EXAM 2: Wk 1

Question 1

Etiology and Conditions of Amputation

Answer 1

Neuropathy and vascular conditions (82%)

Trauma 16%

Cancer <2%

Question 2

Dysvascular Comorbidities

Answer 2

Diabetes (Neuropathies) - lack of protective sensation
Cardiovascular Disease - narrowing, occlusion s
Poor Skin Integrity (dry skin and cracks)
Good limb compromised

Question 3

PAVE

Answer 3

Prevent Amputations in Veterans Everywhere

• establish risk 0 normal, 1 low risk, 2 moderate, 3 high risk

Question 4

HYPOglycemia vs HYPERglycemia

Answer 4

HYPO: sweating, pallor, irritability, hunger, lack of coordination, sleepiness

HYPER: dry mouth, thirsty, weakness, headache, blurred vision, frequent urination

Question 5

Assessment of the High Risk Foot

Answer 5

Sensory Assessment: Pedal Pulse: 0, unable, 1+ barely perceptible, 2+ weak
3+ normal, 4+bounding (Charcot or aneurism) ; ABI (KNOW VALUES) ; monofilament; tuning fork

Motor Assessment: abnormal biomechanics; reflexes, ROM (toe ext, DF), Strength (intrinsics)

Autonomic Assessment: regulation of moisture and blood flow, skin integrity, control hair and nail growth

Footwear Assessment: snug fit at heel to prevent PISTONING, wide, deep toe box, fashionable (shop in mid/late afternoon)

Gait and Balance Assessment: peripheral neuropathy (DM) = gait problems, overall function , fall risk,

Question 6

Musculoskeletal Comorbities after amputation

Answer 6

• osteoarthritis of sound limb
• osteoporosis of residual limb
• LBP
• atrophy
• decreased proprioception
• decrease/restricted ROM
• decreased balance
• asymmetries in posture/pelvis

Question 7

Post AMP - stages of rehab

Answer 7

1. Pre- Operative
2. Acute Post Operative/ Pre prosthetic
3. Prosthetic fitting and training
4. Community re-entry
5. Follow up, support groups/organizations

Question 8

Preprosthetic stage time frame

Answer 8

Generally 6-8 wks or if IPOP 3-6 weeks

Question 9

Guide to rehab prognosis: age , level of amp, cause,

Answer 9

Age = >60
Transfemoral (more energy and oxygen consumption) VS transtibial
Cause: psychological impact

Question 10

What helps us determine a good prosthetic candidate

Answer 10

• PLOF
• above knee TF (75% more energy) vs intact BLE)
• 60-80

Question 11

Amputee Mobility Predictor

Answer 11

K0- does not have ability to ambulate/transfer, prosthetic will not enhance
K1 - using for short inside ambulation and transfers, fixed cadence
K2- potential for ambulation over low level environmental barriers, curbs, stairs, community ambulatory
K3- variable cadence, community ambulatory, vocational, exercise, beyond simple locomotion
K4- out in community doing really well, high impact, energy levels, CHILD, ACTIVE ADULT, ATHLETE