Unit 1: The Orthotic Supply Flashcards
What are the 5 components of Perry’s functional model of normal physical activities
Articulated levers Source of motion Awareness of need and action Control of motion Control of energy
How is the source of motion controlled
Efferent pathways of LMN’s and their myoneural junctions
What is the difference between concentric and eccentric muscle action
Concentric = Contraction Eccentric = Elongating
What is the source of motion control
CNS: conscious and reflex action
What is the source of energy control
Digestive and cardiopulmonary systems
Give 5 causes of structural insufficiency
Fractures Ligaments strains/ruptures Deformities Discrepancies Deficiencies
What is the main consequence of structural insufficiency
Early fatigue and degeneration of structure
What is motor insufficiency and give 2 causes
The inability to produce joint motion.
Causes: trauma (causing direct muscle/tendon/nerve injury) and neurological conditions (polio, peripheral neuropathy)
What is the characteristic appearance of motor insufficiency
Flaccid muscle paresis
Progressive loss of muscle bulk
Give examples where motor insufficiency is combined with impaired sensory feedback
Spinal cord injuries
Spina bifida
Note: pattern of dysfunction will be dictated by the level and extent of the spinal lesion
What pattern of involuntary movement does UMN lesions create
Spasticity
Give 2 of the most common presentations of UMN spasticity
Cerebral palsy (children) and hemiplegia due to CVA/stroke (adults)
What is the spasticity pattern commonly seen in stroke patients
Mass extensor response: creates an equinovarus foot = difficulty achieve hip and knee extension, foot clearance problems
What are the patterns commonly seen in children with cerebral palsy
Spastic paralysis
Dyskinesia
Describe the differences between hemi/di/quadri/tetraplegia
Hemi = one sided Di = both lower limbs Quadri/Tetra = all four limbs
What pattern is scissoring (creating severe balance problems during walking) seen in
Quadriplegia
What is the most common form of dyskinesia seen
Athetosis: involuntary writhing movements which occur when any voluntary postural demand is made
What is assessed during physical assessment of functional loss
Joint ROM, stability and alignment Skeletal integrity and alignment (inc limb length) Muscle power and control Sensation, proprioception and balance Vascular status and skin condition Location and cause of pain/discomfort
How is muscle power graded
0 = no activity 1 = flicker under gravity 2 = power with gravity excluded 3 = power against gravity but with no additional resistance 4 = some weakness 5 = normal activity
How do you distinguish between proprioception and muscle weakness causes of loss of balance
Test the patients balance when standing and when seated
What is the main way of assessing vascular status of the lower limbs
Distal pulses
How must any functional deviation be described with reference to
The joint or segment where the deviation is occurring
The plane of movement
The phase of the gait cycle at which the deviation is apparent
The nature of the deviation (e.g. increased/reduced motion)
What movements are used to assess hand function
Cylindrical grasp Tip pinch Hook pinch Palmar pinch Spherical grasp Lateral pinch
Factors that must be considered when selecting the materials and components to use in an orthosis
Functional requirements Cosmesis Presence of oedema Presence of sensory/vascular deficit Ability to don and doff Anticipated level and duration of physical activity when wearing the orthosis Environment that orthosis will be exposed to Presence of incontinence
Give 4 ways of treating spastic equino-varus deformity
Surgery
Physio
Drugs
Orthotics
