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Neuroscience > Prosthetics day 2 > Flashcards

Prosthetics day 2 Flashcards

Day 2 info

1
Q

what percent account for UE amputations that are trauma related?

A

92%

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2
Q

what are the 4 stages of UE prosthetic rehab?

A
  1. acute care
  2. pre-prosthetic rehab
  3. basic prosthetic training
  4. Advanced functional skills
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3
Q

what 5 things happens in the acute care phase?

A
  1. control edema
  2. control pain
  3. preserve PROM in residual limb
  4. evaluate to identify priorities and predict outcome (not everyone wants a prosthesis and can successfully adapt to one)
  5. promote wound healing
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4
Q

7 pre-prosthetic UE rehab goals

A
  1. De-sensitize limb (dec phantom pain and sensation)
  2. shape limb and control volume
  3. psychological and emotional support
  4. minimize adhesive scar tissue
  5. ROM and strengthening of residual limb
  6. Provide PT intervention for associated injuries (like pulling arm- brachial plexus or neck injuries)
  7. independence in ADL’s (single limb skills)- completely dependent
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5
Q

what are 6 things that can help manage phantom limb pain or sensation?

A
  1. mirror therapy
  2. de-sensitzation
  3. weight bearing on UE
  4. TENS unit
  5. Medication
  6. prosthetic use
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6
Q

How can you practice body symmetry after losing a limb?

A

Walking, sitting, address posture and skeletal alignment (hiking shoulder, leaning over), mirror for visual feedback for asymmetry

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7
Q

psychological support includes who?

A

for person, family, very important in early rehab, peer counselors for limb loss, return to community activities

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8
Q

what are the 5 test and measures for prosthetics?

A
  1. MMT (musculoskeletal)
  2. goniometry (ROM)
  3. Circumferential measurements
  4. sensation (neuro)
  5. Skin integity (integumentary)
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9
Q

Types of prosthesis?

A
  1. no prosthesis
  2. passive prosthesis/ cosmesis
  3. cable or body powered prosthesis (mechanical devices)
  4. myoelectric prosthesis- motors or hybrid elbows- can release part of prosthesis
  5. hybrid design
  6. activity prosthesis
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10
Q

types of UE prosthesis?

A

socket, suspension, elbow, wrist, terminal device

Socket —The point at which the prosthesis is attached to the wearer’s own body, these are cast to fit the person’s residual limb as comfortably and securely as possible.

Suspension —Whether through the use of a harness, suction, or friction, this is the system through which the prosthetic limb is connected between the socket and residual limb.

Interposing joints —These are the points at which the prosthesis can be moved and manipulated, typically at the elbow and wrist and within the terminal device.

Terminal device —This refers to the prosthetic hand at the end of the prosthesis, which can be a hook, claw, or device that more closely resembles a hand.

Control system —These can be body-powered, externally powered (such as myoelectric or myoelectric pattern recognition), or a hybrid of the two systems. This is how the wearer can control his or her prosthesis.

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11
Q

in a conventional or body powered UE prosthetic, what kind of suspension does it have?

How does the cable (connection) to the terminal device function?

A

figure 8 hardness

A cable to terminal device isa system used in upper-limb prosthetics that allows an amputee to open and close a terminal device, such as a hand or hook, by applying tension to a cable:

Cable:The cable is anchored to a harness worn by the amputee.

Terminal device:The terminal device is attached to the cable and can be a hand, hook, or prehensor.

Control:The amputee opens and closes the terminal device by moving their body in a way that pulls the cable.For example, they can bring their arm forward and up (glenohumeral flexion) or move their arm out to the side (scapular abduction).

There are different types of terminal devices, including:

Voluntary-opening:The user must apply force to open the terminal device.

Voluntary-closing:The user must apply force to close the terminal device.

Passive:These devices have no moving parts and don’t require cables or batteries

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12
Q

What 2 motions do you have to do to open and close a body powered prosthesis?

A
  1. Biscapular abduction- lateral movement of the shoulder blades away from the spine
  2. Shoulder flexion- not as much flexion
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13
Q

to the lock and unlock the elbow in an UE prosthesis, what shoulder motions do you do?

A

Shoulder depression, extension and abduction

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14
Q

True or false? in a trans humeral level amputation the biceps are used to close and the triceps are used to open the body powered prothesis

A

true

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15
Q

trans radial amputation level has what common myocyte muscles for wrist flexors and extensors?

A

Flexors- FCR, FCU (forearm)
Extensors- Brachioradialis, ECRB/ECRL (on top)

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16
Q

terminal device types for hands (UE)

A
  1. passive hand (cosmetic not functional)
  2. hook or hand (voluntary opening, passive closing with shoulder movements, actively opening- you do it, myoeletric)
  3. Job specific TD
  4. Sport specific TD
17
Q

after how many months does the success rate or likelihood of continuing to wear prosthesis decrease if individuals are not fitted within this time period for their prosthesis?

A

6 months

18
Q

What are some training for functional tasks?

A
  1. don and doff prosthetic
  2. operate terminal device at all levels
  3. grasp objects of various sizes
  4. Assist in self care: feeding, dressing, toileting
19
Q

other types of prosthetic training (more basic than you think)

A
  1. prosthesis control and proportional control like grabbing water and not spilling it or breaking the glass
  2. increase wearing time
  3. pt ed to understand how to operate all prosthetic components
20
Q

how can addressing posture help with preventing comorbidities?

A

minimize compensatory movements to decrease overuse injuries and secondary comorbidities (remember to have sufficient rest periods)

21
Q

skills training can include:

A
  1. using utensils to eat
  2. preparing food
  3. opening and closing jars
  4. dressing
  5. toileting
22
Q

what does advanced prosthetic training include?

A
  1. fine motor skills with prosthesis
  2. bimanual tasks (picking pen is unilateral vs picking up large physio ball)
  3. return to work and driving
  4. Sports and recreational activities

Neuroscience (6 decks)

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