Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PTH 608 Gen Med II > Exam 2 -prosthetic stuff > Flashcards

Exam 2 -prosthetic stuff Flashcards

1
Q

most common causes of LE amputation (0-5, 5-15, 15-50, 50+)

A 
0-5 = congential
5-15 = cancer
15-50 = trauma
50+ = vascular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

most common causes of UE amputation

A

trauma (80%)

Most commonly a finger amputation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Myoplasty surgical technique

A

-opposing muscles sutured to each other and to periosteum at end of cut bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Myodesis surgical techniques

A
  • muscles and fascia sutured directly to bone
  • structurally more stable

*contraindicated if blood supply to muscle is suspect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Unsatisfactory sites for elective amputations

A
  • distal 1/3 of leg (inf to gastro-soleus)
  • very short BKA (prox to tin tubercle)
  • very high AKA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Functional K levels: Level 0

A

-would not enhance life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Functional K levels: Level 1

A
  • household ambulator

- level surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Functional K levels: Level 2

A
  • limited community ambulator

- uneven surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Functional K levels: Level 3

A
  • variable cadences

- unlimited community ambulator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Functional K levels: Level 4

A

-very active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Relative prosthetic contraindications

A
  • sig cognitive impairment
  • severe hip or knee contracture
  • severe cardiac dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pro-op amputation

A
  • patient education is vital
  • supportive environment
  • cognitive eval
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

6 goals of post op limb care

A 
1 - control edema
2- promote wound healing
3 - protect residual limb
4 - pain control
5 - shaping limb
6 - prep for ambulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

residual limb pain

A
  • any painful sensation in the residual limb
  • “stump pain, incisional pain, surgical pain”
  • may include prox RLP (cramps, spasms)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

phantom limb sensation (what is it and what is treatment)

A
  • any non-painful sensation of the amputated limb

- treatment = patient edu. NOT meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

phantom limb pain

A
  • sensation of actual pain (per pt) in amputated limb

- patient education is essential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

phantom limb pain is magnified by several conditions (3)

A
  • anxiety
  • stress
  • depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

criteria for treatment of phantom limb pain

A

1 - interferes with AD:s

2 - impedes prosthetic use/gait training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Physical modalities for phantom limb pain

A
  • temporary relief - gait theory
  • desensitization
  • acupuncture
  • TENS
  • vibration
  • ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Gabapentin (neurontin)

A
  • anticonvulsant

- Ca channel blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pregabalin (lyrica)

A
  • GABA anolog

- neuropathic pain agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tramadol (ultram)

A

-pain reliever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Amitriptyline (elavil)

A
  • antidepressant

- avoid in elderly due to anti ACh side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Baclofen

A

-muscle relaxant

25
Q

Phantom limb pain - psychological treatment

A

-mirror therapy

26
Q

What is the most effective treatment for phantom limb sensation???

A

-patient edu and reassurance

27
Q

Limb shape - cylindrical

A

ideal shape

28
Q

Limb shape - bulbous end

A

-makes prosthetic fitting difficult

29
Q

Positioning to avoid with BKA

A

-AVOID: knee flexion, hip flex/abd/ER

30
Q

Positioning to avoid with AKA

A

AVOID: Hip flex/abd/ER

31
Q

Position to avoid with partial foot

A

AVOID: plantar flexion

32
Q

positioning to avoid contractors in amputees

A
  • start ROM immediately. PROM with sustained hold at end range
  • progress to AROM ASAP
33
Q

Rooke BK rigid protector

A

-best splint for pt with compromised skin conditions

34
Q

Shaping limb with ACE wrap

A
  • ASAP with surgeon approval
  • distal to prox pressure gradient
  • wrap AKA to facilitate hip IR
35
Q

Desensitization

A
  • progressive tactile stim
  • sensory overload

*start ASAP, 20-30 mins, 3x/day

36
Q

Mirror therapy -start with?

A
  • slow, big movements

- symmetrical movements

37
Q

relative criteria for readiness for temporary prosthesis (5)

A
  • staples/sutures removed
  • dec edema/proper limb shaping
  • stable weight
  • min open/draining wound
  • dec hypersensitivity

*approx time frame 2-6 months after amputation

38
Q

Amputee mobility predictor (test)

A
  • predict functional mobility (k level) with or without prosthesis
  • tests wide range of mobility skills
39
Q

prosthesis skin checks

A
  • every 10-15 minutes

- inc time slowly

40
Q

when can a patient use prosthesis at home? (4)

A
  • (I) with don/doff
  • adjust ply socks prn
  • skin checks
  • safe ambulation on even surfaces
41
Q

initial wearing schedule of prothesis

A
  • 1 hour BID

- add 1/2 hour every other day prn

42
Q

Deviation: modified trandelenburg

A
  • generally lean towards prosthetic side
  • weak hip, short limb

*focus on glut medius

43
Q

Deviation: abducted gait

A
  • wide based gait with prothesis held away from midline

- limb too long, hip ABd contracture

44
Q

Deviation: circumduction

A
  • swings

- difficulty flexing knee, hip abd contracture, habit, limb too long

45
Q

Deviation: vaulting

A
  • up on toes of good leg

- habit, difficulty flexing knee, fear of hitting toe, residual limb discomfort, limb too long

46
Q

Deviation: med/lat heel whip

A

-prosthesis is rotated

47
Q

Deviation: foot rotated at heel strike

A
  • poor socket fit, not controlling rotation

- forcible “driving” heel into ground

48
Q

Deviation: uneven heel rise

A
  • more power to flex knee it goes up higher
  • knee flexion contracture
  • alignment issues
49
Q

Deviation: terminal swing impact

A

-not confident in leg so they forcibly extend knee to make sure it is extended

50
Q

Deviation: uneven step length

A
  • typically longer on prosthetic side (inc WBing on sound limb)
  • hip flexor contracture
51
Q

Deviation: exaggerated lordosis/trunk extension

A
  • hip flexion contracture
  • weak hip ext
  • weak abs
  • slows forward momentum
52
Q

SACH - solid ankle cushion heel

A

for K1-2 (household/limited community ambulator)

53
Q

Dynamic motion, single axis foot (what K level)

A

for K2-3

  • allows some ankle PF/DF
  • stable in ML direction
54
Q

Multi-axial/dynamic response foot (k level)

A
  • for k3-4
  • carbon fiber
  • heel shock absorption
  • energy return
  • variable walking speed
55
Q

Locking knee (K level)

A
  • for K1

- must unlock to sit

56
Q

extension assist knee (k level)

A
  • for k2-3
  • tries to avoid knee buckle when loaded in flexion
  • assists ext with spring mechanism
57
Q

hydraulic knee (k level)

A
  • for k 3-4

- can inc resistance to allow for uneven surfaces, ramps, steps

58
Q

Microprocessor knee (k level)

A
  • c-leg
  • for k4
  • need to charge
  • monitors where you are in gait cycle
59
Q

Stubbies for bilateral AKA

A
  • prevent LOB posteriorly

- no knee joint

PTH 608 Gen Med II (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions