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RS PTRS 746 Musculoskeletal Conditions > Spinal And UE Orthotics > Flashcards

Spinal And UE Orthotics Flashcards

1
Q

What is an orthotic?

A

something used to support, align, prevent or correct deformities, or improve function

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2
Q

Purposes of an orthotic

A 
support and align
immobilize, restrict, or mobilize
prevent or correct deformity
substitute or enhance motion
reduce pain and discomfort
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3
Q

Indications for a spinal orthotic

A

correct or prevent deformity, relieve pain, support fracture healing, post-op protection, prevent further injury, support and align

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4
Q

Spinal orthotic principles

  • ____ pressure system
  • increase ______
  • Provide ______
  • modify_____
A
  • 3 point
  • hydrostatic pressure
  • kinesthetic reminder
  • support systems
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5
Q

Spinal support systems

  • muscles
  • ligaments
  • discs
A 
Muscles- 
-flexors: psoas, abdominals
-extensors: erector spinae, paraspinals
Ligaments- linkage, transfer loads, smooth motion
Discs- shock absorption
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6
Q
  • Extrinsic stability

- Intrinsic stability

A
  • muscles

- ligaments/discs

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7
Q

Soft collars

  • facilitate_____
  • limit _____
  • provide _____
A
  • spinal alignment
  • some ROM
  • kinesthetic reminder
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8
Q

What type of collar is a Headmaster collar?

A

soft

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9
Q

Name 3 types of semi-rigid collars

A

Philadelphia, aspen, miami J

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10
Q

Two types of cervical orthoses with thoracic extension

A
  • SOMI (sternal occipital Mandibular immobilizer)- often used for bed bound pts.
  • Lerman-Minerva
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11
Q

Halos

A
  • tri planar motion control of cervical spine
  • maximum immobilization
  • restricts 90-95% of normal motion
  • poor acceptance, high complication rate
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12
Q

Types of LSO

A
  • flexible LSO
  • Chairback LSO
  • Knight LSO
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13
Q

What does a chairback LSO do?

A

restricts sagittal plane motion, tightening abdominal support reduces lumbar lordosis

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14
Q

What does a Knight LSO do?

A

restricts sagittal and coronal plane motion, tightening abdominal support reduces lumbar lordosis

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15
Q

Types of TLSOs

A
  • knight-taylor TLSO
  • Jewett Hyperextension TLSO
  • CASH hyperextension TLSO
  • rigid TLSO (body jacket)
  • CTLSO (TLSO with cervical extension
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16
Q

Knight-taylor TLSO

A
  • restricts sagittal and coronal plane motion
  • tightening abdominal support reduces lumbar lordosis
  • tightening axillary straps facilitates thoracic extension
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17
Q

Jewett hyperextension TLSO

  • restrictions
  • indications
A
  • restricts thoracolumbar flexion and some coronal plane movement
  • compression fracture, kyphosis, arthritis
18
Q

CASH hyperextension TLSO

  • abbreviation
  • restricts
  • common in
A
  • Cruciform Anterior Spinal Hyperextension
  • thoracolumbar flexion
  • geriatric pts.
19
Q 
Rigid TLSO (body jacket)
-restricts
A

sagittal, coronal, and transverse plane movement

20
Q

Indications for orthotic mgmt of scoliosis

A
  • skeletal immaturity (premenarche)
  • curves between 20 and 40 degrees
  • documented progression
  • single or double curves
21
Q

Accomodative TLSO
(for scoliosis)
-addresses _____
-aligns head and trunk over pelvis, doing what?

A
  • fixed deformity

- reducing shear forcer, facilitating UE use, enhances mobility, facilitates respiratory function

22
Q 
Corrective TLSO
(for scoliosis)
-progressive correction of \_\_\_\_\_\_\_
-stabilization of \_\_\_\_\_
-\_\_\_\_ and or \_\_\_\_\_ deformity
A
  • idiopathic spinal curvatures
  • congenital spinal curvatures
  • prevent and/or correct
23
Q

Types of corrective TLSOs

A
  • Boston brace
  • Milwaukee brace
  • Charleston Bending Brace
24
Q

Boston brace

A
  • considered gold standard for adolescent scoliosis

- worn full time (18-23 hours/day)

25
Q

Milwaukee brace

A
  • for upper thoracic and cervical curvature

- worn full time (18-23 hours/day)

26
Q

Charleston bending brace

A
  • for smaller, flexible lumbar curvatures

- worn only at night (8 hours/day)

27
Q

PT for corrective TLSOs

A
  • skin care
  • trunk mobility and strengthening
  • aerobic training
  • postural feedback and training
  • functional training with brace
28
Q

Indications for UE orthotics

A
  • trauma (burns, MVAs, vocational)
  • congenital deformity
  • disease (RA, SLE, neuro impairments, esp. associated with abnormal tone)
29
Q

Designs of UE orthotics

A

Static, serial static, static progressive, dynamic

30
Q
  • static progressive orthotic

- dynamic orthotic

A
  • uses static components to apply force

- uses elastic components to apply force

31
Q

Which tendon mechanism is more prone to shortening and is more difficult to compensate for?

A

extensor mechanism

32
Q

Intrinsic plus position

anti-deformity position

A

MCP flexion with DIP and PIP extension.

-positioning MCP in flexion protects IP extension

33
Q

Intrinsic minus position

A

MCP extension with PIP/DIP flexion

  • results from intrinsic denervation (ulnar nerve palsy)
  • unopposed extension cause MCP hyperextension and IP flexion
34
Q

Pressure=

  • never ____
  • accommodate for_____
A

P=force*area

  • never eliminated, only distributed
  • bony prominences
35
Q

prominences

A

olecranon, humeral epicondyles, stloid processes, base of 1st MC joint, dorsal thumb, MP and IP joints, pisiform

36
Q

Nerves

A

radial groove of humerus, (radial) cubital tunnel (ulnar), distal forearm (ulnar), carpal tunnel (median), volar digital nerves

37
Q

functional hand splint

  • wrist
  • thumb
  • MCPs
  • IPs
A
  • 20-30 degrees extension
  • palmar abduction
  • 15-20 degrees flexion
  • slight flexion
38
Q

wrist position in intrinsic plus splint

  • palmar burn
  • dorsal burn
  • crush injury
A
  • 30-40 degrees extension
  • neutral-slight extension
  • 0-30 degrees extension
39
Q

MCP position in intrinsic plus splint

  • burn
  • crush injury
A
  • 70-90 degrees flexion

- 60-80 degrees flexion

40
Q

IP and thumb position for intrinsic plus splint

A
  • extension

- palmar abduction

41
Q

Thumb immobilization is used for what conditions

-position

A
  • DeQuervain’s: inflammation of APL and EPB sheaths, RA, Gamekeeper’s thumb: UCL injury
  • CMC in 35-30 degrees of abduction with MP joint in neutral

RS PTRS 746 Musculoskeletal Conditions (7 decks)

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