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Upper Extremity Prosthetics > Final > Flashcards

Final Flashcards

0
Q

What’s the function of the fair-lead cable?

A

Allows it to control multiple functions

Used for elbow flexion/ opening and closing hook

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1
Q

Where is the Fair-Lead cable split?

A

Split at the elbow

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2
Q

Since the housing is split the tension on the control cable flexes the elbow when elbow is _________ and opens the TD when elbow is ___________.

A

Flexes elbow when elbow is unlock

Opens TD when elbow is locked

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3
Q

What is required when the elbow flexion attachment point is close to the mechanical elbow axis?

A

Less cable excursion required to make it work

More force required

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4
Q

What is required when the elbow flexion attachment point is far from the mechanical elbow axis?

A

More cable excursion required

Less force required

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5
Q

Where should the elbow flexion attachment point be placed?

A

1 1/4” distal to elbow axis

1” anterior to elbow axis

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6
Q

How much excursion is required for a Transradial?

A

5cm (2”)

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7
Q

How much excursion is required for a trans humeral?

A

11.3 cm (4.5”)

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8
Q

What are the components of a figure 8 harness?

A 
A. Axilla loop
B. Anterior support strap
C. Lateral support strap  
D. Control strap 
E. Elbow lock control strap
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9
Q

Where is the cross point located?

A

Just to non-amputated side

Distal to C7

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10
Q

Axilla loop

A

Anchor for other harness components
Some straps attach for suspension
Some straps attach for control
Attaches to the cross point

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11
Q

True or False

The northwestern ring is used less frequently for TH as it gives too much freedom - lose excursion

A

True

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12
Q

What is the anterior support strap also known as?

A

Elastic suspension strap anterior suspension strap

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13
Q

Where is the anterior support/suspension strap located?

A

Originates at cross point
Crosses through delto-pectoral groove
Attaches in the distal anterior humeral section
Elastic distal 2/3

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14
Q

What is the purpose of the anterior support/suspension strap?

A

Helps suspend prosthesis (limited due to elastic)
Helps prevent external rotation
Helps “cock” the elbow lock

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15
Q

Where is the elbow lock strap located?

A

Originates on the upper non-elastic portion of the anterior support strap?

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16
Q

The elbow lock strap requires how much excursion?

A

1.3 cm

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17
Q

Where is the lateral support strap located?

A

Originates just posterior to the highest point of the Axilla strap
Stitched to the anterior support strap
Lateral end passes just anterior to acromion
Attaches close to proximal socket trim line

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18
Q

What does the lateral support strap do?

A

Suspends

Helps limit external rotation when control cable engaged

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19
Q

Where is the control cable located?

A

Originates at the cross point

Runs obliquely downward across the back, mid scapula

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20
Q

What happens when the control cable is too high?

A

Not enough cable excursion to operate elbow and TD

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21
Q

What happens when the control cable is too low?

A

Requires too much force to operate

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22
Q

What is the purpose of the cross-back strap?

A

Helps reduce the vertically directed force of the axillary loop
Helps prevent superior migration of cross point -keeping inferior to c7
Helps keep the control cable in the mid-scapula position

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23
Q

True or false

The shoulder saddle harness is more challenging due to the required need for excursion in trans humeral

A

True

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24
Q

When should a shoulder saddle harness being used?

A

Can be used if really need to distribute the forces caused by unusually heavy use

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25
Q

What is the type of harness used for bilateral transhumeral harnessing?

A

Figure 8 harness without axillary loop
Cross back strap is essential for bilateral TH
Over the shoulder strap- stitches to control strap, lateral strap and anterior support strap

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26
Q

What are the Trans humeral control motions?

A

Gleno-humeral flexion

Bi- scapular abduction

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27
Q

What are the elbow lock control motions?

A

Slight glenohumeral extension
Slight Gleno-humeral abduction and
Slight shoulder depression

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28
Q

What are the control motion for shoulder disarticulation?

A

Bi-scapular abduction

Best harnessed by chest strap

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29
Q

Where is the chest strap located?

A

~Buckle an anterior surface of shoulder cap
~Runs horizontally across chest
~Runs inferior to the Axilla of non amputated side
~Terminates Posteriorly on the proximal end of the elbow flexion/terminal device control cable

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30
Q

Where is the elastic suspension strap located?

A

~Posteriorly attaches to the horizontal strap about midline
~Passes over the shoulder along a diagonal path
~Anteriorly attaches to the proximal surface of the socket shoulder cap

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31
Q

What is a excursion Amplifier?

A

Provides increased excursion

Bi-scapular abduction has good power but little excursion

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32
Q

Where is the excursion amplifier located?

A

~Control cable originates posterior surface of the socket.
~Passes through a small pulley that is attached to the posterior horizontal harness strap via a hanger
~cable enter the proximal opening of the split housing

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33
Q

2.5 cm bi-scapular abduction produces ____cm excursion

A

5cm

Requires increased force

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34
Q

The external friction (w/o rotation unit) provides what?

A

Provides constant friction

Positioning in elbow flexion/extension

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35
Q

Who is the external friction (w/o rotation unit) indicated for?

A

For someone who can’t learn lock/unlock action

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36
Q

What is a disadvantage of the external friction (w/o rotation unit)?

A

Won’t hold position for heavy objects

Adds ML bulk

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37
Q

What does the internal friction (w rotation unit) provides?

A

Adjustable constant friction flexion/extension, IR/ER

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38
Q

Who is the internal friction (w rotation unit) indicated for?

A

For someone who can’t learn lock/unlock action

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39
Q

What is a disadvantage of the internal friction (w rotation unit)?

A

Won’t hold position for heavy objects

Less bulky than external joints

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40
Q

Where is the external locking joint located?

A

On medial side

Following joint lateral

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41
Q

The Hosmer small, medium, and large have how many locking positions?

A

7 lock positions

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42
Q

The Hosmer heavy duty has how many locking positions?

A

5 lock positions

Alternating one pull lock, one pull unlock

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43
Q

Where is the external locking forearm lift assist located?

A

On lateral side

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44
Q

Which of the following apply to the external locking joint? Small
A. difficult for children under 5 to operate
B. Decreased power and excursion
C. Complicated to learn at that development age
D. All of the above
E. None of the above

A

D. All of the above

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45
Q

Where is the Otto Bock external locking joint located?

A

Locking joint on medial side
Following joint lateral
Less bulky than Hosmer

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46
Q

What is an disadvantage of the Otto Bock external locking?

A

Can’t use the Hosmer lift assist on lateral

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47
Q

How many locking positions does the Hosmer small (child) internal locking have?

A

10 locking positions

Called E- 50

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48
Q

How many locking positions does the Hosmer medium internal locking have and called?

A

11 locking positions

E- 200

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49
Q

How many locking positions does the Hosmer large internal locking have or called?

A

11 locking positions

E-400

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50
Q

How many locking positions does the Hosmer large heavy duty internal locking have or called?

A

8 locking positions

E- 400

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51
Q

What classes of the TH is the Hosmer internal locking joint used for?

A

For class II and III

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52
Q

What does the forearm lift assist?

A

Counter balance the weight of the TD and other objects
Allows you to adjust the cabling to increase ROM

Lateral side- Adjustable tension

53
Q

What is a advantage of the X- Finger?

A

Great ROM

54
Q

What is a disadvantage of the X- finger?

A 
Insecure hold ( purchase) 
Long wait
55
Q

What is an advantage of the BPF (finger)?

A

Decreased ROM

56
Q

What are the three types of trans-phalangeal mechanical fingers?

A

X- finger
BPF
M-fingers

57
Q

True or False A myoelectric prosthesis functions when a patient generates a voluntary muscle contraction to create an EMG that can be read by an electrode

A

True

58
Q

True or False
EMG travels in the direction of the muscle fibers. However, it Is not necessary for the contact points of the electrode to be aligned in the direction of the fibers to achieve an optimal signal

A

False

59
Q

An electrode performs 3 functions to an EMG signal. What are they?

A

Amplifies, rectifies and filters

60
Q

What psychological activity or signal is measured or detected by the electrode?

A

Action potential

61
Q

Which one of the statements below is correct?
A. All ottobock electrodes have 3 main components
B. 2 differential inputs (one at each end)
C. A center reference input or ground
D. All of the above

A

D. All of the above

62
Q

How much signal is required to operate a Digital hand at full speed?

A

A “high” level signal, any signal just above the “on” threshold & 0.54V

63
Q

How much signal is required to operate a DMC hand at full speed

A

A high level signal, the maximum signal the system can read & 1.5V

64
Q

True or false
An amputee controls grip force in a digital hand by maintaining a signal above the “on” threshold until the desired grip force is achieved?

A

True

65
Q

What does the “first signal wins” principle in myo-testing mean?

A

Whenever two signals are generated simultaneously, the first signal to cross the “on” threshold is the “winner”, only the winning signal is allowed to operate the system; all other signals are ignored.

66
Q

True or false
The goal of myo-testing is to find the strongest signal available then, amplify it as necessary to get the signal as close to the “high” classification as possible ?

A

True

67
Q

True or False

It is safe to charge a lithium ion battery when it’s not completely charged?

A

True

68
Q

True or false

It is safe to charge a NiMH battery when it’s not completely charged?

A

False

69
Q

True or false

Each time the myo-Select tool is used to adjust the hand, it is reset to the NiMH technology?

A

True

70
Q

Identify the appropriate scenarios from the list below in which you could use a switch?
A. When you need to use switches to introduce additional inputs for higher levels of amputation
B. Immediately postoperatively w/an externally powered prosthesis by combining the switch with a harness
C. When the patient has no detectable EMG signal
D. When a patient is transferred from a body-powered to an externally powered system
E. All of the above

A

E. All of the above
When you need to use switches to introduce additional inputs for higher levels of amputation;
Immediately postoperatively w/an externally powered prosthesis by combining the switch with a harness; When the patient has no detectable EMG signal; When a patient is transferred from a body-powered to an externally powered system

71
Q

When would you use a linear transducer?

A

Linear transducers replace a single electrode; when you need to allow for proportional control; when you need to combine a linear transducer with an electrode site can be found

72
Q

Which linear transducer is more robust and more resistant to damage?

A

9 x 52

73
Q

Which linear transducer is more suitable for retro-fitting?

A

9 x 50

74
Q

True or false

The Myoselect can be used to program all ottobock programmable components.

A

False

75
Q

True or false
After making all programmable changes using the Myoselect, you know that all changes are set when you hear an audible beep after holding the jog dial in

A

True

76
Q

What functions are performed by the Myoselect?

A

It automatically returns components to NiCd and NiMH battery mode; choose a program option from available program options for a component; adjust settings (maximum, speed, thresholds)

77
Q

Identify the appropriate scenerios in which you could use a switch?

A

A. When you need to use switches to introduce additional inputs for higher levels of amputation
B. Immediately postoperatively w/an externally powered prosthesis by combining the switch with a harness
C. When the patient has no detectable EMG signal
D. When a patient is transferred from a body-powered to an externally powered system

78
Q

True or false
Due to their ability to monitor and optimize power management, microprocessors are able to increase the operating time of a prosthetic system.

A

True

79
Q

True or false
Closed loop control of all components is made possible by microprocessors which enable improved efficiency and support more smooth and natural movements with the prosthesis

A

True

80
Q

Microprocessor control is unable to over-ride electromagnetic interferences in the environment

A

False

81
Q

True or false
The DMC plus feature of the SensorHand speed is a built in safety feature that prevents the prosthetic hand from inadvertently opening and losing grasp of an object.

A

True

82
Q

What type of control is available in the SensorHand speed?

A

Proportional control and digital control

83
Q

How does the clinician decide which SensorHand speed program should be used to achieve maximum benefit and performance for the patient?

A

The clinician need to combine knowledge of the patients EMG signals with the type of input device they intend to use before determining which program to use

84
Q

For the SensorHand program numbers in the left column, select the corresponding number of inputs required from the right hand column?

A

Programs #’s 1, 2, 5, & 6 = 2 inputs; programs #3 & 4 = 1 input

85
Q

The device used to control the SensorHand speed’s 6 programming options is the Myoselect ?

A

True

86
Q

SensorHand speed has the following unique features

A

Autograsps, ability to activate and de-activate the thumb & flexi-grip

87
Q

How can you tell by looking at the hand whether or not you are holding a SensorHand speed?

A

The coaxial ring is always orange

88
Q

True or False

All programs in the Greifer and Myohand vs variplus speed offer proportional control for both speed and grip force

A

False

89
Q

True or false

You can adjust the speed of the Greifer

A

False

90
Q

True or false You can adjust the speed of the Myohand variplus speed?

A

True

91
Q

Which switching method offers immediate control of either the wrist or hand?

A

Program #1 (Channel control)

92
Q

Which kind of control does the MyoRotronic offer for wrist or hand?

A

Both proportional and digital

93
Q

True or false

It is possible to control hand open/close and supination/ pronation with only one electrode

A

True

94
Q

True or False
The automatic switchback timer caused function to switch from the rotator to the terminal device. The timer only works from hand to rotator, not rotator to hand

A

Fals

95
Q

Identify a fitting challenge that could best be addressed by the trans carpal hand

A

The patient presents w/a short limb

96
Q

Under what conditions would you use a 13E180 switch block

A

Used for wired hands

97
Q

What control options are available for the transcarpal hand or a size 7 hand?

A

DMC & digital

98
Q

How many versions of pediatric limb systems are available from ottobock?

A

Two

99
Q

Which children’s system uses the MyoEnergy integral Lilon battery system?

A

7.4V

100
Q

Identify the improvements the 7.4V children’s system has over the 4.8V children’s system?

A

The 7.4V children’s system can be adjusted using software and Bluetooth connection to optimize these system for the users needs; the 7 in 1 controller system has up to date electronic components which reduces the size of the unit; the 7.4V children’s system allows for battery installation within the prosthesis to reduce bulk and improve cosmesis

101
Q

Which electrode should be used in a child’s hand system?

A

13E202 suction electrode= when the patient presents enough residual limb volume, length, and circumference; 13E200 standard electrode= when the patient presents very small limbs! small radii, or insufficient space

102
Q

True or false

The Myoselect can be used to change the programs in the Ergoarm 12k50

A

True

103
Q

Of the 7 programs available for use with the ErgoArm, programs 1(uses an external switch to lock and unlock the elbow) and 2 (uses co-contraction of the patients EMG signals to lock and unlock the elbow) are the most commonly used programs

A

True

104
Q

True or false

The adjustable forearm Balance (AFB) should be adjusted by the prosthetist only?

A

False

105
Q

True or false
The automatic forearm balance (AFB) is a complex mechanism that allows for varied flexion assistance and resistance throughout the range of elbow joint motion

A

True

106
Q

True or false

Proportional control of the elbow, wrist and terminal device is possible with the dynamic arm

A

True

107
Q

True or false

The “elbow soft) software program is the only means of programming the dynamic arm

A

True

108
Q

What is the maximum live lift capacity of the dynamic arm?

A

13.2 lbs.

109
Q

True or False

Simultaneous control of the elbow and either the hand or rotator is possible through programming the dynamic arm

A

True

110
Q

True or false

To lock or unlock the dynamic arms elbow joint, a separate signal is needed?

A

False

111
Q

What is the movement range of the dynamic arm?

A

15 degrees - 145 degrees

112
Q

When does the dynamic arm need to be switched off ?

A

When exchanging the terminal device; when donning and doffing the dynamic arm; when not in use; when dismounting the dynamic arm from the socket

113
Q

What happens if the locked dynamic arm measures a positive load greater than 6kg or a negative load greater than 1kg and a control signal to flex/extend the elbow is sent?

A

The elbow will not unlock; a warning beep and vibration will be emitted

114
Q

True or false
Mechanical locking and unlocking is only engaged when the dynamic arm is turned off, or when the power down sequence has started

A

True

115
Q

True or false
Locking of the elbow is carried out automatically after elbow movement and unlocking is carried out automatically before elbow movement

A

True

116
Q

What steps should you follow in adjusting the automatic forearm balance (AFB)

A

Flex the elbow fully then turn the finger wheel in a clockwise direction; the AFB is adjusted correctly when the elbow can be held at 90 degrees

117
Q

True or False
The linear transducer can be used to directly control the movement of the dynamic arm in combination with another input device to control the movement of the terminal device, thus allowing simultaneous control of the elbow and terminal device

A

True

118
Q

True or false
All input devices for the dynamic arm will be plugged into one of the ports on the easy plug connection and are opposite for right versus left.

A

False

119
Q

What are the characteristics of the harness, cable, rocker, and pressure switches

A

Provide digital control of the component; produce maximum signal when activated; most often used for sequential switching

120
Q

True or false
All components and tools needed to assemble the dynamic arm are included in the package, including the terminal device and the electric wrist rotator?

A

False

121
Q

True or false
When aligning the dynamic arm to the check socket with the alignment tool, the elbow turntable must be horizontal to the floor to ensure proper elbow function.

A

True

122
Q

What is the correct procedure for calibrating the dynamic arm?

A

Manually flex forearm once just short of the flexion stop and manually extend forearm until reaching the extension stop; after manually extending the forearm to the extension stop, click the “end calibration” button

123
Q

How do you activate “training mode” for the dynamic arm?

A

Switch over to training mode by Unchecking the box beside “active mode”

124
Q

True or false

By default the dynamic arm is delivered with the maximum speed set at 31%

A

True

125
Q

True or false
After loading the control and switching parameters of one of the 9 standard programs into the dynamic arm, you still have the opportunity to further customize the programs

A

True

126
Q

What steps do you take to program the dynamic arm for simultaneous control?

A

Choose 1-POS for the control mode in the elbow column; check the box beside the word “ simultaneous”

127
Q

What are the recommended steps to charge the dynamic arm?

A

Extend the dynamic arm, switch if off and lock the elbow; connect barging plug to charging port of the dynamic arm, then connect power cable to power outlet

128
Q

True or false
When the charger is connected to the dynamic arm the elbow will not move and will be locked, but the terminal device and rotator remain active

A

False

129
Q

True or false
The battery management system monitors battery capacity and initiates a power down sequence, beginning with the dynamic arm

A

True

130
Q

True or false

You will hear an acoustic signal when the dynamic arm is turned ON and OFF

A

False

131
Q

True or fAlse

If you turn the dynamic arm On after the charging port, you will hear an acoustic signal.

A

True

Upper Extremity Prosthetics (2 decks)

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