Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UL Ox > Overview of Ox Management of the Upper Limb > Flashcards

Overview of Ox Management of the Upper Limb Flashcards

1
Q

Major Challenge of UL Ox

A

Fine Motor Function - may require multiple ox to achieve goals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Duration of Use

Percentages

A

Interim Ox = 85-90%
Definitive = 10-15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Activities of Daily Living

DEATH

A
  • Dressing
  • Eating
  • Ambulation
  • Transferring
  • Toileting
  • Hygiene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Instramental Activities of Daily Living

SHAFT

A
  • Shopping
  • Housework
  • Accounting
  • Food Preparation
  • Telephone/Transportation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Common Terminal Points

Anatomy of the UL

A

Palmar creases or distal to distal finger pads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Prehension Patterns

Anatomy of the UL

A
  • Cylindrical - tube
  • Tip - All fingers to thumb
  • Hook - carrying a purse
  • 3 Jaw Chuck - pencil (functional)
  • Spherical - grapping a ball
  • Lateral - holding a credit card

Look at the Picture :)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Intrinsic Plus

Pathological Hand Positions

A
  • Cause - weak extrinsics; spastic intrinsics
  • “safe position”
  • Position: 30 degrees wrist ext., 70-90 degrees MCP flexion, PIP/DIP ext.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Intrinsic Minus

Pathological Hand Positions

A
  • Cause - strong extrinsics; weak intrinsics
  • Positions: MCP hyperext.; PIP/DIP flexion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Functional

Hand Positions

A
  • Wrist: 30 degrees ext.
  • MCP 2-5: 35-40 degrees flex.
  • PIP 2-5: 30 degrees flex.
  • DIP 2-5: 5-10 degrees flex.

Thumb is extended at IP, opposed to digits 2/3, and web space is maintained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Static Ox

Describing Orthoses

A
  • Components are in a single fixed position during use
  • Joints can be adjusted at fitting/eval.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Static-Progressive Ox

Describing Orthoses

A

Anatomical joint positions can be changed, but ox is fixed in each subsequent postion during use
* Used to increase ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dynamic Ox

Describing Orthoses

A

Components of the ox change position during use
* Options - Free, Stop, Assist, Resist

can facilitate AROM or PROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Therapeutic

Describing Orthoses

A
  • Primary use: therapeutic
  • may be worn during activity
  • not intended to enable ADLs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Static Functional

Describing Orthoses

A
  • Primary use: enables ADLs
  • may also have therapeutic effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dynamic Therapeutic

Describing Orthoses

A
  • Not intended to enable ADLs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dynamic Functional

Describing Orthoses

A
  • Intended to enable ADLs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Low Temp. Thermoplastic (LTT)

Common Materials

A
  • 135-180 degrees
  • directly moldable to pt
  • AKA Orthoplast
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

High Temp. Thermoplastic (HTT)

Common Materials

A
  • above 250 degrees
  • PE, CP, PP

we know enough about this by now…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Time

Clinical Decision Making

A

OTS is quicker

20
Q

Cost

Clinical Decision Making

A

OTS is cheaper

21
Q

Fit

Clinical Decision Making

A

Custom for triplanar control

22
Q

Edema

Clinical Decision Making

A

Custom Dorsal style can accommodate for fluctuation

23
Q

Sports

Clinical Decision Making

A

Soft prefeb (protect other players)

24
Q

Rancho Los Amigos (CA)

Three Traditional Systems

A
  • Aluminum w/ Plastazote
  • Easy to Contour
  • Continuous Dorsal/Palmar Bars
  • Components easily attached
25
Q

Texas Institute For Rehab. and Research (TIRR)

Three Traditional Systems

A
  • Prefebricated from thermoset
  • Difficult to adjust
  • Palmar piece is main component
  • Difficult to don (tight webspace)
  • Improved cosmesis
26
Q

Institute for Rehab and Medicine (IRM)

Three Traditional Systems

A
  • Custom from thermoplastic
  • Lowest profile of three
  • Self suspending (AP dimension)
  • No straps
27
Q

Goals

Hand Orthoses

A
  • Maintain palmar arch
  • Maintain thumb position
  • Maintain Webspace
  • Serve as attachment site for components

All HO designs can be used on Ox for more proximal levels

28
Q

Palmar and Dorsal Bars

Hand Orthoses Components

A
  • Maintain palmar arch
  • can be continuous (still titled separately)
29
Q

Opponens Bar

Hand Orthoses Components

A
  • Encapsulates shaft of first MC
  • Maintains thumb in opposition
30
Q

C Bar (thumb adduction stop)

Hand Orthoses Components

A
  • Maintains webspace
  • helps identify proper alignment when donning
31
Q

Thumb Control General Principle

A

Provide the minimum level of control needed to
achieve treatment goals

32
Q

Thumb Post

Thumb Control

A

Used for: Flail Thumb (SCI, intrinsic minus hand, nerve injuries)
* Distal trimline - mid nail bed
* no padding (friction)

33
Q

Thumb Adduction Stop

Thumb Control

A

Used for: Median or Radial Nerve injuries
* usually high tone/spasticity
* adjustable if webspace is tight
* distal trimline - proximal to IP crease of thumb

34
Q

Thumb Abduction Assist

Thumb Control

A

Used for: Radial nerve injury
* dynamic spring component
* balances adductors and abductors of thumb
* attaches to prox. phalynx of the thumb
* distal end - prox. to IP crease of thumb

35
Q

Thumb Extension Assist

A

Used for: Radial Nerve Injury
* weak entensors/strong flexors
* restores muscle balance
* attaches to opponens bar
* Perpendicular pull angle is optimal

36
Q

MP Stop / IP Ext. Assist

MCP Control

A

Used for: Median or Ulnar nerve injuries
* weak lumbricals
* MCPs - extended; IPs - flexed
* Designed to maintain MCP flexion (35 degrees)
* Does not interfere with IP flexion

37
Q

MCP Flexion Assist

MCP Control

A

Used for: Median and Ulnar nerve injuries
* Can address extension contractures

38
Q

First Dorsal Interosseus Assist

Finger Control

A

Used for: Ulnar nerve injury
* Attaches to middle phalanx of 2nd digit
* Angle of pull perpendicular to the middle phalanx is optimal
* Finger loop does not impede PIP or DIP

39
Q

Finger Driven WHO

Finger Control

A

Used for: weakened MP ext.
* Must have active flexion of at least one finger
* Provides 3 point prehension
* Maintain PIP flexion (30) and DIP flexion (5-10)
* Terminate at mid nail bed

40
Q

WH(F)O - Common Diagnoses

Wrist Control

A
  • Carpal Tunnel Syndrome
  • Radial Nerve Palsy
  • Flexor or Extensor Tendonitis
41
Q

WH(F)Os - Common distal trimline

Wrist Control

A
  • At palmer crease = allows normal MCP / IP movement
  • Distal to the finger tips = greatest control
42
Q

Wrist Stability

Wrist Control

A

Orthosis should cross an
unstable joint

43
Q

Dynamic Designs Indications

Wrist Control

A
  • R.O.M.
  • weakness
  • spasticity with spring
44
Q

Static Design Indications

Wrist Control

A

Need for positioning and stabilization

45
Q

Grasp and Release

Wrist Control

A
  • Wrist driven (C6,7) - Harnesses tenodesis grasp
  • Ratchet driven (C5)
  • External power

AKA Prehension

UL Ox (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions