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I. Definition of terms 1. Arthrocentesis - a procedure whereby a sterile needle and syringe are used to drain fluid from a joint.

This is usually done as an office procedure or at the bedside in the hospital. 2. Arthroscope - A thin flexible fiberoptic scope which is introduced into a joint space through a small incision in order to carry out diagnostic and treatment procedures within the joint. An arthroscope is about the diameter of a drinking straw. It is fitted with a miniature camera, a light source and precision tools at the end of flexible tubes. 3. Local anesthesia - involves the injection or application of an anesthetic drug to a specific area of the body, as opposed to the entire body and brain as occurs during general anesthesia. 4. Synovial fluid - is a viscous, non-Newtonian fluid found in the cavities of synovial joints. 5. Diathrosis - Any of several types of bone articulation permitting free motion in a joint, as that of the shoulder or hip.

II. Types of joints

1. Plane joint

- A synovial joint in which the opposing surfaces are nearly planes and in which there is only a slight, gliding motion. Also called arthrodia, arthrodial joint, gliding joint.

2. Hinge joint - a bone joint in which the articular surfaces are molded to each other in such a manner as to permit motion only in one plane backward and forwardthe extent of motion at the same time being considerable.

3. Pivot joint - also called rotary joint, or trochoid joint and is a joint that allows only rotary movement.

4. Condyloid joint - one in which an ovoid head of one bone moves in an elliptical cavity of another, permitting all movements except axial rotation.

5. Saddle joint - permits no axial rotation but allows flexion, extension, adduction, and abduction, as in the carpometacarpal joint of the thumb.

6. Ball and socket joint - A synovial joint, such as the shoulder or hip joint, in which a spherical knob or knoblike part of one bone fits into a cavity or socket of another, so that some degree of rotary motion is possible in every direction.

III. Normal Findings of Synovial Fluid Appearance - viscous and appears clear to light yellow. Microscopic - none or few blood cells. Chemical - Glucose - 40 mg/dl (less indicates abnormality) Protein - 3 g/dl LDH - 333 IU/L (greater value indicates abnormality)

IV. Sites and positions for arthrocentesis 1. Shoulder -patient should be sitting with shoulder in external rotation.

2. Knee -supine position and knee is extended.

3. Ankle -supine position and foot in plantar fixed.

4. Elbow -elbow flexed at 90 degrees palm facing down

5. Wrist -is flexed and ulnarly deviated.