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Med Con Prosthetics > Prosthetics > Flashcards

Prosthetics Flashcards

1
Q

What does IPOP stand for?

A

Immediate Post-Op Prosthesis

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2
Q

What does RRD stand for?

A

Removable Rigid Dressing

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3
Q

Purpose of the preparatory prosthesis?

A

to provide early ambulation, shape the residual limb, and be cost effective

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4
Q

What are the material options for the socket of a preparatory prosthesis?

A

it can be laminated or polypropylene

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5
Q

Is a pylon endoskeletal or exoskeletal?

A

endoskeletal

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6
Q

What is the purpose of the socks?

A

the purpose is to provide stability while in the prosthetic

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7
Q

How long does the preparatory stage normally last?

A

between 4 and 6 months

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8
Q

What will happen to the limb during the preparatory stage? What can be done in relation to fitting?

A

it will continue to decrease in size due to atrophy of the residual tissue. Extra socks can be added to made up for the loss or socket replacement

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9
Q

What are the advantages/disadvantages of an exoskeletal prosthesis

A

Advantages: it is durable; lightweight; and cheap
Disadvantages: it isn’t cosmetically pleasing, limited part options, and not alignable

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10
Q

What are the advantages/disadvantages of an endoskeletal prosthesis?

A

Advantages: cosmetics, component options, alignable
Disadvantages: not as durable, heavy, expensive

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11
Q

What are the various socket design options for trans-tibial prosthetics?

A

open end; patella tendon bearing; total surface bearing; knee joint and thigh lacer

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12
Q

What are some of the ways in which a trans-tibial prosthetic can be suspended?

A

waist belt; suspension sleeve; suction; pin; supracondylar cuff or wedge; sub-atmospheric

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13
Q

How does suction suspension work?

A

through utilization of an expulsion valve to expel extra air and a suspension sleeve to seal

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14
Q

What form of suspension has a large constant suspension and eliminated positioning?

A

Sub-Atmospheric

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15
Q

What are the different types of socket liners?

A

hard; pelite; multi-durometer; gel

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16
Q

What does SACH stand for?

A

Solid-Ankle-Cushion-Heel

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17
Q

What is a SAFE foot?

A

Stationary Attachment Flexible Endoskeleton; this foot is flexible.

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18
Q

What are energy storing feet?

A

Oscar Pistorius

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19
Q

What are the various levels of ability/potential for an amputee?

A 
K0: cant walk even w/prosthesis
K1: in home and even surface walking
K2: community ambulation
K3: various cadences available
K4: highly active (athlete)
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20
Q

What is a Symes amputation?

A

an amputation through the ankle joint leaving the fat pad of the heel as the residual limb.

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21
Q

What are some disadvantages to a syme’s amputation?

A

can’t weight bear; not many prosthetic options;

would be better to do transtibial

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22
Q

What is the most common place for a sore to develop on the trans-tibial amputee? Why?

A

Anterior-Distal Tibia (it is bone, rotation or the prosthesis, and forces on that area)

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23
Q

What are the stages of prosthesis design?

A

Patient eval.; impression technique; positive model modification; socket fabrication; alignment stages (bench, static, and dynamic)

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24
Q

What are the objective of prosthetic fitting?

A

to maximize weight bearing surface; maintain M-L stability; encourage knee flexion throughout stance phase

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25
Q

What is the formula for pressure?

A

Pressure = Force/Area

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26
Q

What are the pressure tolerant areas of the tibia?

A

patella tendon; medial tibial flare; medial tibia; pre-tibial muscles; shaft of fibula; posterior gastrocnemius

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27
Q

What are the pressure sensitive areas on the tibia?

A

tibial tuercle; tibial crest; Anterior-Distal Tibia; distal fibula; hamstring tendons; fibular head; peroneal nerve

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28
Q

What is done to compensate for pressure sensitive areas?

A

we build up over them to help relieve pressure

ex: a shelf for the hamstring tendons (at or above patellar tendon)

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29
Q

What effect does socket flexion have?

A

the greater the flexion of the socket the greater the pressure on the front

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30
Q

What is the landmark for measuring height?

A

the patellar tendon

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31
Q

What is a problem with void in a vacuum type prosthetic?

A

it will suck the limb down into the residual space even if it is too big to fit

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32
Q

What is the purpose of socks?

A

positioning of the limb

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33
Q

What is the purpose of a sleeve?

A

suspension

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34
Q

Why are socks added throughout the day?

A

because when a prosthetic is worn all day the residual limb size will fluctuate requiring addition of socks

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35
Q

Should a new amputee wear their prosthetic all day?

A

No; can take up to a month to reach that point

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36
Q

What is the purpose of proper suspension?

A

to provide comfort, control, and proprioception

37
Q

What type of contractures are common for trans-tibial amputees?

A

Knee/hip flexion contractures

38
Q

What type of contractures are common for transfemoral amputations?

A

need to worry about hip flexion and abduction contractures

39
Q

What is the purpose of a shrinker sock?

A

to help reduce edema

40
Q

What are the various components for a transfemoral prosthetic?

A

Socket; End pad; Suspension

41
Q

What is crucial to gait for a transfemoral prosthetic?

A

the ability to maintain knee extension during gait

42
Q

What is the purpose of the preparatory stage?

A

to allow for a stable limb volume to be obtained;

helps prevent wearing of excessive socks and socket replacement due to improper fit

43
Q

What types of materials must be used if placed over a prosthetic for cosmetics?

A

those that will not interfere with the prosthetic knee

(generally a soft foam)

44
Q

What are the various socket design options for a definitive trans-femoral prosthetic?

A

plug fit-open end; quadrilateral; ischial containment

45
Q

Who invented the ischial containment socket design?

A

Ivan Long

46
Q

What are the suspension options for a trans-femoral prosthetic?

A

TES belt; silesian bandage; hip joint; pelvic band; pelvic belt; suction

47
Q

What is a downside to a TES belt?

A

is elastic so it will stretch during gait potentially causing deviations. (may be better as a secondary suspension incase primary fails)

48
Q

What is a downside to the silesian bandage?

A

it has a tendency to IR the limb

49
Q

What is the most stable suspension type for a trans-femoral posthetic?

A

suction

50
Q

What is a problem with the pin type suction?

A

it want to come off the limb so it end up pulling and can cause a fluid fill tissue build up

51
Q

How does an ICEROSS Seal in liner work?

A

has a ring that needs to remain in contact with the wall of the prosthetic in order to maintain the seal.

52
Q

What are the advantages/disadvantages to a single vs. multi ring ICEROSS?

A

a single ring has the potential to have socks added to it while a multi does not.
a multi ring will maintain suction if a ring fail, but a single ring will lose it

53
Q

What are the different foot types for a definitive prothesis?

A

SACH; Single Axis; Multiaxis; Flexible Keel; Energy Storing

54
Q

What type of feet are used of knee stability is a concern?

A

a foot that allows the ground reaction force to get ahead of the knee as quickly as possible (allows for maintaining of extension)

55
Q

What are the different types of prosthetic knees?

A

single axis; manual locking; weight activated locking; polycentric; pneumatic; hydraulic; MPK (Microprocessor Knee)

56
Q

What is the difference between a pneumatic and hydraulic?

A

pneumatic operates with air while a hydraulic operates with water

57
Q

What population are hydraulic knee prosthetics meant for?

A

those that walk at multiple speed with various cadences

58
Q

What does a posterior offset of a knee prosthetic help with?

A

knee extension due to line of ground reaction force

59
Q

What knee prosthetic has an on board computer?

A

Otto Bock C-Leg (processes information at a speed of 50x per second)

60
Q

What are the various sources of input for the on-board computer in an Otto Bock C-Leg

A

An ankle stress gauge; knee ankle position; and knee motion

61
Q

What is the most common place for a sore to develop on the transfemoral amputee?

A

the lateral-distal femur (it gets pushed to the lateral wall)

62
Q

What knee type is most common for new amputees?

A

a safety knee

63
Q

What is the most common gait deviation in a trans-femoral amputee?

A

a step to gait pattern due to distrust of the prosthetic (want to get “off” it asap)

64
Q

What are the biomechanical objectives for a trans-femoral prosthetic?

A

M-L femoral stabilization (femur wants to move laterally); maintain knee extension during stance phase; allow normal stride length on sound side

65
Q

What role does knee flexion play at the pelvis?

A

it allows for the pelvis to dip

66
Q

What does TKA stand for in relation to prosthetics?

A

Trochanter/Knee/Ankle

67
Q

What is the purpose of the TKA?

A

helps to identify the alignment between the center of socket weight line, the rotation point of the knee and the functional rotation point of the ankle/foot

68
Q

How do Otto Bock C-Legs do with stair?

A

they perform very well due to the constant adjustments made by the computer

69
Q

What effects can alignment have on a prosthesis?

A

can greatly effect both the comfort and stability of the prosthesis

70
Q

What should be considered about a prosthetic foot in relation to alignment?

A

foot length; heel durometer; and heel height

71
Q

What should be considered about a prosthetic knee in relation to alignment?

A

functional level of the amputee; sound side strength; and strength of the upper extremity

72
Q

Why is TKA alignment so important?

A

it promotes knee stability

73
Q

What does socket flexion in a trans-femoral prosthetic allows for?

A

an even stride length

74
Q

What causes a medial whip?

A

Prosthetic: ER of Knee; tight socket; mis-aligned toe break
Amputee: gait habit, socket not on right; ER of hip at toe off

75
Q

What causes lateral whip?

A

Prosthetic: IR of the knee; loose socket; mis-aligned toe break
Amputee: gait habit, socket not on right; IR of hip at toe off

76
Q

What causes an ABducted gait?

A

Prosthetic: too long; medial wall too high; poor femoral stability;
Amputee: Abduction contracture; insecurity by patient requiring wider BOS

77
Q

What causes a circumducted gait?

A

Prosthetic: long prosthesis; excessive knee friction; excessive knee stability
Amputee: lack of knee flexing confidence; abduction contracture; weak hip flexors; habit

78
Q

What causes vaulting?

A

prosthetic: too long; poor suspension; excessive PF; excessive knee resistance
amputee: fear of to catching; poor hip flexor initiation

79
Q

What causes heel rise?

A

Prosthetic: inadequate extension aid; insufficient knee friction; improper knee selection
Amputee: excessive hip flexor use

80
Q

What causes knee instability?

A

Prosthetic: excessive DF; poor TKA alignment; insufficient socket flexion; mal-alignment of foot
Amputee: weak hip extensors; hip flexion contracture

81
Q

What causes uneven timing what a short prosthetic step?

A

Prosthetic: pain; weak extension aid; unstable knee; excessive DF; poor suspension
Amputee: insecurity; weak hip muscles; poor balance

82
Q

What causes uneven timing with a long prosthetic step?

A

Prosthetic: excessive PF; insufficient initial socket flexion
Amputee: flexion contracture; patient insecurity; pain on sound side

83
Q

What causes a lateral shift?

A

Prosthetic: foot too far inset; excessive socket ABD
Amputee: weak hip Abductors; narrow gait base

84
Q

What causes a lateral trunk bend?

A

Prosthetic: foot outset too far; ineffective lateral socket containment; high medial wall; aligned in abduction
Amputee: inadequate balance; abduction contracture; short residual limb

85
Q

What causes a toe drag?

A

Prosthetic: long prosthesis; excessive PF or knee friction
Amputee: weak hip abductors on sound side; poor posture; poor gait habits

86
Q

What are signs that a patients prosthesis is too long?

A

patient reports LBP; feels like walking uphill; noticeable rise and drop of shoulder on effected side; reduced arm swing on effected side and increased on sound

87
Q

What are the four factors that contribute to gait deviations?

A

the patient; prosthetic alignment; socket fit;

rehab teamwork can resolve these

88
Q

What knee types prevent heel rise?

A

pneumatic and hydraulic

Med Con Prosthetics (2 decks)

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