L4 UE Orthotics Flashcards

1
Q

Orthosis refers to

A

permanent device to replace or substitute for loss of function

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2
Q

Splint refers to

A

temporary device that is part of a treatment program

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3
Q

Medicare now requires…

A

any device applied by an orthotist or therapist to be called an orthosis

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4
Q

Therapist fabricated

A

typically work with low temp thermoplastics that can be directly applied to skin

faster to make, patients leave with device on same day, not as durable, easy to adjust

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5
Q

Orthotist Fabricated

A

work with high temp thermoplastics

requires casting, takes days to fabricate, durable, better for long term, less easy to adjust

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6
Q

Biomechanical Reference

A

using principles of kinetics and forces acting on the body, a unique combination of physics and physiology

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7
Q

Make sure to

A

minimize pressure!
avoid shear force and ischemia

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8
Q

Continuous force applied to extremity should not exceed

A

50 gm/cm2

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9
Q

Managing Pressure

A

-pressure is more critical in areas w/less tissue
-assess tissue tolerance to pressure or shear force
-provide max contour
-don’t add padding, create area of relief then pad

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10
Q

Forearm based orthosis should cover

A

2/3 of the forearm in length

width should be 1/2 the circumference

edge should be rounded/flared

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11
Q

Stabilizing force

A

prevents migration or rotation of the orthosis on the arm can be used to protect unstable system like a fx or serve as a base for mob as in static progressive orthosis

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12
Q

Manipulatory forces

A

static forces that direct or control internal and external forces to produce desired outcome

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13
Q

Actuating forces

A

require a system to generate a dynamic force

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14
Q

Sensorimotor approach

A

used for individuals having damaged central nervous systems to inhibit or facilitate normal motor responses

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15
Q

Rehabilitative approach

A

focusing on ability to facilitate return to max function

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16
Q

Finger based

A

dorsal or volar mallet and which joint

17
Q

Hand based

A

thumb spica vs flexion block or extension block

18
Q

Forearm based

A

wrist cock up, ulnar or radial gutter, thumb spica

19
Q

What pathology can benefit from an orthosis?

A

fractures
inflammatory processess
limiting motion while structures are healing
weakness/paralysis
promoting mobility active and passive

20
Q

Immobilization/static orthosis

A

immobilize for fracture healing

position to prevent deformity (like burned hand)

rest tissue to decrease inflammation

21
Q

Purposes of serial static or static progressive

A

sub for loss of motor function
correct an existing deformity
provide controlled motion
aid in fx alignmnet and wound healing

22
Q

restriction orthoses

A

allow controlled motion to facilitate safe mobility to keep tendons gliding and limit soft tissue contracture while protect healing structures

23
Q

Thermoplastic high temp

A

tolerates high force like weight bearing without failure

24
Q

Thermoplastic low temperature

A

heated in water between 135 to 180, can be draped directly on the skin

25
Q

Properties of thermoplastic materials

A

memory
drapability
elasticity
bonding/ self adherence
self-finishing edges

26
Q

Memory

A

ability to return to original shape

27
Q

Drapability

A

ease with which the material conforms to the underlying shape

28
Q

Elasticity

A

the material’s resistance to stretch and tendency to return to previous shape after stretch

material can be worked more aggressively

useful for less cooperative patient

29
Q

Creases of hand

A

mark where edege of the orthosis needs to end to allow motion distally

30
Q

Longitudinal arch

A

formed by phalanges and mcp flexion and extension

31
Q

Distal transverse arch

A

formed by carpal bones

32
Q

proximal transverse arch

A

formed by MCP joint

33
Q

Prehension Patterns

A

tip
lateral
tripod
spherical
power
extension

34
Q

Dorsal wrist cock up

A

used if palm needs to be free
can be the base for dynamic orthosis

less supportive due to weight of hand on small bar, but potential for pressure

must relieve ulnar styloid dorsally

35
Q

Volar Wrist Cockup

A

most commonly used
two types; radial bar and thumb hole

36
Q

Radial bar volar wrist cock up

A

easier to adjust bar, but frequently velcro comes off bar as it is such a small piece of velcro

37
Q

Thumb hole volar wrist cock up

A

no hook velcro needed to attach distal loop velcro

needs to clear thenars and CMC jt with hole for thumb

38
Q

Why use a custom wrist orthosis?

A

radial nerve palsy
zone 5 extensor tendon laceration
tenosynovitis
ganglion
TFCC

39
Q

Be cautious…

A

know your limitations
refer out when possible
consider off shelf when appropriate