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prosthesis Flashcards

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0
Q

articulated

A

a mechanical ankle joint

single axis
multi axis-allow for supination and pronation

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1
Q

5 things needed in a prosthesis

A
  1. stable base
  2. shock absorb
  3. heel to toe gait
  4. looks
  5. cost
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2
Q

non articulated

A

solid ankle foot piece bolted to the shank

material in front piece will allow for adaptation on uneven surfaces

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3
Q

energy storing prosthetic feet: when is it stored, when is it used

A

Midstance–>heelrise: store energy

Toe off–> early swing: use energy

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4
Q

plantar flexion bumper

A

compress at heelstrike, allow a controlled plantarflexion for going into footflat

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5
Q

Dorsiflexion stopper

A

control the amount of dorsiflexion as the person comes over the foot
midstance–> heelrise

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6
Q

SACH Foot

energy
artic

A

doesnt store energy

nonarticulated

controlled plantarflexion with cushion heel

flexible rubber forefoot to allow MTP extension

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7
Q

Seattle Foot

A

energy stored

nonarticulated

C shaped material that is compressed midstance–>heelrise

energy return as push off

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8
Q

Carbon Copy II Foot

A

non articulated

store energy

compressible heel

roll over foot and plantar carbon fibers are stretched: then energy is returned

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9
Q

SAFE Foot

A

Stationary Attach Flexible Endoskeleton

not such a good energy storing

nonarticulated

adaptable, flexible mid/forefoot

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10
Q

STEN foot

A

not so good energy storing foot

not articulated

cushion heel

rigid keel with flexible plugs in between sections

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11
Q

Flex Foot

A

energy storing foot

non-articulated

lightweight and resilient (carbon fibers)

expensive

as go into HS compress and then when go into terminal stance and bring it forward there is a separation when take the weight off

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12
Q

flex walk

A

same as flex foot

but flex walk has a shorter lever arm

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13
Q

college park true step

A

store energy

non-articulated

2 long toe levers, flexible keel

lightweight material

arch flattens and recoils

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14
Q

Shank: Exoskeleton

A

older

more durable but heavier

made of hard plastic laminate

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15
Q

Shank: endoskeleton

A

more common

metal pole central and then a cosmetic covering over it

metal pole allows for adjustments: in rehab start here and then when all the settings are good they put a cosmetic covering

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16
Q

PTB

what is it 
where is WB
bulge 
walls 
channels
A

BK

patella tendon bearing socket: for a below the knee amputation

WB:

  1. infrapatella tendon–shelf for the infrapatella tendon on anterior wall
  2. medial tibial plateau
  3. muscle belly of anterior tibialis: palpate lateral to tibial crest

Popliteal Bulge: on the posterior wall have a convexity that caves in to provide anteriorly directed force to keep patella on patella tendon shelf and improve WB on infrapatella tendon

walls:
anterior: comes up to mid tibia and flares out
medial and lateral: higher than anterior, up over femoral condyles
posterior wall: lowest wall to allow for knee flexion in sitting

channels and cavities:
hamstring channels are lateral and medial to popliteal bulge: go into socket on either side of popliteal bulge for hamstring tendons

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17
Q

Popliteal Bulge:

A

BK
in the PTB for the below knee amputation

on the posterior wall have a convexity that caves in to provide anteriorly directed force to keep patella on patella tendon shelf and improve WB on infrapatella tendon

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18
Q

walls of PTB

A

BK
anterior: comes up to mid tibia and flares out

medial and lateral: higher than anterior, up over femoral condyles

posterior wall: lowest wall to allow for knee flexion in sitting

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19
Q

TSB

what is it

A

BK
total surface bearing socket

even pressure distribution in residual limb, custom made for fit

doesnt have patella tendon shelf usually

-not good if limb is changing size or if sensitive areas cannot tolerate the pressure

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20
Q

Types of Suspension

BK

A

BK

  1. gel liner
  2. pre-lite liner
  3. supracondylar cuff
  4. supracondylar wall
  5. supracondylar suprapatellar walls
  6. Thigh corset suspension
  7. fork strap attached to waist belt
  8. over the knee sleeve suspension
  9. locking gel liner suspension
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21
Q

Gel Liner

what is it
pros (2)
cons (3)

A

BK

suspension: see more with the TSB

silicone, polyurithane cushioning on residual limb

PROS

  1. better to reduce pistoning
  2. even pressure distribution (comfort)

CONS:

  1. not as durable, breakdown overtime
  2. issue with prespiration: sweating can cause skin rashes (eventually sweat glands adapt)
  3. harder to don and doff
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22
Q

Pe-lite liner

Study These Flashcards
A

BK
see more with PTB

foam mold of the residual limb that goes into the liner sometimes called a soft insert

23
Q

Supracondylar Cuff

Study These Flashcards
A

BK
cuff attached on medial and lateral side of prosthetic and goes around the limb

good for fluctuating edema

**bad in that more likely pistoning

24
supracondylar walls
BK medial and lateral wall over the condyles of the femur --less desirable
25
supercondylar suprapatellar walls
BK high medial, lateral walls over condyles of femur anterior walls--come up as high as the medial and lateral wall they can sit but kneeling is difficult USE FOR A VERY SHORT BK
26
Thigh Corset Suspension
BK for below the knee amputation mechanical knee over their knee Pro: 1. for fluctuating size of residual limb 2. pressure intolerance: force through soft tissue of thigh takes some of the WB away from the residual limb CON: 1. heavy 2. mechanical jt can break down 3. can make noise 4. moving parts 5. can cause atrophy in the quads and hamstrings bc pressure on soft tissue isn't contracting to the same extent (like an abdominal binder)
27
Fork strap attached to waist belt
BK for below the knee amputation the fork strap can also be used with the superior portion of the supracondylar cuff (SC cuff) less cosmetic adds bulk
28
Over the knee sleeve suspension
BK for below the knee amputation uses suction: needs to be well fitting valve to push air out of socket--dont want air in the socket over the knee sleeve it goes over the knee and is made of polyurithane/neoprene material and it creates suction suspension NOT GOOD FOR LIMB THAT CHANGES IN SIZE
29
Locking Gel Liner Suspension
BK for below the knee amputation suction and locking pin--not for a fluctuating limb gel liner with a pin at the end that clicks into the prosthesis (put on with 3-4 clicks release button to take off) DECREASED PISTONING REQUIRES A RESIDUALLY STABLE LIMB
30
Iceross Seal in Sleeve
BK has ring things to prevent the air from getting into the socket suction suspension does not go over the anatomy with walls
31
Gel Liner VS Pe-Lite Liner
BK Gel Liner: - -less pistoning/socket fit - -comfort/better pressure distribution - -pressure distribution throughout residual limb Pe-Lite Liner - -more durable - -easier to put on and off - -cheaper - -doesnt have the prespiration issues
32
suspensions: Suction Suspension
BK over the knee sleeve locking gel liner hypobaric gel liner icercross
33
Suspension: Anatomical Contour
BK SC wall: supracondylar wall SC SP wall: supracondylar suprapatellar wall [for short residual limb]
34
Suspension: with straps
BK 1. SC cuff 2. supracondylar cuff
35
suspension: hinges
BK | thigh corset: straps and hinges (the mechanical knee goes over a real knee)
36
Locked Knee Unit
AK pull on anchor to lock knee into extension (shorter because cannot flex the knee to shorten the limb in gait)
37
free knee unit
mostly free but can lock out --able to lock when need more security
38
Types of Friction on a knee unit for AK
1. Mechanical Friction: femoral and tibial surfaces abutt eachother, can adjust how tight the approximation is -FRICTION STAYS CONSTANT AMOUNT 2. Hydraulic Friction: cylinder of viscous fluid creates friction, velocity dependent 3. Pneumatic Friction: sealed chamber of air, velocity dependent
39
C Leg
AK hydraulic friction computerized knee unit: microprocessor to adjust friction and redistribute the fluid to change stability
40
weight activating break
AK in mechanical/pneumatic/hydraulics when WB through the knee joint the surfaces approximate on eachother and dont let the knee flex do not have the breaking action unless you bear weight in the prosthesis
41
safety knee
AK weight activating break --if WB on the prosthesis it doesn't let the knee flex beyond 20 DEGREES in stance we dont flex the knee anymore--like when in swing, if WB through the prosthesis it wont flex beyond 20 degrees so you dont stumble (WB on good leg to stand and to sit)
42
Internal Extension Aide
AK spring in prosthesis helps the knee go into terminal extension --spring compressed in flexion and then recoil in extension ensure complete extension and knee locks so that knee wont collapse when WB in gait ----this is useful for the geriatric lock knee unit to help achieve that terminal extension to lock the knee
43
External Extension Aide
AK rubber elastic band in front runs from socket to anterior portion of the knee unit/lower shank stretches in flexion and recoils in extension
44
Quadrilateral Socket
AK - older: use for 1. fluctuating limb 2. limb that is not tolerant to pressure walls: medial to lateral dimension is greater than anterior to posterior dimension (rectangle, wider medial to lateral) ischial shelf: primary site of WB by Ischial Tuberosity and underlying soft tissue concavities: (relief) - medial to shelf: hamstrings - lateral to shelf: glut max - lateral to socket: bicep femoris - anterior medial: adductor longus - posterior medial: hamstring tendon Scarpas Bulge: anterior wall has a convexity to provide posteriorly directed force to keep the IT on the shelf
45
concavities in the quadrilateral socket
concavities: (relief) - medial to shelf: hamstrings - lateral to shelf: glut max - lateral to socket: bicep femoris - anterior medial: adductor longus - posterior medial: hamstring tendon
46
scarpas bulge
on the anterior wall to provide a posterior directed force to keep the IT on the shelf
47
indications for quadrilateral socket for AK
- older: use for 1. fluctuating limb 2. limb that is not tolerant to pressure
48
which way is the quadrilateral socket wider?
medial to lateral
49
ischial containment socket
AK better pressure distribution --more symmetrical shape for better pressure distribution IT is contained (not on a shelf) more total surface WB around the ischial tuberosity and overlying tissue but also near the inferior pubic ramus
50
difference between ischial containment socket and the quadrilateral socket
AK the ischial shelf and the medial lateral being wider than the AP
51
Suspensions in AK
1. Total Elastic Suspension belt (TES) 2. Silesian Belt 3. Pelvic Band Suspension 4. Suction Suspension
52
Total Elastic Suspension Belt
AK TES belt (like over the knee sleeve that is BK): partial suction with belt uses partial suction--soft velcro material and neoprene material and expel air out of socket and use TES for added suspension
53
Silesian Belt
partial suction comes up and over iliac crests (like SC of BK)
54
Pelvic Band Suspension
AK mechanical hip joint over anatomical hip joint leather band encircles pelvis (like thigh corset of the BK) hip joint with mechanical hip joint and a band that encircles the pelvis --add bulk and heavy but added support for suspension does not use suction suspension GOOD FOR RESIDUAL LIMB THAT FLUCTUATES IN SIZE
55
suction suspension AK
AK total suction if you dont see any belts or straps or bands easier to total suction AK than on BK because tissues more tolerant to suction

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