Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Prosthetic Study > Upper Ext 2 > Flashcards

Upper Ext 2 Flashcards

1
Q

Partial Hand Amputation

A

Any AMPUTATION DISTAL TO THE WRIST

LEAST INVOLVED of the UE amputations

Can be as minor as losing DISTAL PART OF PHALANGE major as LOSING ALL THE METATARSALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Wrist Disarticulation

A

TRANSECTION THROUGH WRIST

Carpals are disconnected from radius and ulna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Trans-Radial (Below Elbow)

A

Amputation that occurs BELOW ELBOW JOINT and PROXIMAL TO THE WRIST

Can be classified further as LONG, MEDIUM, SHORT, VERY SHORT

Ideally beneficial for trans-radial to be LONG ENOUGH that it is at least PAST THE BICIPITAL TUBEROSITY, SHORT ENOUGH to allow approximately 3.5 cm for wrist unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Elbow Disarticulations

A

Amputations that TRANSECT THE ELBOW JOINT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Trans-humeral (above elbow)

A

Amputations that occur THROUGH THE HUMERUS

STANDARD LENGTH for trans-humeral limb is 50-90% of original length

Prosthetic considerations include SUSPENSION and ROTATION control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Shoulder disarticulations

A

Amputations of the COMPLETE HUMERUS at the Gleno humeral joint and everything distal

Commonly due to TRAUMA AND AVULSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Interscapulothoracic Disarticulation (Forequarter)

A

Amputations are commonly performed due to OSTEOSARCOMA OF SHOULDER GIRDLE

Amputation removes the SHOULDER GIRDLE INCLUDING THE SCAPULA and ALL OR PART OF THE CLAVICLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why Disarticulations?

A

NOT AS VALUABLE in UE as LE

DISTAL END WEIGHT BEARING NOT AS ADVANTAGEOUS

However, SPECIAL CONSIDERATIONS for children due to GROWTH

Want to PREVENT OVERGROWTH in a transected bone

Disarticulations are ARGUABLY LESS COSMETIC

ADVANTAGES include SUSPENSION and RETENTION of PHYSIOLOGIC POSITION of the TERMINAL DEVICE IN SPACE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Amelia

A

COMPLETE ABSENCE OF LIMB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Phocomelia

A

VERY SHORT LIMB, usually terminating with a FUNCTIONAL HAND

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Terminal Transverse Hemimelia Above-Elbow

A

Congenital ABOVE ELBOW AMPUTATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Terminal Transverse Hemimelia Below-Elbow

A

Congential BELOW ELBOW AMPUTATION

MOST COMMON OF CONGENITAL LIMB DEFICIENCIES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acheiria

A

ABSENCE OF HAND

Congenital wrist disarticulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Longitudinal Deficiency (Radial or Ulnar) Hemimelia

A

RADIAL is far more common

These usually present with a FUNCTIONAL HAND

Main issue is RADIAL/ULNAR DEVIATION

RARELY REQUIRE PROSTHETIC CARE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Milbrant Device

A

Originally developed in British Columbia for lumberjacks

Used to REPLACE MISSING DIGITS 2-5

Device is traditionally made of leather with buckle closure for durability

FINGER BAR has HIGH FRICTION material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Opposition post

A

SMALLER IN SIZE than the Milbrant

Used for LIGHTER TASKS and is better suited for FINE DETAIL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Spatula

A

LIGHT DUTY device used when there are NO FINGERS PRESENT

WRIST MOTION in order to use device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Functional loss

A

THUMB represents GREAT PORTION OF FUNCTION of our hands

If AMPUTATED AT MC joint, there is 40% loss in hand function, 100% loss of thumb function

If ALL PHALANGES ARE AMPUTATED, it is considered a 100% loss of the hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Conventional Prostheses

A

PASSIVE

BODY POWERED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Passive prostheses

A

Have some MANUAL OPPOSITION functions

Also provide “COSMETIC” coverage of the residuum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Body powered prostheses

A

Usually controlled by using CABLE SYSTEM

Quite DURABLE, have BETTER SENSORY FEEDBACK

These types of prosthesis are NOT AS COSMETICALLY PLEASING as externally powered controlled type

REQUIRE LARGE ROM to control function of prostheses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Trans-radial Body-Powered Prosthesis PARTS

A

Includes

  • Single control harness system
  • Control cable system
  • Triceps Cuff
  • Elbow Hinges
  • Laminated Socket
  • Interface
  • Wrist Unit
  • Terminal Device
23
Q

Grip Types (8)

A
  1. Key
  2. Chuck (3 point)
  3. Span (C in web space)
  4. Hook (carry suitcase handle)
  5. Power (grab rod)
  6. Disc (holding door knob)
  7. Flat hand push (push wall)
  8. Finger push
24
Q

UE Statistics

A

50 000/yr in US

Ration UE to LE is 1:4

MOST COMMON is PARTIAL HAND AMPUTATION with loss of 1 or more fingers

WRIST HAND AMPUTATIONS make up 10% of upper limb population

TRANRADIAL AMPUTATIONS make up 60% of total wrist and hand amputations

70% of all persons with upper limb amputations have amputations DISTAL TO ELBOW

25
Q

Trans Radial Length Classification

A

LONG- longer than 2/3

MED- 2/3 to 1/3

SHORT- 1/3 or shorter

PRONATION/SUPINATION decreases with decreasing length

26
Q

Wrist Disarticulation

A

Characterized by OVAL DISTAL END

DISTAL JOINT retained therefore GREATER ROM in PRONATION/SUPINATION

27
Q

Laminated Socket Types (5)

A
  • SUPRACONDYLAR (Northwestern)
  • 3/4 Socket
  • MUENSTER Socket (NARROW A-P)
  • BASIC Socket
  • SCREWDRIVER Socket
28
Q

Northwestern (SUPRACONDYLAR)

A

Developed at Northwestern University in Chicago

SELF SUSPENDING, presses medially and laterally proximal to epicondyles

Has LOWER ANTERIOR PROXIMAL TRIMLINE than Muenster to allow for more Elbow Flexion

29
Q

3/4 Socket

A

Developed at Hugh Macmillan Centre in Toronto

Similar to Northwestern, except there is POSTERIOR OPENING OVER OLECRANON

4 “QUADRANTS”, quadrant around olecranon didn’t serve a function, quadrant was cut out, hence 3/4 socket name

Result is socket that is LESS CONSTRICTING, ALLOWS MORE AIRFLOW which is beneficial in myoelectric sockets where wicking socks cannot be worn

ELBOW ROM and COSMESIS is also improved with cut out

30
Q

Muenster Socket

A

Developed University of Muenster

SELF SUSPENDING socket

NARROW A-P, sometimes referred to as A-P Socket

ANTERIOR PROXIMAL TRIMLINE is generally HIGHER and ELBOW FLEXION can be LIMITED by tissue bulging in the cubital area during flexion

Socket is BENEFICIAL FOR SHORT TRANSRADIAL

Disadvantages, are LIMITED FLEXION capabilities, DIFFICULTY DONNING

31
Q

Basic Socket

A

Trimlines are DISTAL TO EPICONDYLES AND OLECRANON

Can be SUSPENDED using DIFFERENT types of METHODS

TRICEPS CUFF and HARNESS to attach the HINGES and the socket

Using a LINER WITH A PIN at the distal end

SUCTION OR NEGATIVE PRESSURE using a valve and sleeve ca

32
Q

Screwdriver Socket

A

DESIGN is used for LONG RESIDUUM (at least 60% of the remaining forearm)

DISTAL 1/3 OF SOCKET IS FLATTENED in the SAGITTAL PLANE to stabilize the radius and ulna to be ABLE TO PRONATE/SUPINATE the prosthesis

TRIMLINE is typically CUT BELOW EPICONDYLES AND OLECRANON

33
Q

Interface Options

A

SOCKS

SKIN FIT

SILICONE LINER

34
Q

Wrist units

A

DEPENDENT ON LENGTH of remaining limb (BUILD HEIGHT)

Very long limbs need specialized wrist units

Options are

  • QUICK DISCONNECT (QD)
  • FRICTION
  • Flexion/Radio-ulnar deviation (OMNI)
  • LOCKING
35
Q

Bilateral considerations for Wrist Units

A

FLEXION UNITS ARE IMPORTANT FOR GETTING TO MIDLINE

Aids with ADLs (Activities of Daily Living), buttoning shirts etc.

36
Q

Quick Disconnect Wrists PROs

A

EASY TO SWAP terminal devices

LOCKING OPTION is available

Gives more FUNCTION

37
Q

Quick Disconnect Wrists CONs

A

HEAVIER than friction wrists

MORE MECHANICAL PARTS

MORE COSTLY

LONGER BUILD HEIGHT NEEDED

38
Q

Friction Wrists

A

LOWER BUILD HEIGHT than most QD

CAN BE SHAPED TO OVAL SHAPE OF DISTAL FOREARM for greater cosmesis

ADJUSTABLE TERMINAL DEVICE PRONATION/SUPINATION with washers or set screws

39
Q

Flexion Wrist Unit

A

FLEXION WRIST can only provide flexion and is for conventional only

OMNI wrist has ROM in all planes, can be used for conventional or myo

40
Q

Terminal Devices

A

PASSIVE OR ACTIVE

41
Q

Passive Terminal Devices

A

MOST COMMONLY PRESCRIBED passive terminal device is passive hand

Can be for STATIC GRASP, cosmesis (social acceptance)

COSMETIC - hands, off the shelf glove, silicone finished

OPERATED BY CONTRALATERAL HAND, environment, or does not move

TASK SPECIFIC / ACTIVITY BASED device (bicycle, hockey, baseball etc.). SPORTS, SPECIALIZED ACTIVITIES

42
Q

Active Devices

A

Can be either HOOKS OR HANDS

Provide 3 POINT CHUCK ACTION

Most hooks provide the equivalent of active lateral pinch grip

ACTIVE PROSTHETIC HAND is more COSMETICALLY pleasing but usually HEAVIER AND BULKIER than a hook

Can be VOLUNTARILY OPENING, VOLUNTARILY CLOSING

43
Q

Voluntary Opening (VO)

A

Terminal device CLOSED AT REST

Device can be OPENED BY PROTRACTION of the scapula or FLEXION of the shoulder

RUBBER BANDS on hooks or internal springs/cables in hands offer RESISTIVE FORCE FOR OPENING

RELAXING shoulder muscles allows terminal device to CLOSE

ONE RUBBER BAND provides 1 POUND of pinch force

In order to simulate AVERAGE ADULT PINCH force of 15-20 pounds addition rubber bands added

44
Q

Voluntary Closing (VC)

A

Terminal Device is OPEN AT REST

VC device TYPICALLY HEAVIER AND LESS DURABLE than VO device

In order to MAINTAIN CLOSURE of the device to grasp on to the desired object, ACTIVE MUSCLE CONTRACTION REQUIRED

Amputee can get some SENSORY FEEDBACK with this type of terminal device

CLOSING PRESSURE can be as high as 20-25 lbs

45
Q

Types of Hooks

A

CANTED

LYRE

Many different styles for different activities

Can be either VO or VC

Objects can be visualized better due to open design

Tougher than hands

46
Q

Canted Hooks

A

SIDE approach

OBJECTS MORE VISIBLE when grasping

OBJECT is ROLLED into its GRASP

CANNOT PICK UP SMALL OBJECTS like pins easily

47
Q

Lyre Shaped Hooks

A

STRAIGHT Approach

More applicable to bottle or cylindrical shapes

OBJECT is PINCHED

Can PICK UP SMALL OBJECTS EASIER than canted

48
Q

Terminal Device Hands

A

Can be both VO or VC

ACTIVE OR PASSIVE

POWERED OR PASSIVE operation

FUNCTION OR AESTHETICS

49
Q

Location of Northwestern Ring

A

At HEIGHT OF C7

NO MORE than 1 ‘’ towards SOUND SIDE

50
Q

Quick Disconnect Wrist PROS

A

Easy to SWAP terminal devices

More FUNCTION

LOCKING option

51
Q

Quick Disconnect Wrist CONS

A

Heavier

More mechanical parts

More costly

Longer build height required

52
Q

Friction Wrists

A

LIGHTER

LOWER BUILD HEIGHT

Can be OVAL for COSMESIS

ADJUSTABLE RESISTANCE to pronation/supination

53
Q

Flexion Radio/Ulnar Deviation Wrist

A

LOCKABLE at different ANGLES

WEIGHT and BUILD HEIGHT increase

More MECHANICAL parts

Can be used to get TD CLOSER TO MIDLINE

54
Q

Transhumeral length vs control

A

Condyles remain, primary control is from humerus

Distal to deltoid insertion, primary control is from humerus assisted by shoulder girdle

Proximal to deltoid insertion, primary control is form the shoulder girdle assisted by the humerus

Prosthetic Study (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions