Lect 1 - Basic Terms + Amputation Site Terminology Flashcards
What is the difference between a prosthetic and an orthotic?
simply put, a prosthetic = a REPLACEMENT OR SUBSTITUTE for a body part (leg, arm, tooth, eye, facial bone, palate)
an orthotic = a device used to assist, support, align, or prevent/correct the function of movable body parts –> wrist brace, splints, cast. etc.
facial bones, palate replacements, hip/knee/a joint, leg, arm, tooth, and eye are all examples of ______
prosthetics
A brace or splint are an example of ____
orthotics
Prosthetics are _____ _____ of a body part
(tooth, eye, facial bone, palate, hip/knee/ a bodily joint, leg, arm)
artificial replacements
Orthotics are ____, _____, or ____ used to support, align, prevent, or correct the function of a moving body part
Orthotics are a support, brace, or splint used to ____, ____, ____, or ____ a moving body part
support, align, prevent, or correct the function of
Orthotics are a support, brace, or splint used to support, align, prevent, or correct the function of ________
a moveable part of the body
residual limb is a much better term than ___. Can typically shrink for ___.
stump, 6-12 months
______= The portion of the arm or leg remaining after an amputation, sometimes referred to as a stump or residuum. Can shrink for ____
residual limb, 6-12 months
Residual limb
The portion of the arm or leg remaining after an amputation, sometimes referred to as a stump or residuum.
Rigid dressing
mildly compressive total contact plaster wrap applied immediately following surgery to control pain and edema
mildly compressive total contact plaster wrap applied immediately following surgery to control pain and edema
Rigid dressing
Rigid dressing = mildly compressive _______ applied ____ following surgery to control pain and edema
total contact plaster wrap, immediately
Rigid dressing = ____ compressive total contact plaster wrap applied immediately following ____ to control ____ and ____
mildly, surgery, pain & edema
Immediate Postsurgical Prosthesis (IPOP) = _____, pylon and foot-ankle assembly.
Applied immediately after surgery, and is used as an early form of prosthetic intervention. The benefit of being fit with an IPOP prosthesis is early ambulation if allowed by your physician
- Can help with image/psychsoc. PWB/TTWB
- FYI :
- can assist in wound healing and residual limb maturation.
- minimize postsurgical edema and pain.
- provide psychological benefit of early ambulation.
…
Reinforced rigid dressing that is applied immediately after surgery is known as an _____
Immediate Postsurgical Prosthesis (IPOP)
Preparatory prosthesis*
is ____ but not _____. Worn to expedite _____ and RL ____. Permits better evaluation of prosthetic needs
functional, cosmetic
training, maturation
Preparatory prosthesis*
a temporary prosthesis that allows progressive weight-bearing, so patient can relearn walking
Preparatory prosthesis*
a temporary prosthesis that allows progressive weight-bearing, so patient can relearn walking
Preparatory prosthesis (FYI)
Once wound has healed, pt may be ready for a prosthesis (artificial leg). A prosthesis can help pt regain the ability to walk. Pt starts by working with a prosthetist - an expert who makes and fits the prosthesis. At first, you’ll be fitted with a preparatory or temporary prosthesis. Later, you’ll get your definitive or permanent prosthesis. In some cases, the preparatory prosthesis will serve as the definitive prosthesis. Your activity level and goals help decide the type of definitive prosthesis that will be best for you.
The preparatory prosthesis is fairly basic in design. It has a socket, which fits around your residual limb. The socket is attached to a pylon (pipe) that supports your limb. Or, the socket may lead to a knee-like joint, if needed. The pylon then extends down to a solid foot piece. The foot piece has a cover that makes it look more like a natural foot.
…
______ = replacement for a missing limb which meets accepted standards for comfort, fit, alignment, function, appearance and durability
Definitive Prosthesis
Definitive Prosthesis = ______replacement for a missing limb which meets accepted standards for comfort, fit, alignment, function, appearance and durability
permanent* , comfort, fit, alignment, function, appearance & durability
Definitive Prosthesis = ______replacement for a missing limb which meets accepted standards for ___, ___, ___, ___, ___ and ___.
permanent* , comfort, fit, alignment, function, appearance & durability
Definitive Prosthesis (FYI)
You’ll get a definitive prosthesis when your residual limb volume is stable. It may take 6 to 12 months until you are ready. Even with a definitive prosthesis, you will still need to adjust sock ply as needed. The type of prosthesis you get will depend on your health and special needs. You may continue to use the preparatory prosthesis, and it will serve as your definitive prosthesis. Your definitive prosthesis may have:
- A more advanced knee or foot design.
- A more “natural” look.
- Features for special tasks or higher activity levels.
…
Socket = _____
Open component that fits the residual limb
the open component that fits the residual limb is called the ____
Socket
Pylon= _____
adjustable rigid supporting tube attached to socket or knee unit on one end, and foot-ankle assembly on distal end
adjustable rigid supporting tube attached to socket or knee unit on one end, and foot-ankle assembly on distal end = _________
Pylon
Knee unit = _______
these are included in ____ prosthetics
knee units = when a knee is included in the prosthetic
AKA (above the knee)
Foot/Ankle Assembly = ______
The portion in contact with the ground
The portion of the prosthetic that comes in contact with the ground = ___
Foot/Ankle Assembly
Amputation Site Terminology
site = toe
terminology = _______
phalangeal
Amputation Site Terminology
site = forefoot
terminology = _______ OR _____
ray resection → meaning, one or more COMPLETE metatarsal
Transmetatarsal → meaning, across the metatarsal shaft
Amputation Site Terminology
a ray resection = _____ , and falls under a ______ type amputation
one or more COMPLETE metatarsal,
forefoot
Amputation Site Terminology
a Transmetatarsal amputation = _____ ; it is considered a _____ type amputation
across the metatarsal shaft
forefoot
Amputation Site Terminology
site = midfoot
terminology = _______
partial foot (chopart, Boyd, pirogoff)
Amputation Site Terminology
site = at the ankle
terminology = _______
Syme
Amputation Site Terminology
site = below the knee
terminology = _______
transtibial (long, standard, short)
Amputation Site Terminology
site = at the knee
terminology = _______
knee disarticulation
Amputation Site Terminology
FYI
…
Amputation Site Terminology
site = at the hip
terminology = _______
hip disarticulation
Amputation Site Terminology
site = at the pelvis
terminology = _______
hemipelvectomy
JUST FYI to look over
Amputation Site Terminology
site = _______
terminology = phalangeal
toe
Amputation Site Terminology
site = _______
terminology = ray resection or transmetatarsal
forefoot
Amputation Site Terminology
site = _______
terminology = partial foot (chopart, Boyd, Pirogoff)
midfoot
Chopart, Boyd, and Pirogoff amputation are partial foot amputations that occur at the _____
midfoot site
Amputation Site Terminology
site = _______
terminology = Syme
at the ankle
Amputation Site Terminology
site = _______
terminology = transtibial (long, standard, short)
below the knee
Amputation Site Terminology
site = _______
terminology = knee disarticulation
at the knee
Amputation Site Terminology
site = _______
terminology = transfemoral (long, standard, short)
above the knee
AKA
Amputation Site Terminology
site = _______
terminology = hip disarticulation
at the hip
Amputation Site Terminology
site = _______
terminology = hemipelvectomy
at the pelvis
Limb Measurement Definitions
transtibial = ____
measurement from medial tibial plateau to end of bone with knee extended
Limb Measurement Definitions
measurement from medial tibial plateau to end of bone with knee extended
transtibial
Limb Measurement Definitions
Transtibial = measurement from _____ to ____ with knee extended
medial tibial plateau, end of bone
Limb Measurement Definitions
transfemoral = ____
measure from ischial tuberosity to bone end with hip extended
Limb Measurement Definitions
measure from ischial tuberosity to bone end with hip extended = ____
Transfemoral
Limb Measurement Definitions
Transfemoral = measure from ____to ____ with hip extended
ischial tuberosity, bone end
Team members and their roles
Physicians:
- Often serves as _______
- Assesses _____, performs surgery, monitors ______
- Monitors and manages _______
- Monitors condition of remaining extremity for patients with ____, _____, ______
- coordinator of the team
- need for amputation, healing of suture line
- patient’s overall medical care and health status
- peripheral vascular disease (PVD), neuropathy, or diabetes
Team members and their roles
PTs
- Provides ______ about the rehabilitation process and instruction in single limb mobility
- Designs and manages a ______ that focuses on mobility and preparation for prosthetic training
- Evaluates _______; can make recommendations for prosthetic fitting
- Designs and manages ______ that focuses on _____ and _____
- Monitors ____ for patients with ____, ____, or ____.
- preoperative education
- pre-prosthetic rehabilitation program
- patient’s readiness for prosthetic fitting
- a prosthetic training program; functional ambulation; prosthetic management
- condition of the remaining extremity; PVD, neuropathy, or diabetes
Team members and their roles
PT
- Provides preoperative education about ____ and ____
- Designs and manages a pre-prosthetic rehabilitation program that focuses on ______
- Evaluates patient’s readiness for prosthetic fitting; can make recommendations for ____
- Designs and manages a prosthetic training program that focuses on ____ and ____
- Monitors condition of the ______for patients with PVD, neuropathy, or diabetes
- the rehabilitation process; instruction in single limb mobility
- mobility and preparation for prosthetic training
- prosthetic fitting
- functional ambulation
- prosthetic management
- remaining extremity
Team members and their roles
Prosthetist
- ____, ____, ____ the prosthesis
- ____ the prosthesis to individuals, adjusts _____
- _____ components when necessary
- Monitors _____, _____, and _____ of the prosthesis
- Monitors _______ of the ______ for patients with PVD, neuropathy, or diabetes
- Designs, fabricates, and fits
- Adapts, alignment
- repairs/replaces
- fit, function, and comfort
- condition, remaining extremity
Team members and their roles
Prosthetist
- Designs, fabricates, and fits the prosthesis
- Adapts the prosthesis to individuals, adjusts alignment
- repairs/replaces components when necessary
- _____ fit, function, and comfort of the prosthesis
- Monitors condition of the remaining extremity for patients with ____, ____, ____
- Monitors
- PVD, neuropathy, or diabetes
Team members and their roles
OT
- Assesses and treats patients with _____ amputation, monitors ____ for prosthetic fitting, and ____ components
- Assists with ____ in _____ for patients with upper OR lower limb amputations
- Makes recommendations for _____ modification and ______ to facilitate _____
- upper extremity, readiness, recommends
- problem solving, activities of daily living
- environmental, assistive/adaptive equipment, functional independence***
Team members and their roles
Social worker
- Provides ____ and _____
- Acts as ____ with third-party payers and community agencies
- Assists with patient’s AND family’s ____, _____, and ____
- financial counseling; coordination of support services
- liaison
- social, psychological, and financial issues
Team members and their roles
Social worker
- Provides financial counseling and coordination of support services
- Acts as liaison with ____ and ____
- Assists with patient’s and family’s social, psychological, and financial issues
- third-party payers; community agencies
Team members and their roles
Dietitian
- Evaluates ____ and provides nutritional counseling, especially for patients with:
- ____
- ____
- Patients who are on ___
- patients ____
- nutritional status
- diabetes
- heart disease
- chemotherapy
- recovering from trauma
Team members and their roles
Nurse/ NP
- Monitors patient’s ____ and ____ during rehabilitation
- Provides ongoing ____ on _____and ____ issues
- Monitors condition of remaining extremity for patients with ___, ____, ____
- health and functional status
- patient education; comorbid and chronic health
- PVD, neuropathy, or diabetes
Team members and their roles
Vocational Counselor
- Assesses ____ and ___
- Assists with _____
- patient’s employment status and potential
- education, training, and placement
ROLES & RESPONSIBILITIES
Prosthetists provide care to patients with partial or total absence of limbs by designing, fabricating, and fitting prostheses or artificial limbs. The prosthetist creates the design to fit the individual’s particular functional and cosmetic needs; selects the appropriate materials and components; makes all necessary casts, measurements, and modifications (including static and dynamic alignment); evaluates the fit and function of the prosthesis on the patient; and teaches the patient how to care for the pros(Lusardi 2)
ROLES & RESPONSIBILITIES
Prosthetist
Prosthetists provide care to patients with ____ OR ______ by designing, fabricating, and fitting ____ or ____.
The prosthetist creates* the design to fit the individual’s *particularfunctional and cosmetic needs →
- selects the appropriate materials and components
- makes all necessary ___, ____, and ____ (including static and dynamic alignment)
- evaluates the _____;
- teaches the patient how to _____ (Lusardi 2)
- partial OR total absence of limbs; prostheses; artificial limbs
- casts, measurements, and modifications
- fit and function of the prosthesis on the patient
- care for the prosthesis
ROLES & RESPONSIBILITIES
Orthotist
Orthotists provide care to patients with neuromuscular and musculoskeletal impairments that contribute to functional limitation and disability by designing, fabricating, and fitting orthoses, or custom-made braces. The orthotist is responsible for evaluating the patient’s functional and cosmetic needs, designing the orthosis, and selecting appropriate components; fabricating, fitting, and aligning the orthosis; and educating the patient on appropriate use (Lusardi 2)
ROLES & RESPONSIBILITIES
Orthotist
Orthotists provide care to patients with ______ and _____ that contribute to functional limitation and disability by designing, fabricating, and fitting orthoses, OR ____.
The orthotist is responsible for evaluating the patient’s functional and c_osmetic needs_,
- designing _____
- selecting appropriate components → ____, ____, and ____ the orthosis
- educating the patient on ____ (Lusardi 2)
- neuromuscular and musculoskeletal impairments; OR custom-made braces
- the orthosis
- selecting → fabricating, fitting, aligning OR custom-made braces
- appropriate use
ROLES & RESPONSIBILITIES
PT
EARLY PHASE: The physical rehabilitation process for persons with amputation occurs in different stages beginning with a postoperative acute phase where positioning, skin protection, sensory and proprioceptive training, joint range of motion, muscle strengthening occurs in conjunction with general conditioning activities leading to functional training for independence in mobility including transfer skills, balance exercises, wheelchair mobility, and ambulation with assistive devices that extends to the subacute phase of rehabilitation(Lusardi 465)
- The preprosthetic phase includes management of the residual limb including wound care, edema control, shaping, desensitization, and increasing joint and muscle flexibility. Strengthening of the trunk as well as the extremities is essential for prosthetic use.(Lusardi 465)
- Focus on functional activities
- Determine readiness for fitting and components
- Coordinate prosthetic training and focus on alignment
- Return to activity
ROLES & RESPONSIBILITIES
PT
EARLY PHASE:** The physical rehabilitation process for persons with amputation occurs in different stages beginning with a **postoperative acute phase where positioning, skin protection, sensory and proprioceptive training, joint range of motion, muscle strengthening occurs in conjunction with general conditioning activities leading to functional training for independence in mobility including transfer skills, balance exercises, wheelchair mobility, and ambulation with assistive devices that extends to the subacute phase of rehabilitation (Lusardi 465)
- The preprosthetic phase includes management of the residual limb including wound care, edema control, shaping, desensitization, and increasing joint and muscle flexibility. Strengthening of the trunk as well as the extremities is essential for prosthetic use.(Lusardi 465)
- Focus on functional activities
- Determine readiness for fitting and components
- Coordinate prosthetic training and focus on alignment
- Return to activity
Causes of Amputations
Amputations can be a result of
- trauma
- PVD
- tumors/ cancer
- infections
- congenital/ acquired extremity deformities
Causes of Amputations
Traumatic amputation
- Loss of _____
- ___ or ____ injury
- ____ or burning
- Non-union of fractures
- arterial supply
- Avulsion/ crush
- Freezing
- Non-union of fractures
Causes of Amputations
Peripheral Vascular Disease Amputations
- Acute ____
- Arterio____
- Arteriosclerosis with _____***
- Arteritis
- ____ disease
- emboli
- ateriosclerosis
- Arteriosclerosis with diabetes***
- Reynaud’s (disease that causes small arteries in face/ extremities to constrict when cold or stressed)
Causes of Amputations
FYI: Reynaud’s disease
causes smaller arteries that supply blood flow to the skin to narrow in response to cold or stress. The affected body parts, usually fingers and toes, might turn white or blue and feel cold and numb until blood flow improves, usually when you get warm
Causes of Amputations
Tumors
- Benign
- Malignant- (more often the cause)
Causes of Amputations
Tumors
T/F = Benign tumors cause more amputations than malignant tumors
false!
malignant tumors are more often the cause for amputations
Causes of Amputations
Infections causing amptuations
- Pyogenic (pus)
- Granulomatous (a small area of inflammation)
Causes of Amputations
Congenital or acquired extremity deformities
- Terminal ____
- Terminal ____
- Permanent ____
- deficiency
- deformity
- nerve loss