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Prosthetics > quiz 1 (1-5) > Flashcards

quiz 1 (1-5) Flashcards

1
Q

prosthesis

A

a device that replaces a missing limb (noun)

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2
Q

prostheses

A

plural of prosthesis

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3
Q

prosthetic

A

describes a device (adjective)

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4
Q

prosthetics

A

the study of or practice of working with prostheses

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5
Q

prosthetist

A

a person who practices prosthetics

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6
Q

CP

A

certified prosthetist

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7
Q

CO

A

certified orthotist

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8
Q

CPO

A

certified prosthetist & orthotist
~7500 in US

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9
Q

how many people in the US are living with an amputation?

A

> 2 million

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10
Q

how many new amputations per year?

A

185,000

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11
Q

what is the cause of most LE amputations?

A

vascular disease (82%)

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12
Q

what is the cause of most UE amputations?

A

trauma

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13
Q

top 4 causes of amputation

A
  1. diabetes
  2. trauma
  3. cancer
  4. congenital deficiencies
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14
Q

clinical signs of peripheral neuropathy

A

-deficits of sensation
-motor impairments
-auto dysfunction

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15
Q

4 classic signs & symptoms of PAD

A
  1. intermittent claudication
  2. loss of 1 or more LE pulses
  3. leg numbness
  4. trophic changes
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16
Q

risk factors for PAD

A

smoking, age, diabetes, HTN, heart disease, CVA

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17
Q

Leading causes of trauma causing amputation

A

MVA, farming accident, power tools, firearms, burns/ electrocution

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18
Q

typical trauma patient profile

A

men 20-29

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19
Q

cancer related amputation patient profile

A

osteosarcoma at distal femur, proximal tibia or humerus. male childhood- early adulthood

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20
Q

osteosarcoma red flags

A

pain with weightbearing, deep local pain, fractures

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21
Q

challenges of congenital deformity

A

rapid growth, cosmesis, provide for function

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22
Q

diabetic foot screen risk category 0

A

diabetes but no loss of protective sensation

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23
Q

diabetic foot screen risk category 1

A

diabetes, loss of protective sensation in feet

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24
Q

diabetic foot screen risk category 2

A

diabetes, loss of protective sensation in feet with high pressure or poor circulation

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25
Q

diabetic foot screen risk category 3

A

diabetes, hx of plantar ulceration or neuropathic fracture

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26
Q

foot screen management category 0

A

follow up yearly

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27
Q

foot screen management category 1

A

follow up 3-6 months

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28
Q

foot screen management category 2

A

follow up 1-3 months

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29
Q

foot screen management category 3

A

follow up 1-12 weeks

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30
Q

acute phase

A

time between surgery and discharge from acute care

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31
Q

pre-prosthetic phase

A

time between discharge from acute care and fitting with a definitive prosthesis or until deciding not to do prosthesis

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32
Q

prosthetic phase

A

long term management includes rehabilitation and training with prosthetic

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33
Q

amputation prevention procedures for peripheral arterial disease

A

-angioplasty/ stenting
-LE bypass graft

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34
Q

amputation prevention procedures for osteosarcoma & trauma

A

limb salvage procedure

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35
Q

factors affecting level of amputation

A

-vascular disease
-postoperative function
-disarticulations
-trauma & malignancy

36
Q

what is myoplasty

A

attachment of anterior and posterior compartment muscles to each other over the end of the bone. better if you have ischemia

37
Q

what is myodesis

A

anchoring of muscles to bone. increases stability, muscular control, and proprioception

38
Q

when would equal length anterior/ posterior flap be used?

A

when conserving bone length or if primary healing is not concerned

39
Q

when would a long posterior flap be used?

A

when vascularity is of concern or when padding is needed

40
Q

when would a skew sagittal flap be used?

A

-in severe dysvascular cases to take advantage of saphenous nerve/artery & sural nerve
-remove anterior placement of scar from high prosthetic pressures
helps with blood flow laterally

41
Q

what is the shortest level of a TTA compatible with knee function

A

tibial tubercles

42
Q

how much shorter is the fibula from the tibia for limb shaping in a TTA

A

1 cm

43
Q

historically what was the most common amputation level for people with poor circulation or gangrene?

A

transfemoral

44
Q

reasons for choosing transfemoral vs transtibial

A

-trauma
-gangrene spread to the knee
-circulatory status indicating poor chance of healing

45
Q

in a transfemoral amp, the limb is maintained in ________ & ________ during surgery to maintain proper alignment

A

extension, adduction

46
Q

common issues with transfemoral amp

A

-hip adductor roll
-hip flexure contracture
-hip abduction contracture
-glute weakness

47
Q

common issue with transtibial amp

A

knee flexion cotracture

48
Q

contractures can lead to …

A

pain, pressure ulcers, further immobility, and functional deficits

49
Q

osseointegration

A

connection of bone to prosthetic limb. eliminates need for socket, short residual limb, more natural, improved gait, allows normal swelling

50
Q

downsides to osseointegration

A

-multiple surgeries
-prolonged no ambulation
-risk of fracture
-reduction in high torque activities
-not well known in US

51
Q

hemicorporectomy

A

below wait amputation, both legs amputated

52
Q

transpelvic

A

amputation of portion of pelvis and lower extremity

53
Q

hip disarticulation

A

amputation through hip joint capsule including the entire lower extremity

54
Q

reasons for a knee disarticulation

A

-inability to provide adequate transtibial amputation secondary to trauma
-knee flexion contracture >45
-congenital deformities

55
Q

reasons for an ankle disarticulation

A

severe foot trauma
congenital abnormalities
gangrene

56
Q

reasons for a transmetatarsal amp

A

-infection due to dysvascularity or diabetes
-trauma

57
Q

primary dressing

A

gauze pads and kerlix

58
Q

secondary dressing

A

ace wrap, tubing dressing, shrinker

59
Q

mature transtibial residual limb should look like

A

a tapered cylindrical shape with distal circumference slightly less than proximal circumference

60
Q

mature transfemoral residual limb should look like

A

more conical shape, with distal circumference slightly less than proximal circumference

61
Q

attention & cognition assessment should not forget to screen for …

A

delirium, depression, and fear avoidance

62
Q

social history should include

A

-PLOF
-living conditions
-DME

63
Q

4 questions of pain assessment

A

-location
-type
-nature
-intensity

64
Q

TT residual limb length assessment landmarks

A

medial joint line to end of limb

65
Q

TF residual limb length assessment landmarks

A

ischial tuberosity or GT to end of limb

66
Q

contralateral in tact limb assessment should include

A

-diabetic foot screen
-sensory testing
-strength/ ROM
-DVT screen

67
Q

DVT risk factors

A

-history of thrombosis
-immobilty
-severe infection
-hormone replacement therapy
-surgery
-anesthesia
-critical care admission
-obesity

68
Q

transtibial key muscles for ROM

A

hamstrings
hip flexors
contralateral gastroc

69
Q

transfemoral key muscles for ROM

A

hip flexors
hip abductors
hip external rotators
lumbar extensors
contralateral LE

70
Q

is MMT contraindicated in acute setting?

A

yes if its over the incision. you can do the next proximal joint

71
Q

transtibial key muscles to strengthen

A

-quads
-hamstrings
-glute max
-glute med
-abdominals
-UE

72
Q

transfemoral key muscles to strengthen

A

-glute max
-glute med
-adductors
-core
-lumbar spine
-pelvic floor
-UE

73
Q

motions that are super important for transfemoral amputee gait

A

hip extension, adduction, and pelvic movement

74
Q

functional status assessment

A

upper extremity function
aerobic capacity
postural control
sitting/ standing balance
bed mobility
gait

75
Q

pre-prosthetic phase

A

time between discharge from acute care and fitting with a definitive prosthesis or until decision is made to not fit with prosthesis

76
Q

phantom limb pain interventions

A

-patient education
-compression
-relaxation techniques
-desensitization
-mirror therapy/ VR
-TENS
-heat
-ice

77
Q

residual limb volume assessment

A

circumferential measurements over known bony landmarks

78
Q

a smaller distal circumference allows for less ______ force & better fit during prosthetic use

A

shear

79
Q

transtibial ROM key muscles

A

-hamstrings
-hip flexors
-contralateral gastroc

80
Q

transfemoral ROM key muscles

A

-hip flexors
-hip abductors
-hip external rotators
-lumbar extensors
-contralateral LE

81
Q

Pre prosthetic treatment goals

A

-minimize comorbidities and post op complications
-independence with residual limb
-HEP
-care of intact LE
-fall prevention

82
Q

k0

A

no ability or potential to ambulate or transfer safely with or without assistance; prosthesis does not enhance QOL

83
Q

K1

A

able to or potential to use prosthesis for transfers or ambulation on level surfaces at fixed cadence. limited and unlimited household ambulators

84
Q

k2

A

ability or potential for ambulation with the ability to transverse low level environmental barriers such as curbs, stairs, or uneven surfaces. limited community ambulator

85
Q

k3

A

most common. ability for ambulation with variable cadence. community ambulator who has the ability to transverse most barriers and may engage in vocations, therapeutic, or exercise that demands a prosthesis beyond simple locomotion

86
Q

k4

A

ability for prosthetic ambulation that exceeds basic skills, exhibiting high impact, stress, or energy levels. typical of the child, active adult, or athlete

Prosthetics (2 decks)

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