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fusion of a joint
arthrodesis
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disruption of the blood supply to a bone that causes death and irreversible decay of the osseous bone
avascular necrosis
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cast cut into 2 parts - front and back - for removal and reapplication
bi-valve cast
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adverse physiologic response of patient to placement of bone cement in the medullary canal
bone cement implantation syndrome (BCIS)
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swelling between layers of fascia that causes damage to tissue
compartment syndrome
-
generating heat
exothermic
-
evacuation of blood from a limb before inflating a tourniquet to create bloodless field
exsanguinate
-
emergency procedure to release pressure on region of compartment syndrome
fasciotomy
-
basophilic cells that synthesize collagen and glycoprotein to form bone matrix
osteoblast
-
cells in the bone that influence growth and regeneration by breakdown and resorption of existing cellular material
osteoclasts
-
bone infection
osteomyelitis
-
healing process of a bone
union
-
failure of bone to align and heal
nonunion
-
how many bones does the human skeleton have?
206
-
what does axial skeleton consist of?
- skull, vertebrae and ribcage
- 80 bones
-
what does appendicular skeleton consist of?
-
how many bones does each upper extremity consist of?
32
-
how many bones does each lower extremity consist of?
31
-
-
examples of long bones
- humerus, radius, ulna
- femur, thigh, tibia, fibula
-
end of a long bone
epiphysis
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shaft of a long bone
diaphysis
-
examples of short bones
bones in the hand and foot
-
examples of flat bones
scapula and patella
-
examples of irregular bones
vertebrae
-
outer layer of bone
cortex
-
description of cortex
compact, hard connective tissue that surrounds porous, spongy, cancellous tissue
-
where is red marrow found?
ends of long bones, porosities of cancellous bone, and flatter bones
-
what is red marrow responsible for?
erythropoeisis (formation of red blood cells and certain white blood cells)
-
where is yellow marrow found?
medullary canals
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strong, fibrous membrane that covers bone except at joints
periosteum
-
lengthwise, lamellar structures that provide weightbearing strength and passage for additional blood supply
haversian canals
-
how does blood supply enter bones?
penetrates periosteum and enter through Volkmann canals
-
what is inner aspect of the bone lined with?
endosteum
-
steps of bone healing
- hematoma formation
- callus formation
- calcification process
- remodeling phase
-
how soon after injury is a callus visible on radiograph?
within 1 to 2 weeks of injury
-
how soon after injury is connective tissue completely calcified?
within 6 weeks
-
how soon can complete remodeling take to complete?
6 months to 1 year
-
smooth, relatively firm, compressive connective tissue, cusions most articular surfaces at the ends of bones
cartilage
-
from what does cartilage derive its nutrition?
synovial fluid
-
what does synovial fluid contain that keep the joint free of debris and bacteria?
macrophages and white blood cells
-
examples of ball-and-socket joints
hip and shoulder
-
examples of hinged joints
knee, ankle, elbow and phalangeal joints of the fingers
-
examples of condyloid joint
wrist
-
examples of saddle joint
thumb
-
bands of flexible, tough fibrous tissue that join the articular surfaces of bones and cartilage
ligaments
-
classifications of muscles
- cardiac (branching)
- smooth (involuntary)
- skeletal (voluntary)
-
largest category of muscle tissue
skeletal muscle
-
bands of extremely strong, flexible fibrous tissue that attach muscle bundles to the periosteum of bones
tendons
-
infection in bone
osteomyelitis
-
what may acute osteomyelitis cause?
nonunion of fractures
-
what may chronic osteomyelitis cause?
loss of extremity
-
what is chronic osteomyelitis often associated with?
peripheral vascular disease
-
what types of protective attire is needed for orthopedic surgery?
- knee-high, waterproof shoe covers
- fluid-impervious gown and/or waterproof apron under the gown
- double-glove
- protective eyewear with full-face shield when splatter anticipated
-
semi-sharp instruments used to strip periosteum from bone without destroying its ability to regenerate new bone
periosteal elevators
-
clamps needed to hold smaller bones or grasp a joint capsule
heavy clamps
-
how are power-driven instruments powered?
electricity or compressed air or nitrogen
-
which way is reciprocating movement of power cutting instrument
cutting action from front to back
-
which way is oscillating movement of power cutting instrument?
cutting action from side to side
-
instruments used for insertion or extraction of metallic implants versus actual implants
must be of same metal to prevent galvanic reaction
-
what types of bone grafts are obtained from iliac crest?
autologous cancellous and cortical bone
-
what types of bone grafts are obtained from fibula?
cortical bone
-
how long after procurement of bone graft must a living donor be retested for HIV?
90 days
-
devices used to stabilize or immobilize bone
fixation devices
-
used to permanently replace bone, joints or tendons
prosthetic implants
-
what are prosthetic implants made of?
nonmagnetic and electrolytically insert metals (stainless steel, cobalt and titanium)
-
what is used to reinforce fixation or increase the strength of implant?
methyl methacrylate (bone cement)
-
should implants such as plates and screws be flash-sterilized?
- no, not for any reason
- cannot withstand the heat
-
what method is used to sterilize implants?
ethylene oxide
-
how should a metal implant be handled when removing from the package?
- no instruments should be used (could get scratched)
- powder-free gloves should be worn when handling
-
what device or prosthesis specifics must be recorded in the patient's intraoperative record?
type, size, lot number
-
vaporizes methyl methacrylate to remove cemented joint implant during revision arthroplasty
CO2 laser
-
laser used primarily in knee, ankle, shoulder, and elbow - all joints except spine
Holmium:YAG laser
-
how does Holmium:YAG laser work?
- it can ablate dense cartilage, bone and soft tissue
- used through arthroscope to cut, shape, smooth and sculpt cartilage and tissues in joints
-
laser used primarily in arthroscopy of the knee and shoulder joints on articular cartilage
neodymium:YAG laser
-
how does neodymium:YAG laser work?
it vaporizes protein and bonds collagen
-
used for hemostasis on cut bone
bone wax
-
how is bone wax softened for use?
inner sterile foil packet can be placed in warm saline irrigation
-
used to identify neural tissue during a partial nerve resection to control spastic muscles
nerve stimulator
-
what type of materials are used to suture ligaments, tendons and muscles involved in movement of bony skeleton?
nonabsorbable synthetic materials
-
what type of suture is preferred to suture periosteum?
absorbable suture
-
table used for many surgical procedures requiring traction, x-ray image intensification, and/or cast application
fracture table
-
when is the patient anesthetized in regards to the fracture table?
on the transport cart before being positioned on the fracture table
-
preparations for lifting patient from transport cart to fracture table
- patient will be full lift whether general or regional anesthesia used
- table is very narrow
-
amount of blood loss when suction and autotransfusion is performed
400 mL
-
signs and symptoms of neurovascular impairment in extremity
6 P's - pallor, pulses, pain, paresthesia, puffiness and paralysis
-
fracture that runs across bone
transverse fracture
-
fracture that runs in slanting direction across bone
oblique fracture
-
fracture that coils around bone
spiral fracture
-
fracture that protrudes through skin
compound open fracture
-
who assumes responsibility for supporting the fracture site during transfer of the patient from one bed surface to another?
surgeon
-
3 distinct phases of fracture treatment
- reduction
- immobilization
- rehabilitation
-
methods of treating fractures
- closed reduction with immobilization
- skeletal traction
- external fixation
- open reduction and internal fixation (ORIF)
- electrostimulation
-
pulling force exerted to maintain proper alignment or position
traction
-
force applied directly on the bone after insertion of pins, wires, or tongs placed through or into the bone
skeletal traction
-
traction is applied by means of?
pulleys and weights
-
two or more pins or screws, parallel to each other, inserted into cortex of each fragmented bone section, and connected to metal bar
stabilization bar
-
external fixation frame with more than 120 interchangeable components, forming a framing system (weighs about 8 pounds)
Ilizarov technique
-
anesthesia given for ORIF
- regional block
- IV moderate sedation may be given to dull awareness of drill and mallet sounds
-
fracture of radial bone in the wrist
Colles fracture
-
slotted plate that permits muscle tone of extremity to keep ends of fragments pressed closely together
Eggers plate
-
plate fitted to contour of the bone
Sherman plate
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