Prosthetic Prep Exam 33 Flashcards
In a below elbow amputee, it is desirable to?
Retain at least 50% of pronation and supination
The max pinch force of a two load hook?
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.
When the arm is over head, the trapezius muscles?
Positions the glenoid cavity upward.
The action of the deltoid muscle is to?
Flex the gleno-humeral joint.
T/F Latissimus dorsi and supraspinatus are prime movers in glenohumeral extension?
False
Latissimus dorsi internal rotation, adductions, some shoulder extension
supraspinatus- abducts the shoulder, stabilizes head of humerus.
Glenohumeral horizontal flexion is obtained from action of the?
Deltoid
Which of the muscles listed is a prime mover for elbow flexion?
Brachialis
If a patient with 65% length below elbow can flex his elbow only 90%, the use of a step-up hinge is indication?
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.
The below elbow arm is generally suspended by?
An inverted Y strap
The rhomboids orginate on?
Thoracic vertebrae and insert along the scapula from the root of the spine to the inferior angle.
The deltoids provide?
Humeral abduction, flexion, and extension.
Which of the following are reasonable ranges of glenohumeral motion in the average human?
Flexion 180, extension 60, abduction 180, adduction 20.
The anterior support strap on the AE shoulder?
Pass over the deltoid pectoral groove.
The axilla loop?
Passes under the axilla on the non-amputated side and provides a secure anchor for the entire harness system.
The control attachment strap?
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.
Location of the ring ot cross point of the harness?
Below the spinous process of C7 slightly towards the sound side
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
Because the pronator teres is still largely intacts
pronator teres– pronation, and elbow flexion. innervated by the median nerve.
The cross point of the figure * harness on the AE should be slightly to the sound side because?
It will allow the terminal device control cable to locate low across the scapula
In order to flex the elbow, the AE amputee with a figure of 8 harness?
Unlocks the elbow (with slight ext and abd of glenohumeral joint along with shoulder derpression on prosthetic side), then flexes the gleno-humeral joint.
The amount of humeral flexion required to fully flex the elbow of an AE prosthesis should not exceed?
45 degrees.
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?
The terminal device will open.
Shoulder disart prosthesis is operative pirmarily by what control motion?
Scapular abduction.
If the AE amputee is having difficuilty in flexing the elbow of his prosthesis he would be aided by?
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).
The lever type excursion amlifier provides increased excursion at the expense of?
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
Which normal function can be mechaincally re-produce in a prosthetic arm?
Joint stabilization.
The initial socket brim for a short AE amputation would be trimmed on a line?
One to two inches above the acromion.
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
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.
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.
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
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.
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
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.