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Lower Extremity III > Week 4-Pediatrics > Flashcards

Week 4-Pediatrics Flashcards

1
Q

What is an example of habilitation?

A

congenital deficiency or really young amputees.

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2
Q

What is an example of rehabilitation?

A

acquired amputations

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3
Q

What are the three different development indicators?

A

motor skills and milestones
physical growth
psychosocial

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4
Q

Who are the training goals for?

A

parents and patients

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5
Q

What are the two different classifications for amputations?

A

transverse

longitudinal

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6
Q

What is a transverse classification?

A

nothing exists below a certain point

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7
Q

What is a longitudinal classification?

A

reduction or absence of aspects in the longitudinal axis

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8
Q

What is phocomelia?

A

Distal segments are attached to the torso

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9
Q

What is amelia?

A

complete absence of the limb

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10
Q

What is hemimelia?

A

partial absence of the limb

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11
Q

What is the percent of congential pediatric patients?

A

73%

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12
Q

What is the percent of malignancy in pediatric patients?

A

9%

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13
Q

What is the percent of trauma causing pediatric amputation?

A

8%

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14
Q

What is the percent of bone infection in pediatric patients?

A

4%

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15
Q

What is the percent of other pathologies causing amputations in pediatric patients?

A

6%

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16
Q

What is the percent of 1,000 live births in the U.S have amputations?

A

.3-1%

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17
Q

How many children are affected with amputations each year?

A

15,000-45,000

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18
Q

What percent of children have upper limb deficiencies?

A

58.5%

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19
Q

What is the definition of milestone?

A

Predictable sequence of motor skill development, marking the achievement of important functional abilities.

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20
Q

What could be a reason for not reaching a milestone?

A

May have altered milestone that looks different and so is preceived as not reaching the milestone

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21
Q

What must be planned for in the prosthetic design?

A

Comfort
Symmetrical limb length
Use pelite liner-easy to mold and add to

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22
Q

What is the age range for infants?

A

0-12 months

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23
Q

What is being increased during infancy?

A 
function
strength
gross motion
coordination
interest
ROM
Patterns
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24
Q

How often should a preschooler be schedules?

A

At least every year, usually every few months

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25
Q

How often should grade school patients be scheduled?

A

every 12-18 months

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26
Q

How often should high school students be scheduled?

A

18-24 months

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27
Q

What are some fit issues?

A

slipping in and out of socket
pistoning
pain
skin reddening
flesh rolls around prox/med side of socket
callous/blister
flesh rolls around prox brim for femorals

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28
Q

What is an optimal psychosocial environment?

A

whole-some environment and interactive experience

treating family and patient together

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29
Q

What is important psychosocially for infant patients?

A

early referral so family is shown possibilities to provide hope and less despair

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30
Q

What is the age range for toddlers?

A

1-3 years

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31
Q

What is developing for toddlers?

A 
language
playing with others
mobility
emotional development
spatial awareness
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32
Q

What will help toddlers develop?

A

Doll play

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33
Q

What is important for school-aged children psychosocially?

A 
don't inhibit
make them try
encourage creativity
social connections
thick skin and better body image
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34
Q

What is important for older age children psychosocially?

A

peer groups
counseling
social adjustment
acceptance of themselves

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35
Q

What can occur for patients who acquire an amputation during high school?

A

depression

time of mourning for their limb

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36
Q

What are the training goals for infant patients?

A

Comfort
Tolerance
Ability to stand and lean against a table
Ability to cruise around furniture
Ability to walk with and without assistance

37
Q

What are the training goals for infant parents?

A

Be able to apply and remove device
Care for the skin
Care for the prosthesis
Recognize and report any problems

38
Q

What are the training goals for toddler patients?

A

Full-time wear of the device, except for bathing and sleep

Use of the device for age appropriate ambulation activities

39
Q

What are the training goals for toddler parents?

A

Encourage use of the device
Provide toys and an environment to stimulate and foster
age appropriate behavior and activities
Inspect and care for skin and report problems

40
Q

What are the training goals for school age patients?

A

Monitoring and maintaining proper fit
Inspect and care for skin
Donning and doffing the deviceindependently
Dressing independently
Engaging in the full range of ambulation activities with the device
Recognizing when the device needs maintenance and repairs

41
Q

What are the training goals for school age parents?

A

Encourage independence

Provide opportunities to participate in sports

42
Q

What are the options for a first TT prosthesis?

A

SACH, thigh corset, silicon socket, COMFORT

43
Q

What are the options for a first TF prosthesis?

A

Locked knee, SACH, waist belt, COMFORT

44
Q

What are some other devices that can be used for a pediatric prosthesis?

A

Dynamic response feet, liners, polycentric knees

45
Q

In the Uterus, what is the shape of the spine?

A

C-shaped

46
Q

What strengthens the spine?

A

The Steps of development

47
Q

What needs to be strengthened to help establish balance for sitting?

A

core muscles and neck muscles

48
Q

What does crawling help develop?

A

vestibular system

49
Q

What are the levels of foot deficiencies?

A

Toe and Longitudinal Partial Ray
Transmetatarsal
Lisfranc
Chopart

50
Q

What is present for a chopart amputation?

A

talas and calcaneous

51
Q

What are the prosthetic options for foot deficiencies?

A

toe fillers
soft silicone boots
carbon foot plates and posterior shells can assist ambulation

52
Q

What can foot deficiencies result in?

A

hypermobility of the ankle joint

53
Q

What are the different fibular deficiency classification systems?

A

Achterman & Kalamchi Classifications-bowing of the tibia and the % of fibula left
Letts Classification-comparing to sound side
Birch Classification-% of foot function remaining

54
Q

What is required to see seriousness of deformity?

A

X-ray

55
Q

What are treatment options for fibular deficiencies?

A

shoe lift
equinus device with prosthetic foot
leg lengthening procedures (epiphoseal-less than 5cm, Ilizerob procedure-5-10cm)

56
Q

When can lengthening surgery be performed?

A

At the ages of 3-13 years

57
Q

When should foot amputations occur for fibular deficiencies?

A

When the foot is not useful or the ankle is unstable.

58
Q

What are the different options for foot stability?

A

Boyd-fuse ankle

Symes-remove foot

59
Q

What are the prosthetic options for fibular deficiencies?

A

Symes
Step-in prosthesis
standard prosthesis

60
Q

What are the different classification for tibial deficiencies?

A

Jones Classification-use X-rays and the outcome that is greatest effective, the ability of knee joint, extension power, leg length, extent of foot present
Kalamchi & Dawe-Same as Jones but with knee flexion contracture present, and foot deformity

61
Q

The goal in mind for treatment options for tibial deficiencies is?

A

functional optimization of the limb

62
Q

When will a knee disarticulation be performed for tibial deficiency patients?

A

When there is no extensor power

63
Q

When will a symes procedure be performed for a tibia deficiency patient?

A

When the proximal tibial is present with good quad function

64
Q

When will they try and keep the ankle for tibia deficiency patients?

A

When the proximal tibia and distal tibia are present and foot and ankle are able to function.

65
Q

What does PFFD stand for?

A

Proximal Focal Femoral Disorder

66
Q

What can also be used for PFFD?

A

Longitudinal Deficiency of the Femur, Partial (LDFP)

67
Q

What is PFFD/LDFP?

A

The complex congenital absence of part or all of the femur that is associated with other limb soft tissue and osseous abnormlaities

68
Q

What are the classifications of femoral deficiency?

A

Aitken Classification-femor development

Fixsen & Lloyd-Roberts-X-rays and friction of femur, location of femur shaft, and nature of acetabulum.

69
Q

What is the clinical presentation of fibular deficiencies?

A

Shortened lower limb
Thick, funnel shaped thigh
Common: Fibular deficiency
Common: Foot deformity

70
Q

What is the common position of femoral deficiencies?

A

Flexed
Abducted
Externally rotated

71
Q

What other issues can be present for femoral deficiency patients?

A

spine
heart
upper limb deformities
contractures

72
Q

What are the treatment options for femoral deficiencies?

A 
Shoe lift, stabilize ankle
Fuse knee
Rotationplasty-fuse knee to hip with foot backwards
ankle disarticulation
limb reconstruction
73
Q

What is required for limb reconstruction?

A

muscle strength
stable knee
functional foot

74
Q

What are the prosthetic options available?

A

disartiuclated foot
transtibial with side joint and thigh lacer
transfemoral prosthesis

75
Q

What often occurs with pediatric device treatment

A

A combination of orthotic and prosthetic devices

76
Q

What is the device recommendation for Partial Foot?

A

plastic AFO with padded toe

77
Q

What is the device recommendation for Fibular Deficiency

A

PTB or TSB design with

protective padding

78
Q

What is the device recommendation forTibial Deficiency?

A

Knee disarticulation/Transfemoral, symes with/out SJTL, Transtibial with/out SJTL

79
Q

What must be considered for component selelction?

A

weight
growth
activity

80
Q

What is the 3R38 Aluminum?

A

Modular Single Axis Knee Joint 3R38 from Otto Bock
Lightweight aluminum single axis, pediatric knee
with proximal adjustment pyramid and distal
tube clamp.

81
Q

What is the 3R65 Aluminum?

A

Hydraulic swing phase control, Integrated
terminal dampening, Dynamic adaptation to
various walking speeds, Adjustable

82
Q

What is the 3R66 Aluminum?

A

Modular Knee Joint with Integrated Rotation 3R66 from Otto Bock.
Integrated rotation unit allows the
prosthetic foot to be rotated up to 90°, Large flexion angle of 165°, Allows users to kneel and crouch with ease, Adjustable

83
Q

What is the 1E66 | Children’s Springlite® II?

A

crafted of carbon fiber that offers good energy return. Its pylon design provides additional flexibility that is well-suited to a
child’s activity level.

84
Q

What is the 1E79 Children’s SL Profile of Otto Bock.?

A

A lightweight carbon foot with extremely low clearance, ideal for Symes amputees.

85
Q

What is the 1K10?

A

A durable, dynamic foot with a natural shape, smooth surface, and formed toes. The contoured core design and the use of foams deliver a softer heel strike.

86
Q

What is the 1K30 | Children’s SACH Foot?

A

A robust prosthesis foot adapted for the special needs of young prosthesis wearers. It has a natural shape, smooth surface, and formed toes.

87
Q

What is the 1S30 Children’s SACH Foot of Otto Bock?

A

Is constructed in two sections and is especially suitable for younger children who require a stable foot. The sole of the SACH foot is replaceable

88
Q

What are 8 other pediatric components?

A 
Cheetah Junior
Cheetah Xplore junior
Flex-foot junior
vari-flex junior
total knee junior
Iceross Dermo junior
Iceross stabilo Junior
icelock 700 series

Lower Extremity III (9 decks)

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