Week 3 - Orthotics Lecture Flashcards
1
Q
Name 7 possible causes of harm of orthotic devices.
A
- injury to skin or nerve due to pressure points.
- burn as molding over heated material
- failure to protect healing structures.
- undue stress to tendons, joints, etc. due to poor design or positioning.
- inflammation or injury to shortened soft tissue by excessive force (when trying to reduce contracture).
- disuse atrophy
- edema
2
Q
field of practice
A
orthotics
3
Q
device applied to the body
A
orthosis
4
Q
- low temperature thermoplastics
- made for specific patient.
A
custom fabricated orthotic devices
5
Q
Name 3 goals/objectives of orthotic intervention.
A
- protective
- corrective
- assistive
6
Q
Name 4 aspects/goals of protective orthotic intervention.
A
- Immobile to protect healing structure - prevent any motion, optimal joint alignment
- weak muscles
- prevent joint contractures
- prevent soft tissue contractures
7
Q
Name 2 aspects/goals of corrective orthotic intervention.
A
- to encourage proper alignment (correct subluxation of joint)
- to correct deformity
8
Q
Name 1 aspect/goal of assistive orthotic intervention.
A
- assists muscles that are weak (ex: tenodesis orthosis)
9
Q
- no moveable parts
- hold joint(s) in one position
- may be worn intermittently
- can be part of exercise program
A
static splints
10
Q
- has moveable parts such as rubber bands, hinges, outriggers
- encourages early motion
- prevents
- corrects deformity
A
dynamic splints
11
Q
- combination of static and dynamic splints
- correct deformity
- increase ROM
A
static progressive splints
12
Q
low load over time to change soft tissue structures. changes frequently
A
serial casting
13
Q
- provides a prolong sustained stretch
- a fast, relatively inexpensive method of correcting burn scar contractures
- flexion contractures of over 30 degrees respond well to casting
- provides circumferential evenly distributed pressure
- offers a successful alternative to dynamic splinting when pt. compliance is an issue ex: pediatrics
A
serial casting
14
Q
Most UE splints affect joint ___.
A
ROM
15
Q
Articular 3 point pressure splints influence joint ROM by what 4 things?
A
- immobilization
- mobilization
- restriction
- torque
16
Q
- circumferential - multiple opposing 2 point pressures, non-articular- do not influence joint ROM
- provide specialized materials to healing structures
A
coaptation splints
17
Q
Rigid, hard splint material may cause damage to skin or underlying soft tissue as result of ____ ____.
A
excessive pressure
18
Q
Name 3 clinical applications to prevent damage to skin or underlying soft tissue.
A
- longer, wider splints
- rolled edges on distal and proximal edges.
- continuous, uniform pressure over bony areas not cut outs.
19
Q
___ ____ on hand splints may provide close fitting support surface for hand.
A
elastomer linings
20
Q
heavy felt or foam rubber may help reduce pressure in areas where forces are great or splint is ____.
A
narrow
21
Q
The lining/padding should line what?
A
the patient not the splint
22
Q
Describe how to increase area of force application on an orthosis.
A
- pt. can tolerate force/pressure more when it is spread out on a larger surface.
- make splint longer and wider.
23
Q
How long and wide should splints be for limbs?
A
1/2 width and 2/3 length of limb.
24
Q
Splints are lever systems that work in ____.
A
equilibrium
25
What is the axis of a wrist splint?
wrist joint
26
what is the weight/resistance of a wrist splint?
hand
27
what is the counter force of a wrist splint?
forearm
28
rotational element of force
production of joint rotation
29
translational element of force
production of joint distraction or compression
30
How is force/pull applied to an orthosis?
applied by OT via rubber band, elastic, spring, etc.
31
When we apply a force, it must be what kind of force?
Rotational force (for joint movement)
32
Where should force be applied?
must be applied perpendicular to bone we want to move. has to be applied at 90 degrees. as pt. gets better, must change pull angle to get to 90 degrees.
33
product of force times the length of the arm on which it moves (T = F x d)
torque
34
what does the amount of torque (effectiveness of force) depend on?
distance btwn joint axis and point of application of the force
35
As the ____ btwn the joint axis and point of attachment of the mobilization assist increases, the amount of torque on the joint ____.
distance, increases
36
What is the formula for torque?
T = F x d
37
How should a secondary joint be addressed with regards to the control reaction effect?
reaction effect controlled by careful support of secondary joint splint fabrication or strap placement.
38
Describe "3 point fixation" (the 3 parallel force systems in equilibrium as in first class lever system).
the combined downward weights (forearm and hand) must be opposed by equal upward force at the axis (wrist).
39
Why would you need to widen straps regarding 3 point fixation?
to increase area of force application
40
straps ___ forces
oppose
41
foundation from which force is applied or guided
outriggers
42
How should an outrigger be placed?
must be placed to allow for 90 degree angle of pull
43
- when mobilizing stiff joints; allows for easier adjustment
| - provides greater joint stability
high-profile outrigger
44
-when joints are flexible/supple and purpose is to substitute for absent motion
low-profile outrigger
45
articulated splint components = ___ ___
mechanical joints
46
Articulated splint components must be lined up with what?
anatomical joints
47
What can happen if splint components are not aligned properly with anatomical joints?
splint may tend to "piston" and create shear or friction forces.
48
What is a way to increase material strength?
providing contour
49
Describe 2 clinical applications of contouring splint material to increase material strength.
- round edges
| - contour to body part
50
slightly bent edges
bevel edges
51
disperse forces
round edges
52
Friction may lead to what 3 things?
- skin irritation
- blistering
- eventual breakdown
53
Friction usually indicates what 3 things?
- poor fit
- improper joint alignment
- ineffective fastenings
54
The radial side of the hand is usually used for which general type of function?
fine motor
55
The ulnar side of the hand is usually used for which general type of function?
power grasp
56
Name the 9 creases of the hand.
- thumb - thenar, proximal, distal
- fingers - proximal, middle, distal
- palm - DPC, PPC
- wrist
57
- follows distal carpal row
| - allows wrist motion
proximal transverse arch
58
- follows line of middle finger
| - allows flex/ext of fingers
longitudinal arch
59
dual obliquity
consider the arches of hand when making splints to preserve function.
60
Why should sensory considerations be kept in mind by OT when making splints?
must be able to check skin to see if it's ok
61
Describe the safe position of the hand.
wrist: 20-30 degrees of extension
MCPs: 40-60 degrees of flexion
fingers - full extension
thumb: abduction/extension
62
Name 5 aspects of orthoses to educate the pt. about.
1. purpose of orthosis, consequences of non-use
2. correct application and removal
3. wearing schedule
4. care: cleaning, heat
5. indication of poor fit (pressure points)
63
no moving parts, to immobilize body part
static orthotic
64
push or pull force, to mobilize
dynamic orthotic
65
action of influence that either arrests, produces, or changes the direction of motion.
force
66
push or pull (kind of force)
nature of force
67
amount/quantity of influence present
magnitude of force
68
path or direction along which force acts
line/angle of application
69
location on structure at which line of force act
point of application of force
70
increase ___ of ___ application, applies to any type of splint.
area, force
71
apply passive pulling force in one direction while permitting active resistive motion in the other direction.
dynamic orthoses
72
force should be applied so that the angle of application is how many degrees to the lever?
90 degrees
73
which happens if the angle of application is not at 90 degrees?
beneficial effect is lessened and could be potentially dangerous
74
applies force to a joint to improve PROM, no joint motion permitted while wearing orthotic device.
static progressive orthoses
75
use ___ ___ ___ for dynamic and static progressive orthoses.
optimum rotational force
76
production of joint rotation
rotational element
77
production of joint distraction or compression
translational element
78
product of force times the length of the arm on which it moves (T = F x d)
torque
79
the amount of torque depends on what?
distance between joint axis and point of application of the force
80
if there is a hard end feel of tissue, which types of splints will be indicated?
serial static or static progressive splints
81
designed to correct contractures by applying a gentle prolonged stretch
static progressive splints
82
non-elastic component attached to a themoplastic base is adjusted by small increments as the contracture is reduced
static progressive splints
