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Practice Topics Exam 5 > UE Prosthetics > Flashcards

UE Prosthetics Flashcards

1
Q

What percentage of UE amputees are not fitted with a prosthetic device

A

50%

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2
Q

Etiology

A

Trauma
Disease
Congenital Issues
Tumors

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3
Q

Levels of amputation - Forequarter

A

Absence of any portion of shoulder complex
Usually sacrifice clavicle, scapula, ribs, and entire UE
Usually the result of a malignancy

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4
Q

Levels of amputation - shoulder disarticulation

A

through the GH joint

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5
Q

Levels of amputation - Transhumeral - Short and Standard

A

AE - above elbow
Short = 30-50% of humerus intact
Standard = 50-90% humerus intact

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6
Q

Levels of amputation - Elbow disarticulation

A

Through the elbow joint

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7
Q 
Levels of amputation - Transradial 
Very Short
Short
Medium 
Long
A

BE - below elbow
Very short - up to 35% forearm intact, 2 to 4 in from lateral epicondyle
Short - 35-55% forearm intact, 4 to 6 in from lateral epicondyle
Medium - 55-75% of forearm intact, 6 to 8 from lateral epicondyle
Long - 75-90% forearm intact - 8 to 10 in from lateral epicondyle

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8
Q

Levels of amputation - wrist disarticulation

A

Radiocarpal joint/transcarpal

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9
Q

*** Longer residual limb =

A

more options and the more function they will have

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10
Q

Surgical procedures and post op device - Muscle stabilization

A

Can reattach tendons/mm

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11
Q

Surgical procedures and post op device - Contour bone

A

Remove possible sites of pressure intolerance

Provide enough contour to provide stability for device

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12
Q

Surgical procedures and post op device - Immediate post operative prosthesis

A

IPOP
Prevent edema to help prevent pain and improve healing
Can add terminal device for early function/acceptance

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13
Q

Surgical procedures and post op device - Conventional

A

Most common
Sterile gauze and ace wrap - questionable edema control
Can’t add terminal device

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14
Q

Acute management - goals

A

Promote healing
Independence in ADLs
Pt and family education

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15
Q

Acute management - activities

A 
Evaluation
Wound healing
Edema control
Desensitization
Scar management
Pain control
Gross motor activity
Psych support
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16
Q

Subacute management includes

A

Pre prosthetic training
Prosthetic training
Advance training

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17
Q

Subacute management - pre prosthetic training

A

Postural exercises and strengthening
ADLs/adaptive equipment/hand dominance
Myosite training
Continued residual limb care

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18
Q

Subacute management - prosthetic training

A

Donning and doffing
Device maintenence
Residual limb tolerance

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19
Q

Long term management

A

Device replacement

Ongoing residual limb care

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20
Q

Types of prosthetic devices - Cable powered

A

Prosthesis powered and controlled by gross body movements captured by harness system
Functional use of residual limb to tension the cable
More for labor (picking up child, lumber jack)

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21
Q

Types of prosthetic devices - Externally powered (myoelectric)

A

Operated by battery system
Uses mm contraction to open and close
More for fine motor activity (painter)

22
Q

Types of prosthetic devices - Hybrid

A

Combination of cable and externally powered system
Good for heavy duty and precision use
Hand is usually myoelectric
Elbow myoelectric if moderately heavy duty work/cable if heavy work
Ex - PT

23
Q

Prosthetic components - terminal devices -

A

Hands

Hooks

24
Q

Prosthetic components - terminal devices - Hands

A

Can be passive or active

Passive - cosmetic

25
Q

Prosthetic components - terminal devices - Hands - passive

A

Cosmetic
Covered with flexible plastic glove to match skin
Can passively adjust fingers, use as assist
8 oz.

26
Q

Prosthetic components - terminal devices - Hands - active

A

Can be cable operated or myoelectric

27
Q

Prosthetic components - terminal devices - Hands - Cable operated

A

Shoulder flexion operates
Only digits 1-3 open
14 oz

28
Q

Prosthetic components - terminal devices - Hands - Cable operated - adv

A

cheaper than myoelectric

29
Q

Prosthetic components - terminal devices - Hands - Cable operated - disadv

A

not cosmetically appealing

30
Q

Prosthetic components - terminal devices - Hands - Myoelectric

A

Skin electrodes in contact with intact mm

grip force 20-30#

31
Q

Prosthetic components - terminal devices - Hands - Myoelectric - adv

A

grade grip force/cosmetic

32
Q

Prosthetic components - terminal devices - Hands - Myoelectric - disadv

A

slipping

33
Q

Prosthetic components - terminal devices - Hooks

A

Aluminum or steel
grip force 10#
lightweight (3 oz) and durable
Can interchange between hook and cable powered hand

34
Q

Prosthetic components - Wrist unit

A

Attachment of terminal device
Provides for supination and pronation
Most units are passive
Inc ind for B UE amputees

35
Q

Prosthetic components - Elbow units

A

Transradial may use if very short/weak elbow flexors

Can lock in a variety of positions

36
Q

Prosthetic components - Shoulder joints

A

Not very common

Use with shoulder disariculation or forequarter

37
Q

Prosthetic components - harness systems

A

Function is to suspend prosthesis/control TD and elbow

38
Q

Prosthetic components - harness system for Transradial

A

Figure 8 is most common

Chest strap if very short transradial or heavy work

39
Q

Prosthetic components - harness system for Transhumeral

A

Dual control harness system

Same cable controls elbow and TD

40
Q

PT assessment and intervention - ROM

A

Strive for normal
Transhumeral needs at least 90 shoulder flex/abd and 30 ext
Do not forget cervical and shld complex mobility

41
Q

PT assessment and intervention - Strength

A

Residual limb

Myoelectric sites

42
Q

PT assessment and intervention - EMG training

A

Use of e stim

Biofeedback

43
Q

PT assessment and intervention - Posture

A

Trunk tends to SB towards affected side

Lose arm swing/trunk rotation - balance/gait will be affected

44
Q

PT assessment and intervention - Pain

A

Residual limb pain

Phantom pain

45
Q

PT assessment and intervention - Scar

A

mobility and desensitization

46
Q

PT assessment and intervention - Hand dominance

A

May need to change

Occupational consultatio

47
Q

PT assessment and intervention - Psychological adaptations

A

Body image

Loss of function/perceived loss of function

48
Q

Rehab team members

A 
Physician 
pt
Nursing
Family
Prosthetist
Therapist (PT and/or OT)
Counseling
Vocational rehab
49
Q

Functional outcomes - Unilateral transradial

A 
Ind with don/doff
Ind with ADLs
Drives
Retrun to work with weight lifting limitations
Tie laces and ties
Uses button hook
Meal prep with ad
Able to use tools for simple household chores
Wears prosthesis full time
50
Q

Functional outcomes - unilateral transhumeral

A

Same as transradial but more lifting limitations

Practice Topics Exam 5 (13 decks)

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