Midterm #2 (Lecture 18 - Amputation)

Question 1

Definition of amputation

Answer 1

To cut or remove from the body

Question 2

Person-first language descriptor

Answer 2

A person with an amputation

Question 3

Cultural language model description (how might the individual describe themselves?)

Answer 3

Amputee

Question 4

Other words for the area of amputation?

Answer 4

Residual limb, or stump
Or just arm/leg

Question 5

Today, amputation can sometimes be avoided due to ________ in ______________ surgery

Answer 5

advances
reconstructive

Question 6

Why is the level of amputation so important?

Answer 6

The goal is to remove harmful tissue
(diseased, infected, gangrenous)
to allow limb to heal, while trying
to retain adequate limb length for
prosthetic fitting and
rehab
Usually try to preserve the joint to allow for more movement, daily living can be quite difficult if the joint is also amputated
Skin grafts can also be used to help if there’s dead tissue

Question 7

What are the conditions that lead to amputation?

Answer 7

Trauma (70%): motor vehicle accidents, farming and workplace accidents, violence, frostbite
- Less common because of advances
Tumor: osteosarcoma (most common type of malignant bone cancer)
- younger people in their 20s (Terry Fox)
- femur, tibia, or humerous
- involves bone pain, swelling, and a limp
- Less common because of medical advancements
Infection: MANY kinds
Peripheral vascular disease: disorder of circulatory system, limb could die because of cut-off circulation
- Ex. atherosclerosis of peripheral arteries
- 80% of all amputations (because of increasing obesity)
Diabetic neuropathy: uncontrolled blood glucose levels lead to damage of nerve cells (causes death of limbs)
- Hand-in-hand with peripheral vascular disease
Congenital defects: failure of formation, overgrowth, undergrowth, or general skeletal abnormalities at birth
- Upper limb deficiencies are 60% of newborn congenital abnormalities

Question 8

Concerns after amputation

Answer 8

Pain
Skin problems
Circulatory disturbance – especially if peripheral vascular disease is still a problem in the area
Local osteopenia – lower bone mineral density
Muscle atrophy – from the inability to contract (no insertion) or disuse
Edema – modifies the fit of the prosthetic; can be painful
Psychological and social adjustment

Question 9

Types of post-amputation pain

Answer 9

Residual limb pain: pain in the portion of the area, may be related to prosthetic wear
Back pain: especially in people with leg amputations, may be related to prosthetic wear
Phantom limb pain: – painful sensations in the area (may also be non-painful, ex. itching), mirror therapy can help!

Question 10

Concerns with skin post-amputation

Answer 10

Due to prosthetic wear or hygiene practices:
Erosion/abrasion/blisters: irritation of the skin because of friction, high pressure points
Ulcerations: break down of the skin because of pressure, friction, laceration, or poor circulation (like pressure sores post-SCI)
Skin infection / irritation – bacterial infections or contact with something causing an irritative reaction (redness, itchiness, burning, swelling)