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Phys Dys > Amputations and Orthotics > Flashcards

Amputations and Orthotics Flashcards

1
Q

What are the four most common causes of UE amputation in order?

A
  1. Trauma
  2. Congenital
  3. Tumor
  4. Disease
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2
Q

What are the four most common causes of LE amputation in order?

A
  1. Disease (diabetes, vascular disease, gangrene, infection)
  2. Trauma
  3. Congenital
  4. Tumors
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3
Q

What is a neuroma?

A

A ball of nerves. Can be very painful

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4
Q

How does a mirrorbox relieve pain of phantom limb syndrome?

A

WHen you look into the mirror and see “your limb” there, it can overide the painful feeling in the brain

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5
Q

What are three tx. for phantom limb pain, other than mirror box?

A
  1. Graded textures or particles
  2. Heat or cold therapy
  3. warm water therapy
  4. Ultrasound
  5. TENS unit
  6. Massage
  7. Compression or weight bearing
  8. Isometric exercises and active muscle movements
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6
Q

What is the purpose of using a “Myo-boy”?

A

It is an assessment and training system for people with UE amputations.
Electrodes are attached to a flexor and extensor
a monitor records muscle signal strength for find the best placement of electodes
the pt. get to practice moving their mucles in the appropriate way.

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7
Q

What special considerations are important in prostesis selction and training for people with bilateral amputations?

A
  1. Bilateral amputations should be treated together
  2. Mult. disc. team needs to assess psychosocial, equipment and vocational needs of client
  3. Foot skills may be more functional
  4. Two prosthesis, one harness
  5. Learning separation of controls
  6. Midline activities (wrist flexion and forearm rotation)
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8
Q

Name 4 Pros of body powered prostesis

A
  1. Lower cost
  2. No batteries
  3. durable
  4. lighter weight
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9
Q

Name 5 cons of body powered prosthesis

A
  1. Not as good with fine motor
  2. Bulky
  3. Not the best appearance
  4. Overuse of other muscles
  5. Need power and ROM to operate
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10
Q

Name 7 pros of myoelectronic prosthesis

A
  1. No cables or straps
  2. Precise movements
  3. More natural movement
  4. Can have up to 20-30 lbs of grip
  5. Reduces or eliminates harness
  6. Looks better
  7. Minimal effort to control
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11
Q

Name 7 cons of myoelectronic prosthesis

A
  1. Expensive
  2. Break down/repair cost
  3. Learning curve
  4. Battery life
  5. Fragile to the elements
  6. No proprioceptive feedback
  7. Response time can be slow
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12
Q

What is the recommended progression for UE amputee wearing schedule?

A
  1. 15-20 minutes 3x per day
  2. Increase by 30 mins 3x per day (if no skin problems)
  3. By the end of the first week, worn for whole day
  4. Bands can increase 1 per day
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13
Q

What are the 3. primary elements for Control training?

A
  1. Pt. learns minimal motions to operate with proper body mechanics in mirror
  2. Practice drills to learn/review prosthetic components (combine small and simple movements to get large complex functional tasks)
  3. Emphasis on assists from environment
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14
Q

What are the primary elements of use training?

A
  1. Begins after client understands how to operate and control individual prosthetic components
  2. Repetition
  3. Gain understanding of how to pre-position, the surrounding objects and how to use environment to help
  4. Pre-positioning:Moving prosthetic units in optimal position to grasp an object or perform an activity
  5. Prehension: Terminal device control(start with large, hard objects and progress to small, soft and crushable objects)
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15
Q

What are the primary elements of functional training?

A

Applies the concepts of control and use to complete functional and meaningful activities
1.Problem solving approaches

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16
Q

List 5 ways to encourage success once a person is fitted for his/her prosthesis

A
  1. A well designed wearing schedule with gradual adjustment period
  2. Training in don/doff prosthetic
  3. Care of prosthesis
  4. Talk about body image
  5. Implement a progressive training plan (control, use, functional training)
17
Q

What are the five most common reasons people don’t wear prostetics?

A
  1. Development of one handed ness
  2. Poor comfort
  3. Lack of sufficient training/skills
  4. Maintenance, fitting, appointments too burdensome
  5. Unrealistic expectations of outcomes
18
Q

Describe the role of the prosthetist in amputee rehab?

A
  1. Measures, designs, fabricates, fits and services prosthesis
  2. Assists in formulation of the prosthesis prescription for the person
19
Q

List 2-3 overuse problems that a person with a unilateral UE amputation may face

A
  1. Fatigue, aching, pain, inflamation, decreased endurance
  2. Rotator cuff injuries
  3. Elbow: epicondylitis
  4. Wrist/forearm: carpal tunnel, tendonitis
20
Q

How is foreign tissue rejection avoided among limb transplant patients?

A
  1. Anti rejection meds

2. Bone marrow transplant(which lowers amount of anti rejection meds and the side effects)

21
Q

On days 0-4 of a finger replantation, what does the OT do?

A

Keep hand warm, orthosis in “safe position”

22
Q

On days 5-14 of a finger replantation, what does the OT do?

A
  1. Maintain or adjust orothosis to get “safe position”,
  2. wound care with non-adhereant dressings
  3. Early protected motion via tenodesis effect,
  4. teach home exercise program
  5. Teach precautions(avoid caffeine or nicotine)
23
Q

On days 14-21 of a finger replantation, what does the OT do?

A
  1. Initiate edema management with light compression
  2. Begin place and hold (in intrinsic plus or minus)
  3. would care
  4. Home excersise program
24
Q

On week 3-4 of a finger replantation, what does the OT do?

A
  1. LIght coban wrap
  2. Continue protected A/PROM
  3. Scar massage
25
Q

On weeks 5-6 of a finger replantation, what does the OT do?

A
  1. Begin composite wrist and finger flexion/extension
  2. Dynamic flexion orthosis if needed
  3. night time volar wrist and finger extension orthosis
  4. Light functional activity
26
Q

On weeks 4-5 of a finger replantation, what does the OT do?

A
  1. Composite finger flexion with wrist in neutral
  2. A/PROM of wrist
    3: TENS if poor tendon glide
27
Q

On weeks 6-12 of a finger replantation, what does the OT do?

A
  1. discontinue dorsal blocking splint
  2. Progress functional activities
  3. add light resistance at 8 weeks
  4. Progress strengthening from week 8-12
  5. Sensory evaluation
28
Q

On week 12+ of a finger replantation, what does the OT do?

A
  1. WOrk simulation
  2. Work conditioning
  3. Continue static progressive/dynamic orthotics
  4. Sensory eval every 5-6 weeks

Phys Dys (17 decks)

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