prosethetics Flashcards
what are different causes of UE amputation:
trauma
congenital
disease
what are different causes of LE amputation:
largely a result of a diseas e
why is prosethetics hard to specialize in ?
there are limited number of UE amputations / year
- app 1500 ampuations UE/ year
list seven points of UE amputation:
- forequarter
- shoulder disarticulation
- trans-humeral
- elbow disarthiculation
- trans radial
- wrist disarticulation
- transphalangeal
basic prosthetic goal:
provide appropriate function and appearance to increased independence with ADLs and improve the quality of life
new amputee goals:
delineate prosthetic expectations
rebuilding proprioception
establishing independence and confidence
establishing good habits
etiology of traumatic amputations:
MVA
farming
burns
other etiology of amputations:
traumatic congenital tumors vascular infection
what is the first critical step in the recommendation of a prosthesis:
physical evaluation of the patient
residual limb
special considerations of USER EVAL: of UE:
trauma visually more apparent expectations can differ from reality prosthesis does NOT = hand culture plays a role
four components of a prosthetic:
suspension interface
suction
terminal device
socket
suction component is to ….
to keep them tight so you want to look at skin integrity
socket interfaces are :
- extremely flexible plastic
- improves socket comfort
- looks like a dolphin thing
three types of oppositional prosthesis:
body powered
externally powered
hybrid
all types of prosethsis fall under:
- oppositional
- activity specific
- multiple
body powered means that
there is a cable on the outside so you have to move your hand and the cable allows it to turn on
four reasons NOT to get a prosthesis:
limited perceived functional benefit
reduced sensory input
comfort
hot &/or heavy
two reason for an OT tx
one handed techniques
posture and ergonomics
an oppositional prosthesis are
passive
benefits of oppositional prosthesis
provide aesethetic appearance
light weight and simple
proprioceptive feedback
function of an oppositional prosthesis:
opposition
holding objects
restore body image
limitations of oppositional prosthesis:
no active prehension
high cost for custom
durability
pt can have unreal expectations for cosmesis
body powered prosthesis are called
cable driven
body powered prosthesis relies upon
gross body movements captured thorugh a harness
benefits of body powered prosthesis are
moderate cost and weight
durable
environmentally resistant
prioprioception through harness system
limitations of body powered prosthesis are
grip strength or pinch force
restrictive & uncomfortable harness
requires muscle power & excursion
poor static & dynamic cosmesis
body movements needed for prosthetic control : transradial:
transradial
- elbow flexion
- elbow lock
- terminal device needs:
- scapular AB duction and humeral flexion
body movements needed for prosthetic control: transhumeral
elbow flexion
- scapular ABduction / humeral flexion
elbow lock:
- shoulder depression and humeral: ABduction / extension
an externally powered prosthesis aka means
“electrically powered or “moyelectic”
an externally powered prosthesis is powered by
a battery
and myoelectric signals
- by various input methods
benefits of an externally powered prosthesis:
stronger grip forces moderate or no harnessing minimal energy expenditure least body movement to operate moderate aesthetics
limitations externally powered prosthesis:
heavier
more expensive
limited sensory feedback extensive therapy training
muscle groups for myoelectric control: transradial:
wrist flexors / extensors
- FCR
- FCU
- ECRL / ECRB
- EDC
muscle groups for myoelectric control: transhumeral :
biceps brachii
triceps brachii
deltoid
a myoelectric hand is always stronger than a
hook hand
hook will have less _____ but _____
pinch
is lighter
elbow has to be
body powered
hand can be
externally powered
why would we suggest an activity specific prosthesis:
FUNCTION IN ADLS
an activity specific proshesis is also
adaptive / recreational
activity specific is designed for
a specific activity
- an adaptation to an exisiting prosthesis
TMR means
targeted muscle reinnervation
a TMR is a
reassignment of nerves
some partial hand prosthesis options are:
- silicone restoration
- opposition prosthesis
- mechanical systems
- powered finger systems
success depends on
COMMUNICATION
what are the two phases of rehabilitation?
pre prosthetic
post prosthetic
parts of the preprosthetic phase:
presurgical
post surgical and in fitting process
post prosthetic phase is
after prosthetic delivery
primary goal of the preprosthetic phase is to
reinforce realistic expectations;
EMG steps:
develop two anatagnositic muscles with acceptable EMG output
- develop EMG separation between the muscle sites
- develop stamina in each muscle
things you have to teach with a new prosthetic aka interventiosn:
donning of prosthesis
control of components
functional training
occupational performance
preprosthetic training focuses on :
promoting readiness for the permanent prosthesis
promoting readiness for the permanent prosthesis includes:
promote skin healing conditioning preventing contractures controlling edema providing desensitization to the residual limb
capability factors to getting a prosthestic:
physical
psychosocial
specific needs
performance factors to getting a prosthestic:
activity
vocational
future needs
