Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PTRS 746 > LE, UE, Spinal Orthotics > Flashcards

LE, UE, Spinal Orthotics Flashcards

(82 cards)

Start Studying
1
Q

What is a PRAFO stand for?

A

Pressure Relieving Ankle Foot Orthosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a PRAFO indicated for?

A

Contracture prevention and pressure prevention caused by:
Neuro involvement (CVA, SCI, TBI)
Orthopedic (hip fracture, amputation)
Long term immobility (ICU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main orthotic principle?

A

3 point pressure system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are design considerations for orthotics?

A

diagnosis, prognosis, comorbidities, height, weight, cost, cosmesis, degree of deformity, degree of correction, musculoskeletal factors, mobility requirements, stability requirements, anticipated functional level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 5 trim lines?

A 
Proximal (focuses on knee)
Anterior (determines motion at ankle)
Ankle
Foot (medial and lateral stability)
Metatarsal (effects push off, if behind MT heads you'll have more rocker but less push off, if past toes it extends push off)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you evaluate as a PT for orthotics?

A

Functional ROM: midtarsal, subtalar, talocrural, knee, and hip joints
Functional Muscle Strength: focus on general LE muscle groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do you look at for foot alignment?

A

Supination, pronation, skeletal deviations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do you look at for ankle alignment?

A

foot drop, medial/lateral instability, plantarflexion contracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you look at for knee alignment?

A

Flexion, genu recurvatum, genu varum, genu valgum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the foundation of any orthotic?

A

SHOES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are characteristics of prefabricated AFOs?

A 
"off the shelf"
limited fit and function
mild involvement
temporary use
diagnostic procedures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are custom fit orthotics?

A

prefabricated device modified to fit a specific patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What support does custom fit orthotics provide?

A

Provide limited fit and function
mild to moderate involvement
temporary use
diagnostic procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the process for getting a custom fabricated orthotic?

A

casting, measurement, negative mold, positive mold, fabrication, modification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common orthotic in kids?

A

Supramalleolar (SMO/DAFO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What support does a DAFO provide?

A

allows DF and PF
provides forefoot, midfoot, and subtalar stability
tone management
has no force or stability around ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does ground reaction orthotic facilitate?

A

pre-tibial cuff facilitates knee extension
rigid foot plate facilitates push-off
capable of tri-planar motion control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is purpose of patellar tendon bearing orthotic?

A

reduces force on mid-foot and heel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does a solid ankle orthotic do?

A

trim lines encompass malleoli to immobilize ankle and provide medial and lateral stability.
Maximum motion control in all planes
Disrupts normal gait because it doesn’t allow PF or rocker.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is purpose of semi solid orthotics?

A

Trim lines bisect malleoli which takes away some restriction of solid AFO.
Allows some DF in late stance.
Provides some M-L stabilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is posterior leaf spring?

A

Stores energy during loading.
Releases energy to facilitate swing.
Provides little M-L stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does a articulated AFO do?

A

various materials can be used
can address multiple biomechanical functions (DF stop, PF stop, DF assist)
varying levels of adjustability
Size/weight and cosmesis may be problematic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are types of articulated AFOs?

A

Oklahoma ankle joint with PF stop
Gillete ankle with DF assist
Chamber axis hinge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is metal upright orthosis?

A

Easily adjustable
maximal stabilization
may be indicated for patients with high risk feet or fluctuating edema.
weight and cosmesis are major concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How are dorsiflexors affected in pathologic gait?
DF peak during swing and heel strike in normal gait, prevents foot slap. Compensatory gait patterns: steppage gait, hip hike, circumduct orthotic considerations: DF assist
26
How are plantarflexors affected in pathlogic gait?
Peak activity during push off in normal gait Compensatory patterns: lurching gait because they can't propel forward Orthotic considerations: move MT trim lines to make foot plate rigid, DF stop will create rigid lever for push off
27
What do quadriceps do in pathologic gait?
Peak activity during heel strike of gait. Compensatory gait patterns: hyperextension of knee, may flex trunk so their knee can be locked out, may have hand in pocket to push knee back and lock it Orthotic considerations: posteriorly offset knee joint so it's easier to lock it out.
28
What does a KAFO do?
provides maximal stability creates functional leg length discrepancy increases energy expenditure
29
What do stance control KAFOs do?
stability during stance knee flexion during swing larger and more expensive locking mechanisms vary
30
What are requirements for KAFOs
adequate cognitive function | hip flexion and extension strength >3/5
31
What are contraindications for KAFOs?
``` knee flexion contracture >10 spasticity uncorrectable valgus/varus >15 poor balance or ataxia hip flexion strength ```
32
What are neuromuscular electrical stimulation devices?
electrically stimulates tibialis anterior | some units can stimulate quads and hamstrings
33
What is an IDEO?
Intrepid Dynamic Exoskeletal Orthosis rigid foot plate and ankle enlage limit ankle motion and facilitate push off 3-4 inch cushion blunts heel strike and allows transition from heel to forefoot PF position facilitates deflection of strut and energy storage through terminal stance
34
What are purposes of orthotics?
``` support and align immobilize, restrict, or mobilize prevent or correct deformity substitute or enhance motion reduce pain and discomfort ```
35
What are indications for spinal orthotics?
``` Correct of prevent deformity Relieve pain Support fracture healing Post-op protection Prevent further injury Support and align ```
36
What are the 3 spinal orthotics principles?
3 point pressure system | Increase hydrostatic pressure, provide kinesthetic reminder, modify support systems
37
What are parts of the extrinsic stability of the spine?
Flexors: psoas, abdominals Extensors: erector spinae, paraspinals
38
What intrinsic components of the spine?
Ligaments: linkage, transfer loads, smooth motion Discs: shock absorption
39
What are design considerations of spinal orthotics?
Necessity, cosmesis, weight, available ROM, cost, adjustability, effectiveness, functionality
40
What is purpose of soft collars?
Facilitate spinal alignment, limit some ROM, provide kinesthetic reminder
41
What are the types of collars?
Soft collar | Semi-rigid collars- Miami J, aspen, philidelphia
42
What is a SOMI or Lerman-Minerva?
cervical orthoses with thoracic extension | often indicated with bed ridden patients
43
What is a halo?
Tri-planar motion control of cervical spine Maximum immobilization Restricts 90-95% of normal motion poor patient acceptance with high complication ratew
44
What is an over the counter LSO?
Flexible LSO (lumbosacral corset)
45
What does a chairback LSO do?
restricts sagittal plane motion | tightening of abdominal support reduces lumbar lordosis
46
What does a Knight LSO do?
Restricts sagittal and coronal plane motion | tightening abdominal support reduces lumbar lordosis
47
What do TLSOs do?
restricts sagittal and coronal plane motion tightening abdominal support reduces lumbar lordosis Tightening axillary straps facilitates thoracic extension
48
What is a Jewett hyperextension TLSO indicated for?
Compression fracture kyphosis arthritis
49
What TLSO is more common in geriatric patients?
CASH hyper extension TLSO | restricts flexion
50
What is a turtle shell brace?
``` rigid TLSO (body jacket) restricts sagittal, coronal, and transverse plane movement ```
51
What is a CTLSO?
TLSO with cervical extension
52
What are orthotic indications for scoliosis?
``` skeletal immaturity (premenarche) curves between 20 and 40 degrees documented progression single or double curves ```
53
What is a accommodative TLSO?
addressed fixed deformity aligns head and trunk over pelvis: reduces shear forces, facilitates UE use, enhances mobility base, facilitates respiratory function
54
What is a corrective TLSO?
progressive correction of idiopathic spinal curvature stabilization of congenital spinal curvatures prevent and or correct deformity
55
What are the types of corrective TLSOs?
Boston brace: gold standard, worn full time 18-23 hours/day Milwaukee brace: upper thoracic and cervical curves, worn full time Charleston bending brace: for smaller, flexible lumbar curvature, worn only at night
56
What is physical therapy for corrective TLSO?
``` skin care trunk mobility and strengthening aerobic training postural feedback and training functional training with brace ```
57
What are indications for UE orthotics?
Trauma: vocational, burns, MVAs Congenital deformity Disease: RA, SLE, neurological impairments, especially those associated with abnormal tone
58
What is purpose of UE orthotics?
symptom relief, immobilization, protection, scar management, provide resistance, compensate, prevent deformity, stabilization, correct deformity, aid function, influence spastic muscle
59
What are designs of UE orthotics?
Static Serial static: modify brace weekly Static progressive: use static components to apply force Dynamic: uses elastic components to apply force
60
What is the anatomy of the extensor mechanism?
Mechanism relies on excursion of extensor tendons extensor excursion is less than that of flexors So extensor mechanism is more likely to shorten and it is more difficult to compensate for loss of extensor excursion
61
What is functional anatomy of MCP and PIP?
Ligament length dependent on joint position
62
What is prone to shortening in MCP and PIP?
MCP extension: collateral ligaments are slack and prone to shortening PIP flexion: volar plate is slack and prone to shortening
63
What is the anti-deformity position of the hand?
MCP flexion with PIP and DIP extension (intrinsic plus)
64
What is intrinsic plus position?
MCP flexion with PIP/DIP extension Positioning MCP in flexion protects IP extension Commonly used after trauma, burn, or tendon repair
65
What is intrinsic minus position?
MCP extension wit PIP/DIP flexion Often results from intrinsic denervation of ulnar nerve Unopposed extension cause MCP hyper extension and IP flexion
66
What happens to pressure to an area?
It is never eliminated it is only distributed | must accommodate for bony prominences
67
What are common prominences under pressure?
``` olecranon humeral epicondyles styloid processes base of 1st MC joint dorsal thumb, MP, and IP joints pisiform ```
68
What are common nerves under pressure?
``` Radial groove of humerus (radial) Cubital tunnel (ulnar) Distal forearm (ulnar) Carpal tunnel (median) Volar digital nerves ```
69
What is position of hand in a functional hand splint?
Wrist in 20-30 of extension thumb in palmar abduction MCPs in 15-20 of flexion IPs in slight flexion
70
What is intrinsic plus wrist and MCP position in splints of palmar burns?
30-40 degrees extension of wrist | 70-90 flexion of MCP
71
What is intrinsic plus position of wrist in dorsal burns?
neutral to slight extension
72
What is intrinsic plus position of wrist and MCPs in crush injuries?
0-30 degrees wrist extension | 60-80 degrees of MCP flexion
73
What is IP and thumb position in intrinsic plus splint?
extension of IP joint | palmar abduction of thumb
74
What is position of wrist splint for carpal tunnel syndrome?
0 degrees
75
In radial nerve palsy what is position of wrist splint?
30 degrees
76
What is position of wrist splint in wrist extensor tendonitis?
20-30 degrees
77
With a colles' fracture how is wrist positioned?
up to 30 degrees
78
What is position of wrist in RA?
comfort level up to 30 degrees
79
With RSD/CRPS what is splint position?
as tolerated
80
Splint position with wrist joint synovitis?
0-15 degrees
81
What are syndromes that may cause the thumb to be immobilized?
DeQuervain's: inflammation of APL and EPB synovial sheaths RA Gamekeepers thumb: ulnar collateral ligament injury
82
What is position of thumb if it needs to be splinted?
25-30 degrees of abduction with MP joint in neutral

PTRS 746 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions