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Ortho Eval > Week 3 - Orthotics Lecture > Flashcards

Week 3 - Orthotics Lecture Flashcards

1
Q

Name 7 possible causes of harm of orthotic devices.

A
  1. injury to skin or nerve due to pressure points.
  2. burn as molding over heated material
  3. failure to protect healing structures.
  4. undue stress to tendons, joints, etc. due to poor design or positioning.
  5. inflammation or injury to shortened soft tissue by excessive force (when trying to reduce contracture).
  6. disuse atrophy
  7. edema
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2
Q

field of practice

A

orthotics

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3
Q

device applied to the body

A

orthosis

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4
Q
  • low temperature thermoplastics

- made for specific patient.

A

custom fabricated orthotic devices

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5
Q

Name 3 goals/objectives of orthotic intervention.

A
  1. protective
  2. corrective
  3. assistive
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6
Q

Name 4 aspects/goals of protective orthotic intervention.

A
  1. Immobile to protect healing structure - prevent any motion, optimal joint alignment
  2. weak muscles
  3. prevent joint contractures
  4. prevent soft tissue contractures
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7
Q

Name 2 aspects/goals of corrective orthotic intervention.

A
  1. to encourage proper alignment (correct subluxation of joint)
  2. to correct deformity
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8
Q

Name 1 aspect/goal of assistive orthotic intervention.

A
  1. assists muscles that are weak (ex: tenodesis orthosis)
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9
Q
  • no moveable parts
  • hold joint(s) in one position
  • may be worn intermittently
  • can be part of exercise program
A

static splints

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10
Q
  • has moveable parts such as rubber bands, hinges, outriggers
  • encourages early motion
  • prevents
  • corrects deformity
A

dynamic splints

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11
Q
  • combination of static and dynamic splints
  • correct deformity
  • increase ROM
A

static progressive splints

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12
Q

low load over time to change soft tissue structures. changes frequently

A

serial casting

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13
Q
  • provides a prolong sustained stretch
  • a fast, relatively inexpensive method of correcting burn scar contractures
  • flexion contractures of over 30 degrees respond well to casting
  • provides circumferential evenly distributed pressure
  • offers a successful alternative to dynamic splinting when pt. compliance is an issue ex: pediatrics
A

serial casting

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14
Q

Most UE splints affect joint ___.

A

ROM

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15
Q

Articular 3 point pressure splints influence joint ROM by what 4 things?

A
  • immobilization
  • mobilization
  • restriction
  • torque
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16
Q
  • circumferential - multiple opposing 2 point pressures, non-articular- do not influence joint ROM
  • provide specialized materials to healing structures
A

coaptation splints

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17
Q

Rigid, hard splint material may cause damage to skin or underlying soft tissue as result of ____ ____.

A

excessive pressure

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18
Q

Name 3 clinical applications to prevent damage to skin or underlying soft tissue.

A
  • longer, wider splints
  • rolled edges on distal and proximal edges.
  • continuous, uniform pressure over bony areas not cut outs.
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19
Q

___ ____ on hand splints may provide close fitting support surface for hand.

A

elastomer linings

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20
Q

heavy felt or foam rubber may help reduce pressure in areas where forces are great or splint is ____.

A

narrow

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21
Q

The lining/padding should line what?

A

the patient not the splint

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22
Q

Describe how to increase area of force application on an orthosis.

A
  • pt. can tolerate force/pressure more when it is spread out on a larger surface.
  • make splint longer and wider.
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23
Q

How long and wide should splints be for limbs?

A

1/2 width and 2/3 length of limb.

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24
Q

Splints are lever systems that work in ____.

A

equilibrium

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25
Q

What is the axis of a wrist splint?

A

wrist joint

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26
Q

what is the weight/resistance of a wrist splint?

A

hand

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27
Q

what is the counter force of a wrist splint?

A

forearm

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28
Q

rotational element of force

A

production of joint rotation

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29
Q

translational element of force

A

production of joint distraction or compression

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30
Q

How is force/pull applied to an orthosis?

A

applied by OT via rubber band, elastic, spring, etc.

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31
Q

When we apply a force, it must be what kind of force?

A

Rotational force (for joint movement)

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32
Q

Where should force be applied?

A

must be applied perpendicular to bone we want to move. has to be applied at 90 degrees. as pt. gets better, must change pull angle to get to 90 degrees.

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33
Q

product of force times the length of the arm on which it moves (T = F x d)

A

torque

34
Q

what does the amount of torque (effectiveness of force) depend on?

A

distance btwn joint axis and point of application of the force

35
Q

As the ____ btwn the joint axis and point of attachment of the mobilization assist increases, the amount of torque on the joint ____.

A

distance, increases

36
Q

What is the formula for torque?

A

T = F x d

37
Q

How should a secondary joint be addressed with regards to the control reaction effect?

A

reaction effect controlled by careful support of secondary joint splint fabrication or strap placement.

38
Q

Describe “3 point fixation” (the 3 parallel force systems in equilibrium as in first class lever system).

A

the combined downward weights (forearm and hand) must be opposed by equal upward force at the axis (wrist).

39
Q

Why would you need to widen straps regarding 3 point fixation?

A

to increase area of force application

40
Q

straps ___ forces

A

oppose

41
Q

foundation from which force is applied or guided

A

outriggers

42
Q

How should an outrigger be placed?

A

must be placed to allow for 90 degree angle of pull

43
Q
  • when mobilizing stiff joints; allows for easier adjustment

- provides greater joint stability

A

high-profile outrigger

44
Q

-when joints are flexible/supple and purpose is to substitute for absent motion

A

low-profile outrigger

45
Q

articulated splint components = ___ ___

A

mechanical joints

46
Q

Articulated splint components must be lined up with what?

A

anatomical joints

47
Q

What can happen if splint components are not aligned properly with anatomical joints?

A

splint may tend to “piston” and create shear or friction forces.

48
Q

What is a way to increase material strength?

A

providing contour

49
Q

Describe 2 clinical applications of contouring splint material to increase material strength.

A
  • round edges

- contour to body part

50
Q

slightly bent edges

A

bevel edges

51
Q

disperse forces

A

round edges

52
Q

Friction may lead to what 3 things?

A
  • skin irritation
  • blistering
  • eventual breakdown
53
Q

Friction usually indicates what 3 things?

A
  • poor fit
  • improper joint alignment
  • ineffective fastenings
54
Q

The radial side of the hand is usually used for which general type of function?

A

fine motor

55
Q

The ulnar side of the hand is usually used for which general type of function?

A

power grasp

56
Q

Name the 9 creases of the hand.

A
  • thumb - thenar, proximal, distal
  • fingers - proximal, middle, distal
  • palm - DPC, PPC
  • wrist
57
Q
  • follows distal carpal row

- allows wrist motion

A

proximal transverse arch

58
Q
  • follows line of middle finger

- allows flex/ext of fingers

A

longitudinal arch

59
Q

dual obliquity

A

consider the arches of hand when making splints to preserve function.

60
Q

Why should sensory considerations be kept in mind by OT when making splints?

A

must be able to check skin to see if it’s ok

61
Q

Describe the safe position of the hand.

A

wrist: 20-30 degrees of extension
MCPs: 40-60 degrees of flexion
fingers - full extension
thumb: abduction/extension

62
Q

Name 5 aspects of orthoses to educate the pt. about.

A
  1. purpose of orthosis, consequences of non-use
  2. correct application and removal
  3. wearing schedule
  4. care: cleaning, heat
  5. indication of poor fit (pressure points)
63
Q

no moving parts, to immobilize body part

A

static orthotic

64
Q

push or pull force, to mobilize

A

dynamic orthotic

65
Q

action of influence that either arrests, produces, or changes the direction of motion.

A

force

66
Q

push or pull (kind of force)

A

nature of force

67
Q

amount/quantity of influence present

A

magnitude of force

68
Q

path or direction along which force acts

A

line/angle of application

69
Q

location on structure at which line of force act

A

point of application of force

70
Q

increase ___ of ___ application, applies to any type of splint.

A

area, force

71
Q

apply passive pulling force in one direction while permitting active resistive motion in the other direction.

A

dynamic orthoses

72
Q

force should be applied so that the angle of application is how many degrees to the lever?

A

90 degrees

73
Q

which happens if the angle of application is not at 90 degrees?

A

beneficial effect is lessened and could be potentially dangerous

74
Q

applies force to a joint to improve PROM, no joint motion permitted while wearing orthotic device.

A

static progressive orthoses

75
Q

use ___ ___ ___ for dynamic and static progressive orthoses.

A

optimum rotational force

76
Q

production of joint rotation

A

rotational element

77
Q

production of joint distraction or compression

A

translational element

78
Q

product of force times the length of the arm on which it moves (T = F x d)

A

torque

79
Q

the amount of torque depends on what?

A

distance between joint axis and point of application of the force

80
Q

if there is a hard end feel of tissue, which types of splints will be indicated?

A

serial static or static progressive splints

81
Q

designed to correct contractures by applying a gentle prolonged stretch

A

static progressive splints

82
Q

non-elastic component attached to a themoplastic base is adjusted by small increments as the contracture is reduced

A

static progressive splints

Ortho Eval (24 decks)

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