Osteomyelitis and Surgical Techniques

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Questions and Answers

What is the purpose of surgical débridement in cases of infected bone?

To remove necrotic material and set the stage for healing (correct)

To prevent swelling around the infected area

To strengthen the bone structure

To replace infected bone with metal implants

Which of the following statements about sequestrectomy is true?

It is primarily used to treat joint inflammation

It is a non-surgical procedure

It involves the removal of healthy bone

It enables the removal of sequestrum after removing enough involucrum (correct)

What condition is most commonly associated with osteomyelitis due to vascular insufficiency?

Traumatic injuries

Open fractures

Diabetes and peripheral vascular disease (correct)

Surgical infections

What is the primary organism causing hematogenous osteomyelitis?

Staphylococcus aureus Signup and view all the answers

What is a characteristic of muscle flap procedures in surgical treatment?

Muscle is moved from an adjacent area with the blood supply intact Signup and view all the answers

Which of the following best describes the condition of Gout?

A common inflammatory arthritis affecting a significant portion of men Signup and view all the answers

What surgical technique is used to convert a deep cavity into a more manageable structure?

Saucerization Signup and view all the answers

Which of the following is NOT a common organism associated with osteomyelitis?

Staphylococcus epidermidis Signup and view all the answers

Which clinical feature is NOT part of the classic triad for S/S?

Chest tightness Signup and view all the answers

What is a common cause of Acute Compartment Syndrome?

Tibial fractures Signup and view all the answers

Which of the following symptoms is considered a cardinal symptom of Acute Compartment Syndrome?

Pain Signup and view all the answers

What is typically assessed to evaluate peripheral circulation in suspected Acute Compartment Syndrome?

Skin color and temperature Signup and view all the answers

When do petechial rashes typically develop in relation to the onset of FES symptoms?

2-3 days after onset Signup and view all the answers

Which of the following is NOT a treatment for Fat Embolism Syndrome (FES)?

Surgical intervention Signup and view all the answers

Which symptom may indicate the later stages of nerve ischemia in Acute Compartment Syndrome?

Paralysis Signup and view all the answers

What could a prolonged capillary refill time indicate in the context of evaluating peripheral perfusion?

Impaired arterial perfusion Signup and view all the answers

What is the primary purpose of reducing traction weight as muscles relax?

To promote healing and prevent fracture dislocation Signup and view all the answers

Which nursing intervention helps to prevent footdrop in a patient with traction?

Positioning the patient in a midline position Signup and view all the answers

What should a nurse monitor in the neurovascular status of a patient in traction?

Peripheral pulses and capillary refill Signup and view all the answers

Which of the following is a risk for immobilized patients undergoing traction?

VTE formation Signup and view all the answers

What is the main purpose of using a trapeze in patient care during traction?

To improve patient mobility within bed Signup and view all the answers

Which dressing type is recommended for preventing skin breakdown in critical areas of a patient in traction?

Transparent film or hydrocolloid dressings Signup and view all the answers

How often should neurovascular status be monitored in the first 24 hours after traction is applied?

Every hour Signup and view all the answers

What type of exercise should a nurse encourage for a patient in traction to improve circulation?

Calf-pumping exercises Signup and view all the answers

What is the primary goal of Total Joint Arthroplasty (TJA)?

Restore joint motion Signup and view all the answers

Which of the following materials is NOT commonly used in joint arthroplasty?

Carbon fiber Signup and view all the answers

What preoperative method can be employed to prevent blood loss?

Utilizing pneumatic tourniquets Signup and view all the answers

Which joint is least likely to be replaced due to arthroplasty?

Ankle Signup and view all the answers

What is one of the common complications associated with joint arthroplasty?

Prosthesis loosening Signup and view all the answers

Which of the following methods is used in VTE prevention after joint arthroplasty?

Prophylactic anticoagulants Signup and view all the answers

What is an important postoperative care recommendation following joint arthroplasty?

Early physical therapy within 24 hours Signup and view all the answers

What percentage of hip fractures in older adults results from falls?

95% Signup and view all the answers

Which of the following is NOT one of the 5 Ps used in neurovascular checks?

Pleased Signup and view all the answers

What indicates a sign of arterial insufficiency?

Cool, pale skin Signup and view all the answers

What is the appropriate response when a patient reports pain inside their cast?

Report the pain immediately to the provider Signup and view all the answers

Which action should NOT be performed when caring for a cast?

Bear weight on the cast until fully healed Signup and view all the answers

What is a potential complication of using a hip/spica cast?

Compartment syndrome Signup and view all the answers

What sign might indicate a pressure ulcer developing under a cast?

Severe burning pain over bony prominences Signup and view all the answers

Why is it advised to elevate a cast during the first 48 hours?

To reduce swelling Signup and view all the answers

What is a common symptom of venous insufficiency?

Warm skin and potential ulcers Signup and view all the answers

What is the primary cause of hyperuricemia?

Excessive production or impaired kidney excretion of uric acid Signup and view all the answers

Which of the following is NOT a risk factor for gout?

Regular exercise Signup and view all the answers

Which treatment is commonly used for acute gout attacks?

Colchicine Signup and view all the answers

What triggers the inflammation process in gout?

Macrophages phagocytizing urate crystals Signup and view all the answers

What is a common clinical manifestation of chronic tophaceous gout?

Frequent attacks and formation of tophi Signup and view all the answers

Which medication is used for long-term management of uric acid levels?

Allopurinol Signup and view all the answers

What is the effect of alcohol consumption on gout?

Exacerbates the inflammatory response Signup and view all the answers

Which stage of gout is characterized by severe joint inflammation, often affecting the big toe?

Acute gouty arthritis Signup and view all the answers

Study Notes

Low Back Pain

Caused by numerous musculoskeletal problems, including acute lumbosacral strain, unstable lumbosacral ligaments, weak muscles, intervertebral disc problems, and unequal leg length.
Gerontologic considerations include osteoporotic vertebral fractures, osteoarthritis of the spine, and spinal stenosis.
Obesity, postural problems, structural problems, and overstretching of spinal supports can cause back pain.
Stress and anxiety can evoke muscle spasms and pain.

Pathophysiology

The spinal cord is a rod of rigid vertebrae and flexible intervertebral discs, connected by facet joints, ligaments, and paravertebral muscles.
This structure allows for flexibility and protection of the spinal cord.
Disc degeneration is a common cause of low back pain. Lower lumbar discs, L4-5 and L5-S1, are most susceptible.
Disc protrusion or facet joint changes can put pressure on nerve roots, causing radiating pain along the nerve.

Clinical Manifestations

Acute back pain: less than 3 months.
Chronic back pain: more than 3 months without improvement.
Radiculopathy: pain radiating from a diseased spinal nerve root; pain radiating down the leg.
Sciatica: pain radiating from an inflamed sciatic nerve.
Signs of spinal mobility, gait, reflexes, leg length, leg motor strength, and sensory perception may be affected.
Physical exam may show paravertebral muscle spasm—greatly increased muscle tone of the back postural muscles with loss of normal lumbar curve and possible spinal deformity.

Assessment/Diagnostics

Focused history and physical exam—observation of the patient's gait, posture.
Location, severity, duration, characteristics, radiation, and leg weakness of the pain.
How the pain occurred and how it's been managed by the patient.
Work and recreational activities.
Spinal curvature, back and limb symmetry.
Palpate paraspinal muscles.
Movement ability and effects on ADLs - determine limitations.
DTRs, sensation (paraesthesia), and muscle strength.
Assess posture, position changes, and gait.
Straight leg raising to assess nerve root involvement.
Findings may show nonspecific lumbar strain or serious issues like spinal fracture, cancer, infection, or neurologic deficit, based on clinical signs and symptoms, age, and use of corticosteroids.

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Description

This quiz covers key concepts related to osteomyelitis, surgical débridement, and various associated conditions. Test your knowledge on the organisms responsible for infections, surgical techniques like sequestrectomy, and the conditions linked to acute compartment syndrome. Perfect for medical students or healthcare professionals!