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CPM > LE Oral Questions > Flashcards

LE Oral Questions Flashcards

1
Q

How do you determine stirrup length?

A

2 x height of distal tip of medial malleolus + width of heel + 6 mm

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2
Q

How do you determine band length?

A

1/2 circumference + 1.5”

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3
Q

What are the minimum clearances for ankle joints and knee joints?

A

Ankle: 6mm medial/5mm lateral
Knee: 6mm medial/3mm lateral

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4
Q

In a conventional KAFO what changes could you use to reduce recurvatum?

A

Shallow bands
Move calf band up and distal thigh down (move closer)
Increase heel height

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5
Q

What problems could you encounter in moving the bands of a KAFO?

A

Peroneal nerve impingement

Limited knee flexion

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6
Q

How much PF would you allow a patient who has suffered a CVA?

A

Neutral

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7
Q

How do you determine if a patient requires locks on his KAFO vs free knee?

A

Hip/knee extensor weakness

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8
Q

What do you recommend for a patient who exhibits foot slap at heel strike?

A

AFO with PF stop

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9
Q

What is Legg-Calve-Perthes disease?

A

Avascular necrosis of the femoral head
Usually boys 9-14
Femoral head will return to normal if the leg is abducted and internally rotated

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10
Q

Name 3 orthoses used for LCP.

A

Scottish Rite
Toronto
Newington

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11
Q

Name 3 orthoses for the treatment of hip dysplasia.

A

Pavlik
Rhino
Ilfeld Splint
Frejka pillow

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12
Q

What is tibial torsion?

A

Difference between knee and ankle joint axes as viewed in the transverse plane

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13
Q

How is tibial torsion measured?

A

KF 90*

Measure apex of each malleolus to a surface behind the leg

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14
Q

What types of functional devices can be used for excessive pronation of the foot?

A

FO

UCBL

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15
Q

A UCBL is used for more control of what part of the foot?

A

hindfoot

subtalar joint

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16
Q

What is the cause of Charcot joints in the feet/ankle?

A

Any neuropathic disease can have Charcot joints

diabetes, herpes, syphilis

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17
Q

Evaluation of a patient with a gunshot wound to the hip reveals weak hip flexors. What peripheral nerve is injured?

A

femoral N.

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18
Q

What is your orthotic recommendation for pt w/ weak hip flexors?

A

cane on contralateral side?

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19
Q

Describe chondromalacia.

A

softness of the articular cartilage usually involving the patellofemoral joint

20
Q

What is your orthotic recommendation for chondromalacia?

A

Palumbo orthosis or other patellar stabilizing orthosis

21
Q

A patient’s KAFO has free motion knee, but the mechanical joint is 1” distal to the anatomical joint. In flexion, the resulting pressures will be…

A

Proximal posterior thigh
Distal anterior thigh
Orthosis migrates proximally

22
Q

Toe drag is a bigger problem in what phase of gait? Why?

A

Initial swing - if the toe does not clear the floor, the patient takes short steps and may trip

23
Q

Why do diabetics get foot ulcers?

A

loss of sensation

24
Q

What is the advantage of an offset knee joint for treating recurvatum?

A

puts the weight bearing line anterior to the knee joint, making it unnecessary to lock the knee

25
Q

Describe Guillain-Barre and its effects on the patient.

A

infectious polyneuritis with progressive muscular weakness, distal to proximal, may lead to paralysis
prognosis usually full recovery

26
Q

Describe Charcot-Marie-Tooth.

A

inherited progressive neuromuscular atrophy characterized by progressive weakness of the distal muscles of arms and feet
usually develops in childhood

27
Q

When would you recommend a bail lock on a KAFO instead of drop locks?

A

only one functional hand

When canes/crutches are used with bilateral KAFOs

28
Q

Name two contraindications for plastic AFOs.

A

uncontrolled edema

sensitive skin

29
Q

Name two methods of minimizing knee flexion torque at initial contact in a lower extremity orthosis.

A

beveled heel
undercut heel
SACH heel

30
Q

What implications do weak hip flexors have in your design of a KAFO?

A

a lightweight design could encourage hip flexion at swing phase

31
Q

For which diagnoses would you recommend a rocker bottom shoe?

A

diabetes
arthritis
ankle fusion

32
Q

What is the rx rationale for a rocker bottom shoe?

A

simulate normal foot biomechanics and promote even wt bearing distribution in a pt w/ limited or no ankle motion

33
Q

A polio patient has a flail ankle, good knee muscles, good hip muscles, and full ROM at knee w/ recurvatum of 25*. Knee buckles when tired. What orthosis do you recommend? Describe the mechanical principles.

A

Lightweight KAFO, offset or drop lock knee, solid plastic AFO section w/ rocker bottom shoe or a DAAJ.
Solid ankle for AFO section

34
Q

Six weeks post ACL repair, how do you cast? What two mechanical principles do you want?

A

cast in slight flexion

prevent hyperextension and control rotation

35
Q

Name 2 reasons why you might not use pretibial AFOs for a patient who walks w/ crouch gait.

A

hip flexion contracture
lack of ankle ROM
inability to don

36
Q

Give 4 contraindications for RGOs.

A 
obesity
hip flexion contracture >20* 
spasticity
non-plantigrade foot
hip dislocation
37
Q

Name 3 clinical signs of charcot joints at ankle mortise.

A 
swelling
instability
excessive joint mobility
pain
anesthetic foot
visual deformity
38
Q

Name 3 mechanical principles for treatment of Charcot joints.

A

immobilize in total contact AFO
minimal weight bearing
rocker bottom

39
Q

Name 3 signs in evaluation of heel spur pain

A

valgus foot
pes planus
localized pain at loading

40
Q

Name 2 mechanical principles for treating heel spurs.

A

distribute and reduce pressure in arch support

UBC for hindfoot and/or forefoot control

41
Q

Where should you place the mechanical hip joint?

A

1/2” anterior and 1” superior to GT

42
Q

How would elevating the shoe heel affect a solid ankle AFO?

A

increased KFM at heel strike

43
Q

What effect would posterior placement of knee joints have on a KAFO?

A

migrates proximally with pressure on anterior calf cuff

44
Q

What modifications can you make to a plastic KAFO to reduce recurvatum?

A

trim proximal and distal sections closer to the knee
pad shells
shallow shells

45
Q

Why would you choose a metal AFO over plastic for a patient with Charcot joints?

A

prevent skin breakdown due to insensate foot

46
Q

What are the stance phases of gait and what is the hip position through each?

A 
IC: 30* flexion 
LR: 25-30* flexion
Midstance: 20* flexion to 5* extension 
Heel off: 10* extension
Push off: 10* extension
47
Q

How can you prevent a knee orthosis from migrating down?

A

supracondylar wedge
suprapatellar strap
attach to foot plate
lightweight belt

CPM (13 decks)

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