniques and Open Reduction and Internal Fixation (ORIF) for hip fractures. It highlights the differences between intertrochanteric and femoral neck fractures, their treatment options, and the importance of anatomical alignment in fracture healing.