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MSK III P3 Fall > 10] UE Amputees And Prosthetics > Flashcards

10] UE Amputees And Prosthetics Flashcards

1
Q

Main causes of UE limb loss

A

Vascular disease
Trauma
Cancer

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2
Q

Ratio of UE amputees to LE

A

1:5

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3
Q

70% of all persons with UE amputations are

A

Distal to the elbow

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4
Q

With ROM and MMT pay attention to

A

Scapula

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5
Q

Cognition testing outcome measures used

A

MoCA
SLUMS
MMSE

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6
Q

Surgical incision goal

A

Promote closure

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7
Q

Surgical incision treatment focus

A

Reduce edema
Protect incision
Prevent adhesions

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8
Q

Wound bed prep goal

A

Promote granulation bed and then epithelialization

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9
Q

Wound bed prep is achieved through (3)

A

Serial debridement
Surgical debridement▫
Local wound care

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10
Q

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

A

Skin desensitization

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11
Q

Benefits of skin desensitization

A

●pain control, establishment of body imageand psychological adjustment

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12
Q

Needed skill of skin desensitization for 2 reasons

A
  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.
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13
Q

Skin mob purpose

A

Maintain pliability and motion o prevent blisters during prosthetic use

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14
Q

When can you start skin mobs

A

Right after surgery

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15
Q

Ideal shape of limb

A

Cylindrical because its easiest to don and greatest weight bearing surface

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16
Q

Volume containment options

A
  • Compression Wrapping
  • Stump Shrinker
  • Tubigrip
  • Unna’s Boot
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17
Q

Compression wrap is used for

A

Volume control, Stump shaping, Desensitization.

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18
Q

Compression wrap direction

A

Proximal to distal diagonals

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19
Q

Rewrap compression wrap when?

A

Every 4 hours

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20
Q

Once sutures are removed, what can be used?

A

Stump shrinker usually 2-3 weeks after surgery

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21
Q
  • not durable
  • increased cost
  • can roll and constrict
  • can cause window edema at end
  • difficult to purchase out of hospital
A

Disadvantages of tubi-grip

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22
Q

•Gauze impregnated with

calamine lotion or zinc oxide.

A

Unna’s boot

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23
Q

How does Unna’s boot work

A

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

24
Q

Unna’s boot is effective for

A

Rapid volume reduction; NOT for ongoing volume containment

25
Q

Semi-rigid Unna’s boot advantages

A
  • excellent edema control/reduction
  • allows skin check very 3 days or can be left up to 1 week
  • promotes wound healing in venous insufficiency
26
Q 
•Messy to apply
•Can be expensive over time
•Must be applied by a clinician.
•Draining incisions can cause 
maceration
A

Disadvantages of Unna’s boot

27
Q

tension applied to nerve

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

A

Traction neuroectomy

28
Q

Pharmacological interventions for phantom limb pain

A

Gabapentin

Neurontin

29
Q

Centrocentral nerve union

A

2 severed nerves are coapted to make a loop

30
Q

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

A

Correctly identify 20 images within 2 seconds being 80% accurate

31
Q

Contractures more prevalent with

A

Increasing muscle imbalance and non-use of affected extremity

32
Q

Risk factors for contractures (5)

A
  • Immobilization / Non-use
  • Lack of Education
  • Muscle Imbalance
  • Tone
  • Pain
33
Q

Common contractures

A

Shoulder flex/abd
Scapular winging
Scoliosis

34
Q

Positioning for contractures

A

Avoid pillow positioning

35
Q

Special emphasis for strength training focused on

A

Scapular and Shoulder stabilizers

36
Q

Core strengthening is essential for

A

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

37
Q

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

A

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

38
Q

Most common amputation level

A

Transradial (57%)

39
Q

Digit or Partial Digit amputation

A

Partial hand amp

40
Q

Amputation transecting the carpal bones

A

Transcarpal amp

41
Q

What is preserved with transcarpal amp?

A

Wrist flexion/extension and forearm supination/pronation arepreserved

42
Q

Carpal bones are disarticulated from the radius & ulna

-Styloid process is trimmed

A

Wrist disarticulation

43
Q

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

A

Transradial amp

44
Q

The radius and ulnaare disarticulated

from the humerus

A

Elbow disarticulation

45
Q

Transection of humerus anywhere from the humeral head to the elbow

A

Trans humeral amp

46
Q

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

A

Shoulder disarticulation

47
Q

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

A

Forequarter amputation

48
Q

Advantages of body powered prosthesis (5)

A
  • Heavy Duty Construction
  • Proprioception
  • Less Expensive
  • Lighter in Weight
  • Reduced Cost and Maintenance
49
Q

3 parts of body powered

A

Socket
Suspension
Terminal device

50
Q

3 independent motions of triple control harness

A
  1. activation of
    terminal device
  2. elbow joint lock / release
  3. forearm flexion
51
Q

Patho of electromyography

A

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

52
Q

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

A

Targeted muscle reinnervation

53
Q

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

A

Osseointegration

54
Q

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

A

Passive and myoelectric

55
Q

Hybrid can only be for what amp

A

Shoulder disarticulation

56
Q

Body powered only for which amps?

A

Partial hand
Trans radial
Trans humeral

MSK III P3 Fall (19 decks)

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