Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Prosthetics & Amputation > Intro - Surgical Techniques > Flashcards

Intro - Surgical Techniques Flashcards

1
Q

What gender has a higher risk for dysvascular and trauma related amputations? What races?

A

males > females

AA, Hispanics, and Native Americans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 causes of amputation? (leading cause to least likely cause)

A
  • diabetes and peripheral artery disease (PAD)
  • Trauma
  • cancer
  • congenital deficiencies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical signs of peripheral neuropathy?

A
  • deficits of sensation
  • motor impairments
  • autonomic dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some examples of autonomic dysfunction with peripheral neuropathy?

A
  • inadequate hemodynamics of the foot

- trophic changes - sweeling, color changes, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of distribution pattern does loss of sensation occur in? Does it follow a dermatomal pattern?

A
  • Lose sensation in a stocking glove distribution pattern
  • Does NOT follow dermatomes
  • Follows in a circular distribution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are classic symptoms of PAD?

A
  • intermittent claudication
  • loss of one or more LE pulses
  • leg numbness
  • trophic changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is intermittent claudication? How do you differentiate from a lumbar/spine condition?

A
  • cramping in the calf that general eases with rest, caused from impaired blood flow (oxygen)
  • lumbar conditions usually get better in a flexed position so you can put the patient on the bike and if the symptoms continue then you will know it is not for a lumbar condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are recommendatioons for patients with diabetes and PAD?

A
  • daily foot checks
  • work on flexibility so they can check their feet
  • leather shoes that have support and protection
  • white cotton socks so they can see if skin breakdown is occurring
  • don’t cut their own toenails - have it done by a pediatrist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What determines limb length and shape with PAD amputations? Traumatic amputations?

A
  • PAD - amount of sensation that is left

- Traumatic - amount of trauma that has occurred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Who is the most common patients for amputations due to cancer?

A

males in late childhood through early adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should you look for that may be osteosarcoma?

A
  • pain with weightbearing
  • Hx of worsening, deep local pain
  • Fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who is most likely for traumatic amputations?

A

males - 20-29 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Myoplasty vs myodesis. What are the benefits of each?

A

myoplasty - Attachment of anterior and posterior compartment muscles to each other over the end of the bone
- results in better blood flow and is better in the presence of ischemia

myodesis - anchoring of muscles to bone

  • increased stability and muscular control
  • causes a better line of pull for the muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of closed amputation will be used when vascularity is of concern?

A

long posterior flap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is dehiscence?

A

surgical closure has opened back up after being initially closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of closed amputation is used for severe dysvascular cases? How does it work?

A

skew sagittal flaps

  • takes advantage of saphenous nerve artery and sural nerve
  • removes anterior placement of scar from high prosthetic pressures
  • helps with blood flow laterally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the shortest level of transtibial amputation that is compatible with knee function?

A

tibial tubercles

18
Q

What shape do you want the residual limb in a transtibial amputation?

A

cylindrical

- DO NOT want conical

19
Q

What is important to maintain with transfemoral amputations? Why is it difficult to maintain? What type of muscle attachment do surgeons suggest to maintain normal alignment?

A

femoral shaft axis

  • difficult to maintain because of loss of adductor attachment
  • myodesis of adductor magnus to femur at the level of amputation for maintaining more normal alignment
20
Q

What position is the limb maintained during a transfemoral amputation? Why?

A
  • limb maintained in extension and adduction

- done to maintain proper tension and alignment

21
Q

What type of skin flap is used with transfemoral amputations?

A
  • equal length

- long medial flap in the sagittal plane

22
Q

What are common issues with all amputations?

A
  • pain
  • wound healing
  • fluid collection/edema
  • heterotrophic ossification
  • trauma
23
Q

What is heterotrophic ossification?

A

excessive bone growth where it is not supposed to
– really painful, changes where they bear weight, pressure, and often times comes back if removed so it is often left as is

24
Q

What are common issues with transtibial amputations?

A

knee flexion contracture

25
Q

What are common issues with transfemoral amputations?

A
  • hip adductor roll
  • hip flexor contracture
  • hip abduction contracture
  • glute weakness
26
Q

How is a contracture different than spasticity?

A

spasticity is velocity dependent and a contracture is NOT velocity dependent

27
Q

What is a contracture caused by? What can it lead to?

A

Caused by - Immobility which leads to connective tissue proliferation into the joint space combined with change in muscle and cartilage composition

Can lead to - pain, pressure ulcers, further immobility and functional deficits

28
Q

What are the benefits of osseointegration?

A
  • eliminates the need for a socket
  • short residual limb
  • more natural feeling
  • improved gait
  • allows for normal swelling
29
Q

What are the downsides of osseointegration?

A
  • multiple surgeries
  • prolonged period of no ambulation
  • risk of fracture, infection
  • reduction in activities that require high torque or axial stress
  • not well known in the US
30
Q

hemicorporectomy

A

below waist amputation - B LE amputated

31
Q

transpelvic

A

amputation of portion of the pelvis and LE

32
Q

Hip disarticulation

A

amputation through hip joint capsule including the entire LE

33
Q

What is the goal with hip disarticulations and transpelvic amputations?

A

provide the patient with good soft tissue flap for pressure tolerance and comfort with sitting

34
Q

What are the indications of knee disarticulation?

A
  • inability to provide adequate transtibial residual limb secondary to trauma
  • knee flexion contracture > 45 degrees
  • infection of soft tissue close to knee joint
  • congenital deformities
  • rarely used in individuals with vascular compromise
35
Q

What is a Symes amputation? What must the patient have?

A

Amputation through the ankle preserving the heel pad

- must have circulation to heel pad to be successful

36
Q

What is the most significant factor for positive adjustment after an amputation?

A

premorbid coping mechanism

37
Q

What are the 4 stages of emotional adjustment to amputation? Does everyone follow the stages or experience each stage?

A
  • 1st prior to surgery - initial shock
  • immediately after surgery
  • after initiation of post-op program
  • reintegration into functional lifestyle
  • May or may not follow this sequence or experience each stage
38
Q

When is stage 1 of emotional adjustment to an amputation? What statement should you avoid and what statement should you use?

A
  • prior to surgery
  • awareness that amputation may occur
  • Greif likely the first reaction

Refrain from - “Oh no, no, don’t even think that.”
Utilize more reflective response - “I understand your concerns about your foot.”

39
Q

When is stage 2 of emotional adjustment to amputation?

A
  • immediately after surgery
  • grief likely
  • Individuals may experience insomnia, restlessness and difficulty concentrating
40
Q

When is stage 3 of emotional adjustment to amputation? What should be avoided and what may be helpful?

A
  • acknowledgment of amputation - post-op program
  • Many individuals mourn not only the loss of the limb but also anticipated loss of previous lifestyle (job, activity, etc)
  • Feelings can alternate between hopelessness, despondency, bitterness and anger
  • Avoid overwhelming patient with information
  • Private or group sessions with individuals who have made successful adjustments may be helpful
41
Q

What is stage 4 of emotional adjustment to amputation? What are concerns?

A
  • adaptation
  • reintegration into functional lifestyle

Concerns regarding prosthesis

  • appearance
  • functionality
  • unrealistic expectations

Prosthetics & Amputation (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions