Ortho Oracle - orthopaedic operative atlas

Cruciate Anastomosis

– See:     – Arterial Development: – Components:     – inferolateral branch of arteria comitans nervi ischiadici inf gluteal )     – medial femoral circumflex     – lateral femoral circumflex     – 1st perforating branch of profunda – Discussion:     – persisting distal portions of ischiadic artery become peroneal & … Read more

Cryoprecipitated Factor VIII

See: – Bld Prod Menu – Transfusion Therapy – PT/PTT * Volume: 5-10 mL (approximately 100 units of Factor VIII and 250 mg Fibrinogen per unit of Cryoprecipitate) – it also contains von Willebrand factor; – the standard adult dose is a pool of 10 bags and contains approx 1,000 mg Fibrinogen; * Rate of Infusion: as rapidly as possible; * Indications: Hemophilia A, von … Read more

Crystal Examination of Synovial Fluid

– Discussion:       – careful exam to identify crystals in synovial fluid can establish a dx early and avoid unnecessary hospital admissions for treatment of suspected infectious arthritis.       – presence of crystals does not exclude infection, esp since abnormalities such as Gout may increase likelihood of septic arthritis;               – cultures … Read more

CT Scan for Scaphoid Frx

– Discussion:     – plain x-rays may fail to demonstrate dorsal angulation of proximal pole-lunate complex and the concomitant flexion of distal pole;     – CT scan is indicated w/ any hint of foreshortening due to angulation is suspected;     – scaphoid may be well visualized w/ 6-8 CT sections made along true longitudinal axis; … Read more

Creatinine, Serum

– Adult male: 0.7-1.3 mg/dL; – Adult female: 0.6-1.1 mg/dL; – Child: 0.3-0.7 mg/dL   – Increased:        – Renal Failure       – Postrenal Obstruction       – Gigantism, Acromegaly,       – Ingestion of Roasted Meat       – Aminoglycosides       – H2 Blockers       – NSAIA   False positives: w/ Ketones (DKA); Decreased: Pregnancy, Loss of muscle … Read more

Crescent Frx: (Sacroiliac Fracture)

– Discussion:     – involves a combination of ligamentous injury at inferior portion of SI joint, and verticle fracture of the posterior ilium which            extends thru iliac crest;            – posterior superior iliac spine remain attached to the sacrum;     – often occurs as a part of lateral compression fractures;   … Read more

Criteria for Extubation

– See: Priorities of Weaning from Ventilatory Support Vital Capacity > 15 cc/kg Negative Inspiratory Force < -25 cm H2O Respiratory rate < 30 Spontaneous Tidal vol > 5 cc/kg (may not be important) 48 % false negative prediction of outcome; PaO2 > 300 mm Hg on FiO2 of 100%; Trial of room air @CPApp4fvn[CPAP:  … Read more

Criteria for Oral Antibiotics

1) Resolving clinical course 2) Adequate surgical debridement 3) Adequate serum level of the Antibiotic (verified) 4) Reliable parents 5) No vomiting or diarrhea w/ the Antibiotic 6) Identification of the Organism (relative indication)

Criteria for Ventilatory Support

* Apnea * Deteriorating Alveolar Ventilation  – pH < 7.25  – Rising PaCO2: in appropriate clinical setting, especially with falling pH; PaCO2 > 60 mm Hg; * Inadequate oxygenation: (Pul. Edema, Consilidation, Atelectasis);  – Falling PaO2  – PaO2 < 70 mm Hg on 50% O2 by mask;  – PaO2 < 55 mm on room air … Read more