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116 Cards in this Set
- Front
- Back
what are the three type of prosthetic components
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1) body powered
2) external powered 3) passive |
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how does a body powered prosthetic work
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body power and excursion operate and control the terminal device
- own use of muscles is only thing working prosthetic |
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how does external powered work
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need battery to run but can be driven by internal commands
- EMG of remaining residual limb |
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what is the purpose of the poassive prosthetic
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cosmetic only
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EMG powered control of an UE prosthetic is what type of power
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external power
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which type of power means NO MOTORS
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body powered
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what are the two types of terminal hooks
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1) voluntary opening
2) voluntary closing |
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what is the difference between a voluntary opening and a voluntary closing hook
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voluntary opening = rubberbands determine pinch force and you work to open it.... voluntary closing = usually open, your force determines how tight it pinches
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most prehensors are voluntary _____ providing what functional purpose
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voluntary closing, providing trension feedback that can be used to control grip
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what are the two types of power for a prehensor
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battery powered and myoelectric
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Most hands are for _____ rather than _____
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cosmesis rather than function
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the hybrid is usually a choice becuase it ______ despite it being _______ compared to the hooks or prehensors
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hybrid loos more human, but less functional than hooks or prehensors
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hybrids are voluntary _____
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voluntary closing
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what is the biggest complaint about UE prosthesis
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lack of sensation
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what is the most common pattern for a hand
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3 jaw chuck prehension pattern
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what is very important for a below elbow prosthesis
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full elbow ROM important
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what will determine whether or not a person will have pronation/supination
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if >50% of forearm preserved they will have pronation/supination
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what are the components to a below elbow prosthesis
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- single control cable
- terminal device - triceps cuff (anchor) - wrist unit - suspension (figure 8) |
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how is a below elbow prosthesis operated
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humeral flexion and scapular abduction combine to open and close the hand
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what are the components of an above the elbow prosthesis
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- dual control system using elbow flexion and terminal device operation
- elbow locking cable - split cable housing |
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what makes up the dual control system for the above elbow prosthesis
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- elbow flexion
- termial device operation |
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what is the method for donning UE prosthesis
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"coat method"
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what is a lis france amputation
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amputation for the tarsometatarsal joints
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what is a Symes amputation
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amputation of the foot- maintaining the distal tib/fib
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what type of prosthesis would be used for a lisfranc amputee
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toe prosthesis with a spiral orthosis
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what type of prosthesis would be used for a symes amputee
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one that is open in the back by the calf in order to allow the bulbous end to pass through... the suspension is then paced over the calf cover on the prosthetic and strapping it on
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what is SACH
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solid ankle cushion heel
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wha tare the components of a SACH
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- heel wedge
- wooden keel - toe belting - NO moving parts |
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what would a SACH be used for
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good shock absorption at heel strike (from heel wedge)
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What is a SAFE
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Stationary Attachment Flexible Endoskeleton
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what are the components of a SAFE
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- rigid bolt block
- flexible keel - plantarfascia bend - long plantar ligament band |
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what would a single axis be used for
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- good for more active people
- limited ankle PF and DF increases knee stability |
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what are the nonarticulated types of feet
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SACH
SAFE |
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what are the articulated types of feet
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single axis
multi-axis |
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what are the components of a single axis foot
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woden body, toe apron and sole, ankle bolt, plantar flexion bumper
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how does a single axis foot function
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- limited ankle plantar flexion and dorsiflexion increases knee stability when the person walks
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what does a bumper do
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for an articulating foot
- controls amount of DF/PF |
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why would a patient get a multi axis foot? why not?
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- because would give them more control
- not= has parts that can break down |
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what would be the most likely foot to be used post op for a temporary prosthesis
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SACH
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what is a flex foot-chetah
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- looks like metal "L"
- carbon fiber in feet that loads and absorbs all the energy |
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what would be an energy storing foot
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- seattle foot
- college park foot |
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what is a seattle foot
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- nonarticulating
- keel: C shaped, meant to DF - belting: control relative toe extension |
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what is a college park foot
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- dynamic response keel combines with a multiaxial ankle
- DF and PF bumpers |
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what is a socket
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attaches residual limb to prosthesis (custom made)
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what is the function of a liner on a residual limb
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- reduces friction between skin and socket
- may provide some padding |
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what is the function of a sock
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- fills space in the socket
- padding - moisture absorption - accomodate changes in limb volume |
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what is Ply
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the thickness of the sock
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what does the # for ply indicate about the socket
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if >15 its time for a new socket
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what is the function of a sheath
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thin sock coated with silicone meant to reduce friction/chaffing
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what are the KEY components to a PTB socket
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PTB= patellar tendon bearing
1) relief for hamstrings post. 2) medial tibial flare 3) patellar bar 4) relief area for femoral head |
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what is the purpose of the patellar bar
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providesa place that when you apply force to bear weight, patellar tendon will be loaded
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what is important about the posterior aspect of a PTB socket
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cleared away, flared out for hamstrings to allow the person to sit down
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what is a PTB-SC
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patellar tendon bearing- supracondylar
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what are the characteristics of a PTB- SC
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- higher medially and laterally
- cut away for hamstrings still present - indentation above femoral condyles for attaching the prosthesis to residual limb |
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what is PTB-SC-SP
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patellar tendon bearing - supracondylar- suprapatellar
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what are the characteristics of a PTB-SC-SP
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- enclosed patella
- patellar indentation - quad indentation - femoral condylar indentations |
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why would a pt. opt for a PTB-SC-SP
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- allows the patient to sit and keep the prosthesis attached well enough for normal activities (but sitting is harder)
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who is a PTB-SC-SP appropriate for
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short tibial residual limbs
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what is a supracondylar cuff
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a strap anchored to the supracondylar socket that then attaches to a waist belt to help keep attached
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where is a supracondylar cuff most commonly seen
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someone's temporary prosthesis
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what must someone have in order to use an elastic sleeve
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need UE dexterity and strength
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what is the biggest problem with an elastic sleeve
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heat and sweat
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whats the benefit to a gel and pin suspension
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dens in the front, less in the back to allow the person to sit more comfortably
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what is hte "3-s"
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silicone sleeve suspension (Gel and Pin)
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what is osseointegration
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attaching a screw to the bone and then attaching prosthesis to harware
- PURELY RESEARCH BASED STILL |
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what are the concerns with osseointegration
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- surgicical
- chance of rejection/infection - beating up bone |
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what are the benefits to osseointegration
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- pernament prosthesis
- doesnt rely on skin for adherence |
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what are the options for a shank
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shank = covering
endoskeleton vs. exoskeleton |
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what are the benefits to an endoskeleton
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- lighter weight
- can make shock absorbing - adjustable |
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what are the benefits to an exoskeleton
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- shape and strength of prosthesis from outer shell
- 1st time prescription |
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what is the shank chosen for most prosthesis
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endoskeleton
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what does a knee disarticulation prosthesis look like
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- socket: removable window or elastic to allow femoral condyles through
- 4 bar knee joint with multiple pivots and bars |
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what is common for the foot/ankle for a AKA
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at least a single axix foot
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what type of suspension can be used for a AKA
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- pelvic band
- pelvic straps/belts - suction |
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what are the benefits of using suction for the suspension
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- allows excellent contact with socket
- spreads force to all tissue of the area |
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what are the two types of sockets for AKA (which more common)
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quad or ischial containment
ischial = more common |
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what are the characteristics of a quad socket for AKA
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- shaped like a square
- indentation/bulge anteriorly - high lateral wall - ischial tub shelf - posterior relief for sciatic n. - short medial wall |
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what is Scarpa's bulge
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indentation/anterior bulge in a quad suspension that helps with suspension and allows weight bearing
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what is the purpose of the high anterior wall away from scarpas bulge
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prevents slippage and applies posterior directed force to hold things on
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what is the purpose of the high lateral wall in a quad socket
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exerts medially directed force
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what is the purpose of the shelf on a quad
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for ischial tuberosity, weight bearing when sitting
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what is the posterior relief in a quad for
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for sciatic nerve
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what are the characteristics of the ischial containment that are DIFFERENT from a quad
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- high laterally capturing almost all of the G. trochanter
- larger A-P - cups ischial tube (quad just has a shelf whereas this one holds the ischial tub gently) |
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what is the difference between a Silesian and a TES
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both are pelvic straps but
- Silesian doesnt stretch (rigid plastic) - TES is neoprene, spandex with silicone |
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what is a sabolich
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it a socket for a AKA with a flexible socket and a rigid frame
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what are the two types of Swing control in knees for AKA prosthetics
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1) constant friction knee
2) fluid controlled knee |
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what is a constant friction knee
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- has constant resistance to extension (adjustable)
- cannot reach full extension because too much friction - must be adjusted based on gait speed |
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using a constant friction knee.... the setting slow is for ______ whereas fast is for ______
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- slow is for more free swinging
- fast is for a stiffer swing |
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what is a fluid controlled knee
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acts more like a eccentric hamstrings allowing the knee to extend just until those last few degrees
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what are the two types of stance control in knees for AKA prosthetics
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- manual lock
- friction brake |
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why would a manual lock be appropriate for a knee in an AKA prosthetic
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- for residual limb weakness
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what is a friction brake
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locks into position when weight added on to it
--> if in 25 degrees of flexion or less and put weight on it, it will lock until take weight off |
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what is the problem with a friction brake
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walking slow and don't impart enough momentum onto shank, it doesnt straighten out enough (25 deg) and wont lock --> falls
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what is the necessary angle of knee flexion for a friction brake to lock
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25 degrees flexion or less
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what is important in order for someone to be appropriate for a friction knee
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must have enough residual limb strength to impart enough momentum to straighten out the shank
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what components can be adjusted on a friction knee
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1) friction of the knee joint- to allow it to swing enough to be straight when going to WB
2) position in which the limb locks |
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how does a polycentric 4-bar knee work
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- doesn't lock, but as you WB the AoR shifts around depending on the point of WB
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what is the purpose of a polycentric 4-bar knee
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acts to keep GRF anterior to knee joint so that it will remain in extension
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when is the only time that the GRF is posterior to the knee with a polycentric 4-bar knee
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when you get to toe break (relative to MTP extension)
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who is the polycentric 4-bar knee appropriate for
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someone with little or no UE control
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how do you adjust the amount of friction with a 4-bar knee
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self-adjustable... faster walking increases amount of friction
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what is a C-leg
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computerized knee-shin system for transfemoral amputees
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what is the purpose of a C-leg
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- allow variable cadence, "riding" the leg down stairs, with stumbles, adjusts to uneven terrain
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how is a C-leg controlled
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- hydralically
- faster = stiffer, slower= freer |
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what is a requirement of the foot for a C-leg
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need at least a single axis foot
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what are the shock absorbing shanks
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- soft step shock absorbing pylon
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how do the shock absorbing shanks work
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absorb shock by the bumber moving about 1/2 inch or so (able to adjust stiffness)
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what type of foot would be with a soft step shock absorbing pylon
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SACH (solid ankle cushioned heel)
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what are the characteristics of a hip disarticulation prosthesis
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- socket: around entire waist (like pair of pants)
- knee and foot: need additional articulation because the hip joint far anterior |
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where is GRF in a hip disarticulation prosthesis
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- posterior to hip joint (maintaining extension)
- anterior to knee joint |
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what is a "stubbie"
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shortened prostheses for bilateral AKas
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what are the characteristics of a stubbie
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- regular socket
- no knee or shank - modified rocker bottoms |
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what is the purpose of a stubbie
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- lowers CoG and no articulations so easy to use
- allows erect balance and relatively quick ambulation with only modified levels of energy expenditure |
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why are the rocker bottoms of a stubbie turned backward
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to keep from calling backword
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what is considered a good candidate for a BK prosthetic
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1) no contractures
2) good scar mobility 3) well shaped residual limb 4) pre-ambulatory |
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what are the contraindications to a prosthetic
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1) severe dementia
2) severe depression 3) advanced cardiopulmonary disease 4) bilateral amputee who is unable to transfer independently and put on underwear independently (because can't weight shift) |