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55 Cards in this Set
- Front
- Back
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Effects gluteus medius during gait
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controls pelvic tilt-eccentric
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Effects gluteus maximus during gait
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Powers hip extension- concentric
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Effects ilipsoas during gait
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Powers hip flexion- concentric
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Effects hip adductors during gait
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Controls lateral sway- eccentric
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Effects hip abductors during gait
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controls pelvic tilt-eccentric
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Effects quadriceps during gait
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Stabilizes knee at heel-strike
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Effects hamstrings during gait
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controls rate of knee extension- eccentric
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Effects tibialis anterior during gait
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Dorsiflexes ankel at swing- concentric// slows plantar-flexion rate at heel strike- eccentric
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Effects gastrocnemius/soleus during gait
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Slows dorsiflexion rate- eccentric
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Effects gluteus medius weakness
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abductor lurch
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Effects gastrocnemius/soleus weakness
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Flatfoot (calcaneal) gait
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Effects quadriceps weakness
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back-knee gait
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Cause hip scissoring
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Overactive adductors
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Changes antalgic gait
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shorten stance phase on affected limb/ more rapid contralateral swing phase
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Effects of cane on gait
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shifts center of gravity towards contralateral side when used in opposite hand
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Energy expenditure s/p BKA
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increased 25%
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Energy expenditure s/p bilateral BKA
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increased 40%
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Direct load transfer s/p amputation
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aka terminal weight bearing. Occurs in ankle/knee disarticulation.
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Indirect load tranfer s/p amputation
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End of stump does not take all of weight- load transferred indirectly by total contact of prosthesis socket
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Most important risk factor for amputation in DM
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Peripheral neuropathy
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Biologic amputation level
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most distal functional amputation with high probability of wound healing
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Decreasing phantom pain
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prosthetic use, PT, compression, TENS
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Persistent swelling s/p amputation
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verrucous hyperplasia- overgrowth of skin w/ serous discharge. Tx: total contact cast
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Wrist disarticulation
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benefits: preserve more forearm rotation/ improved prosthetic suspension. Disadvantages: challenging prosthetic fitting
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Transradial amputation- site
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optimal length: junction of middle and distal 1/3
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Diabetic UE gangrene
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Indicator of end stage disease: life expectancy <2yrs
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Toe amputation
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traumatic- lose some stability in late-stance phase. Great toe: amp distal to FHB insertion. 2nd toe: amp distal to P1 flare- acts as buttress vs hallux valgus
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Ray resection
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Single outer--> good results. 2+ rays--> narrow foot w/ poor shoe fitting. Central ray resection--> prolonged wound healing/ worse than midfoot amp
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TMA/ Midfoot amputations
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Long plantar flap preferred. TMA through proximal metaphyses to prevent pressure ulcers. Add TAL to prevent equinus. Late varus may occur--> tx w/ TA transfer to neck of talus
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Syme amputation
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Stable gait, direct load tranfer, minimal skin breakdown complications. Need patent posterior tibial artery. Secure heel pad to tibia.
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BKA site
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Optimal length >12cm below knee joint. Myodese posterior muscles.
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Knee disarticulation
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End bearing, better sitting/transfer function. Suture patellar tendon to cruciate ligaments.
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Dog ears on amputation stump
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Do NOT remove-- will make flap more narrow and compromise blood flow
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AKA site
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12cm above knee joint.
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Prosthetic fitting s/p UE amputation
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very early- before wound healing- increases use from 30-80%
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Prosthesis for midradial amputation
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myoelectric prosthesis for sedentary work/ body powered for heavy labor
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Prosthesis for above elbow amp
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Very inefficient/ poorly tolerated. Require two motions for prehension.
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Prosthesis for proximal transhumeral amp
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limited function. Manual universal shoulder joint positioned w/ other hand.
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Single axis foot
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single hinge-> poor durability and cosmesis
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SACH foot
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solid-ankle, cushioned heel. Was used for general use in low demand. Use being discontinued.
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Articulated dynamic response foot
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allow inversion/eversion and rotation. Useful for uneven surfaces. Flexible keel deforms under load and provides spring for pushoff. Saggital split allows for inversion/eversion
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Non-articulated dynamic response foot
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long keels for very high-demand activities
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Prosthetic shank
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provides structural link between prosthetic components. Endoskeletal or exoskeletal
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Polycentric knee
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moving instant center of rotation- allows for increased flexion
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Stance-phase control knee
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Constant friction knee during swing phase/ freezes when weight applied.
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Fluid control knee
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allows for adjusting cadence. Good for active patients. Allows greater utility and variability
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Constant friction knee
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most commonly used in kids. Allows only single speed walking. Relies solely on alignment for stability during stance phase.
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Preferred suspension method BKA prosthesis
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Gel-liner suspension w/ locking pin
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Knee instability s/p AKA
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knee to anterior/ foot too stiff
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Foot slap/knee hyperextension s/p AKA
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heel too soft
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Knee flexion/bucking s/p AKA
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heel to rigid
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Excessive lordosis s/p AKA
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hip flexion contracture/ socket problems
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Best predictor of ambulation s/p TBI
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balance
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Cervical SCI level and function
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C4 and above- high back/head support; C5- mouth driven wheelchair; C6:manual wheelchair w/ orthoses. C7: independent w/ wheelchair. Transfers: dependent at C4/ assisted at C5/ independent at C6
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Postpolio syndrome
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aging phenomenon- more nerve cells become inactive w/ age. Tx: submaximal exercise w/ rest periods in between
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