Midterm Flashcards
0
Q
Who was the first to develop a tourniquet to stop bleeding during an amputation?
A
Jean Louis Petit in 1718
1
Q
Who was the first person reported to use a tourniquet for hemorrhage control after injury and for amputation?
A
French army surgeon Etienne Morel in 1674
2
Q
What type of closure Encases the bone and transected muscle by closing the fascial envelop over the top of the muscles?
A
Myofascial Closure
3
Q
What type of closure require the surgeon to position the muscle over the distal end of the bone and attaches to the opposing muscle?
A
Myoplasty
4
Q
What type of closure take individual muscle groups and directly attached to the periosteum of the bone?
A
Myodesis
5
Q
What type of closure takes the firm distal attachment of the severed tendon to the bone?
A
Tenodesis
6
Q
Which is the least stable amputation technique Myoplasty Myofascial closure Tenodesis Myodesis
A
Myofascial closure
7
Q
Which amputation technique is most stable? Myoplasty Myofascial Closure tenodesis Myodesis
A
Tenodesis
8
Q
What are the 3 categories of prehension?
A
Precision
Power
Coal hammer
9
Q
What are the 6 types of prehension?
A
Tip Cylindrical Lateral Palmer Hook Spherical
10
Q
What procedure is performed in mainly 3rd world countries on specific populations such as bilateral amputations and the blind pts?
A
Krukenberg procedure
11
Q
What type of amputation where the patient maintains pronation and supination
More pressure can be tolerated in distal aspect of the limb
Wrist unit and hand length are more difficult to match ContralAteral limb?
A
Wrist disarticulation
12
Q
What is a Trans-Radial Amputation?
A
Amputation through radius and ulna
13
Q
True or false?
The longer the residual limb: more control over the prosthetic, and more area to decrease pressure on the limb
A
True
14
Q
True or false
Regarding Elbow Disarticulation amputations trimlines can be shorter on the socket
A
True
15
Q
True or false
Regarding Elbow Disarticulation amputations: epicondyles can be utilized for suspension
A
True
16
Q
The dual cable system (Fair-lead cable system) has what two types of movement?
A
Different movements allow for elbow for elbow flexion and extension
Alternative movements allow for terminal device opening and closing
17
Q
A component for bilateral or involved ContralAteral limb that allows the elbow to lock and unlock by “nudging” the control with the chin is called what?
A
Nudge Control
18
Q
What are some difficulties with forequarter Amputation?
A
~Loss of balance- balance can be increased with prosthetic use
~Prosthetic use is more difficult due to loss of muscle and proximal arm for control
~Lower compliance/ use rate
19
Q
What is an acquired deformity?
A
Resultant of trauma or cancer: law mowers are a large contribution
Adjustment process is crucial to child and family members
20
Q
Congenital deformities are a result of what idiopathic syndrome?
A
Amniotic Band Syndrome (ABS)
21
Q
True or false congenital deformities have a higher chance of rejection compared to acquired prosthetic use
A
True
22
Q
What are the three types of congenital etiologies?
A
Amniotic Band Syndrome
Longitudinal Deficiency
Transverse Deficiency
23
Q
What are some complications that come from amniotic band syndrome?
A
~Syndactyly -Amputation of fingers or toes
~Severe cases can result in clubbed feet or limb amputations
24
An absence extending parallel with the long axis of the limb (forearm and/ or hand, or leg and/or foot), either pre-axial, post axial, or (as in the hand or foot) central in nature
Longitudinal deficiency
25
The limb has developed normally to a particular level beyond which no skeletal elements exist
There may be digital bud
Transverse Deficiency
26
What is a terminal device also referred as?
TD
27
What is the primary function of a terminal device ?
Primary function Is for prehension
28
Voluntary ______ terminal devices Open when the cable is pulled?
Voluntary opening (VO)
29
Which terminal devices are the most commonly used where spring tension is used to grip the object voluntary opening or voluntary closing?
Voluntary opening
30
Voluntary _______ terminal devices Closes when the cable is pulled?
Voluntary closing (VC)
31
Which of the following described a canted terminal device?
A. Offset which allows better line of sight to object or working surface: at an angle
B. Object is rolled into its grasp
C. Cannot pick up pins well
D. All of the above
D. All of the above
32
```
Which of the following applies to a Lyre terminal device?
A. "Straight-approach"
B. Object is pinched
C. Allows user to pick up pins
D. All of the above
```
D. All of the above
33
Which type of metal is best used for high level UE patients?
Aluminum
34
Which type of metal or material is best for longer trans-radial prosthetic use?
Stainless steel
35
Heavier than aluminum but lighter than stainless steel used for moderate work?
Titanium
36
What's the name of the Caucasian rubber material used to coat the fingers of the hook , increase coefficient of friction, most commonly used for children, and his not heat resistant?
Plastisol
37
What is the acronym APRL stand for?
Army Prosthetic Research Laboratory
38
What does the acronym CAPP stand for?
Child Amputee Prosthetic Program
39
A Hosmer TD size 12 is for what patient populations?
Infants
40
A Hosmer TD size 10, 99 are for what patient populations?
Small Adult/Child
41
A Hosmer TD size 8, 88 are for what patient populations?
Medium Adult
42
A Hosmer TD size 5, 555 are for what patient populations?
Adults
43
Hosmer TD sizes 3, 6, 7, and 7LO are what types of terminal devices?
Work TDs
44
Very short residual limb length of less than _____ %
35%
45
Residual limb length of 35% to 55% is what type of amputation level?
Short
46
Residual limb length of 55% to 90% is what type of amputation level?
Long
47
Long TR greater than 55%
The long below elbow residual limb retains from 60 to 120 degrees of supination and pronation and the short below the elbow limb retains less than 60 degrees
48
What are the two types of socket design for a short < 33% socket?
Rigid hinge
| Self suspending
49
The PML is "___ to ____" less than ML across epicondyles
3/8 to 1/2 "
50
What is the posterior trim-lines for a short < 33% socket and medium TR sockets 33% to 55%
1/2 -1"
51
What are the two types of socket types used for medium TR sockets 33% - 55%?
Rigid joints
| Self suspension
52
What two types of materials or socket types used for long TR sockets > 55%
Flexible hinges
| Self suspension
53
On the socket what is the angle from the angle and parallel to the ulna?
45 degrees
54
On the socket what is the angle for the verticle?
60-70 degrees
55
What is the build up over the olecranon?
3/16" to 1/4"
56
What is the verticle horizontal epicondyles build up?
1/8" to 3/16"
57
What is the proximal margin build up?
1/8"-3/16"
58
What is the distal end build up?
1/8"
59
Build up applied to just distal to anterior trimline?
1/4"
60
Anterior trimline reduced to about ____" radius at cubital fold
1/8"
61
Wrist disarticulation is greater than ____%
55%
62
When the hook is open the cable and harnessing should be at least ___" between triple swivel/ball retainer and distal end of housing
1/4"
63
When the hook closed and in max pronation and supination there should be at least ___" between hanger and proximal end of housing
1/4"
64
True or false
| The cable should not rub the forearm ?
True
65
The base plate and retainer is placed distal to the proximal __ and in lateral anterior 1/3 (___o'clock or ___o'clock).
1/3
| 10 or 2 o'clock
66
What are the two types of lengths matter for cable and harnessing?
Length of lateral epicondyles to thumb tip
| Length of arm - epi to thumb post
67
The housing at the elbow should cross which epicondyle?
Lateral
68
True or false the housing does not bind at the elbow or gap away from elbow?
True
69
What happens when the housing flexes with the elbow?
It crosses the epicondyle
70
In a figure 8 harness where is the cross bar is mounted?
Cross bar mounted middle of the numeral cuff
71
In a figure 9 harness where is the cross bar mounted?
Mid proximal posterior trimline of muenster socket
72
True or false the flexible hinges cross the epicondyle apex and allows maximum sup/pro
True
73
In a harness where is the cross point/ Northwest ring?
Inferior to C7 and slightly off set towards the non amputated side
74
True or false the hanger should be lateral enough not to impinge on the patients skin?
True
75
True or false the harness should not be laying flat on the back?
False the harness is laying flat on the back
76
What crosses over the involved side shoulder and through the deltopectoral groove?
Anterior suspension strap
77
In the forearm flexion test the total ROM with the prosthesis should be no less than; muenster = ___degrees
55% or longer = _____degrees
Muenster = 60 degrees
| 55% or longer = 135 degrees
78
What is common fault?
Improper or insufficient socket trimline
79
For length <35% what is the desired pre flexion angle that is recommended?
15-25 degrees
80
For lengths > 35% to < 55% what is the desired pre flexion angle that is recommended?
10-15 degrees
81
For lengths < 55% what is the desired pre flexion angle that is recommended?
5 degrees
82
When performing the forearm flexion resist test you should have the patient hold elbow firmly at angle?
90 degrees
83
How much medial canting should terminal device be in?
3-5 degrees
84
For the forearm extension resist test you should have patient hold elbow at what angle ?
90 degrees
85
For the humeral external rotation resist test you should have the patient hold elbow in what angle ?
90 degrees
86
For the humeral internal rotation resist test you should have the patient hold elbow in what angle ?
90 degrees
87
For the forearm axial load test you should have the patient hold elbow in what angle ?
90 degrees
88
For the forearm rotation resist (>55% and flexible hinges only) ROM should be at least ____% of the ROM without the socket
50%
89
For the forearm rotation (>55% and flexible hinges only) ROM should be at least ____% of the ROM without the socket
50 %
90
For the tension stability test the prosthesis should not slip more than ___" in relation to the residual limb, and no part of the prosthesis or harness should fail when a 50 lbs. distal load is applied
1"
91
For the Hook-Opening Facility (normal use) the wearer should be able to obtain full range of terminal device operation actively with the forearm flexed to ___degrees.
90 degrees
92
For the Hook -Opening Facility (at mouth and perineum) the wearer should be able to obtain at least ___% of full range of terminal device operation actively at the mouth and perineum.
70%
93
What are the four general types of Transradial elbow joints?
Flexible
Rigid
Step up
Locking
94
Flexible joints
Soft- fabric and leather
Metal
Allow free pronation and supination
95
What are the two types of rigid joints?
Single axis -
| Poly centric
96
What does the single axis rigid joints do?
Stabilizes socket preventing pronation and supination
97
What does the poly centric rigid joints do?
Increased distance from epicondyle axis to anterior socket trim
There by limiting tissue bunching in the bicipital fold
Therefore increasing elbow flexion
98
Rigid friction joints functions as what?
Trans-humeral prosthetics
| And allow positioning of elbow flexion/extension for small children
99
What patient population does the rigid friction joints used for?
Very short TR
| Elbow disarticulation pediatric amputees
100
Step -up joints allows for what?
Allows for increased flexion as the short residuum recedes into the humeral tissues beyond 90 degrees of flexion
Used with split socket
101
Step up joints are an alternative for what?
Alternative for very short <35% length
102
Residual limb activated locking hinge joints are used for who?
Very short TR with split socket
Uses split housing fair lead control cable
Functions as an elbow disarticulation system
103
Carlyle Formula
A= .19 x BH humerus length
B + C = .21 x BH forearm length
Forearm = .19/ .21 x Apt
104
Economy wrist
One of the least costly
105
Economy wrist with straps
Most durable wrist that can be purchased
106
Who is the economy wrist with straps indicated for?
Can be used for individuals with non functioning hand as the frame can be contoured around the hand
107
Who is the oval constant friction wrist
Long trans-radial patients
108
Which wrist is the shortest wrist unit in the market?
Wrist disarticulation friction wrist- allows for least space for a TD post.
109
Who does the CAPP Derlin Wrist indicated for?
For adults and children
| Ideal for cosmetic hands
110
What wrist is the shortest quick disconnect?
Wrist Disarticulation Quick change Wrist
111
Who is the wrist disarticulation quick change wrist indicated for?
Long TR or WD patients
112
Who is the wrist disarticulation contra indicated for?
Bilateral Amputees
| Requires PT to be able to grab and twist the ring for locking and unlocking the wrist
113
Which wrist unit is the shortest add-in flexion unit?
APRL child flexion unit
114
Who is the APRL child flexion unit indicated for?
Good for bilateral pediatric or long residuum adults that need flexion and rotation but don't have enough room for the full length Sierra wrist
115
Which is the most commonly prescribed wrist option?
Friction wrist
116
Who is the friction wrist indicated for?
Wrist disarticulation pts
117
Who is the flexion wrist indicated for?
Very important for bilateral patients
Unilateral patients
Useful for midline activities: eating, shaving, toileting
118
Who is the Sierra wrist flexion unit indicated for?
Bilateral patients who need additional assistance reaching midline activities to complete ADLs
119
Four function wrist
Combines the rotational wrist to create the four functions of wrist: wrist flexion, extension, supination, and pronation
120
Who is the four function wrist indicated for?
Bilateral considerations: allows for easier propositioning of the TD's
121
What's a contraindication for the four function wrist?
Low gadget tolerance
122
Five function wrist (Texas Assistive)
Combines a rotational wrist and flexion wrist, and quick disconnect to create the five functions of : wrist flexion, extension, supination, pronation, quick disconnect feature
123
Who is the five function (Texas Assistive) indicated for?
Bilateral considerations
124
Who is the five function (Texas Assistive) contraindicated for ?
Low gadget tolerance requiring extra training and coordination
125
Hands free tool changing station ( Texas Assistive Device) can be used with what device?
Texas Assistive Device quick disconnect set ups.
