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PTRS 746 Exam 2 > Spinal and UE Orthotics > Flashcards

Spinal and UE Orthotics Flashcards

1
Q

Term: An orthopedic appliance or apparatus used to support, align, prevent, or correct deformities or to improve the function of moveable parts of the body

A

Orthotic

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2
Q

Q: What 6 things can an orthotic be used for?

A
  1. Support and align
  2. Immoblize, restrict, or mobilize
  3. Prevent or correct deformities
  4. Substitute or enhance motion
  5. Reduce pain and discomfort
  6. Improve function
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3
Q

Content: Purpose of Orthotics (3)

A
  1. Immobilization (immobilize joints/structures)
  2. Mobilization (Move/stretch tissues/joints)
  3. Restrction (Limit/control joint motion)
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4
Q

Content: Spinal Orthotic Principles (4)

A
  1. 3 point pressure system**
  2. Increases hydrostatic pressure
  3. Provide kinesthetic reminder
  4. Modify support systems
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5
Q

Content: Parts of the spinal support system (2)

A
  1. Extrinsic stability
  2. Intrinsic stability
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6
Q

Content: Parts of extrinsic stability (2)

A

Muscles

  1. Flexors (psoas, abs)
  2. Extensors (erector spinae, paraspinals)
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7
Q

Content: Parts of Intrinsic support (2)

A
  1. Ligaments
  2. Discs
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8
Q

Q: What is the purpose of ligaments in the spinal support system? (3)

A
  1. Linkage
  2. Transfer loads
  3. Smooth motion
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9
Q

Q: What is the purpose of discs in the spinal support system?

A

shock absorption

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10
Q

Content: Design Considerations for Spinal Orthotics (8)

A
  1. Necessity
  2. Cost
  3. Cosmetics
  4. Adjustability
  5. Weight
  6. Effectiveness
  7. Available ROM
  8. Functionality
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11
Q

Content: Cervical Orthoses: Soft Collars (3)

A
  1. Facilitate spinal alignment
  2. Limit some ROM
  3. Provide kinesthetic reminder
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12
Q

Diagram: Identify the Cervical Orthosis

A

Soft Collar

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13
Q

Diagram: Identify the Cervical Orthosis

A

Soft Collar - Headmaster Collar

  • for neck weakness/head drop
  • primarily for support
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14
Q

Diagram: Identify the Cervical Orthosis

A

Semi-Rigid Collar (Phildelphia Collar)

  • support, stability, alignment, kinesthetic reminder
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15
Q

Diagram: Identify the Cervical Orthosis

A

Semi Rigid Collar (Aspen Collar)

  • support, stability, alignment, kinesthetic reminder
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16
Q

Diagram: Identify the Cervical Orthosis

A

Semi-Rigid Collar (Miami J Collar)

  • support, stability, alignment, kinesthetic reminder
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17
Q

Diagram: Identify the Cervical Thoracic Orthosis

A

Cervical orthoses with thoracic extension - SOMI

  • no straps on back, good for pt. in long term supine positing
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18
Q

Content: Cerical orthoses with thoracic extension (2)

A
  1. SOMI (Sternal Occipital Mandibular Immobilizer)
  2. Often indicated for bed bound pts.
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19
Q

Diagram: Identify the Cervical Thoracic Orthosis

A

Cervical Orthosis with thoracic extension - Lerman-Minerva

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20
Q

Content: Halos

A
  1. Tri-planar motion control of the cervical spine
  2. Maximum immobilization
  3. Restricts 90-95% of normal motion
  4. Poor pt. acceptance with relatively high complication rate
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21
Q

Diagram: Identify the Lumbosacral Orthosis (LSO)

A

Flexible LSO

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22
Q

Diagram: Identify the Lumbosacral Orthosis (LSO)

A

Chairback LSO

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23
Q

Content: Chairback LSO (2)

A
  1. Restricts sagittal plain motion
  2. Tightening abdominal support reduces lumbar lordosis
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24
Q

Diagram: Identify the Lumbosacral Orthosis (LSO)

A

Knight LSO

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25
Q

Content: Knight LSO (2)

A
  1. Restricts sagittal and coronal plane motion
  2. Tightening abdominal support reduces lumbar lordosis
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26
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

Knight-Taylor TLSO

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27
Q

Cotent: Knight Taylor TLSO (3)

A
  1. Restricts sagittal and coronal plane motion
  2. Tightening abdominal support reduces lumbar lordosis
  3. Tightening axillary straps facilitates thoracic extension
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28
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

Jewett Hyper-extension TLSO

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29
Q

Content: Jewett Hyper-extension TLSO

A

Restricts thoracolumbar flexion and some coronal plane movement

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30
Q

Content: Common indciations for a Jewett Hyper-extension TLSO (3)

A
  1. Compression fx
  2. Kyphosis
  3. Arthritis
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31
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

CASH Hyper-extension TLSO

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32
Q

Content: CASH Hyper-extension TLSO (3)

A
  1. Cruciform Anterior Spinal Hyperextension (CASH)
  2. Restricts thoracolumbar flexion
  3. More common in geriatric patients
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33
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

Rigid TLSO (Body Jacket)

34
Q

Content: Rigid TLSO (Body Jacket)

A

Restricts sagittal, coronal, and transverse plane movement

35
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

TLSO with cervical extension

36
Q

Content: Orthotic Indications for Management of Scoliosis (4)

A
  1. Skeletal immaturity (premenarche)
  2. Curves between 20-40 degrees
  3. Documented progression
  4. Single or double curves
37
Q

Content: Accommodative TLSO (2)

A
  1. Addresses fixed deformity
  2. Aligns head and trunk over pelvis
38
Q

Content: Accommodative TLSO - Aligns head and trunk over pelvis (4)

A
  1. Reduces shear forces
  2. Facilitates UE use
  3. Enhances mobility
  4. Facilitates respiratory function
39
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

Accommodative TLSO

40
Q

Content: Corrective TLSO (3)

A
  1. Progressive correction of idiopathic spinal curvatures
  2. Stabilization of congenital spinal curvatures
  3. Prevent and/or correct deformity
41
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

Corrective TLSO - Boston Brace

42
Q

Content: Boston Brace (2)

A
  1. Generally considered the gold standard for adolescent scoliosis
  2. Worn full time (18-23 hours/day)
43
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

Corrective TLSO - Milwaukee Brace

44
Q

Content: Milwaukee Brace (2)

A
  1. Indicated for upper thoracic and cervical curvature
  2. Worn full time (18-23 hours/day)
45
Q

Diagram: Identify the Thoracolumbosacral Orthosis (TLSO)

A

Corrective TLSO - Charleston Bending Brace

46
Q

Content: Charleston Bending Brace: (3)

A
  1. Generally indcated for smaller, flexible lumbar curvatures
  2. Worn only at night (8 hours/day)
  3. Bend pt. out of there scolosis and keeps them in that position
47
Q

Content: Corrective TLSO - PT (5)

A
  1. Skin care
  2. Trunk mobility and strengthening
  3. Aerobic training
  4. Postural feedback and training
  5. Functional training with brace
48
Q

Content: Indications for UE Orthoses (3)

A
  1. Trauma (Vocational, burns, MVA)
  2. Congenital Deformity
  3. Disease (RA, SLE, Neuro impairments esp. those with abnormal tone)
49
Q

Content: Purpose of UE Orthoses (11)

A
  1. Symptom relief
  2. Prevent deformity
  3. Immobilization
  4. Stabilization
  5. Protection
  6. Correct deformity
  7. Scar management
  8. Aid function
  9. Provide resistance
  10. Influence spastic muscle
  11. Compensate
50
Q

Content: Designs of UE Orthoses (4)

A
  1. Static
  2. Serial Static (remolding to stretch or mobilize)
  3. Static Progressive (turning dial to apply (new) force gradually)
  4. Dynamic
51
Q

Term: uses static components to apply force

A

Static Progressive UE Orthosis

52
Q

Term: Uses elastic components to apply force

A

Dynamic UE Orthosis

53
Q

Content: Functional Anatomy related to UE Orthoses - Extensor Tendons (3)

A
  1. Extensor mechanism relies on the excursion of extensor tendons
  2. Extensor tendon excursion is considerably less than that of the flexor tendons
  3. Thus the extensor tendon mechanism is more prone to shortening, and it is more difficult to compensate for a loss of extensor excursion
54
Q

T/F: Extensor tendon excursion is considerably more than that of the flexor tendons.

A

False: less

55
Q

Q: What does the extensor mechanism rely on?

A

The excursion of extensor tendons

56
Q

Q: The extensor tendon mechanism is more ________ to _____________, and it is more _____________ to ______________ for a loss of extensor excursion

A

prone, shortening, difficult, compensate

57
Q

Content: Functional Anatomy related to UE Orthoses - MCP, PIP, DIP (2)

A
  1. Ligament length at the MCP and PIP joints is dependent on joint position
  2. MCP flexion with PIP and DIP extension is the anti-deformity (instrict plus) position
58
Q

Q: What is the anti-deformity or intrinsic plus postion of the hand?

A

MCP flexion with PIP and DIP extension

59
Q

Content: Ligament length with MCP extension

A
  1. Collateral ligaments are slack and prone to shortening
60
Q

Content: Ligament length with PIP flexion

A
  1. Volar plate is slack and prone to shortening
61
Q

Content: Hand Position - Intrinsic Plus (3)

A
  1. MCP flexion with PIP and DIP extension
  2. Positioning MCP in flexion protects IP extension
  3. Commonly used after trauma, burn, or tendon repair
62
Q

Content: Hand Position - Intrinsic Minus (3)

A
  1. MCP extension with PIP and DIP flexion
  2. Often results from intrinsic denervation/ulnar nerve plasy
  3. Unopposed extension cause MCP hyper-extension and IP flexion
63
Q

Q: What is the equation for pressure?

A

pressure = force x area

64
Q

Content: Pressure (2)

A
  1. Pressure is never eliminated, only distributed
  2. Accomodate for bony prominences
65
Q

Content: UE prominences to be aware of in regards to pressure (6)

A
  1. Olecranon
  2. Humeral epicondyles
  3. Styloid process
  4. Base of 1st MC joint
  5. Dorsal thumb, MP, and IP joints
  6. Pisiform
66
Q

Content: UE nerves to be aware of in regards to pressure (4)

A
  1. Radial n.
  2. Ulnar n.
  3. Median n.
  4. Volar digit nerves
67
Q

Q: Where in the UE can the radial n. be compressed?

A

Radial groove of humerus

68
Q

Q: Where in the UE can the ulnar n. be compressed?

A

Cubital tunnel or distal forearm

69
Q

Q: Where in the UE can the median n. be compressed?

A

Carpal tunnel

70
Q

Content: Describe the functional hand splint (4)

A
  1. Wrist in 20-30 degrees of extension (neutral if inflamed)
  2. Thumb in palmar abduction
  3. MCPs in 15-20 degrees of flexion
  4. IPs in slight flexion
71
Q

Content: Intrinsic plus splint

  1. IP position
  2. Thumb position
A
  1. Extension
  2. Palmar Abduction
72
Q

Content: Wrist Immobilization Splint for carpal tunnel syndrome

A

0 degrees

73
Q

Q: What is another name for radial nerve palsy?

A

Wrist drop

74
Q

Content: Wrist Immobilization Splint for Colles’ fx

A

up to 30 degrees

75
Q

Term: Inflammation of APL and EPB synovial sheaths

A

DeQuervain’s

76
Q

Term: Ulnar collateral ligament injury

A

Gamekeeper’s thumb

77
Q

Diagram: Identify what the following finger immoblization treats

A

Used for Immobilization

78
Q

Diagram: Identify what the following finger immoblization treats

A

Swan neck

79
Q

Diagram: Identify what the following finger immoblization treats

A

Boutonniere Contracture/Deformity

80
Q

Diagram: Identify what the following finger immoblization treats

A

Mallet Finger

81
Q

Diagram: Identify what the following finger immoblization treats

A

Lateral deviation

82
Q

Diagram: Identify what the following finger immoblization treats

A

Trigger Finger

PTRS 746 Exam 2 (9 decks)

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