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138 Cards in this Set
- Front
- Back
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Name the 6 prehensile patterns
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Cylindical grasp, tip, hook or snap, palmar, spherical grasp, lateral
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Name the sizes of the TD for the Hosmer Numerical System
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12 (infant)
10 (small child) 8 (medium adult) 5 (adult) |
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What are the numerical "exceptions" for the Hosmer TD Numerical System
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99 (samll child)
555 (adult size- lyre shaped) 3, 6, 7, 7LO (work hooks) |
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What does "A" denote for TD hooks?
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Aluminum-
Best for high level upper-extremity amputees |
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What does "SS" denote for TD hooks?
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Stainless steel-
2x the wt of "A" Best for longer transradial amputees |
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What is plastisol?
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Caucasian rubber material used to coat the fingers of the hook. Increase coeficient of friction.
Mostly for children |
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What does "P" denote for TD hooks?
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Plastisol
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What is "PN"
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Plastisol (negroid)
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What does "W" denote for a TD?
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Wafer shaped
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Decribe a wafer shaped TD
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Fingers of the hook are flatter and broader.
Available only for infants. Usually covered in plastisol |
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What does "X" denote for a TD?
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AKA Nytryl
Rubber attached to the gripping surfaces of the hook fingers. Increases the coeficient of friction for grasping Won't withstand heat or caustic materials |
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Name the 2 TD finger shapes
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1) Canted
2) Lyre |
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Describe a canted finger
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offset, allowing better sight line to object or working surface
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Describe 3 things about a figure of 9 harness
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1) self suspending design
2) Doesn't have suspension strap 3) Used on socket with anatomical suspension |
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Name 2 indicaitons for flexible hinges.
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Longer TR and wrist disarticulation
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Name an indicaiton for rigid hinges
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Shorter TR limbs where supination/pronation ROM loss is ok
Heavy duty user To protect the elbow from hyperextension |
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How much travel of the cable is needed to open a TD?
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2"
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Name the 2 motions that operate a TD
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Glenohumeral flexion and biscapular flexion
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Describe the motions used with TH and elbow disartic in order to lock and unlock the elbow
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glenohumeral extension and abduction, and shoulder depression
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What movemnet locks and unlocks the elbow on a TH design?
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shoulder ext, abduction, and depression
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What movemnet locks and unlocks the elbow?
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shoulder ext, abduction, and depression
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What is the main control motion used for operation for a SD
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biscapular abduction
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TR and TH used what motion to perform midline activities
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biscapular abduction
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Why do you need excursion amplifiers for TH?
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2" of excursion needed to operate terminal device. 2 1/2" of excursion needed for elbow flexion= 4 1/2" total
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Fxn of inverted "Y" strap?
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Suspension mechanism
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Y strap: Distal and proximal Attachemnets?
Location? Purpose? |
1)Triceps cuff and anterior suspension strap.
2) 1" inf to clavicle. 3) Extension of anterior suspension strap. Location allows for ease of donning and anterior enough so it doesn't fall off the shoulder. |
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Anterior suspension strap location?
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Comes posteriorly over the shoulder, thru deltopectoral groove and attaches to inverted Y strap
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Purpose of anterior suspension strap
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Main suspensor against axial load
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Location of axilla loop?
Purpose? |
Contralateral axilla to cross point at proximal and distal attachment.
Anchor point of prosthesis |
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Control attachemnet strap (CAS)location?
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Cross point to lower 1/3 of scapula. Terminates at the hanger
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Cross point position?
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Toward sound side and inf to spinous process of C7
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Name 6 pressures that are put on a RL
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1) Length of RL
2) Componentry 3) length of prosthesis 4) Fit of socket 5) Wt of object 6) Suspension |
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Operating force required to open a voluntary opening TD is?
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2 1/2 x the pinch force
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Operating force required for voluntary closing is based on what?
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Users needs
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what is a moment?
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Force x distance
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What does "single control system" mean?
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one cable in the system
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Describe the path of control cable in a TR px
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Passes thru SS housing/tunnel located on triceps by the cross bar assembly. Passes closed to elbow, attached to forearm by base plate and retainer. Terminates distal to forearm.
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Where is the cross bar assembly located?
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Triceps pad of TR px
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What is the fxn of the housing/tunnel?
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to prevent the control cable from "bridging" between the cross bar assembly and forearm retainer when force is applied to open the TD- basically maintains a fixed length of the two ends of the CC regardless of EF/EE
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What are the 2 fxns of the TR harness?
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1) Provide operation of TD
2) Retain the px on the stump in differnet operating systems |
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Describe the axilla loop (location and fxn)
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1" dacron webbing. Passes under the axilla on sound side. Provides ANCHOR for entire system
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Describe anterior support strap (location and fxn)
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Originates the the CP-over the shoulder- thru deltopector groove and fastens to inverted "Y"
Fxn- provide stabiltiy against a downward pull |
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Describe the control attachment strap (CAS)
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Originates at cross point passes below mid-scapular level- to metal hanger on upper end of Control Cable and looped back thru a buckle for adjustability
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What is the best location of the CP?
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Below the spinous process of the C7 and slightly toward the non amputed side
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list 2 indications for TR single pivot hinges
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Short/medium residual limb (50%) and heavy duty use
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list 2 contraindiations for TR single pivot hinges
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pronation/ supination needed
and b/l amputee |
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What positon should the residual limb be in when casting for TR? What design is the contradiction?
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Elbow flexed to 80-90 and neutral pronation/supination.
Northwestern- elbow at 45 degrees |
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What is the Carlyle formula?
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body wt x .21= LE to TT
body wt x .19= AC to LE |
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What sound side msr do you need for a single pivot hinge?
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Apex of lat. epicondlye- thumb tip
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What sound side msr do you need for flexible hinges?
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Olecranon to thumb tip
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How do you determine length of the limb?
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Carlyle formula, functional length, or old prosthesis length
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Describe the shape of canted fingers on a TD
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Offset allowing better sight lines to objects
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Describe Lyre fingers on a TD
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Straight approach allowing easier grasp of flat objects. Larger opening with cylindrical shape
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Name this part
Where is it located? What is its function? |
cross bar assembly.
Attaches to the triceps cuff Helps prevent bridgeing of the control cable |
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Where is the cross bar assembly attached?
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Posterior section triceps cuff
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Name this part
**pic of ball and terminal** |
Ball and terminal
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Name this part. What is its fxn?
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????
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Name this part
** small ball and terminal** |
Small ball and swivel
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3 indications for flexible hinges PX?
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Children, b/l involvment, when you want to capture supination/pronation
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What is the fxn of the cross hanger on a TR px? Where is it located?
NOt sure about this one- cross hanger?? may mean base plate retainer |
Keeps the cable from bridging the elbow.
About 0-50mm distal to trimline of px |
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What type of px is a triceps pad used on?
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Flexible hinges only
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What % of circumfernce do you use to fab Humeral cuff?
Triceps pad? |
75%
50% |
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How do you determine cable housing length?
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Supinate, full flex, and open TD fully
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HOw do you determine cable length?
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Pronated wrist and fully extended elbow
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What is ROM of elbow flexion? shoulder flexion/extension? supination/pronation?
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elbow- 0-145, shoulder flex 0-180, sh extension 0-45 ,pronation/supination 0-90
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what % of amputees are UE
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8-11%
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Why would you use a figure of 9 harness?
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Self suspending design
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How much movment is required to operate the TD?
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2"
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How much excursion is needed for elbow flex/ext?
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2 1/2"
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Name the 4 TR self suspending socket designs
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NYU-Muenster
NWU Otto Bock Liner with pin/lanyard |
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Name 4 advantages of a self-suspending design?
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1-Minimizing harnessing, 2-increase live lift compared to step-up hinges, 3- improved appearance, 4-intimate fit works with myoelectric
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Name 4 disadvantages of self - suspeding design?
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1) Pull sock may be required 2) limits ROM 3)Limb length requirement for certain designs 4) Light duty arm
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What are the compression points for a Muenster design?
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A/P compression at cubital fold and above olecranon in triceps tendon
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Why would you need to preflex or pre-extend a socket?
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In order to make the px more fxnal due to limited ROM
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Name indications for NYU-Muenster?
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11/2-5 1/2 " short to very short TR
Light to moderate duty users Unilateral All others plus want myoelectric |
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Name the contraindications for Muenster socket?
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Long limb with good sup/pronation
Heavy duty users Bilaterals |
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Describe your hand positioning when casting for a Muenster TR socket
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Straddle biceps tendon between the index and middle finger of right hand. With the left, press tripeps tendon insertion into olecranon and control spread of tissue with the thumb and pinky
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Residual limb length for a Muenster socket should be how long?
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1 1/2 - 5 1/2"
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How much total ROM should a pt with a Muenster socket have?
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70 degrees
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What should the ROM limits be for a muenster socket?
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35-110 degrees
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Describe the NU socket suspension
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Supracondylar suspension due to low anterior trimlines
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What limb length is required for the NU socket?
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Greater then 55%
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Why are bilaterals a candidate for NU socket?
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Allows for ROM and a sock isn't required for donning
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Name 3 indications for the NU TR socket design
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1) unilateral TR with long limb where self suspension is desired
2) Medium duty user 3) ++ want a myoelectric px |
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Name 3 contraindications for the NU TR socket
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1) long limb with good pronation and supination
2) heavy duty user 3) short or very short TR limb |
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What is the casting positon for the NU socket
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45 degrees of elbow flexion
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How is a Otto Bock socket suspended?
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A/P and M/L suspension
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How do you cast for the Otto Bock TR Socket?
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Splints used to get contact instead of finger press of the Muenster design
Pt moves thru ROM while casting- dynamic casting |
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What are the 3 advantages of the Otto Bock design?
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self suspending, cosmetic, more ROM compared to muenster
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What are 2 disadvantage of a Otto Bock design?
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Donning difficult esp for long or fleshy limbs
Requires pull sock donning |
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Name 2 indicaitons for the Otto Bock TR socket
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unilateral, TR with the limb not at the extremes of length
Medium duty user |
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Name 4 contraindications for the Otto Bock TR socket
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Long limb with good sup/pronation, very short or very long TR, heavy user, b/l amputee
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Name this type of TR multiple axial elbow hinge.
Describe it. What are the indications? |
Geared step up.
2:1 ratio of elbow flexion to Px forearm flexion. Split socket. Takes 2x the force to lift. B/L, Short TR with limited ROM |
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Name 6 ways to improve ROM for a very short TR
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1) Preflex the socket
2) Use multiple axis hinges -geared step up - sliding step up -SALH stump activated locking hinges 5) Polycentric hinges 6) Sauter Modification |
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What are the indications for geared step up and sliding step up hinges?
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B/L TR with limited ROM
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Describe how a SALH works
HOw many locking positions are there? |
REQUIRES a split housing fair lead instead of single bowden cable. EF/EE locks and unlocks the elbow. Glenohumeral flexion helps with forearm Px flexion.
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Describe how a split housing fair lead works?
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Used with geared and sliding step up hinges and is REQUIRED with a SALH by making it easier to flex the forearm of the Px. The cable needs to bridge the elbow which helps flex the forearm.
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What are the 4 options available that help to ease pressure on the axilla?
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Widen and pad the axilla,
Hessing loop, axilla bypass harness, Michigan roller harness |
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What is the axilla by-pass harness?
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Thermoplastic shoulder shell on sound side. Custom made over the shoulder
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What is the Michigan shoulder saddle and roller harness?
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Not figure of 8 harness it's a chest strap attached to shoulder saddle. Cable incorportaed into saddle
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Name this type of harness
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Michigan shoulder saddle and roller harness
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What are the indications for a outside locking hinge?
HOw many locking postions |
Long TH or elbow disartic.
7 locking positions |
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what's the difference between voluntary opening and voluntary closing terminal device?
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Vol opening- Pt uses body motion to open . Rubber bands close
Vol closing- Remains open until cable closes it. Graded prehension. Pinch force limited depending on user strength. |
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how much pinch force does one rubberband provide?
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1 lb
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describe the #5 adult hook
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stainless steel
canted fingers serrated surface |
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describe the #5X adult hook
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SS
neoprene lined canted fingers Most often used hook in USA |
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describe the #5XA adult hook
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Aluminum alloy
neoprene lined canted fingers |
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describe the #555 adult hook
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AA
neoprene lined lyre shaped fingers |
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describe the #555-SS adult hook
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SS
neoprene lined lyre shaped |
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describe #7 work hook
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SS
serrted surface pail hook nail and chisel holder |
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describe #7 LO work hook
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Large finger opening
Same features as #7 |
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describe #6 work hook
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backlock feature
#7 features |
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describe #3 work hook
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shorter #7
no chisel holder SS |
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name this hook
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sierra 2 load hook
2 pinch forces voluntary opening |
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name this hook
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APRL voluntary closing
lyre shaped fingers self locking feature |
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name this hook
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APRL
*VOLUNTARY CLOSING * lyre shaped fingers |
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describe the #8 medium adult hook
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smaller #5
SS |
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describe #99x small adult hook?
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adolescents
AA neoprene lined |
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describe the #99P small adult hook
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adolsescnet
plastisol coating AA |
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describe the 10X child hook
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children
AA neoprene lined |
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describe the #10P child hook
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plastisol coating
AA |
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describe the #12P infant hook
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plastisol coating
SS |
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name this hook
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voluntary closing
grip force 0-110lbs |
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name this device. describe
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children's TD
R or L Spring loaded |
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name this wrist unit.
who is it indicated for? what is the down side of it? How many positions does it have? |
Sierra wrist flexion unit
Good for b/l It adds weight and length O, 25, and 50 degree positions |
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Name is wrist unit
Who is it indicated for ? how many notches are there? |
WD quick change wrist
not indicated for b/l 36 notches at 10 degree intervals |
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Name this wrist unit
Friction? Describe it |
FM quick change wrist
No friction. Locked or unlocked Easy hook to hand change |
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Name this wrist unit
Who is it indicated for |
CAPP Delrin wrist
Pedi applications Friction collar |
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Name this wrist unit.
Indications? |
Oval constant friction wrist
Not for hands. Longer amputations. Long TR or wrist disartic. |
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Name this wrist unit.
Describe |
Constant Friction wrist
Friction thru range Adjustable friction |
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Name this wrist unit.
Materials it's made of? Describe |
Economy wrist
Al, SS, or Ti Friction range Laminated into the forearm |
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Name this wrist unit
Indicaitons? |
APRL child flexion unit
0 and 36 degree positions Children |
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Name this wrist unit
Indicaitons? How many positions? Describe |
Flexion- friction Wrist
0, 30, 50 degree positions only works in one plane Adjustable friction. Laminated into the forearm. Used when you have limited length to work with |
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name this wrist device
Name 5 positions |
Five fxn Texas Ass. Device
Pro/Sup/ Flex/Ext/Rotation |
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Name this wrist unit.
What type of joint? |
Universal wrist
Ball and socket joint Friction wring. Light duty |
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Name this wrist unit
Describe it |
Friction disconnect wrist
Constant friction Disconnect Friction positioning Rachet positioning Great combo |
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Name this wrist unit.
How many locking positions? Unilateral or bilaterals? |
Sierra Wrist Flexioin Unit
0, 25, and 50 degree positions Good for bilaterals |
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name all of the voluntary closing TD designs
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APRL, TSR, and CAPP
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