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Ox Test Q > Test 1 > Flashcards

Test 1 Flashcards

1
Q

The three “activation methods for stance control ox:

A

Weight, Ankle, Gait

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2
Q

T or f: ankle motion is required for all SCO’s?

A

False

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3
Q

The stance phase of gait is___% of gait cycle?

A

60%

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4
Q

Normal gait has how many phases?

A

8

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5
Q

Name one of the three different weight activated SCO’s

A

Horton SCPKJ, Becker e-knee, otto bock SensorWalk

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6
Q

T or f: Gait activated SCO’s require a reciprocal gait pattern

A

True

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7
Q

T or f: Spasticity is a contraindication for SCO’s

A

True

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8
Q

T or f: a knee flexion moment at terminal stance is required for SCO’s?

A

False: a knee flexion moment at terminal stance will prevent the SCO from unlocking at TS, except with the SensorWalk

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9
Q

What MMT grade at the hip flexor is normally required for SCO’s?

A

Gr. 3, unless patient has a compensatory pattern that is equal to a gr. 3 in motion

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10
Q

What are two of the effects of locking a knee in normal gait

A

Hip hiking, circumspection, vaulting, excessive lateral trunk lean, increased energy consumption, decreased cadence

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11
Q

The ankle is in what position durning the swing phase of gait

A

Neutral to 5 degrees pf

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12
Q

T or f: Locking the knee during normal gait is always safer for the patient

A

False

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13
Q

How do you determine stirrup length?

A

2 times height of distal tip of medial malleolus + SOLE THICKNESS + width of heel +1/4” or 6mm

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14
Q

How doe you determine band length

A

Half circumference pulse 1.5” or 38mm

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15
Q

What are the min. Clearance for ankle joints and knee joints?

A

Ankle: lateral side 3/16” or 5mm- medial 1/4” or 6mm
Knee: lateral side 1/8” or 3mm- medial 1/4” or 6mm

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16
Q

A conventional KAFO what changes could you use to reduce recurvatum?

A

Shallow bands, move calf band up-distal thigh down-move theses two closer, increase heel height

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17
Q

KAFO, what problems could you encounter in moving the bands?

A

Peroneal nerve impingement, limited knee flexion of orthosis

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18
Q

How much pf would you allow a patient who has suffered a CVA?

A

Neutral

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19
Q

How do you determine if a patient requires locks on his KAFO vs. free knee?

A

Hip and or knee extensor weakness

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20
Q

What do you recommend for a patient who exhibits foot slap at heel strike

A

AFO- Conventional or plastic w/ Dorsi-assist and or plantar stop

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21
Q

What is Legge-calve-perches disease?

A

A vascular necrosis of the femoral head usually occurring in boys ages 9-14. Femoral head will return to normal if the leg is abducted and internally rotated to place the femoral head in the accetabulem

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22
Q

Name 3 ox used for legge-calve-perthes?

A

Atlanta (scottish rite), toronto, newington

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23
Q

3 ox for the treatment of Hip dysplasia

A

Frejka pillow, pavlik harness, llfeld splint

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24
Q

What is tibial torsion?

A

Difference between knee and ankle joint axes as viewed in the transverse plane

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25
Q

How is tibial torsion measured

A

With knee at 90- measure apex of each malleolus to the surface behind the leg.. subtract the two numbers the difference is TT.

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26
Q

WHAt type(s) of functional devices can be used for excessive pronation of the foot?

A

Foot ox, UCBL

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27
Q

A UCBL is used for more control of what part of the foot?

A

Hindfoot (calcaneus), sub-Talar joint

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28
Q

What is the cause of Charcot joints in the feet and ankle?

A

Any neuropathic disease can have Charcot joints associated with it ( diabetes, herpes, syphilis)

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29
Q

Eval. Of a patient with a gunshot wound to the hip revivals a weak hip flexors. What peripheral nerve is injured?

A

Femoral nerve

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30
Q

What is your ox recommendation for damage to femoral nerve with weak hip flexors?

A

Cane used on the contralateral side

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31
Q

What is the name for contralateral pelvis drop?

A

Trendeleberg sign, gluteus medius limp

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32
Q

Describe condromalacia

A

Softness of the articulate cartilage usually involving patella-femoral joint

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33
Q

What is your ox recommendation for condromalacia?

A

Palumbo ox or other patellar stabilizing ox

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34
Q

A patient’s KAFO has free motion knee but the mechanical joint is 1” distal to the anatomical joint. In flexion the resulting pressure will be?

A

Proximal posterior thigh, distal anterior thigh- ox migrates proximally

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35
Q

Toe drag is a bigger problem in what phase of gait? Why?

A

initial swing- if the toe does not clear the floor the patient takes short steps and may trip

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36
Q

Why do diabetics get foot ulcers?

A

Loss of sensation- patient cannot tell when he is getting blisters or pressure sores that can develop into ulcers if not detected in time

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37
Q

What is the advantage of an offset knee joint for treating recurvatum

A

Puts the weight bearing line anterior to the knee joint, making it unnecessary to lock the knee

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38
Q

Describe guillian barre and its effects on the patient

A

Infections polyneuritis with progressive muscular weakness, distal to proximal, which may lead to paralysis. Prognosis usually full recovery, though in more severe cases the patient may have some residual weakness in distal extremities

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39
Q

Describe charcot-marie-tooth

A

Inherited progressive neuromuscular atrophy characterized by progressive weakness of the distal muscles of arms and feet usually develops in childhood

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40
Q

When would you recommed a bail lock on a KAFO instead of drop lock?

A

Only one functional hand, when crutches or cane are used with bilateral KAFOs

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41
Q

Name two contraindications for plastic AFOs

A

Uncontrolled edema, sensitive skin

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42
Q

Name two methods of minimizing knee flexion torque at initial contract in a lower extremity ox.

A

Beveled, undercut, or SACH heel

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43
Q

What implications do weak hip flexors have in your design of a KAFO

A

A Lightweight design could encourage hip flexion at swing phase

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44
Q

For what diagnoses would you recommend a rocker bottom shoe?

A

Diabetes, arthritis, ankle fusion, etc.

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45
Q

What is the RX rational for a rocker bottom shoe

A

Simulate normal foot biomechanics and promote even weight bearing distribution in a patient with limited or no ankle motion

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46
Q

A polio patient has a flail ankle, good knee muscles, good hip muscles, full ROM at knee with 25° recurvatum. Knee buckles when tired what ox do you recommend? Describe the mechanical principles.

A

Light weight KAFO, offset or drop lock knee, solid plastic AFO section w/ rocker bottom shoes or double adjustable ankle joints

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47
Q

Six weeks post ACL repair-how do you cast? What two mechanical principles do you want?

A

Cast in slight flexion

  1. Prevent hyperextension
  2. Control rotation
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48
Q

Name two reasons why you night not use pretibial AFO’s for a patient who walks with a crouched gait

A

Hip flexion contracture, lack of ankle ROM, inability to don

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49
Q

Give 4 contraindications for RGOs

A

Obesity, hip flexion contracture +20 deg. , spasticity, non plantargrade foot, hip dislocation

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50
Q

Name 3 clinical signs of charcot joints at ankle mortise

A

Swelling, instability, excessive joint mobility, pain, anaesthetic foot, visual deformity

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51
Q

Name 3 mechanical principles for treatment of charcot joints

A

Immobilize in total contract AFO, minimal weight bearing, rocker bottom

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52
Q

Name 3 signs in evaluation of heel spur pain

A

Valgus foot, pes planus, localized pain @ loading

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53
Q

Mechanical principles treating heel spurs

A

Distribute and reduce pressure in arch support, UCBL for hindfoot and or forefoot control

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54
Q

Where should you place the mechanical hip joint?

A

1/2” anterior, 1” superior to greater trochanter

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55
Q

How would elevating the shoe heel effect a solid ankle afo?

A

Increase knee flexion moment at heel strike

56
Q

What effect would posterior placement of knee joint have on the KAFO?

A

Migrates proximally with pressure on anterior calf cuff

57
Q

What modifications can you make to a plastic KAFO to reduce recurvatum?

A

Trim proximal and distal sections closer to the knee, pad shells- shallow shells

58
Q

Why would you choose a metal AFO over plastic for a patient with Charcot joints?

A

Prevent skin breakdown due to insensate foot

59
Q

What are the stance phases of gait and what is the hip position through each

A 
IC- 30 flexion
LR-25-30 flexion
MS- 20 flexion to 5° extension
TS- 10 extension
PrSw-10 extension
60
Q

How can you prevent a knee orthosis from migrating down

A

Supracondylar wedge, suprapatellar strap, attach to footplate, lightweight belt

61
Q

What is the basic theory of fx bracing?

A

Using hydrostatic pressure to stabilize the fx, micro motion at fx site promotes healing, mobilization of joints above and below the fx decreases habilitation time

62
Q

How would you treat a stable, ten day old, distal 1/3 femoral fx with acute signs of swelling and pain absent

A

Functional femoral fx brace with free knee and ankle

63
Q

What would you recommend for a 3 week old tibial plateau fx.

A

AK fx brace with free knee and ankle

64
Q

Would you fit a tibial fx brace on a painted itch an open wound on the tibia?

A

No, fx bracing is contraindicated with open wounds

65
Q

What could you do to fracture brace to better align a lateral or medial tibial plateau fx?

A

Stress brace into varus or valgus ( if directed by MD)

66
Q

What is the best position for a patient to be in when being fitted with a tibial fracture brace

A

Sitting with legs dangling knees at 90

67
Q

Should of put a femoral fx brace on a proximal femoral fx?

A

No never brace femoral fx above the distal 1/3

68
Q

3 ways to manage a T11 anterior compression fx.

A

Jewett, taylor, body jacket

69
Q

What is the biomechanical principle of a jewett

A

3 pt pressure, hyperextension

70
Q

What is ox recommendation for patient with an odontoid fx who was just removed from a halo

A

SOMI, extended philadelphia

71
Q

What is the major advantage of a SOMI ox?

A

Can be fit on a supine patient

72
Q

Recommend an ox to control flexion and extension for a stable c3 fx

A

Four post, SOMI, two post

73
Q

What is spondylolisthesis

A

Anterior slippage of L4 on L5 or L5 on S1- 4 grades of slippage

74
Q

How would you treat spondylolisthesis

A

BOB brace, williams, raney flexion jacket

75
Q

47 yr old male sustained an L4 compression fx during a fall what is your ox recommendation?

A

BOB, Jewett, chairback, corset

76
Q

What is your ox recommendation for a 68 year old emails with osteoporotic kyphosis

A

Dorsal lumbar corset, taylor

77
Q

How would you treat T3 fx

A

Body jacket with cervical extension

78
Q

Can you use a halo ring on a child

A

Yes more pins less torque

79
Q

Would u apply a halo vest to a patient in ICU w/o a doctor?

A

No, doctor should stabilize neck

80
Q

For stable compression fx of the cervical spine the head should be positioned in flexion or extension

A

Extension

81
Q

Describe the ox treatment and rx rationale for burn patient

A

Pressure garments, burn masks- to reduce hypertrophic scarring

82
Q

What is torticollis

A

Contracture of the sterno-cleido-mastoid muscle

83
Q

What is the recommended torque for halo pins in adult and a child

A

Adult- 8 in pounds

Child-4-6 in pounds

84
Q

What is the reasoning behind using non-ferrous components in halo system

A

MRI compatible

85
Q

Hallo pins are tightened in what fashion

A

2in/lb alternating opposing diagonal forces until 6-8 in/lbs is reached

86
Q

During anterior pin placement should the patients eyes be open or closed

A

Closed

87
Q

What tool would you use to apply halo pins

A

Torque screwdriver

88
Q

The pins on a halo should be re tightened at what time interval after initial application

A

24-? 48 hrs.

89
Q

An inflamed pin-site, pain at pin-site, noise or movement are indications of what

A

Loose pin

90
Q

Your patient comes into your office with a loose pin. You try to re-tighten and no resistance is met. Your next step would be:

A

Call the doctor- puncture of bone..

91
Q

What are the advantages of using a breakages torque wrench

A

Wrench breakers off at set amount of torque. Smaller in size for getting into cramped areas

92
Q

At what spinal level would you consider using a CTLSO rather than a TLSO for scoliosis

A

T6-t8

93
Q

What are the upper and lower limits in degrees for treatment of scoliosis ox.

A

25° to 40° AND progressive

94
Q

Do you treat functional and structural scoliosis the same

A

No, functional curves are fit with corrective devices, structural curves are usually treated with an accommodative device

95
Q

What is the most common type of scoliosis

A

Idiopathic, more often in girls

96
Q

How long does a patient normally wear a scoliosis ox?

A

Until skeletal maturity, then painted is weaned off the ox

97
Q

What is the proper clearance of the throat mold on a CTLSO

A

Two fingers (1”) below chin

98
Q

What is proper placement for throacic pad on the CTLSO

Name and describe two other pads on CTLSO

A

Thoracic pad: two ribs inferior to the apex of the curve pad is ‘L’ shape

Shoulder ring, lumbar (kidney shape) anterior derotation

99
Q

Why are the anterior bars on the Milwaukee made of aluminum?

A

So that it is X-ray transparent

100
Q

What is the purpose of the neck ring on a milwaukee

A

The upper pressure point for high scoliosis curves or kyphosis- not a distractive force

101
Q

What is risser sign

A

Method of determining bone maturity, using x-ray, reading the iliac epiphysis, grade 0-5

102
Q

What is two nerves could be compromised with incorrect positioning of the anterior pins

A

Supra orbital and supratrochlear nerves

103
Q

How do you determine which is the primary curve and the compensatory?

A

The primary curve is the most structural curve will always have rotation, compensatory curves accommodate the primary to center the head over the pelvis

104
Q

Synostotic plagiocephaly occurs when

A

When the sutures fuse early

105
Q

The FDA has classified the CRO as a class ____ device

A

Class II

106
Q

The average male to female ration of plagio is

A

3:1

107
Q

What % of normal skull growth is achieved by 12 months

A

85%

108
Q

Positional plagiocephaly doe not normally resolve it self after___months of age

A

5 months

109
Q

Including the auditory ossicles how many bones make up the skull

A

28

110
Q

T or F: The best treatment period for an infant with plagiocephaly is between 3-8 months

A

True

111
Q

T or f: About 80%of children affected with plagiocephaly show some sort of torticollis

A

True

112
Q

What nerve is affected with ape hand deformity

A

Median

113
Q

What nerve is affected with wrist drop

A

Radial

114
Q

What is normal position for the wrist and arm in a WHO?

A

15-30° Dorsiflexion (extension), no ulnar or radial deviation neutral pronation-supination

115
Q

What residual function would you expect with a complete C-6 cervical lesion

A

Wrist extension

116
Q

How does a wrist driven function

A

Ten odes is action from wrist extension to cause grasp

117
Q

Name the six pretension patterns

A

Spherical, tip, palmar, cylindrical, hook, lateral

118
Q

A thumb post should hold the thumb in what position

A

In opposition to index and second fingers

119
Q

What type of orthotic device would you use for a patient with a complete C-5 lesion?

A

Static WHO, mobile arm support

120
Q

What type of orthosis would you use for an intrinsic minus hand?

A

HO

121
Q

What is clonus

A

Rapid alternating involuntary movement elicited by stretch

122
Q

Home many cervical neural segments are there

A

8

123
Q

Tor F: At the neural segmental level of the spinal cord lesion there will always be a return reflex action

A

False

124
Q

Describe a rotator cuff injury?

A

Damage to the SITS muscles in the shoulder: supraspinatus, infraspinatus, teres minor, subscapularis

125
Q

What is your orthotic recommendation for rotator cuff?

A

Immobilize shoulder in slight abduction- airplane splint

126
Q

Describe Erb’s palsy and make orthotic recommendation

A

A upsilon of C5-6 root resulting in a flail arm( finger flexors and extensors intact) gunslinger ox to position hand and support shoulder

127
Q

What type of neural injury normally results in flaccid paralysis ( upper motor, central nervous system, peripheral)

A

Peripheral nervous system injuries

128
Q

What muscles flexes, abducts, extends, and supports the shoulder joint

A

Deltoid

129
Q

What should one of your primary concerns be in upper extremity orthotics for spinal injury

A

Insensate skin sensitive to pressure

130
Q

What ox would you recommend for a hand with lubricales, interossei, and thumb abduction out?why?

A

HO with C-bar and M-P extension stop to maintain thumb web space, flex M-P’s allowing long extensors to extend I-P’s DIP’s

131
Q

Etiology of carpel tunnel syndrome

A

Compression of the median nerve with the carpal canal caused by edema, synovitis, and fibrosis of the tendon sheath

132
Q

How would you treat a mid-numeral fx with radial nerve lesion

A

Humeral fx brace with positional cock up splint and sling

133
Q

How do you position for carpal tunnel syndrome

A

Immobilize in neutral

134
Q

Describe the muscle picture for radial nerve injury

A

Loss extensors of wrist and elbow, supinator, and thumb abduction

135
Q

Describe muscle picture for median nerve injury

A

Lose lumbricales 1 and 2, opponents pollux, flexure pollicis brevis and palmer sensation- ape hand

136
Q

Describe muscle picture for ulnar nerve injury

A

Lose of most intrinsic of the hand “claw hand”

Ox Test Q (10 decks)

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