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MVMT SCI II > UE AMPUTATION- ASYNCH > Flashcards

UE AMPUTATION- ASYNCH Flashcards

1
Q

prosthesis

A

artificial body part

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2
Q

residual limb

A

remaining limb after amputation

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3
Q

sound side

A

limb that was not amputated

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4
Q

don and doff

A

taking on and off prothesis

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5
Q

socket

A

the interface between the residual limb and prosthesis

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6
Q

terminal device

A

UE specific

hand functioning device in UE prosthesis

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7
Q

suspension

A

how the prosthesis is attached to the body

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8
Q

force

A

how is the force applied through the body or with myoelectric control or external motors?

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9
Q

excursion

A

how much range of motion you need to operate the UE prosthesis

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10
Q

Only ___ percent of patients with amputation have UE amputation

A

9%

-most of these are due to traumatic causes

-rejection rates of UE prostheses are quite high

-proficiency with UE takes much more time and effort than LE

-functional difficulty with UE prosthesis directly proportional to amputation level

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11
Q

Types of UE prostheses:

A

-shoulder disarticulation

-trans-humeral
elbow disarticulation

-trans-radial
wrist disarticulation

-trans-metacarpal
partial hand

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12
Q

Power Strategies for prosthesis

A

how you move the limb in order to generate force

ex: harness system

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13
Q

What is the most common cause for UE amputations in the US

A

TRAUMA

–> as opposed to LE : vascular disease

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14
Q

Control strategies for prosthesis

A

how you manipulate the device that is linked onto the limb (hook, hand, ex)

-ex: cable system controlled with protraction of scapula

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15
Q

Types of UE suspension systems

A

1.) harness
2.) pin-lock liner
3.) suction
4.)anatomical/self-suspending

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16
Q

Harness suspension facts

A

System of straps and buckles about the shoulders, back and chest.

PRO
-simple
-easy maintenance
-durable
-ease of don and doff
-many variations –> depends on use and need of the individual
-good if handling heavy loads

CON
-can be uncomfy –> can cause impingement on neurovascular supply
-poor cosmesis (appearance)

USED FOR:
-all amputation levels
-harness system often used in combo with pin-lock system
-only option for shoulder disartic. or very short transhumeral amputations

EXAMPLES:
-figure of 8
-shoulder saddle and chest strap (no strap on CL UE)
-expanded cross point (figure of 8) connection in back

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17
Q

Pin lock liner suspension facts

A

Silicone or Gel garment worn on the surface of the limb with a distal attachment point which engages a mechanical lock.

PROS
-comfortable
-cushions bony prominences, reduces shear forces

CONS
-somewhat difficult to don (only one UE to help)
-harnessing is usually still needed

USED FOR
-ideal for passive protheses
-mid-short length TH and TR

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18
Q

suction suspension facts

A

skin-tight fit, seal to walls of socket, one-way expulsion valve (don’t always have an interface between inner liner and socket)

PROS
-interface with myoelectric control
-reduce or eliminate harnessing

CONS
-difficult to don -need pull sock or donning sleeve
-distal end discoloration
-very sensitive to volume fluctuations

USED FOR:
-most often at TH level, some TR

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19
Q

Anatomical suspension/self-suspending facts

A

socket encompasses bony prominences (humeral epicondyles) –> slide on and twist to self suspend

PROS:
-integrates with myoelectric control
-reduce or eliminate harnessing

CONS:
-difficult to don, push in or pull sock
-reduced ROM

LEVEL:
-transradial and wrist disarticulation
-can hybridize with suction

20
Q

Types of UE power systems

A

-body power

-passive

-external power (motor)

21
Q

Body power system facts

A

older tech

most common

individual generates the force necessary to cause movement –> usually though scapulothoracic bilaterally and glenohumeral joint ipsilaterally

body power an cable control operate together–> harnessing and cable system captures the force and excursion produced by other body movements and use it to operate the prosthesis

displacement and force of cable proportional to motion and force of scapulothoracic movements bilaterally and GH joint ipsilaterally

22
Q

Force and excursion in relation to prosthesis

A

FORCE - strength or energy causing motion; strength of pull on cable

EXCURSION- movement from axis, distance traveled, translates to cable travel; larger ROM of scapulothoracic interface, the larger pull on the cable

23
Q

Types of control systems for UE prostheses

A

cable control

myoelectric

hybrid

24
Q

Shoulder disarticulation movements for force capture and excursion (what opens the terminal device)

A

-biscapular abduction
-scapular elevation
-chest expansion

25
Q

transhumeral/elbow disarticulation movements to capture force and excursion

A

glenohumeral flexion
biscapular abduction
scapular depression/extension/abduction

26
Q

transradial/wrist disarticulation movements for force capture and excursion (what opens the terminal device)

A

glenohumeral flexion
biscapular abduction

27
Q

Passive prosthesis facts

A

-primarily cosmetic

CAN BE FUNCTIONAL:
-swivel shoulder
-locking elbow
-rotating wrist (supination and pronation)
-passive spring-loaded terminal device

-prepositioned with sound side (power is provided by the sound limb)

28
Q

Externally powered prosthesis facts (power system)

A

power from on-board motor –> provides force for motion

can still be controlled by body

TD, wrist unit, and elbow each motorized and user-selected to function independently as determined by control strategy

-can be controlled myoelectrically.

29
Q

Cable control system facts

A

Integrated with body power:
–harnessing to capture force and excursion through cable attached to harness
–proper harnessing is essential –> for proper control of cable
–analogous to bicycle brake lever or shifter

Integrated with External Power:
- harness connects to a linear transducer or switch

30
Q

Myoelectric control system facts

A

*Most common control for externally powered prostheses (for motor powered UE prostehsis)

-electrodes imbedded in the socket wall for contact with skin
-Electrodes capture the electrical activity of a muscle contraction and convert it into a signal–> prosthetic hand function

-2 electrodes on antagonistic muscle groups
—-> co- contraction can allow you to switch between use of different muscle groups

-1 electrode on any viable site –> one selected movement, terminal device close; program opens when terminal device is relaxed

PROS:
-improved cosmesis
-increased grip force
-minimal to no harnessing
-ability to use overhead
-minimal effort to control
-control more closely corresponds to human physiologic control

CONS
-cost
-need of maintenance and repair
-fragile nature of gloves requiring frequent replacement
-less proprioceptive feedback than BP
-slowness in response
-increased weight

31
Q

Hybrid control facts

A

A combination of cable control and myoelectric control

example: combination of body power cable control elbow with external power Miyo electric control terminal device for forearm

32
Q

Terminal devices

A

replicates some or all of hand function that is lost

33
Q

Grasp pattern types

A

-cylindrical
-hook or snap
-tip
-palmar
-spherical
-lateral

34
Q

Voluntary open terminal devices facts

A

*Closure of the device is the default

-Force an excursion open, spring or rubber bands close

-pinch force is preset

-max pinch force when fully relaxed

35
Q

Voluntary close terminal devices

A

-default the TD is fully open

-Force an excursion close, spring rubber bands open

-pinch force is determined by force exerted by user

36
Q

Transradial considerations - case study in PPT

A

suspension
-harness or pin lock

power
-body powered
(more gross motor control)

control
-cable control

TD
-Voluntary open work hook or voluntary close heavy duty

37
Q

Partial hand amputation considerations

A

use an opposition post to help grasp and hold onto items such as pen

38
Q

WWI accelerated amputation_______-

A

rehabiltation

39
Q

1960s

A

myoelectric arm created for first time

40
Q

Congenital amputation types

A

transverse: absence of limb across its longitudinal axis

longitudinal: limb deficiency along the axis of the limb (such as radial or ulnar deficiencies)

-more common to have upper limb absences

41
Q

Acquired amputation types

A

-traumatic (most for UE)

-dysvascular: necrotizing fasciitis, toxic shock, etc.

malignant: of bone/jont

42
Q

Only__ of those with UE amputation choose to wear a prosthesis

A

50%

-majority of patients with UE acquired amputation are male and between ages of 21 and 64

43
Q

Greifer hook

A

-quick handling and precise manipulation of small objects

-38 pound grasp and parallel gripping surfaces

44
Q

AE amputation and body power vs electric

A

-less control of TD with body movement via the harnessing

-electric components may be more appropriate

45
Q

Who should be referred to a Center for Excellence due to the complexity of the rehab process?

A

individuals with bilateral limb loss

esp those who wish to use myoelectric components

46
Q

What can be used for muscle site control training for myoelectric prostheses?

A

biofeedback with use of phantom limb

practice antagonist motions and co-contraction of those motions

47
Q

What is TMR used for?

A

Allows for the substitution muscle to serve as a myolelectric
control site for several motions at once

Used with myoelectric control, mainly for high BUE amputees
at this time

MVMT SCI II (9 decks)

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