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Prosthetics & Orthotics > Lower Extremity Prosthetic Componentry > Flashcards

Lower Extremity Prosthetic Componentry Flashcards

1
Q

Partial foot/ray resection =
Toe disarticulation =
Partial toe =

A

resection of 3rd, 4th, or 5th metatarsals or digits
disarticulation at MTP joint
excision of any part of one or more toes

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2
Q

Chopart =
Lisfrank =
Transmetatarsal =

A

transtarsal
disarticulation of midfoot
removal of forefoot through all 5 MTP bones

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3
Q

what population are minor LE amputations (partial foot and toes) most common in?
a) individuals with dysvascular disease/diabetes
b) individuals who stand a lot
c) individuals with CV comorbidities
d) young males

A

A)

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4
Q

what kind of gait deviation is common after the following minor LE amputations?
– toe:
– great toe:
– Ray:
– MTP or proximal:

A

– minor gait abnormalities
– loss of push-off
– decreased gait speed, limited LE ROM
– decreased stability, gait speed, and other gait deviations

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5
Q

Syme’s amputation/ankle disarticulation:
– preserves:
– removal of:
– complicated prosthetic fit due to:
– (can/cannot) ambulate without prosthesis

A

– heel pad – attached to distal end of tibia
– malleoli
– limited space
– can

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6
Q

what is the ideal length for a transtibial/below the knee amputation?

A

mid tibia –> allows for prosthetic use
fibula should be 0.5-1 cm shorter than tibia for prosthetic fit

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7
Q

transtibial:
– if < 9 cm, consider:
– if < 5 cm, consider:

A

– removing fibula
– knee disarticulation or TFA

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8
Q

where does the prosthetic knee joint fall compared to intact limb on someone with a knee disarticulation?

A

tibia shaft - below tibial plateau and fibular head

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9
Q

what is hemipelvectomy?
what is it commonly due to?

A

resection of part of pelvis
commonly due to cancer or trauma

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10
Q

what is hip disarticulation?
what remains intact?

A

amputation through hip joint
pelvis remains intact

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11
Q

what are K levels used for?

A

assess patient’s potential functional ability
determines reimbursement for componentry

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12
Q

what is considered a K-level 0?

A

does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their QOL or mobility
– not eligible for prosthetic

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13
Q

what are some mobility characteristics of a K0 patient?

A

– does not have sufficient cognitive ability to safely use prosthesis
– requires assistance for transfers and prosthesis does not improve mobility or independence
– wheelchair dependent
– bedridden - no need/capacity to ambulate or transfer

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14
Q

what is considered a K-level 1?

A
  • ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence
  • household ambulator
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15
Q

what are some mobility characteristics of K1 patient?

A
  • sufficient cognitive ability to safely use prosthesis with or without AD and/or assistance of one person
  • safe but limited ambulation at home or on similar flat surface - w/ or w/o AD, w/ or w/o assistance from one person
  • requires wheelchair for activities outside the home
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16
Q

what is considered a K-level 2?

A
  • ambulation with ability to transverse low level environmental barriers (curbs, stairs, uneven surfaces)
  • limited community ambulator
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17
Q

a K2 level patient can: (w/ or w/o AD, w/ or w/o assistance of one person)

A
  • perform level 1 tasks
  • ambulate on flat, smooth surface
  • negotiate a curb
  • access public or private transportation
  • negotiate 1-2 stairs
  • negotiate a ramp built to ADA specifications
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18
Q

when do K2 patients utilize a wheelchair?

A

distances beyond the perimeters of the yard/driveway, apartment building, etc.

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19
Q

do K2 patients have the ability to increase cadence?

A

only able to for short distances or with great effort
– not necessarily changing speeds regularly

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20
Q

what is considered a K-level 3?

A
  • variable cadence, typical of community ambulator
  • transverse most environmental barriers
  • may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion
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21
Q

A K3 patient can complete Level 2 tasks PLUS: (w/ or w/o AD, NO assistance)

A
  • walk on terrain that varies in texture and level
  • negotiate 3-7 consecutive stairs
  • walk up/down ramps built to ADA specifications
  • open and close doors
  • ambulate through crowded area
  • cross controlled intersection within community within the time limit provided
  • access public or private transportation
  • dual ambulation tasks (walk and talk)
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22
Q

what is considered a K-level 4?

A
  • prosthetic ambulation that exceeds basic ambulation skills
  • exhibits high impact, stress or energy levels (running, jumping, skipping)
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23
Q

what kind of person is commonly a K4?

A

child
active adult
athlete

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24
Q

what are K4 activities? (w/ or w/o AD, NO assistance)

A

running
repetitive stair climbing
climbing of steep hills
being a caregiver for another individual
home maintenance

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25
Match the following foot/ankle component with the appropriate K level: -- flexible-keel feet, multi-axial feet -- any, includes microprocessor -- external keel, SACH or single axis -- flex foot, energy storing foot, multi-axial, or dynamic response feet
-- K2 -- K4 -- K1 -- K3
26
Match the following knee component with the appropriate K level: -- any -- mechanical knee with variable friction (hydraulic or pneumatic) OR microprocessor -- mechanical knee with constant friction -- mechanical knee with constant OR variable friction (hydraulic or pneumatic) OR microprocessor
-- K4 -- K3 -- K1 -- K2
27
how often does insurance reimburse for a prosthetic device?
every 3-5 years depending on insurance
28
the following components are for a _______ amp. socket, pylon, foot
transtibial amputation ankle disarticulation
29
the following components are for a ______ amp. socket, rotator, knee joint, pylon, foot
knee disarticulation transfemoral amputation
30
the following components are for a ______ amp. socket, hip joint, pylon, rotator, knee joint, pylon, foot
hemipelvectomy hip disarticulation
31
what are two methods for socket fabrication?
casting scan
32
TTA socket considerations: pressure tolerant areas? pressure sensitive?
- calf, patellar tendon/knee cap - fibular head, end of fibula, end of tibia, shin bone, hamstring tendons
33
TFA/KD socket considerations: pressure tolerant areas? pressure sensitive?
lateral and medial soft tissue, ischial tuberosity, posterior and anterior soft tissue ASIS, greater trochanter, distal femur, pubic ramus, adductor tendon, pubic tubercle
34
what are the two socket designs for TTA?
patellar-tendon-bearing (PTB) total surface bearing socket (TSB)
35
what's the difference between the patellar-tendon-bearing socket and total surface bearing socket?
PTB = indentation over patellar tendon, specific pressure points TSB = distributed WBing, tight fit all around
36
Quadrilateral socket TFA/KD: -- ________ for ischial tuberosity and glutes -- ______ same level as posterior shelf -- __________ 2.5-3 inches higher -- what type of patients?
-- horizontal posterior shelf -- medial brim -- anterior and lateral brims -- requiring basic mobility needs
37
Ischial containment socket TFA/KD: -- ______ more narrow -- _______ lower -- often see: -- what type of patients?
-- medial-lateral walls -- anterior wall -- excessive anterior pelvic tilt -- more active patients
38
Subischial containment socket TFA/KD: -- "___" -- _____ must be able to tolerate weight bearing -- should not use with what patients?
-- brimless (trimlines are lower) -- soft tissue -- those with poor balance
39
a hip disarticulation/hemipelvectomy socket design encompasses what 3 structures?
pelvis gluteal tissues ischial tuberosity
40
a hip disarticulation/hemipelvectomy socket design must provide: -- adequate ______ support -- _____ capture of pelvic movements -- ____,_____ suspension -- appropriate: (2)
-- coronal -- sagittal -- secure, comfortable -- weight bearing surfaces, contours
41
hip disarticulation/hemipelvectomy socket design accomplishes medial-lateral stability by:
compression on the contralateral pelvis
42
what are the only two socket suspension designs that work for hip disarticulation/hemipelvectomy?
suction vacuum
43
a hip disarticulation/hemipelvectomy socket suspension: -- use of: -- trim lines above ____
-- pelvic band -- iliac crest
44
what are cons of using a thigh corset for suspension?
heavier may facilitate pistoning difficult to don
45
what is a commonly used suspension system? -- what is one pro?
pin system --> shuttle lock system -- helps with pistoning
46
what is a commonly used suspension system that uses a one-way valve and liner? One drawback of this system is pistoning can occur.
suction suspension
47
what is a suspension system that uses a one-way valve and is worn without a liner? This is not for a first time user as the socket fit must be very snug
true suction suspension
48
what are benefits of using a vacuum-assisted socket suspension system?
promote fluid exchange reduce moisture build up regulate volume fluctuations increase proprioceptive awareness of limb helps to control pistoning, may help with wound healing
49
what are cons of using a vacuum-assisted socket suspension system?
expensive heavier noisy
50
what is an option for patients who do not tolerate traditional prosthetic sockets?
osseointegration
51
what are common complications of osseointegration?
infection soft tissue irritation at stoma
52
what is the timeline for osseointegration? -- 1st surgery: -- bone healing _____ months -- 2nd surgery: -- partial WBing _____ months -- finally _____
-- fixture implanted -- 6 months -- abutment placed -- 6 months -- rehab
53
what are options for suspension aids?
supracondylar trim lines outer sleeve thigh corset or other strapping mechanisms
54
SACH feet (solid ankle cushioned heel) is a _______ foot
non-articulating
55
single axis, multi-axial, dynamic response/energy storing, multi-axial dynamic response, hydraulic, and microprocessor are all examples of _______ feet
articulating
56
SACH foot: -- k level: -- pros: -- ____ or _____ keel that extends to the MTP joints -- _______: allows for shock absorption and PF at loading response
-- K1 -- lightweight, inexpensive, low maintenance -- wooden or metal -- rubber heel
57
single axis feet: -- k level: -- some _____ motion allowed -- controlled by interchangeable ____ and ____ bumpers -- no ____ or _____ plane movement -- no _______ -- cons:
-- K1 -- sagittal -- anterior and posterior -- transverse or frontal -- energy return -- heavier, more maintenance
58
multi-axial feet: -- K level: -- allows for some _____ and _______ to cope with uneven terrain along sagittal DF/PF -- cons:
-- K2 -- pronation and supination -- expensive, heavier
59
who are multi-axial feet for?
people who function in areas with uneven terrain, active amputees, golfers, dancers
60
energy storage/dynamic response feet: -- k level: -- leaf spring keel stores energy during _____ rocker and releases it during _____ rocker -- as cadence or activity level increases, ____ comes into play, resulting in _____
-- K3 -- 2nd ; 3rd -- more spring ; greater return
61
multi-axial dynamic response feet: -- k level: -- combination of: -- closest to the ________
-- K3 -- articulated foot and dynamic response -- functional foot replacement
62
Hydraulic feet: -- K level: -- multiaxial with: -- ______ return -- cons: -- smooth _____
-- K3 -- vertical shock absorption -- energy -- expensive, not as durable -- rollover
63
Microprocessor/power feet: -- k level: -- identifies ____ and _____ after first step -- automatically provides DF during _____ phase that allow sufficient ground clearance -- _________ allows users to tuck both feet behind their knees when getting up from chair or sitting down -- automatically _____ foot for more natural appearance when seated
-- K4 -- slopes and stairs -- swing -- active ankle motion -- PF
64
advantages of microprocessor feet:
provide push off increased self-selected gait velocity 9.9% less energy expenditure
65
disadvantages of microprocessor feet:
poor battery life heavy (4.5 lbs) expensive

Prosthetics & Orthotics (17 decks)

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