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Prosthetics > Exam 2: Post-op and Pre-prosthetic Care > Flashcards

Exam 2: Post-op and Pre-prosthetic Care Flashcards

1
Q

A patient is describing feelings of numbness, tingling, pressure and cramping. What is this classified as?

a. pain
b. sensation
c. circulation issues
c. none of the above

A

sensation

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2
Q

Pain is described as shooting, severe cramping, and distressing burning (true/false)

A

true

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3
Q

Psychological adjustment and early education in the rehabilitation process is key (true/false)

A

true

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4
Q

Which setting focuses on initial healing of the surgical site, pain management and volume control, bed mobility and transfers, readiness for single-limb amputation?

a. inpatient
b. outpatient
c. acute setting
d. subacute

A

acute setting

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5
Q

Other team members examination info is not helpful to your examination as a PT (true/false)

A

false

it can prevent redundancy

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6
Q

Which areas of the history should you focus on?

A 
demographics and sociocultural info 
social history 
occupational history 
developmental status 
living environment
current condition
PMH
medications 
functional status
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7
Q

Examination of amputation follows the patient-client management model (true/false)

A

true

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8
Q

It is not relevant to understand their functional status prior to amputation (true/false)

A

false

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9
Q

Your examination should not include communication, affect, cognition, language and learning style (true/false)

A

false

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10
Q

Anatomical and physiological status of these 5 systems is important to include

A 
cardiovascular system 
cardiopulmonary system
integumentary system
musculoskeletal system
neuromuscular system
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11
Q

It is important with tests and measures to modify and adapt the _ or _ of the residual limb

A

condition or length

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12
Q

Adaptation of tests and measures does not effect validity and reliability (true/false)

A

false

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13
Q

Document the _, _ and _ of pain

A

nature, location and intensity

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14
Q

What percentage of amputees experience sensations after recent amputation?

a. 54-99%
b. 46-89%
c. 60-99%

A

54-99%

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15
Q

What percentage of amputees experience phantom pain?

a. 40-60%
b. 54-99%
c. 46-63%

A

46-63%

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16
Q

More than 15% rate their phantom pain as severe or constant (true/false)

A

false

less than 15%

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17
Q

Pain is described as

A

shooting
severe cramping
distressing burning

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18
Q

How is length of the residual limb measured?

a. actual length of the tibia or femur
b. total length of residual limb including soft tissue
c. all of the above

A

all of the above

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19
Q

Measuring the medial joint line to end of bone or soft tissue

a. TF
b. TT

A

TT

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20
Q

Measuring greater trochanter to end of bone or soft tissue

a. TT
b. TF

A

TF

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21
Q

How is volume of the residual limb measured?

A

circumferential with tape measurements

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22
Q

The intact limb is not at risk of increased stress with ambulation (true/false)

A

false

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23
Q

It is important to assess circulation of both _ and _ limb

A

residual and intact limbs

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24
Q

What are ways to assess blood flow and circulation?

A 
skin temp and turgor 
color at rest and with position change 
palpation of pedal or popliteal pulses 
segmental BP 
calculation of ABI
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25
Q

Amputees are at high risk for developing contractures in which areas mostly?

a. hip flexion
b. ankle flexion
c. knee flexion
d. hip and knee flexion

A

hip and knee flexion

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26
Q

It is important to maintain and improve what during the early stages of rehab?

a. ROM
b. muscle length
c. muscle strength
d. a and b

A

ROM and muscle length

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27
Q

What can you assess right away for muscle performance and motor control?

a. MMT
b. active movement
c. movement with resistance
d. active movement and anti-gravity movement

A

active movement and anti-gravity movement

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28
Q

Hip _ and _ should be tested

a. flexion and extension
b. flexion and adduction
c. flexion and abduction
d. abduction and extension

A

abduction and extension

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29
Q

Scores of _ will indicate some sort of cognitive impairment

a. <20
b. >24
c. <24
d. <14

A

<24

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30
Q

Cognition and ability to learn compromised with depression will not affect how long recovery takes (true/false)

A

false

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31
Q

Cognition and attention is common with which disease?

a. diabetes
b. cardiovascular disease
c. peripheral vascular disease
d. cancer

A

peripheral vascular disease

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32
Q

Which activities are harder than anticipated for an individual?

a. bed mobility
b. supine to sit
c. sit to stand
d. all of the above

A

all of the above

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33
Q

What complications need to be managed post op?

a. comorbidities
b. medications
c. all of the above

A

all of the above

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34
Q

What pre-morbid factors tend to predict successful prosthetic use

A

ability to walk functional distances prior to surgery
overall level of physical fitness
requiring little assistance with ADL’s
ability to maintain single limb stance without assistance

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35
Q

What can lengthen rehab?

a. wound healing
b. contractures
c. age
d. all of the above

A

all of the above

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36
Q

What percentage of amputees are able to return to independent living?

a. 75%
b. 80%
c. 90%
d. 100%

A

75%

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37
Q

Goals of wound closure, effective compression, supervision or min assist with transfers, locomotion using w/c or AD on level surfaces describes which setting:

a. sub-acute
b. home care
c. outpatient
d. acute care

A

acute care

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38
Q

Goals of strengthening core, strengthening key muscle groups, adequate ROM, improving cardiovascular fitness, advanced ADLs and IADL’s, advanced mobility skills should be done in which setting

a. acute care
b. sub-acute
c. home care
d. outpatient
e. sub-acute, home care, outpatient

A

sub-acute, home care, outpatient

39
Q

What muscle groups are key to strengthen in rehab?

a. core
b. hip extensors
c. hip abductors
d. b and c

A

hip extensors and abductors

40
Q

Medication does not need to be timed in correlation with PT sessions (true/false)

A

false

41
Q

Which should be done first with GMI therapy?

a. mirror therapy
b. laterality
c. motor imagery
d. it doesn’t matter which one is done first

A

laterality

42
Q

What is important to do with patients who have phantom limb pain?

a. laterality
b. motor imagery
c. mirror therapy

A

mirror therapy

43
Q

Which shaping and volume control dressing is basically an ACE wrap?

a. shrinkers
b. pneumatic compression
c. soft dressing and compression

A

soft dressing and compression

44
Q

What is the challenge with soft dressing and compression?

A

getting the pressure just right because you dont want to push pressure into the distal end of the limb

45
Q

This type of dressing is a compressive type garment with graded pressure and is higher at the bottom and looser at the top

a. soft dressing and compression
b. shrinker
c. rigid removable dressing
d. pneumatic compression for early amputation

A

shrinker

46
Q

Which dressing should NOT be used if there is circulation issues?

a. shrinker
b. soft dressing and compression
c. rigid removable dressing
d. non-removable dressing

A

non-removable rigid dressings

47
Q

What is the biggest risk with a rigid removable dressing?

a. circulation issues
b. edema control
c. contractures
d. shear forces

A

contractures

48
Q

This type of dressing is firm or hard enough to protect, shape, and prevent shear forces on the limb

a. shrinker
b. pneumatic compression
c. rigid removable dressing
d. soft dressing and compression

A

rigid removable dressing

49
Q

This type of dressing helps with shear, compression and friction but is not as protective

a. rigid removable dressing
b. non-removable rigid dressing
c. shrinker
d. semi-rigid removable dressing

A

semi-regidi removable dressing

50
Q

A limb with tough, dry, irritated skin is more tolerant of prosthetic wear (true/false)

A

false

want it to be soft, healthy, pliable skin

51
Q

When is it permitted to massage over the incision?

a. right after surgery
b. during healing with steri-strips
c. once primary healing has taken place and the steri-strips are not needed

A

once primary healing has taken place and the ster-strips are not needed

52
Q

Skin problems do not have to be resolved to wear a prosthetic (true/false)

A

false

53
Q

Transtibial amputees are at high risk of _ and _ contractures

A

hip and knee

54
Q

Transfemoral are at high risk of hip ,,_ contractures

a. flexion, internal rotation and adduction
b. extension, external rotation and abduction
c. flexion, external rotation and adduction
d. flexion, external rotation and abduction

A

flexion, external rotation and abduction

55
Q

What can be problematic for prosthetic fit, alignment and efficiency with gait?

a. ROM
b. flexibility
c. contractures
d. muscle strength

A

contractures

56
Q

How do contractures influence gait with a prosthetic?

A

affects their fit, alignment and efficiency

57
Q

Proper _ is key

A

positioning

58
Q

maintain knee _ as much as possible

a. flexion
b. extension
c. abduction
d. internal rotation

A

extension

59
Q

What is a good stretch for the posterior knee and anterior hip?

A

prone leg hang

60
Q

What are the 2 goals of strengthening programs?

A
  • remediate specific weakness detected in examination

- max overall strength and muscle endurance for safe, energy-efficient gait

61
Q

Stability of the _ is important to address with amputees

A

core

62
Q

How long should contractions be held? How long for a break in between and how many reps?

a. 1 minute, 30 seconds break, 10 reps
b. 30 seconds, 10 second break, 5 reps
c. 10 seconds, 5-10 second break, 10 reps
d. 15 seconds, 5 second break, 10 reps

A

10 seconds, 5-10 second break, 10 reps

63
Q

It is key to work knee _ and _ and hip _ and _ for TRANSTIBIAL

A

knee flexion and extension

hip extension and abduction

64
Q

What two hip movements need to be strengthened for transfemoral amputees?

a. hip external rotation and abduction
b. hip extension and abduction
c. hip flexion and adduction
d. hip extension and adduction

A

hip extension and abduction

65
Q

Transfemoral amputees must learn to control their

a. pelvis
b. trunk
c. hip

A

hip

66
Q

What muscles are important to strengthen for postural alignment?

a. back flexors
b. back extensors
c. abdominal muscles
d. b and c

A

back extensors and abdominal muscles

67
Q

Which machine is good for improving endurance in amputees?

a. LE bike
b. eliptical
c. UBE
d. treadmill

A

UBE

68
Q

How does the COM shift after amputation?

a. slightly up, forward and toward the other limb
b. slightly down, forward and toward the other limb
c. slightly up, back and toward the remaining limb
d. slightly down, back and still over the center

A

slightly up, back and toward the remaining limb

69
Q

What are the effects of walker ambulation once they get a prosthesis?

a. hip flexion is increased
b. knee is stuck extended
c. it does not effect their ambulation
d. lack trunk rotation

A

lack trunk rotation

70
Q

What are the functional testing and outcome measures that can be used?

A

AMPpro or AMPnopro
TUG
L test
6MWT

71
Q

What will you see if the wound is not healing and is potentially infected?

A

increased drainage, thickening and discolored exudate

72
Q

You dont need to assess the intact limb first when assessing joint integrity and mobility (true/false)

A

false

73
Q

Mobile scar without _ is important

A

adhesions

74
Q

The actual length measured is of the _ or _

A

tibia or femur

75
Q

The total length of the limb includes _ _

A

soft tissue

76
Q

,, and _ systems all have age related changes that may affect pts

A

visual, auditory, and somatosensory

77
Q

changes in COM affect _ and _ with mobility

A

balance and safety

78
Q

Only need to assess posture in standing (true/false)

A

false

standing and sitting

79
Q

What are the primary goals of acute care?

A

wound closure
effective compression
supervision or min assist with transfers
locomotion with W/C or AD on level surfaces

80
Q

What are the primary goals of sub-acute, home care or outpatient?

A 
stregnthening of core
strengthening of key muscle groups 
adequate ROM 
improving cardiovascular fitness
achieving more advanced ADL's and IADL's
advance mobility skills
81
Q

Goals should be linked to _ _

A

functional impairments

82
Q

It is important to educate about _

A

phantom limb pain

83
Q

The center rotation for a polycentric promotes _ _ during _

A

knee stability during stance

84
Q

With postural control, it is important amputees learn _

A

how to control COM over their new BOS

85
Q

Patient interview precedes a chart review (true/false)

A

false

86
Q

poor ROM and muscle length has a poor impact on _

A

ambulation with a prosthesis

87
Q

If your patient has a tendency to let their pelvis drop in standing, what intervention should you do?

A

strengthen the sound side

88
Q

What type of disease can slow healing?

A

end stage renal disease

89
Q

Acute care for uncomplicated cases is usually - days with PT daily - min each

A

4-7, 1-2 daily for 30-45 min

90
Q

for frail or chronically ill, stay will be _ days or more

A

21

91
Q

post op edema is important for these reasons:

A

pain control
wound healing
protection of incision with functional activity
shaping and desensitization of limb for prosthetic use

92
Q

What 3 things help prevent soft tissue tightness?

A

manual stretching
active exericse
functional postural training

93
Q

Strengthen remaining hip _, _, and _ for postural control

A

adductors, extensors, abductors

Prosthetics (12 decks)

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