Exam I Flashcards
at what age does a typical 1st amputation occur
51-69
greatest age for amputation risk
65-85
are lower or upper extremity amputations more common?
LE
amputations in men occur greater for _____ than _____
trauma than disease
most common cause of amputation is
neuropathy and vascular conditions, followed by trauma
which disease is the most common contributing factor for LE amputation
PVD and PAD
common sites for arterial disease
popliteal, iliac, femoral and tibial artery
most common causes of death post amputation
DM
Cardiovascular disease
Renal disease
how long do you have as a window for revascularization
6-12 hours
window for replantation
3-6 hours
amelia
absence of an entire limbg
transverse deficiencies
Described by the level at which the limb terminates
longitudinal deficiencies
Reduction or absence within the long bone, but normal skeletal components are present distal to the affected bone
goal of replantation
functional grasp
goal of children’s prostheses
enhance the function of the limb for the most effective use of prothesis
and cosmetic replacement for missing limb
when do you introduce an UE prothesis to a child
4-6 months
when do you introduce an LE prothesis to a child
around 8-12 months
Myodesis:
anchoring of muscle to the bone
Myoplasty
attaching M/L and A/P compartment muscles to each other over the end of the bone
transfemoral ideal shape
conical
transtibial ideal shape
cylindrical
how long can a patient wear a shrinker
up to 6 months
how long is a rigid cast left in place post amputation
3 days
what is the objective of an IPOP
reduce the time without bipedal ambulation
what is the initial weight bearing status with an IPOP
toe-touch WB
which compressive device may facilitate early discharge from hospital
IPOP
which compressive device will facilitate residual limb shrinkage and faster desensitization
RRD
after _______ PLS and PLP intensity, duration and sensitivity won’t change
6 months
appropriate width and length of transfemoral bandaging
6 inch width, 2-3 lengths
appropriate width and length of transtibial bandaging
4 in width, 2 lengths
what is the wrap -wearing schedule for compression
24 hours/day, remove only for bathing or a dressing change, rewrap immediately, wearing during exercise but rewrap after,
rewrap every 4 hours or when compression on the distal limb is lost
when should you wear a clean banadage
every day
indications for PTB socket
medium to long residual limb length
need ease of donning
prominent anatomy
indications for PTB-supracondylar
short residual limbs, increased ML support, anatomical, self-suspending
indications for PTB- supracondylar suprapatellar
higher ML trimlines
increased ML stability
anatomical, self-suspending
anterior trimline prox to patella
indicated for very short residual limbs (tibial tubercle)
control knee hyperextension
indications for joints and corset
increase L support decreased WB on residual limb
tri planar stabilization through knee
previous use
pediatric patients are automatically K level _____
4
which foot finds foot flat quicker
single axis foot
which K level foot has multi-axial features
K2 and K3
dynamic response feet are used for
K3/K4, variable cadence
if patient complains of knee hyperextension, their heel may be too ____
short
at the knee what moment to we create
varus, it will stabilize pelvis for leg advancement
how do we create varus moment at the knee
inset the foot
if you can see the pylon, you will set the pylon to be vertical at _____
midstance
What type of ankle disarticulation keeps the heel pad in place
Syme’s ankle disarticulation
Procedure at the ankle that fuses the tibia and fibula together
Boyd and Pirogoff
Advantage of a syme’s disarticulation
It is a WB procedure
Advantage of Boyd/pirogoff procedure
Slightly better outcomes than Syme’s, more stability of the flap and vascularity, leg length is more symmetrical
Where does a transfemoral amputation typically occur
Between middle and distal 1/3’s of the femur
typical residual limb length of a transtibial amputation
12-15 cm
______ cm of residual limb for every 30 cm of patient height
2.5
What happens to nerves when they are severed
They can put out new tendrils and form small neoplasms/nerve ends (neuromas)
_______ neuromas that are embedded are _____
Small, okay
What happens to arteries and veins during an amputation
Ligated
Neuromas may cause ____
Sharp and intense pain
Incision for transfemoral amputation occurs in the ______ plane
Frontal
Why do we place the residual limb into slight flexion
Increases the surface area
Energy requires _____ as the length of the residual limb _____
Decreases
The varus moment at the knee is accomplished how
Inset the foot and adduct the prosthetic by 5-7 degrees
What components of the prosthesis are used for shock absorption
Foot and pylon
