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Prosthetic Prep Exam 33 Flashcards

0
Q

In a below elbow amputee, it is desirable to?

A

Retain at least 50% of pronation and supination

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1
Q

The max pinch force of a two load hook?

A

7 lbs.
The “two-load” hook has “lyre-shaped” fingers for this reason. As its name suggests, a small switch at the base of the thumb permits the amputee to engage either one spring (1.6 kg, 3½ lb) or two springs (3.2 kg, 7 lb) to vary the pinch force.

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2
Q

When the arm is over head, the trapezius muscles?

A

Positions the glenoid cavity upward.

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3
Q

The action of the deltoid muscle is to?

A

Flex the gleno-humeral joint.

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4
Q

T/F Latissimus dorsi and supraspinatus are prime movers in glenohumeral extension?

A

False
Latissimus dorsi internal rotation, adductions, some shoulder extension
supraspinatus- abducts the shoulder, stabilizes head of humerus.

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5
Q

Glenohumeral horizontal flexion is obtained from action of the?

A

Deltoid

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6
Q

Which of the muscles listed is a prime mover for elbow flexion?

A

Brachialis

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7
Q

If a patient with 65% length below elbow can flex his elbow only 90%, the use of a step-up hinge is indication?

A

True, Step-up hinges are used by very short transradial (below elbow) amputees. Because the trim line of the socket must be high, the patient looses flexion at the elbow. In order for step-up hinges to work, the forearm section and the socket of the prosthesis are separate. As the amputee flexes the residual limb, the forearm section moves twice as far, thus creating a greater range of motion for the terminal device.

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8
Q

The below elbow arm is generally suspended by?

A

An inverted Y strap

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9
Q

The rhomboids orginate on?

A

Thoracic vertebrae and insert along the scapula from the root of the spine to the inferior angle.

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10
Q

The deltoids provide?

A

Humeral abduction, flexion, and extension.

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11
Q

Which of the following are reasonable ranges of glenohumeral motion in the average human?

A

Flexion 180, extension 60, abduction 180, adduction 20.

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12
Q

The anterior support strap on the AE shoulder?

A

Pass over the deltoid pectoral groove.

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13
Q

The axilla loop?

A

Passes under the axilla on the non-amputated side and provides a secure anchor for the entire harness system.

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14
Q

The control attachment strap?

A

Attached strap passes below mid scapula level, is attached to the metal hanger on the upper end of the control cable and looped back through a buckle for adjustability. it is an intergral part of the control cable system.

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15
Q

Location of the ring ot cross point of the harness?

A

Below the spinous process of C7 slightly towards the sound side

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16
Q

In the medium length BE there can be some residual pronation because the? because the pronator teres is still largely intacts
pronator teres– pronation, and elbow flexion. innervated by the median nerve

A

Because the pronator teres is still largely intacts

pronator teres– pronation, and elbow flexion. innervated by the median nerve.

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17
Q

The cross point of the figure * harness on the AE should be slightly to the sound side because?

A

It will allow the terminal device control cable to locate low across the scapula

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18
Q

In order to flex the elbow, the AE amputee with a figure of 8 harness?

A

Unlocks the elbow (with slight ext and abd of glenohumeral joint along with shoulder derpression on prosthetic side), then flexes the gleno-humeral joint.

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19
Q

The amount of humeral flexion required to fully flex the elbow of an AE prosthesis should not exceed?

A

45 degrees.

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20
Q

If the prehension force of the terminal device is less than the force required to flex the elbow, the AE amputee harnessed for dual control with a dorrance hook, will find what happens when he attemps to flex his elbow?

A

The terminal device will open.

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21
Q

Shoulder disart prosthesis is operative pirmarily by what control motion?

A

Scapular abduction.

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22
Q

If the AE amputee is having difficuilty in flexing the elbow of his prosthesis he would be aided by?

A

Moving the forearm life loop distally
increasing the prehension force of the terminal device
replacing a steel hook with aluminum (makes it lighter)
adding a cross back strap to the harness (least effective).

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23
Q

The lever type excursion amlifier provides increased excursion at the expense of?

A

Force: A simple excursion amplifier consists of a small pulley attached near the posterior end of the chest strap of the harness. The proximal end of the elbow flexion/terminal device cable passes through the pulley and is attached to the posterior surface of the prosthetic shoulder cap. With this type of amplifier each 2.5 cm (1 in.) of cable excursion generated by biscapular abduction causes the elbow flexion/terminal device control cable to move through an excursion of 5 cm (2 in.). Consequently 5.6 cm (2¼ in.) of chest expansion produces the 11.3 cm (4½ in.) of cable excursion required for full elbow and terminal device operation
It should be noted that although the incorporation of a pulley in the harness system doubles the cable excursion, it also doubles the input force required for elbow flexion and/or terminal device operation

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24
Which normal function can be mechaincally re-produce in a prosthetic arm?
Joint stabilization.
25
The initial socket brim for a short AE amputation would be trimmed on a line?
One to two inches above the acromion.
26
Symes amputation stovepipe design?
Removable inner soft liner made typically of pelite, built up in med shaft to maintain shape. Rigid outter socket, inner is split to allow bulbos distal end through
27
Canadian bivalve socket? Posterior window that extends to the proximal brim allowing easy inseration of limb. structurally weak due to posterior opening
Posterior window that extends to the proximal brim allowing easy inseration of limb. structurally weak due to posterior opening.
28
Medial opening door of symes amputation?
Similar to canadian, with medial opening becuae of proximal medial malleulous, and natural curvature of resdiual limb. forces around opening of medial window, significantly reduced compared to posterior opening.
29
Biomechanics of symes?
* Limited space between socket, and foot- limits adjustablility * foot should be soft enough to absorb some impact ambulation yet firm enough to provide adequate forward propulsion of limb * knee joint flexes more at initial contact to absorbe shock space between socket, and foot- limits adjustablility * foot should be soft enough to absorb some impact ambulation yet firm enough to provide adequate forward propulsion of limb * knee joint flexes more at initial contact to absorbe shock space between socket, and foot- limits adjustablility * foot should be soft enough to absorb some impact ambulation yet firm enough to provide adequate forward propulsion of limb * knee joint flexes more at initial contact to absorbe shock
30
Transibital amputation eval should include?
``` Activity level/ sports geographic location time since amputation medical condition empolyment patient goals shape of residual limb soft tissue skin problems condition of knee joint range of motion/ muscle strength condition of thigh muscular. ```
31
Patella tendon bearing socket design? Weight bearing areas patella bar medial tibial flare Otto bock socket design: Long residual limbs, supra condylar trim lines, but can be lowered as long as suspension isn't interfered with, dynamic casting starting at 45degrees 194.Plantar flexion bumper: Heel stiffness
Weight bearing areas patella bar medial tibial flare
32
Munster? For short residual limbs, anterior/posterior compression biceps tendon and olcranon cast in 90 degrees, need a pull sock
For short residual limbs, anterior/posterior compression biceps tendon and olcranon cast in 90 degrees, need a pull sock.
33
Northwestern socket design? Medium length residual, may not need a pull sock, cast at 45 degrees, supra condylar suspension
Medium length residual, may not need a pull sock, cast at 45 degrees, supra condylar suspension.
34
Otto bock socket design?
Long residual limbs, supra condylar trim lines, but can be lowered as long as suspension isn't interfered with, dynamic casting starting at 45degrees.
35
Plantar flexion bumper?
Heel stiffness
36
195 Dorsiflexion bumper?
Keel stiffness
37
Which of the following is the most common cause of heel whip during swing phase?
Excessive rotation of knee.
38
The most important reason for gathering and recording a patients information is to?
Ensure the proper componentry is used.
39
An amputation at the level of the styloid would be considered which amputation?
Wrist dis articulation
40
An amputation of the upper extremity through the cubital fold would be classified as?
An elbow disarticulation.
41
Upon heel strike in BK prosthesis, where are the anterior posterior forces?
Anterior distal posterior proximal--> because the foot transitions to foot flat and the tibia moves forward.
42
Primary weight bearing surface in a Symes socket?
Heel pad
43
203.Cuff suspensions are most commonly used for patients who?
Have trouble donning and doffing.
44
Bench alignment for a BK prosthesis begins with?
Center of posterior brim 1.3 cm lateral to the center of the heel.
45
A patient with no flexion contracture?
The amount of flexion in socket at bench alignment is.: 5degrees
46
To increase knee stability in an above knee prosthesis with a single axis foot, the prosthesis should?
Plantar flex foot.
47
What are areas on a BK residual limb are most suitable for weight bearing?
Patella bar Medial tibial flare Gastrocnemius area
48
A person with a above knee amputation may have an abducted gait if?
There is pain or discomfort in the crouch, the prosthesis is too long
49
What type of suspension is best suited for a person with a below knee amputation, a short limb and some medial lateral instability?
Supra condylar.
50
T/F Contra lateral drop of the pelvis lowers the body at its highest point in the gait cycle?
True
51
When the knee is flexing the tibia rotates on the femur, which way?
Internally rotates.
52
When the knee is extending the tibia rotates on the femur, which way?
Externally rotates
53
When should you use flexible hinges?
Body powdered long trans radial and wrist disarticulation.
54
When should you use step-up hinges?
Bilateral amputee, very short bone length very limited elbow flexion.
55
Advantages and disadvantages of body powdered prosthesis?
Advantages-ability to achieve high level of accuracy/speed | Disadvantages-discomfort caused by the shoulder harness and appearance of hook/terminal device.
56
Advantages and disadvantages of myo electric prosthesis?
Advantages- freedom from suspension harness function of prosthesis is closer to human hand. Disadvantages- much stronger grip forces/slower operation than body powdered hook. May find issues with prosthesis in hostile environment where dirt/water/ dust are frequent.
57
Figure 9 harness?
Primarily with self suspending socket that require a harness only to provide terminal device operation.
58
Figure 8 harness?
Most popular, ring cross point provides adjustable posterior fixation for all the strap.
59
Shoulder saddle harness?
For amputees who do unusual amount of heavy lifting. Provide relive from axilla pressure. Can be seen easier with certain clothing (v neck/blouses).
60
Quick disconnect/locking wrist?
One or more terminal device can be used, routinely performed activities that eliminate of any unwanted wrist rotation. Can be locked in many different positions but has no rotation.
61
Standard friction wrist?
Provides passive wrist rotation, economical component.
62
Flexion wrist?
For bilateral amputee, provides passive wrist rotation. Economical wrist unit.
63
Multidirectional ball and socket wrist?
Provides not only flexion but also wrist extension as well as radial and ulnar deviation.
64
Muscles that move the scapula?
Pectoralis major, serrated anterior, trapezius, elevator scapula, rhomboideus major, rhomboideus minor
65
Muscles that move the humerus?
Pectoralis major. Latiddimus dorsi, deltoid, subscapularis, supraspinatus, infraspinstus, teres minor, teres major, corcobrachialis.
66
What is the effect of shimming the dorsi flexion stop to place the shank in a vertical position?
Excessive shortening in range of planter flexion, resulting in stiffened plantar bumper and knee instability.
67
If an AK amputee complains of pressure on the pubic ramus, the prosthetist should?
Lower the medial trim line 1/8 in at a time.
68
To determine the control system efficiency of an upper extremity prosthesis?
Divide the force measured at the terminal device by the force at the hanger. Note-this should be at least 70 percent
69
An axilla pull test on an upper extremity prosthesis should be?
A force of 50 lbs and should not displace the socket more that an inch.
70
In an below elbow amputee, it is desirable to?
Retain at least 50% of pronation and supination available
71
Two load hook, max pinch hook?
7lbs
72
When the arm is over head, the trapezius muscle?
Positions the glenoid cavity upward.
73
T/F The latissimus dorsi and supraspinatus are prime movers in glenohumeral extension?
False Latissimus dorsi-extends addicts and medially rotates Supraspinatus-abducts humerus stabilization the glenohumeral joint.
74
T/F If a patient with 65% length below elbow can flex his elbow only 90 degrees, the use of step up hunger is indicated:
True
75
The below elbow arm is generally suspended by?
An inverted Y strap.
76
The rhomboids originate on?
Thoracic vertebrae and insert along the scapula from the root of the spine
77
External or lateral rotation of humerus is accomplished with the?
Teres minor and infraspinatus.
78
Internal rotation of the humerus is produced by contraction of the?
Subscapularis teres major and Pectoralis major.
79
The triceps muscles?
Extends shoulder, extends elbow.
80
T/F Biceps not only extend the elbow but also flexes the glenohumeral joint?
False
81
In an upper extremity amputation, surgery what is the best length?:
As much length as possible should be retained.
82
The greatest disadvantage to the amputee in using any step-up hinge?
Loss of flexion power in forearm. | But for every 1degree you flex the joint the elbow flexes 2 degrees

Prosthetics (8 decks)

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