Prosthetics

Question 1

Who is a healthcare provider who designs, fabricates, and fits limb prostheses?

Answer 1

Prosthetist

Question 2

Describe the K levels for prostheses.

Answer 2

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

Question 3

What is the difference between an exoskeletal shank and an endoskeletal shank?

Answer 3

Exoskeletal = Rigid plastic  shaped to simulate contour of leg, very durable
Endoskeletal = central aluminum or rigid plastic tube (pylon), looks natural with cover on

Question 4

What is the socket on a transtibial prosthesis?

Answer 4

Plastic receptacle that distributes load, assists in venous blood circulation, and provides maximum tactile feedback.

Question 5

When should the socket be altered or replaced by prosthetist?

Answer 5

When the patient requires a total of 15 ply of socks to achieve snug fit

Question 6

What are the types of suspension for a prostheses?

Answer 6

Distal Metal Pin (Very secure)
Vacuum Assisted Suspension
Thigh Corset

Question 7

What all does a transfemoral prosthesis consist of?

Answer 7

Foot-ankle assembly
Shank
Knee unit
Socket
Suspension device

Question 8

What are the 4 main features of a knee unit?

Answer 8

Axis
Friction Mechanism
Extension aid
Mechanical Stabilizaer

Question 9

Is a single axis hinge or polycentric linkage system more stable?

Answer 9

Polycentric linkage provides more stability

Question 10

What are the 2 types of extension aids?

Answer 10

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

Question 11

Where is the knee axis usually aligned when given a line from the greater trochanter to the ankle?

Answer 11

Posterior

Question 12

Where do you want to avoid excessive pressure with a transferal socket?

Answer 12

Pubic symphysis and perineum

Question 13

What are the types of suspension for a transfemoral protheses?

Answer 13

Total Suction (max control)
Partial suction (need auxiliary suspension too)
No Suction (requires pelvic band

Question 14

How do you want to clean the sockets?

Answer 14

Damp cloth with warm watering small amount of mild soap.

Then wipe with damp cloth and dry with fresh towel

Question 15

How do you want to store your prosthetic?

Answer 15

Upright position with knee extended

Question 16

When are prostheses contraindicated?

Answer 16

Patients with:
Severe dementia
Severe Depression
Advanced cardiopulmonary disease

Question 17

How much can a socket slip?

Answer 17

<1/4 inch

Question 18

What is the goal of walking with a transferal prosthesis?

Answer 18

Make it comfortable, safe, efficient rather than duplicating the gait of someone without an amputation

Question 19

What is the first thing you want to work on with prosthetic training?

Answer 19

Balance

stability -> Controlled mobility -> Skill

Question 20

What are the main causes of amputation in the elderly/young?

Answer 20

Elderly - PVD

Young - Trauma

Question 21

Describe appropriate prosthesis for individuals with a phalangeal amputation.

Answer 21

Can use padding in shoe to fill open space with arch support orthosis

Question 22

Describe appropriate prosthesis for individuals with a transmetatarsal amputation.

Answer 22

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

Question 23

What’s the difference between the Syme’s and the Transtibial amputation prostheses?

Answer 23

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

Question 24

What prosthetic feet are especially suitable for elderly patients?

Answer 24

Single-axis feet - more stable, easier to use, lightweight, can be adjusted
Solid ankle fusion heel (SACH foot) most common

Question 25

What are the relief areas in a transtibial socket?

Answer 25

Fibular head, tibial crest, tibial condyles, anterior-distal tibia,

Question 26

What are the build-ups for a transtibial socket?

Answer 26

Gastric, patellar ligament, proximal-medial tibial corresponding to the pet anserine, and tibial and fibular shaft sides

Question 27

What are the modes of suspension for the transtibial prosthesis?

Answer 27

Distal metal pin
Vacuum Assisted Suspension
Thigh Corset
Supracondylar cuff

Question 28

Which type of suspension is indicated for a very short amputation limb (transtibial)

Answer 28

Supracondylar cuff with possible thigh corset

Question 29

Describe the modes of suspension of a transferal prosthesis.

Answer 29

Suction suspension
Partial suction (requires sock)
No suction (requires sock)

Question 30

What are some important maintenance procedures you want to do with your prosthesis?

Answer 30

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

Question 31

What are some factors you want to consider prior to formulating a prosthetic prescription?

Answer 31

Physical function
Psychosocial characteristics
Ambulation ability
Characteristics of residual limb (scar, length, ROM)
Financial resources
Access to maintenance

Question 32

Briefly describe a training program/plan of care for a patient with a newly fitted transferal prosthesis.

Answer 32

Transfers from various chairs
Donning/doffing prosthesis
Gait training
Weight shifting/balance
control of prosthesis
lifting/carrying objects
Stairs