Orthotic items and Bracing Flashcards
A soft cervical collar provides adequate support for fractures.
TRUE
FALSE
FALSE
Soft collars provide almost no immobilization, allowing 75-80% of normal motion and are not recommended for significant damage to ligaments or bones.
Hard cervical collars totally immobilize the head and neck.
TRUE
FALSE
FALSE
An example of a CTO is:
a. SOMI
b. Minerva
c. Miami JTO
d. Aspen CTO
e. all of the above
e. all of the above
SOMI - sternal occipital mandible immobilizer
Minerva - CTO w/ occipital component
Miami JTO & Aspen CTO - both rigid, semi-rigid cervical collar
Which measurement are required for cervical collars:
a. Neck circumference just below the chin.
b. After placing the head in the prescribed position (neutral, extension, hyperextension) measure the circumference of the neck and and a height from the tip of the mandible to the sternal notch
c. Place the head forward facing and measure the circumference of the neck where it meets the shoulder and the bottom of the chin to the sternum
b. After placing the head in the prescribed position (neutral, extension, hyperextension) measure the circumference of the neck and and a height from the tip of the mandible to the sternal notch
When fitting a patient with a pavlik harness, you would be concerned with this?
a. social history
b. diabetes mellitus
c. rigidity of the brace
a. social history
A Pavlik harness is used in the treatment of hip dysplasia in infants. Social History is important because the parents or caregivers must be responsible to keep the harness donned correctly. DM would not play as a role, and the brace is not rigid
If a patient receives a functional walking boot, you will always instruct them how to bare full weight.
a. True
b. False
b. False
You would not instruct patient to bare weight unless physician has expressed for you to do so. The boot can be ordered for a NWB (non weight bearing status)
A patient calls with a prescription from their physician to fit a back brace and the diagnosis is lower back pain and scoliosis. How should the fitter proceed?
a. measure the patient and order a prefabricated scoliosis corrective brace?
b. Tell the patient they will have o take the prescription to an orthotist
c. obtain more information
c. obtain more information
You don’t have adequate info to know if the brace is for corrective scoliosis. Many elderly patients have scoliosis and can have back pain. First there is a need to assess the patient.
An acute syndesmosis sprain is best fit with:
a. A walking boot
b. a ROM knee brace
c. An elastic ankle brace
a. A walking boot
Also known as a high ankle sprain. A walker boot is the best option of the three, and an elastic ankle brace would not give necessary support
When measuring a patient pre-operatively for a post-operative prefabricated LSO, you, the fitter, should always:
a. Have the patient prone
b. Face the patient facing in a mirror
c. Sit on stool
c. Sit on stool
For patient modesty and also to have an eye level view, a fitter should sit to measure LSO
A person with a ganglion cyst can receive this type of brace:
I. cock up wrist brace
II. Walker boot
III. Thumb brace
a. I only
b. I & II
c. III only
d. All of the above
d All of the above
Ganglion cyst can develop around tendons in the hand or foot. So each item could work. Most frequently located on the wrist or fingers.
Fitting all OTS (off the shelf) braces is within the scope of practice for an orthotic fitter:
a. true
b. false
b. false
Regardless of custom fab or OTS, spinal bracing for an unstable spine is not within your scope of practice, also fitting a fracture brace for long bone at the initial stabilization is not in the scope of practice for an Orthotic Fitter.
An infant correctly fit in a pavlik harness the hips are held in:
a. extension and internal rotation
b. extension and adduction
c. flexion and abduction
d. flexion and internal rotation
c. flexion and abduction
Hips are flexed and in abduction.
What is the best position for the patient while tightening a spinal orthosis?
a. standing
b. supine
c. prone
d. sitting
b. supine
Supine is the best position to fit for support and compression
When fitting a tibial fracture brace, the primary use of the shoe insert is to:
a. preventing migration of the brace
b. allow plantar flexion
c. prevent inversion and eversion of the foot
c. prevent inversion and eversion of the foot
Key word is primary use, you can wear the brace without the shoe so migration isn’t the reason for the insert.
When fitting a tibial fracture brace, where should a metatarsal pad be located?
a. lateral to the metatarsal heads
b. proximal to the metatarsal heads
c. distal to the metatarsal heads
d. medial to the metatarsal heads
b. proximal to the metatarsal heads
Pads are used to unload the metatarsal heads and transfer the weight off the met heads you accomplish this by placing the pad before near the arch which is proximal to the met heads.
When measuring a patient for therapeutic shoes you should have the patient:
a. sit with hips and knees at 90 degrees
b. stand with weight on one leg
c. Stand with feet shoulder length apart
d. remove their socks
c. Stand with feet shoulder length apart
For correctly measuring for shoes it is in a standing position,. Especially for someone with foot problems associated with DM. Their foot can change drastically with weight bearing.
When fitting a patient with a WHO, the most functional position would be:
a. slightly extended
b. slightly flexed
c. fully extended
d. fully flexed
a. slightly extended
functional position for splinting the hand, including the wrist and fingers, consists of dorsiflexing both the wrist between 20 and 35 degrees and the proximal interphalangeal joints between 45 and 60 degrees. The thumb is abducted and in opposition and alignment with the pads of the fingers.
If a patient comes to you with a prescription for an orthosis for CMC arthritis, you should provide what brace?
a. ankle brace
b. thumb brace
c. elbow brace
b. thumb brace
CMC arthritis, also known as basal joint arthritis or thumb arthritis, has to be in the hand so of the choice given the thumb is the only correct answer
A patient has an acute compression fracture at T11 level. What type of orthosis is best to provide for this fracture?
a. LSO clamshell
b. Dorsolumbar corset
c. Jewett Hyperextension Orthosis
c. Jewett Hyperextension Orthosis
Jewett is correct since it is acute and the LSO would be insufficient for a T12 fx. This dx requires hyperextension limitation
An EO could be ordered for all of these conditions except:
a. post-op biceps repair
b. epicondylitis
C. Olecranon Fracture
d. Colles Fracture
d. Colles Fracture
EO stands for Elbow Orthosis. Colles Fracture is a distal Radius fracture, which is in the wrist. It is the only diagnosis that you would not use an Elbow Orthoses for.
Which of the products below would provide the most cervical stabilization?
a. Philadelphia collar
b. Miami J
c. ACE
d. soft collar
b. Miami J
gives the most stabilization w/ thoracic extension
The Miami J provides stabilization w/ thoracic extension because:
a. material
b. length of lateral support
c. length of anterior support
c. length of anterior support
The length of the anterior support is the best answer
The difference between an LO and an LSO is the length.
a. true
b. false
a. true
The LSO is longer.
When fitting an LSO corset, the side laces for a traditional fit should have a/an_______ opening on the lateral side after tightening.
a. 4 inches
b. 1 1/2 inches
c. 3 Inches
b. 1 1/2 inches
You need enough opening to tighten for compression and the instructions for the products call for 1 ½ inches
A functional knee orthosis for an ACL insufficiency should:
a. prevent hyperextension
b. limit flexion
c. prevent de-rotation
a. prevent hyperextension
goal to resist the anterior translation of tibia in relationship to the fibula so the brace used to aid or protect it must limit extension.
What type of heel wedge would you place in the shoe for patient with knees pointed in who recently underwent a lateral meniscectomy?
a. 1” lateral wedge
b. 3/16 “ lateral wedge
c. 3/16” medial wedge
c. 3/16” medial wedge
With a valgus knee you have to lift the medial side
Posterior Tibialis tendon dysfunction could be treated with:
a. Ponseti brace
b. a lateral heel wedge
c. an arch support
c. an arch support
Common condition of the foot is loss of medial arch
A Ponseti brace is used to address clubfoot - keeps the corrected foot growing like it should.
A hernia truss fit worn as instructed will cure a hernia.
a. true
b. false
b. false
Only surgery will cure a hernia.
What might you need to do to a functional knee brace when the patient complains it is falling down their leg?
a. use bending irons to contour the uprights
b. make sure the suspension strap is distal to the gastric
c. tell the patient all braces migrate and they will get used to it.
a. use bending irons to contour the uprights
You could do/offer all 3 however only A would offer any benefit. Remember it is the best answer of the answers given.
A walking boot is an ideal brace to use during early stages of fracture healing, when a non-removeable device is necessary.
a. True
b. false
b. false
Non removable is the key word. Boots are removable.
When measuring for a Jewett brace which measurement would not apply?
a. sternal notch
b. trochanter circumference
c. suprascapular to coccyx
b. trochanter circumference
Of the 3 options the scapular to coccyx is not a necessary measurement since a Jewett brace only has a thoracic pad posteriorly.
The Jewett brace, a TLSO, is designed to give support to your thoracic and lumbar spine by preventing twisting and flexion (bending forward).
Which device would you use for jumper’s knee?
a. patellar strap
b. functional knee brace
c. arch supports
a. patellar strap
Best answer is patellar strap to give counterforce to prevent pull of the patellar tendon.
Jumpers knee or patella tendonitis is pain at base of the patella or kneecap. It is often an overuse injury.
All of the following are functional goals for lower extremity orthoses except:
a. Maintenance or correction of body segment
b. Relief of distal weightbearing forces
c. Increased ground reaction forces
d. Assistance or resistance to joint motion
c. Increased ground reaction forces
Which of these orthoses has a more proximal trim line?
a. AFO
b. HKAFO
c. FO
d. KAFO
b. HKAFO - The HKAFO is a custom-molded plastic shell with contoured metal uprights and a pelvic band that provides support and correction to the hip, knee, ankle and foot. An HKAFO improves body alignment and posture, increases bone and muscle strength, and enhances independence and self-esteem.
AFO - Ankle-foot orthoses are among the most commonly prescribed lower limb orthoses.
FO - Foot orthoses, commonly called orthotics, are specially designed shoe inserts that help support the feet and improve foot posture.
KAFO - A knee-ankle-foot orthosis is a shell with contoured metal uprights and variety of knee joints to provide support and correction to knee, ankle and foot.
This brace looks like a hinged knee brace, but it actually slightly pushes the knee out laterally:
a. PCL brace
b. ACL brace
c. MCL brace
d. OA brace
d. OA brace
Arthritic or post CVA patients are best served with this type of closure:
a. Buttons
b. Snap
c. Hook and Loop
d. Laces
c. Hook and Loop
Spinal bracing helps to control back pain by all of these except:
a. Unloading vertebrae
b. Limiting motion
c. Allowing free vertebral motion
d. Unloading discs
c. Allowing free vertebral motion
These are used to de-weight spinal structures by increasing abdominal compression:
a. Cervical Orthoses (CO)
b. Corsets
c. Sacroiliac Orthoses (SIO)
d. Cervicothoracic (CTO) orthoses
b. Corsets
Thermoplastic panels added to a corset:
a. Enhance A/P control
b. Decrease M/L control
c. Enhance M/L control
d. Decrease A/P control
a. Enhance A/P control
Static Orthoses allows restricted range of motion against resistance at a fixed angle.
a. True
b. False
b. False
A static orthosis is used to immobilize or restrict motion at a joint. It is stiff and holds a given body part in a safe position. This type of orthosis does not apply any over-pressure or stretch to the body part(s) it covers.
These orthoses usually offer additional immobilization for the thumb area. They are indicated for soft tissue injuries, gamekeeper injuries, collateral ligament support and avulsion fractures of the thumb:
a. Wrist-Hand-Finger Orthosis
b. Thumb Spica
c. Wrist-Hand Cock-Up Splint
d. Wrist-Hand Orthosis
b. Thumb Spica
Classic way to splint the hand after a stroke with thumb in full opposition, wrist in dorsiflexion, and MP joints flexed:
a. Wrist-Hand-Finger Orthosis
b. Wrist-Hand Cock-Up Splint
c. Thumb Spica
d. Wrist-Hand Orthosis
b. Wrist-Hand Cock-Up Splint
A Shoulder Orthosis provides _______ pressure on the forearm/elbow:
a. No
b. Lateral
c. Upward
d. Downward
c. Upward
Each of these would be true of the use of assistive devices during ambulation except:
a. Assists in control of abnormal biomechanics
b. Increase in foot pressures
c. Decreases joint forces
d. Assists in balance
b. Increase in foot pressures
Three point force system entails:
a. Two counteractive forces are positioned on the opposite side above and below the corrective force
b. The corrective force is located on the convex side of the curve at the joint addressed
c. Affecting alignment by controlling two adjacent skeletal segments
a. Two counteractive forces are positioned on the opposite side above and below the corrective force
The Three-Point Force System (also known as the Three-Point Pressure System) is paramount to creating an orthosis. In this system, a primary force is applied, generally at the joint to be corrected, and counterforces are applied both above and below the primary force.
These orthoses may also serve as kinesthetic reminders to limit motion or avoid undesirable posture:
a. Lower Extremity
b. Upper Extremity
c. Spinal
c. Spinal
The Philadelphia Collar is made of what material?
a. Co-Poly
b. EVA
c. Kydex
d. Plastazote
d. Plastazote
Co-Poly
EVA
Kydex
The Aspen was the most effective collar at restricting movement in all three planes through physiological ranges. The Philadelphia collar was effective at restricting flexion/extension movements.
a. True
b . False
a. True
In compression hose, the maximum compression is achieved here:
a. At the heel
b. In the forefoot
c. In the calf
d. In the ankle
d. In the ankle
Depending on the disease type, compression stockings may exert compression on a particular leg part of up to 67 hPa (50 mmHg). The strongest compression in medical compression or therapeutic stockings is typically above the ankle and gradually decreases toward the crotch.
All of these are indications for compression garments except:
a. Lymphedema
b. Peripheral Neuropathy
c. Varicose Veins
d. Burn Scar
b. Peripheral Neuropathy
Which of these degrees of compression hose could be purchased over the counter?
a. 40-50 mmHg
b. 20-30 mmHg
c. 30-40 mmHg
d. 10-20 mm Hg
d. 10-20 mm Hg
These compression garments are worn when the patient is non-ambulatory or post-surgical to help prevent pooling of blood in the legs that could lead to a venous thrombosis:
a. Anti-embolism
b. Silver
c. Lymphedema
d. Support stockings
a. Anti-embolism
Once the orthosis is delivered to the facility and in the fitter’s hands, it should be:
a. Permanently labeled with the patients name
b. Billed to the patient
c. Quality checked
d. Fit to the patient
c. Quality checked
Before you fit the orthosis you need to _____the patient.
a. walk with
b. bill
c. warn
d. communicate with
d. communicate with
The patient should be positioned so as:
a. to have their feet higher than their heart
b. to not let them see what you are doing
c. to make it efficient and effective to fit the orthosis
d. to maximize their personal comfort
c. to make it efficient and effective to fit the orthosis
In dealing with patient modesty, the best advice is:
a. close your eyes while fitting the brace
b. do not fit the brace if it will make you uncomfortable
c. be minimally invasive
d. do not fit the brace if it will make them uncomfortable
c. be minimally invasive
Initial fitting of the orthosis should be done:
a. on yourself first in front of the patient so that they know you know what you are doing
b. before measuring
c. as quickly as possible
d. according to the manufacturers guidelines
d. according to the manufacturers guidelines
The first priority when fitting a brace is:
a. proper fit and alignment
b. comfort
c. color
d. appearance
a. proper fit and alignment
The brace should be:
a. Snug
b. Painful
c. Loose
d. Constricting
a. Snug
What material is a lightweight, closed-cell, cross-linked polyethylene foam often used in foam collars and foot orthotics?
Select one:
a. Aliplast
b. Plastazote
c. P-Cell
d. EVA
b. Plastazote
Which of these materials softens when heated and hardens when cooled, retaining the new shape? It is often used when a stiff, semi-rigid material is required in an orthotic.
Select one:
a. Polyethylene
b. Nickelplast
c. Neolon
d. Polypropylene
d. Polypropylene
What is the common term for “hook and loop”?
Select one:
a. Poron
b. Nylon
c. Pile
d. Velcro
d. Velcro
If the brace does not appear to fit correctly:
Select one:
a. Use it anyway
b. Return it to the vendor or inventory
c. Dispose of it
d. Remove it and try again
d. Remove it and try again
You are visiting with a new patient who has some occasional swelling in her feet and legs. She asks you about Compression Garments and wants to know what conditions they are used to treat. Which of these conditions would be contraindicated when using Compression Garments?
Select one:
a. Lymphedema
b. Ischemia
c. Burn Scars
d. Varicose Veins
b. Ischemia