Prosthetics

Front 1

Name the levels of amputation

Back 1

- Transpelvic/Hemipelvectomy
- Hip Disarticulation
- Transfemoral
- Knee Disarticulation
- Transtibial
- Symes
- Partial foot/ray resection
- Transmetatarsal
- Partial Toe

Front 2

What the the percentages of femur remaining in a TFA? (Short, standard, long)

Back 2

- Short <35%
- Standard 35-60%
- Long >60%

Front 3

What the the percentages of femur remaining in a TTA? (Short, standard, long)

Back 3

- Short < 20%
- Standard 20-50%
- Long >50%

Front 4

__________ closure of outer fascial envelope of muscle provides that provides minimal muscle stabilization.

Back 4

Myofascial

Front 5

Classification of when muscle is attach to periosteum of bone.

Back 5

Myodesis

Front 6

Classification of when muscle is sewn to opposing muscle.

Back 6

Myoplasty

Front 7

What two muscles do you want to see during myodesis of a TFA?

Back 7

Quadriceps and Adductor Magnus to the distal femur

Front 8

In a TFA, we typically see myoplasty of _________ to quad and adductor magnus.

Back 8

hamstrings

Front 9

What are some potential complications after amputation?

Back 9

- skin breakdown & pressure ulcers
- nonhealing surgical incisions
- infection and gangrene
- falls
- DVT and PE
- Contractures
- Deconditioning

Front 10

What are the 4 general areas of prosthetic components?

Back 10

- socket
- hip/knee joint
- pylon
- foot/ankle assembly

Front 11

What are five areas to assess when choosing componetry?

Back 11

- anticipated functional status
- cognitive function
- status of residual limb (shape; skin condition; volume)
- UE involvement
- Comorbidities

Front 12

Who determines the K levels?

Back 12

physician/prosthetist

Front 13

K-___ No ability to ambulate/transfer w/ prosthesis, prosthesis does not improve quality of life.

Back 13

K 0

Front 14

K-___ ability/potential to use prosthesis for transfers, ambulating on level surfaces at a fixed cadence; typical of household ambulator

Back 14

K 1

Front 15

K-___ ability/potential for ambulation w/ ability to negotiate low-level environmental barriers usually w/ a fixed cadence; limited community ambulator

Back 15

K 2

Front 16

K-___ ability/potential for ambulation w/ variable cadence; has vocational, therapeutic, or exercise activity beyond simple locomotion

Back 16

K 3 (community + recreational)

Front 17

K-___ ability/potential for ambulation that exceeds basic ambulation skills, exhibits high impact, stress, energy levels; typical demands of child, active adult, or athlete.

Back 17

K 4 (high impact)

Front 18

What two types of systems could include a TTA prosthesis?

Back 18

Exoskeletal or Endoskeletal system

Front 19

T/F: Most insurances will pay for a prep socket prior to a definitive socket.

Back 19

False

Front 20

T/F: A definitive prosthesis is heavier and intended for only short periods of time.

Back 20

False (lightweight

Front 21

T/F: a Test/prep socket cannot withstand high impact activity.

Back 21

True

Front 22

What are the two types of TTA socket designs?

Back 22

- Patellar Tendon Bearing
- Total Surface Bearing

Front 23

What 4 regions of soft tissue are loaded to control socket force in a PTB socket?

Back 23

- Patellar tendon
- Popliteal fossa
- Medial tibial flare
- Interossius

Front 24

What areas of bony prominence have relief in a PTB socket?

Back 24

- Fibular head
- Tibial crest
- Distal tibia and fibula

Front 25

T/F: a Total surface bearing socket has WB uniformally on the entire limb.

Back 25

True

Front 26

What is usually the suspension for a TSB socket?

Back 26

roll on gel liner

Front 27

What are the 4 types of Patellar Tendon Bearing Socket Suspension?

Back 27

- Sleeve suspension w/ pelite liner
- PTB w/ supracondylar
- PTB w/ supracondylar suprapatellar
- PTB w/ joint and corset

Front 28

What are the advantages and disadvantages of a PTB w/ Supracondylar Suprapatellar (SCSP)?

Back 28

ADVANTAGES - good for very short limbs, provides coronal and sagittal plane stability, works for pts who want less straps &/or belts

DISADVANTAGES: enclosed patella can restrict some ROM; difficult suspension on obese or very muscular thighs

Front 29

What are the a advantages and disadvantages of a PTB w/ joint and corset?

Back 29

ADVANTAGES: provides knee stability and can be used for very short residual limbs, corset provides increased WB surface and unloading of the residual limb, knee jt instability , pt preference

DISADVANTAGES: heavy, poor cosmesis, inherent pistoning, difficult to fabricate

Front 30

What are the 3 types of Total Surface Bearing Socket Suspension?

Back 30

- Gel liner w/ pin or lanyard
- Gel line and sleeve
- Seal in liner (Vaccuum assisted)

Front 31

T/F: PTB design is difficult to don.

Back 31

False (easy)

Front 32

Why are extremely active patients contraindicated for PTB sockets?

Back 32

pistoning can occur

Front 33

T/F: TSB sockets involve an easy donning/doffing of liner and difficult donning/doffing of socket.

Back 33

False (difficult liner and easy socket)

Front 34

T/F: TSB sockets have excellent resistance to shear forces but require diligent management at home.

Back 34

True

Front 35

A patient is experiencing daily fluctuations in residual limb volume, what type of TSB socket would be best based on indications/contraindications?

Back 35

gel liner with pin

Front 36

What is one advantage of vaccuum assisted seal in liner vs a line and sleeve?

Back 36

wicks away moisture

Front 37

What TSB suspension involves restriction at the back of the knee specifically?

Back 37

liner and sleeve

Front 38

What type of TSB suspension must a patient be a K3 ambulator to qualify?

Back 38

Vaccuum assisted

Front 39

What are the following Transtibial bench alignments?
- Midpoint of sock ____ mm anterior to ankle bolt
- Foot inset ___ mm medial to midline of the socket

Back 39

- 37
- 12

Front 40

T/F: a symes socket comes 2 inches above the ankle.

Back 40

False (up to below the knee)

Front 41

T/F: a Symes socket can have a posterior or medial opening.

Back 41

True

Front 42

What are three materials that a partial foot prosthesis can be made from?

Back 42

- foam rubber
- silicone
- thermoplastic shoe

Front 43

What are the two types of Transfemoral sockets?

Back 43

- Quadrilateral
- Ischial containment

Front 44

What walls are wider and what walls are narrow in the Quadrilateral socket for a TFA?

Back 44

M-L Wider
A-P Narrow

Front 45

T/F: The Quadrilateral socket involves some pelvic support.

Back 45

False (none)

Front 46

The Quadrilateral socket involves vertical loading of _________ and ___________.

Back 46

ischial tuberosity
gluteal musculature

Front 47

What shape is an ischial containment socket?

Back 47

Triangular

Front 48

What position is the femur held in for an ischial containment socket?

Back 48

adduction

Front 49

T/F: The ischial containment socket contains the ischium and varying amount of the bony lock on the ramus.

Back 49

True

Front 50

T/F: an ischial containment socket typically has a rigid liner and a flexible frame.

Back 50

False (flexible liner and rigid frame)

Front 51

What is verruccous Hyperplasia and how can it occur?

Back 51

formation of thick uneven skin at distal residual limb that looks like a wart. It can occur from negative pressure distally.

Front 52

T/F: A pull in suction socket has an interface that is smaller than the limb.

Back 52

True

Front 53

What provides the suction in the socket for a pull in suction on a TFA?

Back 53

One way expulsion valve

Front 54

How does a patient pull the leg into the socket?

Back 54

with sock or donning sleeve in small increments

Front 55

How does a patient put on TFA suction with seal in liner?

Back 55

donned the same as TTA.
Ensure seal is pushed up toward proximal thigh.
Patient sprays inside of liner with 50/50 alcohol/water mixture and slides into socket. Then screws in valve.

Front 56

A TFA patient with volume fluctuations of the limb would benefit from which type of socket suspension?

Back 56

Partial suction w/ sock fit

Front 57

What are the 3 types of suspension for a TFA socket suspension?

Back 57

- Suction
- Partial suction w/ sock fit
- liner w/ pin-lock/lanyard

Front 58

What is the advantage of a lanyard over a pin lock liner?

Back 58

Lanyard can assist w/ minimizing socket rotation and a pin lock does not help with rotational control

Front 59

Transfemoral bench alignment
_____ line
Socket typically flexed ___ degrees and adductor __ - __ degrees.

Back 59

TKA Line
5 deg.
5-7 deg.

Front 60

What is important for both hip disarticulation and transpelvic prosthesis to have?

Back 60

pressure on both sides of the pelvis for stability

Front 61

Where is the hip joint placed in a hip disarticulation prosthesis? Why?

Back 61

anterior
easier for sitting/stability

Front 62

How are the joints kept stable in a hip disarticulation/transpelvic prosthesis?

Back 62

WB line passes behind the hip joint and in front of the knee joint during parts of the gait cycle when weight is actually being borne on the prosthesis. Prevent collapsing

Front 63

Most prosthetic hips are ______ pivot joint w/ _______ assist.

Back 63

single
extension

Front 64

T/F: Swing and stance are controlled by spring-hydraulic in prosthetic hip.

Back 64

True

Front 65

3 dimensional movement of hip is produced to compensate for what?

Back 65

pelvic rotation

Front 66

What are the two types of mechanical knees?

Back 66

Single axis and polycentric

Front 67

This knee uses sliding friction to prevent leg from swinging forward too fast. It allows for 1 optimal walking speed. Common in children.

Back 67

Single axis knee

Front 68

What are the advantages and disadvantages for a single axis knee?

Back 68

Advantages - lower cost, most durable, lightest

Disadvantages - only safe if there is muscular control/power to make it work.

Front 69

What does manual lock mean?

Back 69

ambulate w/ locked knee, no flexion during swing

Front 70

T/F: With a single axis knee, the user must unweight the knee in order for it to bend.

Back 70

True

Front 71

What is unique about a polycentric knee?

Back 71

Multiple axis of rotation so it can be set for varying stability at different phases of stance.

Front 72

Can the polycentric knee have variable walking speeds?

Back 72

If pneumatic or hydraulic swing control is incorporated.

Front 73

What are the advantages of a Microprocessor knee?

Back 73

- reduced likelihood of falls
- increased sense of stability for more active lifestyle
- Able to descend stairs/ramps w/ reciprocal pattern
- Decreased sound LE strain during sit to stand

Front 74

What are the disadvantages of a Microprocessor knee?

Back 74

Costly
Battery must be charged

Front 75

What K level must a patient be to qualify for a Microprocessor knee?

Back 75

K 3

Front 76

Which Microprocessor involves loading of the Toe?

Back 76

Otto Bock - C leg & Compact

Front 77

Which Microprocessors allow for early stance flexion?

Back 77

ALL

Front 78

Which Microprocessor knee involves Magnetorheologic fluid control (more loading = more resistance)

Back 78

Ossur - Rheo

Front 79

_______ knee involves stance phase control being permanently active unless the user appropriately times/loads the prosthesis to switch it into swing phase.

Back 79

C leg and Compact

Front 80

_______ knee involves off loading to sound side decreasing resistance so pt. doesn't have to load toe.

Back 80

Rheo

Front 81

Which knee allows for step over step stair ascent has 5 modes of programming and inductive charging?

Back 81

Ottobock - Genium

Front 82

Match the K level w/ the type of knee.

Basic single axis
Basic, weight activated stance control
Hydraulic, Pneumatic, Microprocessor
ANY

Back 82

1
2
3
4

Front 83

Which knee is all motor controlled and not driven by hip at all and was primarly designed for active unilateral TFA?

Back 83

Power

Front 84

Which knee can power through obstacles and kick it out of the way?

Back 84

Power

Front 85

What is a trip recovery and which knee is it associated with?

Back 85

knee will prevent flex or power into ext (Power)

Front 86

What is a slip recovery and which knee is it associated with?

Back 86

knee will remain locked thru stance (Power)

Front 87

What are the main categories of prosthetic feet?

Back 87

- Sach- (solid ankle cushioned heel)
- Single Axis
- Flexible keel
- Multi - Axis
- Dynamic Response
- Power

Front 88

Which two prosthetic feet are for household ambulators?

Back 88

SIngle axis and flexible

Front 89

A single axis foot promotes knee stability by allowing ______ but does not allow __________ or __________.

Back 89

DF
Inversion
Eversion

Front 90

The flexible heel is lightweight and allows for what?

Back 90

shock absorption

Front 91

T/F: a multi axis foot conforms to uneven ground and allows for DF/PF and INV/EV allowing for walking on uneven ground.

Back 91

True

Front 92

This type of foot stores and releases energy during gait cycle to allow for energy return.

Back 92

Dynamic response

Front 93

What level of ambulator is appropriate for a Power foot (ossur proprio foot)?

Back 93

K3

Front 94

T/F: The Power foot uses motor power to repace DF/PF and has a split toe plate to allow INV/EV.

Back 94

True

Front 95

This type of foot provides 5 degrees of DF during swing on level ground, ramps, and stairs.

Back 95

Power

Front 96

This foot has powered PF and has dynamic programming to respond based on speed/impact?

Back 96

Powerfoot BiOM.