Prosthetics (Exam 2)

Question 1

IPOP

Answer 1

Immediate postoperative prosthesis

Question 2

RRD

Answer 2

Removable rigid dressing

Question 3

Una paste, air splint.

Answer 3

Semirigid dressing

Question 4

Shrinker, elastic bandage.

Answer 4

Soft

Question 5

Improves outcomes, allows early ambulation, allow for rapid changes in volume, maximizes potential for future prosthetic use, allows for changes in swelling.

Answer 5

IPOP

Question 6

Advantages of IPOP

Answer 6

Protect wound site, reduce falls, speeds-up the training and adjustment period, improve balance and safety during transfers, comfort and protection.

Question 7

The general purpose is to shape the residual limb and decrease swelling in the limb to expedite prosthetic fit and management.

Answer 7

Removable Rigid Dressing (RRD)

Question 8

There must always be _____ layer of sock under RRD.

Answer 8

One

Question 9

Reduces edema, provides soft-tissue support and protection, allows for early ambulation.

Answer 9

Advantages Semi-Rigid

Question 10

Does not protect as well as rigid, requires more changing, may loosen and allow for edema to develop.

Answer 10

Disadvantages Semi-Rigid

Question 11

Reduces edema, provides some protection, inexpensive, easily removed for wound inspection, allows AROM.

Answer 11

Advantages Soft (Ace Wrap, Shrinker)

Question 12

Tissue healing interrupted by frequent dressing, changes and joint ROM. Cannot control the amount of tension in the bandage.

Answer 12

Disadvantages Soft (Ace Wrap, Shrinker)

Question 13

Assists in the shrinking and maturation of the residual limb.

Answer 13

Compression wrapping

Question 14

Compression needed for _____ months after surgery.

Answer 14

3-4 months

Question 15

Two types of Compression

Answer 15

Figure-8, Recurrent

Question 16

Pressure directed ___ and ____ for wrapping technique.

Answer 16

Centrally, proximally

Question 17

Pressure ___ distally and progressively ____ as moved proximally.

Answer 17

Higher, Decreased

Question 18

Elastic sleeve with one end tapered and sewn shut. Held in place with velcro or tape. Easier to apply than compression wraps. Not as much protection.

Answer 18

Shrinker sock

Question 19

ROM to prevent flexion contractures, particularly of the hip and knee. Prone position every 3-4 hours.

Answer 19

Post-op Exercise

Question 20

Sitting promotes ___ flexor and ____ flexor contractures.

Answer 20

Hip (TT, TF), Knee (TT)

Question 21

TF also a risk for _____ contracture.

Answer 21

Abduction

Question 22

Supine resting position promotes hip ____ contracture.

Answer 22

ER (TT, TF)

Question 23

Restore foot function, simulate shape of missing foot segment.

Answer 23

Partial Foot Prostheses

Question 24

Pt. bears most of weight on the heel. Riding plate added into prosthetic foot. To aid late stance, bottom of the prosthesis or sole of the shoe may have a rocker bar.

Answer 24

Transmetatarsal Amputation

Question 25

Adaptation to uneven surfaces, shock absorption, limb length adjustments, stabilization of the knee, limb shortening during gait.

Answer 25

Functions of Prosthetic Feet

Question 26

Wooden keel and polyurethane foam heel wedge, common for TT and TF amputations, no moving parts, simulates PF as the heel wedge compresses at heel strike.

Answer 26

Solid Ankle Cushion Heel (SACH)

Question 27

Allows limited motion for PF/DF.

Answer 27

Single Axis Foot

Question 28

Graphite laminate heel and forefoot. Stored energy from loading the toe is returned at push off. 20% energy savings over SACH foot.

Answer 28

Energy Storing Feet Flex-Foot

Question 29

Wool or synthetic. Severe to add volume within the socket as limb volume increases. Socks come in many sizes and thickness from 1-6 ply. Number and ply may be changed by patient depending on size of residual limb.

Answer 29

Stump Socks

Question 30

Used for TT amputations. Uses total contact (force exerted over entire residual limb), has specific areas of weight bearing and non weight bearing.

Answer 30

Patellar Tendon Bearing (PTB) Socket

Question 31

Patellar tendon, medial flare of the ant. tibia, lateral aspect of limb, lateral surface of the fibula distal to the head, and popliteal fossa.

Answer 31

Weight Bearing Patellar Tendon Bearing (PTB) Socket

Question 32

Patella, tibial tubercle, crest of the tibia, distal end of tibia, fibular head, hamstring tendons, common peroneal nerve, and saphenous nerve.

Answer 32

Non-Weight Bearing Patellar Tendon Bearing (PTB) Socket

Question 33

New amputees often need to be taught to walk in some _____ throughout the stance phase, due to the alignment of the socket.

Answer 33

Knee Flexion

Question 34

Apply forces over the entire residual limb. No areas of relief except no weight bearing on ends of cut bones. Uses a liner.

Answer 34

Total Surface Bearing Socket

Question 35

Refers to the components and design features used to hold a prosthesis in place during ambulation and ADLs.

Answer 35

Transtibial Suspension

Question 36

Riveted to the medial and lateral walls of the socket, closes around the lower thigh. May result in pressure in the popliteal space.

Answer 36

Supracondylar Cuff

Question 37

Used with PTB. Removable wedge. Inserted by the amputee inside the medial wall of prothesis.

Answer 37

Medial Wedge

Question 38

Wedge maintains limb in place during both stance and swing phase. Allows amputee to remove the entire medial aspect of the socket.

Answer 38

Removable Medial Wall

Question 39

Usually when there is instability of the knee and uses knee hinges for support.

Answer 39

Thigh Corset and Knee Hinges

Question 40

Allows for no swing-phase flexion and provides complete stability. Pin allows amputee to bend knee in sitting. Primarily in geriatric patients.

Answer 40

Manually Locking Knee (Transfemoral)

Question 41

Most basic. Allows knee flexion during swing phase but must be stabilized by GRFs during stance phase. Amputee just use hip muscles to hold knee in full extension.

Answer 41

Single Axis (Constant Friction) (Transfemoral)

Question 42

Limited ambulatory. When weight bearing on prothesis, knee compresses the spring and contracts a syndical brake. This friction stabilizes the knee and prevents further motion. Impossible to flex knee during pressing until it fully unlocks and spring opens, releasing brake device.

Answer 42

Stance Control (Friction Brake) Knee

Question 43

Socket characterized by four distinct shaped proximal walls. Uses total contact. Sockets aligned in a few degrees of adduction and flexion.

Answer 43

Quad Fitting (Transferal Sockets)

Question 44

Partially encapsulates the tip of the ischium within the socket walls. Improves stability especially in those with short residual limbs.

Answer 44

Ischial Containment Designs (Transfemoral)

Question 45

Most secure option for suspension. Allowing little or no pistoning during swing phase. Maintain constant weight. Uses silicone sock over residual limb.

Answer 45

Vacuum (Suction) Transferal Suspension

Question 46

Uses when the skeletal contours are such that they can be used to stabilize the socket against displacement in swing phase.

Answer 46

Anatomic Suspension

Question 47

Adjustable and able to accommodate volume changes. Some pistoning is inevitable.

Answer 47

Strap Suspension