prosthetics 2

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Author:
shmvii
ID:
206236
Filename:
prosthetics 2
Updated:
2013-03-10 18:27:32
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prosthetics
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spring 2013 Holland
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  1. ace wrapping for a BKA?
    4 inch wide ace wrap, 20 ft long, go from condyles down, using figure 8s
  2. AKA ace wrap
    • use 6 inch wrap
    • start by anchoring wrap over the sup iliac crest, circle torso 2x, then go down to stump....
  3. shrinkers
    • compression garments/socks for residual limb
    • can attach to a garter
  4. what's JOBST in this class?
    a compression garment
  5. can you soak a residual limb?
    no - it can lead to maceration
  6. care for stump
    • massage around suture line
    • teach pt signs of infection (red, pain, heat, swelling)
    • clean stump w mild soaps
    • frequent skin inspections
  7. articulated foot
    has a mechanical jt at the ankle thru the x-axis of the malleoli -- non-artic is more common
  8. dorsiflexion stop - is where? limits what?
    • ant
    • DF
  9. PF bumper - where? limits what?
    • post
    • PF
    • it acts as eccentrically lengthening of DFers -- in normal gait we get 10-15 degrees, PF. W bumper, 10.
  10. SACH foot - means what? what's it for?
    • solid ankle cushioned heel
    • it replaces a PF bumper to simulate eccentric contraction of DFers in early stance
  11. PTB socket
    • patella tendon bearing
    • for BKA
    • has a shelf (convexity) to put pressure on the tendon, and another for the medial tibial flair, and the ant tibial muscle
  12. TSB socket
    • for BKA
    • total surface bearing
    • less prominent patellar shelf than seen in PTB
    • tries to distribute pressure more to other areas, taking pressure off the tendon
  13. supracondylar cuff
    • a type of suspension for BKA prosthetics
    • soft leather bolted to med + lat sockets, goes up and circles fem condyles
    • doesn't need a mechanical knee joint bc it'll move w knee
  14. supracondylar wall suspension
    • a type of suspension for BKA prosthetics
    • instead of having a cuff go up like in the supracondylar cuff, these have med+lat walls going up over condyles
  15. supracondylar suprapatellar
    • a type of suspension for BKA prosthetics
    • walls raised on ant, med, lat sides
    • limits kneeling, but otherwise allows ROM
  16. when to use a supracondylar suprapatellar suspension?
    when resid limb is very short (BKA)
  17. thigh corset
    • a type of suspension for BKA prosthetics
    • med & lat metal strips go up to a corset fastened to the thigh
    • has a mechanical knee jt
  18. who uses a thigh corset
    pt w pressure-intolerant stump
  19. draw back of the thigh corset?
    atrophy in quads & hamstrings
  20. supracondylar cuff w waist belt & fork strap -- for whom?
    • a type of suspension for BKA prosthetics
    • pt who needs added suspension -- the fork strap attaches from condyles to a waist band
  21. supracondylar wall w/over knee sleeve
    • a type of suspension for BKA prosthetics
    • like a segment of a stocking to add suspension
    • sleeve is neoprene
    • good for vascular pts
  22. gel liner w shuttle lock suspension
    • what Mr. Goodman had
    • a type of suspension for BKA prosthetics
    • if the stump changes size, can put a sock on it to augment when it's smaller
    • not good for pts w sensitive skin, but ok for diabetics
  23. wearing schedule for prosthetics
    start w just an hour, then build up
  24. the deal w socks on stump
    • can be 1, 3, 5 ply
    • pt should be aware how much they need at diff times of day
  25. suction suspension
    similar to the shuttle set-up, but instead of pushing down on a rod, suction is accomplised by pushing air out of the socket ... one comes with a pump to let you suction the air out and creat a vacuum btwn  gel & socket
  26. AKA prosthetics - norms of degrees of freedom?
    • most are uni-axial, but some allow rotation
    • can be un/locked in knee (unlocked = free knee unit)
  27. who'll need a locked knee AKA prosthetic?
    • geriatrics w short residual limb (make the unit a bit shorter to allow swing-thru)
    • a hiker who wants to be able to switch into locked mod on uneven terrain where buckling is a concern
  28. friction in AKA prosthetics? types?
    • must have some friction built into the knee unit
    • mechanical (via the surfaces of joints rubbing/approximating each other)
    • hydrolic
    • pneumatic (sealed compartment of air)
  29. what kinds of knee friction are velocity respondent? why is this useful?
    • hydrolic & pneumatic
    • w/o friction the limb would swing like a mad pendulum as the pt sped up -- this allows the pt to go fast w/o that happening
  30. C-leg
    fancy AKA prosthetic with a microchip that communicates btwn knee and ankle/foot to adjust friction accordingly
  31. external extension aids
    • an anterior band
    • stretches in flexion so it can assist in extension
  32. internal extension aid
    • a posterior spring
    • compresses in flexion to assist in ext
  33. 4 concavities in the quadrilateral socket for AKAs
    • adductor tendons
    • rectus femoris
    • glut max
    • hamstrings
  34. horizontal wall in post of quatrilateral socket is for what?
    it's the ischial shelf -- puts pressure around the IT, making it the primary wt bearing site (like the patella tendon is in the PTB for BKAs)
  35. Scarpa's bulge
    • like the popliteal bulge for the BKA
    • pushes into Scarpa's triangle to help keep IT on the IT shelf
  36. Scarpa's triangle
    • the femoral triangle
    • bound by: inguinal ligament,  medial border of the adductor longus muscle, medial border of the sartorius muscle
  37. ischial containment socket
    • unlike the quad socket, which has an IT shelf making the IT carry most of the load, this one tries to make a more symmetrical distribution of wt
    • looks rounder than the rectangular quad
  38. who shouldn't use the ischial containment socket?
    vascualr & renal pts w stump size changing

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