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Orthotic and Prosthetic Board Prep > Prosthetics Exam > Flashcards

Prosthetics Exam Flashcards

1
Q

Gait cycle

A

Heel strike on one side and the following heel strike on the same side

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2
Q

Venous return of the blood to the heart is assisted by the

A

Action of the skeletal muscles

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3
Q

During normal human locomotion, how many inches does the center of gravity shift from side to side

A

2 inches

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4
Q

The center of gravity of the adult male is located on the midline of the body at approximately the level of the

A

2nd sacral vertebra

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5
Q

To minimize lateral bending of the trunk subsequent to unilateral hip abductor weakness, it is best to use:

A

A cane on the uninvolved side

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6
Q

Surgical attachment of muscle to muscle is known as

A

Myoplasty

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7
Q

Body’s center of gravity reaches its highest point at

A

Mid-stance

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8
Q

Pressure is determined by

A

Force divided by area

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9
Q

During normal human locomotion, b/t heel contact and foot flat, the floor reaction force tends to cause which moments at the hip and knee

A

Hip flexion
Knee flexion

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10
Q

If the sciatic nerve is severed at the level of the lesser trochanter, muscle function will not be impaired at the

A

Hip joint

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11
Q

Which muscle is most readily identified by palpation

A

Sartorius

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12
Q

Muscles which pass posterior to the medial malleolus at the ankle act to

A

Invert and plantar flex the foot

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13
Q

Which of the following muscles flexes the knee joint

A

Biceps femoris

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14
Q

Bones which form the acetabulum

A

Ilium
Pubis
Ischium

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15
Q

Normal hip reaches its maximum extension during

A

Heel-off

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16
Q

Which of the following muscle inserts on the lesser trochanter

A

Iliopsoas

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17
Q

In the hip disarticulation Px, the major function of the iliac crest is to

A

Provide an area for suspension

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18
Q

In a Canadian hip disarticulation socket, which of the following is not affected by A-P placement of the hip joint

A

Lateral stability during stance phase

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19
Q

With respect to the hip and knee joints at midstance, the floor reaction line for a hip dis. Px may be caused by

A

Heel wedge that is too hard

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20
Q

The symphysis pubis is

A

The anterior junction of the pelvic bones

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21
Q

Immediate Post-surgical fitting of the UL amputees offers these advantages

A

Early maturation of the RL
More rapid rehabilitation
Early return of 2 handed grasping patterns

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22
Q

Advantages of a myoelectric Px system over a cable driven Px

A

Requires less force and excursion
Provides inherent sensory feedback
Improves the cosmetic result

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23
Q

Pt with loss of the thumb only would probably benefit most from

A

An opposition post

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24
Q

Mechanical partial hand Px would probably be contraindicated from a transmetacarpal amputation with

A

The thumb and index finger remaining

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25
Q

The amount of residual supination and pronation retained by a wrist disarticulation Pt while wearing a Px should be at least:

A

50%

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26
Q

A 23 yo wrist disarticulation amputee intends to return to work as a carpenter. Which terminal device offers the best tool handling capabilities

A

Dorrance 7 (farmer’s hook)

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27
Q

What would cause decreased pronation and supination in a wrist disarticulation Pt

A

Proximal trim line is proximal to epicondyles

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28
Q

The motions of supination and pronation of the forearm occur at which of the following joints

A

Proximal radioulnar

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29
Q

In the medium length BE (below elbow) amputation, which of the following muscles is missing

A

Pronator quadratus

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30
Q

Which of the following is not part of the BE figure-of-eight harness

A

Lateral suspension strap

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31
Q

If a BE Px is harnessed with a split cable housing, which Px joints has most likely been utilized

A

Step-up hinge

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32
Q

A BE Px with flexible hinges should not inhibit flexion at the elbow more than

A

10 degrees

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33
Q

Primary advantage of a voluntary closing terminal device

A

Graded prehension

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34
Q

Component which provides the greatest ROM for the bilateral BE amputee

A

Wrist flexion unit (Sierra type)

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35
Q

Loss of the UL just distal to the supinator muscle will result in what amputation level

A

Short BE RL

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36
Q

What modifications is made to the figure-of-8 harness for the bilateral BE Pt

A

The axilla loops are unnecessary
A cross back strap is added

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37
Q

The force applied to open the TD (terminal device) of a BE Px is 7 lbs. How many lbs of force applied at the harness would provide acceptable efficiency

A

10 lbs

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38
Q

Pt with long bilateral BE amputations who is also blind will have difficult using conventional Px devices. What surgical intervention can be most useful in this situation

A

Krudenberg’s opperation

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39
Q

When a voluntary opening Px hand is activated, the cable replaces function normally provided by the

A

Extensor carpi radialis longus and brevis

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40
Q

Prehension patterns provided by a Px hand

A

Cylindrical
Spherical
Palmar

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41
Q

Main supinator of the forearm

A

Biceps

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42
Q

Olecranon process is a portion of the

A

Ulna

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43
Q

An excursion amplifier incorporated in a control system provides increased cable excursion at the expense of

A

Requiring more force

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44
Q

When the elbow flexion attachment of the AE (above elbow) forearm is moved toward the TD, it will have what mechanical effect

A

Decrease force required
Increase excursion required

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45
Q

Characteristics of the elbow disarticulation

A

Provides rotational stability
Preserves a long lever arm
Prevents bony overgrowth
Leaves the epiphyseal plates intact

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46
Q

Above elbow amputation is sometimes performed for a complete brachial plexus injury. For optimum Px function, what other steps would be helpful

A

Shoulder fusion

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47
Q

The brachioradialis muscle acts primarily to

A

Flex the elbow joint

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48
Q

The Prosthesis designed for a Pt with a proximal femoral focal deficiency (PFFD) generally utilizes ischial and gluteal WB because the

A

Hip joint is unstable or non-existent

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49
Q

The main flexor of the hip joint is the

A

Iliopsoas

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50
Q

During normal heel strike, the forward hip is

A

Flexed 25 degrees

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51
Q

The biceps femoris produces which of the following hip and knee motions

A

Hip Extension
Knee Flexion

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52
Q

Which externally powered elbow units is not usually adaptable to a switch control in the harness

A

Utah

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53
Q

A split-socket for the BE Px Pt is used so that

A

The amount of forearm flexion is increased

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54
Q

The biceps brachii produces which of the following actions of the elbow and forearm

A

Elbow flexion
Forearm supination

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55
Q

Characteristics of a Px with step-up elbow joints

A

Appropriate for very short RL
Weaker flexion power
2:1 excursion ratio

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56
Q

Muscles that plantar flex the foot

A

Tibialis posterior
Plantaris
Peroneus longus
Gastrocnemius

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57
Q

Which muscles undergoes a lengthening Cx between heel strike and foot flat

A

Tibialis posterior tibialis anterior
Flexor hallucis longus

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58
Q

Pt loosed what after a transmetatarsal amputation

A

Push off

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59
Q

Inversion of the foot is accomplished primarily by the

A

Tibialis anterior and posterior

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60
Q

The talus does not articulate with the

A

Cuboid

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61
Q

Active plantar flexion of the ankle joint is strongest with the

A

Knee extended

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62
Q

The chopart level of amputation is performed through the

A

Mid-tarsal joint

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63
Q

The anterior trimline of the symes Px usually extends to the level of the patellar tendon in order to

A

Provide a long lever arm to distribute force

64
Q

To check Px ht, the amputee should

A

Support their wt equally on both legs

65
Q

When walking, the normal foot should pass close to the AK Px foot to

A

Facilitate shift of body wt

66
Q

Rotation of the foot at heel strike may be caused by

A

A stiff PF bumper

67
Q

If the ischial tuberosity is placed too far toward the medial side of the ischial seat, it results in

A

Crowding of adductor muscles into small area, causing burning sensation

68
Q

The knee bolt of the Px is usually found to be

A

In approximately 5 degrees of external rotation

69
Q

When the adductor longus tightness is observed during initial fitting of the AK socket, you should

A

Flare and contour anterior-medial corner

70
Q

When the AK knee amputee must arch his back to maintain the center of gravity of his body in the proper position while pressing back with his stump, it is an indication that the

A

Stump was fitting into a socket without adequate initial flexion

71
Q

As the AK amputee places his wt on the Px, the femur presses toward the lateral wall. B/c of this, the lateral socket wall should be

A

Adducted to stabilize the femur during locomotion

72
Q

The suction socket Px is aligned so that involuntary alignment stability is minimized and voluntary knee control by stump action is emphasized

A

In order that a minimum amount of energy is consumed during walking

73
Q

If a force of 10 lbs is exerted on the 5 foot arm of a lever, what force must be exerted on the 2 foot arm to balance it

A

25 lbs

74
Q

Medial whip is cased by

A

Excessive lateral rotation of knee bolt

75
Q

In correcting an abducted socket on the adjustable leg, we should

A

Release the medial tilt screw and tighten the lateral

76
Q

When pulling the amputee into an AK socket, the most important anatomical landmark is the

A

Adductor longus tendon

77
Q

If the ischial seat of the AK socket is made too wide, it will cause

A

Burning sensation when the wearer is seated b/c of excessive stretching of the skin

78
Q

gait fault due to incorrect function of Px

A

Circumduction

79
Q

How does an excessively stiff PF bumper in the Px foor affect knee stability

A

Decreases knee stability

80
Q

At push-off, it is common for an AK amputee with well developed hamstring muscles to force themself off the ischial seat as their stump extends. How can this trouble be avoided

A

Align the socket in a position of initial flexion

81
Q

What is the effect of excessively shimming the DF stop to place the shank in a vertical position

A

Excessive increase in range of PF with increase in knee stability

82
Q

If the AK amputee complains of pressure on the pubic ramus, the prosthetist should

A

lower the medial wall 1/8” at a time

83
Q

Pronounced impact shock at full extension of the Px knee indicates need for

A

More extension dampening controls

84
Q

During swing phase, a tendency for the AK Px shin to make a marked inward movement of the knee accompanied by an outward movement of the foot is called

A

Lateral whip

85
Q

If the medial-lateral dimension of the AK socket is too large

A

The ischial tuberosity will move laterally on the seat

86
Q

What is the result of locating the toe-break too far forward in the Px foot

A

Gives amputee a feeling of “climbing a hill” causing excessive energy consumption and awkward gait

87
Q

When hamstring muscle tightness is observed during initial fitting of the AK socket you should

A

Relieve the lateral border of the Scarpa’s bulge

88
Q

Pt wt of 200 lbs is assumed to be concentrated at his center of gravity. The effective length of the lever arm b/t his center of gravity and the support point on his socket is 6 inches. The effective length of the lever arm form the support point to the midpoint of his femur is 10 inches. How many inch-pounds of force must be distributed on his femur to prevent mediolateral instability

A

120

89
Q

Factors that contribute to vaulting with an AK Px

A

Px too long
Excessive knee friction
Inadequate suspension

90
Q

The gluteus medius is most active during

A

Mid-stance

91
Q

Characteristic of the constant friction knee

A

Reduces “heel rise” at normal cadence

92
Q

The toe of an AK Px rotates externally at heel strike. Which of the following is the major cause of this problem

A

PR resistance too firm

93
Q

Selisian Belt Function

A

Aids in rotational control
Improves suspension
Provides sense of security

94
Q

How is the medial lateral dimension of the quadrilateral AK socket determined

A

Divide the thigh circumference at ischial level by 3

95
Q

In a total contact suction socket, edema is prevented by

A

Alternating negative and positive distal pressures

96
Q

Functions of a hip joint and pelvic band

A

Improves lateral stability
Controls rotation
Controls abduction
Provides suspension

97
Q

Compared to the AK amputation, the knee disarticulation offers

A

End bearing
Greater rotational control
More functioning muscles intact

98
Q

Which adductor muscle is always transected in a knee disarticulation amputation

A

Gracilis

99
Q

Swing phase whips are caused by

A

Knee bolt internally rotated
Rectus channel too shallow
Weak RL musculature

100
Q

A burning or stretching sensation near the ischial area of an AK Pt, while they sit, most likely caused by

A

An excessively wide ischial seat

101
Q

If the amount of adduction must be decreased on the AK plaster mold, how must the posterior shelf (seat) be modified

A

Add plaster laterally

102
Q

What would likely cause an AK amputee to walk with an abducted gait

A

Improperly contoured lateral wall

103
Q

Which knee provides the least stance phase stability

A

Constant friction

104
Q

In an AK quadrilateral socket, what can cause discomfort in the hamstrings

A

Socket A-P diameter too small
Excessively wide ischial shelf
Insufficient to medial wall angle too large

105
Q

When a mechanical friction knee is used in an AK Px, it can be expected that excessive heel-rise will occur

A

A faster than normal cadence

106
Q

A result of reduced piston action on an AK suction socket it

A

More toe clearance during swing phase

107
Q

Ertl procedure

A

Tibia bridged with the fibula

108
Q

BK patient feels anterior/distal discomfort in his Px socket. How to address it

A

-Extend the prosthetic socket (moves pressure more proximal to painful area)
-Add pretibial pads (bridges the painful area so it receives less direct pressure)

109
Q

BK stated posterior knee or hamstring discomfort

A

-Lower the posterior medial brim on the Px socket (relieve pressure on hamstring tendon)
-Flex the Px socket (decrease tension on posterior knee joint and hamstring tendon)
-Align Px foot more posterior in relation to the prosthetic socket (more foot posterior to decrease toe lever = decrease extension moment at the knee)

110
Q

Which levels of amputation may lead to an equinus gait deformity

A

-Lisfranc and Chopart amputation (loss of DF attachments causes patient to Pf their ankle)
-Transmetatarsal amputation (Transects the peroneus longus tendon which assist the 1st ray

111
Q

BK wearing PTB style endoskeletal Px with general knee pain and distal end pressure. The Pt doffs their Px and liner and there is redness on the distal tibia and inferior aspect of the patella bone. How to solve it

A

-Add a gastroc pad to Px socket
-Add a 1 ply Px sock over liner

112
Q

Myodesis

A

The suturing and permanent attachment of a muscle to a bone

113
Q

Symes amputation

A

-Removal of the malleoli “distal aspect”
-Placement of thick heel pad
-Amputation through the articulation of the ankle

114
Q

Myoplasty

A

The suturing or permanent attachment of a muscle to another muscle

115
Q

2 advantages of myodesis over myoplasty with regards to amputations

A

-Decreased rate of muscular atrophy
-Decreased rate of antagonistic muscular imbalances

116
Q

During normal heel strike, the forward hip is how flexed

A

25 degrees flexion

117
Q

Which style of muscular tissue management in a HT amputation would be of greatest advantage to a myoelectric Px candidate

A

Myodesis

118
Q

TF patient is seen in clinic that exhibits lateral/proximal loss of contact in stance. Upon Px fit exam it is noted that lateral wall is superior to the greater trochanter, the anterior wall contours to the adductor longus tendon, the posterior socket does not encompass the ischial tuberosity, the medial wall is located 65mm inferior to the perineum. What do you attribute the cause of this deviation

A

The medial wall is located foo far inferior to the perineum

119
Q

With a Krukenberg procedure what muscles is the driver of the pincher grip

A

Pronator teres
Median n. (C6, C7), pronate forearm at prox radioulnar joint and flex forearm at elbow

120
Q

What would be a good quality to look for in a Px foot for a TT amputee who is a K2 designated household ambulator that utilizes his px efficiently during the day but fatigues in the evening and buckles at the knee secondary to quadriceps weakness

A

-Foot that progresses rapidly into PF during LR
-Heel should have a relatively soft durometer = Quick to foot flat (extension moment at knee and knee stability)

121
Q

TT Pt is seen presenting with a traditional exoskeletal PTB Px with a SACH foot. Pt states that she feels like the Px is throwing her knee forward as soon as the heel firmly contacts the ground. She has worn the Px comfortably for 2 years until one month ago. What should be the 1st clinical action you should take at this time in the appointment

A

Check if Pt switched to a shoe with a higher heel height = Will induce flexion moment about the knee

122
Q

TR patient is inquiring as to which TD would be best for picking up a small coin from a table. Which device would you recommend

A

5XA (Canted, non-symmetrical = allows better vision)

123
Q

What are simple options for increase the ease of pre-positioning the Px elbow in flexion, for a TH amputee utilizing a body powered Px who lacks glenohumeral flexion strength and biscapular abduction strength but can operate a elbow lock

A

-Have the forearm lift tab located distally/anterior (you more the pull angle anterior to bridge the elbow joint whereby decrease the force necessary to move the forearm section)
-Check the level of resistance in the cable housing

124
Q

What bony landmark is utilized a WB Px in a hip disarticulation

A

Ischial tuberosity (same as TF)

125
Q

During dynamic alignment of a PTB Px, excessive knee flexion occurs at the beginning of heel rise. Which adjustment best corrects the problem

A

Move foot anterior = Decrease socket flexion
(increase toe lever and increase PF extends socket)

126
Q

Long posterior flap in a BK amputation secondary to ischemia is preferred why

A

Better blood supply

127
Q

A tendon that is readily visible or palpable in the popliteal area when the knee is flexed is that of the

A

Biceps femoris

128
Q

What is strain

A

The change in original length of a body divided by its original length

129
Q

In the transverse plane, as the knee flexes, the tibia ________ with respect to the femur

A

Internally rotates

130
Q

“Cookie-crusher” circuit used for pediatric myoelectric Px is analogous in function to a

A

Voluntary opening TD

131
Q

Appropriate age to activate a cable driven TD for a child with a congenital TR amputation

A

15-24 months

132
Q

Most common cause of LE amputation is

A

Peripheral vascular disease

133
Q

Possible cause of the Pt feeling that they are walking uphill

A

Foot too PF

134
Q

If forearm lift loop is moved distally away from the elbow, how does it effect force

A

Decrease force

135
Q

What might cause the Pt with a TT Px to scuff his toe on the Px side

A

Foot too PF

136
Q

Biceps femoris relief should be _____ and _____ than that of the other hamstrings

A

Higher, smaller

137
Q

Main extensor of the hip joint

A

Gluteus maximus

138
Q

Antero-medial relief in the quadrilateral socket is for the

A

Adductor longus muscle

139
Q

In the PTB design, frontal plane socket tilt should be _____ after bench alignment

A

5 degrees adduction

140
Q

Childhood disease caused by a bacterial infection, often presents in a client as a bilateral TT and bilateral partial hand amputations

A

Menigococcemia

141
Q

In order to check the appropriate length of the distal housing, a hook TD needs to be in a position of

A

Supination

142
Q

What type of moment would you expect to see at toe-off if the Px socket were placed excessively posteriorly

A

Extension
Posterior socket = Longer toe lever = increased extension
*Anterior/Proximal and Posterior/Distal

143
Q

Anterior deltoid is responsible for _____ when the arm is at your side, and for ______ when the arm is flexed

A

Gleno-humeral flexion and Horizontal adduction

144
Q

Thomas test assess

A

Hip flexor tightness

145
Q

In the PTB design, at MPT level, bisecting the socket laterally, a plumb line should fall ____ to the center of the pylon

A

1.25” anterior

146
Q

Spiking or bony overgrowth usually occurs to the person who has

A

TT amputation secondary to amniotic band syndrome

147
Q

Triceps brachii is innervated by the ______ nerve

A

Radial

148
Q

Socket is flexed 5 degrees initially in the PTB socket designed to

A

-Increase the exposure to the appropriate WB surfaces
-Reduce the tendency for the knee to hyperextend during late stance
-Put the quadriceps muscles in initial stretch to increase their ability to contract

149
Q

Self-suspending socket design that utilizes A-P susupension

A

Meunster

150
Q

When using a BK adjustable shank, what would cause the pylon to lean anteriorly during static alignment

A

Foot heel height too low

151
Q

A varus moment is desirable in the PTB socket design to

A
  • Duplicate the normal varus moment in gait
  • Optimize loading on the medial tibial flare
152
Q

During static alignment of a TT Px, a socket that is too flexed will cause

A
  • A posteriorly leaning pylon
  • Toe to be off the ground
  • More WB through the heel
153
Q

In TT Px, if heel height of the shoe is too low

A

Pylon will have a posterior lean

154
Q

Where does the center of the posterior wall trimline on a standard PTB socket design terminate with respect to the MTP

A

3/8” superior

155
Q

Most common surgical Tx of a complete longitudinal deficiency of the tibia

A

Knee disarticulation amputation

Orthotic and Prosthetic Board Prep (9 decks)

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