quiz 2 (6-

Question 1

an asymmetric step length gait pattern may be caused by

Answer 1

-potentially spending less time in stance phase on amputated side
-shortening swing time and step length on intact side

Question 2

knee flexion in amputees is produced by

Answer 2

hip flexion and momentum

Question 3

prosthetic gait has a decreased…

Answer 3

walking speed
stride length
cadence
energy efficiency
biomechanical efficiency

Question 4

transtibial energy expenditure

Answer 4

16-28% above normal

Question 5

transfemoral energy expenditure

Answer 5

60-110% above normal

Question 6

gait goals in initial contact/ loading response

Answer 6

-stride length
-controlled knee flexion

Question 7

gait goals in midstance phase

Answer 7

-pylon position
-step width

Question 8

gait goals in terminal stance phase

Answer 8

-smooth progression over forefoot
-smooth flexion of the limb

Question 9

gait goals in pre-swing phase

Answer 9

pelvic, trunk, and head position

Question 10

gait goals in swing phase

Answer 10

prosthetic path

Question 11

TT: keeping the knee extended as much as possible in both swing and stance phase may lead to what deviations?

Answer 11

excess knee extension, vaulting, and circumduction

Question 12

TT: spending as little time on the prosthesis as possible may lead to what deviation

Answer 12

uneven step length

Question 13

TT: increasing their BOS may lead to what deviation

Answer 13

wide base of support

Question 14

excess knee extension

Answer 14

phase: IC, LR, Mst
plane: Sagittal
prosthetic causes:
socket aligned too posterior, foot too anterior, heel too soft, insufficient socket flexion
user causes:
locking knee, weak muscles around knee

Question 15

bench alignment

Answer 15

static alignment. 1/2 inch medial to center, posterior to center, heel height 5* of flexion

Question 16

checkout

Answer 16

process of dynamic adjustments to make sure the patient is safe and capable of utilizing the prosthesis. aka dynamic alignment

Question 17

what are the 4 alignment goals

Answer 17

1. facilitate heel strike at IC
2. provide adequate single limb stability during stance phase
3. create smooth forward progression in late stance
4. ensure toe clearance during swing

Question 18

transtibial pressure tolerant areas

Answer 18

supracondular ares
suprapatellar areas
patella tendon
tibia flares
lateral flare of fibula
posterior area of stump
popliteal area (gently)
distal end of stump for total contact socket

Question 19

TT: inset foot problems

Answer 19

-excess pressure at medial proximal and lateral distal areas
-gap at lateral proximal area
-lateral instability

Question 20

TT: outset foot problems

Answer 20

-excess pressure at lateral proximal and medial distal areas
-gap at medial proximal area
-medial instability

Question 21

TT: foot too anterior problems

Answer 21

-excess pressure at patellar tendon and posterior distal areas
-posterior instability
-difficulty flexing the knee in stance

Question 22

TT: foot too posterior problems

Answer 22

-excess pressure posterior proximal and anterior distal areas
-anterior instability
-excess flexing the knee during stance

Question 23

TT: heel too high problems

Answer 23

increased flexion moment

Question 24

transfemoral goals

Answer 24

minimize rotation of prosthesis and provide frontal and sagittal plane stability

Question 25

transfemoral pressure tolerant areas

Answer 25

ischial tuberosity medial & lateral flares of stump anterior & posterior flares of stump distal end of the stump for total contact socket (no pressure contact only)

Question 26

transfemoral pressure sensitive areas

Answer 26

greater trochanter ramus ASIS adductor tendon distal end of femur inguinal fossa pubic tubercle surgical suture

Question 27

TF: inset foot problems

Answer 27

-excess pressure at medial proximal and lateral distal areas -gap at the lateral proximal area -lateral instability

Question 27

TF: outset foot problems

Answer 27

-excess pressure lateral proximal and medial distal

Question 28

if the socket is too far anterior it will...

Answer 28

move the line too far in front of the knee axis making it hard to extend/flex the knee

Question 29

if the socket is too far posterior it will....

Answer 29

move the line too far behind the knee axis making the knee prone to buckling

Question 30

excess knee extension causes

Answer 30

-socket aligned too posterior/ foot too anterior -locking knee to prevent fall -seen in IC, LR, MSt

Question 31

vaulting causes

Answer 31

-prosthesis too long -long toe lever arm -socket too posterior -holding knee in extension too long -seen in swing phase

Question 32

in prosthetic uneven step length, the short stride length is the ___ side

Answer 32

sound limb. decreased confidence on the prosthetic will shorten stance phase on prosthetic and swing on sound limb

Question 33

wide BOS causes

Answer 33

-outset foot -medial leaning pylon -insufficient weight shift -pt fear -hip abduction tightness

Question 34

TT weak quads can lead to which deviations

Answer 34

-increased pressure on distal residual limb -shortened stance on prosthetic limb -knee instability -drop off

Question 35

knee instability causes

Answer 35

socket too far anterior/ foot too posterior -heel firm -excessive foot DF -weak quads -knee flexion contracture IC, LR

Question 36

Knee drop off causes

Answer 36

socket too anterior/ foot too posterior -inappropriate foot choice -knee flexion contracture -TSt

Question 37

TT fit issues deviations

Answer 37

-pistoning -hip drop (too short) -circumduction (too long) -vaulting (too long)

Question 38

pistoning causes

Answer 38

socket too large not enough socks volume changes IC, LR, MST, SW

Question 39

hip drop causes

Answer 39

pelvic drop towards prosthetic side. prosthesis too short, residual limb pain MST

Question 40

Terminal impact causes

Answer 40

-inadequate knee friction -fear of knee giving away -forceful hip flexion SW - IC

Question 41

foot slap causes

Answer 41

-PF bumper too soft -increased hip ext force at IC

Question 42

circumduction causes

Answer 42

-prosthesis too long -inadequate suspension -excess knee friction -medial wall high -fear -hip flexor weak -hip abduction contracture

Question 43

abducted gait causes

Answer 43

-prosthesis too long -medial wall too high -lateral wall not adducted -foot too far outset -decreased balance -abduction contracture -lateral/distal RL pain -adductor roll

Question 44

TF glute max weakness can result in

Answer 44

knee instability and excess trunk extension

Question 45

TF glute med weakness can result in

Answer 45

lateral trunk bend, trendelenburg gait pattern

Question 46

excess trunk extenison causes

Answer 46

increased socket extension not enough flexion built in to socket weak hip extensors weak abs hip flexion contracture very short RL MST

Question 47

lateral trunk bend causes

Answer 47

prostheis short socket too abducted medial wall too high glute med weak pain decreased balance adductor roll MST

Question 48

TF fit issues can cause

Answer 48

drop off, medial whip, lateral whip

Question 49

drop off causes

Answer 49

short toe lever, socket too posterior to knee TST

Question 50

medial whip causes

Answer 50

external rotation of knee component, improper alignment of knee, improper donning

Question 51

lateral whip causes

Answer 51

internal rotation of knee component, improper alignment of knee, improper donning