Upper Limb Px Flashcards
To determine the control system efficiency of an UP Px…
Divide the force measured at the TD by the force at the hanger
An axial pull test on an upper extremity Px should be
A force of 50 lbs and should not displace the socket more than 1”
BE amputee should retain at least ____ of the pronation and supination available
50%
Maximum pinch force of the two load hook is
7lbs
When the arm is over head, the trapezius muscle
Positions the glenoid cavity upward
The action of the deltoid muscle
Flex the gleno-humeral joint
Glenohumeral horizontal flexion is obtained from action of the
Deltoid and Pectoralis Major
Prime muscle for elbow flexion
Brachialis
BE arm is generally suspended by
An inverted Y strap
Rhomboids originate on
Thoracic vertebrae and insert along the scapula from the root of the spine to the inferior angle
Deltoid provides
Humeral abduction, flexion, and extension
External rotation of the humerus is accomplished with the
Infraspinatus and Teres Minor
Internal rotation of the humerus is produced by contraction of the
Subscapularis
Teres major
Pectoralis major
Greatest disadvantage to the amputee is using any step-up hinge is
Loss of flexion power in forearm
Triceps action
Extends the elbow joint and glenohumeral joint
Reasonable ranges of glenohumeral motion in the average human
Flexion 180 deg
Extension 60 deg
Abduction 180 deg
Adduction 20 deg
Anterior support strap in the AE should
Pass over the delto-pectoral groove
Medium length BE, there can be some residual pronation because
Pronator teres is still largely intact
The cross point of the figure of 8 harness on the AE should be slightly to the sound side because
It will allow the TD control cable to locate low across the scapula
Northrop-Sierra two load characteristics
Voluntary opening, 2 prehension forces
In the APRL, using the TD, the amputee exerts force to
Unlock it, then relaxes to open it
In order to flex the elbow, the AE amputee with a figure of 8 harness
Unlocks the elbow and flexes the gleno-humeral joint
Amount of humeral flexion required to fully flex the elbow of an AE Px should not exceed
45 deg
If the prehension force of the TD is less than the force required to flex the elbow, the AE amputee, harnessed for dual control with a Dorrance hook, will find what happens when he attempts to flex the elbow
TD will open
Shoulder disarticulation Px is operated primarily by what control motion
Scapula abduction
AE amputee having difficulty in flexing the elbow of the Px, how to aid this
Increase the prehension force of the TD
The lever type excursion amplifier provides increased excursion at the expense of
Force
Which normal function can be mechanically reproduced in a Px arm
Joint stabilization
Initial socket brim for a short AE amputation would be trimmed on a line
1-2” above the acormion
Basic harness for a shoulder amputation Px is
Chest strap
If the application of cable and housing were made on the AE Px as it is on the BE, the amputee would loose
Elbow flexion
If the distance between the acromion and the lateral epicondyle is 14” and the length of the stump is 12” from the acromion to the end of the stump, the amputee would be classified as a
Standard AE
A non-prehensile activity may be illustrated by holding a
Suitcase
When fitting a socket for a VSBE, the mechanical elbow should flex to
135 deg
External movable sheave type excursion amplifier is used with what type of Px
SD (Shoulder Disarticulation)
When the control cable breaks, the unilateral amputee is instructed to manually open his TD and allow it to close over an object to be grasped. This instruction are for an amputee wearing a
Voluntary opening hook
What does the nudge control enable the amputee to do
Lock and unlock the elbow by pressing lever with the chin
When making a plaster wrap for a VSBE split socket or m=Muenster, the elbow is flexed
90 deg
Chief advantage of using the housing cross bar assembly
Reduces control cable bending, increasing cable life
Major limitation that is incurred by the SD amputee
Excursion to operate a Px
WE-500 and WA-600 are what type of units
Friction wrist units
Brachioradialis assists in _____ of the elbow
Flexion
In the forearm, the _____ remains stationary, while the ______ rotates around it
Ulna, radius
Gleno-humeral abduction is performed primarily by the ______ muscle
Deltoid
In the anatomical position, the _____ _____ is nearer the midline of the body than is the thumb
Ulnar styloid
Tripler control simply means there is one cable for elbow _____, one cable for TD ______, and a third for elbow ______
Flexion, Operation, Locking
The E-400 elbow is set in ______ degrees of initial elbow ______
5-10 deg, flexion
When harnessing bilateral amputees, the harness cross point should be
Centered over the vertebral column
The FM wrist disconnect is not recommended for use on
Shoulder disarticulation amputees
Triceps pad is often used for
Long BE and WD
Polycentric hinge is used on which types of amputees
Short BE
Acromion is part of the
Scapula
The basic BE control motion is gleno-humeral
Flexion
The acceptable range of gleno-humeral flexion for AE Px application is
135 deg
In what position should the muscle tunnel be when assembling the control system of the biceps cineplasty
At maximum shortening
When the elbow is flexed to 90 deg, the forearm can be rotated through an arc by humeral rotation. The size of this arc is
110 deg
Description of which level of UE amputation: “Wrist loss, forearm rotation absent, good humeral rotation, good shoulder motion”
VSBE
The proximal-posterior border of the VSBE shocket is shaped to contain the olecranon process, as a result…
The elbow cannot fully extend
Which wrist unit is of least value to the bilateral amputee:
Model B flexion, Oval wrist, Manual friction, or Quick change
Quick change
TD most desirable for use with cineplasty amputees
Voluntary closing
SD amputee, which muscle sites would be most suitable for control of a myoelectric elbow
Pectoralis major and trapezius
In scapulothoracic amputee, which motions can be used to operate the Px
Chest expansion
Muscles that internally rotate the humerus
Subscapularis
Pectoralis major
Latissimus dorsi
The TD on the SD Px is operated primarily by scapular
Abduction
Major limitation of the SD Px
Excursion needed to operate the Px
Most prominent and highest point on the shoulder girdle
Acromion
Characteristics (3) of a shoulder saddle harness
Increases comfort in axial loading
Reduces pressure in the axilla
Presents cosmetic difficulties for females
*Does NOT improve excursion in biscapular abduction
For which type amputation is the external or outside locking joint designed
Elbow disarticultion
Which is not part of the AE figure-of -8 harness
Inverted Y strap
The length of the AE hymeral section is determined by measuring the sound side from the
Acromion process to the lateral epicondyle
Term for “complete absence of the upper limb distal to the shoulder joint”
Amelia
Characteristics (3) of the cross back strap
-Increases available cable excursion
-Decreases force required to operate the TD
-Tends to keep the cross point from migrating
Where should the cross point of the figure of 8 harness be located in relation to the 7ths cervical vertebra
Inferior and toward the sound side
Which epiphyses contributes most to longitudinal growth of the upper limb
Proximal humerus
Elevation of the scapula is accomplished by the
Trapezius muscle
What shoulder function will be lost if the middle section o the deltoid is impaired
Abduction
At what amputation level would flexible elbow hinges be most appropriate
Long BE
Unilateral BE Px Pt complains that the axial loop of the harness is uncomfortable. Most common reason is that the cross point is
Too close to the amputated side
Short AE Px, the trimlines are extended proximally to do what
Increase rotational stability
In the Muenster socket, the principal function of the posterior proximal brim is to limit elbow extension and
Provide suspension in axial loading
