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FRCS Orthopaedics > Rehabilitation > Flashcards

Rehabilitation Flashcards

Key Concepts for the FRCS exam

1
Q

What are the 2 phases of Gait?

A

Stance phase comprises 60% of the gait cycle; swing phase comprises 40% of the gait cycle.

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2
Q

What % of stance is double limb support?

A

12%

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3
Q

The body’s center of gravity (COG) while being propelled forward is also subject
to ……..cm vertical and ………cm lateral displacements.

A

5cm

6cm

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4
Q

Antalgic gait results in…

A

decreased stance phase

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5
Q

The required increase in energy expenditure for ambulation in bilateral transtibial amputation ?

A

41%

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6
Q

unilateral transfemoral amputation energy needed?

A

65%

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7
Q

the factor most predictive of successful wound healing after amputation?

A

Transcutaneous partial pressure of oxygen [TcPO2 ]

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8
Q

what is the most important laboratory value for healing after amputation?

A

Albumin

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9
Q

How do u avoid overgrowth in paediatric amputations?

A

stump capping or disarticulations

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10
Q

What should be performed with transmetatarsal and Lisfranc amputations to prevent late
development of equinus or equinovarus deformity.

A

Percutaneous Achilles tendon lengthening

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11
Q

In Lisfranc amputations, the soft tissue at the fifth metatarsal base should be preserved… Why?

A

because this represents the insertion site of peroneus brevis and tertius, which act as antagonists to the posterior tibial tendon. Failure to preserve these tissues results in
inversion during gait

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12
Q

What is special about a Symes amputation?

A

more energy efficient than a midfoot amputation, despite the fact that it is at a more proximal level.

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13
Q

what parameter is necessary for a symes amputation?

A

The posterior tibial artery must be patent to ensure healing. The heel pad must be secured

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14
Q

Optimal bone length for BKA?

A

12cm

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15
Q

what type of amputation did the LEAP study show to have the slowest walking speed and lowest satisfaction?

A

Knee disarticulation

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16
Q

Optimal bone length for AKA?

A

12CM

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17
Q

In transfemoral amputation, ………………… is crucial for maintaining femoral adduction during gait with a prosthesis.

A

adductor myodesis

18
Q

Transecting the adductor magnus results in a loss of …..% of the adductor pull.

A

70%

19
Q

Define what is a prosthesis?

A

a device or artificial substitute designed to replace, as much as possible, the function or appearance of a missing limb or body part. Prosthetics is defined as the specialty relating to prostheses and their use.

20
Q

……………commonly used for midlength transradial amputation

A

Myoelectric prostheses

21
Q

type of prosthesis for heavy labour?

A

Body-powered prostheses are used for heavy labor. The terminal device is activated by shoulder flexion and abduction.

22
Q

Short forearm amputations, elbow disarticulations, and above-elbow amputations necessitate what kind of suspension?

A

supracondylar suspension

23
Q

what kind of foot is good for uneven terrain?

A

articulated feet

24
Q

type of feet for high demand activities?

A

non articulated long keel feet

25
Q

how does knee centre of rotation affect the knee in gait?

A

Knee center of rotation posterior to line of weight bearing promotes control in stance phase, but flexion is difficult.
• Knee center of rotation anterior to weight bearing makes flexion
easier, but control is poor.

26
Q

type of knee most ambulatory patients with transfemoral amputations?

A

Microprocessor knees with polycentric (four-bar linkage) configuration

27
Q

type of knee for older patients?

A

Stance-phase control (safety) knee prostheses

28
Q

most common prosthetic knee in children.

A

The constant-friction knee

29
Q

The preferred method of suspension for transtibial prosthetic

A

prosthetic sleeves is the gel liner with locking pin

30
Q

Problems are common in prosthetics. Foot placement too anterior results in?

A

increased knee extension and patellar pain.

31
Q

Too soft a heel results in?

A

excessive knee extension

32
Q

too hard a heel causes?

A

knee flexion and lateral rotation of the toes.

33
Q

Define an Orthosis?

A

“a device that is externally applied or attached to a body segment and that facilitates or improves function by supporting, correcting or compensating for skeletal deformity or weakness

34
Q

an arthritic or stiff midfoot during midstance as the foot changes from accepting the
weight-bearing load to pushing off.. what type of orthosis should be recommended?

A

A rocker sole

35
Q

foot drop?

A

A posterior leaf spring AFO

36
Q

Surgical intervention in adult-acquired spasticity should be delayed until

A

patient achieves maximal spontaneous motor recovery (6 months for stroke and 12 to 18 months for traumatic brain injury

37
Q

Equinus deformity is treated by?

A

percutaneous Achilles tendon lengthening.

38
Q

Dynamic varus-producing force in adults is the result of ? and how dou you treat this?

A

out-of-phase tibialis anterior muscle activity during the stance phase.

dynamic varus deformity is corrected by either split (SPATT) or complete lateral transfer of the tibialis anterior muscle

39
Q

what is post polio syndrome?

A

Postpolio syndrome is not a reactivation of the polio virus. It is an aging phenomenon by which more nerve cells become inactive.

40
Q

symptoms of post poliosyndrome?

A

progressive muscle and joint weakness and pain, general fatigue and exhaustion with minimal activity, muscle atrophy, breathing or swallowing problems, sleep-related breathing disorders (e.g., obstructive sleep apnea), and
decreased tolerance of cold temperatures

41
Q

risk factors for post polio syndrome?

A

severity of initial polio illness, initial diagnosis as an adolescent or adult, greater recovery from initial illness, and physical activity to the point of exhaustion or fatigue.

42
Q

treatment of post polio syndrome?

A

limited exercise combined with periods of rest so that muscles are maintained but not overtaxed.

FRCS Orthopaedics (7 decks)

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