P&O upper ext & GAIT

Question 1

center of gravity lies where in relation to the spine

Answer 1

5cm anterior to S2

Question 2

normal base width (distance between heels)

Answer 2

6-10cm

Question 3

normal cadence

Answer 3

80m/min; 3mph

Question 4

normal step length

Answer 4

15-20 inches

Question 5

Name the 6 determinants of gait

Answer 5

1. pelvic rotation
2. pelvic tilt/list
3. knee flexion in stance
4. foot mechanisms (ankle flexion/extension mechanisms)
5. Knee mechanisms
6. Lateral displacement of the pelvis

Question 6

what is the percentage of increased energy expenditure in propelling a wheelchair in patients with paraplegia compared to ambulation in normal subjects

Answer 6

9% - cerny et al 1980

Question 7

name the muscles that require strengthening to crutch walk (6)

Answer 7

crutch walking takes more energy than walking with a prosthesis

Lats
Triceps
Pec Major
Quads
Hip extensors
Hip abductors

Question 8

Possible causes for foot slap on initial contact

Answer 8

moderately weak dorsiflexors

Question 9

possible causes for the following (initial contact through midstance) (4)

• genu recurvatum
• excessive foot supination
• excessive trunk extension
• excessive trunk flexion

Answer 9

• weak, short, or spastic quads; compensated hamstring weakness, achilles tendon contracture, plantar flexor spasticity
• compensated forefoot valgus deformity; pes cavus; short limb
• weak hip extensor or flexor; hip pain; decreased knee range of motion
• weak gluteus max and quads; hip flexion contracture

Question 10

Increased metabolic expenditure above normal:

Symes amputation

Answer 10

15%

Question 11

Increased metabolic expenditure above normal:

Traumatic TT BKA

Answer 11

25%
short - 40%
long - 10%

Question 12

Increased metabolic expenditure above normal:

traumatic bilateral BKA

Answer 12

41%

Question 13

Increased metabolic expenditure above normal:

traumatic TF AKA

Answer 13

60-70%

Question 14

Increased metabolic expenditure above normal:

traumatic bilateral AKA

Answer 14

> 200%

Question 15

Traumatic AKA and BKA

Answer 15

118%

Question 16

Vascular TT BKA

Answer 16

40%

Question 17

Vascular TF AKA

Answer 17

100%

Question 18

In mangled extremity: amputation is considered if irreparable damage occurs to four of what six basic things?

Answer 18

skin
vessels
skeleton
nerves
extensor
flexor tendons

Question 19

Name the components of an upper extremity prosthesis Rx (5)

Answer 19

1 terminal device

2. wrist unit
3. socket
4. elbow hinges
5. shoulder

Question 20

Name the 4 different types of terminal devices

Answer 20

passive
body-powered
externally powered hook
externally powered hands

Question 21

In a _____ socket, the socket and the forearm are set in initial position of flexion and the socket encloses the olecrenon and the epicondyle of the humerus.

Answer 21

Muenster socket

The intimate limb encapsulation, flexion attitude, and high trim lines provide suspension. Although there is some limitation in the range of flexion and suspension, this is compensated by preflexing the socket.

Question 22

preprosthetic training should include what 7 things

Answer 22

1. limb shrinkage
2. muscle strength and ROM
3. postural problems
4. desensitization
5. scar mobilization
6. ADL assessment
7. HEP

Question 23

what two functions are seriously affected by UE ampuation

Answer 23

forearme and humeral rotation