Exam 1 Hard Shit

Question 1

What are clinical signs of peripheral neuropathy?

Answer 1

Decreased Sensation
Autonomic Dysfunction
Motor Impairments

Question 2

Diabetic complications leading to amputations.

Answer 2

Severe ischemic pain
Acute embolism
DVT
Systemic Toxicity
Loss of distal pulses
Local Necrosis
Osteomyelitis

Question 3

What are the classic symptoms of PAD?

Answer 3

Intermittent Claudication
Numbness
loss of distal pulses
Trophic Changes

Question 4

How do we help diabetic patients and PAD patients prevent limb loss?

Answer 4

Give diabetic foot screens and check:
temperature
distal pulses
protective sensations
observe: deformities, swelling, callus formation and nail shape/color

Question 5

What are challenges associated with traumatic amputations?

Answer 5

Pain
Other Injuries
Multiple surgeries
partial vs full amputation
viability of the tissue
limb length/shape

Question 6

How will pts with osteosarcomas present?

Answer 6

pain with weight-bearing, complaints of deep pain and fractures.

Question 7

What are the challenges of congenital deficiencies?

Answer 7

cosmesis
growth
provide for function

Question 8

What factors affect the level of amputation?

Answer 8

vascular disease
disarticulations
postoperative fxn
trauma and malignancy

Question 9

advantages of myoplasty:

Answer 9

more vascularization

Question 10

advantages of myodesis:

Answer 10

more stability and mobility sooner

Question 11

anterior/posterior flaps are best for __________ healing while a long posterior flap is best when __________ is a concern.

Answer 11

bone; vascularity

Question 12

What is the shortest level compatible w knee function?

Answer 12

tibial tubercles

Question 13

Why would someone choose a transfemoral amputation over a transtibial?

Answer 13

gangrene developed
poor circulation at transtibial level
trauma

Question 14

what are common post-op issues for all amputations?

Answer 14

pain
wound healing
edema
heterotrophic ossification

Question 15

what are common post - op issues for transfemoral amputations?

Answer 15

hip adductor roll
hip abductor contracture
hip flexor contracture
glute weakness.

Question 16

What can contractures lead to?

Answer 16

pain, immobility, functional issues, and pressure ulcers

Question 17

what are the benefits of osteointegration?

Answer 17

eliminates socket need
short residual limb
more natural feeling
more natural gait
normal swelling

Question 18

disadvantages of osteointegration:

Answer 18

multiple surgeries
long period of immobility
illegal in US
reduction in high torque exercises
infection/ fracture risk

Question 19

indications for a knee disarticulation:

Answer 19

cannot have a good transtibial limb due to trauma
knee flexion contracture above 45 degrees
infection of soft tissue close to knee joint
congenital deformity

Question 20

when is an ankle disarticulation used?

Answer 20

sever foot trauma
gangrene
congenital deformity

Question 21

What is the role of the heel pad in ankle disarticulation?

Answer 21

heel pad has to have good circulation to be successful
help pad and bone are close which may result in pain and an ineffective fit for a prosthetic.

Question 22

Transmetatarsal amputations are performed secondary to:

Answer 22

infection or diabetes

Question 23

Components of a post surgical evaluation and trx:

Answer 23

chart review/ pt interview/ general systems review
cognition/emotion
pain and sensory testing
ROM, strength, balance
functional status
post - surgical status
post op complications

Question 24

What are the attention and cognition assessments?

Answer 24

MOCA
Mini - Cog
MMSE

Question 25

What can you also screen for with amputated pts when screening for cognition?

Answer 25

Delirium Depression Fear

Question 26

what is used for neuropathic pain?

Answer 26

gabapentin

Question 27

how do we treat pain?

Answer 27

medications ace wraps pt education modallities movement

Question 28

when examining the residual limb we look at:

Answer 28

wound healing vascularity length volume

Question 29

where are measurements taken from if the person has a TTA?

Answer 29

fibular head medial joint line tibial tuberosity

Question 30

What do we check on the contralateral limb?

Answer 30

DVT Sensory Testing Strength/ROM testing diabetic foot screen if needed

Question 31

What are common DVT symptoms?

Answer 31

Swelling Tenderness increased redness

Question 32

What are transtibial key muscles to stretch?

Answer 32

Hamstrings gastroc/soleus quads

Question 33

What are transfemoral key muscles to stretch?

Answer 33

hip flexors hip abductors hip external rotators lumbar extensors contralateral LE

Question 34

What strengthening can you do immediately post op?

Answer 34

isometric and AROM core strength contralateral limb

Question 35

What are transtibial key strength muscles?

Answer 35

hamstrings quads glute max glute med abdominals UE

Question 36

What are key muscles to strengthen with transfemoral?

Answer 36

UE lumbar spine pelvic floor abdominals glute med glute max hip adductors

Question 37

What is something we should know about balance assments?

Answer 37

they are all done without a prosthetic

Question 38

what is the strongest predictor of functional post-operative prosthetic use?

Answer 38

pre amputation ambulatory status

Question 39

What will indicate a pt's ability to ambulate?

Answer 39

assessment of standing balance

Question 40

What are pre prosthetic goals?

Answer 40

Independence of residual limb care and of intact limb independence in joint mobility and demonstration of HEP fall prevention