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NBCOT > Amputations (AOTA) > Flashcards

Amputations (AOTA) Flashcards

1
Q

most common cause of UE amputation

A

trauma

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2
Q

most common cause of LE amputation

A

peripheral vascular disease

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3
Q

goals of surgery during amputation

A

preserve as much limb length as possible while providing healthy skin, soft tissue, vascularization, sensation, muscle, and bone

a residual limb that is pain free and functional

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4
Q

common symptoms during postoperative and preprosthetic phase

A
  1. pain
  2. skin complications (delayed healing, necrosis, skin graft adherence to bone)
  3. edema of residual limb
  4. bone spurs
  5. neuroma on distal end of residual limb
  6. phantom limb (non-painful sensation that limb is still there; may remain forever)
  7. phantom sensation
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5
Q

common symptoms during prosthetic phase

A
  1. skin ulcers as a result of poorly fitting prosthesis socket or wrinkles in prosthetic sock
  2. sebaceous cysts from torque of prosthetic socket
  3. edema from ill-fitting socket or too-tight prosthetic sock
  4. sensory changes (hyper- and hyposensitivity, phantom limb, phantom sensation)
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6
Q

above the knee amputation

A

transfemoral amputation

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7
Q

below the knee amputation

A

transtibial

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8
Q

below the ankle amputation

A

transmetatarsal

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9
Q

below the elbow amputation

A

transradial

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10
Q

above the elbow amputation

A

transhumeral

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11
Q

below the wrist amputation

A

transmetacarpal

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12
Q

disarticulation

A

amputation accross a joint

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13
Q

Symes amputation

A

ankle disarticulation

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14
Q

preprosthetic phase

A

from postsurgery until client receives permanent prosthesis

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15
Q

goals of preprosthetic phase

A
  1. address psychosocial aspects of limb loss
  2. optimize wound healing
  3. maximize residual limb shrinkage and shaping to distal end
  4. desensitize residual limb
  5. maintain/increase ROM and strength
  6. facilitate independence in BADLs
  7. explore prosthetic options
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16
Q

optimal shape for prosthetic socket

A

tapered distal end

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17
Q

goals of prosthetic training

A
  1. teach client to don/doff prosthesis
  2. train the client in care of prosthesis
  3. increase wearing time to full day
  4. encourage independent use of prosthesis
18
Q

most common limitations for people with UE amputation

A

manipulation of objects

19
Q

most common limitations for people with LE amputations

A

mobility and ADLs related to LE care

20
Q

how evaluation of self care activities should be done

A

both with and without prosthesis; include motor skills eval of uninvolved hand in prep for training in one handed techniques and in use of prosthesis when it is worn

21
Q

important client factors that should be evaluated in people with amputations

A
  1. changes in sensation in residual limb
  2. presence and severity of phantom sensations
  3. pain
  4. psychosocial
  5. strength, flexibility, and endurance of residual limb and full body in preparation for prosthesis wearing
  6. skin integrity
22
Q

Things to include in eval on pt with amputation

A
  1. self care activities both with and without prosthesis
  2. include motor skills eval of uninvolved hand in prep for training in one handed techniques and in use of prosthesis when it is worn
  3. vocational and recreational interests
  4. driving eval
  5. environmental analysis of community, home, school, and work
23
Q

preprosthetic interventions

A
  1. training in limb hygiene
  2. wound healing, including whirlpool and massage
  3. limb shrinkage and shaping
  4. desensitization of residual limb through weight bearing on various surfaces, massage, tapping, and rubbing
  5. maintain/increase flexibility and strength of residual limb
    - to prevent flexion contractures of knees and hips in LE amputations
  6. maintain/increase strength of remaining limbs for propelling w/c, using mobility aids, and weight bearing
  7. W/C adjustments
24
Q

wrapping residual limb training

A

pt should use elastic bandage to reduce edema and develop tapered shape

elastic shrinker or removable rigid dressing can be used if pt is unable to perform wrapping technique

25
Q

w/c fitting for person with LE amputation

A

large rear wheels should be placed further back to counterbalance missing limbs

should have antitippers

26
Q

considerations for prosthesis prescription

A
  1. length, strength, flexibility, and skin integrity of residual limb
  2. patient preference of cosmetic appearance
  3. hand dominance
  4. typical activities to be performed with prosthesis
  5. motivation and attitude
  6. financial coverage
  7. cognition
27
Q

passive TD

A

terminal device that is realistic, nonfunctional limb work for cosmetic purposes

28
Q

active TD

A

terminal device that assists with functional activity

can be body powered, externally powered, or hybrid powered

can be a hook or realistic looking limb

29
Q

attaches the prosthesis to the residual limb

A

socket

30
Q

positioning components of prosthesis

A

include wrist, elbow, shoulder, knee, and ankle devices

may have locking system activated by user

31
Q

holds the prosthesis on the residual limb

A

UE: harness or suspension system (control system often combined with harness)
LE: pylon (connects terminal device to socket

32
Q

initial wearing time of prosthesis

A

15-30 min

33
Q

process for progressing wear time of prosthesis

A

when removed, check residual limb for redness

if no red areas are present after 20 min, increase time in 15-30 min increments

if redness still present after 20 min, report areas of redness to prosthetist so adjustments can be made

34
Q

hygiene of limb

A

daily cleansing

daily skin inspection, especially areas with decreased sensation

35
Q

care of prosthesis

A

clean interior with mild soap and water

clean hook or cosmetic hand with soap and water

myoelectric prosthesis wearers must be taught to replace batteries

36
Q

UE prosthesis training includes (types of training)

A 
prosthesis control training
prosthesis use training
prepositioning training
prehension training
functional training
37
Q

prosthesis control training

A

operation of each component of the UE prosthesis

38
Q

prosthesis use training

A

integration of prosthesis components for efficient assist during functional use

39
Q

prepositioning training

A

identification of the optimal postition of each positioning unit to perform activity or grasp an object

40
Q

prehension training

A

TD control during grasp activities

41
Q

functional training

A

control and use of prosthesis during functional activities

-incorporating TD as functional assist

42
Q

postprosthetic interventions

A
  1. education about prosthesis
  2. don/doff training (for myoelectric-proper alignment of electrodes for best contact)
  3. wearing schedule
  4. limb hygiene
  5. care of prosthesis
  6. UE prosthesis training
  7. provision of AE PRN
  8. work with client to gain repertoire of skills needed to complete ADLs IADLs
    - transfers, bedmobility, w/c mobility
    - methods to perform vocational and leisure activities
  9. home eval PRN
  10. psychosocial

NBCOT (16 decks)

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