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Lower Extremity Prosthetics III > Week 2 > Flashcards

Week 2 Flashcards

0
Q

What are the below knee pressure tolerant areas?

A

Patellar tendon
Medial tibial plateau
Tibial and Fibular shafts
Distal end (rarely, maybe sensitive)

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1
Q

What are the below knee pressure sensitive areas?

A

Anterior tibia
Anterior tibial crest
Fibular head and neck
Fibular nerve

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2
Q

What are the Transfemoral pressure sensitive areas?

A

Distolateral end of the femur
Pubic symphysis
Perineal area

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3
Q

What are the Transfemoral pressure tolerant areas?

A

Ischial tuberosity
Gluteals
Lateral sides of the residual limb
Distal end (rarely, may be sensitive)

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4
Q

Who is the patellar tendon bearing socket indicated for?

A

Previous wearer
Extreme Atrophy
Selective hot spots - neuromas, callusing

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5
Q

What is the total surface bearing socket?

A

Even distribution of pressures

Total contact fit

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6
Q

Who is the total surface bearing socket indicated for?

A

Majority of patients
Mild to moderate Atrophy
Patients with skin conditions or considerations
Unstable volume or edema

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7
Q

What are the coronal plane forces?

A

Fulcrum at MTP
Distal lateral forces
Proximal medial forces
Loading pressure tolerant areas

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8
Q

What are the sagittal plane alignment forces?

A

Proximal posterior
Anterior pre-Tibials
Proximal anterior
Patellar tendon

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9
Q

What are the biomechanical goals?

A

~Maximize the weight-bearing capacity of the residual limb
~Provide ML stability at Mid-Stance on the prosthetic side- modification of dynamic forces
~Encourage knee flexion throughout stance phase- modification of dynamic forces.

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10
Q

What is pressure?

A

Pressure= force/area

Even distribution of forces is key

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11
Q

Inclination of forces?

A

Loads pressure tolerant anterior surface
Encourages knee flexion at heel strike
Prevents knee hyperextension

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12
Q

What is the purpose of total contact?

A

Minimize edema
Increase proprioception
Improve weight bearing

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13
Q

Is the floor reaction line medial or lateral to the knee joint (NHL)?

A

Medial

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14
Q

What moment is created at the knee at mid-stance?

A

Varus moment

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15
Q

Prosthetic alignment: foot initially inset at _____mm (medial)

A

12mm

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16
Q

Excessive Varus moment is caused by?

A

Increased distal-lateral and proximal-medial pressure

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17
Q

Insufficient Varus moment is caused by?

A

Valgus moment

Proximal-lateral and proximal-medial pressure

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18
Q

When distal-lateral and proximal-medial are loaded base of support is ____________.

A

Narrowed
Decrease in energy expenditure
Loads pressure tolerant areas and relieved pressure sensitive areas

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19
Q

Effects on forces:
Increase mass&raquo_space; ___________ force on limb
Increase inset&raquo_space; ____________ force on limb
Increase limb length&raquo_space; ___________ force on limb
Increase trim lines&raquo_space; ____________ force on limb

A

Increase
Increase
Decrease
Decrease

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20
Q

Prosthetic alignment: initial foot placement at ____posterior to ankle bolt. Foot is dorsiflexed, socket is aligned with _____degrees of flexion and proper heel stiffness

A

37 mm

10 degrees

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21
Q

Excessive knee flexion at early stance is caused by?

A

Heel too firm, foot too DF, excessive socket flexion, foot too far anterior, heel too high, shoe too tight, keel too soft.

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22
Q

Knee hyperextension at late stance is caused by?

A

Foot too far anterior, foot too PF, inadequate flexion of socket, heel too soft, keel too stiff

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23
Q

Premature loss of anterior support at late stance (drop off): is caused by?

A

Foot too far posterior, foot size too small, keel too soft

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24
Q

What are the modes of suspension?

A 
Joint and Corset suspension 
Belt or cuff suspension 
Compressive sleeve suspension 
Anatomical- 
Suction/ Expulsion valve suspension 
Elevated vacuum
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25
Q

Joint and Corset is indicated for?

A

Incorporates thigh weight bearing
Improves ML stability
Heavy duty user
Patient preference

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26
Q

What are the advantages of the Joint and Corset?

A

Increases weight bearing surface
Unloads the residual limb
Increases ML stability
Knee extension control

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27
Q

What are the disadvantages of the Joint and Corset?

A

Heavy
Un-cosmetic
Inherent pistoning

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28
Q

Who is the supra-condylar cuff indicated for?

A

Many of TT users prefer
Patients with stable ligaments
Juvenile patients
Long residual limbs

29
Q

What are the advantages of the supra-condylar cuff?

A

Provides good suspension over patella
Adjustable
Can be used in combination with waist belt

30
Q

What are the disadvantages of the supra-condylar cuff?

A

Can be restrictive

Does not increase ML stability, un-cosmetic

31
Q

Who is the sleeve suspension indicated for?

A

Many of TT users prefer
Patients with stable ligaments
Juvenile patients
Long residual limbs

32
Q

What are the advantages of sleeve suspension?

A

Provides excellent suspension
Conceals trim lines
Variety of materials available

33
Q

What are the disadvantages of the sleeve suspension?

A

Can cause skin problems
Can increase perspiration, hard to don
May not be indicated for vascular patients

34
Q

Who is the supra-condylar and patellar suspension indicated for?

A

Patients with very short residual limbs
Patient requiring ML stability
Patients who want less straps

35
Q

What are the advantages of supra-condylar and patellar?

A

Increase weight bearing surface
Improved ML stability
Improves cosmesis

36
Q

What are the are the disadvantages of supra-condylar and patellar?

A

Can inhibit some motion and activity

Difficult to use on obese or muscular

37
Q

Who is supra-condylar suspension indictated for?

A

Patients with very short residual limbs
Patients requiring ML stability
Patients who want less straps

38
Q

What are the advantages of supra-condylar suspension?

A

Less restrictive than PTB-SC

Improved cosmesis

39
Q

What are the disadvantages of supra-condylar suspension?

A

Loss of rigid hyperextension stop

Difficult to use on obese or muscular

40
Q

Who is the silicon suction indicated for?

A

Patients with good subcutaneous tissue
Full function of upper extremities
Want less straps

41
Q

What’s the advantages silicon suction?

A

Excellent suspension
Eliminates pistoning
Increased proprioception
Good torque absorption

42
Q

What are the disadvantages of silicon suction?

A

Can be difficult to don

Good hygiene is required

43
Q

Who is vacuum and suction suspension indicated for?

A

Patients with good subcutaneous tissue
Patients who wants less straps
Patients who can’t tolerate distal pulling from a lock and pin

44
Q

What are the advantages of vacuum and suction Suspension?

A

Excellent suspension
Eliminates pistoning
Increased proprioception

45
Q

What are the disadvantages of vacuum and suction suspension?

A

Maintenance is required
Can loose vacuum
Can be complicated to use for some

46
Q

Shock absorbers and Rotational units are indicated?

A

Torque absorption
active users
Special situations and activities

47
Q

Who is the SACH feet indicated for?

A

Many lower limb users

Juveniles

48
Q

What are some contraindications of the SACH feet?

A

Active individuals
When knee stability is required
When inversion/eversion is required

49
Q

What are the advantages of the SACH feet?

A

Cosmetic
Quiet
Little maintenance

50
Q

What are the disadvantages of the SACH feet?

A

Deterioration of soft materials

No torque absorption

51
Q

Who is the single axis prosthetic feet indicated for?

A

Patients needing knee stability

52
Q

What are the contraindications of the single axis feet?

A

Many lower limb users
Active users
When torque, inversion or eversion is needed

53
Q

What are the advantages of the single axis feet?

A

More shock absorption

Promotes knee stability

54
Q

What are some disadvantages of the single axis feet?

A

No torque absorption

Requires bumper replacement

55
Q

What are the indications for the multi-axis feet?

A

Torque absorption needed
Special activities
Need for in/eversion

56
Q

What’s a contraindication for the multi-axis feet?

A

When other components can be used

57
Q

What are the Advantages of the multi-axis feet?

A

Absorbs torque, shock

Foot conforms to surfaces

58
Q

What are the disadvantages of the multi-axis feet?

A

Cosmesis, increased weight

Increased maintenance

59
Q

Who is the dynamic response feet indicated for?

A

Active ambulators

Community ambulators

60
Q

What’s a contraindication of the dynamic response feet?

A

One speed ambulators

61
Q

What are the advantages of dynamic response feet?

A

Smoother gait, less energy expenditure

Light weight, cosmetic, energy storing

62
Q

What’s the disadvantages of the dynamic response feet?

A

Materials durability, limited sizes, expense

63
Q

Who is the multi-axis dynamic response feet indicated for?

A

Active users, varying cadence ambulators

Community ambulators, athletes

64
Q

What’s a contraindication of the multi-axis dynamic response feet?

A

Single speed ambulators

65
Q

What’s the advantages of the multi-axis dynamic response feet?

A

Multi-axial capabilities, dynamic response

Energy storing capabilities

66
Q

What’s the disadvantages of the multi-axis dynamic response feet?

A

Expense

Maintenance

67
Q

What’s an indication of the external power prosthetic feet?

A

Potentially, all mildly active ambulators

68
Q

What are some contraindications of the external power prosthetic feet?

A

K1 level ambulators

Wet or corrosive environments

69
Q

What’s the advantages of the external power prosthetic feet?

A

Anatomical power and propulsion

Anatomical limits for PF and DF

70
Q

What are the disadvantages of the external power prosthetic feet?

A

Batteries, weight , cost
Processing speed
Limited environment use

71
Q

What are the trans-tibial gait deviations?

A 
Inadequate flexion or extension 
Medial or lateral leaning pylon 
Drop off 
Erratic movement 
Heel lever and toe lever 
Whips

Lower Extremity Prosthetics III (3 decks)

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