Rehab: Exam 3

Front 1

basic foundation: shoe , plastic insert, or metal stirrup component

insert: plastic insert or metal insert or foot plate.provides control for foot. helps with donning , light weight

stirrup: riveted through shoe shank

Back 1

what are the parts of an AFO?

Front 2

Back 2

what is an AFO stirrup?

Front 3

medial-lateral control straps

-stiffness of material

-contoured edges

-valgus correction or varus correction leather straps

Back 3

how can you gain lateral stability of the ankle using an AFO?

Front 4

pt weight falls anterior to offset jt

-stabilizes the knee in ext during stance

-hinge is set posteriorly

does not interfere with knee flexion during swing or sitting. Go to bend it bends with you

disadvantage: can dis-engage during stair climbing or walking on ramps

Back 4

what is the alignment of WB for use of KAFO?

Front 5

offset jt,drop ring lock and pawl lock with bail release

Back 5

what are the different locks of a KAFO?

Front 6

in standing , ring drops into place.-prevents uprights from bending

disadvantage: have to manually put the lever up to sit.

Back 6

what is a drop ring lock?

Front 7

unlock by pulling on posterior bail. can be intentionally activated by nudge against chair

disadvantage: bulky, can release unexpected against an object

Back 7

what is the pawl lock with bail release?

Front 8

metal hinge-drop ring lock

most appropriate

Back 8

what type of lock is used at the hip jt for a HKAFO?

Front 9

THKAFO with hips joined with a metal cable or rod.

components: offset knee jts, pre tibial bands, solid AFO

Back 9

what is a reciprocating gait orthoses?

Front 10

1. shift weight onto RLE

2.tuck pelvis by extending upper thorax

3. press on crutches

4. allow LE to swing through

5. reverse for next step

Back 10

what is the gait pattern w/ RGO?

Front 11

increase intra-abdominal pressure , decrease frontal mvmnt.

-not rigid, no horizontal rigid structure

-some have rigid vertical structure (stays)

Back 11

what is the purpose of a LS corset?

Front 12

Back 12

TLS corset

Front 13

Back 13

TL corset

Front 14

short sitting or supine to wrap

Back 14

what position should a BKA pt be in to wrap?

Front 15

sideline to wrap

Back 15

what position should a AKA pt be in to wrap?

Front 16

two 4 inch bandages

Back 16

what type of bandage is used for a BKA?

Front 17

two 6 inch bandages

Back 17

what type of bandage is used for a AKA?

Front 18

longest bone length.preserving as many its as possible. vascular supply. skin flaps, preserve max muscles

flaps: long posterior-allows better blood supply

skew flap,

Back 18

what does the surgeon take into account when performing amputations?

Front 19

to break up scar tissue -friction

Back 19

what is the purpose of massage following amputation?

Front 20

advantage: allows early WB, reduce edema and pain, enhance healing

disadvantage: expensive, application requires special training, must learn use, limits examination, close supervision during early healing

types: IPOP, rigid removeable

Back 20

what are rigid dressings?

Front 21

advantages: better edema control than soft dressings .promotes better heeling than soft. some have impregnated compounds

disadvantages: may loosen, not rigid

types: Unna dressing( gauze has compound of zinc oxide , gelatin, glycerin,and calamine-applied in OR

Back 21

what is a Semi rigid dressing?

Front 22

advantages: inexpensive, lightweight, easily cleaned

disadvantages: poor edema control, easily slip off.elastic requires skill to apply.expense of purchasing new shrinkers as edema decreases.cannot use shrinker until sutures or staples removed

types: elastic wraps applied over dressing to provide compression .shrinkers are easier to apply but more expensive

Back 22

what are soft dressings?

right-soft

left-rigid

Front 23

generally good potential.most common problem-knee flexion contracture.

contraindication- if the contracture influences ambulation

not contraindications with todays prosthetics

-flexion contractures

-scars

-poorly shaped residual limb

-adherent skin (impaired pliability)

Back 23

what is a BKA candidate prosthetic potential?

Front 24

greater requirements: energy, balance, strength

computerize knee components decrease energy consumption

can impede successful ambulation

-hip flexion contracture

-weakness/paralysis of hip muscles

-obesity

-poor balance

-poor coordination

Back 24

what is a AKA candidate prosthetic potential?

Front 25

young, agile

to use - need strength , coordination, balance, cardio respiratory

Back 25

what is a B amp prosthetic potential?

Front 26

ankle disarticulation amp.

just above malleoli

retain calcaneal fat pad

long lever arm- increases prosthetic control

might be able to WB on end of residual limb

bulky or bulbous end of residual limb

Back 26

what are the advantages of a SYMES amp?

Front 27

harder to produce a prosthesis for this type of amputation

Back 27

what is the disadvantage of a symes amp?

Front 28

foot ankle assembly,shank, socket, suspension

Back 28

what are the components of a prosthesis ?

Front 29

non articulated and articulated

Back 29

what are the different types of feet for a prosthesis ?

Front 30

most common- non articulated

-heel cushion provides a small amount of medial -lateral and transverse motion

-available in many sizes

-varying heel cushions

-several PF angles for different heel heights

Back 30

what is a SACH foot?

Front 31

key feature: simulated sub talar jt.-non articulated

-rigid ankle block joins the heel at a 45* angle

-provides more medial-lateral ROM in rear foot

-allows ambulation on uneven terrain

disadvantage : more expensive, heavy

Back 31

what is a SAFE foot?

Front 32

key feature: energy storing carbon plates- non articulated

-2 longitudinal carbon flexible plates

-during gait, distal plate bends and springs back

-during running, both plates bend and spring back

Back 32

what is a Carbon Copy II foot?

Front 33

key feature: energy storing plastic heel- non articulated

-flexible plastic keel bends at heel contact, to store energy

-late stance (unloading), keel recoils- releasing energy at termination of stance

Back 33

what is a Seattle foot?

Front 34

key feature: energy storing long carbon bands- non articulated

-long band of carbon extending from toe to proximal shank to heel

-stores energy in early and mid stance.

-good for athletes

-covered for cosmosis

-expensive

Back 34

what is a flex foot / springlite foot?

Front 35

most common- articulated

motions permitted: DF,PF, toe break action

motions not integrated : medial lateral , transverse plane motion

Back 35

what is a single axis foot?

Front 36

slight movement in all planes-articulated

purpose: maintain max surface contact during ambulation, including uneven terrain

disadvantage: heavy, less durable than single axis or non articulated feet.

Back 36

what is a multi axis foot?

Front 37

absorbs shock in the transverse plane-articulated

prevents skin chaffing

-allows socket to rotate in skin

used w/

-active individuals

-single axis foot

-AKA

Back 37

what is a rotator foot?

Front 38

concavities

pressure from sensitive areas

-fibular head, tibial crest, tibia condyles, anterior distal tibia

Back 38

what are prosthetic reliefs?

Front 39

convexities

-contact of pressure tolerant areas

-belly of gastric , patellar tendon, proximal medial tibia, pes anserinus, tibial fibular shafts

Back 39

what are prosthetic build ups ?

Front 40

holds prosthesis in place

types: cuff variant, distal attachment, brim variants, thigh corset, vacuum assisted socket system

Back 40

what are the different suspension mechanisms for a prosthesis?

Front 41

supracondylar cuff, fork strap and waist belt, rubber sleeve

Back 41

what are the different cuff variants?

Front 42

leather strap above the femoral condyles .can adjust snugness with the straps

Back 42

what is a supracondylar cuff suspension?

Front 43

added to the supracondylar cuff to add more support.strap attaches anteriorly to the prosthesis

Back 43

what is the fork strap and waist belt suspension?

Front 44

tubular.covers proximal prosthesis and distal thigh.

disadvantages: requires two strong hands. will not accommodate large quantities of tissue

Back 44

what is the rubber sleeve for a prosthetic suspension?

Front 45

silicone sheath with distal pin

-sheath clings to pin

-pin inserts into prosthesis

osseous integration

Back 45

what is the distal attachment suspension?

Front 46

medial and lateral walls extend over femoral epicondyles. plastic wedge insert in medial wall

advantages: increase medial lateral stability. cosmosis of knee , eliminates straps and buckles

disadvantage: harder to fabricate and expensive

Back 46

what is a supracondylar brim variant suspension?

Front 47

anterior wall extends over patella

disadvantage: high anterior wall can interfere with kneeling. prosthetic knee more prominent in sitting

Back 47

what is a supra patellar brim variant suspension?

Front 48

leather or plastic attach to hinges on the prosthesis.

advantage: increase frontal plane stability, increase WB load distribution

disadvantage: heavier, increase piston action, pressure atrophy of thigh, difficult to don laces and velcro

Back 48

what is a thigh corset suspension?

Front 49

use a pump liner and sleeve to create air tight environment

advantages: decrease edema, regulate fluctuations in edema, decrease moisture accumulation, increase proprioceptive awareness

Back 49

what is a vacuum assisted suspension?

Front 50

ant-medial: for pressure sensitive add longs tendon

post medial: HS tendons and sciatic nerve

post lateral: allow glute max to contract

ant lateral: rectus femoris

Back 50

what is a quadrilateral socket?

Front 51

walls over ischial tuberosity

Back 51

what is the ischial containment socket?

Front 52

locks the ischium and pubic ramis into the socket

Back 52

what is the comfort flex socket?

Front 53

patellar tendon

Back 53

where does WB occur when using a below knee prosthesis?

Front 54

stairs and curbs

Back 54

what activities make it difficult for people with higher amputations?

Front 55

frame with pelvic girdle, 2 posterior uprights, anterior upright, superior ring that lies on upper chest

Back 55

what is the Milwaukee brace?

Front 56

mass produced, can be customized

Back 56

what is the Boston brace?

Front 57

custom made, TL jacket

Back 57

what is the Wilmington Brace?

Front 58

axillary straps, 3pt system limits flexion and ext.

Back 58

what is the Taylor Brace?

Front 59

increase knee flexion, decrease knee stability

Back 59

what is the affect of increase DF with foot control?

Front 60

increased knee extension and increased knee stability

Back 60

what is the of increased PF with ankle control?

Front 61

never goes above the fibular head, height provides longer lever arm and increased stability.

components: uprights , shell, band , brim

Back 61

what is the superstructure of an AFO?

Front 62

9x more energy used when ambulating than normal adult

Back 62

what is a SCI pt with an orthosis during ambulation?

Front 63

energy expenditure is proportional to the amount of spasticity

Back 63

what is the energy expenditure of a CVA pt with an orthosis?

Front 64

smoking and diabetes

Back 64

leading causes of PVD?

Front 65

skin flap, edema and shaping residual limb, potential for prosthetic use, mourning the loss of body part

Back 65

what are the components of rehab after an amputation?

Front 66

sensation that extremity is still there

often: tingling, itching, pressure, numbness

tell pt its normal, prosthesis can regulate

Back 66

what is phantom limb sensation?

Front 67

cramping, squeezing, shooting, burning

intervention: prosthesis, US,icing , TENS, massage

Back 67

what does phantom pain feel like and what are the interventions used to control it?

Front 68

ankle disarticulation prosthesis

Back 68

what is the Symes prosthesis?