Amputations Flashcards

1
Q

Etiology

A

PVD (most common- Type 2 diabetics)
Trauma
Malignancy
Infection
Congenital deficiency

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2
Q

Residual limb

A

The part of the limb that is left

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3
Q

Common levels of amputation- LE (foot)

A

Partial toe amputation
Toe disarticulation
Ray resection
Transmetatarsal
Lisfranc (not done anymore commonly)
Chopart (not done anymore commonly)

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4
Q

Syme’s

A

Amp through malleoli

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5
Q

Transtibial

A

Amp through tibia

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6
Q

Knee disarticulation

A

Disarticulation at the tibiofemoral jt

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7
Q

Transfemorla

A

Above knee through femur

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8
Q

Transtibial amp ad and disad

A

Ad
- greater potential of ambulation
- decreased energy expenditure w ambulating

Disad
- not a weight bearing end
- bony prominences are at increased risk for skin breakdown

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9
Q

Transfemoral amp

A

Ad
- greater healing in vascular amputees

Disad
- not a weight bearing end
- lower potential for ambulations
- increased energy expenditure

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10
Q

Rotationplasty

A

Take the thigh and replace with tibia and foot and rotate it backwards at the knee. So the ankle acts as a knee
Removal of a boney tumor

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11
Q

Postsurgical dressings

A

Rigid dressing
Semi-rigid
Soft

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12
Q

Goals of post surgical dressings

A

Control edema
Prevent infections
Protect limb from external, trauma
Shape residuum in preparation for prosthesis

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13
Q

Rigid dressing- types

A

Non-removable
- immediate postoperative prosthesis (IPOP)

Removal
- removable rigid dressing

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14
Q

Semi-rigid- paste and ads/disad

A

Unna’s paste
Good edema control, removable for inspection
May loosen easily and needs frequent changes

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15
Q

Sorts dressings- types and ads/disads

A

Elastic wraps
-Easily removable if there is an infection and cheap
-Poor edema control and minimal protection

Elastic Shrinkers
- socklike garment
- easily to apply with good edema control and stump shaping
- requires changing of size as residuum shrinks (correct size essential)

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16
Q

Phases of care

A

Postsurgical (time b/w surgery and hospital discharge)
Preprosthetic (time b/w hospital discharge and prosthetic fitting)
Prosthetic (time after fitting)

17
Q

Post surgical phase- goals

A

Healing residuum
Protecting unamputated limb
Increase independence in transfers and mobility
Understanding and demonstrating proper positioning

18
Q

Post surgical phase Common contracture for Transtibial

A

Knee flexion and hip flexion
To prevent, encourage client to lie prone

19
Q

Post surgical phase Common contracture for Transfemoral

A

Hip flexion, abduction and ER

Encourage to spend time in prone (15-20 mins/ day)

20
Q

Post surgical phase Balance training

A

COG will be change
Sitting and single leg balance (on unamputaed limb) balance

21
Q

Post surgical phase Transfer training

A

Transfer leading with unamputated limb

22
Q

Post surgical phase Mobilty training

A

Fit patient with appropriate mobility aid
Walker= greater stability, crutches= greater mobility
Wear shoe on the remaining limb to prevent slippage and protect remaining foot

23
Q

Post surgical phase Residual limb care

A

Teach wrapping to patient and family
Teach how to protect limb while moving in bed and transferring (don’t drag residual limb)
Gentle ROM
No strength on residual care

24
Q

Post surgical phase REmaining limb car

A

Foot care

25
Q

Preprosthetic phase- Goals

A

Independent residual limb care, and mobility and transfers
Home exercise care understanding
Unaffected limb care

26
Q

Preprosthetic phase- residual limb care

A

Skin
Shape
Length
Circumference
Pain

27
Q

Preprosthetic phase- strength and ROM

A

ROM to prevent the common contractures

Strength for gross motor strength (functional activities- like arm strength for movement)
MMT of residuum must wait until most healing has occurred

28
Q

Preprosthetic phase- remaining limb inspection

A

Skin
Pulses
Sensations
Temp
Edema
Pan on exercise or at rest
ROM
Strength

29
Q

Preprosthetic phase- functional status

A

ADLS
Functional mobility skills
Balance

30
Q

Preprosthetic phase- phantom limb

A

Sensations and pain in the area of the limb that has been amputated

31
Q

Preprosthetic phase- Intervnion

A

Residual limb care (desensitizing skin where the prosthetic will be fitted
Skin care
ROM
Strengthening
- key muscles for ambulations:
- TF: hip extensors, abductors, and adductors
- TT: hip extensors, abductors, adductors, knee flexors and extensors
Balance and mobilty exercises

32
Q

Prosthetic phase- Goals

A

Smooth and energy efficient gait so ADL’s are okay
Slowly get off stability structures

33
Q

Prosthetic phase- pressure sensitive and tolerant areas

A

Areas where are more sensitive and areas where they are not

34
Q

Prosthetic phase- Donning Prosthesis

A

1 roll liner over amputated lib
2 Fill up socket with socks
3 fit prosthesic
4 stand on prosthetic
5 continue to bear weight until prosthesis is locked in place

35
Q

Prosthetic phase- prosthetic training (critical training elements)

A

Stability ove both legs
Knee control
Stability on prosthesis
Prosthetic control
Proprioception
Pelvic control
Stepping with prosthesis
Stepping with sound leg
Side stepping/ backward stepping

36
Q

Prosthetic phase- Advanced Training (in gym before going home)

A

Going up and down stairs and ramp
Sitting on the floor
Getting up from the floor
Kneeling
Picking up and object from the floor
Clearing obstacles

37
Q

Gait Deviations

A

Look into it