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Prosthetics > Prosthetic Management > Flashcards

Prosthetic Management Flashcards

1
Q

what is the importance of K levels

A

determines what prosthetic they get and is important for insurance companies

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2
Q

basic description of K2 level

A

community ambulator

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3
Q

basic description of K1 level

A

household ambulator

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4
Q

basic description of K3 level

A

community ambulator with variable cadence

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5
Q

basic description of K4 level

A

ambulation exceeds basic skills; exhibits high impact stress and energy levels

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6
Q

what is the most commonly used prosthetic for transtibial amputations

A

lock and pin

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7
Q

things to be aware of for donning and doffing

A

make sure its reflected all the way back to avoid blistering and skin breakdown
check alignment of the pin

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8
Q

what are the warning signs of poor skin care

A

change in color of skin lasting more than 15-20 min
red, irritated or open area on skin
increased pain or edema
calluses or dry cracked skin

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9
Q

wearing schedule of prosthesis

A

day 1-2: 30 min am and pm
day 3-4: 1 hour am and pm
day 5-10: 2 hors am and pm
day 11-14: full day but remove at lunch and dinner for skin checks
day 14: full time; recommended to check fit once a day

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10
Q

cleaning of inserts and sockests

A

inserts should be wiped out daily with mild soap and warm water with time to dry. inspect for cracks or damage

sockets should be cleaned out at least weekly by wiping with warm water and towel. clean at night to dry

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11
Q

what incorrect foot placement is more concerning in the sagittal plane

A

when the foot is placed lateral to the socket. placement tends to cause a rotation of the socket that creates friction and rubbing

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12
Q

what side of the UE should be removed from the parallel bars first during weight shifting activities

A

remove the sound side UE first and keep the prosthetic limb as the stance leg

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13
Q

what muscles are active to stabilize the body during prosthetic stance activities

A

hip extensors and hip AB

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14
Q

what key element are you working on during initial ambulation in the parallel bars

A

working on facilitating pelvic rotation. important to restore this by using manual cuing for normal gait pattern

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15
Q

what type of gait pattern on the stairs does someone with a transfemoral amputation usually have

A

step to pattern

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16
Q

what type of gait pattern on the stairs does someone with a transtibial amputation usually have

A

step over step pattern

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17
Q

what is the purpose of loading the prosthetic toe

A

to achieve knee flexion

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18
Q

which side of the body would be able to achieve more arm swing

A

more arm swing on the sound side due to the fact that there is less rotation on the prosthetic side

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19
Q

what happens to the knee when there is posterior displacement of the socket over the foot

A

the knee is extended for too long because the foot is too far forward

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20
Q

reasons for why the knee remains extended along with corrections

A
  • foot is too anterior (move foot posteriorly to correct)
  • foot is too PF (move foot into DF to correct)
  • excessive use of knee extensors or weak quads (strengthening and gait training to correct)
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21
Q

what occurs with anterior displacement of the socket

A

excessive knee flexion

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22
Q

causes and corrections of knee flexion

A
  • foot too posterior (move foot anteriorly to correct)
  • foot too DF (move foot into PF)
  • weak knee extensors (quad strengthening to correct)
23
Q

with what type of amputation does lateral trunk bending always occur

A

hip disarticulation

24
Q

causes and corrections for lateral trunk bending

A

prosthesis too short (measure leg length to correct)

RL pain (evaluate fit and need for additional socks to correct )

weak RL ABductors (abductor strengthening exercises to correct)

25
Q

what is a correction for wide based gait

A

move the foot medial

26
Q

what is a simple correction for a narrow based gait

A

move the outset foot laterally

27
Q

how is the direction of a whip determined

A

named for what the heel is doing

28
Q

why would vaulting occur

A

in transfemoral if the prosthesis is too long

29
Q

why would circumduction occur

A

in transfemoral if the prosthesis is too long, poor suspension or difficulty flexing the knee

30
Q

cause of unequal stride length

A

fear of putting weight through the prosthetic limb

31
Q

causes and corrections of lateral trunk bending in TRANSFEMORAL

A 
weak AB (strengthen abductors)
high medal wall of prosthesis (modify prosthesis )
short prosthesis (lengthen prosthesis)
AB contracture (stretch AB)
instability (balance training)
foot outset too far (move foot medially)
32
Q

causes and corrections of pistioning

A

socket too loose (add socks, assess fit)

inadequate suspension (assess suspension)

improper donning (patient education)

33
Q

causes and corrections of circumduction

A 
long prosthesis (shorten it)
excessive PF ( move foot into DF)
weak hip flexors (strengthen hip flexors)
abductor contracture (stretch abductors )
34
Q

what motion at the hip is crucial for knee stability in stance

A

hip extension

35
Q

causes and corrections of whips

A

improper alignment of knee joint in relation to the socket (realign knee)

36
Q

what is the knee joint set in for a medial whip to occur

A

external rotation

37
Q

what is the knee joint set in for a lateral whip to occur

A

internal rotation

38
Q

why do people with transfemoral amputations need hip extension

A

controls knee extension

39
Q

how would a silesian bandage be a helpful correction for whips

A

coming above the waist can help control the rotation from below

40
Q

possible causes of instability at the knee

A

malfunction of stance control knee
weak hip extensors
hip flexor contractuure
excessive DF

41
Q

What occurs during an audible snap

A

terminal knee extension before heel strike

42
Q

possible causes of terminal swing impact

A

insufficient knee friction

fear of buckling causes pt to forcefully extend the hip

43
Q

possible causes of foot rotation at heel strike

A 
stiff heel cushion
malrotation of the foot
poor hip control
weak hip rotators
socket too loose
44
Q

possible causes of uneven step length

A

hip flexion contracture
excessive knee friciton
pain on prosthetic limb
prosthesis too long

45
Q

what side of the body will have a shorter step length and why

A

the sound side will have a shorter step length because they don’t want to stand for a long time on the prosthetic side

46
Q

what is the main cause of uneven arm swing

A

not enough pelvic rotation

47
Q

possible causes of drop off at terminal stance

A

inadequate DF resistance
foot positioned too far posterior
foot too DF
stride too long on sound leg

48
Q

possible causes of lordosis (excessive trunk extension)

A

hip flexor contracture
weak hip extensors and abdominals
excessive anterior pelvic tilt
inadequate socket flexion

49
Q

possible causes of excessive heel rise

A

insufficient knee friction

forceful hip flexion to ensure adequate knee extension and cleareance

50
Q

causes of excessive knee flexion in early stance

A

SACH heel too firm
foot set in too much DF
knee axis too anterior to hip and ankle
severe hip flexor contracture

51
Q

causes of pisitioning

A

socket too loose
inadequate suspension
improper donning

52
Q

what does pisitioning do to the limb

A

lengthens the limb

53
Q

what gait deviations are more common for transfemoral

A 
vaulting
circumducted gait
unequal stride length
lateral trunk bending
abducted gait
hip hiking
whips
excessive heel rise
pistioning
lordosis
drop off
decreased arm swing
foot rotation at heel strike
terminal swing impact
54
Q

what gait deviations are more common for transtibial

A 
knee hyperextension
excessive knee flexion
lateral trunk bending
wide based gait
delayed knee flexion

Prosthetics (2 decks)

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