Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
159 Cards in this Set
- Front
- Back
|
what are some causes of amputations? (3)
|
(1)congential limb defects (2)acquired secondary to trauma (3)acquired seocondary to a disease process
|
|
|
what are some secondary ways that amputations can be caused by? (7)
|
(1)gun shot (2)car accident (3)burns (4)frostbite (5)diabetes (6)PVD (7)renal faliure
|
|
|
what are some types of UE amputations? (7)
|
(1)forequarter (2)shoulder disarticulation (3)AE (4)BE (5)wrist disarticulation (6)transcarpal (7)partial hand
|
|
|
what does AE stand for?
|
above the elbow
|
|
|
what does BE stand for?
|
below the elbow
|
|
|
what are some types of LE amputations? (10)
|
(1)interpelevicabdominal (2)hip disarticulation (3)AKA (4)knee (5)disarticulation (6)BKA (7)ankle disarticulation (8)syme's (9)chopart's (10)great toe amputation
|
|
|
what does AKA stand for?
|
above the knee amputation
|
|
|
what does BKA stand for?
|
below the knee amputation
|
|
|
the stump is also called (1)
|
residual limb
|
|
|
(1)is also called residual limb
|
stump
|
|
|
how might the client w an amputation appear after surgury? (4)
|
they might have (1)gauze bandage (3)dressing (4)immediate postperative prothesis
|
|
|
what are some complications for an amputation? (6)
|
(1)slow healing (2)infection (3)pain (4)phantom sensation (5)phantom pain (6)deformities
|
|
|
what is phantom sensation?
|
when feel limb such as wiggling toes
|
|
|
what is the differ btwn phantom sensation and pain?
|
(1)phantom sensation-can still feel limb such as wiggling toes (2)phantom pain-pain
|
|
|
People w burns or amputations tend to go into a (1)
|
position of comfort
|
|
|
T or F
prothestic devices are not expensive |
false
|
|
|
T or F
prothestic devices have a high rejection rate |
true
|
|
|
why do prosthesis devices have a high rejection rate? (4)
|
(1)compensation-using one hand or ambulation aides (2)not comfortable (3)poorly made (4)lack of training
|
|
|
what are some ways to reduce the rejection rate of a prothessis? (5)
|
(1)early intervention (2)team approach (3)patient directed prothestic training (4)pt education (5)patient monitoring and follow up
|
|
|
t or f
the sooner they use the prothesis after loosing the limb the lower the chance of rejection |
true
|
|
|
the sooner they (1)after loosing their limb, the lower the chance of rejection
|
use the prothesis
|
|
|
what are some pre-prosthetic goals? (8)
|
(1)residual limb skrinkage and shaping by wearing the stump skriner or using a firgue-8 wrap (2)wound healing and skin hygiene (3)desensitization...get used to missing limb can do this by light to deep touch pressure, soft to hard, smooth to abrasive, tapping and vibration, and theraband (4)increase ROM to prevent or reduce contractures (6)increase strength in residual limb using a theraband, wrist weights, and pulleys and site idenficiation for myo-electric (7)independence in ADL and IADL using adaptive equipment, one handed techniques, and modified ambulation (8)psychological issues
|
|
|
what are (2)ways to shape the limb so that it will fit the prosthesis?
|
(1)use firgue 8 banadage (2)stump shrinker
|
|
|
why does the resdiual limb have to be reshaped?
|
to fit in the socket of the prothesis
|
|
|
Contractures result from a person going to a (1)
|
position of comfort
|
|
|
NAME
this results from the person going into a position of comfort |
contracture
|
|
|
what are some prosthetic options? (5)
|
(1)passive prosthesis (2)passive prosthesis (3)external powered (4)hyprid (5)no prothesis at all
|
|
|
if the person chooses not to get a prothesis is bc they have already learned how to (1)
|
compensate
|
|
|
describe the passive prothesis?
|
is strictly cosmetitc
|
|
|
NAME
this prothesis is strictly comsetic |
passive prothesis
|
|
|
describe the cable activated prothesis?
|
is body powered
|
|
|
NAME
this prothesis is body powerd |
activated prothesis
|
|
|
Describe the external powered prothesis?
|
is myo-electric
|
|
|
describe the hybrid prothesis?
|
is body powered and myo-electic
|
|
|
what are some examples of AT people may need w a amputations? (4)
|
(1)walker (2)bath tub bench (3)crutchs (4)stump board (5)reacher for pants
|
|
|
what is one big problem w someone w amputations?
|
balance
|
|
|
what is the big toes used for?
|
balance
|
|
|
what is hip gait?
|
when you cannot feel your prothestic foot touch the ground...so the person circumated the food instead-putting all their pressure on the good limb
|
|
|
NAME
this is when you cannot feel your prothestic foot touch the ground...so the person circumated the food instead-putting all their pressure on the good limb |
hip gait
|
|
|
what is the step-two gait?
|
is when the person only move their prothestic foot half way
|
|
|
NAME
this is when the person only moves their prothestitic limb only half a step |
step-two gait
|
|
|
what are some prostehtic considerations? (6)
|
(1)funding (2)level of amputation (geographic location) (3)shape of the stump-cone vs dog eared and available site for mm training (4)roles (family,vocational, and community (5)cognition (6)psyhosocial (coesmesis/motivation)
|
|
|
what kind of shape do you want the limb to be in for a prothesis?
|
cone shape to fit the prothesis
|
|
|
The residual limb needs to be in a (1)shape vs (2)
|
(1)cone vs (2)dog eared
|
|
|
after sugury, w.out wrapping or stump limb, the residual limb will assume a (1)shape
|
dog eared
|
|
|
what are some advantage of a passive prosthesis? (5)
|
(1)body image (2)does not weight much (2)does not require as mch harnessing (4)requires limited training (5)decreased cost
|
|
|
what are some disadvantages to a passive prothesis?
|
(1)no prehension (2)can aide w gross bilateral activites
|
|
|
what are some options w the passive prothesis? (2)
|
(1)embeddded colors vs surface application (2)silcone material
|
|
|
what are some advantages of the body powered prosthesis? (5)
|
(1)less expensive (2)heavy duty construction and function (3)proprioception--feedback through joints and harnesses (4)generally lighter weight (5)reduced maintance costs
|
|
|
what are some body powered prosthesis disadvantages? (5)
|
(1)low grip strength (2)functional ROM (3)restrictive and uncomfortable harness (4)cosmesis (5)restrictive overhead functions
|
|
|
describe the parts of the body powered protehsis? (2)
|
usally has a firgue 8 harness and cable (2)hooks are used for griping etc
|
|
|
describe how the body powered prothesis works? (4)
|
(1)scapulat abduction to provide to tension for the firgue 8 harness (2)chest expansion used when firgue 8 cannot be used (3)shoulder depression, extension, and abduction-required to lock the elbow (4)humeral flexion-allows terminal device to open
|
|
|
t or f
the higher the ampuation the les s chance that a prosthesis will work |
true
|
|
|
what are some types to the external powered prosthesis? (2)
|
(1)myo-electric (single or dual site (2)switch using a rocker, pull, or push
|
|
|
what are some externally powered advantages(4)
|
(1)increased ROM except upper ROM(2)cosmesis (3)grip force btwn 20-42 (4)limited harness system or eliminating hraness for comfort
|
|
|
what are some disadvantages of a externally powered prosthesis?
|
(1)costs (2)weight (3)maintenance costs (4)battery (5)environment susceptibiltiy
|
|
|
t or F
costs of an electric prosthesis can exceeed 100,000 |
true
|
|
|
40,00 persons loose their limb a yr w (1)loosing thier hand or arm
|
30%
|
|
|
the chance is greater that someone will loose thier arm or leg?
|
leg
|
|
|
even w the body powered prosthesis, the cleint will still have trouble w (1)ROM
|
upper
|
|
|
what are some advantages of the hybrid prosthesis?(3)
|
(1)combo of body powered and eletrically powered components (2)optimze functional performance (3)unique (
|
|
|
you have to remove a client 2 wool socks at noon. why would you need to do this?
|
bc of swelling
|
|
|
when training to use the hook or regular prosthesis, what kind of activities should you start w and why? --functional or non functional?
|
non functional-such as picking up cones bc they will get fustrated easily w self
|
|
|
what are some parts to the prosthetic training ? (4)
|
(1)orientation to the prosthesis such as the basic components (2)indepedence w don/doffing socks--come up a sock schedule (ex wear sock 15-30 min 3x a day advancing by 30 min incrimindents) (3)care of residual limb such as wearing stumb shrinker or elastic bandage (4)opening and closing the prosthetic hand
|
|
|
if you are working on training the person to open and close the prosthetic hand how would you proceed w treatment? (7)
|
start w (1)opening and closing for nonfunctional objects (2)arm placement levels (3)placing objects in terminal device and controling the tension needed to hold object (4)repositioning object in the TD (5)movement of the object (combined movements (6)functional movements such as grasping a object and moving to another location and different sizes (7)bilateral integration w ADL and IADLs
|
|
|
write a long term and (4)short term goals for the client below:
Tom is a LE amputee below the knee. He jst got out of surgury 2 days ago is in gauze and dressing and 64 yrs old NOTE-list problems first (5) |
(1)problems-
a)knee wants to flex, hip add, b)slow healing c)high rejection rate d)depression e)eval cognitive f)sensory disturbance g)phantom limb and pain h)edema i)mobility j)edema k)transfers l)balance, m)endruance n)bed mobility (2)LRG=pt will be able to I w LE dressing for 2 wks -pt will restate parts/fuction of the prostehtic device (3 days) -pt will be able to I don/doff prosthesis (1 week) -pt will require min assist w dressing (2 weeks) (3)above could also be for bathing (4)LTG-pt will transfer bed to wheel w.stand by assitance and use adaptive equipment (2 weeks) -pt will demonstrate dynamic sitting on EOB for 5 mins such as crossing midline -pt will be I w bed mobility -pt will increase UE strength by using 2 reps 2x sets w theraband (4)pt will tolerate LE splint for knee extension for 2 hrs off daily and wear all night |
|
|
how would you start w bed mobility?
|
work on going from supine to sitting then standing w
|
|
|
Why would you need to keep someone leg extended when in wheelchair?
|
if position of comfort is flexion...in a wheel chair the leg is always in hip flex and knees bent
|
|
|
the interpelivabdominal amputation is also called (1)
|
hemicorpectomy
|
|
|
(1)is also called the hemicorpectomy
|
interpelivabdominal amputation
|
|
|
w. a BE amputation what are some limitatiosn and contractures you may see?
|
(1)Limited-rotation, abduction, extension, adduction, and retraction of the scapula, and shoulder-external rotation, flex, abduction
|
|
|
w. a AE amputation, what are some limitations and contractures you may see?
|
Limited-external rotation,flexion
Have rounded shoulder and want to stay in flexion and internal rotation |
|
|
w a BKA what are some limitations and contractures you may see?
|
(1)watch for knee flex (2)limited ext, add, internal rotation
|
|
|
what are some contrcatures and limitations you may see w a AKA?
|
(1)hip flex, add, and internal rotation (2)limited0 abd, extension and external rotation
|
|
|
what is the Medicare llevel?
|
more subjective measures how much the caregiver has to help the client
|
|
|
NAME
this assessment is more subjective and measures how much the caregiver has to help the client |
Medicare leve
|
|
|
what are some limitations and position of comforts you would expect w someone w a BE amputation?
|
(1)position of comfort-elbow: flexion, supination
shoulder: adduction, internal rotation, extension scapula: protraction (2)limitations-elbow: extension, pronation shoulder: abduction, external rotation, flexion scapula: retraction |
|
|
what are some limitations and position of comforts you would expect w someone w a AE amputation?
|
(1)position of comfort-shoulder: add, int rot, exten
scapula: protract (2)limitations-shoulder: abd, exter rot, flex scapula: retract |
|
|
what are some limitations and position of comforts you would expect w someone w a BKA?
|
(1)position of comfort-knee: flexion
hip: flexion, adduction, internal rotation (2)limitations-knee: extension hip: extension, abduction, external rotation |
|
|
what are some limitations and position of comforts you would expect w someone w a aka?
|
(1)position of comfort-hip: flex, add, int rot
(2)limitations-hip: exten, abd, extern rot |
|
|
what does FIM stand for?
|
functional indepdence measure
|
|
|
what is the FIM?
|
measures how much the CLIENT does during the activity
|
|
|
NAME
this assessment measures how much the client does during the activity |
FIM
|
|
|
what is the differ btwn the FIM and the Medicare levels?
|
(1)FIM-measures how much the client does (2)Medicare-levels measures how much the caregiver does for the client during the activity
|
|
|
T or F
the FIMs can be universal |
true
|
|
|
the FIM scale ranges from (1)to (2)
|
(1)7 (2)total assistance
|
|
|
describe the FIMs scale?
|
(1)scale of 1-7
7=complete indepdence 6-modified indpedence (uses assistive device and/or needs more time) 5-supervision (needs cuing or coaxing) or set up required 4-min assistance- (only need incidental assistance) 3-moderate assistance 2=max assistance 1=total assistance (2)degree the subject helps w 7 and 6= gets no help (INDEPENDENT) 5, 4 and 3-does half or more (MODIFIED DEPENDENCE) 2 and 1-does less than 50%=(COMPLETE DEPENDENCE) |
|
|
what is a 7 on the FIMS?
|
complete indepdence
|
|
|
what is a 6 on the FIMs?
|
modified indepdence (uses AT or needs more time)
|
|
|
what is a 5 on the FIMS?
|
supervision or set up or cuing or coaxing
|
|
|
what is a 4 on the FIMS?
|
min assistance (needs only incidental assistance and setup/cuing or coaxing)
|
|
|
what is a 3 on the FIMS?
|
moderate assistance
|
|
|
what is a 2 on the FIMS?
|
max assistance (does less than 50% of work)
|
|
|
what is a 1 on the FIMS?
|
total assisatance
|
|
|
a person has a score of 7. they would be considered to be (1)
|
complete independent (no helpers)....all activities are performed safely and a reasonable time w out. AT
|
|
|
a person has a score of 6 on the FIMS. they would be considered to be (1)
|
independent .....may need AT, more time, or may be concern for safety (no helpers)
|
|
|
a person has a score of 5 on the FIMS. they would be considered (1)
|
modified dependent.....usally needs set up, cueing, coaxing, or supervision
|
|
|
a pesrson has a score of 4 on the FIMS. they would be considered (1)
|
modified dependent......person only needs incidental assistance w no more help than touching and does at least 75% of the work
|
|
|
a person has a score of 3 on the FIMS. they would be considered (1)
|
modified dependent....the client does btwn 50% and 75% of the work
|
|
|
a pesron has a score of 2 on the FIMS. they would be considered to be (1)
|
complete depedence....can do some work but less than 50%
|
|
|
a person has a score of 1 on the FIMS. they would be considered to be (1)
|
complete dependence-client expands less than 25% of the work
|
|
|
NAME FIMS SCORE
the client completes all the tasks described as making up the activity and typically performed safely w. out meds, assistive devices, or aids in a reasonable time manner |
7
|
|
|
NAME FIMS SCORE
one or more of the following may be true-the activity requires an assistive device, the activity takes more than reasonable time or there are safety risk considerations |
6
|
|
|
NAME FIMS SCORE
TOM can dress himself but needs a reacher to pick up his pants |
6
|
|
|
NAME FIMS SCORE
Sue can cook w out help but always forgets to turn off the stove or burner |
6
|
|
|
NAME FIMS SCORE
Brad has low endurance. however, he can make his own lunch if his wife gets all the material ready for him |
5
|
|
|
NAME FIMS SCORE
subject requires no more help than standby, cuing, or coazing w.out physical contact. or helps sets up needed items or applies orthoses |
5
|
|
|
NAME FIMS SCORE
subject requires no more help than touching and expends less than 75 % of the effort |
4
|
|
|
NAME FIMS SCORE
subject requires more help than touching or expands half (50%) or more (up to 75%) of the effort |
3
|
|
|
NAME FIMS SCORE
subject expands less than 50% of the effort but at least 25% |
2
|
|
|
NAME FIMS SCORE
subject expands less than 25% of the effort |
1
|
|
|
NAME
this means that the subject expands half or more of the effort |
modefied dependence
|
|
|
Which FIMS levels fall under independence? (2)
|
7 and 6
|
|
|
which FIMS levels fall under modified independence?
|
5,4,3
|
|
|
which FIMS levels fall under complete dependence?
|
2,1
|
|
|
NAME
this means that the subject expends less than 50% of the effort w max or total assistance being needed |
complete dependence
|
|
|
NAME
this means that another person is not required for the activity |
indepdence
|
|
|
what does I stand for?
|
indepdent
|
|
|
what does S stand for?
|
supervision
|
|
|
what does cga stand for?
|
contact guard
|
|
|
what does sba stand for?
|
standby
|
|
|
ega can also be called (1)
|
sba
|
|
|
(1)can also be called ega
|
sba
|
|
|
what does min stand for?
|
min assistance
|
|
|
what does mod stand for?
|
moderate assistance
|
|
|
what does max stand for?
|
max assistance
|
|
|
what does D stand for?
|
dependent
|
|
|
according to the Medicare levels of assistance, what is I?
|
no assistance in any situation
|
|
|
according to the Medicare levels of assistance, what is S?
|
no hands on/cues for safety
|
|
|
according to the Medicare levels of assistance, what is cga?
|
w.in reach/be ready to assist physically
|
|
|
according to the Medicare levels of assistance, what is min?
|
physical and /cueing caregiver will need to assists 25% of the task
|
|
|
according to the Medicare levels of assistance, what mod?
|
physical and/or cueing and assissts 50% of the task
|
|
|
according to the Medicare levels of assistance, what is max?
|
physical and/or cueing and assists 75% of time
|
|
|
according to the Medicare levels of assistance, what is D?
|
unable to assist, caregiver provides 100% of the assistance
|
|
|
describe the Medicare levels of Assistance? (7)(
|
(1)I=no assistance in any situation (2)s-no hands on/cues for safety (3)cga-w.in reach/ready to assist physically (4)min-physical and cueing assist 25% of time (5)mod-physical and cueing assists 50% of the task (6)max-physical and cueing-assists 25% of the task (7)D-unable to assist caregiver provides 100% of the care
|
|
|
NAME MEDICARE LEVEL
unable to assist caregiver provides 100% of the care |
D
|
|
|
NAME MEDICARE LEVEL
physical and cueing-assists 25% of the task |
max
|
|
|
NAME MEDICARE LEVEL
physical and cueing assists 50% of the task |
mod
|
|
|
NAME MEDICARE LEVEL
physical and cueing assist 25% of time |
min
|
|
|
NAME MEDICARE LEVEL
w/in reach /ready to assist physically |
cga/sba
|
|
|
NAME MEDICARE LEVEL
no hands on/cues for safety |
S
|
|
|
NAME MEDICARE LEVEL
no assistance in any situation |
I
|
|
|
complete a practice framework worksheet on the following person
73 yr old women. dc yesterday w right total hip replacement...has 3 steps to get into house and no assistive devices. |
(1)facts/problems
-hip precautions -no AD (2)goals LTG-client will be I w transfers to the following surfaces, bed, w/c, commide, and bath tub transfers, bench, ad, (4 weeks) STG- client will demonstrate 1 safe transfer -client will be able to moderate assist (2 weeks0 -client will complete bed mobility w min assist (2 weeks) LTG-client will be I w BADLs (LE dressing, tioleting, and bathing) w aid of AD (4 weeks) -min or moderate assist (2 weeks) -LE dressing (1 week) LTG_ client will report completation of home modificany purchase of assistive devices to allow for safety. -client will restate hip precautions -client will demonstrate hip precautions (3)PROCESS day-1 (EVAL the following) -UE ROM/mm testing -BADLS (FIMS, observations, and context) -mobility-bed, comade, or w.c. -screen-cogintive, oriented, memory, problem solving, mini-mental test, and observations DAY 2 -finish eval -work on mobility and instruction of using AD, -BADLS (dressing and tioleting -UE strengthening home program DAY 3- much the same DAY 6-8 -bathing (dry transfers)-request dr. permission for wet transfers) -cont BADLS/IADLS 3rd WEEK -homemaking tasks/any outlying problems w BADLS car transfers? |
|
|
complete practice framework worksheet on the following pt
NOTE you are in a acute care setting Tom, a 6 yr old male broke his femor at the surgical head (right hip fracture) w a status post hip fracture of the surgical neck. -all of the above happened 2 days ago. -he also has upper reduction and fixation plates and screws |
(1)diagnosis-characteristics-
-femur broken -may be in spica cast -6 yr old male -cast-heat/precautions, water heat, weight bearing, -look for signs of abuse -prior function (2)use rehab approach (3)OT profile-roles, priorities, perceptions of current status, contexts, same occupational history (4)Occupational Performance Assessment areas -FIMS -observations (including rest periods, PRE, length of time) -performance skills-posture, balance, mobility, positions, reaches, walks, bends, strength, and effort, moves, transports, lifts, energy, and adaptation, accommodation, and adjusts (4)MEDICAL COURSE PROGNOSIS -healing -hemotoma-granulation-procallus tissue -remodeling- (5) OCCUPATIONAL AREAS- -play* -tioleting* -school (Home health) -sleep (hh) -mobility (hh)* -dressing (hh)* -social interaction (hh) (6)CLIENT FACTORS -neuromusckloskeletal, function (joints and bones) -sensory, -sensation of joints (7)TREATMENT APPROACH -1st modify (active as possible) -2-maintain 3-restore if out of spica -want to resume normal life as much as possible (8)COURSE OF TREATMENT PLAN day 1 -eval day 2 -parent instructions, work transfers, BADL (tioleting and assistive devices) -start w in room program of 2 pds ...give handout day 3- -much of same and may work on dressing if time -care giver d.c -look at context at home such as do they need a ramp? -referal to hh (9) GOALS LTG client will require min assistance for BADL dressing, toileting, w. assistive devices -client will demonstrate efficient use of assistive devices to be used for toileting (3 days) - LTG 2-caregiver will demonstrate ability to safely transfer client bed to and from wheelchair or wagon (2 weeks) STGS- -caregiver will be I in completing bed mobility -caregiver will transfer client from bed to wagon w min assistance LTG-3 client will resume premorbid fine motor play activities (2 weeks) -STG-client will participate in 2 familiar premorbid play activities (1 week) LTG-client will tolerate strength and endurance straining -all motions -will do 10 reps weights, 4 sets, and 3x a day |
|
|
what does ICP stand for?
|
intracranial pressure
|
|
|
what is craniotomy?
|
removal of half of the skull to relieve ICP...it is later sown back on
|
|
|
NAME
this the removal of half of the skull to relieve ICP...it is later sown back own |
craniotomy
|
|
|
how is ICP montiored?
|
by ventricular cath
|
|
|
what is a ventricular catheter?
|
is inserted into the skull then connected to the transducer which registers the pressure
|
|
|
NAME
is inserted into the skull then connected to the transducer which registers the pressure |
ventricular catheter
|
|
|
what are some precautions for someone w a craniotomy?
|
wear a helemt..keep head protected
|
|
|
what are some precautions for someone w high ICP? (3)
|
(1)keep ICP below 20-25 mmHg (2)avoid raising the head of bed (3)ICP d on head position-avoid extreme neck flex, log roll rather than segmental roll.maintain, cervical collars limit jugular damage, and avoid hip flex greater than 90
|
|
|
what are some precautions for someone w high ICP? (3)
|
(1)keep ICP below 20-25 mmHg (2)avoid raising the head of bed (3)ICP d on head position-avoid extreme neck flex, log roll rather than segmental roll.maintain, cervical collars limit jugular damage, and avoid hip flex greater than 90
|
|
|
For every 10 percent of elevation the ICP increases by (1)
|
1 mmHg
|
|
|
for every (1)the iCP increases by 1 mmHg
|
10 percent of elevation
|
|
|
you should keep ICP btwn (1)
|
20 to 25 mmHg
|
|
|
what should you keep ICP at?
|
20 to 25 mmHg
|
|
|
ICP is depedent on (1)
|
head position
|
|
|
NAME
this is dependent on head position |
ICP
|
