Amputations, equipment, and assistive technology Flashcards
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?
shift the ground reaction force behind the knee joint to produce a knee flexion moment.
Which characteristic of a prosthesis promotes knee stability during the gait cycle of a person with transfemoral amputation?
Polycentric 4-bar linkage prosthetic knee
What is the primary advantage of a 4-point crutch gait over a 2-point crutch gait?
stability
How are mobility devices paid for through Medicare?
Medicare part B pays 80% of the allowed purchase price in one lump sum
What is the primary disadvantage of moving the rear axle of a wheelchair forward?
Ascending a ramp becomes more difficult
Spinal orthotic prescription for adolescent idiopathic scoliosis should be considered once the Cobb angle reaches:
25 degrees
Which of the following prosthetic knees facilitates flexion while weight bearing during the pre-swing phase (terminal stance) of the gait cycle?
Polycentric
How should the hand of a child with juvenile rheumatoid arthritis be positioned in splinting?
Wrist in 15° of extension, MCP joints in 25° of flexion, thumb in opposition
The primary advantage of an ischial containment socket over a quadrilateral socket in a transfemoral amputee is
Promotion of femoral adduction by distributing the pressure through the socket along the shaft of the femur
How does a ischial containment socket hold the femur?
holds the femur in adduction and distributes the pressure through the socket along the shaft of the femur
The grip height of a rolling or standard walker:
Should be about even with the ulnar styloid/greater trochanter of the hip
In an individual with a transfemoral amputation, which patient characteristic would most lead you to consider prescribing a weight-activated stance-control knee?
Requires a preparatory prosthesis
Which of the following will result in an increased knee flexion moment during stance phase of a transtibial amputee?
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.
Where does a Lisfranc amputation occur?
Occurs between the tarsal and metatarsal bones
Which of the following adjustments would correct the lateral whip observed in a transfemoral amputee as swing phase begins?
Externally rotating the knee bolt
what motion does knee extension facilitate at the ankle
plantar flexion
Which of the following methods of controlling a myoelectric hook on a transradial prosthesis is the easiest to learn to operate functionally?
Two-site/two-function with the electrodes placed over the flexors/extensors of the forearm
What is the primary advantage of a body powered upper limb prosthesis compared to a myoelectric prosthesis?
moderate cost, most durability, highest sensory feedback, and a variety of prehensors available for various activities
what are some disadvantages of a body powered upper body prosthesis?
they require the most body movement to operate, have the most harnessing and require increased energy expenditure to use.
Which of the following is a risk factor associated with increased incidence of phantom pain?
shorter residual limbs, lower extremity amputation, bilateral amputees, patients with history of infection, and patient with pain in the amputated limb prior to amputation
Bracing can help slow the progression of adolescent idiopathic scoliosis for Cobb angles of:
20-39 degrees
Which of the following is a recommended static alignment for an uncomplicated transtibial amputee with no significant knee contracture?
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.
In children, which of the following is an advantage of a through-joint disarticulation compared to a transection amputation?
Absence of terminal overgrowth
The Philadelphia collar or similar hard cervical orthosis requires a thoracic extension to:
Provide increased stabilization for cervicothoracic injuries
Which of the following would typically be specified in a shoe prescription for a patient with a Charcot foot?
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.
What is the MOST important biomechanical factor for decreasing the vertical loading of the lumbar spine using a TLSO or LSO?
Reinforce core musculature to distract vertebral bodies
What does the application of a 3-point pressure system for TLSO/LSO aim to do?
restrict triplanar motion (flexion/extension/lateral flexion and trunk rotation).
Prescribing power mobility in young children has been shown to:
Increase receptive language level
What is the primary advantage of a soft insert fitted into the socket of a transtibial prosthesis?
Skin protection
What is the primary goal of treatment with orthotic bracing for scoliosis from neuromuscular disease?
Improve sitting posture in wheelchair
Which wheelchair would be most appropriate for a 50-year-old man who had a stroke with right hemiparesis?
Manual wheelchair with lower seat height
In a patient with a Syme’s residual limb, the following area would be considered non-pressure tolerant:
bony prominence around the distal expansion is considered a pressure sensitive area in a Syme disarticulation.
Contralateral axillary and neck pain in a patient with a short transhumeral amputation is the result of the harness:
Resting on or superior to the C7 spinous process
The primary stabilizing effect of the flexible lumbosacral orthosis is its ability to:
Elevate intra-abdominal pressure
The patellar tendon bearing (PTB) socket for a transtibial amputee is designed:
With alignment in 5° - 8° of anterior flexion
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)?
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.
Which of the following is true regarding the pylon of a lower extremity prosthesis?
Endoskeletal tends to weigh less
The function of a wrist cock-up splint is to:
Stabilize the wrist in extension to increase the mechanical advantage for grasp
The function of a resting hand splint is to:
Preserve balance between extrinsic and intrinsic musculature when the hand is at rest
The function of a resting thumb spica splint is to:
Provide a stable post against which the index finger can pinch
What is the minimal number of points of contact that an orthosis must have in order to exert rotational control?
3
A resting wrist-hand-orthosis (WHO) has which of the following characteristics:
Distal and proximal interphalangeal joint extension
Increasing the camber of a wheelchair will result in which of the following:
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.
What is the function of the anterior pin in an ankle-foot orthosis (AFO) with a dual-channel ankle joint?
Limits dorsiflexion
