Test Bank for Surgical Technology
Question and Answer Solutions
Fracture classifications -answer open and closed
Causes of fractures - answerstrauma and pathological
types of fractures - answersknow what each are
Greenstick/stress: barely fractured
Potts: @ fibula near ankle
Colles: Fall on outsretched hand (FOOSH)
Compound: penetrates skin
Comminuted: more than 2 pieces of bone fragments
Transverse: horizontal fracture
Oblique: angled across cortices
Spiral: curves around bone
Impacted: end of bones forced into each other
External Fixation - answersoutside of skin; bone anchoring devices, cast, skeletal
tractions, splints
Internal Fixation - answersinside of skin; rods on bone, screws, plates, nails
basic steps of instruments used in an ORIF procedure. - answersDrill, Measure (depth
guage), insert screw
Procedure steps ORIF - answersOpen incision
Reduction of fracture
Internal Fixation
casting - answershandle with palms
luke warm water
not too tight
cast is removed before entering OR
bones are repaired by a closed intramedullary nail - answersfemur, humerus, and tibia
steps in a closed intramedullary nail surgery - answersIncision, AWL to create hole in
bone, reaming, then insert nail
anatomical landmarks and where - answersTrochanter: head of femur
Medial malleolus: tibia distal end
,Lateral malleolus: fibula.
Olecranon: elbow (ulna)
Condyles: femur
Epicondyles: above condyles
bone graft site - answersiliac crest (pg. 451-452 alexander's)
instruments used to retrieve bone - answerslambotte osteotomes, mallet, ronguers,
currettes, russian pickups
5 stages of bone healing - answersInflammation- bleeding, fibrin meshwork
Cellular Proliferation- osteoblast invade fibrin meshwork
Callus Formation- granulation, cartilage developes semigrid
Ossification- 2-3wks after injury, last 3mths, osteoblast calcify
Remodeling- new CT cells; osteoblast of periosteum
PG 453 Alexanders
complications to fracture healing - answersDelayed Union: doesn't heal w/in avg time
Malunion: doesn't heal correctly (deformed)
Nonunion: doesn't heal together
complications of fractures - answersFat embolism
Thrombophebitis
Nerve compression
Compartment syndrome
Infection
Intertrochanteric fracture of the hip - answersInternal fixation; unite w/out difficulty;
occurs in older pts (pg. 473-475 Alexander)
Femoral neck fracture of hip - answerscannulated screw; reduction is necessary before
internal fixation of femoral neck b/c of high incidence of complications
Femoral Head fracture - answersprosthesis; unipolar vs bipolar
knee ligaments - answersTo stabilize the knee
Cruciate: anterior/posterior
Collateral: medial/lateral
How are meniscus tears fixed? - answersmeniscectomy
total joint Arthroplasty - answersrestore motion of joint and function to muscles and
ligaments
Compositions of the rotator cuff - answerssupraspinatus
infraspinatus
,teres minor
subscapularis
Laminectomy - answersremoves portion of posterior vertebral arch; in conjuntion with
spinal fusion procedures
Bunion (Hallux valgus) procedures - answersKeller, mayo, or McBride
Developmental dislocation of hip and procedures - answersprogressive condition when
hip structures fail; DDH reduction, derotational osteotomy, and pelvic osteotomy
Orthopedic pathologies - answersRheumatoid arthritis: inflammation of joints, cartilage
degenerates; most severe
Osteoarthritis: wear and tear on joints
Ostomyelitis: inflammation of bone marrow
Joint movement terminology - answersAbduction: away
Adduction: towards
Circumduction: around
Rotation: back and forth
Flexion: plantar and dorsiflexion
Extension: straight out
Eversion: turn foot out (ballet dancer)
Inversion: turn foot in
Pronation: face down
Supination: face up
Preparing for orthopedic surgery - answersAseptic technique
Meticulous prepping and draping
minimal room traffic
Positioning - answersEquipment: fracture table, bean bag, McGuire positioner, Andrews
frame
Preparing for Ortho case - answersCasts are removed before OR
Pneumatic tourniquets
Anesthesia
Hemostatic agents
irrigations
special instruments
biological indicator
What are the tourniquet pressures? - answers250-300 mm Hg for upper extremity
300-350 mm Hg for lower extremity
what are the tourniquet pressure times? - answersupper extremity: 1hr
, lower extremity: 2hrs
Sutures - answersSurgical steel- bone to bone, most inert, sternum
Polyester- ethibond, tendons
Prolene
Nylon- min tissue reaction
Chromic- periosteum, slow absorbtion
Vicryl- tendons, muscle
Powered instruments
(look at pictures) - answersSaws-
Reciprocating: back and forth motion
Oscillation: side to side (safety on when not in use)
Fracture treatment - answersClosed reduction
External fixation-
Bone-anchoring device
longitudinal supporting devices
Connecting devices (pins, clamps, rods)
Risks factors for proximal femur fractures - answersOsteoporosis
Previous fracture
Excessive caffine
Increased drinking
Psychotropic meds
Visual impairment
Types of hip fractures - answersFemoral neck fracture
Intertrochanteric fracture
Subtrochanteric fracture
Femoral Head- needs replacing
Intertrochanteric fracture - answersDynamic Hip Screw plate; guide pin, then drill out
core in femoral head, and depth gauge, then plate will be added
Retractors - answersCobra, belly cobra, femoral, hohman, hibbs, bennett, adson
beckman, iliac crest
Balanced suspension traction - answersskeletal traction; pulley sys with constant
traction
Tibia fracture - answersmost common site for open fracture
treated with External fixator 1st, followed by ORIF
Tibial Plateu fractures (look at pictures) - answersPg 478
1) pure cleavage unicondylar fracture
Question and Answer Solutions
Fracture classifications -answer open and closed
Causes of fractures - answerstrauma and pathological
types of fractures - answersknow what each are
Greenstick/stress: barely fractured
Potts: @ fibula near ankle
Colles: Fall on outsretched hand (FOOSH)
Compound: penetrates skin
Comminuted: more than 2 pieces of bone fragments
Transverse: horizontal fracture
Oblique: angled across cortices
Spiral: curves around bone
Impacted: end of bones forced into each other
External Fixation - answersoutside of skin; bone anchoring devices, cast, skeletal
tractions, splints
Internal Fixation - answersinside of skin; rods on bone, screws, plates, nails
basic steps of instruments used in an ORIF procedure. - answersDrill, Measure (depth
guage), insert screw
Procedure steps ORIF - answersOpen incision
Reduction of fracture
Internal Fixation
casting - answershandle with palms
luke warm water
not too tight
cast is removed before entering OR
bones are repaired by a closed intramedullary nail - answersfemur, humerus, and tibia
steps in a closed intramedullary nail surgery - answersIncision, AWL to create hole in
bone, reaming, then insert nail
anatomical landmarks and where - answersTrochanter: head of femur
Medial malleolus: tibia distal end
,Lateral malleolus: fibula.
Olecranon: elbow (ulna)
Condyles: femur
Epicondyles: above condyles
bone graft site - answersiliac crest (pg. 451-452 alexander's)
instruments used to retrieve bone - answerslambotte osteotomes, mallet, ronguers,
currettes, russian pickups
5 stages of bone healing - answersInflammation- bleeding, fibrin meshwork
Cellular Proliferation- osteoblast invade fibrin meshwork
Callus Formation- granulation, cartilage developes semigrid
Ossification- 2-3wks after injury, last 3mths, osteoblast calcify
Remodeling- new CT cells; osteoblast of periosteum
PG 453 Alexanders
complications to fracture healing - answersDelayed Union: doesn't heal w/in avg time
Malunion: doesn't heal correctly (deformed)
Nonunion: doesn't heal together
complications of fractures - answersFat embolism
Thrombophebitis
Nerve compression
Compartment syndrome
Infection
Intertrochanteric fracture of the hip - answersInternal fixation; unite w/out difficulty;
occurs in older pts (pg. 473-475 Alexander)
Femoral neck fracture of hip - answerscannulated screw; reduction is necessary before
internal fixation of femoral neck b/c of high incidence of complications
Femoral Head fracture - answersprosthesis; unipolar vs bipolar
knee ligaments - answersTo stabilize the knee
Cruciate: anterior/posterior
Collateral: medial/lateral
How are meniscus tears fixed? - answersmeniscectomy
total joint Arthroplasty - answersrestore motion of joint and function to muscles and
ligaments
Compositions of the rotator cuff - answerssupraspinatus
infraspinatus
,teres minor
subscapularis
Laminectomy - answersremoves portion of posterior vertebral arch; in conjuntion with
spinal fusion procedures
Bunion (Hallux valgus) procedures - answersKeller, mayo, or McBride
Developmental dislocation of hip and procedures - answersprogressive condition when
hip structures fail; DDH reduction, derotational osteotomy, and pelvic osteotomy
Orthopedic pathologies - answersRheumatoid arthritis: inflammation of joints, cartilage
degenerates; most severe
Osteoarthritis: wear and tear on joints
Ostomyelitis: inflammation of bone marrow
Joint movement terminology - answersAbduction: away
Adduction: towards
Circumduction: around
Rotation: back and forth
Flexion: plantar and dorsiflexion
Extension: straight out
Eversion: turn foot out (ballet dancer)
Inversion: turn foot in
Pronation: face down
Supination: face up
Preparing for orthopedic surgery - answersAseptic technique
Meticulous prepping and draping
minimal room traffic
Positioning - answersEquipment: fracture table, bean bag, McGuire positioner, Andrews
frame
Preparing for Ortho case - answersCasts are removed before OR
Pneumatic tourniquets
Anesthesia
Hemostatic agents
irrigations
special instruments
biological indicator
What are the tourniquet pressures? - answers250-300 mm Hg for upper extremity
300-350 mm Hg for lower extremity
what are the tourniquet pressure times? - answersupper extremity: 1hr
, lower extremity: 2hrs
Sutures - answersSurgical steel- bone to bone, most inert, sternum
Polyester- ethibond, tendons
Prolene
Nylon- min tissue reaction
Chromic- periosteum, slow absorbtion
Vicryl- tendons, muscle
Powered instruments
(look at pictures) - answersSaws-
Reciprocating: back and forth motion
Oscillation: side to side (safety on when not in use)
Fracture treatment - answersClosed reduction
External fixation-
Bone-anchoring device
longitudinal supporting devices
Connecting devices (pins, clamps, rods)
Risks factors for proximal femur fractures - answersOsteoporosis
Previous fracture
Excessive caffine
Increased drinking
Psychotropic meds
Visual impairment
Types of hip fractures - answersFemoral neck fracture
Intertrochanteric fracture
Subtrochanteric fracture
Femoral Head- needs replacing
Intertrochanteric fracture - answersDynamic Hip Screw plate; guide pin, then drill out
core in femoral head, and depth gauge, then plate will be added
Retractors - answersCobra, belly cobra, femoral, hohman, hibbs, bennett, adson
beckman, iliac crest
Balanced suspension traction - answersskeletal traction; pulley sys with constant
traction
Tibia fracture - answersmost common site for open fracture
treated with External fixator 1st, followed by ORIF
Tibial Plateu fractures (look at pictures) - answersPg 478
1) pure cleavage unicondylar fracture
