Orthotics Flashcards by Chelsea Notton

Ox would be used for a 4 week post-burn to the entire volar aspect of the wrist and hand

WHO: Volar Ox

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opponens bar should be located

proximal to the thumb MP joint

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boutonnere defomity

PIP flexion and DIP hyperextension

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Swan neck deformity

PIP hyperextension and DIP flexion

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Pt is a 20 yo male with dx of T10 incomplete SCI which occurred in 2007. Ambulation exhibits moderate extensor spasticity with 10 deg knee hyperextension. Ankle control of choice is?

Solid AFO with 5 deg PF

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Type of prehension provided by a wrist driven tenodesis Ox

Three jaw chuck

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Extension at the MP joints is produced by

Extensor digitorum

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MOst important motor acquisition of the C5 quad is

Shoulders and elbow flexion

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Muscle grade of FAIR means the person is able to get through complete ROM

Against gravity

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C6 would have all the muscles intact except:
Biceps
Deltoids
Extensor carpi ulnaris
Pronator Teres

Extensor Carpi Ulnaris

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Colles Fx

Distal radius Fx

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Ulnar nerve lesion at the wrist will clinically be presented with

Hyperextension of 4th and 5th MP joints and positive Froment’s sign

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Clinical presentation of Claw hand will occur with which injury

Combined median and ulnar nerve injury and mid-forearm and below ulnar nerve injury

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Symptoms of Erb’s palsy

Internal rotation and adduction of humerus

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Complete SCI at C6, Pt would require what type of WHO

Hyperextension of MP joints and flexion of the IP joints of the 2-5th fingers

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The soft tissue Cx of the hand which is likely to develop following paralysis of the ulnar and median nerves include

Hyperextension of Mp joints and flexion of the IP joints of the 2nd-5th fingers

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A radial nerve injury at the elbow

WHO with a wrist extension assist

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Which component will be used by a pt with a 0-2 intrinsics and 3-4 extensor digitorum/flexor digitorum superficialis and profundus

MP extension stop

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Ox recommendation for a radial-ulnar nerve injury at the elbow

WHO with MP extension stop and 4th/5th IP extension assist

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The volar surface of the forearm contains the ______ muscles which as a group originate at the _____ humeral condyle

Wrist flexors, medial condyle

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The _____ interossei abduct and while the ______ interossei adduct

Dorsal, Palmar

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The movement of the thumb called opposition occurs at the

Carpometacarpal joint

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Nerve that innervates all of the anterior muscles of the arm

Musculocutaneous

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A C6 quad powers a wrist driven flexor hinges

Extensor carpi radialis longus and brevis

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General terms: Radial nerve of the brachial plexus innervates

Supinators and extensors

Most common MP joint deformity for digits 2-5 in RA is

Volar subluxation and ulnar deviation

Mobile segments of the hands proximal transverse arch are carpometacarpal joints

1-4-5

Radial nerve injury might require what additional component for the thumb on a HO

Thumb post

Total arc of motion of the wrist joint in the coronal plane

50 degrees

Goals for fitting an Inguinal Hernia Truss

-Place the Pt on their back with legs flexed (relaxes internal organs and allows gravity to assist in reducing the hernia into the inguinal tear -Reduce the hernia

Pt comes into office with an open draining odorous wound to their medial malleolus. You should...

-Wear protective equipment when making PE -Contact Pt's physician and advise them of your observations

Cauda Equina refers to

The nerve roots/fibers at the end of the spinal column

Measuring a Pt for a TLSO hyperextension Ox, the Pt should be

Supine and standing

Anterior displacement of the vertebral body on the next lower vertebrae is known as

Spondylolisthesis

Opposition of the thumb and index finger is known as

Tenodesis

Nerve most likely involved in the Pt with drop foot is the

Peroneal nerve (innervates the tibialis anterior muscle and when stimulated, causes concentric Cx of the muscle belly initiating a DF moment of the foot-ankle complex during normal gait

Desired wrist angle relative to the forearm in the "position of function" to pick up an object from a table is

30 degrees extension

Pt with radial nerve weakness would exhibit

Weakness when extending the wrist (Innervates the extensor musculature of the wrist)

Most common Tx regime for a Pt referred to your facility with Radial nerve palsy would be

Static flexion control Ox (Due to weakness in the extensor muscles resulting in wrist drop)

The Williams Flexion Spinal Ox differs from a APML style device in that it has a

Dynamic Superior band (sidebars are not attached directly to the pelvic band)

Superior margin of the Williams Flexion Ox

1" inferior to the inferior angle of the scapulae

Pt presentation of median nerve palsy

Inability to flex the wrist (median nerve innervates the flexors of the UE)

Arthritis affects the

Cartilage (Inflammation of the joint, wear of the cartilage of the synovial joints)

Main plantarflexors of the lower extremity

Gastroc and Soleus

Weight Bearing KAFO using a Thomas Ring to achieve suspension incorporates which bony prominence to take weight to un-weight the knee

Ischium (Thomas Rings is a shaped metal rod of at least 3/8" diameter in adults that when properly contoured, achieves a bony purchase on the ischium to achieve un-weighting the lower extremity limb)

Muscle group that extends the hip during gait is

Hamstrings (Extends the hip via a concentric contracture)

When taking an impression for a KAFO, for the best possible impression, it is important to use the Segmented impression procedure and

Posterior Popliteal rest (helps to assure that correct positioning of the impression will help to control recurvatum in the impression)

Visually impaired 70 y.o. male Pt is referred to your office with a Rx for a "hyperextension back brace" for an anterior thoracic compression Fx as a result of a fall at home. Upon PE, you find a male with marked kyphosis and significant arthritis of both hands. Your choice of Ox devices should include

Utilization of Velcro for the closure to adapt to the Pt's arthritis

14 y.o. with crouch gait. Types of Ox devices to consider

Custom molded floor reaction AFO with solid ankle and full footplate

The tibialis anterior fires concentrically during which cycle of gait

Toe Off (push off) (This Cx enables the foot to clear the floor in both DF and supination)

Most commonly prescribed position for fitting a Pt with a s/p rotator cuff repair

15 degrees abduction and elbow at 90 degrees

Morton's Neuroma

Neuroma is an inflammation of a nerve Common between the 3rd and 4th toes

Common treatment of Morton's Neuroma

Foot Orthotics Injection of Analgesic Injection of a Corticosteroid Accommodative footwear

Prune Belly Syndrome

Congenital anomaly involving the Pt with an absence of abdominal musculature

Prune Belly Syndrome Device

Custom flexible soft spinal support (requires the spinal support to assist in urination and bowel movements as well as support when sitting)

Ideal lesion level for Tx of an SCI Pt is with an RGO is

L1-L3 (Hip flexors are able to "drive" the Ox resulting in less energy expenditure and the ability to ambulate further in the RGO device)

C4 innervates what muscle actions

Diaphragm and shoulder elevators

Shoulder flexors and abductors Elbow Flexors

Wrist extensors

Elbow extensors (Triceps)

Finger flexors, extensors, and intrinsics

T1-T6

Upper trunk muscles

T7-T12

Lower trunk muscles

L1-L2

Hip flexors

Knee extensors

Ankle dorsiflexors

Toe extensors

S1-S5

Ankle plantarflexors, bowel, and bladder

An SCI Pt at the level of _____ will be able to feed themselves

C7 Patient with sparing of C7 has 3 important functional additions: -Triceps, common finger extensors, and long finger flexors

Latissimus Dorsi receives its initial innervation at this level

C6 Innervated from the thoracodorsal nerve

Tricep musculature receives its innervation at level

C7 Innervated from the radial nerve

Ability to grasp occurs through innervation at this level

Scheuermann's disease involves which area of the spine

Kyphosis of the Thoracic spine

Average age of Pt suffering from Scheuermann's disease is

Adolescents -Curve angles are usually 15-40 degrees -More exaggerated in females

Which nerve innervates the Quadricep muscles

Femoral Nerve L2-4

What is aponeurosis

Flattened tendon

Function of the Latissimus Dorsi on the humerus

Adducts, medially rotates, and extends the humerus C6-8

Serratus Anterior muscle

Abducts the scapula and rotates it Stabilizes vertebral border of scapula Draws scapula forward and upward Innervated by the long thoracic nerve

Paralysis of the arm caused bty injury to the upper group of the arm's main nerves during birth is known as

Erb's Palsy

Trauma to the anterior compartment of the shoulder resulting in a flail arm results in a disorder known as

Brachial Plexus damage (A nerve bundle ventral rami of the lower cervical and upper thoracic nerve roots of C5 vertebrae

Brachial plexus damage side effects

Brachial plexus innervates the deltoid muscle which is one of the primary supportive muscles that support the entire arm Without innervation, the result is dislocation of the Glenoid Humeral joint

Treatment of Brachial Plexus injury

A/C separation Ox (Arm flails through lack of muscular control) Goal is to support the arm and keep the glenoid humeral joint in place

In the operative suite, the area below the table is considered

Non-sterile