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77 Cards in this Set
- Front
- Back
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name the 5 px feet catagories
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sach
single axis multi-axis flexible-keel dynamic response |
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SACH foot
soft heel provides more/less stability? firm heel provides more/less KNEE flexion? |
solid ankle cushion heel
more stability more flexion |
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the KEEL of the SACH foot replaces what fxn?
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grastoc
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heel compression in a SACH at IC/LR simulates what motion?
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pf
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describe the 5 K levels
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K0- non prosthetic user
K1- limited, limited potential for ambulation K2- unlimited household, ability to transverse low level barriers K3- unlimited community , ability for variable cadence K4- active adult, athlete, child. ability beyond basic ambulation |
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2 indications for SACH foot
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majority of LL amputees
peds |
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contraindications for SACH
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Active individuals
when in/ev are required individuals who need increased knee stability |
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name adv / disadv for a SACH foot
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comesis, quiet, little maintenance
deteriorations of soft material, no torque absorption |
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which px foot reaches foot flat most quickly
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single axis articulated ankle
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primary indication for single axis foot?
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Pt needing increased knee stability
low activity, TF amputees |
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a TF amputee with what sort of muscle weakness would be good for single axis foot?
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isolated hip extensor weakness
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what are the indications for multi-axis feet?
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when inv/ eversion needed
torque absorption special activities- uneven surfaces TF amputee with isolated HE weakness golfers, hikers, community outdoors, surveyors |
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advantages of multi-axis feet?
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absorbs torque
shock absorption foot conforms to surface-accomidates irregularities by bending into pro/sup used in prep limbs, peds, CONTRAIND- runners who need fast pushoff- flexible rubber keel |
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disadvantage of mult-axis feet?
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cosmesis, increased maintenance , weight
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indications for dynamic response foot?
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active ambulators, community ambulators
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contraindications for dynamic response feet?
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one speed ambulators- anyone reluctant to load the forefoot
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advantages of dynamic response feet?
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smoother gait
less energy expenditure light weight cosmesis dynamic energy component |
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disadvantages of dynamic response feet?
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material durability
limited sizes expense |
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indication for multi-axial dynamic response foot
contraindication? |
active individual
one speed ambulators |
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advantages of multi-axial DR foot?
disadvantage? |
multi-axial
dynamic response expense and maintence |
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name the four socket design types
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PTB
Total surface bearing hydostatic weight bearing combination of the 3 |
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describe PTB socket v. total surface bearing
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PTB-pressure tolerant areas
pressure sensitive areas triangular in shape *foam insert interface typically indicated for thin/boney RL Total surface bearing- uses tension values to uniformly distribute weight over the entire limb *gel liners used as interface Global reduction fleshy/ cylindrical shapes |
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name 4 types of materials soft liners are made of
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pelite
silicone urethane elastomer/mineral oil (alpha) |
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name the 7 mods of suspension
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joint and corset
belt/cuff compression sleeve suspension supra - condylar pin suction/expulsion valve vacuum |
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name 6 indications for joint and corset
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incorporates thigh weight bearing (for short RL that can't tolerate full load bearing)
improves m-l stability heavy duty user patient preference short limb- fragile skin knee instability- laxity. hyperextension stop also |
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advantages of joint and corset?
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increases weight bearing surfaces
unloads RL increases M-L/A-P stability |
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disadvantages of joint and corset?
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heavy, bulky
uncosmetic inherent pistoning |
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who is indicated for suprapatellar cuff and belt?
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majority of TT amputees
pt's with good ligaments juvenile patients long residual limbs volume changes anticipated- dialysis, post edema, CA treatment |
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advantages of suprapatellar cuff?
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also known as PTB strap-one of the most common types of strap suspensioin
provides good suspension over patella adjustable can be used in combo with waist belt |
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disadvantages of supracondylar cuff?
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can be restrictive
doesn't provide m-l stability un-cosmetic some pistioning |
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who is indicated for sleeve suspension?
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most TT amputees
pt with good ligaments juvenile amputees long residual limbs ** supplementary suspension for sports** |
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advantages of sleeve suspension
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provides excellent suspension
conseals trimlines variety of materials |
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disadvantage of suspension sleeves?
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can cause skin problems
can cause increased perspiration difficult to don not indicated for vascular pt's |
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who is indicated for SCSP socket?
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very short residual limb
requires m-l stability pt who wants less straps ** good for people with visual/hand impairments |
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advantages of SCSP
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increased wt bearing surface
increased m-L stability improved cosmesis |
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disadvantages of SCSP?
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enclosing patella can inhibit some activities
difficult to achieve suspension on obese or muscular thighs |
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who is indicated for SC socket?
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pt's requiring increased m-l stability
pt's wanting unrestricted knee extension who want less straps upper extremity involvement |
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advantages of SC socket
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less restrictive then PTB SCSP
improved cosmesis |
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disadvantages of SC?
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loss of rigid hyperextension stop
difficult to suspend on obese and muscular pt's |
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who is indicated for PTB silicone suction?
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pt's with good subcutaneous tissue
pt's with full fxn of UE those who want less suspension straps |
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advantages of PTB silicon suction socket?
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excellent suspension
eliminates pistoning of RL increased propreoception |
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disadvantages of PTB silicon suction?
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difficult to don
can't be used on all limb shapes |
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vacuum and suction suspension is indicated for what sort of pt?
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good subcutaneous tissue
want less restrictive straps can't tolerate distal pulling of shuttle pin |
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disadvanges of vacuum and suction suspension?
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knee sleeve necessary which can easily damage, restrict KF, retain perspiration
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what is verrucous hyperplasia?
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wart-like dry/cracked skin on the distal end of RL due to lack of total contact and negative pressure
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what is edema?
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excessive accumulation of fluid in tissue spaces. caused by disturbance of fluid balance between capillaries and surrounding tissues
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what is venous insufficiency?
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inability to drain deoxygenated blood FROM a body part
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what is arteriole insufficiency?
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inability to deliver oxygenated - rich blood TO a body part
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anterior distal pressure on the tibia during dynamic alignment is caused by what 5 reasons?
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socket too flex/ foot too DF
foot too far posterior heel too stiff posterior wall too low |
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anterior distal pressure on the tibia during dynamic alignment. what are the solutions?
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extend socket/ pf foot
move foot more anterior soften the heel |
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explain the role of the quads at heel strike?
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contracting ECCENTRICALLY to control KF
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what phase of gait produces the most force on the ant/distal tibia
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heel strike/loading response
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pt is getting ant/distal pain at HS, other then alignment changes, what can be done to adj px?
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add socks
pre tibial pads |
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why do we encourage knee flexion in gait?
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to load pressure tolerant areas.
promote KF at heel strike discourage KE at heel off |
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what is optimal foot to go with a J&C?
what is optimal alignment? |
single axis foot
18mm posterior, 12 mm inset |
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Describe how you would align a foot with a J&C?
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you can inset more in order to narrow the BOS
you want an extension moment thru stance phase to load the px |
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describe hydrostatic socket
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Based on Pascals Law
increase elongation increase stiffness increase stability of boney anatomy fluid loading TSB with elongation global reduction, cylindrical shape |
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what happens if J&C are positioned:
too anterior? too proximal? too distal? too posterior? |
patella tendon bar pressure
pistioning distal end pressure popliteal pressure |
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what type of px is indicated for pt with genurecuratum?
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j&c
scsp |
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what muscles cross the knee?
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what 7 anatomical considerations do you look at when evaluating a TT pt?
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ht, wt, DOA, COA, length/shape of limb, edema, redundent tissue (verrocous hyperplasia; > 1/2"), strength/ ROM
*consider sound side limitations condition of the skin |
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Rectus femoris- O, I, N, and A?
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Vasti muscles- O, I, N, and A?
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posterior muscles of thigh?
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biceps femoris muscles- O, I, N, and A?
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semimembranosis- O, I, N, and A?
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semitendonosis- O, I, N and A?
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popliteus- O, I, N and A?
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name the pes anserine muscles
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Sartorius- O, I, N and A?
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gracilis- O, I, N and A?
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Illiotibial band/TFL- O, I, N, and A?
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popliteal fossa-boarders and contents?
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what 3 nerves innervate the knee?
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congenital malformations often necessitate what sort of Px socket design?
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fenestrations/ windows
socket strength is effected though |
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what is one of the most common forms of atatomical suspension?
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wedge above the medial femoral condyle
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when would you use a distal end pad?
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often on PTB sockets.
to ensure total contact distally, increase comfort, protect distal portion of RL as a result of volume loss |
