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S5 PTA Special Topics > Orthotics and prosthetics > Flashcards

Orthotics and prosthetics Flashcards

1
Q

Orthotic

A

External device that provides support or stabilization, improves function, corrects deformities, and distributes pressure from one area to another.

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2
Q

Orthotic functions

A
  • preventing deformity - maintaining proper alignment - inhibiting tone - assisting weak limbs - protecting against injury - facilitating motion
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3
Q

Corset

A

Provides abdominal compression and support

- provide pressure and relieve pain associated with mid and low back pathologies

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4
Q

Halo vest orthosis

A

Invasive cervical throracic orthosis that provides full restriction of all cervical motion

  • metal ring and four posts that are secured by in sterling four pins through the ring into the skull
  • prevent further damage or dislocation
  • wear until spine stable
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5
Q

Milwaukee orthosis

A

Designed to realign spine due to scoliosis curvature

- extends from pelvis to upper chest

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6
Q

Taylor brace

A

Thoracolumbosacral orthosis that limits trunk flexion and extension through a three-point control design

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7
Q

thoracolumbosacral orthosis

A

Prevents all trunk motions and commonly utilized as a post-surgical stabilization

  • don in supine
  • *BLT
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8
Q

FO

A

Semirigid insert worn inside a shoe that corrrects foot alignment and improves function
- relieve pain

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9
Q

AFO

A

Cast is subtalar neutral

  • metal or plastic
  • primarily assists with DF and prevents foot drop
  • peripheral neuropathy, nerve lesions or hemiplegia
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10
Q

KAFO

A

Provides support and stability to knee and ankle

  • ankle held in proper alignment
  • lock mechanism at knee for stability
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11
Q

Craig-Scott KAFO

A

Specifically for paraplegia

- stand with posterior lean of trunk

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12
Q

HKAFO

A

Indicated for weakness

  • controls rotation at the hip and abd/add
  • restricts patients to a swing-to or swing-through gait pattern
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13
Q

Reciprocating gait orthosis

A

Derivative of HKAFO and incorporates a cable system to assist with advancement of the LE during gait

  • after weight shift, cable system advances opposite LE
  • paraplegia
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14
Q

Parapodium

A

Standing frame designed to allow a patient to sit when necessary

  • ambulation is achieved by shifting weight and rocking the base across the floor
  • peds
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15
Q

Heel wedge

A

Applied to medial heel to prevent excessive hind foot eversion or to the lateral heel to prevent excessive hind foot inversion
- peds planus or peds cavus

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16
Q

Heel lift

A

Rigid insert which adds extra height to the heel of a shoe

  • relieve pressure of calcaneal tendon
  • limit leg length discrepancies
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17
Q

Heel cushion

A

Soft pad placed on heel of inner sole to suction the heel and decrease pain
- calcaneal spur or plantar fasciitis

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18
Q

Heel cup

A

Rigid insert that covers the plantar surface of the calcaneal and extends upwards on all three sides

  • stabilize calcaneus in neutral position and provide shock absorption for the heel
  • calcaneal spur or plantar fasciitis
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19
Q

Metatarsal bar/pad

A

Flat padding placed posterior to metatarsal heads on other sole or inner sole of shoe
- relives pressure form metatarsal heads by transferring it to the metatarsal shafts, thus helping relive pain for patients with metatsalgia

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20
Q

Rocker bar

A

Convex strip similar to metatarsal bar

  • relieves pressure from metatarsal heads
  • assists with limited mobility in foot, esp big toe
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21
Q

Forequarter

A

Scapulothoracic

- surgical removal of the upper extremity including the shoulder girdle

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22
Q

Shoulder disarticulation

A

Surgical removal of the UE through the shoulder

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23
Q

Transhumeral

A

Surgical removal of the UE proximal to the elbow joint

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24
Q

Elbow disarticulation

A

Surgical removal of the lower arm and hand through the elbow joint

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25
Q

Transradial

A

Surgical removal of the UE distal to the elbow joint

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26
Q

Wrist disarticulation

A

Surgical removal of the hand through the wrist joint

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27
Q

Partial hand

A

Surgical removal of a portion of the hand and/or digits at either the transcarpal, transmetacarpal or transphalangeal level

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28
Q

Digital amputation

A

Surgical removal of a digit at either the metacarpophalangeal, proximal interphalangeal or distal interphalangeal level

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29
Q

Hemicorporectomy

A

Surgical removal of the pelvis and both LE

30
Q

Hemipelvectomy

A

Surgical removal of one half of the pelvis and the LE

31
Q

Hip disarticulation

A

Surgical removal of the LE from the pelvis

32
Q

Transfemoral

A

Surgical removal of the LE above the knee joint

33
Q

Knee disarticulation

A

Surgical removal of the LE through the knee joint

34
Q

Transtibial

A

Surgical removal of the LE below the knee joint

35
Q

Syme’s

A

Surgical removal of the foot at the ankle joint with removal of the malleoli

36
Q

Transverse tarsal (chopart’s)

A

Amputation through the talonavicular and calcaneal cuboid joints
- the amputation preserves the plantar flexors, but sacrifices the dorsiflexors often resulting in an equinus contracture

37
Q

Tarsometatarsal (lisfranc)

A

Surgical removal of the metatarsals

- the amputation preserves the dorsiflexors and plantar flexors

38
Q

Pressure tolerant areas transtibial

A
  • patellar ligament
  • lateral fibula shaft
  • medial tibial shaft
  • lateral tibial shaft
39
Q

Pressure tolerant areas transfemoral

A
  • ischium

- soft tissues of residual limb

40
Q

Socket

A

Interface between the residual limb and prosthesis

- ideally disperses pressure throughout limb with total contact

41
Q

Liner

A

Comfort and health

  • gel liners hold pin and cushion residual limb and provide negative pressure
  • nonbreathable: take precautions to protect skin integrity
42
Q

Insert

A

Foam or plastic used to fill space

- foam offer shock absorption but plastic offer pressure reliefs

43
Q

Sock

A

Maintain a congruent and comfortable fit

  • no wrinkles
  • 1, 3, 5 ply
  • if exceeds 12-15 ply, notify prosthetist for recast
44
Q

Wear schedule

A

When first starting out, 1hr total with 30 min ambulation and check skin integrity every 30,in or immediately after walking
- increase skin check 15-30 minutes

45
Q

Red flags

A

Education on

- skin breakdown - abrasions or wounds - hygiene

46
Q

Timeline

A
  1. Pre-prosthetic: 1 day - 6wks post op
    - limb protection - contracture prevention - developing single limb mobility, and preparing pt for prosthetic phase of rehab
  2. Prosthetic phase 4-6wks: staples removed and residual limb skin integrity intact. Sized for shrinker and first prosthetic
  3. Several months later, limb size fluctuations have stopped and pt is comfortable, sized for permanent prosthesis
    - medicare reimburses for a new prosthesis every 5 years
47
Q

Complications after amputation

A
  1. Contractures
  2. DVT
  3. Hypersensitivity
  4. Neuroma
  5. Phantom limb
  6. Phantom pain
  7. Psychological impact
  8. Wound infections
48
Q

Lateral bending

A
  1. Prosthetic causes: prosthesis too short - improperly shaped lateral wall - high medial wall - prosthesis aligned in abduction
  2. Amputee causes: poor balance - abduction contracture - improper training. -short residual limb - weak hip abductors on prosthetic side - hypersensitive and painful residual limb
49
Q

Abducted gait

A
  1. Prosthetic causes: prosthesis too long - high medial wall - poorly shaped lateral wall - prosthesis positioned in abduction - inadequate suspension - excessive knee friction
  2. Amputee causes: abduction contracture - improper training - adductor roll - weak hip flexors and adductors - pain over lateral residual limb
50
Q

Circumdated gait

A
  1. Prosthetic causes: prosthesis too long - excessive knee friction - socket too small - excessive PF
  2. Amputee causes: abduction contracture - improper training - weak hip flexors - lacks confidence to flex the knee - painful anterior distal residual limb - inability to initiate prosthetic knee flexion
51
Q

Excessive knee flexion during stance

A
  1. Prosthetic causes: socket set forward in relation to foot - excessive DF - stiff heel - prosthesis too long
  2. Amputee causes: knee flexion contracture - hip flexion contracture - pain anteriorly in residual limb - decrease in quad strength - poor balance
52
Q

Vaulting

A
  1. Prosthetic causes: prosthesis too long - inadequate socket suspension - excessive alignment stability - excessive PF
  2. Amputee causes: residual limb discomfort - improper training - fear of stubbing toe - short residual limb - painful hip/residual limb
53
Q

Rotation of forefoot at heel strike

A
  1. Prosthetic causes: excessive toe-out built in - loose fitting socket - inadequate suspension - rigid SACH heel cushion
  2. Amputee causes: poor muscle control - improper training - weak medial rotators - short residual limb
54
Q

Forward trunk flexion

A
  1. Prosthetic causes: socket too big - poor suspension - knee instability
  2. Amputee causes: hip flexion contracture - weak hip extensors - pain with ischial weight bearing - inability to initiate prosthetic knee flexion
55
Q

Medial or lateral whip

A
  1. Prosthetic causes: excessive rotation of knee - tight socket fit - valgus in the prosthetic knee - improper alignment of toe break
  2. Amputee causes: improper training - weak hip rotators - knee instability
56
Q

Acquired amputation

A

Refers to the surgical removal of a limb due to disease, trauma, or infection

57
Q

Dysvascular

A

Refers to the disease of the blood vessels, including peripheral vascular disease, peripheral arterial disease, and complications related to diabetes

58
Q

Endoskeletal shank

A

This type of shank consists of a ridid pylon covered with material designed to simulate the contour and color of the contralateral limb

59
Q

Exoskeleton shank

A

This type of shank consists of a rigid external frame covered with a thin layer of tinted plastic to match the skin color dismally

60
Q

Extension assist

A

A mechanism that assists the knee joint into extension during the swing phase of gait

61
Q

Myoelectric prosthesis

A

A device using electromyography signals to control movements of the prosthesis with surface electrodes or implantable wires

62
Q

Non-traumatic amputation

A

An amputation that is not the result of direct injry

- vascular disease and infection are types of non traumatic amputations

63
Q

Pistoning

A

The translation of the prosthetic limb from the residual limb
- result of inadequate suspension and can result in distal residual limb skin issues

64
Q

Polycentric knee

A

Refers to a knee joint that has multiple axes of rotation that allows for a more natural gait cycle when compared to a single axis knee

65
Q

Prosthesis

A

Artificial body part - noun

66
Q

Prosthetic

A

Adjective to describe artificial body part

67
Q

Pylon

A

Describes a pipe-like structure used to connect the socket of the prosthesis to the foot/ankle components
- assists with WB and shock absorption

68
Q

Residual limb

A

Remaining extremity following amputation

- characterized based on location and length

69
Q

Shrinker

A

Elastic sleeve that is placed over the end of the residual limb to control edema and encourage limb shaping

70
Q

Stance control (safety)

A

Weight-activated mechanism that maintains knee extension during WB even if the knee joint is not fully extended
- if knee flexed greater than what is is designed for, the mechanism will not engage

71
Q

Suspension

A

Term used to describe how the prosthetic socket is attached to the residual limb
- vacuum - shuttle lock - suction - waist belt - harness

72
Q

Traumatic amputation

A

An amputation performed secondary to a direct injury

S5 PTA Special Topics (13 decks)

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