Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 15 > Amputation Surgery > Flashcards

Amputation Surgery Flashcards

1
Q

Is incidence of CA related amputation increasing or decreasing?

A

Decreasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common type of CA related amputations

A

LEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the primary treatment for tumors?

What is the level selection based on in these cases?

A

limb salvage

Clean borders, biopsy. Level selection is very clear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Midfoot amputation is also called what? what does this spare

A

Midfoot = Lisfranc

Tarsals are spared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Midtarsal amputation is also called what? what does this spare?

A

Midtarsal = Chopart

Calcaneus and talus remain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Major amputations are considered what?

A

anything other than the foot/toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TTA is from _____ to _____

A

TTA is from tibial tubercle to malleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symes is what?

A

Ankle disarticulation which is a kind of TTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If you get to the greater trochanter (even if you keep it) what is this considered?

A

hip disarticulation bc there’s not enough residual limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

TFA is from ____ to ____

A

greater trochanter to femoral condyles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Knee disarticulation is classified as TTA or TFA?

A

TFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

25-30 cal/kg increase is important for what

A

ulcer healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

only increase what nutritional supplement if there is a deficit?

A

zinc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Major cause of amputation

A

dysvascular disease. Trauma is not as common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is priority one and two of amputation

A

1) healing of the residual limb
2) maintain as much length as possible

Healing is fast with shorter limbs so this is a problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What shape do you want residual limb to be

A

cylindrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mortality rate is higher in higher or lower levels of amputation

A

higher levels of amputation have a higher mortality rate: many people are dysvascular so this makes sense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Healing rate is faster is high or low level amputations

A

high: the shorter the limb the faster the healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Energy conservation is better with longer or shorter limbs

A

longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Joint funciton is maintained with longer or shorter limbs

A

longer obviously bc you have more joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

functional mobility is higher in shorter or longer limb segments

A

longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

insertion of distal muscle groups are maintained with higher or lower level amputations?

A

lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Weight distribution is greater with longer or shorter limbs? think within segment

A

longer: the more surface area you have the better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

supension is easier with longer or shorter amputations

A

longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Energy consumption is a lot more for TFA or TTA

A

TFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

People with amputations conserve energy by doing what with gait?

A

walking slower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The leading cause for all major amputations is

A

PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Tissue loss that is visible
End stage renal disease
poor functional status
DM are all factors that predict what

A

need for amputation in people with critical limb ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does the surgeon go by to pick amputation level for PAD?

A

clinical exam! not much else

30
Q

Vascular tests have ___ sensitivity for predicting wound healing

A

low

31
Q

If profunda femoris and superficial femoris are impacted that means what?

A

poor TTA prognosis

32
Q

angiography used primarily for what

A

bypass surgery rather than picking limb length

33
Q

Ankle pressure vs thigh pressure for healing levels

A

ankle pressure: not good

Thigh pressure: good predictor for healing at TTA

34
Q

Trauma level selection “motto” is what?

what do you preserve heroically

A

fracture of the soft tissue/ injury zone

all heroic measures to preserve the knee

35
Q

Salvage vs. amputation rates of complication, longer duration of hospital stay

Functional outcomes?

A

salvage: higher complication rates

Amputation: longer duration and more secondary hospitalization

Functional outcomes: no significant differences btwn

36
Q

What will someone with diabetes show when they have a systemic infection?

A

malaise, hyperglycemia

NO fever

37
Q

Systemic infections are what? and how are they treated amputation wise

A

medical emergency!

Two part amputation: guillotine, secondary closure

38
Q

Myodesis

A

drill holes to attach muscles to distal bones

39
Q

myoplasty

A

muscles form opposing groups are attached to each other: typically TFA

40
Q

What happens if the length tension relationship is off at the gastroc and it’s too tight?

A

knee flexion contracture

41
Q

Transected nerves form a ______

A

neuroma: small tension on the nerve and it will “bounce back” into soft tissue

42
Q

True or false, toe amputation (MTP joint) does not need a shoe modification

A

true: maybe a different kind of shoe (wider etc) but nothing to actually accomodate for the loss of the toes

43
Q

Ray resection do you need shoe modification

A

yes! this is where you start thinking about it

44
Q

Explain cascade of length for transmetatarsal surgery

A

1st ray is longest, 5th ray is shortest to preserve push off

45
Q

Transmetarsal, Lisfranc and Chopart amputations are susceptible to ______ due to muscle imbalance?

A

PF contracture, DF lost their insertion. Can cause wound right on the end of the stump. Need to fillers/high top shoe.

Achilles lengthening in surgery is common

46
Q

Lisfrance and Chopart need what kind of modification?

A

anterior stability

  • slipper prosthesis
  • carbon inserts
  • AFO with toe fillers
47
Q

Compromise to the heel pad, cellultis that has advanced proximall or poor vascularity proximal to ankle is a contraindication for what?

A

symes

48
Q

What happens to talus and calcaneus in symes?

A

they come out, fat pad gets put on

49
Q

What is the advantage of symes?

A

end bearing possible on fat pad, better energy conservation.

Cons: they need full prosthetic device that goes up to knee

50
Q

If you have gangrene/infection within 4-5 cm of tibial tubercle then what?

A

consider higher level than TTA

51
Q

If you have a knee flexion contracture greater than 70 degrees then what does that mean for decisions needing to be made for amputation?

A

consider higher level than TTA

52
Q

TTA surgical technique posterior or anterior?

A

posterior flap and long posterior flap commonly used

53
Q

Fibula should be what?

A

equal to or shorter than

54
Q

What is the muscle mostly impacted by TTA.

A

gastroc: they wrap it around the distal end of the strump

55
Q

Major problem with posterior approach?

A

the incision starts to heal and its directly over the distal end of the bone

56
Q

What is the ERTL procedure?

A

bone bridge synostasis: increases distal WB

57
Q

Knee disarticulation (which is a TFA) major advantage!

A

ADD insertion is maintained!! it inserts in the femoral condyles

inatact growth plate for children

Alows distal end bearing

58
Q

How do you extend the knee with the TF prosthesis?

A

extend the hip

59
Q

Hamstrings during a knee disarticulation?

A

they are resected and are allowed to float bc of insertion on the posterior side.

Hamstring muscles are myodesed to quds tendon and posterior capsule to cover the distal femus.

60
Q

Quads during knee disarticulation?

A

sewn to the preserved cruciate ligament

61
Q

For TFA the shorter the residual limb the greater loss of ______ power

A

ADD

62
Q

For TFA The shorter the residual limb the _____ the lever arm to control the knee

A

shorter the residual limb the shorter the lever arm

63
Q

Major muscles involved in TFA

A

ADD: myodesis to distal bone

hamstrings and quads: myoplasty

64
Q

What muscle is super affected by loss of ADD in TFA?`

A

Glute med: its in a shortened position because the femur drifts laterally. They will have so much trouble stabilizing the pelvis because its in open chain

65
Q

Realigning the _____through muscle insertion is super important for the surgeon in TFA

A

Realigning the femur

66
Q

Three ADD lost with TFA

A

ADD longus, brevis, magnus

FEMUR POSITION AND ADD STRENGTH ARE IMPORTANT FOR STABILIZATION

67
Q

What is normal anatomical position for femur ADD

A

15 degrees

68
Q

Prosthetic acceptance is low or higher for hip disarticulation?

A

low, a lot of rejections

69
Q

ABD musculature is sutured to where during hip disarticulation?

A

joint capsule

70
Q

Glute max is moved where during hip disarticulation?

A

anteriorly and sutured to inguina ligament

71
Q

Hemi-pelvectomy muscle attachment?

A

no reattachment, they’re just sitting on soft tissue

Unit 15 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions