MT: Intro to NURIC Flashcards
1
Q
Desired Features vs NURIC
A
- proper contours for functioning muscles - RF and Gluteal Channel
- stabilizing - ischial containment/shelf
- distribute pressures - support gluteal muscles
- precise contouring - not forcing limb into quad shape
- total contact - prevent distal end edema
2
Q
Biomechanical Objectives: Coronal Plane
A
- provide ML stability of the pelvis during midstance on prosthetic side
- conserve energy by minimizing lateral displacement of CoG
3
Q
Early Ischial Containment
*
A
- recognized need for narrow ML
- to allow coronal plane stability
- align head of femur and distal aspect of the femur
4
Q
TF Specific considerations
A
- evaluate & accommodate ROM in hip extension and permit normal stride on contralateral side
- flexor and extensor muscles accommodated inside socket
- adductor shape can vary with design
5
Q
Critical Design Features
A
- axial support
- compartments of NURIC socket
- amount/degree of containment
- alignment
- objective measurements
6
Q
Axial Support
A
- ischial support (direct skeletal support)
- gluteal support
- hydrostatic support
7
Q
Ischial Support
A
- critical for patients with minimal muscle tone
- inadequate support may result in ramus pressure and reduced comfort
8
Q
Gluteal Support
A
- achieved by appropriate socket contours (proper shelf height)
- critical for short residual limbs
- aids in general loading and comfort
9
Q
Hydrostatic Support
A
- achieved by volume reduction (tension values)
- volume reduction to compress tissues
10
Q
Compartments of NURIC Socket
A
- anterior
- medial
- lateral
11
Q
Anterior Compartment
A
- adductor longus relief
- femoral (scarpa) traingle compression
- rectus femoris relief
- tensor fascia lata/ASIS relief
- opposing ischial support
12
Q
What are the boundaries of scarpa’s triangle
A
- inguinal ligament
- sartorius
- adductor longus
13
Q
What does the contour of the rectus area provide?
A
counter force to stabilize ischium in proper location
14
Q
Rectus Channel Goals
A
- provides equal distribution of pressure between firm and soft tissues
- control rotation
- allow room for functioning muscles
15
Q
Medial Compartment
A
- medial wall internal rotation relative to LOP
- Sub-ischial triangle
- medial brim flaring
- ramus relief
16
Q
Internal Rotation of Medial Wall
A
- pre-compress adductors
- facilitate early stance phase loading
- prevents lateral shifting of socket
17
Q
Sub Iscial Triangle Boarders
A
- inferior pubic ramus
- semitendinosis
- Gracilis
18
Q
Medial Brim Flaring
A
- prevent adductor roll
- protects distal aspect of ramus from excessive pressue
- no vertical component at all
19
Q
Adductor Roll Caused by
A
- tight scoket
- inadequate flaring of prox/medial brim
- too low medial wall
- patient not getting into socket !!!!!
20
Q
Lateral Compartment
A
- Stabilization of femur
- relief for lateral distal femur
- proximal lateral cupping
- externally rotated
21
Q
Lateral Wall Contours
A
- proximal lateral cupping reduces gapping during mid-stance
- lateral wall stabilized femur
22
Q
Amount of Ischial Containment
A
- greater containment distributes forces over a larger area
- contributes to coronal plane stability
- does not produce “skeletal lock”
23
Q
Socket Flexion
A
- Allows for even step length on sound side
- puts extensors on stretch and at functional advantage
24
Q
Socket ADduction
A
- allows loading of lateral femur
- puts hip Abductors on stretch and at functional advantage
- places femur in anatomical alignment
25
Goals of Medial AP measurement
* ischial support
* medial containment
* locate ischium in impression
26
Goals of Lateral AP measurement
* gluteal loading
* prevent anterior gapping while seated
* allow sufficient room for adductor musculature
27
Subischial Triangle
* provides loading distal to the ischial containment
* decreases load on ischium
* compresses adductors to aid in their functinoing
* parallel to ischium
