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Prosthetics - Midterm > Biomechanics 1 - TT > Flashcards

Biomechanics 1 - TT Flashcards

1
Q

casting for a TT socket

A

casting for negative mold

create positive mold

create socket

select components

assemble/static alignment of prosthesis

dynamic alignment prosthesis

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2
Q

alignment

A

position of parts

one to another

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3
Q

alignment –> parts

A

foot to knee

knee to socket

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4
Q

how should we align the prosthesis

A

as close to normal alignment as possible

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5
Q

optimal alignment has

A

pain free ambulation

protection of RL and intact joints

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6
Q

optimal alignment increases/decreases

A

increases WBing and quality of gait

decrease energy cost

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7
Q

overall goals of alignment

A

to align the prosthesis so that…

to reduce compensation that are the result of a prosthetic replacement

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8
Q

to align the prosthesis so that… –> goals

A

there will be AP & ML stability at the knee and hip

there will be AP & ML stability of the RL in the socket

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9
Q

to reduce compensation that are the result of a prosthetic replacement –> goals

A

keep as close to normal

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10
Q

phases of alignment

A

static alignment

dynamic alignment

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11
Q

static alignment is also called

A

bench

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12
Q

bench alignment

A

alignment ‘gig’/LASAR

based on prosthetist judgement

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13
Q

dynamic alignment

A

pt involved

gait analysis

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14
Q

normal M/L alignment –> TT

A

normal base of support (BoS)

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15
Q

normal BoS –> normal ML alignment

A

b/w the feet

measured heel center to heel center

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16
Q

prosthetic goal –> ML alignment

A

to mimic normal BoS when possible

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17
Q

transtibial BoS

A

prosthetic weight line

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18
Q

prosthetic weight line –> TT BoS

A

patella tendon/midline socket

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19
Q

patella tendon/midline socket –>prosthetic weight line

A

to the floor

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20
Q

establishes –> TT BoS

A

midline for prosthetic alignment

measurement for BoS for prosthetic foot

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21
Q

alignment terms –> M/L alignment

A

inset

outset

neutral

normal

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22
Q

inset –> alignment terms

A

medial to weight line

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23
Q

outset –> alignment terms

A

lateral to weight line

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24
Q

neutral –> alignment terms

A

in line w/ weight line

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25
Q

normal –> alignment terms

A

prosthetic foot set in inset alignment gives normal BoS

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26
Q

what is there a tendency for the RL to do while walking –> RL socket pressures

A

RL to move w/in the socket

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27
Q

what does the RL moving in the socket create –> RL socket pressures

A

pressure b/w these 2 surfaces

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28
Q

goal –> RL socket pressures

A

minimize or compensate for those pressures

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29
Q

socket pressures w/ an inset foot

A

in single stance

-distal lateral
-proximal medial

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30
Q

why are pressures that are distal lateral more concerning?

A

foot is medial to the weight line and pushes the top of the socket out laterally

31
Q

PTB socket –> inset foot alignment

A

relief for the distal fibula

32
Q

TSB socket –> inset foot alignment

A

no reliefs

urethane sleeve for pressures

33
Q

socket pressures w/ an outlet foot

A

lateral pressure shifts proximal

medial pressure shifts distal

34
Q

pressures _____ not as problematic

A

proximal lateral

35
Q

PTB socket –> outlet foot

A

relief for head of fibula

36
Q

TSB socket –> outlet foot

A

urethane sleeve

37
Q

neutral foot alignment socket pressures

A

somewhere in the middle

medial

lateral

38
Q

ideal –> choosing inset v. outset

A

ideal is to aim for normal alignment w/ normal BOS or inset alignment

39
Q

when will normal alignment work –> choosing inset v. outset

A

normal length of RL

good skin w/o skin dysfxn

ideal RL

40
Q

alignment change/adjustment –> inset v. outset

A

when the pt feels pain

move foot laterally

41
Q

possible reasons for pain/breakdown –> inset v. outset

A

short RL

scar tissue

sensitive skin

prominent fibula

42
Q

how is decision confirmed –> inset v. outset

A

dynamic alignment

pain

gait deviation

43
Q

goal of A/P alignment

A

create stability

44
Q

create stability –> AP alignment

A

RL in socket in sagittal plane

knee joint in sagittal plane

45
Q

what do we have to consider –> AP alignment

A

in relation to the stance phase of gait

foot levers

46
Q

consider alignment in relation to stance phase of gait –> AP alignment

A

HS

MS/HO

PO

47
Q

normal ground rxn for at knee –> HS

A

posterior to knee

knee flexion

48
Q

normal ground rxn for at knee –> MS/HO

A

anterior to knee

knee extension

49
Q

normal ground rxn for at knee –> HO/TO

A

posterior to knee

knee flexion

50
Q

normal AP alignment –> socket

A

center is set just anterior to anterior margin of the heel

(breast of the heel)

51
Q

what does normal alignment mimic –> AP

A

normal GRF

52
Q

normal alignment has –> AP

A

normal gait levers

53
Q

socket position –> normal AP

A

socket set in in flexion (5 degrees) w/ respect to the foot

54
Q

where is the GRF –> HS

A

behind the knee

55
Q

GRF behind the knee –> HS

A

knee flexion

body stable/socket move

top of socket rotates anterior

56
Q

socket pressures –> HS

A

anterior - distal

posterior - proximal

57
Q

what socket pressure is problematic –> HS

A

anterior distal

58
Q

@ HS –> pressure v. fit

A

anterior distal

area for concern

59
Q

anterior distal –> HS

A

cut end of distal tib

pressure sensitive

60
Q

PTB socket –> HS

A

relief at anterior distal socket

61
Q

TSB socket –> HS

A

no relief

urethane sleeve to pad

still a concern

62
Q

where does GRF move –> MS/HO

A

moves from neutral to anterior knee

63
Q

socket pressures –> MS/HO

A

anterior proximal

posterior distal

64
Q

are there problematic pressures –> MS/HO

A

no

65
Q

what is a concern –> MS/HO

A

knee hyperextension

66
Q

socket pressures –> TO

A

anterior - distal

posterior - proximal

double support

67
Q

double support –> TO socket pressures

A

less force

pressure less significant

68
Q

socket fit/design –> TO

A

same as HS

69
Q

what pts get normal alignment

A

w/o contractures

adequate muscle strength

adequate RL length

good skin condition

70
Q

what pts may get alteration in alignment

A

w/ contracture

mm weakness

short RL

scaring

fragile skin

71
Q

what is TT bench assessed w/

A

w/ anticipated typical shoe

72
Q

ML alignment –> bench

A

foot medial to support line (inset)

toe out approx 7 degrees

73
Q

AP alignment –> bench

A

socket flexed on shank 5 degrees

AP socket center falls anterior to heel

Prosthetics - Midterm (8 decks)

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