Nbr - Arthroscopy

Front 1

Portals should be separated as widely as possible, consistent with the anatomy, ot avoid this?

Back 1

Skin necrosis due to the portals place too close ot each other.

Front 2

If an instrument fails or breaks within the joint, what should be done immediately?

Back 2

Outflow of aline should be shut down while the inflow is left open to keepthe oint distended for retrieval of the broken piece.

Front 3

What anatomical structures are consedered when making an anterolateral portal?

Back 3

beween the extensor digorum longus and the the superficial peroneal nerve.

Front 4

When is the ransmalleolar appoach for lesions of the talus contraindicate?

Back 4

In children with open eiphyses

Front 5

What anatomical structures shoudl be consedred when making an danteromedial portal?

Back 5

Between the saphenou vein and the tibialis anterior tendon.

Front 6

When is the transmaleolar approach for lesions fo the talus contraindicated

Back 6

in children with open epiphyses

Front 7

what is the most common size and angulatin of an arthroscope used in an ankle?

Back 7

2.7 mm and 30 degrees or zero degrees of angulation

Front 8

What is the minimum distance an accessory portal shuld be placed between the two working portals?

Back 8

At least 1 cm apart to avoid ski nnecrosis.

Front 9

How would one confirm that the loose body seen on x-ray is intra-articular instead of intra capsular or extra-articular?

Back 9

Perform an arthrogram, perhaps in combination with a CT or MRI.

Front 10

In anterior soft tissue impingement of the ankle, pathology is generally limited to what?

Back 10

The syndesmosis and the lateral gutter.

Front 11

When usin ghte posterolateral approach one shuuld avoid what anatomical structures?

Back 11

subcutaneous sural nerve or the short saphenous vein. Als avoid entering the STJ.

Front 12

In an terior soft tissue impingement of the ankle, pathology is generally limited t what?

Back 12

the synesmosis and the lateral gutter.

Front 13

When using the poterolateral approach, one hsould avoid what anatomical structures?

Back 13

subcutaneous sural nerve or the short saphenous vien. Also avoid entering the StTJ.

Front 14

Transmalleolar portals are more often required on which side of the ankle joint and why?

Back 14

On the medial side because lateral dome lesions are more anterior than on the medial side,k and because the lateral malleolus i furhter posterior than the medial malleolus.

Front 15

what ar ethree basic joint surveying techniques in ankle arthroscopy?

Back 15

scanning, pistoning and rotationg

Front 16

prior to beginning arthroscopy, which portal is develped first?

Back 16

The medial portal is developed first adn the scope is placed in to survey the joint prior to lateral ortal development.

Front 17

What are the colntrainications for manual distraction and or gravity distraction?

Back 17

Tight ankles ptahology not easily accessible, and proloned procedures.

Front 18

What arthe contraindicatoins to the use of non-invasive distraction?

Back 18

Impaired circulatory status, diabetes, generalized medical conditions, ankle edema, or gragile skin.

Front 19

What are three basic joint surveying techniques in ankle arthroscopy?

Back 19

scanning, pistoning, and rotating.

Front 20

Prior to beginning arthroscopy, which portal is develope dfirst?

Back 20

The medial portal is developed frist and the scope is placed i to surey the joint porior ot lateral portal development

Front 21

What are the contraindications for manual distraction and/or gravity distraction?

Back 21

Tight ankles, pathology not easily accessible, and proloned procedures

Front 22

What ar the contraindications to the use of non-invasive distraction?

Back 22

impaired circulatory status, diabetes, generalized medical conditions, ankle edema, or fragile skin

Front 23

What ar the contraindications to the use of skeletal distraction?

Back 23

local or generalized infections, osteopenia, openepihysis, and lax ligaments.

Front 24

What are the contraindication to the use of skeletal distraction

Back 24

locla or generalized infections, nosteopenia, open epihysis, and lax ligaments

Front 25

What are some the indiecatiosn for the use of single heavy pin disraction (3/16 inch)?

Back 25

Large bone structure in males, long caes or difficult pathology, bery tight ankles, ankle arthrodesis, etc.

Front 26

Whata re some advatages of double pin (7/64 inch) distraction

Back 26

better control, less stres riser than 3/16 inch, less chance of pin tract infection.

Front 27

What are the recommended parameters of force and druation for non-invasive distraction?

Back 27

20-25 lbs of force for about 30-45 minutres.

Front 28

What are the parameters for proximal pin placement in skeletal distraction?

Back 28

3/16 in 7/64 in insered 2 inches; 2 1/4 up to 4 inches above ankle joint usually from the lateral side.

Front 29

What ar eth e three insertion sites for distal pin placement in skeletal distractionj?

Back 29

tow i nthe calcanedus and one hte talus.

Front 30

How is the distal pin inserted int he clacaneus ?

Back 30

It is inserted at a 20-35 degree downaward slope so that when distraction occurs the pin will become parallel with the proximal pin

Front 31

what size of pin is used i nlight double distraction mode?

Back 31

7/64th smooth pins

Front 32

what size of pin is used in heavy single of double distraction?

Back 32

3/16 threated pin

Front 33

When a 3/16 invasive distaction used, how long post operatively should the patient avoid atheletic activiy or heavy work?

Back 33

WITH HEAQVY DISTRACTION, THE PATEINT SHOULD AVOID ATHLETIC ACTIVY OR HEAVY WORK FOR 8-10 WEEKS TO DECREAE THE RISK OF FRACTURE.

Front 34

When 7/64 invasive distraction is used, when can the paitent reuturn to activity?

Back 34

four to six weeks.

Front 35

Whyat type of specific synovitsi occurs in three stages?

Back 35

chronic synovial chndromatosis.

Front 36

which disease entitiy is characterized by synovitis with advanced paillary formation and hemosdierin cells present?

Back 36

pigmented villonodular synovitis.

Front 37

Osteochondral lesion of the talar dome are commonly foun where?

Back 37

commonly found at he anterior lateral spect or the posterior medial aspect of the dome.

Front 38

What is themechanism of injury in a medial talar dome osteochondral lesion?

Back 38

Inversion of the foot with ankle plantarflexed.

Front 39

What ti sthe mechanism of injur in a lateral talar dome osteochondral lesion?

Back 39

inversion of the foot with the ankle dorsiflexed and the tibia internally rotated.

Front 40

What is the mechanism fo injury in a medial talar dome osteochondral lesion?

Back 40

inversion of the foot with ankle plantarflexed.

Front 41

How should a bone graft be palced in gthe articualr cartilage of the talar dome?

Back 41

the graft should be placed 1-2mm below the level of the articular cartilage.

Front 42

What is one method that has been proven helpful in viewing chondral lesions of the ankle joint?

Back 42

the use of methylene blue dye injected into the joint and then washed out with irrigant saline

Front 43

What technique is use d in arthrcopic ankle arthrodesis?

Back 43

arthroscopic transmalleolar cross-screw fusion.

Front 44

What are some adavatages of the artrhroscaopic approach to anke fusion over the oopen mnethod?

Back 44

less surgical morbidity and improved cosmesis.

Front 45

What are the disasvangages of the arthroscopic approach to ankle fusion?

Back 45

sever varus/valgus malalignment is difficult ot correct arthroscopically.

Front 46

what is a contraindication to doing arthrscopic ankle fusion?

Back 46

a varus / valgus malalignemnt greater than 15 degrees.

Front 47

What type and size of screw is used in an arthroscopic ankle fusion to fuse the nakle?

Back 47

cannulated 6.5 mm cancellous screw system.

Front 48

What are considered abnormal values i nthe anterio drawer stres test?

Back 48

between 5-10 mm of anter displacement of hte talus from the distal tibia are consdiered abnormal, and over 10 mm of displacement are consdiered grossly abnormal. In comparison with the unaffected extemiety theinjured ankle should have an anterior drawer test result of 3 mm or more to be consedired significant.

Front 49

Name the arthroscopic technique that involves insetion of another object suh as a probe beside a target structio into th efield of view on the arthroscope in orde for the physician t better conceptualize the relative positions fo these objeccts to one another of the adjacent structures.

Back 49

triangulation.

Front 50

Which side of the anterior half of the talar doem usually produces a shallow wafer shaped fractue?

Back 50

lateral

Front 51

Which side of the posterior therid of the talar dome is subject to deep cup shaped lesions

Back 51

medial

Front 52

What is th eprocedure for sterilzation of an arthroscope?

Back 52

first case - ethylene oxid gass, additional cases - activated glutaradlehyde solution for 20 minuts. Arthroscopes cannot be autoclaved.

Front 53

What si the probable dignosis if ony 10-12 ml of saline can be injectied intot th e nakle joint capsule f a normal sized adult?

Back 53

capsular adhesion or bibrosis

Front 54

plantar flexion of hte foot increases the visualization for which group of arthroscopic portal approaches

Back 54

anterior.

Front 55

Dorsiflexion of the foot increases the visualization for which group of arthroscopic portal approaches

Back 55

psoterior

Front 56

Name the indcatiosn for ankle joint arthroscopy

Back 56

chronic ankloe isntability, persisten ankle joint pain, ankle fracutes, ankel fusions, arthritis, adhesive caspulitis, synovits, meiscoid boides, chrondormalcia, chondral and osteochondraal defects, arteri impingement exoxtosis, anmd pre-oprative planning

Front 57

Name and describe thre three principles or nameuvers perforned in arthroscopy

Back 57

pisotnin is the moviemnt of the arthroscope toward or away from an object. Pistoning toward an object would increase the objects apparent size whil decresing the toal field of visoin
scanning o sweeping is the side to side or up and down omvement of the qarthroscope to get a more complete view of a jont . The ideas is to go from known to unkown areas of the joint ot disinguish normal from pahaological structures.
Rotation is the movment of the arthroscope about is axis. The filed of vision is changed depending on the obliquiety of the arthroscope tip. The arge the degree of tip cut, the wider the field

Front 58

The first perosonto perform and endoscopic intra-articular observation (1918) and also the firswt successful ankle arthroscopy?

Back 58

takagi - university of tokyo

Front 59

What instrument ahs a sharp point and is used to peirce soft tissue and capsuel?

Back 59

troca

Front 60

What instrumen has a blunt pint and is ued to enta a jont? WHy?

Back 60

obturator to pervent iotrogenic carialgniosu damage

Front 61

ARthroscopoes are available in what size

Back 61

1.7 to 8.0mm

Front 62

What is used to distend the ankle jont and maintain a clean field for the came?

Back 62

irrigation system of normal salin.

Front 63

For chorndormalacia o, ostoechondral defects, and osteorarthritis, burrs are sued to abarde articular defects to what level

Back 63

viable bleeding bone

Front 64

What structue is the landmark for locating the propelr site ofr an anteromedial portal appoach for an ankel arhtoscopy;

Back 64

tinbialsi anteri tendon (must go medial to it)

Front 65

What is used to distend the ankle jont and maintain a clean field for the camera

Back 65

irrigation system of normal saline

Front 66

For chbondormalacia, osteochondara defects, and osteoarthrits, burss are used to abrade articular defects to what level

Back 66

viable bleeding bone

Front 67

What struhure is the landmark for lcatin gthe proper site for an anteromedialportal appaoach fror an ankel arthroscopy

Back 67

tibialis anterio tendon

Front 68

an naterocentral protal is always located lateral to what structuer?

Back 68

EHL

Front 69

What nerves are at reisk of bieng injured with the five idffent portals of ientry into the ankle jont

Back 69

anteromeidal - saphenous nerve
anterocentral - deep peroneal nerve
anterolateral - terminal branches of superfidal peroneal nerve
posterio medial -osterior tiebial nerve
posteriro lateral - sural neerve

Front 70

What is the prupose of stopcock, on the seidar of a cannula

Back 70

the ingress or egress of fluids

Front 71

What er the three types of light sources used in arthroscopy

Back 71

senon, quartz halogen, incandscent (tungsten halogen)

Front 72

The tree main type sof motorized shower tips attach to hand engins of power arthocopy instrumentation ar ethe open ended, side -cutter, and full radus,. Whic tip contains a normal rotation blade that prevent inaadvertntdamage to cartialge? whic tip is themost aggressive?

Back 72

The full raidus typ of tip has aroudn rotating blade
Teh open endid tip is the ost aggresive type becasue the endo fhte blade is comelety exosed

Front 73

Are the fluetes itn ehs pher of an abrader more aggesive in cuttin in aforward or reverwse dierectin?

Back 73

forward

Front 74

How does the force of suciton affect the aggresivens of ashb e? and abader

Back 74

it increase the aggresivenes of both by aspriatin mor etissuse into the opeing s at hthe nend of ithe inastruments.

Front 75

How does the speed of rotations iof its blades affect a shave? an abrader?

Back 75

The slwer a shaver ottes the more aggresively it cuts.
The faster an abrader moves the more aggressively it cuts

Front 76

What two bones are th emcanical dstraction system hooked into?

Back 76

lwoer tibia an d hte calcaneus

Front 77

What areidographic veiw is usded to evaluate and anteror drawer test

Back 77

lateral

Front 78

How many degrees of varus tialt are need befoer and inversiotn stress test cosneered abnormasl

Back 78

15 degrees whencompared ot the unaffeccted anke

Front 79

Waht radiographic projection is used to evalute and inversion streesss test?

Back 79

AP projeciton

Front 80

What color or appearance does synovia fluid have normallyh? In an inmammatory process? in the presenco fo gout orheujmatoid arthitis?

Back 80

Normallyy - clear ligh, pale yellow
with inflammatin, tubid,
with gbout or rheumatoid arthitis milkey

Front 81

how is size of an arthroscope dettermined?

Back 81

by the diameter of thecsting that contains the lens system

Front 82

What determins the obliquity or direction fo the field of vew seen through an arthroscope

Back 82

the tip cut of the endo f the arthroscope

Front 83

Whata rethe two commonly used lens systems for arthroscopes?

Back 83

Rod lesn (HOking)
and hte GRIN (gradient index)

Front 84

Abrasion arthroplasty resects necrotic islnand so fcartlage and or subcohnodr bone to what depth? why?

Back 84

1.0 mm ( to the level of the tidemark) bleow the surface of sbchondral bone. Because this si the area that ocntains the vasuclarity that provide nutrition to suppor grwoth of new healthy hyaline cartilag.e

Front 85

How does the speed of rotations iof its blades affect a shave? an abrader?

Back 85

The slwer a shaver ottes the more aggresively it cuts.
The faster an abrader moves the more aggressively it cuts

Front 86

What two bones are th emcanical dstraction system hooked into?

Back 86

lwoer tibia an d hte calcaneus

Front 87

What areidographic veiw is usded to evaluate and anteror drawer test

Back 87

lateral

Front 88

How many degrees of varus tialt are need befoer and inversiotn stress test cosneered abnormasl

Back 88

15 degrees whencompared ot the unaffeccted anke

Front 89

Waht radiographic projection is used to evalute and inversion streesss test?

Back 89

AP projeciton

Front 90

What color or appearance does synovia fluid have normallyh? In an inmammatory process? in the presenco fo gout orheujmatoid arthitis?

Back 90

Normallyy - clear ligh, pale yellow
with inflammatin, tubid,
with gbout or rheumatoid arthitis milkey

Front 91

how is size of an arthroscope dettermined?

Back 91

by the diameter of thecsting that contains the lens system

Front 92

What determins the obliquity or direction fo the field of vew seen through an arthroscope

Back 92

the tip cut of the endo f the arthroscope

Front 93

Whata rethe two commonly used lens systems for arthroscopes?

Back 93

Rod lesn (HOking)
and hte GRIN (gradient index)

Front 94

Abrasion arthroplasty resects necrotic islnand so fcartlage and or subcohnodr bone to what depth? why?

Back 94

1.0 mm ( to the level of the tidemark) bleow the surface of sbchondral bone. Because this si the area that ocntains the vasuclarity that provide nutrition to suppor grwoth of new healthy hyaline cartilag.e

Front 95

How does the speed of rotations iof its blades affect a shave? an abrader?

Back 95

The slwer a shaver ottes the more aggresively it cuts.
The faster an abrader moves the more aggressively it cuts

Front 96

What two bones are th emcanical dstraction system hooked into?

Back 96

lwoer tibia an d hte calcaneus

Front 97

What areidographic veiw is usded to evaluate and anteror drawer test

Back 97

lateral

Front 98

How many degrees of varus tialt are need befoer and inversiotn stress test cosneered abnormasl

Back 98

15 degrees whencompared ot the unaffeccted anke

Front 99

Waht radiographic projection is used to evalute and inversion streesss test?

Back 99

AP projeciton

Front 100

What color or appearance does synovia fluid have normallyh? In an inmammatory process? in the presenco fo gout orheujmatoid arthitis?

Back 100

Normallyy - clear ligh, pale yellow
with inflammatin, tubid,
with gbout or rheumatoid arthitis milkey

Front 101

how is size of an arthroscope dettermined?

Back 101

by the diameter of thecsting that contains the lens system

Front 102

What determins the obliquity or direction fo the field of vew seen through an arthroscope

Back 102

the tip cut of the endo f the arthroscope

Front 103

Whata rethe two commonly used lens systems for arthroscopes?

Back 103

Rod lesn (HOking)
and hte GRIN (gradient index)

Front 104

Abrasion arthroplasty resects necrotic islnand so fcartlage and or subcohnodr bone to what depth? why?

Back 104

1.0 mm ( to the level of the tidemark) bleow the surface of sbchondral bone. Because this si the area that ocntains the vasuclarity that provide nutrition to suppor grwoth of new healthy hyaline cartilag.e

Front 105

How does the speed of rotations iof its blades affect a shave? an abrader?

Back 105

The slwer a shaver ottes the more aggresively it cuts.
The faster an abrader moves the more aggressively it cuts

Front 106

What two bones are th emcanical dstraction system hooked into?

Back 106

lwoer tibia an d hte calcaneus

Front 107

What areidographic veiw is usded to evaluate and anteror drawer test

Back 107

lateral

Front 108

How many degrees of varus tialt are need befoer and inversiotn stress test cosneered abnormasl

Back 108

15 degrees whencompared ot the unaffeccted anke

Front 109

Waht radiographic projection is used to evalute and inversion streesss test?

Back 109

AP projeciton

Front 110

What color or appearance does synovia fluid have normallyh? In an inmammatory process? in the presenco fo gout orheujmatoid arthitis?

Back 110

Normallyy - clear ligh, pale yellow
with inflammatin, tubid,
with gbout or rheumatoid arthitis milkey

Front 111

how is size of an arthroscope dettermined?

Back 111

by the diameter of thecsting that contains the lens system

Front 112

What determins the obliquity or direction fo the field of vew seen through an arthroscope

Back 112

the tip cut of the endo f the arthroscope

Front 113

Whata rethe two commonly used lens systems for arthroscopes?

Back 113

Rod lesn (HOking)
and hte GRIN (gradient index)

Front 114

Abrasion arthroplasty resects necrotic islnand so fcartlage and or subcohnodr bone to what depth? why?

Back 114

1.0 mm ( to the level of the tidemark) bleow the surface of sbchondral bone. Because this si the area that ocntains the vasuclarity that provide nutrition to suppor grwoth of new healthy hyaline cartilag.e

Front 115

How does the speed of rotations iof its blades affect a shave? an abrader?

Back 115

The slwer a shaver ottes the more aggresively it cuts.
The faster an abrader moves the more aggressively it cuts

Front 116

What two bones are th emcanical dstraction system hooked into?

Back 116

lwoer tibia an d hte calcaneus

Front 117

What areidographic veiw is usded to evaluate and anteror drawer test

Back 117

lateral

Front 118

How many degrees of varus tialt are need befoer and inversiotn stress test cosneered abnormasl

Back 118

15 degrees whencompared ot the unaffeccted anke

Front 119

Waht radiographic projection is used to evalute and inversion streesss test?

Back 119

AP projeciton

Front 120

What color or appearance does synovia fluid have normallyh? In an inmammatory process? in the presenco fo gout orheujmatoid arthitis?

Back 120

Normallyy - clear ligh, pale yellow
with inflammatin, tubid,
with gbout or rheumatoid arthitis milkey

Front 121

how is size of an arthroscope dettermined?

Back 121

by the diameter of thecsting that contains the lens system

Front 122

What determins the obliquity or direction fo the field of vew seen through an arthroscope

Back 122

the tip cut of the endo f the arthroscope

Front 123

Whata rethe two commonly used lens systems for arthroscopes?

Back 123

Rod lesn (HOking)
and hte GRIN (gradient index)

Front 124

Abrasion arthroplasty resects necrotic islnand so fcartlage and or subcohnodr bone to what depth? why?

Back 124

1.0 mm ( to the level of the tidemark) bleow the surface of sbchondral bone. Because this si the area that ocntains the vasuclarity that provide nutrition to suppor grwoth of new healthy hyaline cartilag.e ---- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- -------- ----

Front 125

How far above the paitn msut gags used for a gravity ingress system be lpalced?

Back 125

2-3 meters

Front 126

if visualization fo the anke jont is noet adquate usign the anteroentral portal, which anterio poertal is the best alternive? why?

Back 126

anetromedial mbeause of a laco of ligamentosu structus and ue ot the fract that iha ahs thelawse amosunt of pahtolyg sasociate with it. Therefore it is lees apto to have hperthrophnic snoyuvail tissue iwhti it.

Front 127

What type of paortal allows for flusing and rinso of ajoint?

Back 127

egrees portal

Front 128

What is the term used to describe soft tisuse patholgoy that involce the yherptroph of neormal antaotomic strucurs ecnodary to the inflammatory precess?

Back 128

impingement syndreome

Front 129

of ligament , joints capsusle and synovia menbranes, whic deos not hav a rich supply of nerves?

Back 129

synovial membrane

Front 130

How woudl and acute synovits appear diffentyly form achonic synovits arhtorsopically?

Back 130

acutge synovitis presents with long transparent hypertorpohic villi and of uniform length with and enlarge dental vess (inject) or avessel that has rupture (hermoagic hypertorpohic synovitis)
chornic hypertorphic synovits is netier transparent no hemrrahgeic and present with frayed opaque vili of diffent lenghts secondary to necrosie if ther itips.

Front 131

Fibers of what ligament makeu p the floor of the meidal gutter?

Back 131

anteir tibiotalar ligaemnt of the deep deltoid

Front 132

The medial ben is par to fhte antomy of what bone?

Back 132

the tibia

Front 133

What is the name of the deprression in the talra sruface that runs form anteri to psoter near the anterocetnar prot oion o fhte ankle jont?

Back 133

sagittal groove

Front 134

The m anterio tibial lip is made of what substance.

Back 134

perisoteum coverd subcnhondrfal bone

Front 135

What is the name of htarea between the tibial tubercle, the fibular, and the laterl shoulder of hte talus

Back 135

the lateral interval

Front 136

What is the redudnant kjoint cpasuel attached on top th esynovial reces fo hte tibial called

Back 136

capuselar refleciotmn

Front 137

What isthe name of hte arhroscopic procedure inwhich one resects heyertrophic synovia tissue? What cuttinginstrument is used to remove this tissue?

Back 137

synovectomy; shaver or punch or suciton punch

Front 138

What is the name of thearthroscopic procedufre in whic one debrides uneven or fibrillated carilagenou tissue form an ankle joint?

Back 138

chnondroplasty

Front 139

Does a properly performed chondropaslty initiate carilage repair? why o rwhy not?

Back 139

no veaue chondro;sty only somoothes out the fibrillated or unevne portions of caritlage nad noes onto revscualrize the actual defect