Orthotic Manufacturing Flashcards

1
Q

what position is the calcaneal bisection as the positive is made

A

perpendicular to the ground

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2
Q

when i the negative cast removed

A

when the plaster is hardened

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3
Q

what are the types of positive plaster modifications

A
  • FF platform
  • heel cup accommodation
  • arch fill
  • “sweet” spots
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4
Q

how is a FF platform created

A
  • nail is placed on the plantar sufrace of the 1st (for FF varus) OR 5th (for FF valgus) MT head to prop up the positive in the appropriate position
  • plaster is applied to build a platform at an angle dictated by the position of the nail
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5
Q

where is the calcaneal bisection when forming a FF platform

A

-perpendicular to the ground or FF may be “balanced” to RF

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6
Q

for a FF varus, where will the FF platform me thicker

A

medially

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7
Q

fore a FF valgus, where will the platform be thicker

A

laterally

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8
Q

how is a heel cup accommodation added

A

plaster is added around the periphery of the heel

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9
Q

what does a heel cup accommodation allow for

A

-soft tissue spread when the patient bears weight

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10
Q

where are arch fills added

A

to the medial arch to allow for soft tissue expansion and to provide a smooth transition into the FF platform

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11
Q

a minimal arch fill will provide for

A

greater control

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12
Q

a heavier arch fill will allow for

A

more flattening of the arch

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13
Q

how do you accommodate for “sweet spots”/bony prominence

A

add a small mound of plaster to the area of the prominence which will then lead to a pocket on the shell

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14
Q

what are the material requirements for the shell

A

heat moldable

able to hold their shape

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15
Q

where does a standard functional device extend to

A
  • just proximal to the MT heads distally
  • to the centre of the 1st MT medially
  • to the centre of the 5th MT laterally
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16
Q

is the device width dependent upon foot width

17
Q

the wider the device the —

A

greater the control

18
Q

the width of the device is highly dependent upon

A

the type of shoe in which the device will be work

19
Q

a wide device extends from

A

the medial side of the 1st MT head to the lateral side of the 5th MT head

20
Q

a normal device extends from

A

the centre of the 1st to the centre of the 5th

21
Q

a narrow device extends from

A

the lateral aspect of the 1st MT head to the medial aspect of the 5th MT head

22
Q

where is an extrinsic RF post applied to

23
Q

is an extrinsic post the same thing as a heel lift

24
Q

how do functional devices work

A
  • prevent excessive pronation
  • allow the STJ to function around its neutral position
  • prevent compensation
25
what are 3 functional device theories
1. pre-positioning of the foot 2. proprioceptive facilitations 3. altering the extrinsic moments
26
pre-positioning of the foot means that
- STJ neutral position - MTJ maximally pronated (locked) position b/c that is the ideal position of the foot in the middle of midstance as it prepares for the propulsive phase of gait
27
what phase of gait do most pathologies occur
propulsive phase
28
functional orthosis generally cannot control the motion of the foot during the propulsive phase, why?
-b/c so little of the foot (only the MT heads) is actually weight bearing
29
how do functional orthosis help control motion of the foot
- by placing the foot in an optimum position as it enters the propulsive phase - theoretically, the deleterious stresses will be minimized
30
how can orthoses prevent excessive pronation
- providing increased proprioceptive clues - allowing the patient to respond to the rate and amount of pronation more appropriately - the more direct contact you have on the plantar surface, the more cues you have about where your body is in space
31
what is posting
- bringing the ground up to the deformity | - eliminating the need for compensation
32
arch support provides for
- increased proprioceptive feed back | - allows for a surface in which posting may be used
33
does posting bring the ground up to the MT heads
NO! | Functional orthosis does not control MT head contact to the ground
33
how are osseous restraining mechanisms optimized
-by placing the foot in a more stable position
33
which part of the orthosis help prevent excessive pronation
- distal medial shell - anterior medial edge of the RF post - "anti-pronatory" pressure (extrinsic supinatory moment) at the distal medial calcaneal tuberosity (as determined by the contour of the heel cup)
34
a deep heel cup provides for ---- compared to a lesser heel cup
greater control
35
do functional orthosis function as an arch support
NO! | The arch area of the device is not a component to control pronation
35
heel cup helps control
- STJ motion | - minimize the amount of calcaneal inversion and eversion
35
control of the lateral column provides for
increased stability of the foot