Pre-Prosthetic Evaluation and Training Flashcards
What are some things you will find in the chart review that will help you with your interview process of a patient with a prosthesis?
- reason for amputation
- level of amputation
- past medical history
- age
- mental and psychological state
- medical precautions (WB or ROM restrictions)
- patient’s goals
What are factors that contribute to skin integrity and circulation for someone with a prosthesis
- residual limb
- any open areas
- potential for breakdown
- incision location and integrity
- presence of scar tissue
- size, shape and length of residual limb
- temperature of limb
- tissue mobility
what would be a specific neurological reason for you to refer your patient bak to the surgeon
presence of neuromas
make sure you palpate- they will feel like a litle bubble
how would you educate someone so they dont develop phantom limb
teach them scar mobilization and desensitization to get use to somatosensation
what is the 2 most important motions that you want to maintain
hip and knee extension
what is the most common contractures in transtibial amputations
knee flexion
may also have hip flexion if in a wheelchair
what is the most common contracture for transfemoral amputations
hip flexion and also hip external rotation
what key muscles would you need to work on strengthening
hip and knee extensors hip ABductors scapular depressors shoulder and elbow extensors hand intrinsics
why would you need to strengthen the scapular dpressors, shoulder and elbow extensors
need these muscles for wheelchair mobility, transfers and use of assistive devices
what would be a reason to strengthen the hand instrinsics
you need these muscles for donning/doffing the prosthesis
what is the purpose of dressings
control post-op edema
absorb wound drainage
protect residual limb from trauma
facilitate prosthetic fitting through shaping of residual limb
may provide attachment of prosthetic device for early ambulation
what type of dressing is made of gauze, cotton padding and elastic bandage
a soft dressing
what are the advantages of soft dressings
low cost
ease of application
easy inspection
what are the disadvantages of soft dressings
poor edema control
slippage
little protection form trauma
frequent rewrapping
what dressing is typically used in traumatic ampuations
the IPOP (Immediate Post-Op Prosthesis) it is a rigid dressing with pylon and foot fit within 3 hours post op and changed weekly
