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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
Prosthetic components - terminal devices - Hands - passive
Cosmetic Covered with flexible plastic glove to match skin Can passively adjust fingers, use as assist 8 oz.
26
Prosthetic components - terminal devices - Hands - active
Can be cable operated or myoelectric
27
Prosthetic components - terminal devices - Hands - Cable operated
Shoulder flexion operates Only digits 1-3 open 14 oz
28
Prosthetic components - terminal devices - Hands - Cable operated - adv
cheaper than myoelectric
29
Prosthetic components - terminal devices - Hands - Cable operated - disadv
not cosmetically appealing
30
Prosthetic components - terminal devices - Hands - Myoelectric
Skin electrodes in contact with intact mm | grip force 20-30#
31
Prosthetic components - terminal devices - Hands - Myoelectric - adv
grade grip force/cosmetic
32
Prosthetic components - terminal devices - Hands - Myoelectric - disadv
slipping
33
Prosthetic components - terminal devices - Hooks
Aluminum or steel grip force 10# lightweight (3 oz) and durable Can interchange between hook and cable powered hand
34
Prosthetic components - Wrist unit
Attachment of terminal device Provides for supination and pronation Most units are passive Inc ind for B UE amputees
35
Prosthetic components - Elbow units
Transradial may use if very short/weak elbow flexors | Can lock in a variety of positions
36
Prosthetic components - Shoulder joints
Not very common | Use with shoulder disariculation or forequarter
37
Prosthetic components - harness systems
Function is to suspend prosthesis/control TD and elbow
38
Prosthetic components - harness system for Transradial
Figure 8 is most common | Chest strap if very short transradial or heavy work
39
Prosthetic components - harness system for Transhumeral
Dual control harness system | Same cable controls elbow and TD
40
PT assessment and intervention - ROM
Strive for normal Transhumeral needs at least 90 shoulder flex/abd and 30 ext Do not forget cervical and shld complex mobility
41
PT assessment and intervention - Strength
Residual limb | Myoelectric sites
42
PT assessment and intervention - EMG training
Use of e stim | Biofeedback
43
PT assessment and intervention - Posture
Trunk tends to SB towards affected side | Lose arm swing/trunk rotation - balance/gait will be affected
44
PT assessment and intervention - Pain
Residual limb pain | Phantom pain
45
PT assessment and intervention - Scar
mobility and desensitization
46
PT assessment and intervention - Hand dominance
May need to change | Occupational consultatio
47
PT assessment and intervention - Psychological adaptations
Body image | Loss of function/perceived loss of function
48
Rehab team members
``` Physician pt Nursing Family Prosthetist Therapist (PT and/or OT) Counseling Vocational rehab ```
49
Functional outcomes - Unilateral transradial
``` 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
Functional outcomes - unilateral transhumeral
Same as transradial but more lifting limitations

Practice Topics Exam 5 (13 decks)

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