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פרםתיסיס > prosthesis > Flashcards

prosthesis Flashcards

0
Q

articulated

A

a mechanical ankle joint

single axis
multi axis-allow for supination and pronation

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1
Q

5 things needed in a prosthesis

A
  1. stable base
  2. shock absorb
  3. heel to toe gait
  4. looks
  5. cost
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2
Q

non articulated

A

solid ankle foot piece bolted to the shank

material in front piece will allow for adaptation on uneven surfaces

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3
Q

energy storing prosthetic feet: when is it stored, when is it used

A

Midstance–>heelrise: store energy

Toe off–> early swing: use energy

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4
Q

plantar flexion bumper

A

compress at heelstrike, allow a controlled plantarflexion for going into footflat

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5
Q

Dorsiflexion stopper

A

control the amount of dorsiflexion as the person comes over the foot
midstance–> heelrise

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6
Q

SACH Foot

energy
artic

A

doesnt store energy

nonarticulated

controlled plantarflexion with cushion heel

flexible rubber forefoot to allow MTP extension

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7
Q

Seattle Foot

A

energy stored

nonarticulated

C shaped material that is compressed midstance–>heelrise

energy return as push off

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8
Q

Carbon Copy II Foot

A

non articulated

store energy

compressible heel

roll over foot and plantar carbon fibers are stretched: then energy is returned

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9
Q

SAFE Foot

A

Stationary Attach Flexible Endoskeleton

not such a good energy storing

nonarticulated

adaptable, flexible mid/forefoot

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10
Q

STEN foot

A

not so good energy storing foot

not articulated

cushion heel

rigid keel with flexible plugs in between sections

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11
Q

Flex Foot

A

energy storing foot

non-articulated

lightweight and resilient (carbon fibers)

expensive

as go into HS compress and then when go into terminal stance and bring it forward there is a separation when take the weight off

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12
Q

flex walk

A

same as flex foot

but flex walk has a shorter lever arm

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13
Q

college park true step

A

store energy

non-articulated

2 long toe levers, flexible keel

lightweight material

arch flattens and recoils

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14
Q

Shank: Exoskeleton

A

older

more durable but heavier

made of hard plastic laminate

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15
Q

Shank: endoskeleton

A

more common

metal pole central and then a cosmetic covering over it

metal pole allows for adjustments: in rehab start here and then when all the settings are good they put a cosmetic covering

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16
Q

PTB

what is it 
where is WB
bulge 
walls 
channels
A

BK

patella tendon bearing socket: for a below the knee amputation

WB:

  1. infrapatella tendon–shelf for the infrapatella tendon on anterior wall
  2. medial tibial plateau
  3. muscle belly of anterior tibialis: palpate lateral to tibial crest

Popliteal Bulge: on the posterior wall have a convexity that caves in to provide anteriorly directed force to keep patella on patella tendon shelf and improve WB on infrapatella tendon

walls:
anterior: comes up to mid tibia and flares out
medial and lateral: higher than anterior, up over femoral condyles
posterior wall: lowest wall to allow for knee flexion in sitting

channels and cavities:
hamstring channels are lateral and medial to popliteal bulge: go into socket on either side of popliteal bulge for hamstring tendons

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17
Q

Popliteal Bulge:

A

BK
in the PTB for the below knee amputation

on the posterior wall have a convexity that caves in to provide anteriorly directed force to keep patella on patella tendon shelf and improve WB on infrapatella tendon

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18
Q

walls of PTB

A

BK
anterior: comes up to mid tibia and flares out

medial and lateral: higher than anterior, up over femoral condyles

posterior wall: lowest wall to allow for knee flexion in sitting

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19
Q

TSB

what is it

A

BK
total surface bearing socket

even pressure distribution in residual limb, custom made for fit

doesnt have patella tendon shelf usually

-not good if limb is changing size or if sensitive areas cannot tolerate the pressure

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20
Q

Types of Suspension

BK

A

BK

  1. gel liner
  2. pre-lite liner
  3. supracondylar cuff
  4. supracondylar wall
  5. supracondylar suprapatellar walls
  6. Thigh corset suspension
  7. fork strap attached to waist belt
  8. over the knee sleeve suspension
  9. locking gel liner suspension
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21
Q

Gel Liner

what is it
pros (2)
cons (3)

A

BK

suspension: see more with the TSB

silicone, polyurithane cushioning on residual limb

PROS

  1. better to reduce pistoning
  2. even pressure distribution (comfort)

CONS:

  1. not as durable, breakdown overtime
  2. issue with prespiration: sweating can cause skin rashes (eventually sweat glands adapt)
  3. harder to don and doff
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22
Q

Pe-lite liner

A

BK
see more with PTB

foam mold of the residual limb that goes into the liner sometimes called a soft insert

23
Q

Supracondylar Cuff

A

BK
cuff attached on medial and lateral side of prosthetic and goes around the limb

good for fluctuating edema

**bad in that more likely pistoning

24
Q

supracondylar walls

A

BK
medial and lateral wall over the condyles of the femur

–less desirable

25
Q

supercondylar suprapatellar walls

A

BK
high medial, lateral walls over condyles of femur

anterior walls–come up as high as the medial and lateral wall

they can sit but kneeling is difficult

USE FOR A VERY SHORT BK

26
Q

Thigh Corset Suspension

A

BK
for below the knee amputation

mechanical knee over their knee

Pro:

  1. for fluctuating size of residual limb
  2. pressure intolerance: force through soft tissue of thigh takes some of the WB away from the residual limb

CON:

  1. heavy
  2. mechanical jt can break down
  3. can make noise
  4. moving parts
  5. can cause atrophy in the quads and hamstrings bc pressure on soft tissue isn’t contracting to the same extent (like an abdominal binder)
27
Q

Fork strap attached to waist belt

A

BK
for below the knee amputation

the fork strap can also be used with the superior portion of the supracondylar cuff (SC cuff)

less cosmetic
adds bulk

28
Q

Over the knee sleeve suspension

A

BK
for below the knee amputation

uses suction: needs to be well fitting
valve to push air out of socket–dont want air in the socket

over the knee sleeve
it goes over the knee and is made of polyurithane/neoprene material and it creates suction suspension

NOT GOOD FOR LIMB THAT CHANGES IN SIZE

29
Q

Locking Gel Liner Suspension

A

BK
for below the knee amputation

suction and locking pin–not for a fluctuating limb

gel liner with a pin at the end that clicks into the prosthesis (put on with 3-4 clicks release button to take off)

DECREASED PISTONING

REQUIRES A RESIDUALLY STABLE LIMB

30
Q

Iceross Seal in Sleeve

A

BK
has ring things to prevent the air from getting into the socket

suction suspension

does not go over the anatomy with walls

31
Q

Gel Liner

VS

Pe-Lite Liner

A

BK

Gel Liner:

  • -less pistoning/socket fit
  • -comfort/better pressure distribution
  • -pressure distribution throughout residual limb

Pe-Lite Liner

  • -more durable
  • -easier to put on and off
  • -cheaper
  • -doesnt have the prespiration issues
32
Q

suspensions:

Suction Suspension

A

BK

over the knee sleeve

locking gel liner

hypobaric gel liner

icercross

33
Q

Suspension:

Anatomical Contour

A

BK

SC wall: supracondylar wall

SC SP wall: supracondylar suprapatellar wall [for short residual limb]

34
Q

Suspension:

with straps

A

BK

  1. SC cuff
  2. supracondylar cuff
35
Q

suspension:

hinges

A

BK

thigh corset: straps and hinges (the mechanical knee goes over a real knee)

36
Q

Locked Knee Unit

A

AK
pull on anchor to lock knee into extension

(shorter because cannot flex the knee to shorten the limb in gait)

37
Q

free knee unit

A

mostly free but can lock out

–able to lock when need more security

38
Q

Types of Friction on a knee unit for AK

A
  1. Mechanical Friction: femoral and tibial surfaces abutt eachother, can adjust how tight the approximation is -FRICTION STAYS CONSTANT AMOUNT
  2. Hydraulic Friction: cylinder of viscous fluid creates friction, velocity dependent
  3. Pneumatic Friction: sealed chamber of air, velocity dependent
39
Q

C Leg

A

AK

hydraulic friction

computerized knee unit: microprocessor to adjust friction and redistribute the fluid to change stability

40
Q

weight activating break

A

AK
in mechanical/pneumatic/hydraulics

when WB through the knee joint the surfaces approximate on eachother and dont let the knee flex

do not have the breaking action unless you bear weight in the prosthesis

41
Q

safety knee

A

AK

weight activating break

–if WB on the prosthesis it doesn’t let the knee flex beyond 20 DEGREES

in stance we dont flex the knee anymore–like when in swing, if WB through the prosthesis it wont flex beyond 20 degrees so you dont stumble

(WB on good leg to stand and to sit)

42
Q

Internal Extension Aide

A

AK

spring in prosthesis helps the knee go into terminal extension –spring compressed in flexion and then recoil in extension

ensure complete extension and knee locks so that knee wont collapse when WB in gait
—-this is useful for the geriatric lock knee unit to help achieve that terminal extension to lock the knee

43
Q

External Extension Aide

A

AK

rubber elastic band in front

runs from socket to anterior portion of the knee unit/lower shank

stretches in flexion and recoils in extension

44
Q

Quadrilateral Socket

A

AK

  • older: use for
    1. fluctuating limb
    2. limb that is not tolerant to pressure

walls: medial to lateral dimension is greater than anterior to posterior dimension (rectangle, wider medial to lateral)

ischial shelf: primary site of WB by Ischial Tuberosity and underlying soft tissue

concavities: (relief)
- medial to shelf: hamstrings
- lateral to shelf: glut max
- lateral to socket: bicep femoris
- anterior medial: adductor longus
- posterior medial: hamstring tendon

Scarpas Bulge: anterior wall has a convexity to provide posteriorly directed force to keep the IT on the shelf

45
Q

concavities in the quadrilateral socket

A

concavities: (relief)
- medial to shelf: hamstrings
- lateral to shelf: glut max
- lateral to socket: bicep femoris
- anterior medial: adductor longus
- posterior medial: hamstring tendon

46
Q

scarpas bulge

A

on the anterior wall to provide a posterior directed force to keep the IT on the shelf

47
Q

indications for quadrilateral socket for AK

A
  • older: use for
    1. fluctuating limb
    2. limb that is not tolerant to pressure
48
Q

which way is the quadrilateral socket wider?

A

medial to lateral

49
Q

ischial containment socket

A

AK

better pressure distribution

–more symmetrical shape for better pressure distribution

IT is contained (not on a shelf)

more total surface WB around the ischial tuberosity and overlying tissue but also near the inferior pubic ramus

50
Q

difference between ischial containment socket and the quadrilateral socket

A

AK

the ischial shelf and the medial lateral being wider than the AP

51
Q

Suspensions in AK

A
  1. Total Elastic Suspension belt (TES)
  2. Silesian Belt
  3. Pelvic Band Suspension
  4. Suction Suspension
52
Q

Total Elastic Suspension Belt

A

AK

TES belt (like over the knee sleeve that is BK): partial suction with belt

uses partial suction–soft velcro material and neoprene material and expel air out of socket and use TES for added suspension

53
Q

Silesian Belt

A

partial suction

comes up and over iliac crests

(like SC of BK)

54
Q

Pelvic Band Suspension

A

AK
mechanical hip joint over anatomical hip joint
leather band encircles pelvis (like thigh corset of the BK)

hip joint with mechanical hip joint and a band that encircles the pelvis –add bulk and heavy but added support for suspension

does not use suction suspension
GOOD FOR RESIDUAL LIMB THAT FLUCTUATES IN SIZE

55
Q

suction suspension

AK

A

AK

total suction

if you dont see any belts or straps or bands

easier to total suction AK than on BK because tissues more tolerant to suction

פרםתיסיס (7 decks)

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