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Amputation Flashcards

1
Q

A surgery to remove all or part of a limb or extremity

A

Amputation

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2
Q

Purpose of doing amputation

A

Control infections

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3
Q

Amputation comes from the latin word

A

Amputare (to cut around)

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4
Q

Leading cause of amputation

A

Peripheral Vascular Disease (PVD)

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5
Q

Second leading cause of amputation

A

Diabetes Mellitus (DM)

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6
Q

Other causes of amputation

A

HTN
Dyslipidemia

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7
Q

Amputation is more common in what sex?

A

Males

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8
Q

A type of amputation wherein soft tissues are closed primarily over the bony stump

A

Closed-type

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9
Q

Principles of closed amputation

A

Tourniquets
Level of amputation
Flaps
Muscle
Methods of muscle suture
Compression dressing
Absolute bed rest
Limb fitted
Nerves
Bones
Blood Vessels
Drains

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10
Q

What does a tourniquet do in a closed amputation?

A

Prevents excessive blood loss

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11
Q

When should a tourniquet be applied?

A

Done before actual amputation

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12
Q

Contraindication for tourniquet

A

Ischemic limb

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13
Q

Important to fit prosthesis

A

Level of amputation

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14
Q

Skin should be mobile and sensitive

A

Flaps

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15
Q

3 methods of muscle suture

A

Myodesis
Myoplasty
Tenodesis

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16
Q

Muscle is sutured to the bone

A

Myodesis

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17
Q

Contraindication for myodesis

A

Ischemic limb

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18
Q

Muscle to muscle closure

A

Myoplasty

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19
Q

Tendon attached to the bone

A

Tenodesis

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20
Q

What are the types of compression dressing used in amputation?

A

Elastic or rigid plaster dressing

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21
Q

Acceptable for conventional prosthesis with adequate vascularity

A

Absolute bed rest with limb elevation

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22
Q

How long is a conventional prosthesis fitted for?

A

A minimum of 8-12 weeks after surgery

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23
Q

How are nerves cut in amputation?

A

Cut proximally and allowed to retract

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24
Q

How are large nerves cut?

A

Large nerves are ligated before division

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25
How are blood vessels cut in amputation?
Doubly ligated and cut
26
How long do drains stay for?
Removed after 48-72 hours
27
Two types of open amputation
Guillotine Circular
28
Treatments following open amputation
Rigid dressing concept (Pylon) Soft dressing concept
29
POP cast is applied to the stump over the dressing after surgery
Rigid dressing concept (Pylon)
30
Stump is dressed with the sterile dressing and elastocrepe bandage applied over it.
Soft dressing concept
31
Complications of amputation
Hematoma Infection Necrosis Contracture Neuroma Stump pain Phantom sensation Hyperesthesia of stump Stump edema Bone overgrowth Causalgia
32
The sensation in body regions where limbs or body parts used to exist
Phantom limb
33
Sensation felt in phantom limb
tingling burning itching pressure numbness (sometimes)
34
Scar over the surgical incision poses a problem in process of rehab
Painful adhesive scar formation
35
How can a phantom limb be addressed?
Providing proprioceptive feedback for the artificial limb
36
Scar over surgical incidion
Painful adhesive scar
37
How can painful adhesive scar be addressed?
Early mobilization of the painful scar with other therapeutic modalities
38
How many weeks does new bone form after electrical burn?
5 weeks
39
Signs found in the residual limb that may be a sign of new bone formation
Warmth Tenderness Swelling
40
What is the percentage of trauma-caused amputation?
16.4
41
What is the percentage of amputations caused by neuropathy and vascular conditions?
81.9
42
What is the percentage of cancer-related amputation?
0.9%
43
What is the percentage of amputations that is caused by congenital abnormalities?
0.8%
44
Exclusion of any of one or more toes
Partial toe
45
Disarticulation at the MTT joint
Toe disarticulation
46
Resection of 3rd, 4th, and 5th MTT and digits
Partial foot/ray resection
47
Amputation through the midsection of all MTT
Transmetatarsal
48
Ankle disarticulation c the attachment of the heel to the distal end of tibia; May include removal of malleoli and distal tibia/fibula flares
Ankle disarticulation (Syme’s)
49
More than 50% of the tibial length
Long transtibial (below knee)
50
Less than 20% of the tibial length
Transtibial (below knee)
51
Amputation through the knee joint; femur is intact
Knee disarticulation
52
More than 60% of the femoral length
Long transfemoral (above knee)
53
Between 35-65% of the femoral length
Transfemoral (above knee)
54
Less than 35% of the femoral length
Short transfemoral (above knee)
55
Amputation through the hip joint; pelvis intact
Hip disarticulation
56
Resection of the lower half of the pelvis
Hemipelvectomy
57
Amputation of both lower limbs and pelvis below L4-L5
Hemicorporectomy
58
Partial hand
Partial hand
59
Wrist disarticulation
Wrist disarticulation
60
Below elbow
Transradial
61
Elbow disarticulation
Elbow disarticulation
62
Above elbow
Transhumeral
63
Energy above baseline of long transtibial
10 %
64
Speed of long transtibial
70 m/min
65
O2 cost of long transtibial
0.17 mL
66
Energy expenditure of average transtibial
Energy: 25% Speed: 60 m/min O2 cost: 0.20 mL
67
Energy expenditure for short transtibial
Energy: 40% Speed: 50 m/min O2 cost: 0.20 mL
68
Energy expenditure for bilateral transtibial
Energy: 41% Speed: 50 m/min O2 cost: 0.20%
69
Energy expenditure for Transfemoral
Energy: 65% Speed: 40 m/min O2 cost: 0.28 mL
70
Energy expenditure for W/C
Energy: 0-8% Speed: 70 m/min O2 cost: 0.16 mL
71
3 domains assessed during pre-op
Physical Social Psychological
72
PT Education for amputees
Phantom Limb Pain Discussion of the surgical level Post-op prosthetic plans Training Reassurance Process for adaptation
73
Systems assessed in physical assessment
Ms strength Joint mobility Respiratory function Balance reaction Functional ability Vision and Hearing status
74
What is assessed psychologically?
Psychological of pt Motivation Other psychological issues
75
What can be found under social assessment?
Family and friends support Living/Work environment Proximity to stores/shops
76
What are the goals of a pre-operative training?
Minimize post-op complications Lower the rehab cost Shorten rehab duration
77
What are done in training programs for amputees?
Prevent thrombosis Prevent chest complications Relieve pressure Improve mobility Educate the pt
78
Unaffected parts do not occur distal to and in line with deficient portion
Terminal deficiencies
79
Complete absence (both Rad/Ul or Tob/Fib) distal to the level of loss
Transverse
80
Complete longitudinal absence in either pre or post axial elements
Terminal paraxial
81
Intermediate parts are deficient; elements proximal to and distal to deficient portion are absent
Intercalary deficiency
82
Segmental absence of either pre or post axial segments; intact proximal and distal
Intercalary paraxial
83
Presents with foreshortening of limb
Phocomelia
84
Where does the length measurement of a transtibial amputation start?
Starts from the medial joint line of the knee (Alternative: Tibial tub)
85
Where does the length measurement of a transfemoral amputation start?
Ischial tuberosity/GT

Assistive Technologies (8 decks)

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