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Prosthetics > Prosthetic Components and Wearing > Flashcards

Prosthetic Components and Wearing Flashcards

1
Q

Socket

A
  • Portion of the prosthesis that encompasses residual limb
  • Made by casting of residual limb; making bony prominences to be built up
  • Avoid pressure on bony prominences; weight bear through patellar tendon
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2
Q

Transtibial Sockets

A
  • Medial and lateral brims extend above femoral condyles for increased stability
  • Posterior wall lower medially
  • Picking sockets depends on patient’s anatomy
  • May need multiple sockets because residual limbs change in size so often the first year
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3
Q

Patellar tendon bearing (PTB)

A
  • Type of transtibial socket
  • Patellar bar - indentation in socket at patellar tendon for WB purposes
  • Posterior wall stabilizes and maintains contact of patellar ligament on bar
  • Medial tibial flare is other major WB surface
  • Relief given at fibular head
  • Sockets are total contact but not WB through end so gives change for distal edema
  • Socket in 5 degrees flexion but with extension puts pressure forward
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4
Q

Total surface bearing (TSB)

A
  • Type of transtibial socket
  • Distributes pressure throughout residual limb
  • Will incorporate PTB components
  • Will permit WB on soft tissue of residual limb
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5
Q

Supracondylar/Suprapatellar

A
  • Type of transtibial socket
  • Socket extends above patella
  • Similar to PTB with addition of quad bar above patella that goes into quads
  • Increased stability particularly for short residual limbs
  • Is its own form of suspension
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6
Q

Symes amputations

A
  • Expandable wall socket
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7
Q

Quad socket (square-like)

A
  • Transfemoral socket
  • Narrow anterior to posterior
  • Ischium sits on posterior brim
  • Wide medial to lateral
  • Abducted femur in stance
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8
Q

Ischial containment or ischial ramal containment socket (IRC)

A
  • Transfemoral socket
  • Narrower medial to lateral
  • Pushes femur into anatomical adduction
  • Wider anterior to posterior than quad socket
  • Improves muscle contraction
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9
Q

Marlo Anatomical Socket (MAS)

A
  • Transfemoral socket
  • most similar to ischial containment but has differences
  • Variation of IRC
  • Posterior trim line lower than IRC
  • Allows more freedom of glut max and improved comfort in sitting
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10
Q

Subischial Socket/Elevated Vacuum socket

A
  • Transfemoral socket

- Only used with elevated vacuum suspension

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11
Q

Interface

A
  • What goes between patient and socket
  • More interface, more protection from shear forces of socket
  • ADds more padding for purposes of WB
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12
Q

Sheath

A
  • Type of interface
  • Very thin nylon
  • May be silver impregnated
  • Disperse moisture
  • Reduce friction/shear on skin
  • Helps with patients who get very sweaty
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13
Q

Gel Liners

A
  • Type of interface
  • Can be used for protection or suspension
  • Thicker side in front; inside is sticky on skin
  • Silicone elastomers or gels
  • Urethane - good for custom liners for limbs that have unusual shape or bony prominence
  • May be donned directly on skin or over sheath
  • Reduce pressure
  • Decrease shear
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14
Q

Prosthetic socks or ply socks

A
  • Type of interface
  • Comes in different thicknesses
  • Decreases moisture
  • Reduce pressure
  • Decrease shear
  • Adds extra cushioning
  • Also used over gel liner to maintain optimal fit of socket with residual limb volume changes
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15
Q

Soft insert

A
  • Type of interface
  • Made of dense foam for further protection
  • Good for patients with bulbus distal end - more flexible
  • Molded similar to socket
  • Separate from socket, don separately
  • Extends slightly above trim line of socket
  • Should have interface between skin and soft insert but does provide pressure relief
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16
Q

Flexible inner socket

A
  • Type of interface
  • Made of flexible but firm plastic
  • Adheres to inside of rigid socket
  • Adds cushion; improves pressure distribution
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17
Q

Suspension

A
  • How prosthesis adheres to body
  • Form of suspension is determined by length of limb, shape of residual limb, shape of body/body habitus, sensation/propioception (esp UE), dexterity of individual, cognition
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18
Q

Belt Suspension

A
  • Type of suspension
  • Inverted Y and waist belt (transtibial, elasticized to allow for hip extension & knee flexion, elastic recoil assists with limb advancement during swing, waist belt attaches to Y strap at anterior thigh)
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19
Q

Silesian Belt

A
  • Type of suspension
  • Transfemoral
  • Generally not used as sole form of suspension
  • Difficult to control rotation of limb inside socket
  • Strap secured to lateral socket, buckled around waist or to anterior socket
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20
Q

Total elastic suspension (TES) Belt

A
  • Type of suspension
  • Transfemoral
  • Similar to Silesian belt
  • Neoprene cuff around socket with velcro secured waist belt
  • Not used as only form of suspension
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21
Q

Cuff Strap

A
  • Type of suspension
  • Transtibial
  • Thigh cuff, secured with buckle
  • Above femoral condyles and proximal brim of patella
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22
Q

Thigh Corset

A
  • Old form of suspension
  • Transtibial
  • Corset secured to thigh
  • Hinged knee joint
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23
Q

Sleeve Suspension

A
  • Transtibial
  • Neoprene and other elasticized material with silicone inside
  • Fits snug around thigh
  • Must be incontact with skin for several inches if using other interface
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24
Q

Locking or suspension liners

A
  • Gel liners for comfort or shock absorption that has some sort of suspension to them
  • Types: Pin locking, strap suspension, KISS, coyote lock
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25
Q

Pin locking

A
  • Transtibial or transfemoral
  • Pin secured to end of gel liner and will drop in hole in prosthesis
  • Shuttle lock at bottom of socket
  • Push button on outside to release
  • Allows for rotation
26
Q

Strap suspension

A
  • Transtibial or transfemoral
  • Strap secured to end of gel liner
  • Feeds through hole in bottom of socket
  • Velcros back on itself once fed through D ring attached to outside of socket
  • Allows for rotation
27
Q

KISS (Keep it simple suspension)

A
  • Transfemoral
  • Same as strap suspension distally
  • Has window in upper part of socket for strap
  • Has buckle attached to anterolateral thigh which feeds through hole in socket
  • Strap attaches back onto buckle vs. D ring on outside of socket
28
Q

Coyote lock

A
  • Transfemoral
  • Looks like ski-boot clip
  • Buckle attached to anterolateral thigh feeds through hole in socket
  • Locks into attachment on outside of socket
  • Can help prevent more rotation than suspension
29
Q

Suction Suspension

A
  • Not appropriate for patients with fluctuating edema

- Types: True/pull-in, seal-in, elevated vacuum

30
Q

True Suction/Pull-in suction

A
  • Transfemoral more common
  • Negative pressure, one way air valve
  • Skin to socket, no interference
  • Dooming sock/parachute
  • Lubricant
  • Do not use with new amputee
31
Q

Seal in suction

A
  • Transfemoral or transtibial
  • Negative pressure, one way air valve
  • Cushion liner with rubber seal
  • Donning parachute
  • Can use ply socks with bottom cut off but cannot cover gasket
32
Q

Elevated vacuum

A
  • Transfemoral or transtibial
  • Creates negative pressure via vacuum pump on outside of socket
  • Cushion liner with rubber seal
  • Helpful for short residual limbs
  • More expensive than other suspensions
  • Most intimate
33
Q

Initial wearing

A
  • Progress much like wearing an orthosis (begin about 1-2 hours)
  • Patient education (skin checks before or after; areas that blister; decreased ability for temp regulation; increased potential for shearing; should not wear lotions on skin; should not shave; volume changes)
34
Q

Selection of Dynamic Prosthetic Components

A
  1. Cognition
  2. Functional goals
  3. Functional level
  4. K levels
  5. Amputee Mobility Predictor Assessment
35
Q

K0

A
  • Patient does not have ability or potential to ambulate or transfer safely with or without prothesis
36
Q

K1

A
  • Patient has ability or potential for transfers or ambulation on level surfaces only at a fixed cadence
37
Q

K2

A
  • Patient has the ability or potential for ambulation with low-level environmental barriers
38
Q

K3

A
  • Patient has the ability or potential for ambulation with variable cadence and can traverse most environmental barriers
39
Q

K4

A
  • Patient has ability or potential for ambulation and activities that exhibit high impact stress or energy levels
40
Q

AMPPRO

A
  • Used for single LE amputation of any level with prosthetic donned
  • Can be done with or without assistive device
41
Q

AMPNOPRO

A
  • Used for single LE amputation without a prosthesis
42
Q

AMP-B

A
  • Bilateral LE amputation with bilateral prosthesis donned
43
Q

Toe fillers

A
  • Improve gait kinematics and prevent mobility and shearing inside shoes
  • Insert in bottom of shoe with custom lace up shoe/boot
  • Foot orthosis with attached filler for toes
  • Symes feet - similar to other feet but made with lower profile
44
Q

K1 feet

A
  • Solid ankle, cushion heel (SACH foot)
  • Heel allows for shock absorption
  • Flexibility for toe off comes from rubber forefoot
45
Q

K2 feet

A
  • Single or multi-axis ankles
  • Flexible heel
  • Full length toe
  • Adjustable flexibility
  • Much more stable than K3
46
Q

K3 feet carbon fiber

A
  • May be called energy storing or dynamic response feet
  • Full length toe, split toe design
  • Split toe - helps with pronation, supination, inversion, eversion
  • Multi-axial ankles
  • Adjustable flexibility of plantarflexion response
47
Q

K3 microprocessor

A
  • Respond to changes in terrain
  • Adjust PF and DF to inclines
  • Weights more than carbon fiber
  • Most have split toe design
  • BiOM generates PF power to replicate gastroc
  • Must be customized/programmed and requires charging
48
Q

K4 feet

A
  • Special activity feet for running, swimming, rock climbing, cycling, and skiing
49
Q

Covers & Add-ons

A
  • Torsion rotator - decrease impact on leg and knee; can add height
  • Shock absorber - decrease impact on leg and knee
  • Adjustable heel height
  • All feet except K4 have cover to fit in shoes and provide lifelike appearance
  • Knee rotator for transfemoral prosthesis allows for prosthetic components to rotate at attachment at socket
  • Silicone covers/cosmetic covers are not covered by insurance
50
Q

Pylon exoskeletal

A
  • Transtibial socket is attached to ankle via hard frame shaped to match the contralateral limb
  • Durable
  • Difficult to adjust
51
Q

Pylon endoskeletal

A
  • Most common
  • Generally tubular structure connecting socket to ankle
  • May or may not be covered to provide lifelike shape & appearance
  • Highly adjustable
  • Modular parts
52
Q

Integrated pylon

A
  • Foot is continuous with pylon
  • Lightweight
  • Decreased adjustability
53
Q

K1 prosthetic knee

A
  • Single axis knee
  • Hinge that swings freely from flexion to extension; most have locks because of poor stability
  • Constant friction determines speed of swing
  • Unable to vary cadence
  • May have extension assist
  • Difficult to stabilize in stance
  • May have manual lock and can be used when locked in extension
54
Q

K2 polycentric knee

A
  • Also called four knee bar
  • Moving center of rotation based on several hinges that work in relation to one another
  • Shortens once flexed, improved symmetry of gait for patients w/ long residual limb
  • Unable to vary cadence
  • Improved stability in stance
55
Q

K2 weight-activated stance control knee

A
  • Essentially a single axis knee but with breaking mechanisms
  • Break is weight reactive to prevent further flexion while WB
  • Provides increased stability during initial contact and throughout stance
56
Q

K3 & K4 pneumatic knees

A
  • Use of air pressure & compression to control knee extension
  • Increased compression force yields increased speed of extension
  • Allows for variable cadence
  • Can be affected by temperature (cold worse)
57
Q

K3 & K4 Hydraulic knees

A
  • Similar mechanism as pneumatic knee but uses fluid
  • Heavier than pneumatic knee but more consistent due to increased density of fluid
  • Can be affected by temperature (cold worse)
58
Q

K3 & K4 swing and stance (SNS)

A
  • Combination of hydraulic knee with weight activated stance control
  • Allows for break in flexion while WB
59
Q

K3 & K4 microprocesser

A
  • Use of sensors determines relationship of knees to ankle jt, pressure of ground forces, speed & direction of acceleration
  • All used to determine flexion v. extension and speed of progression into knee extension
  • Must be customized via computer
60
Q

Bilateral transfemoral prosthesis - stubbies

A
  • Used for initial prosthetic training to achieve ability to balance, core stability, weight shift, and ambulate without added complexity of knee joints
  • Sockets are same as other sockets
  • Have short pylons and feet are flat discs/ovals
  • Heights can be progressed

Prosthetics (4 decks)

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