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S3- Amputation And Prosthetics > Fitting and Device Selection > Flashcards

Fitting and Device Selection Flashcards

1
Q

OIOIOIOI

A

OIOIOIOI

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2
Q

What are some pressure sensitive areas of the TT stump?

A
  • Patella
  • Lateral tibial condyle
  • Tibial tuberosity
  • Anterior-distal end of tibia
  • Fibular head
  • Distal end of fibula
  • Distal end of stump with surgical suture
  • Medial femoral condyle
  • Lateral femoral condyle
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3
Q

What are some pressure tolerant areas of the TT stump?

A
  • Supracondular areas
  • Suprapatellar area
  • Patellar tendon
  • Medial flare of tibia
  • Lateral flare of tibia
  • Lateral flare of fibula
  • Posterior area of the stump
  • Popliteal area
  • Distal end of stump for total contact socket
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4
Q

A prosthetic set up in too much dorsiflexion can create what?

A

Encourages knee flexion at heel strike, causing patient residual limb hits the anterior aspect of the socket, causing skin breakdown.

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5
Q

What is one of the biggest concerns when first fitting a patient for a prosthetic?

A

In-bearing = Most patients have neuropathy, leading to the patients not being able to feel the residual limb as well, leading to skin breakdown.

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6
Q

SOCKS

A

SOCKS

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7
Q

What happens when the prosthetic is ill fitting due to volume loss or atrophy of the residual limb?

A

Patella sinks into socket causing fib-head pressure, condyle pressure, and tibia pressure.

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8
Q

First 0-__m after below knee amputation, patients are more likely to have volumetric, cylindrical, circumferential changes as well as atrophy. What fixes this?

A
  • 18 months

- Adequate amount of socks to lift residual limb out of prosthesis.

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9
Q

________ liner provides high stability and good adhesion if your limb has a lot of soft-tissue. It performs best with shuttle-lock suspension, what is this?

A
  • Silicone
  • “Shuttle lock suspension” means there is a pin attached to the end of the liner which inserts into a locking mechanism in the bottom of the socket. The lock connects your socket to your prosthesis.)
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10
Q

____________ has a unique ability to flow away from high pressure. That means the pressure in your socket is well distributed.

A

Polyurethane

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11
Q

__________ is soft, cushiony and highly elastic, offering good protection for low activity for many types of residual limbs. Usually a thermoplastic elastomer, which contains skin-friendly white oil, it is especially good for residual limbs with dry skin.

A

Copolymer

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12
Q
  • Silicone liners are for individuals with a _______ to _______ activity level.
  • Polyurethane is for individuals from ______ to especially _______ activity levels.
  • Copolymer liners are for individuals with a ______ activity level.
A
  • low to moderate
  • low to especially high
  • low
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13
Q

SUSPENSION METHODS

A

SUSPENSION METHODS

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14
Q

What are the 4 main suspension methods?

A
  • Pin locking
  • Lanyard
  • Suction
  • Elevated vacuum
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15
Q

What is pin-locking suspension?

A

A silicon or gel liner with a pin at the bottom of the liner is used on the residual limb. When the limb is placed into the socket the pin has to go into a locking mechanism at the bottom of the socket. This mechanism will lock the pin in place, creating a secure suspension in the socket.

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16
Q

What are the advantages of pin-locking suspension?

A
  • Auditory feedback for the user when pin engages
  • Easy donning and doffing
  • Can be done in sitting position
  • Forgiving with volume fluctuations
17
Q

What are the disadvantages of pin-locking suspension?

A
  • Elongation effect can occur at bottom of the residuum and cause skin breakdown
  • Wear and tear on liners
  • When the pin is misaligned or the liner is donned incorrectly the locking mechanism will not be engaged
18
Q

What are some indications for pin-locking suspension?

A
  • Volume fluctuation
  • Secure mechanical suspension
  • Mid-length to short amputations
  • Absorb sheer forces
19
Q

What are the indications for lanyard suspension?

A
  • Geriatric patients can donn while sitting
  • Obese patients
  • Poor dexterity/eye sight
  • Liner alignment is not critical
  • Bulbous limbs
20
Q

What is suction suspension?

A

A liner that is donned on the residuum is used to create suction instead of the skin suction described above. These liners are usually made of silicone or gel, to create a seal with the inside of the socket the liner can have silicone rings/ribs or a membrane.

21
Q

What are the indications for suction suspension?

A
  • Stable limb volume
  • Long residual limb allows for more room for components
  • Difficulty engaging pin-locking liner
22
Q

What are the advantages of suction suspension?

A
  • Even pressure throughout socket
  • Secure fit
  • Donning in a sitting position is possible
  • Stabilize excess residual tissue
  • Good suspension even with small volume fluctuations
23
Q

What are the disadvantages of suction suspension?

A
  • Relatively expensive
  • Wear and tear on liners
  • Poor suspension with significant volume fluctuations
  • Hand strength and dexterity needed
  • Lubricant needed
24
Q

What is elevated vacuum suspension?

A

Suction suspension is created with direct contact between the liner (or with the membranes on the liner) and the socket wall. With this system a mechanism/pump sucks the air out between the liner and the socket creating a negative pressure that is the same across the entire surface. To seal off the system an external sleeve or seal is used at the top of the socket.

25
Q

What are the indications for elevated vacuum suspension?

A
  • Offers rotation and shock absorption
  • Reduces shear forces/pistoning within socket
  • Improved proprioception
26
Q

What are the advantages of elevated vacuum suspension?

A
  • Creates a constant negative pressure and allows for better suspension when there is volume fluctuation
  • Less pistoning and rotation occur within the socket
27
Q

What are the disadvantages of elevated vacuum suspension?

A
  • More expensive
  • Mechanical components that can break
  • Adds weight to the prosthesis
28
Q

Many patients have to wear an ________ sleeve over the vacuum suspension to help.

A

external

29
Q

FOOT SELECTION

A

FOOT SELECTION

30
Q

What are 7 foot selections in regards to prosthetics?

A
  • SACH
  • Single Axis
  • Multi-Axial
  • Dynamic Response
  • Multi-axial w/ Dynamic Response
  • Hydraulics
  • Microprocessor
31
Q

What are multi-axial feet for?

A
  • Someone who isn’t super high activity, but does want to be a community ambulator.
  • Helps to acclimate to uneven terrain.
32
Q

What are sports feet used for?

A
  • People involved in athletics

- Also commonly used in pediatrics

33
Q

What is dynamic response feet?

A

-Straight ahead energy, not getting multi-axial component.

34
Q

What are heel height adjustable shoes used for?

A

-Allows for needs of different shoes.

35
Q

What is the main use of shock technology in prosthetics?

A

Decreases abuse on residual limb

36
Q

What is the use of a hydraulic ankle?

A

Allows the ability to control plantar and dorsiflexion at heel strike and midstance.

S3- Amputation And Prosthetics (10 decks)

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