Chapter 4- Prosthetic Management

Question 1

When should the patient be informed about future rehabilitation?

Answer 1

As early as possible

Question 2

What are usual feelings felt by the patient?

Answer 2

Depression
Feeling withdrawn
Angry
Relief

Question 3

What is an unusual feeling after an amputation?

Answer 3

Feeling no difference at all.

Question 4

What are the usual purposes of the support groups?

Answer 4

Introduce the recent amputee to realistic role models who have gone through the rehabilitation process and are functioning normally in society
Provide ongoing social and educational programs

Question 5

How can prosthetists speed up the preprosthetic management?

Answer 5

With use of rigid dressings
elastic bandaging
Prosthetic shrinkers

Question 6

What should be told to the patient when they are ready for the prosthetic fitting?

Answer 6

Explanation of the different stages of the rehabilitation process
Length of wear of preparatory prosthesis
When evaluation of definitive prosthesis will occur

Question 7

About when are prosthetic patients seen in the clinic?

Answer 7

1 or more months following surgery

Question 8

What should the prosthetist assume, when the new patient is seen?

Answer 8

That no one has explained the process and then offer a concise overview of the prosthetic procedure

Question 9

What are the five general types of prostheses?

Answer 9

Postoperative
Initial
Preparatory
definitive
Special purpose

Question 10

When are postoperative prostheses provided?

Answer 10

24 hours of amputation

Question 11

What does IPSF stand for?

Answer 11

Immediate postsurgical fitting

Question 12

What does IPOP stand for?

Answer 12

Immediate postoperative prosthesis

Question 13

Postoperative fittings should be given to, who?

Answer 13

Younger, healthier people needing amputations due to tumors, trauma, or infection

Question 14

Postoperative fittings should not be given to who, if not under close supervision?

Answer 14

The elderly

Dysvascular patients

Question 15

When is the initial prosthesis provided?

Answer 15

As soon as the sutures are removed

Question 16

What is another name for initial prosthesis?

Answer 16

Early Postsurgical Fitting (EPSF)

Question 17

How long are initial prostheses worn?

Answer 17

1-4 weeks after amputation

Question 18

Where are Postoperative and initial prostheses more commonly used?

Answer 18

In rehabilitation units or hospitals with very active amputee programs

Question 19

What are preparatory prosthesis used for?

Answer 19

Rehabilitation
Assess ambulatory or rehabilitation potential
Help clarify details of the prosthetic prescription

Question 20

When can a preparatory prosthesis be applied?

Answer 20

A few days following suture or staple removal

Question 21

The modern preparatory prosthesis incorporates what?

Answer 21

Definitive-quality endoskeletal componentry but lacks the protective and cosmetic outer finishing

Question 22

How long are preparatory prostheses generally worn?

Answer 22

3-6 months following amputation

Question 23

What can cause the patient to need to wear a preparatory prosthesis to be worn longer?

Answer 23

Speed of maturation of the residual limb
Weight gain
Weight loss
Health problems

Question 24

How do you determine when a definitive prosthesis should be prescribed?

Answer 24

When the number of plies of prosthetic socks worn remains the same over several weeks

Question 25

What do prosthetic socks provide to the patient?

Answer 25

``` Cushioning Comfort Prevent sheer force Absorb perspiration Adjustment to volume changes ```

Question 26

When should prosthetic socks not be worn?

Answer 26

When using a suction system

Question 27

At what plie should a replacement socket be prescribed?

Answer 27

10 plie

Question 28

What is the cause of the limb shrinkage?

Answer 28

Atrophy | Weightloss

Question 29

What is a definitive prosthesis not?

Answer 29

A permanent prosthesis because mechanical devices will wear out

Question 30

What is the lifespan of a definitive prosthesis?

Answer 30

3-5 years

Question 31

What can cause a change in the prosthetic prescription?

Answer 31

Substantial change in Amputees lifestyle or activities

Question 32

What is usually required for special-use prostheses?

Answer 32

Special alignment

Question 33

What is done to the foot of a patient wanting to swim?

Answer 33

Plantarflex the foot

Question 34

What is done to the foot if the patient wants to snow ski?

Answer 34

Dorsiflex the foot

Question 35

What factors influence the prosthesis?

Answer 35

``` Weight bearing Suspension Activity level General Prosthesis structure Components Expense Unique circumstances ```

Question 36

What is the first concern for lower-limb prostheses?

Answer 36

Weight bearing

Question 37

Why might a clinician provide special provisions to the weight bearing component of a prosthesis?

Answer 37

Scarring Neuromas Sensitive areas

Question 38

What is a big factor for deciding on the suspension of the prosthesis?

Answer 38

Volume changes

Question 39

What are the two major structural types of a prosthesis?

Answer 39

Endoskeletal | Exoskeletal

Question 40

What should the componentry be based on?

Answer 40

Activity level Body weight Functional Goals

Question 41

What is the expense of the prosthesis based on?

Answer 41

Componentry

Question 42

What should the clinician record when evaluating a patient?

Answer 42

``` Scar tissue Neuromas ROM Edema Muscular development Personal history ```

Question 43

What is involved in the personal history?

Answer 43

``` Weight fluctuations Medical factors Previous fractures Visual impairments Concomitant disease- diabetes, arthritis ```

Question 44

Where should measurements be taken?

Answer 44

Length of residual limb Circumferences- both limbs Myoelectric control sites- if needed negative impression of residual limb

Question 45

How should initial static alignment be recorded?

Answer 45

Plumb line

Question 46

What does CAD/CAM stand for?

Answer 46

Computer aided design/ Computer aided manufacturing

Question 47

What four factors are evaluated in a test socket fitting?

Answer 47

Comfort Even distribution of weight-bearing pressure and biomechanical forces Suspension Freedom of motion at next proximal joint

Question 48

What is the purpose of dynamic alignment?

Answer 48

Provide maximum comfort Efficient function Cosmesis

Question 49

What is the procedure of the alignment process?

Answer 49

Function of the prosthesis is explained Instruction on how to don/doff device Contours are checked for comfort Length and angulation of prosthesis is checked Suspension tested Instructed in standing in a relaxed attitude Static alignment Controlled ambulation in parallel bars Adjustments to device for sitting comfort

Question 50

What minor problems can occur after a week or two after the initial alignment?

Answer 50

Pressure areas in socket Discomfort while sitting Wearing different shoes

Question 51

How often should patients be seen after their fitting?

Answer 51

Every 4-6 months

Question 52

Why should a patient come in for follow up care even after he/she has their definitive prosthesis?

Answer 52

The mechanical components require cleaning Maintenance Replacement at intervals Joint cleaning

Question 53

What should the clinician keep track of at the follow up visits?

Answer 53

Alignment adjustments | Socket adjustments