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Finals - No Share > Trans Femoral > Flashcards

Trans Femoral Flashcards

1
Q

When donning a TF prosthesis, if the amputee is using a sleeve to pull into the socket, what are the two most important land marks to insure proper rotation?

A

Adductor longus tendon and ischial tuberosity

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2
Q

The correct location of the modular expulsion valve is as follows:

A

on the anterior medial surface, with the lower edge of the valve as close as possible to the distal end of the model

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3
Q

The wallet hollow or lateral sulcus is a good place to compress the residual limb on the transfemoral amputee’s tissue as it is the:

A

intersection of the gluteus medius, vastus lateralis and the lateral aspect of the hamstring muscle group

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4
Q

When the above knee amputee must actively arch his back to maintain center of gravity of his body in the proper position while pressing back with his residual limb, it is an indication that the:

A

residual limb was fit into a socket without adequate initial flexion

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5
Q

In the TF socket, the lateral wall is:

A

adducted to stabilize the femur at midstance

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6
Q

The TF ptient displays an abducted gait at midstance when ambulating with her prosthesis. Which of the following is the best cause for this deviation?

A

the patient is experiencing excessive ramus pressure

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7
Q

One biomechanical reason that flexion is placed into an ischial containment prosthesis is:

A

to more closely mimic the angle of the limb behind the TA line at toe off

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8
Q

The initial placement of the prosthetic knee bolt is usually found to be:

A

in approximately 5° external rotation relative to LoP

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9
Q

Which of the following is not among the adductor group

a) gracilis
b) adductor magnus
c) adductor longus
d) sartorius

A

sartorius

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10
Q

During dynamic alignment, the TF patient is walking on the lateral border of their prosthetic foot and the pylon is leaning laterally. The prosthetist should:

A

adduct the socket

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11
Q

Lateral trunk bending in the TF may be caused by:

A

painful distal lateral femur pressure

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12
Q

During swing phase, a tendency for the TF prosthetic to make marked inward rotation of the knee accompanied by an outward rotation of the heel of the Px foot is called.

A

Lateral whip

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13
Q

If the skeletal M-L dimension of the IC socket is too large

A

The ischium drops into the socket and the ramus hits the medial wall

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14
Q

Circumduction may be caused by:

A

an uncomfortable medial brim

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15
Q

The MTP measurement is taken from:

A

the medial-tibial plateau to the floor with the amputee sitting

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16
Q

Pronounced impact shock at full extension of the prosthetic knee indicates a need for:

A

more extension dampening controls

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17
Q

A possible amputee cause for lateral trunk bending on the prosthetic side would be:

A

very short residual limb

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18
Q

What muscle that is primarily an extensor of the knee becomes a major hip flexor on TF amputations

A

rectus femoris

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19
Q

Which of the following would tend to cause the lateral proximal brim on the ICAK socket to exhibit gapping during static alignment?

A

All the above

Skeletal M-L too tight
Skeletal M-L too loose
Too much socket adduction

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20
Q

Short stride length on the prosthetic side would normally be caused by:

A

excessive initial socket flexion

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21
Q

The starting height for knee center in the transfemoral prosthesis:

A

Sound side MTP + 1/2”

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22
Q

T/F: Based upon his studies of biomechanics and kinematics of the TF amputee’s gait Radcliffe advocates the use of a firm SACH heel cushioned prosthetic foot.

A

False

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23
Q

In late stance phase, when the TF prosthetic foot is placed in excessive dorsiflexion:

A

The knee is made unstable

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24
Q

According to the Atlas, if the TF amputee is having difficulty arising from a straight chair, he should be instructed to:

A

Place his sound foot under the chair behind his prosthetic foot

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25
Q

In order to walk efficiently and with good appearance, the amputee should be able to extend his prosthesis to an angle of 15° back of the perpendicular at push off. Which one of the following examples would meet this criterion:

A

Anatomic hip flexion + 10°; initial socket flexion + 15°

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26
Q

The A-P measurement is the distance between the:

A

Adductor longus and ischial tuberosity

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27
Q

Voluntary knee control refers to:

A

Knee axis anterior to the TKA line

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28
Q

A lateral whip is caused by:

A

excessive internal rotation of the knee bolt

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29
Q

Visual examination of the TF residual will reveal:

A

abrasions

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30
Q

The toe lever in the prosthetic foot substitutes in part for the:

A

gastrocnemius

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31
Q

In normal human locomotion the total distance the pelvis travels medio-laterally during locomotion is:

A

2”

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32
Q

In normal human locomotion, the pelvis rotates in the horizontal plane approximately how far?

A

8°

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33
Q

In normal human locomotion, the normal width of the walking base, from the medial border of the heels of the shoe, in adult males is:

A

2-4 inches

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34
Q

In TF prosthetic gait, what muscle group acts to decelerate the leg before initial contact

A

hamstrings

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35
Q

What is the maximum amount of knee flexion during swing phase of normal human locomotion?

A

60°

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36
Q

A medial whip in the TF prosthesis may be:

A

excessive external rotation of knee axis

37
Q

When standing still, the amputee’s ischial tuberosity in a TF QUAD socket is held in place on the seat chiefly by the:

A

Anterior wall

38
Q

Amputees with short TF residual limbs generally exhibit lateral bending of the trunk due to:

A

loss of adequate lever arm

39
Q

If TF suction suspension is inadequate, the first auxiliary suspension that should be tried is a:

A

SIlesian bandage or TES belt

40
Q

Vaulting on the sound foot by the TF Quadrilateral suction socket prosthesis wearer may be caused by:

A

prosthesis that is too long

41
Q

The “T” landmark on the lateral wall of the TF Quad socket is established by measuring one inch:

A

1” anterior from the ischial seat, then at right angles from the medial wall to the lateral wall transferred to the lateral brim

42
Q

Suppose an unmodified ICAK master plaster model doesn’t have a line of progression drawn on it. The landmarks and guides used to determine the LoP are:

A

a line drawn 2-4° internally rotated from a line drawn from the apex of the rectus femoris channel to the apex of the posterior channel

43
Q

Excessive heel rise at pre-swing and into swing phase by the TF suction socket wearer may be caused by:

A

knee friction set too loose

44
Q

You check the TKA line on a TF prosthesis with a yardstick and find the knee center is 1 1/2” posterior to that line. What is the reult of this alignment?

A

Excessive alignment stability

45
Q

While observing a TF amputee walking, you note that he vaults on his sound side. What prosthetic factor could cause this gait deficit?

A

Knee friction control too tight and prosthesis too long

46
Q

According to Radcliffe’s stability equation: The muscle moment about the hip joint on the TF amputated side required to maintain the weight bearing knee in a stable position can be reduced to almost zero if the knee mechanism:

A

is a weight activated stance control knee

47
Q

The origin of the hamstring muscle group is the:

A

ischium

48
Q

Mediolateral stability of the pelvis is attained chiefly through the contraction of what muscle?

A

gluteus medius

49
Q

Scarpa’s triangle is bounded by:

A

inguinal ligament, sartorius, adductor longus

50
Q

During swing phase in the TF prosthesis with a hydraulic swing control unit, resistance to ___ stimulates the eccentric action of the quadriceps muscle group in ambulation for the uninvolved person.

A

knee flexion

51
Q

Referring to knee stability, what would be the effect of lowering the vertical height of the instant center of rotation

A

increases the hip moment required to maintain prosthetic knee stability

52
Q

Between TF heel contact and push off, Radcliffe describes the ‘zone of voluntary stability’, which allows considerable variation in the alignment of the prosthetic knee joint. The two major consideration in the alignment are:

A

Knee stability at heel contact and ease of flexion during push-off

53
Q

Why do the inner medial hamstring wall and medial containment wall form a different angle to the line of progression?

A

The inner medial hamstring wall forms the medial-distal margin of the inferior containment wall to provide a comfortable radius for the hamstrings, while the medial containment wall is shaped to the ramus angle to contact and stabilize against the medial side of the ischium

54
Q

The anterior-medial quadrant of an ischial containment shaped socket is contoured to provide depression of the femoral angle. All of the following are reasons this depression is in place except:

a) relief of adductor longus
b) provide rotational control
c) insures proper donning
d) provides area for weight bearing in early stance

A

Provide area for weight bearing

55
Q

An ischial containment shape that is too tight in the anterior lateral quadrant would most likely result in:

A

a swing phase whip

possible loss of ischial containment

56
Q

The height of the lateral wall proximal to the trochanter is important for:

A

cosmetic appearance

57
Q

Why would a lanyard type suspension be used for a TF prosthesis?

A

to allow the amputee to pull the residual limb into the socket

58
Q

It is critical that the TF amputee keeps the prosthetic knee joint extended throughout stance phase by the action of the knee unit’s inherent stability and the amputee’s voluntary control over it. The knee unit characterized by the least inherent stability and requiring the most voluntary control is the:

A

Constant Friction (single axis) knee

59
Q

According to the Atlas, two distinct advantages to the knee disarticulation amputation as compared to the transfemoral type are:

A

distal weight bearing and maintains femoral length in growing children

60
Q

Which of the following are advantages to the knee disarticulation amputation for prosthetic fitting?

A

bulbous condyles may allow non-suction suspension through removable medial plate

61
Q

The two most common knee mechanisms used in the knee disarticulation prosthesis to simulate the anatomic knee center are:

A

polycentric and outside hinges

62
Q

The terminology used to describe the distance between points A and B is:

A

bi-ischial diameter

63
Q

What is the angle called?

A

pubic arch angle

64
Q

In most individuals the angle will be:

A

greater in females

65
Q

The skeletal M-L is measured

A

from the medial side of the ischium to just below the greater trochanter laterally, on a perpendicular with the ramus angle

66
Q

The term ischial containment means:

A

containing the ischium from the medial, posterior, and inferior sides

67
Q

The ‘true’ silesian bandage has ___ anterior attachment points

A

two

68
Q

T/F: The silesian bandage has been found a valuable aid in stabilizing the TF prosthesis against rotation and lateral instability in cases of short or excessively flabby residual limbs

A

True

69
Q

If the silesian bandage does not correct a whip, you conclude that the problem is:

A

prosthetic caused; knee bolt rotation

70
Q

The starting point for location of the rigid pelvic joint to the socket is:

A

1/2” anterior and 1” superior to the trochanter mark

71
Q

What is a disadvantage of the TES belt?

A

tends to be more difficult for arthritis sufferers to don and dof

72
Q

The mauch swing-n-stance cylinder offers a combination of knee mechanisms. They are:

A

hydraulic swing and stance control, hydraulic swing control only and manual locking mode.

73
Q

Present hydraulic swing control prosthetic knees aim to provide friction from fluid passing through valve orifices or rough channels. The resistance of the fluid flow increases as a ____ of the cadence, so there is very little resistance at slow motion, moderate resistance at normal speed comparable to a well djusted mechanical friction device, yet extremely high resistance to fast motion at hight speed

A

square

74
Q

A polycentric knee with hydraulic swing phase control may be paid for my Medicare if the patient is classified at what functional level.

A

K3

75
Q

What socket style allows the gluteus maximus to be outside of the trim lines while stabilizing the prosthesis at midstance in the coronal plane with containment of the medial aspect of the ischial tuberosity

A

ICAK

76
Q

Which socket style keeps the gluteus medius contained inside the trimlines

A

CAT-CAM

77
Q

What socket style allows the gluteus maximus to be outside of the trim lines while stabilizing the prosthesis at midstance in the coronal plane with containment of the medial aspect of the Ascending ischial ramus

A

MAS

78
Q

With a Mauch prosthetic knee of similar SNS hydraulic cylinder, changing the position of the upper ring (hydraulic) will effect

A

knee flexion resistance

79
Q

During swing phase in the TF prosthesis with a hydraulic swing control unit, resistance to ___ stimulates the action of the eccentric action hamstring muscle group in ambulation for the uninvolved person

A

knee extension

80
Q

According to Radcliffe’s knee stability equation: it is possible to reduce the prosthetic knee alignment stability to exactly zero by aligning the prosthesis in such a manner that the knee center:

A

lies on the load line

81
Q

According to the academy’s online module ‘outcome measures in lower limb prosthetics’ outcome measures:

A

all the above

answer questions about patients
help guide clinical decisions
help guide plans of care

82
Q

T/F: According to the academy’s online module ‘outcome measures in lower limb prosthetics’ the AMP cannot be used if the amputee has any medical comorbidities

A

False

83
Q

According to the academy’s online module ‘outcome measures in lower limb prosthetics’ the product of energy cost and steady-state walking speed is called what?

A

energy expenditure rate

84
Q

According to the academy’s online module ‘Alignment secrets’ alignment rules and guidelines have been previously established by leaders in the field. they were judged as either practical or impractical based largely on their:

A

empirical success

85
Q

T/F: According to the academy’s online module ‘Alignment secrets’ a suggestion by the author is to not overstabilize the knee but rather optimize voluntary control, which is the best type of control

A

True

86
Q

T/F: According to the academy’s online module ‘liner materials’ one advantage of these traditional liner materials is that they are compatible with many socket designs, but two disadvantages are that they may hold bacteria and they are difficult to produce and duplicate

A

True

87
Q

T/F: According to the academy’s online module ‘liner materials’ one perceived advantage of the TPE liner is that this liner can be heat molded, thus fitting the limb better and being impervious to temperature and pressure changes within the socket. Thus it maintains its thickness over periods of high pressure

A

False

88
Q

According to the Atlas, postsurgical management evaluation of the lower limb amputee includes all of the following EXCEPT:

a) mental status
b) ROM
c) strength
d) ambulation with an assistive device without a prosthesis
e) step over step stair descent

A

step over step stair descent

89
Q

According to the Atlas, a large number of factors affect the prescription, not all of which readily come to mind until one examines all the parameters of a given patient’s life. First and foremost, the prosthesis should:

A

meet the needs and desires of the patient, moth vocationally and non-vocationally

Finals - No Share (1 decks)

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