UEpx Flashcards
6 common grip styles
Cylindrical grasp Tip (hook TD) Hook/snap Palmer (hand TD) (most common for picking up objects and hold use) Spherical Lateral (hook TD)
Advantages and disadvantages Hook TD
Adv: Light weight Can see object Mechanically simple Versatile Easy to use Disadvantage: Uncosmetic
Advantages vs Disadvantage hand TD
Advantages: Cosmetic Grasp some round objects Disadvantages: Heavier Difficult to open More difficult to see objects Mechanically complex Hard to put into pocket Less versatile
Lyre shape
Straight approach
Top approach to object
Can’t see as well
Object is being pinched
What is the difference b/w a pair of outside locking hinges and a pair of flail arm hinges
Flail arm hinges utilizes a spring loaded joint on the lateral side
Polycentric hinges are used for?
Minimize bunching in the cubital fold- very short /short BE
What advantage is gained using variable ration step up hinges
Very short TR amputee are able to flex the px forearm a full 135 degrees
The above elbow control cable must always
Pass in front of the elbow center
The lever type excursion amplifier provides increased excursion at the expense of:
Force
Basic harness for shoulder amputation px is a:
Chest strap
Homer e-400 elbow unit allows the amputee to
Lock the elbow in 11 positions of flexion
The amount of glenohumeral flexion required to fully flex the elbow of a TH px should not exceed:
45 degree
Before fitting the class II, standard TH check socket, the rough proximal trim line should come:
Just over the acromium
To operate the locking mechanism of the Homer e-400 internal locking elbow adult size requires:
1/2-5/8” cable excursion and 2-3lbs of force
For class I TH amputee, the anterior and posterior trimline terminate where?
Just lateral to the deltopectoral groom and off the scapula
For class II TH amputee, what is the biomechanical reasoning for the position of the anterior and posterior timeline
To limit internal and external rotation of the glenohumeral joint
How does the prosthetist determine the humeral length of the prostheses for a bilateral TH amputee
Body height(in) x 0.19
What effect does the spring lift assist have on the force required to raise the forearm?
Helps to reduce force needed to begin initial flexion from a fully extended position of the forearm
For TH amputee what are the motions involved in operating the elbow lock?
GH extension, abduction and should depression
TH amputee cant fully pen the TD at mouth. Name 3 possible solutions for this problem
Tighten harness
Adjust cross point placement
Adjust housing length (TD HITTING DISTAL HOUSING)
Correct position of EFA
Correct control attachment strap placement (control strap not over distal 1/3 of scapula)
Move base plate and retainer distal and posterior
Add cross back strap
Fix loose fitting socket
Fix sharp bends or kinks in cable
TH TD is opening before reaching the mouth. Name two possible solutions for the problem:
Add more rubber bands to TD
Cable short
Fair leads split housing hitting on elbow flexion
More EFA more distal
Move base plate and retainer proximal and anterior
Lighter TD
Shorter forearm
Add elbow lift assist
Add second base plate and retainer to keep cable anterior to elbow joint
forearm is reflexes order to
Reach mouth
A mechanical partial hand px would be contraindicated for a transmetacarpal amputation with:
The thumb and index finger remaining
The initial socket brim for a short AE amputation would be trimmed on a line
1 to 2 inches above the acromion
For those amputee that incorporate a step-up hinge: IT requires more_____ to flex the forearm but you gain____
Force; range of motion
How many carpal bones are there in the human body
16
What does the nudge control enable the amputee do:
Lock and unlock the elbow by pressing a lever with the chin
What is the purpose of fig. 8 BE harness
To suspend the px and to operate the TD
What is greatly minimized for a shoulder disarticulation amputee
Sphere of work area activities
In performing the checkout of the TR px the following force measurements where made: 6lbs. Pull at TD, and 10lbs pull at the control attachment strap. The housing is lined with teflon. The control system efficiency for this cable is
60%- below standard
What is the major advantage of using the housing cross bar assembly?
Reduces control cable bending, increasing system efficiency
What normal functions can be mechanically reproduced in a px arm:
Joint stabilization
The major TR px control motion is glenohumeral:
Flexion
The muenster design TR px presents a dilemma in that it
Offers excellent suspension but limits ROM
What is considered the correct length for a BE px.? The curve of the hook shoulder correspond to the :
Sound side thumb tip
Major supinator of the forearm is the:
Biceps
Loss of the upper limb just distal to the supinator muscle will result in what amputation level:
Short BE RL
What would be lost if a Bowden control cable were to be used instead of a fair lead control cable on a THpx
Elbow flexion
Elbow flexion is obtained through the
Brachialis
Rigid joints would be indicated for a patient who:
Had 50% forearm length
What is the dual control cable system called?
Fair lead
When does the trimline in a trans-radial px extend over the humeral epicondyles
When there is inadequate pronation and supination that can be captured in the socket
The retainer is coated in the proximal 1/3 of the TR px becasue:
To allow rotation of the TD with out kinking the housing
In the TR px, the cross bar is located mid-humerus (or up 1”) in order to
Fully open the TD with minimal glenohumeral humeral flexion
When fabricating the TR control cable, the prosthetist measure the distal housing length with TD in:
Supination
To fit the triceps cuff, prosthetist must take circumferential measurements where?
1” proximal to the cubital fold and around deltoid insertion
The total normal range available in forearm rotation (sup and pro) is:
170 degrees
To allow maximum rotation in the long BE and wrist disarticulation the prosthetist must provide what shape?
Screwdriver
Self suspending transracial socket suspends in what manner?
M-L pressure, assisted by AP pressure
Medium length TR there can be some residual pronation becasue:
Pronation teres is till largely intact
The Northwestern supracondylar design for self suspending TR socket
Has trimline that sweeps distally on the anterior socket
TR less than 50% forearm remaining indicates for:
Rigidhinges
Oval wrist units preferred to round wrist unit
For WD px- permits the TD to pick up articles from a flat surface
Retainer on a Class 1 TH amputee is placed where?
50% of anatomical humerus
Retainer on a 50% length Cass II AE amputee is placed where?
1” proximal to the cut end of the bone
In the coronal plane, a plumb line dropped through the acromium of the class II AE socket should fall through what landmark in a person with normal weight?
The medial boarder of the turntable
What is a possible cause of external rotation of the AE px during humeral flexion
Humeral retainer too far lateral
Lateral suspension strap attached too far posterior
Hosiery E-400 elbow unit allows the amputee to
Lock elbow in any 11 positions b/w 15-135 degree flexion
In placing the outside locking elbow joint on an ED px the joint enter should be placed on the humeral epicondyles. T/f?
True
Complete absence of the upper limb distal to the shoulder joint is termed
Amelia
In normal movement, when the elbow is flexed to 90 the forearm can be rotated horizontally through an arc by activate internal and external humeral rotation. The size of the arc is?
110 degrees
When considering children with phocomelic upper limbs, the common transverse deficiency is_____, and the common longitudinal deficiency is____.
Humeral, radial
When a radial deficiency (partial or complete) is present, the hand typically presents with:
Radial deviation of the hand on the ulna
Becasue of the loss of glenohumeral rotation in bilateral class II trans humeral amputation, the surgeon may perform a procedure to enhance the amputee’s ability to actively position the px in space on one or both sides:
Angulation osteotomy
Approximately____incehs of excursion are required to operate a dual control system
4.5
When operating a voluntary opening TD close to the body, the TR or Th amputee uses _____as the source of excursion and force:
Scapular abduction
The syndrome resembling a lobster flow or bifurcation of the hand (sometimes into forearm) is called___
Ectrodactyly (central ray syndrome)
