Non-Systems_Prosthetics

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  1. 4 types of LE amps that don't require a prosthesis
    • big toe
    • trans-metatarsal
    • Lis Franc (removing all metatarsals)
    • Chopart (removing all but talus and calcaneus)
  2. Lis-Franc amputation - what is kept? What is removed?
    • Kept: Tarsals
    • Removed: Metatarsals
  3. Chopart amputation - what is kept? What is removed?
    • Keep: talus & calcaneus
    • Remove: tarsals & metatarsals
  4. Boyd's amputation - what is kept? What is removed?
    • Keep: calcaneus
    • Remove: talus
  5. Image UploadName amputation; What is kept & what is removed?
    • Lis Franc amp
    • Kept: Tarsals
    • Removed: Metatarsals
  6. What do pts w/big toe, trans-metatarsal, Lis-Franc, & Chopart amputations need? - 2
    • Rocker bottom shoe +
    • Soft cushion heel to promote PF w/Lis-Franc
  7. Common contracture for trans-metatarsal, Lis-Franc, & Chopart amputations
    PF contracture (so work on DF)
  8. Image UploadName amputation; What is kept?
    • Chopart
    • Keep talus & calcaneus
  9. Image UploadName amputation; What is kept?
    • Boyd's amp
    • Keep calcaneus
    • Remove talus
  10. Syme's amputation - what is kept & what is removed?
    • Amputation through distal ankle
    • Removed - tarsals, talus, calcaneus
    • Preserved - Heel pad (attached to distal end of tibia for WB)
  11. Where should mechanical joints be for a prosthetic for a hip disartic or hemipelvectomy - hip, knee, ankle, and why?
    • Hip - anterior to facil extension
    • Knee -post to facil ext
    • Ankle - post to facil DF
  12. What do you put in heel for a hip disartic or hemipelvectomy
    Soft cushion heel to promote PF
  13. External aids in a prosthetic for a hip disartic or hemipelvectomy - where are they?
    • Hip - post - prevents excessive flexion - ex - step length control strap, prevents more than 15 degrees hip flexion
    • Knee - ant
  14. Hemicorporectomy aka translumbar amputation where is it usually?
    • Amp of both limbs & pelvis btwn L4 and L5
    • Pt uses a "bucket prosthesis"
  15. Partial hand amputation, means what?
    • @ CMC joint
    • keep carpals, lose everything distal
    • it's like a Lis Franc, which keeps the tarsals and removes everything distal
  16. Wrist disartic - what's amputated
    • Keep: ulna and radius
    • Lose: carpals and everything distal
  17. Below elbow amp means what?
    Removal of ulna and radius - try to keep as much as possible (at least 4 in) for muscle attachment
  18. Elbow disartic means what?
    Lose: radius and ulna completely
  19. Shoulder disartic is what?
    • Humerus taken out of glenoid fossa
    • Remove: clavicle & scapula
  20. Where's the suture line & flap in a BKA?
    Anterior skin flap is folded over posteriorly - suture line posterior
  21. Ace wrapping - AKA vs BKA - width of wrap & how
    • AKA - 6" wide; start by anchoring wrap over sup iliac crest, circle torso 2x, then go down to stump
    • BKA - 4" wide; 20 ft long; go from condyles down, using figure 8s
  22. Transtibial amputation lengths - 3
    • Long - 50% of tibial
    • Standard - 20-50%
    • Short - 20% of the tibia
  23. If sitting in a WC what should BKA pts have?
    A board to elevate calf & put knee into extension
  24. Amb goal for B/L transtibial amputees
    1/3 mile (in stairs & w/aids; older or more stable amputation becomes "good" leg)
  25. AKA - where is suture line?
    Posterior flap (skin/quad heads) and wrap it anteriorly - suture line anterior
  26. AKAs are most susceptible to which contracture? why?
    • ABD
    • Attachment sites for ADD are gone
  27. Transfemoral amputation femoral length - 3
    • Long - 60% of femoral length
    • Ideal - 35%-60% of femoral length
    • Short - 35% of femoral length
  28. Amb goal for TF/TF amputees
    100-200 ft
  29. Image UploadWhat is it? What does it do? (3) Allows for what motions? (2) Used by who? (2) Not used when?
    • SACH - Solid ankle cushioned heel (Non­ articulated foot) 
    • Energy-absorbing cushion heel - permits PF in early stance
    • Internal wooden keel that limits PF - eccentric control of DF
    • Replaces a PF bumper to simulate eccentric contraction of DF in early stance

    • Allows for:
    • Sagittal plane motion (primarily PF)
    • Very limited frontal plane motion (mediolateral motion)

    • Used by:
    • Limited ambulators
    • Syme's amputees

    Not used over uneven terrain for long-distance ambulation, or if energy conservation is needed
  30. Cushion heel in non-articulating feet permits what?
    PF in early stance & allows for a small amount of mediolateral & transverse motion
  31. SAFE foot - 4
    • Version of SACH
    • Walking on moderately uneven terrain
    • Mediolateral motion in rear-foot
    • Prescribed for more active individuals
  32. Image UploadWhat is it? What does it do?
    • Seattle foot
    • Slightly flexible plastic keel bends at heel contact
    • Stores energy & recoils in late stance releasing energy
    • Heavier than SACH
  33. Image UploadName type of socket
    Patella tendon bearing socket
  34. P sensitive areas in PTB socket are where? - 4
    • Anterior tibia + tibial crest
    • Fibular head & neck
    • Peroneal (fibular) nerve
    • Image Upload
  35. P tolerant areas in PTB socket - 4
    • Patellar tendon
    • Medial tibial plateau (flare)
    • AT mm belly
    • Distal end of tibia
    • Image Upload
  36. Image UploadName suspension; Used by who?
    • Supracondylar wall suspension
    • BKA
  37. Image UploadName suspension; Used by who
    • Supracondylar/suprapatellar suspension
    • Short residual limbs
  38. Friction mechanism is usually prescribed for who?
    Older individuals who do not vary their gait speeds greatly
  39. Hydraulic/pneumatic knee units are prescribed for who?
    Younger, more active individuals
  40. Prosthetic alignment: how?
    • Knee center: posterior to TKA line
    • Knee aligned farther posterior will be very stable (will not flex easily)
    • May be prescribed for short residual limbs
  41. Image UploadImage UploadName; Used by who?
    • Quadrilateral socket
    • AKA - long
    • Medial & posterior wall - same height 
    • Anterior & lateral walls - 2.5-3 inches higher
    • Has posterior shelf for ischial tuberosity & gluteals
  42. Quadrilateral socket reliefs - 4
    • Adductor tendons
    • Rectus femoris
    • Gluteus maximus
    • Hamstring tendons
    • Image Upload
  43. P sensitive areas AKA residual limb - 3
    • Distolateral end of femur
    • Pubic symphysis
    • Perineal area
  44. P tolerant areas of AKA residual limb - 4
    • Ischial tuberosity
    • Gluteals
    • Lateral sides of residual limb
    • Distal end (rarely, may be sensitive)
  45. TSB (total surface bearing) socket for BKA
    • Less prominent patellar shelf than seen in PTB
    • Tries to distribute P more to other areas, taking P off tendon
  46. Image UploadName; Used by who?
    • Supracondylar cuff
    • Suspension for BKA prosthetics
    • Soft leather bolted to med + lat sockets, goes up & circles fem condyles
    • Pt who needs added suspension
  47. Image UploadName; Used by who?
    • Silesian bandage
    • A strap that anchors prosthesis by reaching around pelvis
    • Controls for rotation
  48. Image UploadName; Used by who?
    • Thigh corset - Suspension for BKA prosthetics
    • Provides larger area for WB
    • Individuals w/sensitive skin & unstable knee jt
  49. Supracondylar wall w/over knee sleeve - 4
    • Suspension for BKA prosthetics
    • Like a segment of a stocking to add suspension
    • Sleeve is neoprene
    • Good for vascular pts
  50. Image UploadExtension aids - external vs internal
    • External - Anterior - stretches in flexion so it can assist in extension
    • Internal - Posterior - compresses in flexion to assist in ext
  51. Scarpa's bulge - 2
    • Like popliteal bulge for BKA
    • Pushes into Scarpa's triangle to help keep IT on IT shelf
  52. Image UploadImage UploadName; Used by who?
    • Ischial containment socket
    • AKA - short
    • Unlike quad socket, which has an IT shelf making IT carry most of load, this one tries to make a more symmetrical distribution of wt
    • Looks rounder than rectangular quad
  53. Who shouldn't use ischial containment socket?
    Vascular & renal pts w/stump size changing
  54. P in a BKA if foot is lateral leads to what kind of rotation?
    • Prox & lat (at knee)
    • Distal & med (at stump)
  55. P in a BKA if foot is too medial
    • Prox & med (at knee)
    • Distal & lat (at stump)
  56. Foot alignment - BKA vs AKA; When would you want it less offset from center for BKA?
    • BKA - post/medial - for knee flexion & varus
    • AKA - W/center of socket
    • Shorter resid limb; More wt intolerant pt
  57. AKA socket - tilt how? why? (2); w/flexion contracture tilt how?
    • Posterior 5 deg 
    • Makes P on IT more tolerant
    • Helps w/post movement of limb in later stances
    • Flexion contracture - tilt more posteriorly
  58. BKA socket - tilt how? Why? (1); w/hip flexion contracture tilt how?
    • Anterior 5 deg
    • Helps promote knee flexion during early stance
    • Hip flexion contracture - tilt it more ant
  59. AKA - knee alignment; why?
    • A bit post to plum line (trochanteric-ankle line)
    • To build in extension stability (reduce impulse to buckle)
  60. Acceptable leg length differences btwn norm & prosthetic, BKA and AKA
    • BKA - no more than 1/4 inch
    • AKA - 1/2 inch, a bit more if it's a locked knee
  61. BKA socket is too far ant tilted - what gait dev?
    Rapid & excessive knee flexion in early stance
  62. Desired shape for end of resid UE limb?
    Oval, not circle
  63. Myodesis vs Myoplasty
    • Myodesis = Attaching tendon to bone
    • Myoplasty = Attaching mm to soft tissue
  64. Amputation - resistive exercises done when?
    • When sutures are removed
    • If not dissolving type, stay in 10-20 days
  65. Can you soak a residual limb?
    No - it can lead to maceration
  66. One technique for addressing a hip flexion contracture
    Lay prone
  67. PF bumper - where? limits what?
    • Post
    • PF
    • It acts as eccentrically lengthening of DFs
  68. AKA - terminal swing impact - d/t what? - 1
    Insufficient knee friction
  69. Transfemoral (AKA) – which sockets – 2
    • Ischial containment
    • Quadrilateral
  70. Socks - how many ply?
    Not to exceed 15 ply

Card Set Information

Author:
Tanuisha
ID:
323252
Filename:
Non-Systems_Prosthetics
Updated:
2017-01-12 22:16:11
Tags:
Prosthetics
Folders:
Non-Systems
Description:
Prosthetics
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