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546 Body Systems 2 > Amputation > Flashcards

Amputation Flashcards

(51 cards)

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1
Q

How many pts in the US have amputations yearly?

A

185k

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2
Q

limb loss vs limb difference

A

limb loss is an amputation from vascular or trauma
limb difference is a congenital condition where a person is born without a limb

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3
Q

myodesis

A

muscle secured to bone by suturing distal tendon to the bone by drilling a hole
leads to the best limb shaping post op

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4
Q

myoplasty

A

securing muscles to adjacent muscles in a sling
can cause irritation due to movement under the skin

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5
Q

minor amputation is classified as

A

toe or partial foot amputation

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6
Q

major amputation is classified as

A

proximal to tarsometatarsal joint

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7
Q

why do amputees have reduced balance after amputation?

A

reduced weight bearing through residual limb
decreased somatosensory
reduced confidence
high fall risk
limitations in ADLs
loss of ankle strategy
lack of kinesthesia

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8
Q

lisfranc

A

tarsometatarsal amputation

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9
Q

symes

A

ankle disarticulation

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10
Q

short transtibial amputation leaves what % behind?

A

<20% of tibial length spared

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11
Q

knee disarticulation leaves which bone(s) intact?

A

femur
tibia and patella removed

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12
Q

gait characteristics of a BKA

A

decreased step velocity
shorter step length
longer stance time on sound limb
decreased stance time on amputated limb
leads to asymmetrical stance phase

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13
Q

long BKA leaves what % of tibia behind?

A

20-50%

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14
Q

long AKA leaves what % of femur behind

A

35-60%

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15
Q

short AKA leaves what % of femur behind?

A

<35

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16
Q

how much does energy expenditure increase in walking with an AKA?

A

60-65%

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17
Q

gait characteristics of an AKA

A

lateral trunk lean
widened BOS
circumduction
abducted gait
uneven step length
exaggerated lordosis

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18
Q

1 cause of UE amputation

A

80% from trauma
next is cancer

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19
Q

which age is at greatest risk of UE amputation

A

65+

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20
Q

progression of rehab for amputee

A

pre operative
amputation with resconstruction
acute post op
pre prosthetic
prosthetic prescription
prosthetic training
community reintegration
vocational reintegration
functional follow up

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21
Q

pt exam subjective should include

Study These Flashcards
A

chief complaint
amputation history
patient goals
emplyment history
prior hobbies.activities
living environment
PLOF
psychosocial
ADLs
pain
gait

22
Q

phantom limb pain

Study These Flashcards
A

can be severe and not shown to resolve though it may improve with time and therapy
due to cut nerve/neuroma
pins/needles or pain perceived in amputated part of leg

23
Q

manage phantom pain

Study These Flashcards
A

compression
medication
breathing/relaxation techniques
massage
biofeedback
TENS

24
Q

amputee limb shapes

Study These Flashcards
A

conical: ideal, base is narrower than proximal
cylindrical: proximal and distal are the same diameter
bulbous: distal has larger diameter than proximal, least ideal for prosthetic

25
integumentary inspection: amputaion
scars/incision, open wounds, skin texture at risk for skin breakdown with prosthetic due to skin being in contact with plastic all day
26
27
vascular assessment: amputation
pulse color temp edema pain trophic changes IC
28
neuro assessment: amputation
proprioception visual vestibular function pain cognition neuropathy
29
MSK assessment: amputation
ROM strength contracture sites hip ext and abd for gait training
30
residual limb assessment: amputation
circumferential measurement length shape
31
outcome measures for amputation
amputee mobility predictor gait velocity 10 m walk 2MWT/6MWT TUG Amp-pro
32
amputee mobility predictor categories
21 categories, 47 points
33
how is gait speed correlated with walking potential?
those with higher gait speed are more likely to succeed at walking with a prosthetic after an amputation
34
ABC scale% scores indicate:
<67% indicates fall risk <50% low level physical function >80% high level physical function
35
post op rehab goals
edema management promote healing limb shaping hygiene optimize ROM optimize strength desensitize residual limb functional sitting and standing
36
pre prosthetic goals for amputee
edema management limb shaping ROM strength desensitization of limbs functional sitting and standing balance bed mobility and transfers pain sitting and bed positioning WC independence
37
when to discontinue PT interventions
excessive drainage from wounds sharp localized pain fever foul odor identifying infection
38
necessary components of a prosthetic
socket - molded to residual limb liners- silicone or gel to protect skin and minimize shear socks - accomodate volume changes throughout the day terminal device - interface between the socket and external environment - the foot part
39
pressure sensitive areas of a BKA
patella tibial tuberosity tibial crest anterior distal tibia fibular head/neck fibular nerve
40
pressure tolerant areas in BKA
patellar tendon supracondylar area suprapatellar area tibial/fibular shaft distal end
41
pressure sensitive areas of AKA
greater trochanter ASIS distal end of femur pubic ramus adductor tendon pubic tubercle sutures
42
pressure tolerant areas of AKA
ischial tuberosity lat/med or AP flare of stump distal end of stump with total contact
43
compression dressing: ace wrap
4-6 in, larger for AKA figure 8 pattern compression reduces on proximal limb controls edema, cheap, and easy to access limb not protective, hard to apply properly with even compression, won't prevent contracture
44
compression dressing: shrinker
elastic compression sock that is sized to patient controls edema, good wound access, cheap, even compression may catch on sutures, painful, not protective or preventing contracture
45
compression dressing: rigid dressing
plaster with rigid outer layer that can stay in place 7-10 days protect limb, controls edema, prevents contractures higher risk of infection, heavy, requires monitoring and limited wound access
46
how often should you change stump wrapping
every 4 hours
47
k0
no ability or potential to ambulate or transfer safely without assistance, prosthesis won't enhance QoL
48
K1
Pt has the ability to use prosthesis for transfers or ambulation on level surface, limited household ambulation
49
K2
ability or potential to be a limited community ambulator
50
K3
ability or potential to be a high level/typical community ambulator as well as vocational exercise beyond walking
51
K4
pt has ability or potential for prosthesis ambulation at highest level, sports

546 Body Systems 2 (8 decks)

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