Amputations & Prosthetics

Question 1

Forequarter

Answer 1

surgical removal of upper extremity including shoulder girdle

also called scapulothoracic

Question 2

UE Prosthesis parts

Answer 2

socket
suspension
elbow unit
wrist unit
terminal device

Question 3

Socket

Answer 3

area that joins the RL to prosthesis

Question 4

Suspension

Answer 4

keeps the RL connected to the prosthetic device

Question 5

Types of wrist units

Answer 5

quick change
wrist flexion
ball and socket
constant friction

Question 6

Terminal device

Answer 6

device that interacts with the environment
can be hook, hand, cosmetic glove

Question 7

Hemicoporectomy

Answer 7

surgical removal of pelvis and both lower extremities

Question 8

Hemipelvectomy

Answer 8

surgical removal of one half of the pelvis and LE

Question 9

Chopart’s

Answer 9

transverse tarsal
amputation through talonavicular and calcaneocuboid

preserves the PFs but loses DF
results in equinus contracture/contracture into PF

Question 10

Lisfranc

Answer 10

tarsometatarsal

surgical removal of metatarsals
preserves DF and PF

Question 11

Parts of LE prosthesis

Answer 11

socket
suspension
knee
shank
foot system

Question 12

Shank

Answer 12

shaft of suitable length to mimic the amputated limb

Question 13

Types of foot systems

Answer 13

SACH
SAFE
single or multi axis
hydraulic
powered
dynamic response

Question 14

K-Level

Answer 14

“Medicare Functional Classification Level” to classify pts based on their status prior to prosthesis. Can be deteremined with AMPPRO or with objective/subjective testing. Can be determined by at PT, MD, or prothetist

Question 15

K-Level 0

Answer 15

-prosthesis will not change QOL
-not eligible for prosthesis

think “bed bound”

Question 16

K-Level 1

Answer 16

-can transfer, ambulate on level surfaces, limited household ambulator
-can receive single axis knee/foot, SACH foot.

think “low level”

Question 17

K-Level 2

Answer 17

-can go over low-level barriers, limited community ambulator
-can receive polycentric knee, flexible foot, multi-axial foot

think “low to moderate level”

Question 18

K-Level 3

Answer 18

-variable cadence, unlimited community ambulator, traverse most environments, would use prosthetic for more than just locomotion
-can receive hydraulic, microprocessor, energy sotring foot, dynamic response foot

-think “moderate to high level”

Question 19

K-level 4

Answer 19

-exceeds basic ambulation skills
-exhibits high impact, stress, energy
-can receive any type of prosthetic

think athlete, child, high active adult

Question 20

Rigid post-op dressing

Answer 20

+allows early ambulation
+stimulates circulation, healing, proprioception, protection, support
+limits edema
+can use immediate post op prosthesis

-can’t inspect wound easily
-can’t change dressing daily
-need professional application

Question 21

Non-weight bearing Rigid Removable Limb Protectors

Answer 21

+ removable, easily applied
+ accommodates for fluid changes
+ prevents contracture and protects soft tissue

-not for ambulation

Question 22

Semi-rigid post op

Answer 22

Unna paste, air splints

+reduce edema
+ supports soft tissues and protects
+ easily changeable

-doesn’t protect as well
-requires more changes vs rigid
-may loosen over time

Question 23

Soft post-op dressing

Answer 23

ACE wrap or shrinker

+ reduces edema
+ provides some protection
+ allows for AROM
+ easily removed and inexpensive

-frequent dressing changes
-less control of pain
-cannot control amount of tension in dressing
-risk of tourniquet effect

Question 24

Transtibial pressure tolerant areas

Answer 24

patellar ligament
lateral fibula shaft
medial and lateral tibial shaft

Question 25

Transfemoral pressure tolerant areas

Answer 25

ischium soft tissues of residual limb

Question 26

How many plys of socks can a patient wear before a new fitting is required?

Answer 26

12-15

Question 27

Donning prosthetic leg layers

Answer 27

1. liner (has the pin that is lined up with the residual limb) 2. sock (has a hole that allows it to go around the pin of the liner 3. Socket (the actual prosthesis that attaches to the pin)

Question 28

ACE wrapping for RL

Answer 28

2-4 in for UE 3-4 in for transtibial 6 in for transfemoral elbow, knee, and hip should be in full extension when wrapping

Question 29

Transmetatarsal and Syme's contractures

Answer 29

equinus deformity (into PF)

Question 30

Transtibial contractures

Answer 30

knee flexion

Question 31

Transfemoral contractures

Answer 31

hip flexion and abduction

Question 32

Most common due to trauma

Answer 32

-transhumeral -elbow disarticulation -transradial

Question 33

Most common due to cancer

Answer 33

-forequarter -shoulder diarticulation -hip disarticulation

Question 34

Lateral Bending

Answer 34

Prosthetic: too short, lateral wall improperly shaped, high medial wall, aligned in abduction pt: poor balance, abd contracture, improper training, short limb, weak hip abductors, painful RL

Question 35

Abducted gait

Answer 35

Prosthetic: too long, high medial wall, poor shape of lateral wall, prosthesis in abduction, inadequate suspension, excessive knee friction pt: abduction contracture, adductor roll, weak hip flexors/adductors, painful RL

Question 36

Circumducted gait

Answer 36

Prosthetic: too long, excessive knee friction, soclet too small, excessive pf pt: abduction contracture, weak hip flexors, can't intiate knee flexion

Question 37

Excessive knee flexion in stance

Answer 37

Prosthetic: socket set forward, excessive df, stiff heel, too long pt: knee flexion contracture, hip flexion contracture, pain in residual limb, decrease in quads strength, poor balance

Question 38

Vaulting

Answer 38

prosthetic: too long, inadequate suspension, escessive alignment stability, too much pf pt: discomfort, fear of stubbing toe, short RL, painful RL

Question 39

Rotation of forefoot at heel strike

Answer 39

prosthetic: excessive toe-out built in, loose fitting socket, inadequate suspension, rigid SACH heel pt: poor muscle control, weak IR, short RL

Question 40

Forward trunk flexion

Answer 40

prosthetic: socket too big, poor suspension, knee instability pt: hip flexion contracture, weak hip extensors, pain with ischial wb, can't intiate knee flexion

Question 41

Medial/lateral whip

Answer 41

prosthetic: excessive rotation of knee, tight socket fit, valgus in prosthetic knee, improper alignment of toe break pt: weak hip rotators, knee instability