UE Prosthetics

Question 1

prothetic goal

Answer 1

provide appropriate function to meet each individuals goals and abilities

Question 2

psychological perspective

Answer 2

• majority of UE amps are result of trauma
• UE limb loss is highly visual
• reliance on others may be significant

Question 3

UE amputation etiology because they aren’t above asking these bs questions

Answer 3

• injury: 83%
• other: 15.9%
• infection: 8.4%
• gangrene: 7.5%
• vascular disease: 3.7%

Question 4

Amputation level

Answer 4

• trans-humeral: 38.3%
• trans-radial: 30.8%
• partial hand: 14%
• wrist disarticulation: 5.6%
• partial digit: 4.7%

Question 5

evaluation and prescription criteria

Answer 5

• Physical condition
• Hobbies
• Profession
• Family life
• Mechanical aptitude
• Cognitive level
• Self-image

Question 6

Evaluation Considerations

Answer 6

• medical concerns
• Contralateral indications
• Decreased ROM
• Overuse
• Decreased grip strength
• Peripheral neuropathy
• Bilateral involvement
• Lower extremity involvement

Question 7

Socket Designs

Answer 7

• self suspending (supracondylar design or radial/ulnar styloids)
• suction (suspension sleeve, valve, seal-in liner)
• harness
• hybrid
• osseointegration

Question 8

interface (socket) design

Answer 8

• Link between patient and prosthesis.
• Most important part of any prosthetic design.
• Must be comfortable.
• Material selection –> Elastic/flexible socket

Question 9

unique socket variations

Answer 9

• WD suction
• PH silicone
• Noodle
• TH with susp ring.

Question 10

No prosthesis

Answer 10

• Comfort
• Proprioception
• Mobility
• Simplicity (reliable)

Question 11

passive prosthesis

Answer 11

• Static design.
• May be anatomically accurate. * For activities that do not require active prehension.
• May be passively manipulated to change shape/function

Question 12

what operates body powered prosthesis

Answer 12

• Force (power generation)
• Excursion (movement or travel)

Question 13

Body powered prosthesis

Answer 13

• Uses harness for control and/or suspension
• Lightweight
• Durable
• May be lower cost
• Fast operation
• Very functional (“sensory” feedback)

Question 14

external powered prosthesis

Answer 14

• Terminal device (and elbow) contains motors.
• Power supplied by batteries.
• Myoelectric, switch, hybrid.
• Self-suspending a possibility.
• Microprocessors, electronics, small-moving parts.
• Increased weight.
• May be costly.
• Function+cosmetic.

Question 15

benefits of electric powered prosthesis

Answer 15

• Increased functional ROM
• Functional cosmetic restoration
• Increased grip strength
• No harness/strap system, or minimized

Question 16

indications for external powered prosthesis

Answer 16

• When force generation and/or excursion unavailable.
• When load acceptance areas are compromised.
• Overuse symptoms.
• Multiple, or unique grasp options required.
• Users goals/expectations.

Question 17

myoelectric control

Answer 17

• Socket contains skin surface electrode(s).
• Electrode(s) pick up EMG signals.
• EMG signals used to control prosthetic components.

Question 18

Microprocessor controllers

Answer 18

• Systems programmed to optimize prosthetic operation.
• Manipulate gain/amplification * Design custom grasp options
• Apply “triggers” to increase degrees of freedom

Question 19

Hybrid system

Answer 19

• Combination of external and body powered designs.
• Used often to simplify, especially with higher amputation levels (Ease of use, durability)

Question 20

hooks

Answer 20

• Prescribed for function
• Different sizes and shapes: Canted vs lyre
• Different materials

Question 21

advantages of hooks

Answer 21

• Useful tool
• Lightweight
• Durable
• Significant pinch force

Question 22

hands

Answer 22

• Prescribed for function with cosmetic consideration
• Many sizes
• Protective glove
• 3-jaw chuck prehension
• Increased weight
• Decreased visibility

Question 23

Voluntary opening

Answer 23

• Pinch force determined by pre-loaded rubber bands.
• 1 rubber band = 1lb of pinch force
• Shoulder motion must overcome friction in system
• Grasp limited by rubber band tension.

Question 24

Voluntary closing

Answer 24

• Force/excursion closes TD
• Pinch force determine by effort applied by user.
• Increased sensory feedback.
• Commonly used in pediatrics

Question 25

Harness

Answer 25

• Suspends the prosthesis.
• Anchors the control system.
• Figure of 8 vs figure of 9.
• Cross point location distal to C7, and toward non-involved side

Question 26

Body powered operations - transradial

Answer 26

• biscapular protraction
• humeral flexion

Question 27

body powered operation - transhumeral

Answer 27

• biscapular protraction
• humeral flexion + dual control cable
• shoulder depression
• humeral extension
• excursion demand

Question 28

external powered terminal device

Answer 28

• Batteries provide source of power
• Control prosthesis through EMG signals OR switches.
• High prehension forces.

Question 29

types of ext powered terminal devices

Answer 29

• Hooks and hands
• VO and VC
• May be closer to achieving function and appearance.
• High pinch force capability (>20lbs)

Question 30

advantages of external powered terminal devices

Answer 30

• Functional and cosmetic
• Powerful pinch force
• Ease of operation (overhead)
• Absence of harnessing
• Reduced energy expenditure

Question 31

disadvantages of external powered terminal devices

Answer 31

• cost
  -weight
• durability

Question 32

Osseointegration

Answer 32

• Titanium implant, directly into bone
• Fixture protrudes through skin * Prosthesis directly attaches to fixture: Solves many socket fit problems; Infection consideration

Question 33

implanted electrodes

Answer 33

• Leads implanted into muscle bellies.
• Signal transferred wirelessly through skin,
  to prosthesis.