Exam1 Flashcards
In the case of transmetatarsal amputation, the more proximal the level of amputation, the the less what is available?
leverage for forward progression over the foot while walking
the shorter the length of the residual limb in the case of a person with a transtibial amputation using a prosthesis, vs a longer length will affect the level of comfort in what way?
the more discomfort the patient will feel while wearing the prosthesis.
A Charcot foot deformity is most typically seen in the person with
diabetes because of neuropathy
Typically the suture line on the residual limb of a transtibial amputation will be where?
on the anterior aspect , extending from medial to lateral
a neuropathic ulcer is typically located where?
on the plantar surface of the foot
To help keep the knee joint of a prosthetic knee from buckling, the user of a transfemoral prosthesis should strengthen the what muscle?
hip extensors
neuropathy is associated with what 3 ailments?
autonomic dysfunction, claw toes, loss of protective sensation,
In a Syme amputation what is preserverd and anchored to the distal tibia?
the fat pad of the heel
A Van Ness procedure involves
re-positioning the tibia 180 degrees in relation to the femur or pelvis
The most common type of cancer responsible for amputation is
osteogenic sarcoma
which of the following compression devices necessitates an alternate means of compression if the compression device remains off the patient for more than several minutes?
removable rigid dressing
of the following, which patient would be most likely to eventually use a lower extremity prosthesis? a. patient with long list of chronic illness b. patient with moderate to severe dimentia c. pt with end stage renal disease d. pt with advanced coronary artery disease
a. patient with long list of chronic illness
to prevent mediolateral instability at the pelvis while walking with a transfemoral prosthesis, the pateint should strengthen which muscle group in teh residual limb?
abductors
what is the frequency that most rehab professionals suggest that Ace bandages be removed from and reapplied to a residual limb?
every 4-6 hours
appropriate pt care management by PT in an IP acute setting for a person who is 2 days post lower extremity amputation typically include which, cross friction massage at the surgical incision line or compression of the residual limb?
compression of the residual limb. DO NOT perform cross friction massage at the surgical incision 2 days post op!
Phantom pain tends to decrease or increase over time
decrease
a cast applied immediately following a transtibial amputation is an effective method of ?
edema control, prevention of knee flexure contracture, protection of the residual limb
in cases of amputation secondary to neuropathic dysvascular disease, it is especially important to perform on the intact foot:
monofilament testing on the weight bearing surface
safe application of gentle massage to an amputated limb is applied
start when primary healing has been established below and above incision
generally, in an acute care setting, the protocol is that the person who first assesses the condition of the patient’s surgical incision post amputation is?
the surgeon
Which prosthetic knee is best described by the following: enhances prosthetic foot clearance throughout swing phase; is cosmetic for person with long residual limb or knee disarticularion when sitting; has inherant stance phase stability
polycentric
in order to keep the prosthetic knee from buckling, a patient with transfemoral amputation needs adequate muscle performance in which muscles?
hip extensors
the ischial ramal containment socket
controls femoral abduction tendency
silicone liners with a locking pin on a transtibial prosthesis, suspension results from what?
friction between the sleeve and the wearer’s skin, once the pin is locked into the prosthesis
regarding the SACH foot, what is the function of the compression of the heel cushion
simulates normal eccentric contraction of the ankle dorsiflexion as the foot goes into foot-flat position
regarding traditional pull-in suction suspension (straight suction with valve) in a transfemoral prosthesis, the socket does what
provides the wearer with good proprioception during walking.
The 4 C’s of an ideal prosthesis
comfort, cosmesis, control , cost
disarticulation of the midfoot from the forefoot at the level of the talus and calcaneus
chopart
disarticulation of the forefoot (metatarsals) from the midfoot (tarsals)
lisfranc
the person least appropriate for endoskeleton accountant computer programmer construction worker hair dresser
construction worker
the patellar-tendon bearing supracondylar (PTB-SC) socket provides:
suspension and mediolateral stability
K0 vs K1 code
- no ambulation vs use prosthesis for transfers or ambulation on level surfaces at fixed cadence
- no safe transfer vs household ambulatory
K1 vs K2
- use prosthesis for transfers or ambulation on level surfaces at fixed cadence vs ambulation on low level surfaces , curbs , stairs, uneven surfaces household
- ambulatory vs limited community ambulatory
K3 vs K4
- ambulate with varied cadence vs ambulate with high impact, stress or energy levels community ambulator with vocational or therapeutic beyond simple
- locomotion vs child active adult or athlete
K0 prosthesis
not eligible
K1 prosthesis
- ankle/foot - external keel, SACH , single axis
- knee - single axis, constant friction knee
K2 prosthesis
- ankle/foot - flexible keel feet or multi-axial ankle/feet
- knee - polycentric, constant friction knee
K3 prosthesis
- ankle/foot - flex foot,flex walk, energy storing, multiaxial or dynamic response
- knee - fluid and pneumatic control knees
K4 prosthesis
any appropriate system
Biomechanical principles of orthotics include (choose all that apply):
- protection of the affected area to prevent further deformities
- provide function to an area of the body that is injured
- provide function to an area of the body that is weakened
- preservation of range of motion in the case of injury and/or weakness
all the above
A person with left LE spasticity was fitted with a solid AFO. What are potential areas of concern for skin breakdown (choose all that apply?
- malleoli
- posterior calcaneous
- fibular head
- great toe
- metatarsal heads
alll the above
A client has stance recurvatum of 45 degrees on the left, as well as medial instability of the left foot. Which orthosis would be most appropriate for this client?
- Lenox Hill re-rotation orthosis
- Supra Malleolar Orthosis (SMO)
- Rigid AFO
- Articulating AFO
- KAFO
- HKAFO
KAFO
A prefabricated orthoses that is readily available in your clinic is most appropriate for which patient/client(s)?
- Client with multiple contractures of the lower extremity
- Patient who might be a candidate for an orthosis to use as a trial
- Client with mild impairments
- Client who has severe foot drop secondary to spasticity
- Patient who might be a candidate for an orthosis to use as a trial
- Client with mild impairments
A ground reaction force AFO is used for clients with
- foot drop due to spinal nerve root involvement
- crouched gait
- an ipsilateral hip contracture
- excessive pronation
crouched gait
A child with mild LE spasticity who walks with the involved foot in PF(but has full DF ROM) would be best suited for which orthosis?
- SMO
- rigid AFO
- articulated AFO
- KAFO
3.articulated AFO
A client with fluctuating edema and foot drop would be best suited for which orthosis?
- articulated plastic AFO
- conventional AFO with metal uprights
- solid plastic AFO
- Ground (floor) reaction orthosis
2.conventional AFO with metal uprights
A client has with significant lower extremity hemiparesis secondary to stroke. During stance phase his knee tends to buckle and he has difficulty progressing lower extremity during swing phase. The best KAFO option for this client is:
KAFO with drop locks in locked position
Walkaide
stance control orthosis
ground (floor) reaction orthosis
stance control orthosis
The phase of gait from foot flat to toe off is considered the ________ rocker.
second
