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PM&R > Prosthetics and Orthotics > Flashcards

Prosthetics and Orthotics Flashcards

1
Q

Most common cause of UE amputation?

A

trauma (due to MVC)

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2
Q

Most common cause of LE amputation?

A

dysvascular disease

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3
Q

Most common suspension system for UE prosthetic?

A

Figure 8 harness

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4
Q

UE prosthetic terminal device that is best suited for lifting heavy objects

A

hook

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5
Q

What type of grasp due UE body-powered devices normally employ?

A

three-jaw chuck pinch

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6
Q

What type of terminal device remains closed at rest?

A

voluntary-opening

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7
Q

With an UE prosthetic with dual cable controls, what actions flex the elbow into place or open/close the terminal device?

A

biscapular abduction and humeral flexion

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8
Q

In an UE prosthetic with dual cable controls, what actions lock or unlock the elbow into/out of place?

A

shoulder depression, extension, and abduction (“down, back, and out”)

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9
Q

What is the ideal residual limb shape in a transfemoral amputation?

A

conical

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10
Q

What is the ideal residual limb shape for a transtibial amputation?

A

cylindrical

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11
Q

What is the name for a horizontal amputation through the calcaneus?

A

Boyd

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12
Q

What type of amputation is preformed at the tarsal-metatarsal joint?

A

Lisfranc

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13
Q

What is it called when muscles are sutured to bone?

A

Myodesis

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14
Q

What is it called when muscles are sutured to each other?

A

Myoplasty

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15
Q

What is a vertical amputation through the calcanenus called?

A

Pirigoff

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16
Q

What K levels have variable cadence?

A

K3 and K4

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17
Q

What K level is a unlimited household ambulator but limited community ambulator?

A

K2

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18
Q

What is the range of grades for K levels?

A

K0 to K4

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19
Q

What K levels have fixed cadence?

A

K1 and K2

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20
Q

What is the difference between K1 and K2?

A

K1 ambulates in one environment (house) where as K2 ambulates in two environments (house and community)

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21
Q

What is the mantra for remembering energy cost of ambulation in a traumatic amputation?

A

“20, 40, 60, 200” for uni TT, bi TT, uni TF, bi TF respectively. Practice motion of chopping off limbs at different sites and repeating the mantra. Double numbers for dysvascular.

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22
Q

What is the prefered socket for transfemoral amputation?

A

Ischial containment with narrow ML dimension

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23
Q

How does an ischial containment socket position the thigh?

A

In slight flexion and adduction (advantageous stretched postion for extensors and abductors)

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24
Q

How do the dimensons of a quadrilateral socket differ from an ischial containment socket?

A

The quadrilateral socket has a wide medial-lateral dimension as opposed to the narrow ML dimension of the ischial containment socket

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25
Q

What are the six pressure-tolerant areas for a transtibial socket? (know cold)

A
  1. patellar tendon
  2. fibular shaft
  3. medial tibial flare
  4. medial tibial shaft
  5. anterior tibial muscles
  6. popliteal fossa
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26
Q

What four lab markers can be elevated in heterotopic ossification?

A

Alk phos, ESR, CRP, CK

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27
Q

What causes verrucous hyperplasia in amputees?

A

poor socket fit causing venous choking

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28
Q

What are two main causes of excessive valGus knee moment in a transtibial amputee?

A

ValGus knee is secondary to the foot being set too far Laterally, socket is too aDducted (GLaD)

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29
Q

In a transtibial amputee, how does foot placement affect knee movement?

A

If the foot is too far anterior, this will cause excessive knee extension. (opposite effect for the socket)

30
Q

With pediatric prosthetics, how often is the socket replaced up to age of 5?

A

every year

31
Q

In pediatric prosthetics, from what ages is the prosthetic replaced every two years?

A

12 to 21

32
Q

What is a non invasive cervical orthosis that can be used for unstable cervical fractures?

A

Minerva Jacket

33
Q

What are two TLSO braces that can be used to prevent hyperflexion of the TL spine in treatment of vertebral body compression fractures?

A

Jewett, CASH

34
Q

What TLSO has straps over the shoulders to promote an upright spine posture?

A

Taylor

35
Q

What is the intrinsic plus position used for hand splinting?

A

MCPs in flexion (70 -90 degrees), PIPs and DIPs in extension, thumb in palmar abduction

36
Q

What type of AFO can be used in cases of severe spasticity?

A

rigid

37
Q

What type of knee brace is used to prevent hyperextension?

A

Swedish Knee Cage

38
Q

Among those with diabetes who have a LE amputation, how long until up to 55% will require amputation of the second leg?

A

2 - 3 years

39
Q

Diabetes contributes to what portion of all LE amputations?

A

two-thirds

40
Q

When is amputation of the “mangled hand” considered?

A

Irreparable damge to four of the six basic parts (bone, tendon (F/E), vessels, nerves, skin)

41
Q

In what type of patient would you consider using an electric wrist rotator unit?

A

bilateral UE amputee

42
Q

What type of socket is preferred for the short transradial amputee?

A

Muenster socket (self-suspended)

43
Q

Between body-powered and myoelectric devices, which one provides stronger grip force?

A

myoelectric

44
Q

What is the most common cause of LE amputation in patients up to 5 years old?

A

congential or deformity requiring amputation

45
Q

What is the most common cause of LE amputation in those aged 15 - 50 yo?

A

trauma

46
Q

What ABI indicates Moderate PAD?

A

0.41 - 0.70

47
Q

What percentage of tibial length is preserved in a standard BKA?

A

20-50%

48
Q

What precentage of femoral length is preserved in a standard AKA?

A

35-60%

49
Q

What type of foot deformity results from a Lisfranc and Chopart amputations?

A

equinovarus

50
Q

What can be done to prevent equinovarus deformity after Lisfranc or Chopart amputation?

A

dorsiflexor tendon reattachment with Achilles tendon lengthening

51
Q

What is the advantage of a modified knee disarticulation over a standard AKA?

A

With a modified knee disarticulation, the patient can bear weight on the residual limb with a suction-socket and there is no need for ischial weight bearing

52
Q

In a healing surgical wound, what are three causes of a chronically draining sinus?

A

abscess, osteomyelitis, bone spur

53
Q

For about how long after surgery is a temporary prosthesis used?

A

3 - 6 months

54
Q

What are three types of prosthetic feet available for a Syme’s amputation?

A

SACH, SAFE, Energy-storing carbon fiber

55
Q

How many degrees of knee flexion contracture can be accomodated in a transtibial socket?

A

25 degrees

56
Q

What is the advantage of a single-axis foot over SACH foot?

A

A single-axis foot can progress to foot flat more quickly and therefore provide greater knee stability

57
Q

What is the cause of choke syndrome?

A

proximal prosthetic socket is too tight

58
Q

How will a hard heel cushion affect the knee?

A

A hard heel cushion will create more of a knee flexion moment

59
Q

What change in knee mechanics will cause a lateral whip?

A

excessive knee Internal Rotation will cause a Lateral WHip. Mnemonic is WHIRL a whip (an actual ice cream/burger joint outside Sprinfield, IL)

60
Q

Which bone is the most common site of bony overgrowth in acquired amputations in children?

A

humerus (bony overgrowth in childern with an amputation is no laughing matter)

61
Q

Where does the line of gravity pass during quiet standing?

A
  • behind cervical vertebrae
  • in front of thoracic vertebrae
  • behind lumbar vertebrae
  • behind the hip (hip extension moment)
  • in front of the knee (knee extension moment)
  • in front of the ankle (dorsiflexion moment)
62
Q

What are the three different set-up options for a single channel ankle joint?

A
  • posterior spring (dorsiflexion assist)
  • posterior pin (plantar flexion stop)
  • posterior spring and pin (combination of above)
63
Q

What is a Scott-Craig orthosis?

A

bilateral KAFOs with posterior offset knee used for standing and ambulation in adults with paraplegia (L1 or lower)

64
Q

What modification can be made to a knee immoblizer to decrease rotational instabiity of the knee?

A

adding a footplate

65
Q

What is a Swedish knee cage used for?

A

prevent knee hyperextension

66
Q

How does the long opponens splint differ from the basic opponens orthosis?

A

the long opponens splint crosses the wrist to maintain the wrist in extension and prevent radial/ulnar deviation

67
Q

How does a swan neck splint function?

A

It prevents PIP hyperextension (Image A)

68
Q

What level tetraplegia can benefit from a tenodesis orthosis?

A

C6 (3+ or better wrist extensors)

69
Q

What can be used as an alternative to a halo vest in unstable C-spine fractures?

A

Minerva jacket

70
Q

What are two TLSOs that prevent flexion and are used to treat compression fractures?

A

Jewett (image below) and CASH braces

71
Q

What is a Milwaukee brace?

A

A CTLSO used to treat scoliosis

PM&R (78 decks)

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