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Prosth/Ortho > Orthotics > Flashcards

Orthotics Flashcards

1
Q

Orthosis is commonly known as

it is an orthopedic device that is applied …

A

a brace or splint

externally to the limb or body

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2
Q

What is an orthotist

what do they do

A

health pros who provide care to pts w/ neuromuscular and muskulo impairments that contribute to functional limitations and disability

they design, frabricate, and fit pt for an orthosis

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2
Q

Purpose of orthotics

A

provide support, protection and replacement of lost function

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3
Q

Responsibilities of an orthotist

A

1 evaluate pt for needs
2 design device
3 select material and component
4 fabricate the device
5 evaluate fit
6 educate pt

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4
Q

Prosthesis

purpose

it can ____ or _____

A

an artifical body part replacement

retrieve function or cosmetic

external or internal

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5
Q

Difference between orthotic / prosthetic

A

O: added onto body
P: replacement

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6
Q

What is a prosthesis

what do they do

A

health pro who provides care to pt w/ partial or total absence of a limb

design, fabricate, and fit pt for prosthesis

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7
Q

Responsibilities of an prosthetist

A

1 design device
2 select material and component
3 fabricate device
4 evaluate fit
5 educate pt

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8
Q

Examples of pros in rehab team

A

PT, nurse, dietitian, social worker, physician

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9
Q

Assessment for lower extremity orthosis - body structure and function

A

joint
alignment of limb
leg length
sensory assessment
skin condition/ vascular supply
motor function

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9
Q

Things that are assessed for ICF

A

body structure and function, activities (functional limitations), participation (restrictions)

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10
Q

Assessment for lower extremity orthosis - body structure and function.

joint specific tests (ALOT)

A

ROM - goni, prom, contracture, thomas test, flexion, extension of hip, thomas test, ober test, hip joint stability, knee joint stability MCL ACL LCL, ankle joint stability

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11
Q

GRF has nothing to do with

A

angulation

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11
Q

Normal hip alignment angle of inclination

A

125 degrees

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12
Q

JRF is max in coxa ____

A

valga

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13
Q

Children with anteversion have in-toeing and often prefer

A

W sitting

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14
Q

Assessment for lower extremity orthosis - body structure and function.

alignment of limb segment

A

hip alignment (valgum, varum, recurvatum, normal)

knee alignment

ankle and forefoot alignment

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15
Q

Valgum and varum only affect the knee not the ____

A

BOS

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16
Q

Assessment for lower extremity orthosis - body structure and function.

sensory assessment

A

pt eyes closed, have them answer yes when they feel a point

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17
Q

Assessment for lower extremity orthosis - body structure and function.

leg length

A

differentiate leg discrepancies, asses segmental and total leg length

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17
Q

Assessment for lower extremity orthosis - body structure and function.

skin condition/ vascular supply

A

skin color
hydration
temperature
wounds
prolonged arterial capillary refill time

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18
Q

Assessment for lower extremity orthosis - body structure and function.

motor function

A

muscle tone
spasticity in UMN
flaccid in LMN
muscle strength and endurance
dynamic strength

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19
Q

Muscle tone

A

resistance to passive movement

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20
Q

Negative affects for orthosis

A

atrophy of immobilized muscles
carry more weight

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21
Q

We want ____ orthotic trx for the pt

A

minimal

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22
Q

Gait efficiency is more important than reduction in

A

compensatory gait deficit

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23
Q

Steppage gait

symptoms

causes

A

foot drop

drop foot and toes while walking

neurom disorder, impaired dorsifl

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24
Q

Injury to C2 - C3 level of impairement?
Rehab potential?

A

-usually fatal as a result of inability to breathe
-totally dependent for all care

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25
Q

Injury to C4 level of impairement?
Rehab potential?

A

-quadriplegia and breathing difficulty
-dependent for all cares; usually needs a ventilator

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26
Q

Injury to C6 level of impairment?
Rehab potential?

A

-quadriplegia with some shoulder and elbow and wrist function
-may be able to help feed, groom, and dress self, dependent on other transfers

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27
Q

Injury to C5 level of impairement?
Rehab potential?

A

-quadriplegia with some shoulder and elbow function
-may be able to feed self with AD, usually does not need ventilator but other types of respiratory support

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28
Q

Injury to C7 level of impairment?
Rehab potential?

A

-quadriplegia with some shoulder and elbow, wrist, hand function
-may be able to propel wheelchair inside on smooth surfaces, drive with adaptations, bowel and bladder programs

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29
Q

Injury to C8 level of impairement?
Rehab potential?

A

-quadriplegia with normal arm function; hand weakness
-may be able to propel wheelchair inside on smooth surfaces, drive with adaptations, bowel and bladder programs

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30
Q

Injury to T1-T6 level of impairment?
Rehab potential?

A

-paraplegia with loss of function below mid-chest; full control of arms
-independent with self care and in wheelchair; able to be employed full time

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31
Q

The 7 Steps of the Gait Cycle

Categorize into Stance vs Swing phase

A

Stance phase

Heel Strike (initial contact)
Loading response (flat foot)
Midstance
Terminal stance (heel off)
Preswing (toe off)
Swing phase

Initial and Mid swing
Terminal swing

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31
Q

Injury to T6-T12 level of impairment?
Rehab potential?

A

-paraplegia with loss of function below the waist; good control of torso
-good sitting balance; greater ability for operation of a wheelchair and athletic activities

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32
Q

Injury to L1-L5 level of impairment?
Rehab potential?

A

-paraplegia with varying degrees of muscle involvement in the legs
-may be able to walk short distances with braces and AD

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33
Q

Massachusettes General Hospital functional amb classification

A

1: non functional amb
2: require assistance
3: require light touch assistance
4: need of verbal cueing or occasional assist
5: indep amb of level surfaces
6: indep amb in all surfaces

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34
Q

Crouch gait symptoms (3)

it is often seen in combo with

results from

A

-exaggerated knee and hip flexion
-persistent flexion of knee during stance
-overact of hammy and weak calf

  • combo with toe walking

-spastic diplegic cerebral palsy

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35
Q

Stiff knee/hip gait cause
results from

A

insufficient flexion of knee during swing
CP

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36
Q

Antalgic gait

results from

A

lateral lean of trunk to bring COG over joint to reduce loading

pain or fracture of hip joint

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36
Q

Hemiplegic gait symptoms (4)

results from

A

1 LE held in extension
2 unilateral weakness and spasticity
3 UE held in flexion
4 cirumduction

stroke, CVA

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37
Q

Glut max gait

result from

A

backward lean of trunk (scared of falling forwards)

paralysis of glut max

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38
Q

Purpose of documentation prescription guidelines

what does it record

A

define anatomic segment that requires orthotic trx
describe biomechanical control needed for trx

functional limitation (sensational, contractures)
physical impairments
general patient information

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39
Q

Anatomic segments fro which an orthotic device is being considered (3)

A

Volitional force
Hypertonicity
Proprioception

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40
Q

Biomechanics control functions
F
A
R
S
V
H
L

A

free
assisit
resisit
stop
variable
hold
lock

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41
Q

Spinal levels for ADL and bed skills

A

C1-C3

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42
Q

Spinal levels for wheelchair skills (independent with manual wheelchair)

A

C5

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43
Q

Spinal levels for transfer skills (independent without sliding board)

A

C7

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44
Q

Spinal levels for independent in light housekeeping and driving with hand controlled cars

A

C8-T1

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45
Q

Spinal levels for household ambulation

A

T9-T12

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46
Q

Spinal levels for functional ambulation

A

L1-L5

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47
Q

The materials in O&P are tested for (4)

A

strength
stiffness
durability
density

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48
Q

Leather is a good material to use because (3)

A

-does not create allergies (good for people who are highly allergic)
-dimensional stability
-moldability

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48
Q

Steal can be negative because of the

good because

A

extra weight

stress occurs without an increase in stretch, durability

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49
Q

Wood is good because it

A

does not create any allergies and is strong

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49
Q

Titanium and magnesium are ______
and have the _____

A

expensive, strength of steel/ length of aluminum

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50
Q

Low temp thermo plastics can be

weaker than

problem?

usually used for

A

less then 176 degrees F can be applied directly to the body

high temp

will soften and lose shape if left in hot car

UE

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51
Q

High temp thermo plastics are used for

A

LE orthotics

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51
Q

Low temperature thermo plastics less than ____ degrees F

A

300

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52
Q

Applied over a positive model in liquid and then chemically cured

A

thermosetting

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52
Q

Most common laminates

A

acrylic (#1), polyester, epoxy

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53
Q

Open cell foamed plastics

Closed cell

A

cells are interrelated (sponge)
cells are separated (less likely to absorb body fluids such as urine or perspiration)

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54
Q

Where would you place the three points of pressure to correct genu valgum on a knee orthosis?

A

laterally above knee
medially at knee
laterally below knee

54
Q

Viscoelastic polymers have

A

stress relaxation and creep (memory foam)

55
Q

Flexible deformity

Fixed deformity

A

can be fixed manually

can adjust or provide comfort or work around it, cannot be fixed

56
Q

CAD/CAM

fabrication?

positives

they have a high

A

computer aided design/ manufacteror

CNC machine carves cast

simplicity, low cost

return rate

57
Q

4 points of pressure is used for

A

prevent hyperextension in genurecurvatum, sagittal plane translatory motion in unstable knee

57
Q

Examples of LE orthosis

A

Foot, ankle foot, knee ankle foot, hip knee ankle foot, knee, hip

57
Q

The principle for orthotic design for LE

A

3 points of pressure

58
Q

To control a proximal joint it is not always necessary to

A

make an orthosis that extends beyond that joint proximally

59
Q

Orthotic weight is determined by

A

the material and how much of the limb is encompassed by the device

60
Q

Able to get out of a wheelchair or bed and walk for a reasonable distance - may use AD

A

community walker

61
Q

Able to walk within home with relative independence and need help to get out of bed or wheelchair

A

Household walker

62
Q

No molding, tracing is _______

A

conventional

63
Q

AFO, no braces are ______

A

molded

63
Q

Local vs central manufacturing which is more expensive

A

local most expensive

64
Q

+/- with conventional

A

Pt doomed to where same shoe all the time but better control of leg

64
Q

Hybrid

A

components of traditional and molded

65
Q

Hybrid is usually in ____ shoes

A

athletic shoes

66
Q

Limb cuffs, shells, and shoe insert are usually _______ with _______

A

molded, articulations (hinged, moving joints)

67
Q
A
67
Q

Blucher vs Bal pattern of shoe anatomy

which shoes have Blucher

A

blucher better: has better opening can put shoe on more comfy, all athletic shoes usually have this
bal: NO

68
Q

Proper fitting of a shoe is important for

Ill fitting shoes may cause

A

diabetes, arthritis, other foot disorders

bunions, hammertoes, claw, mallet, neuromos

69
Q

Types of children corrective shoes

A

conventional, straight, outflare, inflare, reverse

70
Q

Pediatric foot (in toeing) is due to

A

positional factors utero and during sleep, muscle imbalance

70
Q

Cause of flexible flat foot

trx

A

hereditary ligamentous laxity

a shoe that corrects heel valgus, support arch, pronate forefoot

70
Q

Trx for metatarsus adductus

internal tibial torsion

internal femroal torsion

A

out flared shoe

Dennis Browne bars

no trx, encourage x sitiign

71
Q

Reasons for toe walking

trx

A

utero or congenital shortening of Achilles tendon, early signs of CP, MD

up until age 4: stretching AFO

71
Q

Out toeing is due to

trx

A

sleeping in frog position/ soft tissue contracture

no footwear treatment

72
Q

Severe valgus of the heel

trx

may persist in adolescence into

A

calcaneovalgus in pediatrics

stretching / serial casting for sever cases

pes planus

73
Q

Trx of clubfoot or equinovarus

A

serial casting, surgery, dennis brown bars

74
Q

Trx of hallux valgus (bunion)

A

orthotics, comfy shoes

75
Q

Walking shoes should have

A

thomas heel, shock absorption heel and sole

76
Q

Special considerations for pregnancy conditions:

older adults:

A

edema, LBP, changes in COM, no high heels

walking or running shoes

77
Q

Used to protect feet that are vulnerable due to vascular insufficiency, neuropathy or deformity

A

thermold footwear

77
Q

Basketball vs running shoe

A

B: mediolateral stability
R: more cushion

78
Q

Advantage of wearing socks

A

shock absorption, shield skin, prevent skin irritation

79
Q

Temporary protective shoe for pt with sensitive or ulcerated feet

what do they allow

A

plastazote / heeling sandal

ambulation without pressure on the healing area

80
Q

Lifts and leg discrepancy shoes are for

A

leg length discrepancy of 9mm or more

81
Q

Leg length discrepencies can be due to

A

shortening on one side or lengthening on other side (PF contracture)

82
Q

Barton wedge is for

A

severe flexible pronation deformities or supination

83
Q

Heel wedging used to

medial heel wedge:
lateral:

A

alter lines of stress

flexible valgus of calc
flexible varus of calc

84
Q

Sole wedging is for

A

inversion/eversion effect of forefoot

85
Q

Metatarsal bars, rigid leather rocker sole and extended crepe rocker bar are located, what do they reduce, what pt are they for

A

posterior to met heads, reduce pressure at met head during push off, for pt with transmeta amputation, diabetes

86
Q

Leather around the deforimity area is cut off and replaced with a softer material

A

blowout patch

87
Q

irritation of plantar digital nerves around the head of MTs due to presure and or atrophy of MT fat pad

trx

A

metatarsalgia

shoe with wide width, high toe box

88
Q

Trx for inflammation of sesamoid

A

transverse MT bar, rocker sole

89
Q

Trx of morton’s syndrome

A

shoe with long medial counter, thomas heel

90
Q

Trx for hallux valgus bunion, hammertoe, claw, mallet toes

A

long and wide shoe

91
Q

Trx for pes planus

pes cavus

plantar fasciatis

A

thomas heel

firm heel counter

high heel to reduce tension

92
Q

THKAFO

A

trunk hip knee ankle foot orthosis

93
Q

PRQS for safe, energy efficient functional gait

A

enough stability of LE tolerate weight
clearance of foot during swing
prep for initial contact
control motion ankle knee hip joint

94
Q

tibia advances over the ankle foot

from heel rise to push off

A

ankle rocker

toe rocker

95
Q

What happens during heel rocker

A

eccentric contraction of quad, tib anterior prevents foot slap, protects knee against GRF

96
Q

AFO functions 3

A

assist resist block

97
Q

Df assist PF assist conventional double upright

A

prevent foot drop

98
Q

Conventional AFO uses

A

thermoplastic

99
Q

Models of AFO

A

UCBL, SMO, DAFO

100
Q

Immobilizers are good for

A

after surgery

101
Q

Anterior floor reaction AFO good for (2)

bad for

A

pt with weak quad, fixed flexion contracture

recurvatum cases

102
Q

Prophylactic knee orthoses are for

Functional knee orthoses are for

A

attempt to prevent injury

to provide additional protection

103
Q

Functions of dynamic knee orthoses

A

gentle, controlled, adjustable constant force, low load, for nighttime use

104
Q

Lenox Hill brace

A

supports moderate to severe knee instabilities for both non operative and post operative knee reconstruction pts

105
Q

Patellofemoral joint orthoses used to

A

control tracking

105
Q

Knee guard that helps reduce medial or lateral instability

A

McDavid knee guard

105
Q

Compare and contrast conventional vs thermoplastic KAFO

A

conventional: strong durable, heavy, less cosmetic
thermoplastic: light weight, interchangeable shoes

106
Q

Compare and contrast conventional vs thermoplastic KAFO

indications

A

c: significant obesity, uncontrolled edema
t: control of transverse plane motion is needed

107
Q

Compare and contrast conventional vs thermoplastic KAFO

contraindications

A

c: control of transverse plane motion is needed

i: obese, edema

108
Q

The offset joint and basic drop ring or pawl locks are contrain in the presence of a

A

knee flexion contracture

109
Q

light weight variation of KAFO

indications

A

Craig-Scot orthosis

parapkegia T10 SCI

110
Q

HKAFO common for (3)

A

polio, SCI, CP

110
Q

When bilateral KAFOs are used pt cannot …..

A

pt cannot ambulate w/o AD, need to be able to stand wb

111
Q

Center rotation of hip is located

A

little above greater trochanter

111
Q

Pavlik Harness

includes

A

to treat young babies with developmental dysplasia of the hip

chest, shoulder, calf, and front leg strap

112
Q

A system that incorporates a rigid body brace, hip joint, stable knees ankle and shoe plate

A

THKAFO - parawalkers (hip guidance orthosis)

113
Q

THKAFO that uses a dual cable system couple flexion of one hip with extension of other

usually used for

used in combo with

A

Reciprocating gait orthosis RGO

active individual, not for inactive pt

crutches or walker

114
Q

Indications for RGO

A

spina bifida, MD, paraplegia

115
Q

Parapodim

A

designed to enable sitting good for spina bifida

116
Q

Negative side effects of spine orthosis

A

weakness and atrophy, tightness/ contracture, psychological dependence

117
Q

Corsets are for

not good for

____ limiting spine orthosis

A

management of LBP or herniation of nucleus pulposa

severe cases

least

118
Q

Chairback orthosis does not limit

A

frontal plane

119
Q

Combo of williams and chairback

what does it control

A

knight orthosis: sagital coronal control

120
Q

Williams orthosis does not limit

A

sagittal plane

121
Q

Highest level of limitation CO

Least

A

halo vest

collar

122
Q

collars and Philadelphia CO does not limit

collar CO also does not limit

A

rotation

weight support

123
Q

Molded Type CO limits what movements the most

A

fl, ext, side bending, rotation

124
Q

halo vest CO limts what the most

A

fl, ext, side bending, rotation, weight support

125
Q

what limits flexion CO the most

A

SOMI, four poster, molded type, halo vest

126
Q

3 important orthotics for the management of scoliosis

A

Milwaukee (thoracic curvature), Under arm , and Charleston Bending brace (night time bending)

127
Q

Charleston bending brace is for

A

nighttime in reverse position of scoliosis

127
Q

Spine and LE will never be made from

A

low temp thermo not strong enough

128
Q

Splint vs orthosis are

diff

A

interchangeable terms

s: short term
o: long term

129
Q

Static vs dynamic splints

A

s: maintain joint in one position
d: apply force to correct deformities

130
Q

Freq of splints
surgical
tendon repair
unstable fracture

A

s: static splint 6 days gentle passive
t: static 6-7 days gentle passive mvmt
u: immob in cast 4-6 weeks then static splint

131
Q

Usually recomm for those awaiting hernia surgery or undergone hernia removal surgery

A

elastic truss, umbilical truss

132
Q

ESTIM ortho

for?

A

stim of common peroneal nerve - foot drop

133
Q

Why are hand and wrist splints made of low temp thermoplastics

A

molded directly to pt hand, less expensive, easily adjustable, done in one visit

Prosth/Ortho (2 decks)

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