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PTH 703 - Unit 2 (Amputations and Protheses) > UE Amputations > Flashcards

UE Amputations Flashcards

1
Q

What is osseointegration?

A

Direct attachment to the bone; no socket required

Can be used with myoelectrics; Maximize existing ROM

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2
Q

What is a common problem with osseointegration?

A

Infection

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3
Q

Where can you receive osseointegration?

A

Europe (possibly US soon)

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4
Q

Who wore the first UE prosthesis?

A

Roman general, Marcus Sergius

No advancements until 1800s

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5
Q

What are 6 different UE prothesis we learned about?

A 
None
Passive (semi-hensile)
Cable-operated
Electric
Hybrid
Adaptive/activity-specific
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6
Q

How many UE amputees wear a prosthesis?

A

Less than 50%

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7
Q

What are benefits and limitations of no prosthesis? (4,4)

A 
Comfort
Proprioception
Mobility 
Simplicity
---
Functional range of motion
Active prehension (typically)
Balance
Cosmesis
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8
Q

What is a Passive (Semi-Prehensile) Prosthesis?

A

A cosmetic restoration with limited functional capabilities.

Used for functional activities that do not require active prehension.

(Typically digits can be manipulated to enhance function).

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9
Q

What are benefits of a passive (Semi-Prehensile) Prosthesis? (6)

A 
Provides opposition
Can be cosmetic
Can be lightweight
Most are simple
Usually little maintenance
Can be inexpensive
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10
Q

What are limitations of a passive (Semi-Prehensile) Prosthesis? (4)

A

No active prehension
Limited function
Durability
Patient can have unreal expectations for cosmesis

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11
Q

What are 3 different types of passive (semi-prehensile) prosthesis?

A

Finger
Partial Hand
Higher Level

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12
Q

How does Cable-Operated Prosthesis work?

A

Powered and controlled by gross body movements captured by a harness system

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13
Q

What are the 2 basic requirements for cable-operation?

A
  1. Excursion (utilize body motions for control)

2. Force (force associated with those body motions)

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14
Q

Benefits of cable-operated prosthesis? (4)

A

Reduced weight

Reduced maintenance cost

Prehensor shape allows for improved visibility

Increased excursion velocity

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15
Q

Limitations of Cable-Operated Prosthesis?

A

Grip strength or pinch force

Functional range of motion

Restrictive and uncomfortable harness

Poor static and dynamic cosmesis

Axilla anchor (possible nerve entrapment syndrome)

Atrophy of intrinsic muscles within encapsulated limb

Poor correlation between the neuromuscular system utilized for prosthetic action and that utilized for normal human movement

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16
Q

What is an electrically powered prosthesis?

A

Powered by battery systems and are controlled by various input methods

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17
Q

What are the different control options for an electrically powered prosthesis? (7)

A 
Myoelectric (single or dual side)
Switch:
-Rocker
-Pull
-Push
Touch Pads (FSR's)
Servo
Linear Potentiometers
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18
Q

What is the most common electric system?

A

Myoelectric control

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19
Q

How does myoelectric control work?

A

Surface EMG signals are developed by muscle contractions that are used by microporcessors to control elbows, wrists, and hands, or other terminal devices

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20
Q

What are benefits of an electrically powered prosthesis? (5)

A 
Increased functional ROM
Provides functional cosmetic restoration
Increased grip strength
Harness system reduced or eliminated
-Improved comfort
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21
Q

What are 6 reasons people may choose to not use a UE prosthesis?

A

Bad first experience

Financial concerns

Unaware of options

Limited functional ability

Not worth the “hassle”

No rehabilitation program

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22
Q

What prosthesis is used for activities that do not require active prehension?

A

Passive (Semi-prehensile) Prosthesis

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23
Q

What prosthesis would you use for increased excursion velocity and improved visibility? (assuming you don’t care about poor cosmesis)

A

Cable-operated prosthesis

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24
Q

What type of battery is separated for more options?

A

Split cell

Split cell batteries are a nice option if space is limited within the prosthesis. As shown in the transcarpal fitting, the split cell batteries were placed inside the 4th and 5th digit of the hand shell, therefore reducing the bulk inside the prosthesis.

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25
Q

What are 9 different terminal devices we learned about in class?

A

Sensorhand Speed

Transcarpal hand

DMC hand

Motion Control hand

ETD

Greifer

VASI

System 2000

I-Limb

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26
Q

What terminal limb uses coding plugs to change the control mode?

A

Sensorhand speed

Myoselect
Increased speed- 300mm/sec
Auto grasp feature
Flexigrip feature

27
Q

Which prosthetic hand offers an auto grasp feature?

A

Otto Bock Sensorhand Speed-

28
Q

What terminal limb is:

Available as DMC or Digital twin

1/3 the weight and length of adult hands?

A

Transcarpal hand

Direct lamination to socket or QD option

Good lightweight option with endoskeletal adapter

29
Q

T or F: The transcarpal hand is not available with a quick disconnect feature

A

False (it does have a quick disconnect feature)

30
Q

What are features of a motion control hand? (6)

A

Can operate with up to 18 volts (faster)
Made of high strength lightweight composite
Battery save feature (shuts off power when max force is reached)
Wide finger opening (4 inches)
With or without controlled
Available with flexion wrist

31
Q

What are features of ETD (Motion control) (8)

A 
Lightweight electric option
Good visibility
With or without controller
Wrist flexion option
Titanium finger option
Anodized black finger option
Water resistant
Optional nylon sleeve
32
Q

What is “a nice lightweight option if fine prehension is desired?” (allows for grasping of larger shaped objects)

A

ETD (Motion Control)

Available in different flexion and extension positions. Titanium fingers are available to help improve strength and durability and anodized black fingers are also an option

33
Q

What has the only available electric hook prehensor which is water resistant and an optional water resistant sleeve can be added to protect the wrist and other components from debris and moisture.

A

ETD (Motion Control)

34
Q

The software used to program the Motion Control hand and ETD is:

A

ProControl 2

35
Q

What terminal limb has: Safety release lever
Manual grip force control wheel
Max speed 180 mm/sec
Extended finger tip option
Built in friction flexion/deviation feature
High grip force

A

Otto Bock greifer

36
Q

What terminal limb has a removable plug that is used to activate the PLUS feature?

A

Otto Bock greifer

37
Q

What terminal limb: The fingers can also be opened or closed manually by rotating the grip force control wheel. The grip force control wheel can give the individual fine prehension which may not be possible through EMG control. Extended finger tips can also be added to improve prehension and visibility

A

Otto Bock greifer

38
Q

What terminal limb was designed with a built in wrist flexion feature to help position the hand in the most functional position?

A

Otto Bock greifer

39
Q 
What terminal limb: Sizes from 0-11 years
Many wrist options
Proportional control
Wide opening
Single or dual site
Programmable
A

VASI pediatric hands

40
Q

What terminal limb: Sizes- 5, 5.5, 6, 6.5
Control options with 4-in-1 controller
Proportional or digital

A

Otto Bock System 2000

41
Q

What are different UE arm prosthesis available?

A 
Motion Control Utah 3
Boston Digital Arm
VASI elbow
Otto Bock 12K50
Microporcessors and Controllers
42
Q

What elbow holds more weight, Utah or Boston?

A

Boston Digital Arm (9 lbs) vs Motion Control Utah 3 (2 lbs)

43
Q

What elbow is used for kids?

A

VASI

44
Q

What is a hybrid elbow which offers body powered control of the elbow and electric power to the terminal device?

A

Otto Bock 12K50

45
Q

Are microprocessors built in or external?

A

Both; Can be either.

46
Q

The new titanium hook from Hosmer is similar to which hook design?

A

Model 5X

47
Q

What Must be used with teflon lining?

A

Spectra Cable

3x less friction than steel on steel

48
Q

What is an alternative to myoelectrodes that is a Good option for patients with little or no EMG?

A

Linear potentiometers

49
Q

What is the most common UE amputation?

A

Fingers, by a lot

Then thumb, prox to wrist, and hand

50
Q

What terminal limb is designed for the TMC amputee?

A

I-Limb Digits

51
Q

What terminal limb is Microprocessor controlled and used I-MO technology (Gesture control)

A

I-Limb

52
Q

How are fingers aligned for the I-Limb?

A 
Fingers aligned for function, not appearance
---
Custom silicone socket interface
Improved ROM
Improved comfort
Very durable
Carbon fiber frame
Very thin and strong
53
Q

What are 5 different thumb options we learned about in class?

A 
Two position
M-Thumb
Powered thumb (passive rotation)
Powered thumb (powered rotation)
Static post
54
Q

What are considerations for bilateral UE amputees in regards to their prosthesis?

A

Modified, teeth friendly zipper pulls

Confirm that patient will be able to independently don during evaluation fitting

Goals:
independent donn/doff
Maximize function with and without prosthesis

55
Q

What 4 things does the M-Thumb provide?

A 
Opposition (adjustable)
Flexion/extension (adjustable)
Rotation
Durability
(and ability to use power tools)
56
Q

What are 3 ideal candidates for finger prostheses?

A

Proximal to PIP
PIP where multiple fingers are affected
Someone seeking active function

57
Q

How do finger prosthesis (e.g. M-Thumb) work?

A

MCP motion drives Partial M-Finger
Very natural motion
Finger nail improves grasp

Good strength and ROM required

58
Q

What socket: Works well with multiple fingers, Trim-lines coated with plasti-dip, but No adjustability

A

Pre-Preq

59
Q

Is it easy to make a Silicone/Pre-Preg/Silicone low profile?

A

No

60
Q

Is a Final silicone layer necessary for Silicone/Pre-Preg/Silicone?

A

no

61
Q

Do you want to use Silicone/Pre-Preg/Silicone on single or multi finger involvement?

A

Single!

62
Q

Who are candidates for silicone or pre-preg designs?

A

Ideal length proximal to PIP (.4 inches)
Strength and ROM are essential
Silicone and Pre-Preg currently optimal design
Fabrication services available

63
Q

What are the 4 objectives for this lecture?

A

Describe the common causes of UE amputation, and the most common level (e.g. fingers vs. whole arm).

Discuss the pros & cons of using an UE prosthesis, from a patient’s perspective.

Identify the various types of “hands” that are available for UE prosthetic options, and compare / contrast the more functional hands vs. the more aesthetic hands.

Explain the advantages & disadvantages of cable vs. electric vs. myoelectric powered prostheses.

PTH 703 - Unit 2 (Amputations and Protheses) (17 decks)

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