upper extremity amputee Flashcards

1
Q

complications with ue limb loss

A

Edema
Contracture
Body asymmetry
Skin breakdown
Cosmetic acceptability
Neuroma

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2
Q

what is neuroma in limb loss

A

nerves are severed and then they grow back in a cluster in tissue. can be painful.

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3
Q

What healthcare professionals are involved with UE limb loss

A

MD, prosthetist, nurse, OT, PT (maybe), SW (social worker), psychologist, vocational rehabilitation

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4
Q

When is the best time for UE prostethics?

A

right away! within the first 30 days

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5
Q

What assessment would you choose for UE amputee?

A

Occupational Profile
ADL
UE AROM
Edema
Pain
Strength
Sensation
Cognition
Balance
Fine motor
Prosthesis check out
Activities Measure for Upper Limb Amputees (AM-ULA)

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6
Q

How do we build muscle strength for a person with UE amputee

A

isometrics, tightening the limb, squeezing muscles, weighted cuff, once skin is healed, use a thera band, tuba grip sleeve and then thera band on there.

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7
Q

What cognition test would you do with UE amputee

A

start small, mini mental, then progress to performance based.

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8
Q

Why would we check balance with UE amputee

A

reduce chance of falling.

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9
Q

WHat is the assessment designed specifically for UE amputee

A

activities measure for upper limb amputees (AM-ULA)

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10
Q

Why do we care about wound care if the nurse is watching it?

A

because our treatment will be guided by it.

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11
Q

What’s an intervention for edema control

A

movement, strength

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12
Q

how would we intervene for scar management

A

teach them how to do a scar massage

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13
Q

intervention for pain management

A

mostly desensitization. see what they can tolerate. smooth fabric - have them rub that on residual limb. rub lotion after bathing gradually work towards more textured fabrics. Eventually have them weight bear in a rice bucket. Soft brisle brushes.

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14
Q

how can help managing pain help emotionally

A

it will help limb loss acceptance

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15
Q

What is peri operative care in OT?

A

promote wound care and healing, edema control, scar management, pain managment, Optimize joint ROM
Maximize strength
Emotional /psychological support
Connect patient with peer mentor

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16
Q

What is some pre-prosthetic training?

A

Emotional support
Stabilize limb volume
shrinkage , shaping and desensitization
Limb hygiene
Optimize limb ROM & strength
Prepare to change limb dominance
Maximize ADL indep
Myoelectric site testing

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17
Q

With a bilateral UE amputee what is the dominant side?

A

The longer limb is the dominant limb.

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18
Q

OT role before prosthetic training

A

we need to make sure they are independet without the prosthetic. so they have options

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19
Q

What is myoelectric site testing

A

for the myoelectric site testing, find out where the nerves end to see where the prosthetic can be useful.

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20
Q

when does limb shaping start?

A

right away

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21
Q

What soft dressing do we use for limb shaping?

A

ace wrap, tubi grip

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22
Q

What shape do we need to make the limb when limb wrapping for shaping?

A

cone shape

23
Q

How do we wrap the residual limb for shaping

A

distal to proximal figure 8

24
Q

how often whould yuou clean shaping wrap?

A

every 2 days

25
Q

how often should a shrinker be worn?

A

all the time

26
Q

phantom limb pain

A

pain in the absent limb

27
Q

residual limb pain

A

pain that is present in residual limb

28
Q

phantom sensation

A

non-painful sensation in absent limb

29
Q

incisional pain

A

acute, localized along the incision, improves with healing

30
Q

What is effective with phantom limb pain?

A

mirror therapy and VR mirror therapy

31
Q

What is the amputee coalition of america protocol for desentization?

A

Increase tolerance to prosthetic socket s/p wound closure
- Massage
- Tapping
- Long handled sponge
- Sensory bins
- Baby brush
- Towel
circular motion for 2-3 minutes.
start 2x/day then progress to more frequently.

32
Q

pain is correlated with

A

emotional state

33
Q

if the emotional state is higher what may take longer

A

management of pain and acceptance of body image

34
Q

pain management for UE amputee

A

mirror, tens, compression, analgesics (meds) gabbapentin for nerve pain.

35
Q

Check the weather to manage

A

pain. weather / pain pregame

36
Q

prosthetic training steps

A
  • Skilled instruction in the functional use of the prosthesis
  • Limb hygiene and care
  • Care of the prosthetic limb
  • Donning and doffing
    -Clean liner and socket
  • Wearing schedule
37
Q

What is dominent when a pt has a Unilateral prosthesis -

A

always non-dominant

38
Q

What body function is needed for body powered prosthetic

A

shoulder movements

39
Q

Voluntary opening (VO) TD

A

stays closed all the time but need to voluntarily open. With elbow locked, upper arm comes forward to open TD

40
Q

prosthetic training repetitive activities

A

Manipulate various sizes and shapes
Seated, standing and walking
Clothes pins
Pens and pencils
Small wooden blocks
Cup
Softball
Deck of cards

41
Q

What is the standard for using sound arm vs. prosthesis?

A

Sound arm used with bilateral tasks only
All unilateral tasks are with prosthesis

42
Q

wearing schedule for prosthatic

A

Begin with no more than 15-30 min with skin checks
Frequent checks of socket fit
If redness > 20 min after removal, prosthetist will adjust socket
Increase wearing time by 30 min if no issues
Goal is to wear prosthesis all day within 1 week

43
Q

different types of prosthetic

A

passive or cosmetic (finger)
active - body powered prosthetic, myoelectric, hybrid, activity

44
Q

myoelectric are

A

battery powered, they have sensors on the nerves of the patient.

45
Q

How do prosthetics help physical health?

A

Protect sound side, provide symmetry, avoid overuse

46
Q

how does prosthetic improve social help

A

Enhance work roles and ADLs

47
Q

how does prostehtic improve psychological well being

A

Independence, support positive body image, enhance self confidence, reduce depression

48
Q

how does prosthetic help with reinegration>

A

Family, society, work roles

49
Q

advantages of prosthetic

A

Body image
Provides non-dominant hand
Enhances bimanual activities
Accelerates function
Better function if injury or loss of other limb occurs

50
Q

downside of prosthetics

A

Sensory feedback & movement
Comfort
Skin reaction
Frequent visits to prosthetist & OT

51
Q

reimbursement for prosthetics

A

Health Insurance
Worker’s Compensation
Private Payment
Liability Insurance
Auto insurance & homeowners
Government Agencies
Veteran’s Affairs
Vocational Rehabilitation

52
Q

instances when you couldn’t use a prosthetic

A

Unilateral amputee may forego prosthesis
Partial hand amputee can function well without prosthesis
Patient with cognitive or psychiatric issues may function without

53
Q
A