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Transfemoral/Hip Prosthesis components Flashcards

1
Q

can you end weight bear with a knee disarticulation

A

yes
*also allows for more ROM

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2
Q

what are removed with knee disarticulations

A

femoral condyles

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3
Q

Van Ness Rotationplasty (VNRP)

A

tibia is attached to femur and rotated 180 degrees for ankle to act as knee

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4
Q

VNRPs are typically seen in pts with…

A

sarcoma of distal femur

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5
Q

what is the advantage to a VNRP? disadvantage?

A

it is very functional but not cosmetically appealing

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6
Q

2 socket designs for above knee

A

quadrilateral and ischial containment

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7
Q

what are two general goals for above knee prosthetics

A

1 - achieve M/L stability
2 - knee stability and security

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8
Q

ischial containment creates more of a _______ effect

A

cupping

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9
Q

which gives you more M/L and rotational control… quadrilateral or ischial containment

A

ischial c

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10
Q

quadrilateral socket gives compression on the _____ portion of the residual limb

A

anterior
*helps keep ischium where it needs to be

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11
Q

where does the pt sit with a quadrilateral socket

A

posterior shelf

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12
Q

with a quadrilateral socket, what do you rely on for control

A

muscles, there is no bony lock

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13
Q

how does a quadrilateral socket control rotation

A

by restricting muscle and tendon movement

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14
Q

the medial wall of a quadrilateral socket has a relief area for…

A

adductor longus tendon

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15
Q

the posterior wall of a quadrilateral socket has a relief area for…

A

glute max and hamstring tendon

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16
Q

the anterior wall of a quadrilateral socket has relief area for…

A

rectus femoris

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17
Q

what is the purpose of the lateral wall of a quadrilateral socket

A

to wrap around the trochanter

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18
Q

which one contains more limb volume… quad or ischial containment

A

ischial c

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19
Q

which one is usually preferred by pts… quad or ischial containment

A

ischial c

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20
Q

T or F: ischial containment sockets often include a flexible liner for comfort

A

T

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21
Q

the posteiror wall of ischial containment socket has a relief area for….

A

glute max

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22
Q

3 structural goals of a prosthesis

A

1 - structural support for skeletal system
2 - transfer support forces through soft tissue to femur
3 - stabilizes the femur into the hip in a natural position for posture and force

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23
Q

The medial lock of ischial containment socket contains and supports _________. The lateral lock supports ______ and maintains _____ control

A

ischial tuberosity
sub-trochanter
femoral

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24
Q

4 T’s of socket design/conform

A

1 - total contact
2 - total contouring
3 - total control
4 - total comfort

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25
A shorter prosthetic allows for more ________
stability
26
what is the standard height for bilateral transtibial prosthesis and why?
18 inches b/c that is standard chair height
27
generally, above knee sockets are aligned in _______ degrees of hip adduction and ______ degrees of hip flexion
10 5 *add 5 deg to hip flexion contracture
28
what is the max hip flexion contracture that can typically be accommodated for?
30*
29
why is it extremely important to put hip flexion into the socket? (2)
1 - assist with weight bearing 2 - ensure TKA line is in front of knee
30
T or F: K-1 level can have a rotator
F: have to be K2 or above
31
What can a lack of hip flexion in the socket cause (3)
1) knee instability 2) inability to take proper length step 3) limited time on prosthesis
32
Too high of a heel will cause what?
knee buckling
33
T or F: adjustments to the knee of a prosthesis can be made
T
34
What are some pt-related reasons for prosthetic knee failure
1 - activity level has changed 2 - weight or activity has increased since initial fitting 3 - pt does not meet criterial for design and function of the knee
35
Why is it important for pts to follow up with prosthetist regularly?
because a prothesis is a piece of equipment and that equipment needs to be properly maintains. sometimes it fails.
36
Manual locking knees are used for what K-levels?
1 or 2
37
How does a manual locking knee work
The pt must manually unlock the knee to sit. If they fall, the knee will not collapse under them
38
What is the standard height for bilateral transfemoral prostheses
24 inches
39
What K-levels are friction knees for?
1 or 2
40
Friction setting allows for ______ walking speed.
one
41
T or F: friction plates require regular maintenance and replacement
T: they wear
42
Weight activated stance control knees are for what k-levels
1,2,3
43
this knee provides added stability during a misstep or on uneven surfaces
weight activated stance control
44
on a weight activated knee, a braking mechanism locks the knee during ______ phase
stance
45
What is the most popular knee fit in the US?
weight activated stance control
46
are polycentric or single axis knees more stable at heel strike
polycentric
47
________ knees shorten during swing
polycentric *easy to initiate swing
48
is polycentric or single axis cheaper? which is heavier?
single axis polycentric
49
How is stability achieved in a polycentric knee
the location of the "instant center" at full extension
50
hydraulic swing and stance (SNS) knees
provide hydraulic control during both stance and swing
51
what k-levels are hydraulic swing and stance knees for
3 and 4
52
This knee provides resistance to flex/ext during swing and stance and can provide stumble recovery and ability to walk down stairs/ramps
hydraulic swing and stance
53
in microprocessor knees, when weight is put on the toe the knee ______ and when weight is put on the heel the knee _______
flexes extends
54
what k-levels are microprocessor knees for
3-4 *maybe 2
55
this knee provides max cadence response over a wide range of functional applications
microprocessor
56
disadvantages of microprocessor knee
1 - expensive 2 - maintenance is crucial 3 - charging
57
axillary suspension is often needed as a secondary to a suction prosthesis in pts who have...
volume fluctuations
58
what is an advantage to a liner with suction/lanyard?
pts can put it on while sitting as long as they have the dexterity
59
where is the static evaluation for a prosthetic completed
in parallel bars
60
the medial wall and brim of the socket should contain all of the ____ tissues
adductor
61
the posterior wall of the socket should contain (3)
ischial tub pubic ramus portion of glute max
62
the lateral wall of the socket should have relief wall over the....
greater trochanter allows for snug fit against glute med
63
transpelvic and hip disarticulations are primarily due to what?
cancer
64
in hip disarticulations, a 3D hip joint is used with what prosthesis
C-leg
65
how do amputees assist with hip flexion during gait?
lumbar posterior tilt
66
when checking AKA prosthetic fit, the medial wall and brim should contain all of the....
medial adductor tissues
67
when checking AKA prosthetic fit, the posterior wall should contain the....
ischial tub, public ramus, and a portion of glute max.

Prosthetics (12 decks)

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