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Ox Mock Exam Questions > Lower Extremity > Flashcards

Lower Extremity Flashcards

1
Q

How do you determine stirrup length?

A

2 times height of distal tip of medial malleolus plus width of heel plus 1/4” (6 mm)

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2
Q

How do you determine band length?

A

Half circumference + 1.5 in (38 mm)

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3
Q

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

A

Knee: medial side 1/4” (6 mm) - lateral side 1/8” (3mm)
Ankle: lateral side 3/16” (5 mm) - medial side 1/4” (6 mm)

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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 (moving them closer)
Increase Heel Height

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5
Q

What problems could you encounter moving the bands?

A

Peroneal Nerve Impingement

Limited Knee Flexion of Orthosis

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6
Q

How much plantar flexion 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 versus free knee?

A

Hip &/or extensor weakness

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8
Q

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

A

An AFO- conventional or plastic/dorsi-assist and/or plantarstop

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9
Q

What is Legge-Calve-Perthes disease?

A

Avascular Necrosis of the femoral head usually occurring in boys ages 9-14. Femoral head will return to normal if the leg is abducted and internally rotated to place the femoral head into the acetabulum.

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10
Q

Name 3 orthoses used for Legg-Calve-Perthes?

A

Atlanta Scottish Rite, Toronto, Newington

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11
Q

Name 3 orthoses for the treatment of hip dysplasia

A

Freak pillow, pavlik harness, ilfeld splint

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12
Q

what is tibial torsion?

A

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

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13
Q

How is tibial torsion measured?

A

with the knee at 90 degrees-measure apex of each malleolus to a surface behind the leg

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14
Q

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

A

FO, UCBL

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15
Q

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

A

hind foot (calcaneus), subtler joint

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16
Q

What is the cause of Charcot Joints in the feet and ankle?

A

Any neuropathic disease can have Charcot joints associated with it (DM, 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 nerve

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18
Q

What is your orthotic recommendation for the gunshot wound patient?

A

maybe a cane use on the contralateral side

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19
Q

what is the name for a contralateral pelvic drop?

A

Trendelenberg sign or gluteus medium limp

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20
Q

describe chondromalacia

A

softness of the articular cartilage usually involving patella-femoral joint

21
Q

What is your orthotic recommendation for chondromalacia?

A

Palumbo Orthosis or other patellar stabilizing orthosis

22
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 - brace migrates proximally

23
Q

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

A

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

24
Q

Why go diabetics get foot ulcers?

A

Loss of sensation - patient cannot tell when he is getting blisters or pressure sores that can develop into ulcers if not detected in time

25
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 to lock the knee

26
Q

describe Guillain Barre and its effects on the patient?

A

infectious polyneuritis with progressive muscular weakness, distal to proximal, which may lead to paralysis. Prognosis usually if full recovery, though in more severe cases the patient may have some residual weakness in distal extremities.

27
Q

Describe Charcot-Marie Disease

A

Inherited progressive neuromuscular atrophy characterized by progressive weakness of he distal muscles of arms and feet, usually develops in childhood

28
Q

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

A

Only one functional hand, when crutches or canes are used with bilateral KAFOs

29
Q

Name 2 contraindications for plastic AFOs

A

Uncontrolled edema

sensitive skin

30
Q

Name 2 methods of minimizing knee flexion torque at initial contact in a lower extremity orthosis

A

beveled, undercut or SACH heel

31
Q

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

A

a lightweight design could encourage hip flexion at swing phase

32
Q

For what diagnoses would you recommend a rocker bottom shoe?

A

Diabetes, arthritis, ankle fusion. etc

33
Q

What is the RX rational for a rocker bottom shoe

A

simulate normal foot mechanics and promote even weight bearing distribution in a patient with limited or no ankle motion

34
Q

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

A

Light weight KAFO, offset or drop lock knee, solid plastic AFO section with rocker bottom shoe or double adjustable ankle joints

35
Q

How would you trim the AFO section for the polio patient? Why?

A

Solid Ankle, anterior trim, flail ankle needs stability in all planes

36
Q

6 weeks post ACL repair- how do you cast? What 2 mechanical principles do you want?

A

You want the cast in slight flexion to prevent hyperextension and to control rotation

37
Q

Name 2 reasons why you might not use pretibial AFOs for a patient who walks with crouched gait?

A

Hip flexion Contracture
Lack of Ankle ROM
Inability to don

38
Q

Give 4 contraindications for RGOs

A 
Obesity
Hip flexion contracture +20 degrees 
Spasticity
Non-plantargrade foot
Hip Dislocation
39
Q

Name 3 clinical signs of Charcot Joints at ankle mortise

A 
swelling 
instability 
excessive joint mobility
pain
anesthetic foot
visual deformity
40
Q

Name 3 mechanical principles for treatment of Charcot joints.

A

Immobilize in total contact AFO
Minimal Weight Bearing
Rocker Bottom

41
Q

Name 3 signs in evaluation of heel spur pain

A

values foot
pes planes
localized pain @ loading

42
Q

Name 2 mechanical principles for treating the above

A

Distribute & reduce pressure in arch support
UCB
for hind foot &/or forefoot control

43
Q

Where should you place the mechanical hip

A

1/2 “ anterior 1” superior to greater trochanter

44
Q

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

A

increase knee flexion moment at heel strike

45
Q

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

A

migrates proximally with pressure on anterior calf cuff

46
Q

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

A

trim proximal & distal sections closer to the knee-pad shells- shallow shells

47
Q

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

A

prevent skin breakdown due to insensate foot

48
Q

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

A 
initial contact (heel strike) - 30 degrees of flexion
loading response (foot flat) - 25 - 30 deg flexion
midstance - 20 deg flexion to 5 deg extension terminal stance
49
Q

How can you prevent a knee orthosis from migrating down?

A

supracondylar wedge - supramalleolar strap, attach to a footplate, lightweight belt

Ox Mock Exam Questions (7 decks)

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