UE Amputation Flashcards

1
Q

___% of all amputations are upper limb loss

A

3%

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2
Q

what are common causes of UE amputations?

A

trauma
tumor

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3
Q

what are problems specific to UE amputations?

A

self esteem
psychological impact
less research
loss of dexterity
different grasping patterns
shaking hands
hand dominance

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4
Q

when should we fit a patient with an UE prosthesis for best outcomes?

A

the earlier the better

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5
Q

which digit would be indicative of worse prognosis in a partial hand and digit amputation?

A

thumb –> used more for function

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6
Q

wrist disarticulation:
– better potential for ______
– allows _______ at terminal end
– better surface area for _____
– limited prosthesis options due to ______

A

– active supination/pronation
– WBing
– suspension
– short working length

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7
Q

transradial:
– (more/less) favored and prosthetic options
– (easier/harder) prosthetic fit
– preservation at _____ for ideal function
– at least ______ of ulna necessary for functional use of elbow

A

– more
– easier
– elbow
– 5 cm

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8
Q

in children, is elbow disarticulation or transhumeral amputation more desirable? why?

A

elbow disarticulation
- transhumeral amputations result in higher incidence of bony regrowth

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9
Q

in adults, is elbow disarticulation or transhumeral amputation more desirable? why?

A

long transhumeral favored - at least 5-7 cm of humerus to preserve shoulder function and prosthesis use
- elbow disarticulation allows for better device suspension and control

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10
Q

harness suspension, self-suspending, and adjustable sockets are all _____ designs

A

socket

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11
Q

suspension methods:
– one-way valve, passive
– active pump (noisy), minimizes pistoning
– over socket & connects with skin to stay on
– shuttle ____/pin

A

– suction
– vacuum
– outer sleeve
– lock/pin

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12
Q

what suspension method has good implications for a patient that has skin breakdown and sweats a lot?
– with this suspension method, what do you need to be cautious about?

A

osseointegration
– fractures –> rod always sticks out

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13
Q

liner (gel or silicone), socks, and flexible inner socket are all __________
– which one is most common?

A

sockets interaces
– liner

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14
Q

cosmetic/passive prosthetic:
– active/electronic parts??
– intended to:
– primarily for _____ use
– may assist with:

A

– no
– closely resemble natural body part
– cosmetic
– pushing, balancing, or supporting objects

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15
Q

what ROM needs to be addressed for each level of amputation:
– transhumeral
– transradial
– wrist disarticulation & long transradial
– any level

A

– shoulder depression, extension, abduction
– elbow flexion, extension
– forearm pronation and supination
– scapular abduction and humeral flexion

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16
Q

how are powered prostheses powered?

A

exaggerated movement of shoulder/s, neck and back
harness systems

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17
Q

how do the body powered prostheses voluntarily open and close?

A

tension is applied to the cables

18
Q

in someone with a transradial amputation and body powered prostheses, how is tension created to open and close?

A

shoulder flexion and scapular protraction

19
Q

in someone with transhumeral amputation and body powered prostheses, how is tension created to open/close and lock elbow?

A
  • shoulder flexion, scapular protraction for elbow control
  • lock elbow using shoulder extension and scapular depression to control terminal device using a dual cable
20
Q

what are advantages of powered prostheses?

A

lower initial cost
lighter weight
easy to repair

21
Q

what are disadvantages of powered prostheses?

A

mechanical appearance
lack fine motor control
may be difficult to use

22
Q

how does externally powered/myoelectric prostheses work?

A

user contracts muscles of the residual limb, generating EMG signals that control the motor of hand/wrist/elbow functions

23
Q

what are advantages of externally powered/myoelectric prostheses? (3)

A

no harness or cable system, built to look more realistic
battery powered - doesn’t depend on patient strength
provide a forceful grip

24
Q

what are disadvantages of externally powered/myoelectric prostheses? (4)

A

higher initial cost
heavier
higher cost to repair
poor battery life

25
Q

a hybrid prostheses combines:

A

use of body powered and externally powered prosthetic components

26
Q

what is targeted muscle reinnervation? (TMR)

A

surgical procedure that reassigns nerves

27
Q

how does TMR work?

A

use of pattern recognition to distinguish movements involving multiple degrees of freedom

28
Q

what is the benefit of TMR?

A

helps to better control prosthetic device

29
Q

a prosthesis with an elbow joint allows for ______ and can have _______

A

flexion/extension ; rotation (sup/pro)

30
Q

a prosthesis with a wrist joint allows for ______ and can have _______

A

flexion/extension ; rotation

31
Q

a wrist joint is often a part of ____

A

hand component

32
Q

what are 3 examples of terminal devices?
what’s the purpose of them?

A

hooks/split hooks
prehensors
artificial hands
– replaces the hand to make them more functional

33
Q

what are hook devices used for?

A

hold object between hook
they can see the object they are trying to hold

34
Q

what are advantages to hook devices?
– disadvantage?

A

durable
low maintenance and repair cost
lightweight
– cosmetic problem

35
Q

what are prehensor devices?

A

similar functionality to hook
hook like - looks like lobster claws, pliers, birds beak

36
Q

what are disadvantages to prehensors?

A

difficult to pick up small objects
bulkier than split hook

37
Q

what are advantages to artificial hands?

A

cosmetically appealing
pattern recognition for improved motor skills

38
Q

what are disadvantages to artificial hands?

A

more degrees of freedom to control, with articulating fingers
more difficult to learn how to use

39
Q

true or false. most UE amputees wear their prostheses all the time

A

false - 30-80% abandon their prosthetic

40
Q

what are some outcome measures that can be used for UE amputees?

A

box and block test
suitcase packing activity
Self-Report: QuickDASH, PROMIS-9 UE, OPUS, UEFS, PSFS

41
Q

what are some advanced surgical procedures for UE amputees?

A

thumb reconstruction by digital transposition (toe replaces the thumb)
hand/arm transplantation