Amputations, equipment, and assistive technology

Question 1

What do Flexion moment at the hip, a rigid heel in the solid ankle cushion heel (SACH) foot, and the anterior position of the shank all do at the knee during gait in a transfemoral amputee?

Answer 1

shift the ground reaction force behind the knee joint to produce a knee flexion moment.

Question 2

Which characteristic of a prosthesis promotes knee stability during the gait cycle of a person with transfemoral amputation?

Answer 2

Polycentric 4-bar linkage prosthetic knee

Question 3

What is the primary advantage of a 4-point crutch gait over a 2-point crutch gait?

Answer 3

stability

Question 4

How are mobility devices paid for through Medicare?

Answer 4

Medicare part B pays 80% of the allowed purchase price in one lump sum

Question 5

What is the primary disadvantage of moving the rear axle of a wheelchair forward?

Answer 5

Ascending a ramp becomes more difficult

Question 6

Spinal orthotic prescription for adolescent idiopathic scoliosis should be considered once the Cobb angle reaches:

Answer 6

25 degrees

Question 7

Which of the following prosthetic knees facilitates flexion while weight bearing during the pre-swing phase (terminal stance) of the gait cycle?

Answer 7

Polycentric

Question 8

How should the hand of a child with juvenile rheumatoid arthritis be positioned in splinting?

Answer 8

Wrist in 15° of extension, MCP joints in 25° of flexion, thumb in opposition

Question 9

The primary advantage of an ischial containment socket over a quadrilateral socket in a transfemoral amputee is

Answer 9

Promotion of femoral adduction by distributing the pressure through the socket along the shaft of the femur

Question 10

How does a ischial containment socket hold the femur?

Answer 10

holds the femur in adduction and distributes the pressure through the socket along the shaft of the femur

Question 11

The grip height of a rolling or standard walker:

Answer 11

Should be about even with the ulnar styloid/greater trochanter of the hip

Question 12

In an individual with a transfemoral amputation, which patient characteristic would most lead you to consider prescribing a weight-activated stance-control knee?

Answer 12

Requires a preparatory prosthesis

Question 13

Which of the following will result in an increased knee flexion moment during stance phase of a transtibial amputee?

Answer 13

socket anterior relative to the foot or Foot aligned posterior to the socket, dorsiflexion alignment of the foot, excessive anterior socket flexion, and a weak or broken prosthetic foot keel.

Question 14

Where does a Lisfranc amputation occur?

Answer 14

Occurs between the tarsal and metatarsal bones

Question 15

Which of the following adjustments would correct the lateral whip observed in a transfemoral amputee as swing phase begins?

Answer 15

Externally rotating the knee bolt

Question 16

what motion does knee extension facilitate at the ankle

Answer 16

plantar flexion

Question 17

Which of the following methods of controlling a myoelectric hook on a transradial prosthesis is the easiest to learn to operate functionally?

Answer 17

Two-site/two-function with the electrodes placed over the flexors/extensors of the forearm

Question 18

What is the primary advantage of a body powered upper limb prosthesis compared to a myoelectric prosthesis?

Answer 18

moderate cost, most durability, highest sensory feedback, and a variety of prehensors available for various activities

Question 19

what are some disadvantages of a body powered upper body prosthesis?

Answer 19

they require the most body movement to operate, have the most harnessing and require increased energy expenditure to use.

Question 20

Which of the following is a risk factor associated with increased incidence of phantom pain?

Answer 20

shorter residual limbs, lower extremity amputation, bilateral amputees, patients with history of infection, and patient with pain in the amputated limb prior to amputation

Question 21

Bracing can help slow the progression of adolescent idiopathic scoliosis for Cobb angles of:

Answer 21

20-39 degrees

Question 22

Which of the following is a recommended static alignment for an uncomplicated transtibial amputee with no significant knee contracture?

Answer 22

Socket positioned in 5° to 10° of anterior tilt (flexion). The patella tendon bar is located halfway between the tibial tubercle and the distal end of the patella. The posterior brim of the socket should end about an inch below the patella tendon bar.

Question 23

In children, which of the following is an advantage of a through-joint disarticulation compared to a transection amputation?

Answer 23

Absence of terminal overgrowth

Question 24

The Philadelphia collar or similar hard cervical orthosis requires a thoracic extension to:

Answer 24

Provide increased stabilization for cervicothoracic injuries

Question 25

Which of the following would typically be specified in a shoe prescription for a patient with a Charcot foot?

Answer 25

incorporating a rocker bottom into the rubber sole of the shoe will significantly reduce the dynamic pressure experienced by the foot during stance phase by minimizing the plantar area in contact with the ground at any one time.

Question 26

What is the MOST important biomechanical factor for decreasing the vertical loading of the lumbar spine using a TLSO or LSO?

Answer 26

Reinforce core musculature to distract vertebral bodies

Question 27

What does the application of a 3-point pressure system for TLSO/LSO aim to do?

Answer 27

restrict triplanar motion (flexion/extension/lateral flexion and trunk rotation).

Question 28

Prescribing power mobility in young children has been shown to:

Answer 28

Increase receptive language level

Question 29

What is the primary advantage of a soft insert fitted into the socket of a transtibial prosthesis?

Answer 29

Skin protection

Question 30

What is the primary goal of treatment with orthotic bracing for scoliosis from neuromuscular disease?

Answer 30

Improve sitting posture in wheelchair

Question 31

Which wheelchair would be most appropriate for a 50-year-old man who had a stroke with right hemiparesis?

Answer 31

Manual wheelchair with lower seat height

Question 32

In a patient with a Syme’s residual limb, the following area would be considered non-pressure tolerant:

Answer 32

bony prominence around the distal expansion is considered a pressure sensitive area in a Syme disarticulation.

Question 33

Contralateral axillary and neck pain in a patient with a short transhumeral amputation is the result of the harness:

Answer 33

Resting on or superior to the C7 spinous process

Question 34

The primary stabilizing effect of the flexible lumbosacral orthosis is its ability to:

Answer 34

Elevate intra-abdominal pressure

Question 35

The patellar tendon bearing (PTB) socket for a transtibial amputee is designed:

Answer 35

With alignment in 5° - 8° of anterior flexion

Question 36

Which of the following is true when the rear wheel camber of manual wheelchair is increased (angling the rear wheels so the top is tilted inward and the bottom outward)?

Answer 36

increases the lateral base for increased lateral stability. The superior aspect of the wheels is narrower, which allows the user increased access to the pushrim and reduces need for reduced shoulder abduction.

Question 37

Which of the following is true regarding the pylon of a lower extremity prosthesis?

Answer 37

Endoskeletal tends to weigh less

Question 38

The function of a wrist cock-up splint is to:

Answer 38

Stabilize the wrist in extension to increase the mechanical advantage for grasp

Question 39

The function of a resting hand splint is to:

Answer 39

Preserve balance between extrinsic and intrinsic musculature when the hand is at rest

Question 40

The function of a resting thumb spica splint is to:

Answer 40

Provide a stable post against which the index finger can pinch

Question 41

What is the minimal number of points of contact that an orthosis must have in order to exert rotational control?

Answer 41

3

Question 42

A resting wrist-hand-orthosis (WHO) has which of the following characteristics:

Answer 42

Distal and proximal interphalangeal joint extension

Question 43

Increasing the camber of a wheelchair will result in which of the following:

Answer 43

chair more stable side-to-side and forward, increased propulsion efficiency, increases maneuverability in turning (decreased turning radius), and affords greater protection to the hand during propulsion, as they are closer to the chair.

Question 44

What is the function of the anterior pin in an ankle-foot orthosis (AFO) with a dual-channel ankle joint?

Answer 44

Limits dorsiflexion