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prosthetics > Transfemoral Prosthetics > Flashcards

Transfemoral Prosthetics Flashcards

1
Q

True or False:

We want to hold the femur in adduction (varus)

A

True

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2
Q

True or False:

It is easier to hold the femur in adduction (varus) with a longer femur (residual limb)

A

True

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3
Q

What is successful prosthetic management of transfemoral and knee disarticulation (4)

A
  1. Comfortable in containing the residual limb
  2. Stable during the stance phase of gait
  3. Smooth in transition to the swing phase of gait
  4. Acceptable in appearance
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4
Q

True or False:

We mostly make endoskeleton prosthesis due to ease of adjustment

A

True

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5
Q

What must the prosthetic team consider when selecting components of the transfermoral or knee disarticulation prosthesis (5)

A
  1. Weight
  2. Function
  3. Cosmesis
  4. Comfort
  5. Cost
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6
Q

True or False:
The most functional or technologically sophisticated components are also the heaviest, most expensive, most likely to need maintenance, and least cosmetic

A

True

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7
Q

True or False:

Longer residual limb makes recovery and potential better than a short residual limb

A

True

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8
Q

What happens to energy cost of gait as length of the residual limb decreases

A

Increases

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9
Q

True or False:
Individuals with a transtibial amputation walk 36% more slowly expending 2% more kilocal’s per min and 41% more kilocal’s per meter vs normal

A

True

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10
Q

True or False:
Individuals with a transfemoral amputation amputation walk 43% slower, energy cost is reflected as 5% more kilocals per min and 89% more kilocal’s per meter vs normal

A

True

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11
Q

True or False:
Increase in energy cost is manifested as an increased rate of oxygen consumption, elevated HR, and notable decrease in comfortable walking speed

A

True

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12
Q

What is a quadrilateral transfemoral socket design

A

4 distinct walls fashioned to contain thigh musculature with a flat posterior shelf for ischial weight bearing

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13
Q

What does the anterior wall of the quadrilateral socket design do

A

Creates a posterior counterforce at Scarpa’s triangle stabilizing the ischium on posterior shelf

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14
Q

What is an ischial containment transfemoral socket design

A

Stabilizes socket on the residual limb and controls socket rotation by containing the ischial tuberosity and ramus it also maintains femoral adduction and distributes pressure through socket along the shaft of the femur

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15
Q

Where is the quadrilateral socket narrow

A

A-P

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16
Q

Where is the ischial containment socket narrow

A

M-L

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17
Q

What is the goal of transfemoral socket design (3)

A
  1. Achieve comfort in weight bearing
  2. A narrow base of support in standing and walking,
  3. As close to normal swing phase as possible
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18
Q

What are the 2 socket options

A
  1. Hard socket

2. Flexible socket

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19
Q

How is the hard socket made

A

Thermoplastic or thermosetting resin

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20
Q

How does the hard socket fit

A

Intimate total contact fit worn with prosthetic sock as interface

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21
Q

What is the advantage to a hard socket (3)

A
  1. Very durable
  2. Easy to clean
  3. Less expensive
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22
Q

What is the disadvantage to a hard socket

A

More difficult to adjust fit on bony or sensitive residual limbs

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23
Q

How is the flexible socket made

A

Vacuum formed with flexible thermoplastic materials encased in a rigid frame

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24
Q

What is the advantage of the flexible socket (3)

A
  1. Accommodates to change in muscle shape
  2. Provides relief for bony prominences
  3. Comfort in sitting
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25
Q

What is the disadvantage to a flexible socket (3)

A
  1. Less durable
  2. Bulkier
  3. More expensive to make
26
Q

How do you weight bear in an exoskeletal system

A

Through laminated shell

27
Q

How do you weight bear in an endoskeletal system

A

Through an internal pylon with a soft foam cover

28
Q

What is the advantage to an exoskeletal system (2)

A
  1. Very durable

2. Requires little maintenance

29
Q

What is the disadvantage to an exoskeletal system

A

Cannot be easily aligned or adjusted

30
Q

What is the advantage to an endoskeletal system (2)

A
  1. Quickly adjust alignment

2. Can replace modular components

31
Q

What is the disadvantage to an endoskeletal system

A

Durability of foam cover

32
Q

What does an extenion aid internal spring or elastic strap do

A

Initiate knee extension in early swing and control heel rise

33
Q

What do torque absorbers do

A

Decrease shear on limb

34
Q

What do transverse rotational units do

A

Allow you to cross legs

35
Q

What is a traditional pull in suction suspension system

A

You lubricate the skin and milk your limb down into the prosthesis using negative pressure by pulling an ace bandage through a small hole and push a button to suck remainder of air out

36
Q

What is the advantage of the traditional pull in suction suspension system (2)

A
  1. Enhance prosthetic control

2. Intimate fit

37
Q

What is the disadvantage to the traditional pull in suction suspension system (2)

A
  1. Recent amputation (within last year)

2. Need to control volume and weight

38
Q

What is a roll on suction liner suspension system

A

Liner is turned inside out and rolled over skin can have a locking pin but not all have them

39
Q

What is the advantage to roll on suction liners (2)

A
  1. Decrease shear on skin

2. Don while seated

40
Q

What is the disadvantage to roll on suction liners (3)

A
  1. Expense
  2. Durability
  3. Hygiene
41
Q

What is a Silesian belt suspension system

A

Leather belt system that attaches to lateral socket encircles the pelvis runs to buckle on anterior surface

42
Q

What patient is the Silesian belt system indicated for

A

Long residual limbs who are not vigorous ambulators

43
Q

What is the disadvantage to the Silesian belt system

A

If sole means of suspension it has an inability to control rotation

44
Q

True or False:

You need to load the prosthesis before tightening the waist belt or else it could cause rotation of prosthesis

A

True

45
Q

What is the total elastic suspension belt system

A

Distal sleeve fits snugly around proximal half of transfemoral socket with a belt that encircles the waist

46
Q

What is the advantage of the total elastic suspension belt (3)

A
  1. Easy to don
  2. Comfortable
  3. Excellent auxillary suspension
47
Q

What is the disadvantage of the total elastic suspension belt (3)

A
  1. Controlling rotation
  2. Durability
  3. Heat
48
Q

What is the pelvic belt and hip joint suspension system

A

Leather belt that is attached to transfemoral socket with metal hip joint now we have light weight plastic with the joint center positioned anterior/superior to apex of trochanter

49
Q

What is the advantage of the pelvic belt and hip joint system (3)

A
  1. Controls rotation
  2. Provides M-L stability
  3. Very short residual limb
50
Q

What is the disadvantage of the pelvic belt and hip joint system (3)

A
  1. Bulky
  2. Weight
  3. Uncomfortable when sitting
51
Q

What is the goal of all prosthetic feet

A

Achieve foot flat quickly

52
Q

True or False:

Normal ambulation has a dynamic symmetric relationship between head, spine, and upper and lower extremities

A

True

53
Q

True or False:
With a transfemoral prosthesis ambulation becomes asymmetric which leads to uneven cadence increased energy cost of walking and postural adaptions and balance reactions

A

True

54
Q

True or False:
Patients with impairment of musculoskeletal neuromusculr systems are common with diabetics and advanced age leading to increased instability/falls

A

True

55
Q

What are the 3 ways the normal gait muscles of hip knee and ankle work

A
  1. Muscle contraction provides stability during stance by resisting the effects of gravity
  2. Provide propulsion and accelerate limb during push off and early swing phase
  3. Decelerate forward progression especially in late swing in preparation for initial contact
56
Q

What are the 3 variables influencing knee stability during stance

A
  1. How well individual is able to voluntarily control knee using muscular power
  2. Alignment of the knee unit with respect to the weight line (TKA)
  3. Inherent mechanical stability of the knee unit
57
Q

What does TKA stand for

A

Trochanter, knee, ankle

58
Q

What does the weight line (TKA) being posterior to the knee do

A

Causes flexion at the knee

59
Q

What does the weight line (TKA) being anterior to the knee do

A

Causes hyperextension at the knee

60
Q

Do we see the weight line (TKA) falling anterior to the knee

A

Not really because it makes gait difficult

61
Q

When would you want the weight line (TKA) to fall pposterior to the knee

A

When the patient is lacking knee flexion

prosthetics (8 decks)

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