10] UE Amputees And Prosthetics

Question 1

Main causes of UE limb loss

Answer 1

Vascular disease
Trauma
Cancer

Question 2

Ratio of UE amputees to LE

Answer 2

1:5

Question 3

70% of all persons with UE amputations are

Answer 3

Distal to the elbow

Question 4

With ROM and MMT pay attention to

Answer 4

Scapula

Question 5

Cognition testing outcome measures used

Answer 5

MoCA
SLUMS
MMSE

Question 6

Surgical incision goal

Answer 6

Promote closure

Question 7

Surgical incision treatment focus

Answer 7

Reduce edema
Protect incision
Prevent adhesions

Question 8

Wound bed prep goal

Answer 8

Promote granulation bed and then epithelialization

Question 9

Wound bed prep is achieved through (3)

Answer 9

Serial debridement
Surgical debridement▫
Local wound care

Question 10

Technique of massage and tapping of the
residual limb starting the 1st day after surgery to help reduce and control pain through self
management.

Answer 10

Skin desensitization

Question 11

Benefits of skin desensitization

Answer 11

●pain control, establishment of body imageand psychological adjustment

Question 12

Needed skill of skin desensitization for 2 reasons

Answer 12

1. Pt knows their tolerance and can easily administer based on their own comfortlevel.
2. Allows the patient to become accustomed
   to their body after surgery.

Question 13

Skin mob purpose

Answer 13

Maintain pliability and motion o prevent blisters during prosthetic use

Question 14

When can you start skin mobs

Answer 14

Right after surgery

Question 15

Ideal shape of limb

Answer 15

Cylindrical because its easiest to don and greatest weight bearing surface

Question 16

Volume containment options

Answer 16

• Compression Wrapping
• Stump Shrinker
• Tubigrip
• Unna’s Boot

Question 17

Compression wrap is used for

Answer 17

Volume control, Stump shaping, Desensitization.

Question 18

Compression wrap direction

Answer 18

Proximal to distal diagonals

Question 19

Rewrap compression wrap when?

Answer 19

Every 4 hours

Question 20

Once sutures are removed, what can be used?

Answer 20

Stump shrinker usually 2-3 weeks after surgery

Question 21

• not durable
• increased cost
• can roll and constrict
• can cause window edema at end
• difficult to purchase out of hospital

Answer 21

Disadvantages of tubi-grip

Question 22

•Gauze impregnated with

calamine lotion or zinc oxide.

Answer 22

Unna’s boot

Question 23

How does Unna’s boot work

Answer 23

Apply it without any tension; tightens as it dries and ace wrap over it lightly

Question 24

Unna’s boot is effective for

Answer 24

Rapid volume reduction; NOT for ongoing volume containment

Question 25

Semi-rigid Unna’s boot advantages

Answer 25

- excellent edema control/reduction - allows skin check very 3 days or can be left up to 1 week - promotes wound healing in venous insufficiency

Question 26

``` •Messy to apply •Can be expensive over time •Must be applied by a clinician. •Draining incisions can cause maceration ```

Answer 26

Disadvantages of Unna’s boot

Question 27

tension applied to nerve | prior to division resulting in proximal retraction of the nerve away from distal limb.

Answer 27

Traction neuroectomy

Question 28

Pharmacological interventions for phantom limb pain

Answer 28

Gabapentin | Neurontin

Question 29

Centrocentral nerve union

Answer 29

2 severed nerves are coapted to make a loop

Question 30

How do you progress them to the next level with GMI?

Answer 30

Correctly identify 20 images within 2 seconds being 80% accurate

Question 31

Contractures more prevalent with

Answer 31

Increasing muscle imbalance and non-use of affected extremity

Question 32

Risk factors for contractures (5)

Answer 32

* Immobilization / Non-use * Lack of Education * Muscle Imbalance * Tone * Pain

Question 33

Common contractures

Answer 33

Shoulder flex/abd Scapular winging Scoliosis

Question 34

Positioning for contractures

Answer 34

Avoid pillow positioning

Question 35

Special emphasis for strength training focused on

Answer 35

Scapular and Shoulder stabilizers

Question 36

Core strengthening is essential for

Answer 36

Prosthetic control Sitting and tending posture Reducing stress to the spine that could lead to LBP

Question 37

Significant evidence that it is critical to fit the the unilateral amputee patient with prosthetic in

Answer 37

First 6 months b/c theres a high incidence of rejection due to them getting used to one hand

Question 38

Most common amputation level

Answer 38

Transradial (57%)

Question 39

Digit or Partial Digit amputation

Answer 39

Partial hand amp

Question 40

Amputation transecting the carpal bones

Answer 40

Transcarpal amp

Question 41

What is preserved with transcarpal amp?

Answer 41

Wrist flexion/extension and forearm supination/pronation arepreserved

Question 42

Carpal bones are disarticulated from the radius & ulna | -Styloid process is trimmed

Answer 42

Wrist disarticulation

Question 43

Amputation through the radius and ulna from level of wrist to the elbow

Answer 43

Transradial amp

Question 44

The radius and ulnaare disarticulated | from the humerus

Answer 44

Elbow disarticulation

Question 45

Transection of humerus anywhere from the humeral head to the elbow

Answer 45

Trans humeral amp

Question 46

Humerus is disarticulated from the Glenoid fossa, scapula and partor all of the clavicle remain

Answer 46

Shoulder disarticulation

Question 47

amputation of part or all of the scapula & clavicle. - Usually a last resort to remove cancer

Answer 47

Forequarter amputation

Question 48

Advantages of body powered prosthesis (5)

Answer 48

- Heavy Duty Construction - Proprioception - Less Expensive - Lighter in Weight - Reduced Cost and Maintenance

Question 49

3 parts of body powered

Answer 49

Socket Suspension Terminal device

Question 50

3 independent motions of triple control harness

Answer 50

1. activation of terminal device 2. elbow joint lock / release 3. forearm flexion

Question 51

Patho of electromyography

Answer 51

Acetylcholine initiates an action potential that is passed in the direction of muscle fibers across sensors embedded in prosthetic socket.

Question 52

Residual nerves from the amputated limb are transferred to reinnervate new muscle targets that have otherwise lost their function

Answer 52

Targeted muscle reinnervation

Question 53

Direct structural and functional connection between living bone and the surface of a load-carrying implant.

Answer 53

Osseointegration

Question 54

What two types of prothestics can be used for any amp level?

Answer 54

Passive and myoelectric

Question 55

Hybrid can only be for what amp

Answer 55

Shoulder disarticulation

Question 56

Body powered only for which amps?

Answer 56

Partial hand Trans radial Trans humeral