Prosthesis Flashcards by Janna Marie Valencia

artificial substitute designed to replace a missing limb or body part

Prosthesis

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Goals of Prosthesis

Stability
Energy efficiency
Ease of movement
Appearance of normal gait

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UE Prosthesis

Body powered or Conventional
External powered or Electric
Passive or Cosmetic

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patient uses his/her own residual limb, strength, ROM

Body powered or Conventional

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Components of Body Powered or Conventional

Suspension
Socket
Terminal Device
Interposing joints
Control Cable System

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interface between residual limb & prosthesis

Socket

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Types of Socket (UE Prosthesis)

Dual walled
3-walled
Muenster

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fabricated from the custom mold of residual limb (primary interface)

Inner Socket

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fabricated to have a normal appearance/contour of the missing body part

Outer Socket

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socket commonly seen in pediatric patients

3-Walled

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socket commonly seen in very short below elbow amputation

Muenster

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holds the residual limb to the prosthesis (socket)

Suspension

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Types of Suspension (UE Prosthesis)

Harness-based
Self-suspending sockets
Suction

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MC Suspension (UE)

Figure of 8 Strap

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Figure of 8 Strap (intact & prosthetic side)

Intact side: harness loops around the axilla
Prosthetic side: anterior strap

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indirectly attached to the socket using Y-strap and triceps pad

Transradial

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anterior strap directly attached to the socket

Transhumeral

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Purpose of shoulder saddle strap with chest strap

Heavy lifting

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bony configuration allows suspension
(+) socks

Self-suspending socket

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Criteria in using Suction-suspension socket

Good tissue envelope
(-) Scarring

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water based/lubricant
creates suction within socket

One Air-Valve Suction

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the sleeve rolled onto the residual limb and inserted into the socket to mate the mechanical lock

Silicon Gel Sleeve with Distal Pin Attachment

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links the movement of shoulder and humerus to activate the terminal device

Control Cable Mechanism

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Motions affecting Control Cable Mechanism

Scapular abduction
Shoulder abduction
Shoulder depression
Elbow flexion

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Types of Control Cable Mechanism

Single control or Bowden cables Dual-Control cable system

replacement for the hand

Terminal Device

Types of Terminal Device

Hooks Functional/Active hands Cosmetic/Passive hands Specialized terminal device

Mechanism of Hooks

Lateral prehension 3 point chuck action

MC used Terminal Device

Functional/Active Terminal Device

MC Active Terminal Device

Voluntary opening

Mechanism of Voluntary opening

Opening: Cable system Closing: Spring/Plugs

Prehensile strength of Voluntary opening

5-10lbs

Prehensile strength of Voluntary closing

20-25 lbs

Terminal device passively positioned by the patient; less function

Passive/Cosmetic Hand

Elbow unit mechanism

5-130 deg elbow flexion (-) Full elbow extension

connects the terminal device to prosthesis

Wrist Unit

Types of Wrist Unit

Friction control wrist unit Lock wrist unit Wrist flexion unit

for quick changing of terminal device

Quick Disconnect Option

uses small electric motors incorporated to the prosthesis

Externally powered

Control System (Externally powered)

Myoelectrical Switches

Types of Myoelectrical

Dual-electrode Single site control

provides passive positioning; lightweight should match the skin color/texture of intact side

Cosmetic Prosthesis

Post op Care for Transradial Amputation

Rigid Removable Dressing

Initial fitting for UE Prosthesis

3-6 months post-op

until definite prosthesis is prescribed

every 2-6 months

initial routine follow up with a new amputation

within 4-6 weeks after receiving prosthesis

life period of UE Prosthesis

3-5 years

Goals of LE Prosthesis

COsmesis MObility Durability Stability

Components of Transtibial Prosthesis

FOot ankle assembly Socket Suspension element SHank

substitute for the anatomic foot

Foot Ankle Assembly

directly attached to the shank (-) joint motion

Non-Articulated

weight supporting structure (FAA)

Keel

MC prescribed Foot Ankle Assembly

SACH

Parts of SACH

Keel - firm Heel - soft Belting - distal end of keel to end of toes

if heel is too soft

excessive PF; knee flexion

if heel is to firm

excessive DF; knee extension

purpose of belting

prevents toe dropping during swing phase

SACH is common in

K1-K2 walkers

Parts of SAFE

Rigid block Keel (flexible) Long plantar ligament band

Energy storing FAA

STEN Seattle Carbon Copy II Quantum Flex walk Flex foot

Parts of STEN

3 wooden keel 2 rubber plugs

transfer of WB over the foot compresses the plugs then permits recoil

STEN

earliest energy-storing foot to be commercially available

Seattle

Shape of Keel in Seattle Foot

C-shaped

transfer of WB over the foot bends the keel stored energy returned during late stance -> forward propulsion

Seattle

lighter, most expensive, stronger FAA

Carbon Copy II

fxn of upper plate (keel)

high impact activities (jumping & running)

fxn of lower plate (keel)

last half of stance phase

Flex walk keel

from MTP joint to heel section

Flex foot keel

from MTP joint to bottom of socket

Energy-storing foot (HEAVY)

SAFE STEN Seattle

Energy-storing foot (LIGHT)

Quantum Carbon Copy II

Energy-storing foot (MEDIOLAT STABILITY)

SAFE SACH Quantum Carbon Copy II

non ambulatory

household ambulator

limited community ambulator

community ambulator

high impact activities

Articulated foot types

Single axis Multiple axis

PF Bumper

15 def PF only

DF Stop

only 5 deg DF

replacement for the amputated leg maintains the connection b/w socket & foot

Shank

Exoskeletal

Crustacean Leg

Endoskeletal

Central Support/Pylon

Types of Socket

PTB Hard Socket ISNY PTB Socket

composed of thin, flexible thermoplastic PTB socket

ISNY PTB Socket

ISNY PTB Socket covers the

Patellar tendon Medial flare Popliteal area

Types of Suspension System

Cuff suspension Supracondylar System Suprapatellar System Thigh Corset

attached to the medial & lateral wall prevents Genu Recurvatum

Cuff Suspension

mediolateral wall is higher than PTB socket

Supracondylar system

high anterior wall covers the entire patella

Suprapatellar System

oldest form of suspension

Thigh Corset

exerts upward pull to assist in suspension

Elastic Belt

Pressure Tolerant areas

Patellar Tendon Pretibial muscle Posterodistal residual limb Popliteal fossa Distal end, medial flare lateral tibia Tibia & fibular shaft

Pressure Sensitive areas

Anterior crest of tibia Anterior tibia Hamstrings tendon Fibular head & neck Peroneal, Fibular nerve

Components of Transfemoral Prosthesis

FAA Knee assembly Socket Suspension Shank

Types of Knee axis

Single axis Polycentric

Types of Friction

Constant Friction Variable Friction Fluid Control

control the movement of shank

Friction

if there is no friction

inc knee flexion during early swing phase abrupt stop with noisy impact during extension

MC type of Friction

Constant Friction

same amount of resistance during swing phase (+) screw

Constant Friction

Initial & Terminal Swing friction

increase friction

Midswing friction

decrease friction

cadence dependent; simulates normal gait pattern

Fluid Control

controls the heel rise, accelerates shank, replaces the function of quads

Extension Aid

extension lever upper end

knee block

extension level lower end

extension bias spring

(+) harness/strap attached to anterior socket

"Kick strap"

Types of Braking & Locking Mechanism

Weight activated friction brake Manual lock

Types of LE Socket

Quadrilateral Ischial Containment

Quadrilateral WB

Ischial tuberosity

Ischial Containment WB

Ischiopubic Ramus

Mechanism of Weight Activated Friction Brake

WB on prosthesis during 20-25 knee flexion -> Automatic locking mechanism

Mechanism of Manual lock

Locking during knee extension during sit to stand

Types of LE Suspension

Suction Partial suction with Auxillary suspension Silesian bandage Pelvic belt

suspension recommended for younger & active patients

Suction

use suction with socks there is no intimate fit between socket and residual limb

Partial Suction

webbing band around the torso

Silesian Bandage

leather strap with rigid metal band

Pelvic Belt

Energy Expenditure: Wheelchair

Energy Expenditure: Crutches

60%

Energy Expenditure: Single BK

10-40%

Energy Expenditure: Double BK

41%

Energy Expenditure: Single AK

65%

Energy Expenditure: Double AK

100%

Energy Expenditure: Single BK + Single AK

75%

UE Prosthesis Length

3-5 inches

UE Prosthesis Stump/Flap

Fishmouth

UE Prosthesis Shape

Any

BK Prosthesis Length

5-7 inches

BK Prosthesis Stump/Flap

Burgess

BK Prosthesis Shape

Cylindrical

AK Prosthesis Length

>10 inches

AK Prosthesis Stump/Flap

Fishmouth

AK Prosthesis Shape

Conical

Prosthesis Flashcards

(136 cards)