Brainscape's Knowledge GenomeTM

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


See full index

Assistive Tech > P - Functional Characteristics of TT/TF Amps > Flashcards

P - Functional Characteristics of TT/TF Amps Flashcards

1
Q

what is a prosthesis

A

externally applied device designed to replace the structural and functional characteristics of limb loss

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

what is a prosthetist

A

board certified clinician who designs, fabricates, delivers, and maintains prosthetic devices for pts w limb loss

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

what are prosthetics

A

specialty w/i field of medicine which describes design, fabrication, application of prostheses

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

what is the leading cause of amputation

A

dysvascular dz

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

what are common comorbidities of dysvascular dz

A

DM
HTN
dyslipidemia
PVD
PAD

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

what does the majority of amputations result from

A

a dz process (neuropathic and vascular process)

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

what does elevated blood sugar levels cause and why is this relevant

A
  1. damage to blood vessels which impairs circulation and affects healing
    -> relevant to amp healing and prosthetic timeline
  2. damage to nerve fibers which causes impaired sensation (neuropathy)
    –> impaired proprioception to know how socket is sitting on limb and how the foot is being placed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are 5 typical traumatic causes of amputation

A

MVA
work-related accidents
violence (gun/war)
severe burns
electrocution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the main consideration for the diabetic population

A

managing elevated blood sugar levels

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

what are considerations with amputations in a traumatic poulation

A

may have undergone several limb salvage attempts prior to amp

likely to have significant psych sx (ie grief)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the congenital amputee pop often referred to as instead

A

limb different

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

what are the 2 categories of congenital pop amputees

A

transverse
- distal segments affected, prox segments intact
(ex: small hand, normal radius)

longitudinal
- dec/absence occurs w/i long axis of limb, distal segments un affected
(ex: short femur, normal tib/foot - commonly seen in PFMP)

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

how does surgery for a congenital amp population differ from acquired and why

A

surgery may be necessary throughout childhood to prep limb for optimal fitting
- bones not growing equally, can stunt the growth so other side can catch up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does the psych impacts on a congenital amp population differ from acquired

A

since born w it, don’t necessarily feel like they are missing anything

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

are LE or UE amps more common

A

LE 11x more frequent than UE amps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the common reason for UE amps vs LE amps

A

UE: traumatic, congenital

LE: diabetic, dz process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how is an amputation classified

A

by location

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

where is a lisfranc amp located

A

partial foot
- where MT meet tarsal bones

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

where is a chopart amp located

A

partial foot
- where tarsal bones meet talus and calcaneus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the 2 principles that determine the level of amputation

A
  1. adequate circulation to remaining tissue
  2. preservation of anatomical joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

why is the preservation of anatomical joints an important guiding principle for amputation level determination

A

the more joints you have to replace and control the harder it is
- want to save as much as possible as appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the optimal length residual limb

A

midlength or 2/3 of original length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are factors when determining the optimal length for residual limb

A
  1. lever arm to control prosthesis and space for suspension
  2. force distribution
  3. build height - more gain out of more material there is (more room to store and fit energy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is there a constant balance of with when determining optimal residual limb length for a prosthesis

A

build height with lever arm and suspension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is a disarticulation amp

A

going thru joint space but entire bone and proximal articulating condyles are still intact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

disarticulation: pros vs cons

A

pros:
- still have surface designed for weight bearing
(cutting thru middle of bone, part of bone isn’t meant for weight bearing)

cons:
- losing space of componentry for prosthesis
- changes joint center

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

transfem vs knee disartic outcomes

A

transfem - more common, do better
- more suspension options
- surface meant for weight bearing

knee disartics harder
- shape is harder for donning bc of size of condyles
- changes knee center (lower) –> impacts gait and step length

28
Q

what is a syme technique

A

ankle disarticulation
- disarticulate TC joint
- removal of calcaneus
- trim malleoli
- reposition fat pad and heel soft tissue under distal tib/fib

29
Q

what are qualities of a syme amputation

A

shortens leg length
creates WBing surface
- person can functionally amb w/o prosthesis

30
Q

what is a con of a syme amputation

A

long residual limb so it’s difficult to fit w good componentry

31
Q

what are 3 common surgical techniques for a TT amp and what is the most common

A

**posterior flap
ewing procedure
ertl procedure

32
Q

what is posterior flap TT technique and what is a common pt complaint

A
  1. leave posterior section of tissue longer
  2. cuts tib and fib (fib shorter than tib)
  3. sew flap anteriorly

can feel funky like calf is in front bc circulation and nerves are now at bottom on limb

33
Q

what is an ertl procedure and what are pros and cons

A

takes some bone from trans tib amp and some of fib bone to make bony bridge

pros: end bearing w/o negatively impacting build height, good WBing surface

cons: more intensive surgery, bone bridge could break

34
Q

what is ewing procedure and what are pros and cons

A

attaches agonist and antagonist ms together (reattaches cut ends) so they can continue to function how they usually would
- in prep for long term futuristic tech of mind control for ms activity

pros: less atrophy over time bc can activate ms more than traditional amputee would
- prep for future tech

cons: longer healing process, have to. keep knee straight for 6wks

35
Q

why is an optimal transfem amp at 2/3

A

want to keep as much ADD magnus as possible
- major ADD and helps prevent ADD contractures

36
Q

what is an osseointegration procedure and what are pros and cons

A

implant rod into center of femur, rod sticks outside the skin tissue

pros: when rod heals, attach component to attach right to prosthesis - eliminating need for a socket

cons: last resort
- would rather fit w traditional socket first bc less invasive
- big risk of infection, always considered an open wound

37
Q

what is arguably the most important thing to talk about in a pre-amp consultation

A

managing expectations

38
Q

what are key points to post op care of an amp (5)

A

acute surgical pain mgmt
phantom sensation/pain
psych impact
early ed
post-op and pre-pro interventions

39
Q

what directly influences pt’s future prosthetic success when postop

A

acute care and early rehab

40
Q

while interprofessional team member goals post op may vary, what do they have in common

A

all lead to the same outcome of independent management of a prosthesis

41
Q

what are 3 goals of surgical/medical team post-op

A
  1. healing suture line
  2. overall health status
  3. pain mgmt
42
Q

what are 3 goals of PT/OT team post-op

A
  1. desensitization
  2. edema mgmt / limb shaping
  3. ROM / strength / mobility
43
Q

what are 3 goals of prosthetist team post-op

A
  1. shrinker fitting
  2. rigid removable dressing
  3. prepping for prosthetic fitting
44
Q

what are the 3 things needed to start the prosthetic fitting

A
  1. sutures/staples removed
  2. minimal drainage present
  3. cylindrical shape
45
Q

what is is the progression of drainage presentation postop

A

drainage transitions from sanguineous to serosanguinous and eventually to serous exudate

46
Q

what is meant that a residual limb should have a cylindrical shape to start prosthetic fitting and why is this

A

distal circumference is roughly equal or no more than 1/4’’ greater than proximal circumference

need to push thru socket so don’t want distal bigger than proximal

47
Q

why is compression an important post op intervention

A

key w managing edema and pain, phantom sensation

48
Q

shrinkers vs ace wrap for pre prosthetic compression

A

shrinkers = compression socks
- implemented right after sutures come out

ace wrap = while sutures are still in
- tightest at bottom and loosest at top
- only as good as last person using it

49
Q

what is a semi-rigid removable dressing (SRRD) and what are the pros to this as a pre-prosthetic intervention

A

prevents knee flexion contracture (keeps leg straight)
protects healing residual limb (from falls, common occurrence)

pro: allows for frequent skin checks, easy to apply

50
Q

what is an IPOP and what are the pros to one

A

immediate post-op prosthesis

all same benefits as SRRD
allows for early WBing
improved psych acceptance of amp
potential for inc early rehab progress -> starts desensitizing limb and prepping it for WBing

51
Q

how long does it take from amputation surgery to starting the prosthetic fitting process

A

6-8wks

52
Q

what is the giant list of things to get in the IE when doing a prosthetic eval (12)

A

amp cause and level
med, surg, family hx
personal/social status
current overall health
functional level
goals
ROM
MMT
balance
bony anatomy deformities
cog
sound side condition

53
Q

what are K classifications important for

A

used for insurance to determine what prosthesis the pt needs

54
Q

what are the K-Level classifications

A

K0: not a candidate
K1: household amb
- one speed, level surfaces
K2: limited comm amb
- one speed, navigate small barriers
K3: community amb
- multiple speeds, uneven surfaces
K4: child/athlete
- high impact/energy levels beyond just walking

55
Q

what is used to determine the k level

A

the amputee mobility predictor

56
Q

how does the amputee mobility predictor work

A

can admin w pro or w/o pro
structured for interrater reliability for more objective measure

K levels can changed based off these scores

57
Q

how does coding for prostheses work

A

code for part of prosthesis, part of body
- make list of codes to explain what they are going to build for pt

58
Q

what does it mean that prosthetics uses an “add-on” billing system

A

BKA + socket material + ankle piece
- can add more on from there

59
Q

what are prescription requirements for prostheses

A

special Rx for medicare
need original signature on Rx
Rx must include ICD-10 dx
can’t take Rx from DPT

60
Q

what type of billing does prosthetics follow

A

lump sum
- pts don’t pay for any visits, only one big fee for prosthesis when it arrives

61
Q

what is the prosthetic parity bill

A

every insurance has to pay for 80% ( can be more), it has to match Medicare

62
Q

how much does Medicare reimburse for prostheses

A

80%

63
Q

how much does Medicaid reimburse for prostheses

A

100% of a reduced list of codes

64
Q

how much does HMO and private companies reimburse for prostheses

A

follow individual payment structures
- has to match medicare tho w min of 80%

65
Q

what are exclusions to insurance reimbursement in prostheses

A

microprocessor or myoelectric tech

Assistive Tech (17 decks)

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