Prosthetics Exam 2: Transfemoral Amputation Flashcards
What are the four socket designs for transfemoral amputees
quadrilateral
ischial containment
Marlo Anatomical
Elevated Vacuum
What type of socket is used with a subischial amputation
elevated vacuum
A quadrilateral socket has ___ distinct walls
4
A quadrilateral socket has a _____ ____ which is an ischial seat or the primary weight-bearing surface
posterior shelf
The (anterior/posterior) wall contours direct forces (anterior/posterior) to try to stabilize ischium on its prosthetic seat
anterior; posterior
True or False:
A quadrilateral socket is narrower M-L than it is A-P
false, more narrow AP
Why is a quadrilateral socket more narrow AP than it is ML
Because its trying to push the ischium back to its shelf/ischium seat
What type of socket was made to try to control an abducted residual femur
Ischial containment
An ischial containment socket was created to control a femur that is (adducted/abducted)
abducted
Long’s line, CAT-CAM, and ischial ramal containment are what type of transfemoral sockets
ischial containment
Which type of socket attempts to encapsulate the ischial tuberosity as well as portions of the ramus with a very distinguishable containment buttress
marlo anatomical socket
A Marlo anatomical socket has a (lower/higher) posterior trim line to make it easier to sit on the glute instead of the posterior socket
lower
A Marlo anatomical socket has a low (anterior/posterior) trim line as well as a low (medial/lateral) trim line
to make it easier to sit on the glute instead of the socket
Why does a Marlo anatomical socket have a low medial trim lines and a high lateral trim line as opposed to a high medial and low lateral trim lines
The high lateral trim line helps control/contain the ischium and the low medial trim line aid in the flattening of the thigh while seated
A Marlo anatomical socket (does/does not) limit ER, so there (is/is not) a need for a rotation unit proximal to the knee joint
does not, is not
What is another name for an elevated vacuum socket
subischial socket
An elevated vacuum/subischial socket has (low/high) trim lines, (decreased/increased) patient comfort, (decreased/increased) patient ROM, and proximal trim lines that are lowered by __-__ inches
low; increased; increased; 2-4
An elevated vacuum/subischial socket has ___ trim lines
Increased ____ ____
Increased patient ____
and (proximal/distal) trim lines that are lowered 2-4 inches
low
patient comfort
ROM
proximal
A weaker limb will need a prosthetic with a (lower/higher) design
higher
In general, what are the two types of socket materials
rigid and flexible
(rigid/flexible) socket material is usually resin-laminated or thermoformed plastic that is intended to have an intimate, total contact fit
rigid
What are the five characteristics of a rigid socket material
durable easy to clean less bulky (not really though) less expensive difficult to adjust
True or False:
A socket with rigid material leaves little to no room for additional socks or cushion outside of what the socket provides
true
(rigid/flexible) socket material is vacuum formed with any number of flexible thermoplastic materials
flexible
Flexible socket material is incased in a rigid frame that provides support with ___ and helps keep socket ___
WB; shape
is rigid or flexible material more comfortable, especially in sitting
flexible
Which type of socket material is used if suction suspension is desired
flexible
Which type of socket material is more durable than the other
rigid is more durable than flexible
Which type of socket material is bulkier than the other
flexible is more bulky than rigid
Which socket material is more expensive than the other
flexible is more expensive than rigid 9
What are the 6 types of suspension
pull in suction roll on suspension liners elevated vacuum silesian belt total elastic belt pelvic belt and hip jont
What type of suspension has negative air pressure, skin to socket contact, and muscle tension used to hold the limb on
pull in suction
What is the most common type of pull in suction
a pull sock or sleeve - sometime lubricant is used instead of a pull sock
A patient with pull in suction must be ____ and have ____.
agile; balance
How is air released in a pull in suction suspension
there is an air expulsion valve at the bottom to release air as limb enters socket
What type of patient is a pull in suction suspension not appropriate for
Recent amputees that will have fluctuation in limb volume, or those with a history of fluctuating edema or unstable weight
True or False:
A pull in suction suspension is appropriate for those with fragile skin
False, it is not appropriate because of the high friction with donning
Roll on suspension liners are essentially like ___ liners
gel
What are three types of roll on suspension liners
shuttle lock, lanyard, cushion liner with air expulsion valve
Which type of roll on suspension liner is a pin lock system
shuttle lock
Which type of roll on suspension liner uses a strap or cord to help pull the limb into the socket
lanyard
Which type of roll on suspension liner has a rubber ring that makes close contact with socket and expulses air through valve and then creates the suction
cushion liner with air expulsion valve
Shuttle lock, lanyard, and cushion liner with air expulsion valve are all types of what suspension category
roll on suspension liners
(pin lock/lanyard) is common with transfemoral amputees
lanyard
An elevated vacuum suspension system has negative pressure (when the limb is load/all the time)
all the time
Which type of suspension system uses leather or a lightweight webbing for belt
silesian belt
Describe what a silesian belt suspension systems looks like
A belt is attached to lateral aspect of socket, encircles pelvic and then attaches to a loop or buckle on the anterior side of the prosthesis
When is a silesian belt often used for
as a backup for a traditional suction system
True or False:
A silesian belt system does not control rotation of a limb
true
Which is more common, a silesian belt or a total elastic suspension belt
total elastic suspension belt
What type of material is a total elastic suspension belt
elastic neoprene material
Which type of suspension system is great for auxiliary suspension
total elastic suspension belt
Which type of suspension system is used a lot with new amputees who may have fluctuation in limb volume and need a little extra suspension as limb shrinks
total elastic suspension belt
What type of suspension system has a belt with a metal hip joint and is traditionally used for short residual limbs
pelvic belt and hip joint
A pelvic belt and hip joint helps (increase/limit) rotation and (increase/decrease) M-L stability
limit; increase
A pelvic belt and hip joint helps limit ____ and increases (AP/ML) stability
rotation; ML
What are the drawbacks of a pelvic belt and hip joint suspension system
bulky, heavy, uncomfortable when sitting
What are some special considerations with a knee disarticulation
- Bulbous distal end of residual limb can make intimate fit difficult as donning and doffing must not be too difficult or the patient may not wear device
- Special fit liners help with this problem
What are the 8 types of prosthetic knee units
single axis polycentric weight activated manual locking hydraulic pneumatic microprocessor next generation
What type of prosthetic knee unit is a simple hinge that allows the prosthesis to swing freely
single axis knee
How much mechanical stability does a single axis knee have
not much
True or False:
A single axis knee is not good for a short residual limb
true
In a single axis knee, friction can be set for tibial advancement, and (will/won’t) change swing speed for change in cadence
won’t
A _____ knee has a moving center of rotation to more closely mimic the human knee
polycentric
A polycentric knee has a (stable/moving) center of rotation to more closely mimic the human (foot/knee)
moving; knee
Which phase of gait does a polycentric knee support stability through the center of rotation
stance phase
A polycentric knee is good for (short/long) residual limbs or _____
long; disarticulation
Why is a polycentric knee good for long residual limbs or disarticulations
Because the knee tucks back under the thigh when sitting and allows a more natural cosmesis
Why is a polycentric knee good for short residual limbs or pts with significantly weak hips
Because of the stability it has during stance
List the types of patients that a polycentric knee is good for
patients with a short residual limb, long residual limb, disarticulations, and prs with significantly weak hips
What is the disadvantage of polycentric knees
it has multiple mechanical joints and durability
Which type of prosthetic knee unit is used for stance control that has a locking mechanism that is activated when weight is placed through the knee during stance
weight activated stance control units
What is another name for a weight activated stance control unit
the safety knee
True or False:
A weight activated stance knee will buckle if the knee is not straight at initial contact
false, it is a safe knee and will NOT buckle if the knee is not straight
What type of patient will benefit from a weight activated stance control unit
recent amputees, short residual limbs, or hip extensor weakness
What type of prosthetic knee unit is a single axis knee with a locking pin
manual locking knee
A manual locking knee will lock automatically when the knee is fully (flexed/extended)
extended
Although a manual locking knee provides maximum ____ stability, it often causes gait deviations like increased circumduction or vaulting
stance
What type of gait deviations does a manual locking knee promote
circumduction, vaulting, stiff legged gait
A manual locking knee compromises (mobility/stability) and ____ _____
mobility and toe clearance
True or false:
A manual locking knee is often shorter than the sound limb to help in toe clearance
true
A manual locking knee automatically locks when the knee is fully extended, explain how it unlocks
Manually unlock knee with pulley system one knee is unloaded
Patients using a manual locking knee will often experience ____ pain
back
What type of prosthetic knee unit uses hydraulic fluid flow through channels for resistance
hydraulic knees
Can you have variable cadence with a hydraulic knee
yes
Will a hydraulic knee buckle
yes, but it is slower so it gives a patient more time to react
A hydraulic knee with (increase/decrease) in weight, require (lower/higher) maintenance, and (less/more) costly
increase weight
higher maintenance
more costly
What type of prosthetic knee unit allows variable cadence and uses air pressure dynamics like hydraulics uses fluid dynamics
pneumatic knees
pneumatic knees provide (less/more) precision with cadence control than hydraulics and require (less/same/more) maintenance
less precision, same maintenance
What type of prosthetic unit has sensors that monitor knee position during swing and pressure sensors evaluating ground reaction forces during stance
microprocessor
A microprocessor knee provides a ___ recovery and a more natural gait down ___ and ___
stumble; ramps and steps
A microprocessor knee has (increased/decreased) energy expenditure
decreased
Microprocessor knee users can have symmetrical gait going down stairs but will have to use a (1/2/3) gait pattern to go up stairs
2
A single axis knee cannot have more than ___ degrees of flexion or it will buckle
20
What are the two names of microprocessor knees in the powerpoint
C-leg and Rheo
Which type prosthetic knee unit has actuators that actively life and simulate the users own muscles for ascending stairs, inclines, and ramps
next generation knee
What type of knee can cause a generated force to help lift a person up
next generation knee
What are three additional components that can be added to prosthetics
extension aids, torque absorbers, transverse rotation units
When choosing a prosthetic foot, what is the main consideration to take into account
The influence the foot has on knee stability during stance
When choosing a prosthetic foot, why is it important to choose a foot that reaches foot flat quickly
This enhances stability, especially is short residual limbs or weak hip musculature
When choosing a prosthetic, what type of feet are great for active individuals that want to walk at faster speeds
dynamic response
A change in ___ height will totally change how a patient is able to walk or clear the prosthesis
heel
What type of prosthetic alignment ensures knee stability
bench alignment
What type of prosthetic alignment focuses on a level pelvis, socket fit, knee stability and BOS with the pt in standing
static alignment
What type of prosthetic alignment checks iliac crests
height of prosthesis
What type of prosthetic alignment must a pt be able to easily extend the knee and keep it locked
knee stability
How many inches should be between the heels to provide optimum BOS
2-3 inches
What type of prosthetic alignment uses a laser line in static alignment
LASAR posture
When checking lateral prosthetic alignment, what are the four key areas to look at
- Knee stability in stance
- Transition from IC to foot flat
- Symmetry of step length and step duration
- Quality of knee flexion during late stance and swing phase
When checking anterior prosthetic alignment, what are the four key areas to look at
- suspension
- width of bos
- control of pelvis during stance
- quality and pattern of swing
What are the 9 areas of prosthetic alignment
bench alignment static alignment height of prosthesis knee stability base of support LASAR posture dynamic alignment lateral anterior
