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Chapter 21 Ortho (Surg Tech)

front 1

ACL

(Anterior Cruciate Ligament)

back 1

is attached to the posterior lateral condyle of the femur and to a notch in the midline of the tibia between the tibial condyles. prevents the femur from sliding posteriorly on the tibia, prevents hyperextension of the knee, and limits the medial rotation of the femur when the leg is in a fixed position with the foot planted. A common injury of the knee

front 2

Posterior Cruciate Ligament

back 2

is attached to the posterior midline surface of the tibia and passes anteriorly, attaching to the medial condyle of the femur. prevents the femur from sliding anteriorly on the tibia, especially when the knee is bent.

front 3

Bankart

back 3

is an avulsion (tear) injury of the anterior capsule and labrum of the glenoid rim; it is usually caused by subluxation or luxation of the joint. The tear affects that portion of the labrum called the inferior glenohumeral ligament;

front 4

Indications for a Total Shoulder Artroplasty

back 4

chronic pain from glenohumeral arthritis with significant loss of ROM and joint function the condition has not been resolved by conservative medical therapy. Complications include narrowing of the joint space, osteophyte formation, and cysts.

front 5

Acromion

back 5

is a bony process on the scapula (shoulder blade). Together with the coracoid process it extends laterally over the shoulder joint.

front 6

Acetabulum

back 6

is a concave surface of the pelvis. The head of the femur meets with the pelvis at the this, forming the hip joint.

front 7

Greater Trochanter

back 7

is located on the upper, lateral part of the upper shaft of the femur. It serves as the point of insertion for the gluteus medius and gluteus minimus.

front 8

Lesser Trochanter

back 8

The iliopsoas muscle inserts onto

front 9

Liston amputating knife

back 9

front 10

Gigli-Strully saw handle

back 10

front 11

Gigli 12-in. saw

back 11

front 12

Satterlee bone saw

back 12

front 13

Above the Knee Amputation

back 13

front 14

Below The Knee Amputation

back 14

front 15

Bunionectomy

back 15

medically referred to as hallux valgus, is a bony exostosis located on the medial side of the first metatarsal head of the great toe causing a lateral deviation of the toe.

Various types of surgical procedures are used to treat the condition, such as the Aken, Chevron, McKeever, Keller, and McBride techniques

front 16

Meniscus

back 16

A joint in which the two bony surfaces are joined by fibrocartilage The knee joint is cushioned to withstand activities such as walking, jumping, and running by a pair of are thick, crescent-shaped pads of cartilage that rest on the upper articular surface of the tibia. Injuries, particularly athletic injuries, are common and result in various types of tears in the cartilage.

front 17

Biters

back 17

Used in Arthroscopy Cases, Types include up, down, right, and left

front 18

Types of Arthroscopes

back 18

30 degree and 70 degree

front 19

How do you create a path for Screws and Nails?

back 19

Nontapping screws require that the drill hole be tapped with a tapping device prior to placement of the screw. Screws that are self-tapping can be identified by an angled notch near the tip of the screw.

front 20

Abduction

back 20

Moving a body part away from the midline of the body

front 21

Adduction

back 21

Moving a body part toward the midline of the body

front 22

Flexion

back 22

Bending a joint

front 23

Extension

back 23

Straightening a joint

front 24

Pronation

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Pointing a body part downward (e.g., facing the palm of the hand downward)

front 25

Supination

back 25

Pointing a body part upward

front 26

Short arm cast

back 26

Applied from below the elbow to the metacarpal heads; wrist fracture

front 27

Long arm cast

back 27

Applied from axilla to metacarpal heads; fracture of forearm or elbow

front 28

Short leg cast

back 28

Applied from tibial tuberosity to metatarsal heads; ankle and foot fractures

front 29

Long leg cast

back 29

Applied from hip to metatarsal heads; fracture of femur, tibia, fibula, ankle

front 30

Cylinder cast

back 30

Applied from the groin to the ankle; required when complete knee immobilization is desired

front 31

Hip spica cast

back 31

Applied to trunk, complete leg of affected side, one-half of unaffected leg

front 32

Body jacket cast (Minerva jacket)

back 32

Applied to trunk of body to immobilize the spine

front 33

Who is responsible for implants

back 33

The FDA

front 34

What does an MRI diagnosis for Ortho?

back 34

This is a noninvasive imaging technique that relies on the body’s responses to a strong magnetic field.

front 35

CT Scan

back 35

is an X-ray of an organ or body detailing that structure at various depths. Multiple radiographs are taken at multiple angles, and the computer reconstructs these images to represent a cross-section or “slice” of the structure.

front 36

Polymethyl methacrylate (PMMA)

back 36

also referred to as bone cement, is routinely used during total joint arthroplasty. Bone cement stabilizes and keeps the implants in the correct anatomical position. The cement fills the cavity and spaces of the bone to form a bond between the implant and bone.

front 37

Tourniquet Times

back 37

should not be applied for more than 1 hour on an upper extremity or for more than 1½ hours on the thigh. After 1 hour of pressure, the surgeon should be notified, and again every 15 minutes thereafter.

front 38

fracture table

back 38

commonly used for surgery on a hip fracture and for femoral nailing. must be well understood by the personnel using it in order for it to be properly set up. have several moving parts and can cause injury to the patient and OR personnel if not correctly handled. The patient can be placed in the supine or lateral position

front 39

lateral position

back 39

is frequently used for operations on the hip and shoulder. The vacuum beanbag is often used to stabilize the patient in the lateral position, eliminating the need for roll towels and tape over the hips. The beanbag can be contoured to the body shape of the patient by adjusting the beanbag while the air is suctioned out.

front 40

reamers

back 40

The canal is reamed with subsequent larger sizes of reamers until the opening in the canal corresponds to the diameter of the shaft of the prosthesis.

front 41

Charnley

back 41

Self Retaining retractor used in total hip arthroplasty

front 42

Immovable Joints

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synarthroses, the bones are in close contact with each other and separated by a thin layer of cartilage. An example is the suture lines of the cranial bones.

front 43

Slightly Movable Joint

back 43

amphiarthrosis -Lying between the bones of the joint is a disk of fibrous cartilage that connects the bones. Examples of this type of joint include cartilage that connects the vertebrae and the disk of cartilage called the symphysis pubis that connects the pubic bones. This type of joint allows some movement due to the limited flexibility of the cartilage.

front 44

Freely Movable Joints

back 44

A diarthrosis. All diarthroses are also referred to as synovial joints because these joints all contain a synovial membrane that secretes synovial fluid. Diarthroses are further classified according to the movements they allow

front 45

Ball-and-Socket Joints

back 45

This type of joint allows for the widest range of motion (ROM). It consists of a bone with a ball-shaped head that articulates with the cup-shaped socket in another bone. Movement in all planes is possible, including rotational. Examples include the shoulder and hip joints.

front 46

Condyloid Joints

back 46

allows for movement in only one plane with some lateral movement. The joint is composed of a condyle of one bone fitting into the fossa of another bone. An example is the temporomandibular joint in which the condyle of the mandible fits into the fossa of the temporal bone.

front 47

Gliding Joints

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allow side-to-side and twisting movements. The articulating surfaces of the bones in the gliding joint are either flat or slightly curved. An example is the carpals of the wrist joint.

front 48

Hinge Joints

back 48

The elbow . This type of joint allows movement in only one plane, much like the motion permitted by the hinge on a door. is formed by the convex surface of one bone fitting into the concave surface of the adjacent bone.

front 49

Pivot Joints

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allow only a rotational movement around a central axis. The joint formed at the proximal end of the radius

front 50

Saddle Joints

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allow movement in a variety of planes. The articulating surfaces of the bones have both concave and convex regions. The surface of one bone fits into the equivalent surface of the other bone. An example is the joint formed by the trapezium of the wrist with the metacarpal of the thumb.

front 51

What is the thickest and strongest tendon in the body

back 51

The achillies Tendon

front 52

When to use Nails

back 52

  • The type of nail to be used depends on the type and location of the fracture, whether ipsilateral trochanteric or condylar fractures are present, and whether bone fragments are present.

front 53

Names and Types of Nails

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flexible nails such as the Rush and Ender; interlocking nails such as the Trigen; retrograde interlocking intramedullary nails; and standard nails such as the AO (surgical procedure description is for AO titanium femoral nail system).

front 54

Plates

back 54

  • Surgical repairs that have been used in the past but have fallen out of favor include external fixation and plates and screws. The complications associated with plates and screws include infections and broken or bent screws and plates, which have contributed to femoral refracture.

front 55

Patella

back 55

Sesamoid (round) bones are found within tendons. Another example is the two sesamoid bones found on the head of the metatarsal in the foot forming what is referred to as the “ball” of the foot.

front 56

long bones

back 56

include bones of the arm (humerus), legs (femur), hands, and feet (phalanges)

front 57

Short bones

back 57

are the bones of the wrists (carpals) and ankles (tarsals). As evidenced by the wrist and ankle bones, short bones usually occur in clusters and aid in the movement of an extremity.

front 58

Esmarch

back 58

Used to exsanguinate the limb before use of the Tourniquet

front 59

Type of suture used for tendon to tendo

back 59

Fiberwire or Ethibond

front 60

Spinal Needle

back 60

Used for positioning

front 61

Distraction

back 61

s a term used to describe bone fragments that are separated so that bone contact does not occur.

front 62

Avascular necrosis

back 62

occurs when the capillary network or collateral circulation cannot be reestablished following a traumatic injury or when the vascular system is disrupted by other means.

front 63

compound fracture

back 63

compromises the integrity of the skin and allows for the possible entry of microorganisms, which may cause infection of the bone and injury to surrounding soft tissues

front 64

Delayed union

back 64

is a term used to describe an increase in the healing time of fractures. The reasons for are pathological (e.g., osteoporosis), mechanical (e.g., distraction of the fracture site or inadequate immobilization), or traumatic, referring to the type of injury sustained (e.g., comminuted fractures).

front 65

Nonunion

back 65

is when the fractured bone ends do not unite.

front 66

Malunion

back 66

occurs when the fracture heals in a position that does not resemble the original anatomical form of the bone and alters the mechanical function of the bone.

front 67

Compartmental syndrome

back 67

is an increase in pressure within a closed space that usually occurs in the forearm and tibia.

front 68

Stages of Healing

Inflammation

back 68

begins at the time of injury and lasts approximately 2 days.

front 69

Stages of Healing

Cellular Proliferation

back 69

begins approximately on the second day following the traumatic event. Macrophages debride the area and allow for the formation of a fibrin mesh that seals the approximated edges of the fracture site. The fibrin mesh serves as the foundation for capillary and fibroblastic ingrowth. A soft tissue or periosteal callus is formed on the outer surface or cortex of the fractured bone by the collagen-producing fibroblasts and osteoblasts.

front 70

Stages of Healing

callus formation

back 70

stage lasts 3–4 weeks. The soft tissue growth continues and the bone fragments grow toward one another, bridging the gap. Osteoblasts form a matrix of collagen that invades the periosteal callus, bridging the fracture site and uniting the two ends of the bone. Fibrous tissue, cartilage, and immature bone stabilize the fracture site.

front 71

Stages of Healing

Ossification

back 71

begins 2 or 3 weeks following the injury and can last 3–4 months. The matrix of osteoblasts, now called the osteoid, calcifies, firmly uniting the bone. The bone is now able to accept mineral deposits.

front 72

Stages of Healing

Remodeling

back 72

is the maintenance state of normal bone. Following a fracture, any devitalized tissue is removed and the new bone is organized to provide maximum support and function.

front 73

Colles Fracture

back 73

  1. a fracture of the lower end of the radius in the wrist with a characteristic backward displacement of the hand.

front 74

Active Bone Growth

back 74

epiphyseal plate

front 75

epiphyses

back 75

The proximal portion of a long bone

front 76

diaphysis

back 76

is composed of compact bone that surrounds the medullary cavity.

front 77

Cortical Bone

back 77

Type of bone tissue that is hard and dense, and that surrounds the marrow cavity; also referred to as compact bone

front 78

cancellous bone

back 78

A type of bone tissue found at the ends of bone and lining the medullary marrow cavity; composed of columns of trabeculae with large spaces in between; also referred to as spongy bone due to its appearance

front 79

Para Thyroid Hormone

back 79

Stimulates Bone Growth

front 80

Unicompartmental implants

back 80

are used to replace either the medial or lateral side of the corresponding articular surface of the femur and tibia.

front 81

Bicompartmental implants

back 81

replace the medial and lateral surfaces of the femur and tibia.

front 82

Tricompartmental implants

back 82

replace the medial and lateral surfaces of the femur and tibia, including the patella.

front 83

Unconstrained implant:

back 83

Requires minimal resurfacing of the tibia and femur, and good collateral and posterior cruciate ligaments;

front 84

semiconstrained implant:

back 84

Used when there is a difficulty with ligament balance

front 85

fully constrained implant

back 85

Implant is jointed together by hinges and only allows motion in a sagittal plane.

front 86

ACL Grafts

Autografts

back 86

patellar tendon, hamstring, quadriceps tendon,

front 87

allograft

back 87

Taken from another person

front 88

Most common Cause for a distal Radius Fracture

back 88

Fall onto an outstretched Arm

front 89

Ringers Solution

back 89

Used in Arthroscopy cases when using the ESU

front 90

Softening bone in children

back 90

Osteomalacia also called Rickets

front 91

Bucket Handle Tear

back 91

consists of an incomplete longitudinal tear with displacement of the inner portion of the meniscus. When a tear of this type is encountered, an arthroscopic partial meniscectomy or repair can be completed.

front 92

What instrument is commonly called Turkey Foot or Eagle Talon

back 92

Lowman Bone Holding Clamp