BK Px Exam Flashcards
Pt complains of difficulty rolling over the ball of the foot, most likely cause
Excessive PF of the foot
Which portion of stance phase is the Px side in knee extension likely to occur
Initial contact
Rehabilitation of the BK amputee should ideally be initialed
Preoperatively
When wrapping a BK limb for shrinkage, it is important that
Most of the pressure is in the distal end of the limb
Purposes for wearing Px socks (3)
-Reducing friction between stump and skin
-Allow padding between stump and skin
-Wick sweat away from skin
PTB cuff suspension strap derives its suspension over which area
Proximal patella
Redundant tissue is described as
Excessive soft tissue
The A-P measurement of a BK amputee is taken in flexion at
15 deg
A-P measurement of the BK amputee is taken between the
Patella-tibial tubercle and the medial/lateral hamstrings tendons
M-L dimension of the plaster model when using a soft liner should be
Same as measurement
Preferred Px foot and ankle unit for the BK PTB Px
SACH
In PTB socket, anterior brim of the socket should extend to the
Point midway between upper and lower borders of the patella
In evaluation of a unilateral LE amputee’s ability to utilize a Px successfully, an important consideration is their
Balance and coordination on crutches
Pt complains of prolonged anterior distal tibia discomfort
Foot too posterior
In order to obtain optimum M-L stability of he PTB during gait, observe that socket diplaces _____ not more than _____” during midstance phase of gait
Laterally, 1/2”
As the amputee rolls over the foot in stance phase, his knee joint should
Extend slightly
In dynamic alignment, lateral gapping at the socket brim is reduced by
Tilting the socket medially
In dynamic alignment, if the knee if forced forward and knee flexion is exaggerated at heel contact, it indicates
Socket positioned too far anteriorly
In evaluating the PTB Px during gait, the foot must be flat on the floor at mid-stance, of which the indication is
Pylon vertical
If the amputated limb is short, it may be necessary in dynamic alignment to reduce the medial-proximal and lateral-distal forces on the stump by
Moving foot lateral
As the outset of the foot is increased in aligning a BK Px, pressures are increased on the following areas of the stump
Medial-distal and lateral-proximal
When the BK amputee controls the tendency of the knee to flex after heel strike, the pressures are increased on the following aspects of the stump
Anterior-distal and posterior-proximal
Hyperextension of the knee can be decreased by moving the socket ______ in relation to the foot
Anterior
2 main functions of the BK cuff suspension strap
Maintains the knee in flexion and suspends Px
When the foot of a BK is inset, the forces are distributed
Proximal/medial and distal/lateral
With a BK at mid-stance, where are the pressures (forces) in the socket in the sagittal plane
Straight down to the floor
Main areas (2) of weight bearing in a BK
Patella tendon and medial tibial flare
For a very short BK, why is a PTS advantageous
Added M-L stability
When bench aligning a BK, the M-L foot placement is
Inset 1/2”
When static aligning a BK, if the pylon leans laterally, the cause may be
Too much abduction in the socket
What is the effect of moving the socket more forward over the foot
Reduces length of anterior lever arm of foot
The modification at the medial flare of the tibia is primarily made
To aid in vertical loading in the socket
What is the effect on gait of lengthening the posterior lever arm of the foot
Tends to flex the knee at heel strike
Function of a Px foot must simulate motion of a normal foot. If PF or heel compression does not occur
Knee stability of the amputee will be affected
When the Px foot is placed in excessive DF
The knee is made unstable
Pts who are converted from side joints and thigh lacer to corsetless PTB commonly exhibit what problem
Knee extension throughout stance phase
A-P instability of the knee is caused by a tear of the
Cruciate ligaments
The final factor that determines your selection of heel cushion durometer in a SACH foot is the
Compression of heel cushion at heel strike
During normal human gait, the primary function of the gluteus medius is
Maintain lateral stability of the pelvis
Compared to a PTB with cuff suspension, the PTB SC/SP socket offers what advantages (4)
-Enhanced M-L stability
-More positive knee extension stop
-Less pistoning during swing phase
-A self-suspending Px
In a PTB Px, the BK RL should have the greatest vertical loading force during stance phase concentrated at the
Medial flare of the tibia
When the counter of the shoe fits too tightly on a SACH foot, which problem can result
Less compression of the heel
1 week after receiving a new Px, a BK Pt complains of hyperextension of the knee a mid-stance. The most likely cause
Pt has changed to a shoe with a lower heel
Landmarks that can be used to determine the correct length of a Px
-Medial tibial plateau
-Posterior superior iliac spine
-Anterior superior iliac spine
-Iliac crest
The anterior stop in a single axis foot substitutes for which muscle
Gastrocnemius
When a rigid plaster dressing is applied following a BK amputation, the relief pads should be placed
To bridge the tibial crest
With a PTB Px, excessive knee flexion occurs after heel strike. Which foot and socket adjustments best corrects the problem
Move foot anterior and decrease socket flexion
On reason for aligning the PTB Px so that the Pt’s knee is partially flexed is to
Give the amputee better balance while standing
In BK bench alignment, correct M-L placement of the foot with reference to the midline of the socket it
Inset up to 1/2” (12mm)
Improperly located PTB studs can cause (3)
-Swing phase whips
-Inadequate suspension
-Difficulty in sitting
The PF bumper substitutes in part for which of the following muscles
Tibialis anterior
Advantages (3) of a multi-axial Px foot
-Absorbs torque
-Accommodates uneven ground
-Minimizes shear forces on the skin
When the BK Pt controls the tendency of the knee to flex after heel strike, the pressure are increased on which areas of the limb
Distal/anterior and proximal/posterior
Compared to a PTB SC, the joints and corset PTB offers with advantages (3)
-Enhanced M-L stability
-MOre positive knee extension stop
-Greater WB distribution
During dynamic alignment of a PTB, excessive knee flexion occurs at the beginning of heel right. How to correct it
Move foot anterior and decrease socket flexion
A long posterior flap in a BK amputation secondary to ischemia is preferred because of
Better blood supply
A tendon that is readily visible or palpable in the popliteal area when the knee is flexed is that of the
Biceps femoris
During static alignment of a PTB Px, the prosthetist noted that the Pt’s knee was going into hyperextension while standing, even though bench alignment had been correct. The prosthetist should
Check the compression of the SACH heel
