Prosthetics & Neurology

Question 1

what type of limb deficiency is more common?

Answer 1

congenital (60%)

Question 2

most common etiology for limb deficiency for 1-4 yo?

Answer 2

lawnmower, power tools

Question 3

most common etiology for limb deficiency for older child?

Answer 3

MVA, machinery, GSW

Question 4

congenital limb deficiency

Answer 4

transverse
longitudinal

Question 5

acquired limb deficiency

Answer 5

traumatic
infection
tumors
vascular malformation

Question 6

limb buds 1st appear at ______

Answer 6

4 weeks gestation

Question 7

when are limb buds fully developed?

Answer 7

week 7 gestation

Question 8

what is crucial for sensory input with limb deficiency?

Answer 8

nubbins

Question 9

Aitken classification A (PFFD)

Answer 9

acetabulum present
femoral head present
shortened femoral segment

Question 10

Aitken classification B (PFFD)

Answer 10

well defined acetabulum
unossified femoral head at birth

Question 11

Aitken classification C (PFFD)

Answer 11

no femoral head
poorly defined acetabulum

Question 12

Aitken classification D (PFFD)

Answer 12

extremely short or absent femur

Question 13

the femur needs to be ____ cm shorter than contra side for epiphysiodesis surgery to improve knee componentry

Answer 13

5 cm

Question 14

how is the limb usually positioned with PFFD?

Answer 14

flexion, abduction, and ER

Question 15

_____% of children with PFFD also have deficiency in the fibula

Answer 15

70-80%

Question 16

most common gait deviations with PFFD

Answer 16

posterior and lateral trunk lean during stance phase due to poor strength of adbuctors and extensors

Question 17

common clinical presentation of tibia deficiency

Answer 17

equinovarus
knee flexion contracture due to extremely weak or absent quads

Question 18

type 1 tibial deficiency

Answer 18

complete absence of tibia
no extensor mechanism

Question 19

type 2 tibial deficiency

Answer 19

proximal tibial well formed
have quads

Question 20

type 3 tibial deficiency

Answer 20

presence of distal tibia only

Question 21

tibial limb deficiency common deficits

Answer 21

ACL deficient
anterior bowstring
varus/valgus requiring growth manip
missing 1st or 2nd ray
revisions needed during growth

Question 22

it’s crucial to check for _____ for tibial limb deficiency

Answer 22

quad strength to drive amputation level

Question 23

what type of amputation is done is tibia is absent?

Answer 23

knee disarticulation

Question 24

type 1 fibular hemimelia

Answer 24

hypoplastic fibula

Question 25

type 2 fibular hemimelia

Answer 25

absent fibula

Question 26

how do you distinguish b/w missing fib and tib?

Answer 26

fib - missing lateral toes

Question 27

clinical presentation of fibular hemimelia

Answer 27

missing lateral toes anterior medial bowing shortening of femur ACL deficiency or absence varus or valgus missing lateral 2nd or 3rd rays

Question 28

surgical management for limb deficiencies (PFFD, fibular hemimelia)

Answer 28

Boyd or Symes amputation

Question 29

when to start with unlocked knee prosthetic?

Answer 29

3 yo

Question 30

residual limbs tend to ____ after initial ambulation if no wrapping performed

Answer 30

shrink

Question 31

gait ROM requirements

Answer 31

at least 5-10 deg hip ext (term stance) full knee extension (stance stability) neutral adduction (normal BOS)

Question 32

most common contractures for AKA

Answer 32

hip flexion hip ER hip abduction

Question 33

most common contractures for BKA

Answer 33

hip flexion knee flexion

Question 34

what gait deviation would weak hip extensors lead to?

Answer 34

improper placement of foot for IC

Question 35

_____ pts will have weakness that may not respond to strengthening

Answer 35

PFFD

Question 36

overall progression for gait training with prosthetic

Answer 36

stance --> stride --> stepping

Question 37

TBI etiology in infants

Answer 37

falls near-drowning abuse

Question 38

TBI etiology in pre-school

Answer 38

falls MVA

Question 39

TBI etiology in 5-9 yo

Answer 39

falls MVA sports/rec

Question 40

TBI etiology in 10+

Answer 40

sports/rec

Question 41

kids _____ yo are often diagnosed with CP for any injury to brain

Answer 41

<3 yo

Question 42

____% of children who sustain a TBI will develop HO

Answer 42

5-20%

Question 43

interventions for rancho I-III

Answer 43

maintain ROM and skin integrity provide sensory stimuli WB

Question 44

interventions for rancho IV-VI

Answer 44

provide structure prevent overstimulation task specific training that's familiar emphasize safety relaxation techniques encourage mobility work on attention to task

Question 45

interventions for rancho VII-X

Answer 45

increased independence community re-integration (dual-task, altered surfaces, high level balance)

Question 46

congenital SCI

Answer 46

spina bifida

Question 47

non-traumatic SCI

Answer 47

oncology congenital anomalies infection

Question 48

a child is 99-100% likely to develop scoliosis if SCI acquired before ____

Answer 48

5 yo

Question 49

the NRS can be used for patient older than

Answer 49

12 yo

Question 50

how to progress rolling?

Answer 50

sidely --> wedge --> supine

Question 51

according to NDT, posture = ___ + ____

Answer 51

BOS + alignement

Question 52

the smaller the BOS, the ___ the mm activation

Answer 52

greater

Question 53

activity based restorative therapy (ABRT) focuses on activity ___ the level of the lesion

Answer 53

below