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NPTE - MSK > Amputation > Flashcards

Amputation Flashcards

1
Q

Primary etiology of amputations

A

peripheral vascular disease

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2
Q

Hemicorporectomy

A

surgical removal of the pelvis and both lower extremities

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3
Q

Hemipelvectomy

A

surgical removal of one half of the pelvis and the lower extremity

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4
Q

Symes

A

surgical removal of the foot at the ankle joint with removal of the malleoli

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5
Q

Transverse tarsal

A

amputation through the talonavicular and calcaneocuboid joints. preservation of the plantarflexors, but severs the dorsiflexors (results in a equinus contracture)

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6
Q

Tarsometatasal

A

surgical removal of the metatarsals. preservation of the dorsiflexors and plantarflexors

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7
Q

Transradial - socket

A

Standard: covers 2/3 of forearm, can be shortened for increased pronation/supination
Supracondylar: self-suspending and require no additional harness

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8
Q

Transhumeral - socket

A

Standard: extends to acromion level
Modified design: allows for more stability with rotational movements
Lightweight friction: used with passive prosthetic arms

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9
Q

Transradial - suspension

A
  • triceps cuff
  • harness
  • cable system
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10
Q

Transhumeral - suspension

A
  • harness
  • cable system
  • suction
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11
Q

Transradial - elbow unit

A

attaches to triceps cuff or upper arm pad, flexible or rigid hinge connects socket to proximal component

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12
Q

Transhumeral - elbow unit

A

internal or external locking unit

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13
Q

Transradial/Transhumeral - wrist unit

A
  • quick change unit
  • wrist flexion unit
  • ball and socket
  • constant friction
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14
Q

Transradial/Transhumeral - wrist unit

A
  • voluntary opening or closing
  • body-powered, externally powered, myoelectric or hybrid
  • hook, mechanical hand, cosmetic glove
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15
Q

Transfemoral - socket

A
  • quadrilateral socket
  • ischial containment socket
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16
Q

Transtibial - socket

A
  • patella tendon bearing socket (PTB)
  • supracondylar patella tendon socket (PTS)
  • supracondylar - suprapatella socket (SC-SP)
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17
Q

Transfemoral - suspension

A
  • landyard strap
  • shuttle lock
  • suction (seal in, skin fit)
  • partial suction (silesian bandage, pelvic belt)
  • vacuum
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18
Q

Transtibial - suspenstion

A
  • supracondylar cuff
  • thigh corset
  • supracondylar brim
  • rubber sleeve suspension
  • waist belt with fork strap
  • suction with sleeve
  • shuttle lock
  • vacuum
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19
Q

Transfemoral - knee

A
  • single axis
  • polycentric
  • hydraulic
  • microprocessor
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20
Q

Transfemoral/transtibial - shank

A
  • exoskeleton (rigid exterior)
  • endoskeleton (pylon covered with foam)
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21
Q

Transfemoral/transtibial - foot system

A
  • solid ankle cushion heel (SACH)
  • stationary attachment flexible endoskeleton (SAFE)
  • single axis
  • multi-axial
  • hydraulic
  • powered
  • dynamic response
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22
Q

Rigid dressing

A

(+) early ambulation, stimulates proprioception, provides soft tissue support, ability to use immediate post-operative prosthesis
(-) cannot immediately inspect wound, cant do daily dressing changes, professional application

23
Q

Semi-rigid dressing

A

(+) easily changeable, protection, soft tissue support
(-) does not protect as well as rigid, requires more changing, may loosen (develop edema)

24
Q

Non-weight bearing rigid removable dressing

A

(+) removable, easily applied, prevents contracture, provides protection
(-) not for ambulatory purposes

25
Q

Soft dressing

A

(+) inexpensive, easily removed, allows for AROM
(-) tissue healing is interrupted by frequent changes, AROM may delay healing times, less control of residual limb, risk of tourniquet effect

26
Q

K-level 0

A

Prothesis will not enhance QOL - not eligible

27
Q

K-level 1

A

Transfers, ambulate on level surfaces, household ambulator
Knee: single axis
Foot: SACH

28
Q

K-level 2

A

Limited community ambulator, low level barriers
Knee: polycentric
Foot: flexible kneel, multi-axial foot/ankle

29
Q

K-level 3

A

Community ambulator, variable cadence, tranverse more than simple locomotion
Knee: hydraulic, microprocessor
Foot: energy storing, dynamic response

30
Q

K-level 4

A

Higher level (child/athlete) - any knee/foot

31
Q

Prosthetic Training Considerations - forequarter

A
  • loss of shoulder/arm/hand function
  • most commonly caused by malignancy
  • light weight prosthetic
32
Q

Prosthetic Training Considerations - shoulder disarticulation

A
  • most commonly caused by malignancy or electrical injuries
  • external prosthetic shoulder joint in typically required
33
Q

Prosthetic Training Considerations - transhumeral

A
  • most commonly caused by trauma
  • second most common UE amputation
34
Q

Prosthetic Training Considerations - elbow disarticulation

A
  • self-suspending socket
  • external prosthetic elbow typically required
35
Q

Prosthetic Training Considerations - transradial

A
  • most common UE amputation
36
Q

Prosthetic Training Considerations - wrist disarticulation

A
  • uncommon
37
Q

Prosthetic Training Considerations - partial hand

A
  • limb sparing technique utilized when functional pinch can be preserved
38
Q

Prosthetic Training Considerations - digit

A
  • preserved function is variable
39
Q

Prosthetic Training Considerations - hip disarticulation

A
  • commonly caused by malignancy
  • no activation of prosthesis through residual limb
  • prosthetic limb advancement through pelvic motion
40
Q

Prosthetic Training Considerations - transfemoral

A
  • length of limb effects energy expenditure
  • susceptible to hip flexor contracture
  • stance control not activated until WBing
41
Q

Prosthetic Training Considerations - knee disarticulation

A
  • susceptible to hip flexor contracture
42
Q

Prosthetic Training Considerations - transtibial

A
  • susceptible to knee and hip flexion contractures
43
Q

Prosthetic Training Considerations - symes

A
  • diminished toe off during gait
44
Q

Prosthetic Training Considerations - transmetatarsal

A
  • loss of forefoot leverage
  • tendency to develop equinus deformity
45
Q

Complications

A
  • DVT
  • contractures
  • hypersensitivity
  • neuroma
  • phantom pain
  • phantom limb
  • psychosocial
  • infections
46
Q

Lateral bending

A

prosthetic causes:
- too short
- high medial wall
- aligned in abduction
amputee causes:
- abduction contracture
- short residual limb
- weak abductors

47
Q

Abducted gait

A

prosthetic causes:
- too long
- high medial wall
- aligned in abduction
amputee causes:
- abduction contracture
- weak hip flexors/adductors

48
Q

Circumducted gait

A

prosthetic causes:
- too long
- excessive pf
amputee causes:
- abduction contracture
- weak hip flexors
- inability to initiate hip flexors

49
Q

Excessive knee flexion

A

prosthetic causes:
- too long
- socket set too forward
- excessive df
- stiff heel
amputee causes:
- knee flexion contracture
- hip flexion contracture
- decreased quad strength

50
Q

Vaulting

A

prosthetic causes:
- too long
- excessive pf
amputee causes:
- short residual limb
- pain

51
Q

Rotation of forefoot at heel strike

A

prosthetic causes:
- excessive toe-out
- excessive pf
amputee causes:
- poor muscle control
- weak medial rotators

52
Q

Forward trunk flexion

A

prosthetic causes:
- too big
- knee instability
amputee causes:
- hip flexor contracture
- weak hip extensors
- inability to initiate knee flexion

53
Q

Medial or lateral whip

A

prosthetic causes:
- excessive knee rotation
- tight socket
- valgus
amputee causes:
- weak hip rotators
- knee instability

NPTE - MSK (14 decks)

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