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Prosthetics & Orthotics > Prosthetics Exam 2: Transfemoral Amputation > Flashcards

Prosthetics Exam 2: Transfemoral Amputation Flashcards

1
Q

What are the four socket designs for transfemoral amputees

A

quadrilateral
ischial containment
Marlo Anatomical
Elevated Vacuum

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2
Q

What type of socket is used with a subischial amputation

A

elevated vacuum

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3
Q

A quadrilateral socket has ___ distinct walls

A

4

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4
Q

A quadrilateral socket has a _____ ____ which is an ischial seat or the primary weight-bearing surface

A

posterior shelf

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5
Q

The (anterior/posterior) wall contours direct forces (anterior/posterior) to try to stabilize ischium on its prosthetic seat

A

anterior; posterior

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6
Q

True or False:

A quadrilateral socket is narrower M-L than it is A-P

A

false, more narrow AP

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7
Q

Why is a quadrilateral socket more narrow AP than it is ML

A

Because its trying to push the ischium back to its shelf/ischium seat

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8
Q

What type of socket was made to try to control an abducted residual femur

A

Ischial containment

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9
Q

An ischial containment socket was created to control a femur that is (adducted/abducted)

A

abducted

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10
Q

Long’s line, CAT-CAM, and ischial ramal containment are what type of transfemoral sockets

A

ischial containment

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11
Q

Which type of socket attempts to encapsulate the ischial tuberosity as well as portions of the ramus with a very distinguishable containment buttress

A

marlo anatomical socket

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12
Q

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

A

lower

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13
Q

A Marlo anatomical socket has a low (anterior/posterior) trim line as well as a low (medial/lateral) trim line

A

to make it easier to sit on the glute instead of the socket

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14
Q

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

A

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

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15
Q

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

A

does not, is not

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16
Q

What is another name for an elevated vacuum socket

A

subischial socket

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17
Q

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

A

low; increased; increased; 2-4

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18
Q

An elevated vacuum/subischial socket has ___ trim lines
Increased ____ ____
Increased patient ____
and (proximal/distal) trim lines that are lowered 2-4 inches

A

low
patient comfort
ROM
proximal

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19
Q

A weaker limb will need a prosthetic with a (lower/higher) design

A

higher

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20
Q

In general, what are the two types of socket materials

A

rigid and flexible

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21
Q

(rigid/flexible) socket material is usually resin-laminated or thermoformed plastic that is intended to have an intimate, total contact fit

A

rigid

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22
Q

What are the five characteristics of a rigid socket material

A 
durable
easy to clean
less bulky (not really though)
less expensive
difficult to adjust
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23
Q

True or False:

A socket with rigid material leaves little to no room for additional socks or cushion outside of what the socket provides

A

true

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24
Q

(rigid/flexible) socket material is vacuum formed with any number of flexible thermoplastic materials

A

flexible

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25
Q

Flexible socket material is incased in a rigid frame that provides support with ___ and helps keep socket ___

A

WB; shape

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26
Q

is rigid or flexible material more comfortable, especially in sitting

A

flexible

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27
Q

Which type of socket material is used if suction suspension is desired

A

flexible

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28
Q

Which type of socket material is more durable than the other

A

rigid is more durable than flexible

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29
Q

Which type of socket material is bulkier than the other

A

flexible is more bulky than rigid

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30
Q

Which socket material is more expensive than the other

A

flexible is more expensive than rigid 9

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31
Q

What are the 6 types of suspension

A 
pull in suction
roll on suspension liners
elevated vacuum
silesian belt
total elastic belt
pelvic belt and hip jont
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32
Q

What type of suspension has negative air pressure, skin to socket contact, and muscle tension used to hold the limb on

A

pull in suction

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33
Q

What is the most common type of pull in suction

A

a pull sock or sleeve - sometime lubricant is used instead of a pull sock

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34
Q

A patient with pull in suction must be ____ and have ____.

A

agile; balance

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35
Q

How is air released in a pull in suction suspension

A

there is an air expulsion valve at the bottom to release air as limb enters socket

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36
Q

What type of patient is a pull in suction suspension not appropriate for

A

Recent amputees that will have fluctuation in limb volume, or those with a history of fluctuating edema or unstable weight

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37
Q

True or False:

A pull in suction suspension is appropriate for those with fragile skin

A

False, it is not appropriate because of the high friction with donning

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38
Q

Roll on suspension liners are essentially like ___ liners

A

gel

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39
Q

What are three types of roll on suspension liners

A

shuttle lock, lanyard, cushion liner with air expulsion valve

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40
Q

Which type of roll on suspension liner is a pin lock system

A

shuttle lock

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41
Q

Which type of roll on suspension liner uses a strap or cord to help pull the limb into the socket

A

lanyard

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42
Q

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

A

cushion liner with air expulsion valve

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43
Q

Shuttle lock, lanyard, and cushion liner with air expulsion valve are all types of what suspension category

A

roll on suspension liners

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44
Q

(pin lock/lanyard) is common with transfemoral amputees

A

lanyard

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45
Q

An elevated vacuum suspension system has negative pressure (when the limb is load/all the time)

A

all the time

46
Q

Which type of suspension system uses leather or a lightweight webbing for belt

A

silesian belt

47
Q

Describe what a silesian belt suspension systems looks like

A

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

48
Q

When is a silesian belt often used for

A

as a backup for a traditional suction system

49
Q

True or False:

A silesian belt system does not control rotation of a limb

A

true

50
Q

Which is more common, a silesian belt or a total elastic suspension belt

A

total elastic suspension belt

51
Q

What type of material is a total elastic suspension belt

A

elastic neoprene material

52
Q

Which type of suspension system is great for auxiliary suspension

A

total elastic suspension belt

53
Q

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

A

total elastic suspension belt

54
Q

What type of suspension system has a belt with a metal hip joint and is traditionally used for short residual limbs

A

pelvic belt and hip joint

55
Q

A pelvic belt and hip joint helps (increase/limit) rotation and (increase/decrease) M-L stability

A

limit; increase

56
Q

A pelvic belt and hip joint helps limit ____ and increases (AP/ML) stability

A

rotation; ML

57
Q

What are the drawbacks of a pelvic belt and hip joint suspension system

A

bulky, heavy, uncomfortable when sitting

58
Q

What are some special considerations with a knee disarticulation

A
  1. 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
  2. Special fit liners help with this problem
59
Q

What are the 8 types of prosthetic knee units

A 
single axis
polycentric
weight activated
manual locking
hydraulic
pneumatic
microprocessor 
next generation
60
Q

What type of prosthetic knee unit is a simple hinge that allows the prosthesis to swing freely

A

single axis knee

61
Q

How much mechanical stability does a single axis knee have

A

not much

62
Q

True or False:

A single axis knee is not good for a short residual limb

A

true

63
Q

In a single axis knee, friction can be set for tibial advancement, and (will/won’t) change swing speed for change in cadence

A

won’t

64
Q

A _____ knee has a moving center of rotation to more closely mimic the human knee

A

polycentric

65
Q

A polycentric knee has a (stable/moving) center of rotation to more closely mimic the human (foot/knee)

A

moving; knee

66
Q

Which phase of gait does a polycentric knee support stability through the center of rotation

A

stance phase

67
Q

A polycentric knee is good for (short/long) residual limbs or _____

A

long; disarticulation

68
Q

Why is a polycentric knee good for long residual limbs or disarticulations

A

Because the knee tucks back under the thigh when sitting and allows a more natural cosmesis

69
Q

Why is a polycentric knee good for short residual limbs or pts with significantly weak hips

A

Because of the stability it has during stance

70
Q

List the types of patients that a polycentric knee is good for

A

patients with a short residual limb, long residual limb, disarticulations, and prs with significantly weak hips

71
Q

What is the disadvantage of polycentric knees

A

it has multiple mechanical joints and durability

72
Q

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

A

weight activated stance control units

73
Q

What is another name for a weight activated stance control unit

A

the safety knee

74
Q

True or False:

A weight activated stance knee will buckle if the knee is not straight at initial contact

A

false, it is a safe knee and will NOT buckle if the knee is not straight

75
Q

What type of patient will benefit from a weight activated stance control unit

A

recent amputees, short residual limbs, or hip extensor weakness

76
Q

What type of prosthetic knee unit is a single axis knee with a locking pin

A

manual locking knee

77
Q

A manual locking knee will lock automatically when the knee is fully (flexed/extended)

A

extended

78
Q

Although a manual locking knee provides maximum ____ stability, it often causes gait deviations like increased circumduction or vaulting

A

stance

79
Q

What type of gait deviations does a manual locking knee promote

A

circumduction, vaulting, stiff legged gait

80
Q

A manual locking knee compromises (mobility/stability) and ____ _____

A

mobility and toe clearance

81
Q

True or false:

A manual locking knee is often shorter than the sound limb to help in toe clearance

A

true

82
Q

A manual locking knee automatically locks when the knee is fully extended, explain how it unlocks

A

Manually unlock knee with pulley system one knee is unloaded

83
Q

Patients using a manual locking knee will often experience ____ pain

A

back

84
Q

What type of prosthetic knee unit uses hydraulic fluid flow through channels for resistance

A

hydraulic knees

85
Q

Can you have variable cadence with a hydraulic knee

A

yes

86
Q

Will a hydraulic knee buckle

A

yes, but it is slower so it gives a patient more time to react

87
Q

A hydraulic knee with (increase/decrease) in weight, require (lower/higher) maintenance, and (less/more) costly

A

increase weight
higher maintenance
more costly

88
Q

What type of prosthetic knee unit allows variable cadence and uses air pressure dynamics like hydraulics uses fluid dynamics

A

pneumatic knees

89
Q

pneumatic knees provide (less/more) precision with cadence control than hydraulics and require (less/same/more) maintenance

A

less precision, same maintenance

90
Q

What type of prosthetic unit has sensors that monitor knee position during swing and pressure sensors evaluating ground reaction forces during stance

A

microprocessor

91
Q

A microprocessor knee provides a ___ recovery and a more natural gait down ___ and ___

A

stumble; ramps and steps

92
Q

A microprocessor knee has (increased/decreased) energy expenditure

A

decreased

93
Q

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

A

2

94
Q

A single axis knee cannot have more than ___ degrees of flexion or it will buckle

A

20

95
Q

What are the two names of microprocessor knees in the powerpoint

A

C-leg and Rheo

96
Q

Which type prosthetic knee unit has actuators that actively life and simulate the users own muscles for ascending stairs, inclines, and ramps

A

next generation knee

97
Q

What type of knee can cause a generated force to help lift a person up

A

next generation knee

98
Q

What are three additional components that can be added to prosthetics

A

extension aids, torque absorbers, transverse rotation units

99
Q

When choosing a prosthetic foot, what is the main consideration to take into account

A

The influence the foot has on knee stability during stance

100
Q

When choosing a prosthetic foot, why is it important to choose a foot that reaches foot flat quickly

A

This enhances stability, especially is short residual limbs or weak hip musculature

101
Q

When choosing a prosthetic, what type of feet are great for active individuals that want to walk at faster speeds

A

dynamic response

102
Q

A change in ___ height will totally change how a patient is able to walk or clear the prosthesis

A

heel

103
Q

What type of prosthetic alignment ensures knee stability

A

bench alignment

104
Q

What type of prosthetic alignment focuses on a level pelvis, socket fit, knee stability and BOS with the pt in standing

A

static alignment

105
Q

What type of prosthetic alignment checks iliac crests

A

height of prosthesis

106
Q

What type of prosthetic alignment must a pt be able to easily extend the knee and keep it locked

A

knee stability

107
Q

How many inches should be between the heels to provide optimum BOS

A

2-3 inches

108
Q

What type of prosthetic alignment uses a laser line in static alignment

A

LASAR posture

109
Q

When checking lateral prosthetic alignment, what are the four key areas to look at

A
  1. Knee stability in stance
  2. Transition from IC to foot flat
  3. Symmetry of step length and step duration
  4. Quality of knee flexion during late stance and swing phase
110
Q

When checking anterior prosthetic alignment, what are the four key areas to look at

A
  1. suspension
  2. width of bos
  3. control of pelvis during stance
  4. quality and pattern of swing
111
Q

What are the 9 areas of prosthetic alignment

A 
bench alignment
static alignment
height of prosthesis 
knee stability
base of support
LASAR posture
dynamic alignment
lateral
anterior

Prosthetics & Orthotics (7 decks)

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