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Prosthetics > Transtibial Prosthetic Components > Flashcards

Transtibial Prosthetic Components Flashcards

1
Q

The majority of amputations are due to…

A

PVD/diabetes

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2
Q

what 3 pops have a higher incidence of diabetes

A

african americans
native americans
hispanic/latino americans

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3
Q

UE/LE amputations more common

A

LE

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4
Q

what is the most common amputation

A

transtibial

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5
Q

what is scar massage so imperative for amputees

A

more mobile scar tissue = less skin breakdown

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6
Q

what can you get for a pt with an amputated great toe or lateral digits

A

an insole with toe filler and carbon plate

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7
Q

what is another name for a midtarsal amputation

A

chopart

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8
Q

can you weight bear with a midtarsal amputation

A

yes, but base of support is very small

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9
Q

the more foot removed during amputation the greater the tendency for _______ contracture

A

equinovarus

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10
Q

for lateral toe(s) amputation, what kind of prosthetic do you need

A

simply a filler material such as lambs wool, sponge, or foam

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11
Q

for great toe amputation, what kind of prosthetic fo you need

A

a filler and a long steel shank in shoe to assist with push off

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12
Q

if all of your toes are amputated what kind of prosthetic do you need

A

shoe insole with metatarsal pad to relieve weight from met-heads, filler shaped from plastazote

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13
Q

what is the most common contracture with partial foot amputations

A

PF

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14
Q

syme’s amputation

A

ankle disarticulation

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15
Q

with symes amputations, the distal end of the limb is usually

A

bulbous

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16
Q

disadvantages of syme’s amputation

A
  • poor healing
  • heel can be too mobile or misaligned
  • bone spurs
  • prosthesis is not very attractive
  • leg length discrepancy
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17
Q

advantages of syme’s amputation

A
  • end weight bearing
  • long lever arm
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18
Q

T or F: feet are made specifically for syme’s amputation

A

T: to minimize leg length discrepancy

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19
Q

entrance in a syme prosthesis

A
  • removable window posterior or on sides
  • expendable material for entrance from top
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20
Q

lengths of transtibial amputations

A

long = 50% of tibia or longer
mid-calf = 20-50% of tibia
short = less than 20%

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21
Q

what is the standard length of transtibial amputation

A

mid-tibial

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22
Q

two options for skin closure with TTAs

A
  • posterior skin flap/ant closure
  • fish mouth
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23
Q

the shorter the residual limb, the ______ ROM

A

less

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24
Q

ertl procedure

A

bone bridge between tibia and fibula

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25
Q

schon’s bridge

A

ertl adaptation with bone and screws

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26
Q

T or F: you can change some’s k-level

A

T: so when in doubt go more conservative and if they improve then you can up it

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27
Q

K1 feet (2)

A
  • solid ankle cushion heel
  • single axis
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28
Q

K2 feet (3)

A
  • solid ankle flexible endoskeletal
  • flexible keel
  • multi-axial
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29
Q

K3 feet (4)

A
  • flex foot, flex walk
  • energy storing
  • dynamic response
  • multi-axial
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30
Q

T or F: K4 can have any foot ankle system

A

T

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31
Q

general cost of transfemoral prosthesis

A

6-90k

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32
Q

general cost of transtibial prosthesis

A

4-60k

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33
Q

is exoskeletal or endoskeletal prosthesis more durable

A

exo

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34
Q

both exoskeletal and endoskeletal prosthesis have these 3 components

A
  • foot/ankle assembly
  • shank
  • socket
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35
Q

why are exoskeletal prosthetics not appropriate for growing children

A

they cannot be adjusted much

36
Q

_______ has the socket and shank as one piece while with ____ components are added to one another

A

exoskeletal
endoskeletal

37
Q

are endoskeletal or exoskeletal prosthetics heavier

A

exoskeletal

38
Q

does endoskeletal or exoskeletal have a hard outer shell

A

exoskeletal

39
Q

all prosthetic feet do what? (4)

A

1- provide a balance weight bearing surface
2 - help absorb force and stability during stance
3 - look like feet
4 - stimulate some motions of the foot during gait

40
Q

this is the traditional foot for K1

A

solid ankle cushioned heel
*good for smooth and level surfaces

41
Q

benefits of SACH foot (4)

A

1 - low cost
2 - many varieties
3 - light weight
4 - no moving parts

42
Q

drawbacks of SACH foot (2)

A

1 - decreased forefoot stability in late stance
2 - not responsive to variations in terrain

43
Q

what are benefits of stationary attachment flexible endoskeleton (SAFE) feet? (3)

A

1 - accommodates varied surfaces/terrains
2 - decreased torsional force on limb
3 - good roll over during stance

44
Q

K3 feet keels are made of materials that combine _______ and ________. what does this allow for?

A
  • stiffness and flexibility
  • allows foot to be responsive and return energy
45
Q

this foot is responsive to varied terrain, accommodates for walking incline, and allows for heel height adjustment

A

dynamic energy storing foot

46
Q

T or F: running feet are used for general walking

A

F: they don’t have a heel so it is difficult to walk

47
Q

what happens during gait if the feel height is too high

A

the toe does not hit soon enough so you have poor stability and pressure on anterior tibia

48
Q

what happens during gait if the heel height is too low?

A

the toe hits too soon so the knee is forced into hyperextension and you have pressure on the patellar tendon

49
Q

most common sockets are variation of the _____ socket

A

hard
*worn with socks or soft liners

50
Q

more recently, hard sockets have been designed with window cutouts. what does this do?

A

makes them more flexible and responsive to muscle contractions

51
Q

are flexible or hard sockets good for pts on dialysis. why

A

flexible because the insert can be removed to allow room for swelling

52
Q

what is the standard socket for transtibial amputations?

A

patellar tendon bearing

53
Q

where is a counter force applied in a patellar tendon bearing socket

A

popliteal fossa

54
Q

the total weight bearing socket is a modification to the PTB socket that occured with the use of…

A

flexible inserts and gel liners

55
Q

what are some pressure intolerant areas (4)

A

1 - tibial crest
2 - distal end tibia
3 - prox and distal head of fibula
4 - hamstring tendons

56
Q

what are some pressure tolerant areas?

A

1 - femoral condyles
2 - patellar tendon
3 - medial tibial flare
4 - tibial shaft
5 - fibular shaft
6 - posterior compartment

57
Q

what does the shape of a PTB socket accommodate for

A

adductors and hamstrings
*medial side is lower

58
Q

T or F: hard sockets have an insert inside

A

F: you only use a sock

59
Q

pelite liners are used primary in a ______ socket

A

PTB
*before silicone gels and urethane liners

60
Q

T or FL pelite liners have identical pressure tolerate and relief areas that the socket will have

A

T: they are formed on the positive cast of the residual limb

61
Q

can pelite liners be removed for cleaning

A

yes

62
Q

T or F: pelite liners have to be positioned in the socket to precisely match the contours

A

T

63
Q

gel and urethane liners form a ________ between the limb and socket

A

suction… so they can also be used as a means of suspension

64
Q

T or F: gels and urethanes come in varied thickness

A

T

65
Q

what is the problem with a gel liner

A

they can “hide” skin problems so you are not aware of it until it is really bad

66
Q

what are some advantages of gel/urethane liners

A
  • disperse forces
  • more comfortable fit
  • soft skin
  • suspension
  • helpful for pts with fragile skin
  • true total contact with prosthesis
67
Q

2 ways to take an impression for a prosthesis

A

casting
scanning

68
Q

what is the good thing about scanning over casting

A

scanning takes the human element out of it and you can also create the same exact prosthesis years later

69
Q

what are prosthetic socks used for

A

to adjust to fluctuations in residual limb volume

70
Q

T or F: the residual limb often shrinks during therapy

A

T

71
Q

T or F: residual limb volume usually does not change throughout the day

A

F: it is not uncommon for it to reduce which means you may need to add a sock

72
Q

T or F: it is not uncommon for pts to regularly wear 3-5 ply socks

A

T

73
Q

a new socket is normally required when pts need _______ ply socks

A

10-12

74
Q

how are socks applied

A

the thickest is put next to the skin and then you follow with thinner socks

75
Q

many amputees wear a nylon sheath between their limb and socks. why?

A

to help with perspiration and reduce shear forces on skin

76
Q

with pelite liners, socks are work where? what about w/ gel and urethane liners?

A

pelite = between the limb and pelite
gels/urethane = outside of the liner

77
Q

how should you wash socks

A

hand wash, mild detergent, blotted dry, and dried flat

or gentle cycle machine wash and dry on low (updated ppt)

78
Q

flexible inserts accommodate for…

A

expansion (ex: muscle contraction)

79
Q

are flexible inserts more common in above or below knee sockets

A

above knee

80
Q

what are some suspension methods for below knee amputations (5)

A

1 - waist belt fork strap
2 - PTB cuff
3 - PTB supracondylar
4 - PTB supracondylar suprapatellar
5 - suction or vaccum

81
Q

a pin locking system may not be a good option if the pt has a lot of…

A

scar tissue

82
Q

if a pt needs more _____ pinlocking may be a good option

A

ROM

83
Q

is osteoarthritis more prevalent in the intact or residual joints?

A

intact

84
Q

T or F: long term prosthetic use (TTA) with a proper prosthetic fit does not predispose wearer to premature degenerative arthritis

A

T

85
Q

amputees are at an ____ risk for back pain

A

increased

Prosthetics (12 decks)

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