Upper Extremity Prosthetics

Question 1

what is the common cause for UE amputees

Answer 1

• most commonly industrial accidents or combat injuries
• usually younger
• if due to cancer, will usually be above elbow

Question 2

what percentage is congenital amputees are UE

Answer 2

• 60

- sometimes will go further up the arm to make more functional

Question 3

what percentage is traumatic amputees are UE

Answer 3

70

Question 4

scar placement considerations

Answer 4

• not critical

- just straight distal

Question 5

levels of amputation

Answer 5

• wrist disarticulation
• forearm
• elbow disarticulation
• above elbow

Question 6

wrist disarticulation

Answer 6

hand and carpals taken

Question 7

forearm amputation

Answer 7

• lose pronation/supination - cant have rotation in socket

- as distal as possible - better socket = more stable limb

Question 8

elbow disarticulation

Answer 8

only humerus left

Question 9

prosthetic fit

Answer 9

prosthetic arm may be slightly shorter, the limb looks lifelss which may look longer if not done shorter

Question 10

bony landmarks for prosthetic

Answer 10

C7
clavicle
acromion
scapula

Question 11

C7

Answer 11

harness ring below

if not, pulls into flexion

Question 12

clavicle

Answer 12

site of breakdown particularly for small people

Question 13

acromion

Answer 13

to measure length of residuum

Question 14

scapula

Answer 14

• need good mobility

- function is based off of your scapula mobility

Question 15

below elbow harness system

Answer 15

• body powered cable system
• voluntary open
• both operational and suspension

Question 16

how do you operate terminal device in a below elbow harness system

Answer 16

• shoulder flexion tightnes cable and operates TD

- shoulder extension relaxes cable and closes TD

Question 17

what does shoulder abduction do in a below elbow harness system

Answer 17

increases shoulder flexion –> better operation of TD

Question 18

what does the anterior strap resist against in a below elbow harness

Answer 18

downward translation/slippage

Question 19

above elbow harness systme

Answer 19

• body powered cable system

- main suspension is over the deltoid at the shoulder saddle

Question 20

how do you operate terminal device in a above elbow harness system

Answer 20

• elbow must be locked

- shoulder flexion

Question 21

how do you lock the elbow in a above elbow harness system

Answer 21

through depression of shoulder with humeral abduction and extension

Question 22

myoelectric system

Answer 22

• operated via EMG-like activity

- electrodes sense muscle contraction to control terminal device

Question 23

how is myoelectric system suspended

Answer 23

through pin and lock system, suction or supracondylar

Question 24

in a myoelectric system what closes TD

Answer 24

flexion

Question 25

in a myoelectric system what closes TD

Answer 25

wrist flexion

Question 26

if you have damage to muscles or nerves in arm, how do you operate a myoelectric system

Answer 26

using chest or back muscles

Question 27

how to open TD in a myoelectric system

Answer 27

wrist extension

Question 28

targeted muscle reinnervation

Answer 28

- high level shoulder amputee or disarticulation - control of arm becomes intuitive - nerves from brachial plexus in residuum are transferred to target muscles that no longer perform function - increases signal to muscle for easier and enhanced prosthetic control

Question 29

targeted muscle reinnervation

Answer 29

- high level shoulder amputee or disarticulation - control of arm becomes intuitive - nerves from brachial plexus in residuum are transferred to target muscles that no longer perform function - increases signal to muscle for easier and enhanced prosthetic control

Question 30

osseointegration

Answer 30

- gives more sensation - similar to LE - two surgeries 6 months apart - improved function and QOL

Question 31

neural prosthesis interfaces

Answer 31

- uses functioning neural transmission pathways for direct control of robotic limbs - can restore movement and touch - combine forward control with feedback control; something slipping from hand

Question 32

hook vs hand

Answer 32

- functionality - cost - cosmetic - ADLs - a hook is more durable and better sense of manipulating objects, easier to pick things up

Question 33

myoelectric vs. harness

Answer 33

- cose - freedom of motion - skin irritation - muscle activation (myoelectric) - ideal at motor point (myoelectric) - break alot and noisey (myoelectric)