Exam 19: Orthopedic Surgery

MATCHING Match the skeletal structure with its appropriate description. a.Ligaments b.Tendons c.Cartilage -Callus formation

Colles' (wrist)fracture is a dorsally angulated fracture of the distal end of the radius.Most of these fractures can be managed successfully with closed reduction and immobilization,but external fixation is especially useful in the case of a comminuted intra-articular fracture.Internal fixation with Kirschner wires (K wires)is indicated when the distal end of the radius is severely comminuted and displaced.Select the nursing considerations for a patient with a Colles' fracture fixation.

Bone grafting using allografts or autografts may be used to fill cavities after removal of large amounts of bone that might result in instability,or to fill bony defects and to promote the union of fractures at the time of open reduction.Banked bone is available in many shapes of cortical and cancellous tissue.The American Association of Tissue Banks (AATB)accredits and periodically inspects bone-banking programs to ensure that specific standards are followed in the retrieval,processing,storage,and distribution of bone grafts.Bone graft that is sealed in a sterile labeled envelope from a tissue transplant company and stored in a vacuum-sealed freezer,monitored with an alarm,would be considered a(n):

An OR fracture bed is used for orthopedic surgical procedures such as femoral neck or shaft fixation.The patient can be positioned in a partially suspended supine or lateral position.This specialized supportive bed provides several therapeutic options that promote a safe,efficient,and ergonomic approach to the area to be repaired.Select all the therapeutic options that promote the successful accomplishment of a femoral fracture procedure.

Vertebroplasty and kyphoplasty are used for the treatment of vertebral compression fractures attributable to osteoporosis or pathologic conditions.Bone cement is injected into the vertebral body to decrease back pain and prevent further vertebral body height loss.Equipment includes C-arm,radiolucent OR bed,and x-ray vests for staff as well as bone biopsy needles,vertebroplasty system,and cement injection system.An important nursing consideration relevant to this interventional radiology-assisted procedure would be:

Osteoporosis is one of the most common and serious of bone diseases and is responsible for more than 2 million fractures a year.Osteoporosis-related fractures most commonly occur in the hip,spine,and wrist,but any bone can be affected.The excessive reduction of total bone mass in osteoporosis is due to the loss of:

While not as prevalent as arthroplasty of the shoulder,knee,or hip,total elbow replacement is indicated for patients with traumatic lesions or excessive bone loss from rheumatic or degenerative arthritis,resulting in elbow instability and pain or bilateral elbow ankylosis.The prosthesis may be used with or without PMMA,depending on the quality of the diseased bone and the design of the implant.If PMMA is not used,what replacement product,element,or substance is used?

The scaphoid,also called the navicular,links the proximal row of carpal bones as it:

Frances Hartman,a 68-year-old retired art dealer,has chronic joint pain in both knees and hips.She does not have osteoarthritis,but is overweight and sedentary.While Frances believes she needs to convince her orthopedic surgeon that she should be considered a candidate for joint replacement surgery,her neighbor Chris,a perioperative orthopedic nurse,is teaching Frances about the role of cartilage in the joints and how to prevent further injury.Chris has convinced Frances to join her in stretching exercises and a daily walk through the neighborhood.Chris has explained to Frances that this program can help prevent degenerative conditions because:

MATCHING Match the skeletal structure with its appropriate description. a.Ligaments b.Tendons c.Cartilage -Layer of elastic,resilient supporting tissue found at the ends of the bones

MATCHING Match the skeletal structure with its appropriate description. a.Ligaments b.Tendons c.Cartilage -Fibrin network formation

MATCHING Match the skeletal structure with its appropriate description. a.Ligaments b.Tendons c.Cartilage -Tough,long strands of fibers that form the ends of muscles

Identify the layer of connective tissue that covers all bone.

Paget's disease is a disorder affecting older adults.The bones are weak and poorly constructed.It is characterized by the proliferation of osteoclasts and compensatory increased osteoblastic activity.This degenerative process results in:

The surgeon may treat distal limb fractures with a closed reduction,rather than open or external fixation,manipulating the fragments into position without incising the skin.When possible,this is the treatment of choice because it decreases the opportunity for infection,improves results (including bone union of the fracture),and minimizes the recovery period.Closed reduction with local or light anesthesia may permit ambulatory surgery.Select a situation where closed reduction would be performed in addition to open reduction and fixation surgery to a distal limb.

Polymethyl methacrylate (PMMA,or bone cement)is an acrylic,cement-like substance composed of a liquid methyl methacrylate monomer and a powder methyl methacrylate-styrene co-polymer.What element is added to the powder component to make the finished product radiopaque?

MATCHING Match the skeletal structure with its appropriate description. a.Ligaments b.Tendons c.Cartilage -Hematoma formation

MATCHING Match the skeletal structure with its appropriate description. a.Ligaments b.Tendons c.Cartilage -Invasion of osteoblasts

In an open anterior cruciate ligament (ACL)repair,an examination under anesthesia (EUA)is performed immediately after induction of anesthesia,when the ligaments are completely lax,to evaluate the severity of the injury.The surgeon then makes a straight midline or slightly medial incision across the knee.Arthroscopic repair causes less patellar pain and decreased disturbance of extensor mechanisms.What preoperative indicators contribute to selecting the surgical approach (open or arthroscopic)of choice?

Select the true statement about application and operation of the pneumatic tourniquet.