Ortho part 2

includes skull, face, ear bones, hyoid, sternum and ribs

axial skeleton

includes leg, feet, hands, trunk, and spine

appendicular skeleton

found on the surface of bones and is organized in tubular units called osteons

cortical (compact bone)

found in the ends of bones and is the inner,softer, less dense layer

cancellous (spongy bone)

-tough, bilayered membrane that covers bone
-protects the bone surface and provides attachment for tendons
-contains osteoblasts

periosteum

-lines the inner channels of long bones
-fills the interstitial spaces of cancellous bone and the haversian canal
-initiates bone growth and provides nutritional substances to bone

endosteum

-functions as areas of attachment for tendons and ligaments
-passageway for nerves and blood vessels
-raised projections, bumps, ridges

landmarks

- a joint with limited movement or fixed articular surfaces, such as between skull bones

synarthrosis (suture joint)

a joint in which the bones are connected by cartilage and only slightly movable

amphiarthrosis (cartilaginous joint)

-a joint that is freely movable, such as a hip or a shoulder. Also called synovial joints because the joint capsule contains a fluid called synovial fluid

Diarthrosis

-made of articulating bone ends and connective tissue surrounding them
-the capsule is lined with a synovial membrane which provides fluid that nourishes the joint
-space inside the joint capsule is called joint cavity

synovial joint

Nonsynovial joints

-separated by immovable cartilaginous or fibrous tissue
-fixed articulation and no joint cavity
-includes sutures and symphesese

hinge joint

-has a rocker and cradle components, allow extension and flexion only
-elbow, knee

saddle joint

-the two components have a complementary covex-concave shape, and the bones slide over each other
-thumb

gliding joint

joint in which relatively flat surfaces of bone slide over each other
-vertebrae

ball and socket joint

joint with a spherical component and a concave component
-hip and humerous

pivot joint

-composed of a bony protuberance and an open collar components
-1st and 2nd verterbraie of the neck

condyloid joint

small protrusion slides within a slightly elliptical component
-carpal bones of wrist

tendons attach-

muscle to bone

tendons can take the form of a fibrous cord, or a sheet of connective tissue called

an aponeurosis

ligaments attach

bone to bone

when ligament attach to cartilage they stabilize the joint and -

limit movements that might injure it

neither tendon or ligaments have a significant-

blood supply

systematic inflmmatory disease that affects connective tissue

rheumatoid arthritis

necrosis of the bone tissue occurs when the blood supply is interuppted

avascular necrosis

tissue damage and necrosis resulting from increased pressure in any anatomical space

compartment syndrome

talipes equinovarus

clubfoot

coxa vara

dislocated hip

forward curvature of the spone

kyphosis

backward curvature of the spine

lordosis

abnormal lateral curvature of the spone

scoliosis

complications from ortho surgery

osteomyelitis-inflammation of the bone marrow that may last a lifetime
pain
immobilzation issues

osteotomes

Curettes

bone cutting forceps

bone hooks

meniscus clamp

bone holding forceps

fixation devices

-screws
-plates
-pins
-rods/nails
-staples

cortical screws

dense bone

cancellous screws

spongy bone

compression screws

impacts two bone fragments together

cannulated screws

hole in the shaft to pass screw over guide pins

placement procedure of a screw

DRILL, MEASURE, TAP, SCREW

shapes of plates

-tubular
-flat
-t-plate

types of pins

-plain/smooth
-threaded

kirschner wires

0.035-1/8 diameter

steinmann pins

larger than 1/8

arthroscopic surgery

-minimally invasive surgery of the joints
-diagnostic use and repair and reconstruction of soft tissue
-most open soft tissue procedures of the joints can be done this way

tourniquet

-used to exsanguinate limb during surgery
-sterile/unsterile cuffs of various size
-bone wax is used as hemostatic agent

use of unsterile tourniquet

-maximum time cuff inflation time 1 1/2-2 hours (if longer let down for 5-10 mins)
-deflate cuff at the time of wound closure or after application of pressure dressing

when the surgical incision involves a joint-

the skin prep includes area to the joint above and below

when the incision is located between two joints-

the skin prep should be extended beyond the joint above and below

common types of dressings

Nonadherent material (Adaptic, Xeroform, Providone-iodine gauze)
Kerlix fluff, 4x4 gauze
Rolled gauze- Kerlix, Kling
Ace/elastic bandage for compression

closed (simple) fracture

skin is unbroken

open (compound) fracture

bone protrudes through the skin,carries high morbidity

traumatic (accidental injury) fracture

may be open or closed

pathologic (spontaneous) fracture

caused by bone disease, such as osteoporosis

greenstick fracture

one side of bone is broken with another side bent.. common in children

comminuted fracture

splintered or crushed

depressed fracture

broken bone portion is pressed inward

compression/impacted fracture

bone fragments are driven into each other causing a "collapse" of the bone structure

transverse fracture

at right angle to the bone axis

epiphyseal fracture

fracture of the growth plate

colles'

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