Quiz 3 - Prosthetics Flashcards
What kind of liner should be used for well padded and muscular limbs?
Hard Liner
What’s the best ankle foot assembly for a trial or someone with no insurance? Why?
SACH Foot - Cheaper than Articulated Foot
Within the Overview of Prosthetic Feet, how expensive are the cost of a Dynamic Response?
High-Very High
What is a Dynamic Response Energy Storing Foot’s actions?
- Heel wedge compression - Compression of internal mechanism from midstance to heel-off - Dynamic push-off of keel from stored energy - Some feet provide inversion eversion and rotation
An athlete that uses an energy storing foot for running typically uses less energy than a healthy limb. T/F
False (the stored energy propels them to run very fast and they perform like a normal limbed person. Doesn’t compromise energy or limit endurance)
What type of people are SACH Feet contraindicated for?
- Active amputees - Amputees that lack knee stability - Amputees requiring torque absorption or inversion/eversion (saggital foot movement)
What type of patient is a PTB Supracondylar, Suprapatellar indicated for?
- Patients with short to very short residual limbs* - Patients requiring increased M-L stability - Patients who request less suspension straps
Within the Overview of Prosthetic Feet, how expensive are the cost of an Elastic Keel?
Moderate
What type of action does a uniaxial foot provide?
Plantar/Dorsiflexion
What are the advantages and disadvantages of an Exoskeletal System?
Advantages: - Durable Disadvantage: - Cosmetic - Lack of easy adjustments - Increased weight, especially at higher amputation levels
What kind of liner should be used for extensively scarred residual limbs?
Soft Liner
Within the Overview of Prosthetic Feet, what are the general indication(s) to be had of a Dynamic Response?
High Activity
What are the advantages and disadvantages of an Uniaxial Prosthetic Foot?
Advantages: - Somewhat smoother push-off action - More shock absorption (posterior bumper) - Promotes knee stability (in those lacking) Disadvantages: - Toe sets dorsiflexed (extended) - No torque absorption - Frequent bumper replacement
Within the Overview of Prosthetic Feet, how is the reliability of an Elastic Keel?
Moderate
What type of patient is a Transtibial Prosthesis with Joints and Corsets indicated for?
Indications: - To increase weight-bearing - To improve M-L stability - Patient preference*
Within the Overview of Prosthetic Feet, what is the performance expectations of a Dynamic Response?
High-Very High
Within the Overview of Prosthetic Feet, what is the performance expectations of a Multi-Axis?
Moderate
Within the Overview of Prosthetic Feet, what are the general indication(s) to be had of a Single-Axis?
- Need of increased knee stability
What type of prosthetic system is characterized by a pylon system covered by a soft outer shell? What’s another name for it?
Endoskeletal System - Modular
What are the advantages and disadvantages of an Energy Storing Feet (Dynamic Response)
Advantages: - Smooth gait - Less energy expenditure (vs other prosthetics) - Very light weight - Cosmesis - Dynamic energy component Disadvantages: - Durability of new materials not known - Variety of sizes limited in women and juvenile styles - Expensive
Within the Overview of Prosthetic Feet, how is the reliability of a Dynamic Response?
Moderate-High
What kind of liner should be used for pt preference?
Hard or Soft Liners
Within the Overview of Prosthetic Feet, what is the weight range of a Dynamic Response?
Very Light-Heavy
What type of patient is a PTB Supracondylar with Cuff indicated for?
- Majority of Transtibial amputees* - Patients with good ligamentous structure* - Juvenile amputee* - Patients with longer residual limb lengths
Within the Overview of Prosthetic Feet, how is the reliability of a S.A.C.H.?
Very High
Within the Overview of Prosthetic Feet, how is the reliability of a Single-Axis?
Moderate
What are the advantages and disadvantages of a PTB with Supracondylar Cuff prosthetic?
Advantages: - Provides good suspension over the patella - Adjustable - Provides kinesthetic hyperextension stop - Can be used in combination with a waist belt Disadvantages: - Can be restrictive in sitting - Does not provide maximum M-L stability - Increased time required to don - Can be uncosmetic
Even though not a completely hard material, what is considered to carry the same rules as a hard liner?
Silicon
What type of patient is a PTB Supracondylar indicated for?
Indications: - Patients who require increased M-L stability - Patients who want unrestricted knee extension* - Patients who request less suspension straps
Within the Overview of Prosthetic Feet, how expensive are the cost of a Multi-Axis?
Moderate-High
Within the Overview of Prosthetic Feet, what are the general characteristics to be had of a Dynamic Response?
- Active Push-Off (toe off)
Within the Overview of Prosthetic Feet, what are the general indication(s) to be had of an Elastic Keel?
Ease of ambulation
Within the Overview of Prosthetic Feet, what are the general characteristics to be had of a Multi-Axis?
- Hindfoot Inversion/Eversion - Transverse Rotation
Within the Overview of Prosthetic Feet, what is the weight range of a Single-Axis?
Medium-Heavy
What type of patient is a Transverse Rotation Unit contraindicated for?
- A patient that does not require torque absorption
Within the Overview of Prosthetic Feet, what are the general characteristics to be had of a Single-Axis?
- Rapid foot flat (plantarflexion after heel strike)
Within the Overview of Prosthetic Feet, what is the weight range of a S.A.C.H.?
Low-Medium
Within the Overview of Prosthetic Feet, what are the general indication(s) to be had of a S.A.C.H.
- Utility (easy, go to for many) - Juveniles
What kind of liner should be used for volumetrically stable residual limbs?
Hard Liner
Which prosthetic foot has the action of… - Toe section that bends by deforming soft material - Ankle dorsiflexion and plantarflexion
Uniaxial Articulated
Within the Overview of Prosthetic Feet, how expensive are the cost of a Single-Axis?
Low-Moderate
Within the Overview of Prosthetic Feet, what is the performance expectations of a Single-Axis?
Low
Within the Overview of Prosthetic Feet, what are the general characteristics to be had of a S.A.C.H.?
- Durability - Simplicity
What kind of liner should be used for well healed soft tissue?
Hard Liner
Which Prosthetics foot is made up of… - Wooden or Metal Keel - Rubber like body - Wedges - Toe Belting
SACH Foot
What type of addition can provide the action of… - Internal and external rotation - Adjustable range of rotation
Transverse Rotation Unit
An energy storing device can have only a toe section, but what makes it a true energy storing system?
Having a heel and toe energy storing capacity
Within the Overview of Prosthetic Feet, what are the general characteristics to be had of an Elastic Keel?
- Smooth Rollover - Shock Absorbtion
What type of prosthetic system is characterized by a hard, plastic outer shell and hallow inside? What’s another name for it?
Exoskeletal System - Crustacean
Give one type of foot prosthetic that is good for a community level ambulator.
Uniaxial (single axis)
Which prosthetic addition has components such as… - Rotation inner assembly - Torque bearings
Transverse Rotational Unit (Multiaxial)
What type of indications are SACH Foot for?
- Majority of Lower limb amputees - Juveniles
What type of patient is a Uniaxial Foot Prosthetic indicated for?
Patient that requires more knee stability (doesn’t have knee stability)
What are the advantages and disadvantages of an Endoskeletal System?
Advantages: - Cosmetics - Weighs less, especially at higher amputation levels - Can change components - Permanent alignment adjustability *It is possible to make angular, linear and height changes in the alignment of the prosthesis after it has been finished Disadvantage: - The soft foam cover is less durable and may often need to be replaced
What are the advantages and disadvantages of a PTB Supracondylar with Removable Wall prosthetic?
Advantages: - Can be more cosmetic around the proximal thigh - May be easier to don than the conventional PTB SC prosthesis* Disadvantages: - Components can make the prosthesis heavier* - Can increase the bulk around the knee*
Within the Overview of Prosthetic Feet, what is the performance expectations of a S.A.C.H.
Low
Within the Overview of Prosthetic Feet, what is the weight range of a Multi-Axis?
Medium-Heavy
What kind of liner should be used for bony residual limbs?
Soft Liner
What type of patients are Energy Storing Feet (Dynamic Response) indicated for?
- Active Patient - Community ambulators
Within the Overview of Prosthetic Feet, how is the reliability of a Multi-Axis?
Moderate
What are the advantages and disadvantages of an SACH Foot?
Advantages: - Cosmesis - Shock absorption - Quiet - Little maintenance *components lighter than articulated foot Disadvantages: - Deterioration of soft material - No torque absorption - Moderate durability
What are the advantages and disadvantages of a PTB Supracondylar, Suprapatellar prosthetic?
Advantages: - Increase the weight bearing surface - Provides a rigid hyperextension stop - Increases M-L stability - Improves cosmesis Disadvantages: - Enclosing patella can inhibit some activities - Difficult to achieve suspension on patients with obese or muscular thighs
What kind of liner should be used for volumetrically unstable residual limbs?
Soft Liner
What type of patient is a Transverse Rotation Unit indicated for?
- Active Patient - Patient requiring torque absorption - Specific functions
Within the Overview of Prosthetic Feet, how expensive are the cost of a S.A.C.H?
Low
What are the advantages and disadvantages of a PTB Supracondylar prosthetic?
Advantages: - Less restrictive than PTB SC-SP (can have SP without SC. Very unlikely) - Improves cosmesis Disadvantages: - Does not provide a rigid hyperextension stop - Can be difficult to achieve suspension on patients with obese of muscular thighs
Which prosthetic foot has components such as… - Soft heel cushion - High tech material for keel mechanisms - Soft toe function
Energy Storing Foot (Dynamic Response)
What kind of liner should be used for peripheral/systemic vascular disease?
Soft Liner
What type of patient is a PTB Supracondylar with Removable Wall indicated for?
Indications: - Patients with large differences between the M-L dimension of the knee and the proximal M-L dimension of the thigh
What are the advantages and disadvantages of an Transverse Rotation Unit?
Advantages: - Absorbs torque - Can be used with SACH foot (*book says also uniaxial foot) - Can be place in shin or thigh section Disadvantages: - Cosmetics - Maintenance - Weight
Within the Overview of Prosthetic Feet, what is the weight range of an Elastic Keel?
Low/Light-Moderate
What type of patients are Energy Storing Feet (Dynamic Response) contraindicated for?
- Household ambulators - One speed ambulators
What kind of liner should be used for good systemic circulation?
Hard Liner
What type of patient is a Uniaxial Foot Prosthetic contraindicated for?
- Majority of lower-limb patients (most use SACH Foot) - Active patients (no torque, limited movement) - Patients requiring torque absorption and inversion/eversion
Within the Overview of Prosthetic Feet, what are the general indication(s) to be had of a Multi-Axis?
- Accommodate uneven terrain
What are the advantages and disadvantages of a Transtibial Prosthesis with Joints and Corsets?
Advantages: - Increases the weight-bearing surface* - Unloads the patient’s limb* - Provides maximum M-L stability* Disadvantages: - Heavy - Uncosmetic - Inherent pistoning*
Which prosthetic foot has components such as… - Toe apron and sole in one piece rubber or polyurethane foam - Belting - Ankle bolt - Plantarflexion bumper (* dorsiflexion bumper in pg.1368)
Uniaxial Articulated
Within the Overview of Prosthetic Feet, what is the performance expectations of an Elastic Keel?
Moderate
What are sources of weight bearing in a transtibial prosthesis? a. Older: b. Newer:
A: More weight bearing on specific areas (patellar tendon bearing) B: Total Surface Bearing (smaller PTB indentation)
What does a SACH foot acronym stand for?
Solid Ankle Heel Cushion
How many socks can be added before a new socket will need to be made?
15 plys
Why are socks a good acute use and long term use for some patients?
Acute: - Edema - Venous Return Long Term: - Adjustable - Inexpensive
What type of suspension would work best for a obese transtibial patient?
Transtibial Prosthesis with Joints and Corset (Corset, Pelvic Strap)
What type of foot would work best for a highly active prosthetic patient?
Dynamic Response (Energy Storing Foot)
Where are the the sources of weight bearing in a transfemoral prosthesis?
Quadralateral: (4 areas of relief are the 4 areas of redness/ skin checks) - Anteromedial: Adductor Longus T. (Obturator N.) - Anterolateral: Rectus Femoris M. - Posteromedial: Hamstring T. (Sciatic N.) - Posterolateral: Gluteus Maximus M.
Where is the source of weight bearing in a transfemoral prosthesis with a plug socket?
.
Where does the adductor longus tendon sit in a quadrilateral socket?
Anteromedial
Why is the quadrilateral or ischial containment socket set in slight flexion?
Quadrilateral: - Enhance position of ischial tuberosity on posterior brim Ischial Containment Socket: - Facilitates Hip Extensor Contraction - Reduce Lumbar Lordosis - Provide a zone for the thigh to extend for taking steps of equal length
What differeienciates a suction socket from a non-suction socket? Explain.
- Suction Socket: Release/Check Valve - Non-Suction Socket: Hole without Valve
What patient characteristic are contraindicated for a suction transfemoral socket? (Give 3 examples)
- CHF - Lymphedema - Cancer (Tumor Removal) - Kidney Failure
Can you identify seven characteristics on the temporary plug fit transfemoral socket?
- SACH Foot - Uniaxial - Hinge Joint (knee) - Pelvic Strap with Lateral Metal Hinge - Temporary Plug - Padding (posterior for quiet sitting) - Quadrilateral Socket -
Why would a patient use a thigh lacer system (Corset) in a transtibial prosthesis?
- Maximum M\L Stability - Good for Obese - Fluctuating Leg Girth - Increased Weight Bearing Load Distribution