Prosthetics Flashcards
Who is a healthcare provider who designs, fabricates, and fits limb prostheses?
Prosthetist
Describe the K levels for prostheses.
K0=Not a candidate
K1=Household ambulation
K2=Limited community ambulation
K3=Community ambulation, and the ability to vary cadence
K4=High levels of activity such as active adults and athletes
What is the difference between an exoskeletal shank and an endoskeletal shank?
Exoskeletal = Rigid plastic shaped to simulate contour of leg, very durable Endoskeletal = central aluminum or rigid plastic tube (pylon), looks natural with cover on
What is the socket on a transtibial prosthesis?
Plastic receptacle that distributes load, assists in venous blood circulation, and provides maximum tactile feedback.
When should the socket be altered or replaced by prosthetist?
When the patient requires a total of 15 ply of socks to achieve snug fit
What are the types of suspension for a prostheses?
Distal Metal Pin (Very secure)
Vacuum Assisted Suspension
Thigh Corset
What all does a transfemoral prosthesis consist of?
Foot-ankle assembly Shank Knee unit Socket Suspension device
What are the 4 main features of a knee unit?
Axis
Friction Mechanism
Extension aid
Mechanical Stabilizaer
Is a single axis hinge or polycentric linkage system more stable?
Polycentric linkage provides more stability
What are the 2 types of extension aids?
External - elastic webbing in front of knee axis, stretches during knee flexion and recoils to extend in late swing
Internal - elastic strap or coiled spring within the knee unit
Where is the knee axis usually aligned when given a line from the greater trochanter to the ankle?
Posterior
Where do you want to avoid excessive pressure with a transferal socket?
Pubic symphysis and perineum
What are the types of suspension for a transfemoral protheses?
Total Suction (max control) Partial suction (need auxiliary suspension too) No Suction (requires pelvic band
How do you want to clean the sockets?
Damp cloth with warm watering small amount of mild soap.
Then wipe with damp cloth and dry with fresh towel
How do you want to store your prosthetic?
Upright position with knee extended
When are prostheses contraindicated?
Patients with:
Severe dementia
Severe Depression
Advanced cardiopulmonary disease
How much can a socket slip?
<1/4 inch
What is the goal of walking with a transferal prosthesis?
Make it comfortable, safe, efficient rather than duplicating the gait of someone without an amputation
What is the first thing you want to work on with prosthetic training?
Balance
stability -> Controlled mobility -> Skill
What are the main causes of amputation in the elderly/young?
Elderly - PVD
Young - Trauma
Describe appropriate prosthesis for individuals with a phalangeal amputation.
Can use padding in shoe to fill open space with arch support orthosis
Describe appropriate prosthesis for individuals with a transmetatarsal amputation.
Plastic socket fixed to a rigid plate that extends for the remainder of the foot in the shoe. It can have a plastic calf shell that is strapped around the leg
What’s the difference between the Syme’s and the Transtibial amputation prostheses?
Syme’s is suspended by the contour brims and socket walls, doesn’t have a shank. Distal tibia/fibula is cut but they save the calcanea fat pad.
Transtibial - include foot-ankle assembly, shank, socket, and suspension component. Knee intact, generally medium length of leg below the knee left
What prosthetic feet are especially suitable for elderly patients?
Single-axis feet - more stable, easier to use, lightweight, can be adjusted
Solid ankle fusion heel (SACH foot) most common
What are the relief areas in a transtibial socket?
Fibular head, tibial crest, tibial condyles, anterior-distal tibia,
What are the build-ups for a transtibial socket?
Gastric, patellar ligament, proximal-medial tibial corresponding to the pet anserine, and tibial and fibular shaft sides
What are the modes of suspension for the transtibial prosthesis?
Distal metal pin
Vacuum Assisted Suspension
Thigh Corset
Supracondylar cuff
Which type of suspension is indicated for a very short amputation limb (transtibial)
Supracondylar cuff with possible thigh corset
Describe the modes of suspension of a transferal prosthesis.
Suction suspension Partial suction (requires sock) No suction (requires sock)
What are some important maintenance procedures you want to do with your prosthesis?
Make sure screws and bolts are tight Store upright Replace bumper Avoid areas with high amounts of dust or are wet Don't scratch piston Clean with moist cloth
What are some factors you want to consider prior to formulating a prosthetic prescription?
Physical function Psychosocial characteristics Ambulation ability Characteristics of residual limb (scar, length, ROM) Financial resources Access to maintenance
Briefly describe a training program/plan of care for a patient with a newly fitted transferal prosthesis.
Transfers from various chairs Donning/doffing prosthesis Gait training Weight shifting/balance control of prosthesis lifting/carrying objects Stairs
