PROSTHETIC MOCK EXAM

Question 1

The Ertl procedure is known as an osteomyoplastic amputation reconstruction that perfroms a bone bridge between what:

A. Tibia bridged with the fibula
B. Distal end of the radius and ulna
C. Distal end of femur bridged with the tibia
D. Humerus bridged with the ulna

Answer 1

A. The Ertl procedure uses an osteoperiosteal graft which is used for an arthrodesis of the tibia to the fibula. This offers improved weight distribution and is thought to aid in pain control.

Question 2

A below knee amputee is seen in your clinic for a follow up appointment and states he feel anterior/distal discomfort in his prosthetic socket. Choose all correct answer(s) to address this problem:

A. extend the prosthetic socket
B. flex the prosthetic socket
C. add pretibial pads to the prosthetic socket
D. lower the posterior socket brim

Answer 2

A. Extending the socket moves pressure more proximal to the painful area.
C. Adding pretibial pads bridges the painful area so it receives less direct pressure

Question 3

A below the knee amputee is seen in your clinic for a follow up appointment and states he has posterior knee or hamstring discomfort. Choose all correct answers(s) to address this problem:

A. lower the posterior medial brim on the prosthetic socket
B. extend the prosthetic socket
C. flex the prosthetic socket
D. Align prosthetic foot more posterior in relation to the prosthetic socket

Answer 3

A,C,&D

A. lowering the posterior brim relieve pressure on hamstring tendons
C. flexing the socket decreases tension on posterior knee joint and hamstring tendons
D. moving the prosthetic foot posterior decreases the toe lever whereby decreasing the extension moment at the knee

Question 4

Which level(s) of amputation may lead to an equinus gait deformity:

A. Lisfranc amputation
B. Chopart amputation
C. Symes amputation
D. Transmetatarsal amputation

Answer 4

A,B,&D: Both the Lisfranc and Chopart amputation may result in an equinus deformity due to the dorsiflexor attachments, causing a patient to plantarflex their ankle. Transmetatarsal amputation transects the peroneus longus tendon which assists in first ray plantarflexion. This creates a muscular imbalance causing the muscles participating in supination to override muscles involved in pronation. The Symes amputation is through the articulation of the ankle and would not cause an equines deformity.

Question 5

A below knee amputee presents in clinic wearing a PTB style endoskeletal prosthesis with general knee pain and distal end pressure. The patient doffs her prosthesis and liner, upon examination of her residual limb you note redness on the distal tibia and inferior aspect of the patella bone. what would be the most logical clinical action(s) you could take at this point in addressing this problem:

A. Recommend the patient be evaluated for a new liner that will provide cushioning to her residual limb.
B. Flex the prosthetic while concurrently plantar flexing the prosthetic foot
C. Add a gastroc pad to the prosthetic socket
D. Add a 1 ply prosthetic sock over liner

Answer 5

C&D

C. Adding a gastroc pad decreases socket volume effectively lifting the residual limb reducing patellar contact with the patellar bar and socket bottom.
D. Adding a prosthetic sock decreases socket volume effectively lifting the residual limb reducing patellar contact with the patellar bar and socket bottom.

Question 6

Myodesis can be described as:

A. condition associated with calcification of muscle fibers
B. The suturing and permanent attachment of a muscle to bone
C. The suturing or permanent attachment of a muscle to another muscle
D. A muscle going through atrophy

Answer 6

B. Myodesis involves the attachment of a muscle to a bone.

Question 7

Which of the following is not part of a symes amputation procedure:

A. removal of the malleoli “distal aspect”
B. Placement of thick heel pad
C. amputation through the articulation of the ankle
D. Transmetatarsal amputation

Answer 7

D. All the above are seen with a symes procedure except for amputation at the transmetatarsal level

Question 8

Myoplasty can be described as;

A. A condition associated with the loss of sarcomerers
B. the suturing and permanent attachment of a muscle to a bone
The suturing or permanent attachment of a muscle to a bone
C. the suturing or permanent attachment of a muscle to another muscle
D. A muscle experiencing hypertrophy

Answer 8

C. Myoplasty involves the attachment of a muscle to another muscle

Question 9

What are two advantages in the list below of myodesis over myoplasty with regards to amputation:

A. decreased rate of infection related revisions
B. decreased rate of muscular atrophy
C. decreased rate of antagonistic muscular imbalances
D. provides a bulbous distal residual limb for self suspending applications in TT and TF cases

Answer 9

B&C

B. Myodesis provides an anchor for muscle to pull against which encourages hypertrophy.
C. most joints in the body operate with the cooperation of antagonistic muscle groups, imbalances in these groups causes dysfunction in movement, myodesis try’s to maintain muscular balances.

Question 10

During normal heel strike, the forward hip is how flexed:

A. neutral
B. 10 deg flexed
C. 25 deg flexed
D. 40 deg flexed

Answer 10

C. During normal heel strike the anterior hip is flexed to 25 degrees

Question 11

Which style of muscular tissue management in an TH amputation would be of greatest advantage to a myoelectric prosthesis candidate:

A. myodesis
B. myoplasty

Answer 11

A. Myodesis can provide anchors for the muscles innervated by the musculocutaneous and radial nerves. This provides palpable, separable, antagonistic muscular contractions which are most likely to exhibit a strong myo-signal.

Question 12

A TF patient is seen in clinic that exhibits lateral/proximal loss of contact in stance. Upon prosthetic fit examination it is noted the lateral wall is superior to the greater trochanter, the anterior wall contours to the adductor longus tendon, the posterior socket does not encompass the ischial tuberosity, the medial wall is located 65mm inferior to the perineum. What do you attribute to the cause of this deviation:

A. The posterior wall does not have ischial containment
B. the lateral wall is located too proximal for an ischial containment socket
C. the patient is causing the deviation from antalgic gait secondary to adductor longus tendon socket pressure
D. The medial wall is located too far inferior to the perineum

Answer 12

D. When a medial wall is located too distal, the counter force with lateral wall is lost causing the socket gap laterally, impinging the adductors, and losing optimal grasp of the ischial tuberosity.

Question 13

With a Krukenberg procedure what muscle is the driver of the pincer grip:

A. Supinator
B. Pronator teres
C. Brachioradialis
D. Flexor carpi radialis

Answer 13

B. The Krukenburg procedure is used at times with below elbow amputations. It relies on the strength of the pronator teres for the patient to use a pincer grip between the radius and ulna which have been separated.

Question 14

What would be a good quality(s) to look for in a prosthetic foot for a TT amputee who is K2 designated household ambulator that utilizes his prosthesis efficiently during the day but fatigues in the evening and buckles at the knee secondary to quadriceps weakness:

A. foot that progresses rapidly into plantar flexion during loading response
B. foot that progresses slowly into plantar flexion during loading response
C. heel should have a relatively firm durometer
D. heel should have a relatively soft durometer

Answer 14

A&D

A. Feet that plantar flex rapidly from heel strike to foot flat keep the ground reaction force anterior to the knee joint whereby increasing knee stability
D. feet with soft heels or plantar flexion bumper keep the ground reaction force anterior to the knee joint whereby increasing knee stability and workload across the knee extensors (quadriceps)

Question 15

Today in clinic a TT patient is seen presenting with a traditional exoskeletal PTB prosthesis with a SACH foot. Patient states that she feels like the prosthesis is throwing her knee forward as soon as the heel firmly contacts the ground. She has worn this prosthesis comfortably for two years until one month ago. What should be the first clinical action you should take at this time in the appointment:

A. plantar flex the prosthetic foot
B. dorsiflex the prosthetic foot
C. check to see if the patient switched to a shoe with a higher heel height compared to what she used to wear
D. check to see if the patient switched to a shoe with a lower heel height compared to what she used to wear

Answer 15

C. switching to a higher heel shoe “relatively dorsiflexing the foot will induce a flexion moment about the knee. Since this is an exoskeletal prosthesis you cannot make real alignment changes to remedy the problem

Question 16

The Krukenburg procedure is used at times in developing countries where expensive prosthesis are not attainable. What other patient population(s) would this be potentially used for:

A. blind patients with bilateral below elbow amputations
B. unilateral above elbow amputee
C. a patient concerned with the cosmetic appearance
D. failed prosthetic use for bilateral below elbow amputations

Answer 16

A&D: Krukenburg procedure is used in third world countries along with developed countries with blind patients with bilateral below elbow amputations as with the Krukenburg procedure sensation and proprioception is preserved. Also patients that have failed with use of prosthetics may consider this procedure for improved function and grip.

Question 17

A TR patient is seen in your clinic. The patient is inquiring as to which terminal device would be best for picking up a small coin from a table. Which device would you recommend:

A. 555
B. #7
C. 5XA
D. a mechanical prosthetic hand

Answer 17

C. The 5XA has a non-symmetrical or “canted” approach which allows better vision of the object being manipulated whereby making it easier to grasp the object as opposed to the other options which can interfere with the users ability to see what they are doing

Question 18

What are simple option(s) for increasing the ease of pre-positioning the prosthetic elbow in flexion, for a TH amputee utilizing a body powered prosthesis who lack glenohumeral flexion strength and biscapular abduction strength but can operate an elbow lock:

A. have the forearm lift tab located distally/anterior
B. have forearm lift tab moved proximal/anterior
C. move proximal base plate and retainer on humeral section posterior
D. check the level resistance in the cable housing

Answer 18

A&D

A. by moving the forearm lift tab anterior/distal you move the pull angle anterior to bridge the elbow joint where by decreasing the force necessary to move the forearm section about the humeral section.
D. This is overlooked commonly

Question 19

What bony landmark is utilized for a weight bearing prosthesis in a hip disarticulation:

A. pubic rami
B. greater trochanter
C. ischial tuberosity
D. iliac crest

Answer 19

C. with hip disarticulations you would utilize the ischial tuberosity just as with above knee prosthesis

Question 20

What is an option for pre positioning the prosthetic elbow in flexion, for a TH amputee utilizing a triple control body powered prosthesis who lacks glenohumeral flexion strength and biscapular abduction strength but can operate an elbow lock:

A. have the forearm lift tab located posterior/proximal
B. have forearm lift tab moved proximal
C. change triple control to dual control, switch split housing to single housing, utilize ballistic motion for forearm lift
D move NW ring laterally towards the prosthetic side

Answer 20

C. This is an option for “gathering” vs. “harnessing” energy for use as a force elsewhere.

Question 21

Why is choosing a SACH foot with a firm heel durometer not advised for TT patients with poor prosthetic side knee stability:

A. it will increase knee stability
B. it will decrease knee stabiliy
C. it will increase shock absorption at heel strike
D. it will not provide enough keel resistance

Answer 21

B. SACH feet with firm heel hurometer moves the ground reaction force posterior to the knee inducing a flexion moment whereby decreasing knee stability

Question 22

You are doing a gait assessment with your patient that has a below knee prosthesis. You notice that there is lateral trunk bending at mid stance to the prosthetic side. Choose the choice that would NOT be a potential cause of this gait deviation:

A. prosthesis too short
B. residual limb pain
C. prosthesis too long
D. weak quadriceps

Answer 22

D. Weak quadriceps would not account for lateral trunk bending but would contribute to abrupt knee flexion

Question 23

A TF patient is seen in your clinic. It is noted that as he ambulates with a circumducted gait. Select ALL possible causes:

A. prosthesis height is longer than his sound side ischial tuberoisty to floor measurement
B. prosthetic suspension is not adequate
C. the user does not have adequate hip flexor strength
D. prosthetic foot is plantar flexed excessively

Answer 23

A,B,C,&D

A. if the prosthesis is too long the patient may circumduct to clear the prosthetic foot
B. if the prosthesis does not suspend well the patient may circumduct to clear the prosthetic foot
C. if the patient does not have adequate hip flexor strength other muscles may be recruited to clear the prosthetic foot
D. excessively plantar flexed feet create a relative leg length discrepancy causing the patient to circumduct to clear the prosthetic foot.

Question 24

A TF patient is seen in your clinic. In stance, the prosthetic foot “smears” externally as she simultaneously abducts her prosthesis whereby advancing forward in the sagittal plane. She complains of low back pain as well. What is a prosthetic cause:

A. prosthetic keel too short
B. prosthetic knee has too little resistance to flexion
C. not enough flexion is built into the socket
D. prosthetic socket is excessively flexed

Answer 24

C. If inadequate flexion is built into the TF socket the patient will develop gait deviations utilizing compensatory motions for forward progression. Inadequate flexion of the socket will cause compensatory hyperlordorsis, causing discomfort for the patient over time

Question 25

A patient with an above knee amputation has a prosthesis. During gait analysis you find that she has knee instability while standing and you see knee buckling with any weight shift. You suspect the cause of the instability is: A. prosthetic knee set too far posterior to the TKA line B. tight extension aid C. prosthetic knee set too far anterior to the TKA line D. weak hip flexors

Answer 25

C. for knee stability in a prosthesis the knee is aligned posterior to the trochanter knee ankle line. If the knee is set anterior to the TKA line the stability will be poor and can cause buckling. An extension aid helps with extension during swing phase. Weak hip flexors would influence swing through of the prosthetic limb but would not cause knee instability

Question 26

TT prosthetic sockets that are excessively extended cause excessive pressure in what areas: A. anterior/proximal B. anterior/distal C. posterior/distal D. posterior/proximal

Answer 26

A&C TT prostheses with excessively extended sockets concentrate pressure ant/prox, post/dist as it creates an extension moment across the knee

Question 27

T/F, outsetting the prosthetic foot on a TT prosthesis socket pressure medial/distal and lateral/proximal: A. True B. False

Answer 27

A-True This will cause a valgus moment at the knee

Question 28

A forequarter amputation removes what structures: A. femur and half of pelvis B. femur and acetabulum C. arm, clavicle, and scapula D. arm and scapula

Answer 28

C. describes a forequarter amputation

Question 29

A TT patient is seen in clinic. Upon examining gait you notice a mild extension moment at the knee in stance phase. What could be the cause? Note: alignment is proper: A. prosthetic keel too short B. prosthetic heel is too firm C. prosthetic keel is too soft D. prosthetic heel is too soft

Answer 29

D. soft prosthetic heels will cause the ground reaction force to be anterior to the knee whereby causing an extension moment in stance

Question 30

When choosing if a prosthetic patient is a gel liner candidate, which of the following option(s) would assist you in this decision: A. general hygiene B. hand dexterity C. k-level D. allergies

Answer 30

A,B,C,&D A. because a prosthetic socket does not circulate fresh air, body temperature, and the fact that gel is porous it creates an environment optimal for breeding bacteria B. poor hand dexterity may cause donning to be difficult C. activity level is important as gel durometer varies from model to model which may impact your decision D. gel composition varies between manufactures and models allergies need to be considered

Question 31

In a transmetatarsal amputation you would expect to see what gait deviation: A. absent push off B. absent heel strike C. foot drop due to loss of dorsiflexion D. loss of supination during gait

Answer 31

A. with transmetatarsal amputations gait deviations include limited push off on the affected side along with diminished stance phase. You would not expect to see any of the other gait deviations as the muscle tendinous insertions remain intact to perform dorsiflexion and supination.

Question 32

Dorsiflexing the prosthetic foot is synonymous with________________: A. flexing the prosthetic socket B. extending the prosthetic socket C. switching to a shoe with a lower heel height D. switching to a shoe with a wider heel

Answer 32

A. dorsiflexing the prosthetic foot is the same as flexing the prosthetic socket

Question 33

Why is it necessary to utilize a Berkeley alignable componentry prior to final fabrication of an exoskeletal prosthesis: A. this will allow alignment changes in the final prosthesis b. this will allow you to align the prosthesis properly as exoskeletal prostheses cannot be re-aligned C. this will make the prosthesis more cosmetic D. none of the above

Answer 33

B. Berkeley alignable componentry simulate endoskeletal componentry but differ in that they are only utilized prior to final fabrication for alignment purposes. This can save you time and the frustration of re-fabrication in exoskeletal applications

Question 34

What muscle group would you expect to be the weakest in an above knee amputee: A. hip flexors B. hip abductors C. hip extensors D. hip adductors

Answer 34

D. Hip adductors would expected to be weak due to their transection. The shorter the amputation the weaker expected. Hip extension may be slightly weaker due to the loss of the adductor magnus which also aides in extension

Question 35

When flexing an AK socket to accommodate a flexion contracture what concurrent alignment adjustment should also be made: A. dorsiflex the prosthetic foot B. plantarflex the prosthetic foot C. move the prosthetic knee anterior D. move the prosthetic knee posterior

Answer 35

D. when ever you flex an AK socket this moves the prosthesis weight line posterior to the prosthetic knee whereby decreasing knee stability. By making a linear adjustment moving the prosthetic knee posterior knee stability can be maintained. Note: always utilize manufacturer instructions for pinpointing knee location with respect to the socket

Question 36

An AK patient is seen in clinic. When ambulating the patient complains of knee instability. What alignment change could possible assist in regaining knee stability: A. flex the prosthetic foot B. move the prosthetic knee anterior relative to the socket C. move the prosthetic knee posterior relative to the socket D. move the prosthetic foot posterior relative to he prosthetic knee and socket

Answer 36

C. by making a linear adjustment moving the prosthetic knee posterior we can decrease ground reaction forces running posterior to the knee center whereby promoting knee stability

Question 37

With a knee disarticulation amputee what is a cosmetic concern: A. knee extends too far out when sitting or kneeling B. leg length discrepancy C. the non amputated side extends too far past the surgical knee side D. Knee too bulky

Answer 37

A. with a knee disarticulation one concern is the leg length discrepancy seen when a patient is sitting or kneeling. However the patient would not have an actual leg length discrepancy when standing and walking. The knee joints in the past, used to be more bulky but with modern prosthetics this is not as much of a concern.

Question 38

An AK patient is seen in clinic. When ambulating the patient complains of knee instability. What alignment change could possible assist in regaining knee stability: A. extend the prosthetic socket B. move the prosthetic knee anterior relative to the socket C. shorten the overall height of prosthesis D. move prosthetic socket posterior in relation to the prosthetic knee

Answer 38

A. by making an angular adjustment moving the prosthetic socket into extension we can decrease ground reaction forces running posterior to the knee center whereby promoting knee stability. Note: extend socket with caution as to not cause hyperlordosis when range of motion at the hip is limited.

Question 39

When making an angular change utilizing endoskeletal componentry it is necessary to: A. loosen the bolt opposite the direction of desired angulation and tighten the opposing bolt on the side of desired angulation B. loosen the bolt on the side of desired angulation and tighten the opposing bolt opposite the side of desired angulation

Answer 39

A. endoskeletal componentry can be counter intuitive but in general you always tighten the bolt on the side of desired angulation

Question 40

# Choose all the apply to the benefit of a knee disarticulation over an above knee amputation with prosthetic fit: A. socket rotational control B. natural weight bearing surface C. muscular balance equalized with abductors and adductors D. large surface area for prosthetic sockets E. all the above

Answer 40

E. all the above are reasons that describe the benefits of a knee disarticulation over an above knee disarticulation in regards to prosthetic fit

Question 41

When removing endoskeletal prosthetic componentry for adjustment, how do you save your original alignment: A. completely back out two opposing bolts B. completely back out three adjacent bolts C. completely back out two adjacent bolts D. completely back out all bolts

Answer 41

C. backing out two adjacent bolts you can then rely on the remaining two "untouched" bolts to hold the memory of the previous alignment when you re-assemble the prosthesis

Question 42

In general polycentric prosthetic knees are considered inherently stable. Why is this: A. polycentric knees have multiple linkages which increases resistance to flexion B. polycentric knees have a theoretical knee center which is located posterior and superior C. polycentric knees are difficult to bend manually and under body weight the resistance increases making them even more difficult to bend D. polycentric knees utilize fluid friction which resist fast motions such as knee buckling

Answer 42

B. Polycentric knees have a centrode which is a projection of the linkages specific to each brand of knee. this projection is like two lines converging more superior and posterior to the actual physical knee unit which can decrease ground reaction forces running posterior to the theoretical knee center whereby promoting knee stability

Question 43

Which of the following is not part of the Scarpa's triangle: A. rectus femoris B. inguinal ligament C. sartorius D. adductor longus

Answer 43

A. rectus femoris is not part of the Scarpa's triangle. Adductor longus, sartorius and inguinal ligament are the boundaries of the triangle.

Question 44

# Choose all answers that are considered benefits of polycentric knees: A. they relatively shorten in swing phase of AK prosthetic gait B. they provide increases cosmesis when sitting C. they are inherently stable D. They have less moving parts when compared to other prosthetic knee designs

Answer 44

A,B,&C A. polycentric knees when flexed allow the linkages to work in coordination to fold relatively compact whereby decreasing the distance between the socket and foot which allows for greater prosthetic foot clearance. B. polycentric knees when flexed allow the linkages to work in coordination to fold relatively compact which can assist in matching knee centers on longer residual limbs when sitting increasing cosmesis. C. polycentric knees have a centrode which is a protection of the linkages specific to each brand of knee. This projection is like two lines converging more superior and posterior to the actual physical knee unit which can decrease ground reaction forces running posterior to the theoretical knee center whereby promoting knee stability.

Question 45

T/F: In a TT amputation, when trying to increase the energy return of a dynamic response foot it may be necessary to increase plantarflexion: A. True B. False

Answer 45

A-True By plantarflexing the prosthetic foot, forefoot pressures increase relatively earlier in stance which allows greater energy to build up "stored" to be released in terminal stance.

Question 46

The gait cycle is composed of what: A. heel strike on one side followed by heel strike by the same foot B. heel strike to push off C. heel strike on one side followed with heel strike on the other side D. push off on one side followed by push off on the opposite side.

Answer 46

A. Gait cycle is heel strike followed by heel strike on the same side

Question 47

A TH patient is seen in clinic. The patient is utilizing a body powered prosthesis with a Hosmer mechanical elbow and complains that he can operate it throughout its full range of motion but it requires too much effort. What could you do to remedy this: A. dial the automatic forearm balance mechanism located proximal posterior on the forearm shell B. install a spring lift assist C. lengthen the forearm section 10mm D. switch the terminal device from a 5XA hoo, to a #7 hook

Answer 47

B. By installing a spring lift assist you can decrease the effort required to flex the prosthetic elbow throughout its ROM

Question 48

What is a simple option for pre positioning the prosthetic elbow in flexion, for a TH amputee utilizing a body powered prosthesis who lacks glenhomumeral flexion strength and biscapular abduction strength but can operate an elbow lock: A. have the forearm lift tab located proximal and anterior B. have forearm lift tab moved proximal and anterior C. move the proximal base plate and retainer on humeral section anterior D. move proximal base plate and retainer on humeral section posterior

Answer 48

C. by moving the control cable retainer on the humeral section anterior you move the pull angle anterior to bridge the elbow joint whereby decreasing the force necessary to move the forearm section about the humeral section.

Question 49

During many amputations the surgeon will perform a myoplasty. What does this consist of: A. surgical attachment of muscle to muscle B. surgical attachment of the muscle to bone C. bone bridge between two bones, artificial joint ossification D. surgical replacement of a joint due to osteoarthritis

Answer 49

A. During some amputations myoplasties "muscle to muscle" are used such as with an above knee amputation with the quadriceps muscle. When possible myodesis "muscle to bone" is used as it gives the cut muscle an anchor to pull from whereby promoting hypertrophy. An arthrodesis is used in the case of the Ertl procedure with a bone bridge of the fibula to the tibial. Arthroplasty is the procedure for joint replacements.

Question 50

T/F: When fabricating a TR figure of eight harness it is necessary to incorporate elastic materials in the control strap: A. True B. False

Answer 50

B-False When fabricating a TR figure of eight harness inelastic material must be utilized to capture maximal cable excursion where as excursion will be lost within the elastic material

Question 51

T/F: When fabricating a TR figure of eight harness the inverted Y-strap should be located in the delto-pectoral grove: A. True B. False

Answer 51

A-True A properly fit figure of eight harness locates the inverted Y-Strap in the delto-pectoral groove

Question 52

What muscle is responsible for scapular elevation: A. trapezius muscle B. deltoid C. pecotralis major D. rotator cuff

Answer 52

A-True the upper trapezius muscle is responsible for scapular elevation.

Question 53

A TF client is seen in clinic, upon doffing the suction socket you notice a red, war like formatiom, and cracked skin distally. Chose the name of this condition AND its cause: A. verrucous hyperplasia B. ackerman's tumor C. excessive distal pressure within the prosthetic socket D. incomplete seating of the residual limb in the prosthetic socket

Answer 53

A&D A. verrucous hyperplasia D. verrucous hyperplasia is caused by a loack of contact or a void distally, when utilizing a suction socket in AK applications a distal void can cause excessive draw or the "hickey" effect on the distal residual limb tissue.

Question 54

A TH patient is seen in clinic. The patient is utilizing a body powered prosthesis and is wondering which terminal device would be best suited for holding a broom handle: A. 5XA B. #7 C. mechanical prosthetic hand D. 555

Answer 54

D. The 555 has a symmetrically shaped "lyre shaped" hook that is ideal for holding round objects

Question 55

With a hip disarticulation prosthesis, what is used for suspension: A. ischial tuberosity B. iliac crest C iliac crest of the intact side D. sacrum

Answer 55

B. the whole iliac crest is used for suspension of hip disarticulation prosthesis

Question 56

When fitting a figure of 8 harness with a NW ring on a TR patient, why is it advantageous to locate the NW slightly toward the sound side and at the level of C7: A. it will increase the comfort of the user B. it will position the control cable optimally C. it will position the inverted Y-strap in the delto-pectoral groove D. none of the above

Answer 56

B. By placing the NW ring slightly toward the sound side and at the level of cervical vertebrae 7, the control strap will lie across the affected side scapula allowing for the most efficient excursion of the control cable.

Question 57

When recommending an ischial containment TF socket what are some of the biomechanical goals that accompany this design: A. the ischial seat provides a weight bearing surface B. by containing the ischium we can decrease distal lateral discomfort in weight bearing C. by containing the ischium we can decrease proximal medial irritation D. by containing the ischium we can decrease proximal anterior irritation

Answer 57

A&B A. When designing a ischial containment socket weight bearing will occur on the ischial seat, hydrostatic loading over the whole residual limb, as well as gluteal loading. B. Ischial containment sockets are designed to "lock" onto the ischial tuberosity bony anatomy whereby holding the femur in adduction so upon weight bearing as the femur try's to migrate laterally it is held in place away from the distal lateral socket. Note: the tendency for a TF amputees femur to migrate laterally upon bearing is due to a muscular imbalance second to a loss of full adductor strength.

Question 58

With the upper extremity, supination and pronation occur at what joint: A. distal radioulnar B. radiocarpal C. proximal radioulnar D. A and C

Answer 58

D. the majority of supination and pronation occur at the proximal radioulnar joint along with some which occurs at the distal radioulnar joint.

Question 59

A TF patient is seen in clinic. Upon socket fit evaluation the ischial-tuberosity is not located on the seat but further down in the socket. What adjustment(s) could you attempt to remedy this: A. add a prosthetic sock B. drop the ischial seat 1cm distally C. add pad adjacent to Scarpa's triangle D. add a proximal posterior pad inferior to the ischial seat

Answer 59

A&C A. the limb may have lost volume due to normal anatomical changes. By incorporating a prosthetic sock to essentially lift the limb from the socket, the ischial seat may be in proper placement once again. C. Scarpa's triangle compression acts as a counter force to the ischial seat and assists with maintaining the ischial tuberosity located on the seat

Question 60

Standard bench alignment for a TT prosthesis with a SACH foot in the coronal plane is: A. 0-12mm outset B. 0-12mm posterior C. 0-12mm anterior D. 0-12mm inset

Answer 60

D. 0-12mm inset in the coronal plane helps to aid in a mild genu varum moment at midstance which keeps the body's center of mass over the base of support "the prosthetic foot"

Question 61

With a below elbow amputation all of these muscles would be transected except: A. flexor carpi radialis B. supraspinatus C. brachioradialis D. pronator quadratus

Answer 61

B. In a below elbow amputation all muscles would be transected except supraspinatus.

Question 62

A TT patient is seen in clinic. The patient has been utilizing a TT prosthesis successfully for 10 years but the patient has a grade 1 osteochondral defect "OCD" to his medial femoral condyle that is painful in weight bearing. what alignment change could you incorporate assist in the clients discomfort: A. outset the foot 3mm B. inset the foot 3mm C. dorsiflex the foot D. plantarflex the foot

Answer 62

A. by outsetting the foot you can create an external genu valgum moment at the knee in weight bearing. By creating an external genu valgum moment, you can assist in opening the medial knee compartment and pressure over the OCD.

Question 63

Many prosthetic knees require the toe to be loaded an un-weighted in order to transition from stance features to swing features. Why would recommending two knees that function in this way to a bilateral TF amputee be contraindicated: A. the patient would have difficulty moving from sit to stand B. the patient would have difficulty during double support instances in prosthetic gait C. the patient would be unable to sit D. the patient would have shortened step length

Answer 63

C. this patient would have the ability to disengage stance mode with toe pressure loss on one knee but would be unable to disengage the second knee without falling to the seat

Question 64

Which muscle is the primary forearm supinator: A. biceps brachii B. brachioradialis C. brachialis D. coracobrachialis

Answer 64

A. Biceps brachii innervated by musculocutaneous nerve is the primary forearm supinator. Also it acts to flex the forearm when supinated. Brachialis flexes forearm in all positions. Coracobrachialis helps to flex and adduct arm. Brachioradialis is one of the elbow flexors innervated by radial nerve.

Question 65

In reference to TT prosthetics excessive adduction of the prosthetic pylon would cause what at midstance in gait: A. genu varum B. genu valgum C. genu flexion D. genu extension

Answer 65

A. by adducting the prosthetic pylon you would be bringing the prosthetic foot closer to midline whereby bringing the prosthetic foot "base of support at midstance" medial to the center of mass above causing a varum moment at the knee

Question 66

One of the characteristics of the TT total surface bearing socket is: A. emphasizing pressure on the patellar ligament B. emphasizing pressure equalization across all residual limb surfaces C. emphasizing pressure distribution on the tibial fibula interosseus membrane to prevent residual limb scissoring D. Emphasizing pressure adjacent to the bony anatomy

Answer 66

B. total surface bearing sockets are designed to equalize pressure across a greater surface area of the residual limb.

Question 67

With a knee disarticulation what adductor muscle is transected: A. adductor magnus B. Adductor longus C. Gracilis D. Adductor brevis

Answer 67

C. with a knee disarticulation the gracilis muscle along with sartorius and hamstrings are transected.

Question 68

When evaluating a new trans-metatarsal amputee, what deformity of the foot and ankle complex is typical without tendon transfers: A. pes plano valgus B. forefoot adductus C. Equino varus D. Club foot

Answer 68

C. When a trans-metatarsal amputation is performed, peroneus longus is transected, this causes a weakness of pronators allowing suponator muscle to override the foot and ankle complex resulting in an equino varus deformity.

Question 69

The most accurate description of a hydraulic single axis knee is: A. a prosthetic knee that utilizes pneumatic friction resistance to modify TF prosthetic swing B. a prosthetic knee that utilizes mechanical friction resistance to modify TF prosthetic swing C. a prosthetic knee that utilizes variable Elastoplast resistance to modify TF prosthetic swing D. A prosthetic knee that utilizes fluid resistance to modify TF prosthetic swing

Answer 69

D. Fluid prosthetic knees fall into two categories (pneumatic-gas) (hydraulic-liquid) therefore a hydraulic or pneumatic knees utilizes "FLUID" resistance to modify TF prosthetic swing.

Question 70

All of the following muscles make up the pes anserinus except A. sartorius B. gracilis C. semitendinosus D. Semimembranosus

Answer 70

D. Semimembranosus inserts along the posterior aspect of the medial condyle of the tibia where the pes anserinus inserts on the medial surface of the superior part of the tibia.

Question 71

When evaluating fluid TF prosthetic knees, which type of resistance is most adversely effected by cold environmental temperate changes: A. hydraulic B. pneumatic C. mechanical D. constant friction

Answer 71

A. hydraulic fluid becomes more viscous in cold temperatures making the response of the prosthetic knee sluggish in response to cold temperatures

Question 72

In TF prosthetic alignment the relationship between the posterior socket shelf and the lateral wall is referred to as: A. Q-angle B. TKA alignment C. sagittal flexion alignment D. adduction angle

Answer 72

D. The adduction angle is the relationship of the posterior shelf to the lateral wall of the prosthetic socket.

Question 73

In determining the correct length of the prosthesis what bony landmark is NOT used: A. greater trochanter B. iliac crest C. anterior superior iliac spine D. posterior superior iliac crest

Answer 73

A. iliac crest, ASIS, PSIS, along with the medial tibial plateau are all used to establish the length of the prosthesis. The greater trochanter is not a bony landmark used for proper prosthesis height measurements

Question 74

A TT patient is seen in clinic. At heel strike the SACH prosthetic foot rotates externally. What is one cause of this gait deviation: A. the prosthetic heel durometer is too firm B. the prosthetic heel durometer is too soft C. the prosthetic keel is too firm D. the prosthetic keel is too soft

Answer 74

A. if the prosthetic heel is too firm, at heel strike instead of absorbing the energy, the force is translated laterally causing rotation externally. Note: this can also be caused if a SACH foot is squeezed into a shoe that is too small. The tight fitting shoe does not allow for proper compression of the SACH heel, essentially falsely creating a 'firm heel'

Question 75

A force of 2lbs is exerted on a 1.5 foot lever arm. What amount of force must be exerted on a 2 foot lever arm to balance the system: A. 3 lbs B. 6 lbs C. 1.5 lbs D. 12 lbs

Answer 75

C. 2 * 1.5 = 2 * X X= 1.5

Question 76

The biceps femoris causes what motion at the hip and knee respectively: A. hip extension, knee extension B. hip extension, knee flexion C. hip flexion, knee extension D. hip flexion, knee flexion

Answer 76

B. Biceps femoris along with semitendinosus and semimembranosis make up the hamstrings. Due to its proximal attachment at the ischial tuberosity it acts to extend the thigh, distal attachment on lateral side of fibula will assist with knee flexion

Question 77

A TF client is seen in clinic, a medial whip is noted in prosthetic gait. What adjustment would be appropriate to normalize swing phase: A. externally rotate the prosthetic knee B. internally rotate the prosthetic knee C. internally rotate the prosthetic foot D. externally rotate the prosthetic foot

Answer 77

B. medial whips are caused by excessively rotated prosthetic knees and are fixed by internally rotating the prosthetic knee

Question 78

A TF client is seen in clinic, a lateral whip is noted in prosthetic gait. What adjustment would be appropriate to normalize swing phase: A. externally rotate the prosthetic knee B. internally rotate the prosthetic knee C. internally rotate the prosthetic foot D. externally rotate the prosthetic foot

Answer 78

A. lateral whips are caused by excessively internally rotated prosthetic knees and are fixed by externally rotating the prosthetic knee

Question 79

During normal gait you see the pelvis drop during midstatnce. What muscle weakness could cause this: A. piriformis B. gluteus minimus C. gluteus medius D. iliopsoas

Answer 79

C. Weakness in the gluteus medius will cause what is known as Trendelenburg gait. One function of this muscle is to maintain lateral stability of the pelvis

Question 80

When a prosthetic foot inset is increased, socket pressures will become more apparent: A. lateral/distal & medial/proximal B. lateral/proximal & medial/distal C. medial/distal & medial/proximal D. lateral/distal & lateral/proximal

Answer 80

A. As a prosthetic foot inset is increased pressures in the socket increase lateral/distal & medial/proximal

Question 81

What is the maximum amount of knee flexion contracture that could be fit with a traditional TT PTB socket: A. 10 deg B. 15 deg C. 25 deg D. 35 deg

Answer 81

C. A TT amputee with a 25 degree flexion contracture can still be fit with a traditional PTB socket but further contractures may indicate a bent knee prosthesis which has very poor cosmesis

Question 82

Which muscle of the quadriceps femoris group will steady the hip joint and help iliposoas to flex the thigh: A. rectus femoris B. vastus lateralis C. vastus medialis D. vastus intermedius

Answer 82

A. The quadriceps femoris acts primarily to extend the leg at the knee joint. the rectus femoris acts at the hip joint due to its proximal attachment at the anterior inferior iliac spine.

Question 83

When evaluating the mechanics of a prosthetic foot, it could be said that the resistance of the prosthetic keel is acting like which muscular group and what type of muscular contraction: A. ankle dorsiflexors & eccentric contraction B. ankle dorsiflexors & concentric contraction C. ankle plantarflexors & concentric contraction D. ankle plantarflexors & eccentric contraction

Answer 83

D. The prosthetic foot keel is acting like ankle plantarflexors eccentrically contracting where by controlling the anterior translation of the prosthetic pylon and socket over the foot in stance

Question 84

when aligning the prosthetic socket posterior in relation to the prosthetic foot, forces present in the socket will increase where: A. anterior/proximal & posterior/distal B. proximal/medial & distal/lateral C. posterior//proximal & anterior/distal D. proximal/lateral & distal/medial

Answer 84

A. When moving the socket posterior in relation to the prosthetic foot, the length of the prosthetic foot keel is relatively longer causing an extension moment at the knee in midstance as well as increased socket pressures anterior/proximal & posterior/distal.

Question 85

T/F: When fabricating a below the knee prosthesis for a 4 year old patient it may be necessary to make a socket that includes multiple removable volume layers "onion skin lamination": A. True B. False

Answer 85

A-True By providing removable volume layers this will allow for accommodation to the natural girth/volume changes of the child as he/she grows. This will minimize the number of socket replacements.

Question 86

A TT patient is seen in clinic. When evaluating gait you notice a Trendelenburg sign on the prosthetic side during midstance. What muscle group would you expect to show low MMT scores on the prosthetic side: A. gluteus maximus B. adductor magnus C. vastus lateralis D. gluteus medius

Answer 86

D. Gluteus medius is a hip abductor. When this muscle is weak, the patient will lean over the involved side (Trendelenburg sign) to create abduction whereby maintaining stability.

Question 87

For prosthetic patients utilizing a cane in rehabilitation, why is it recommended that the cane be held in the hand opposite the side of involvement? Choose ALL correct answers: A. to give tripod base for support B. to facilitate natural arm swing C. to facilitate normal prosthetic step length D. to encourage knee stability and confidence

Answer 87

A,B,C,&D A. The tripod is one of the most stable bases. In prosthetics that is created by the prosthetic side forward, sound side lower extremity back and uninvolved side hand with cane. B. In normal gait during swing phase of the prosthesis the contralateral arm swings to oppose the rotational torque "dog chasing tail" and allow forward progression to occur. C. with use of a cane it will allow for potential equalized step length. D. having the cane does promote knee stability and confidence with prosthetic patients early on in their rehabilitation

Question 88

All are bony landmarks that are easily palpable in the lower limb except: A. lateral mallelous B. tibial tuberosity C. lesser trochanter D. ischial tuberostiy

Answer 88

C. The lesser trochanter can not be palpated as it is on the proximal medial surface of the femur covered by soft tissue of the adductors.

Question 89

A TF client is seen in clinic, if the patient is utilizing suction suspension you can best differentiate the socket pressures as _______ in stance phase and _____ in swing phase: A. less, more B. negative, postivie C. dynamic, static D. positive, negative

Answer 89

D. Suction suspension provides positive pressure as the patients weight is going through the socket in stance phase and also negative pressure during swing phase

Question 90

An elbow disarticulation patient is seen in clinic for a prosthesis replacement. What type of articulation at the elbow would be indicated: A. Hosmer friction elbow B. Residual limb activated locking hinge C. outside locking hinge D. Ergo arm

Answer 90

C. Outside locking hinges allow elbow center to be matched in a long TH or ED in addition they allow the patient to lock the elbow in multiple positions (varies per model type) similar to a TH user with a Hosmer locking elbow. Note: cosmesis can be poor.

Question 91

T/F: When fabricating a prosthetic socket in general, it is necessary to have all "like" fibers directly adjacent to aid in strength A. True B. False

Answer 91

B-False By alternating different fiber types in your lamination you can utilize principals similar to the (I-BEAM) effect.

Question 92

When deciding to add a cross back strap to a figure of eight harness. What material would be best to fabricate the cross back strap with: A. elastic strapping B. inelastic strapping C. leather strapping D. cotton webbing

Answer 92

B. Cross back straps are used to promote increased excursion. Inelastic materials are ideal as they will capture more body motion in the form of cable excursion where as an elastic material will capture the excursion in the elasticity of the material vs cable excursion.

Question 93

Why are flexible elbow hinges recommended for longer TR amputees: A. allows better pre-positioning B. Durability C. improved residual limb comfort D. allows patient to maintain natural pronation/supination

Answer 93

D. By utilizing flexible hinges for longer TR amputees we can allow their natural pronation/supination to occur without the prosthetic hinges impeding the motion

Question 94

Partial foot amputees often present with a lack of controlled third rocker late in stance. What options can assist with this other than a partial foot insert with toe filler: ``` A. rigid sole shoe B. rocker addition to the shoe C. carbon insert D. OTS carbon AFO E. all of the above ```

Answer 94

E. All of the above are correct options for a partial foot amputee as they attempt to increase the toe level arm and aid in a controlled third rocker.

Question 95

When recommending a prostheses for a bilateral TR patient, what style of suspension would you not recommend: A. northwestern self suspending sockets B. custom silicone suction suspension sockets C. munster self suspending sockets D. pin lock suspension sockets

Answer 95

C. Munster self suspending sockets are contraindicated for bilateral TR amputees as they require a pull sock to be utilized for donning the prosthesis which requires at least one sound hand to assist in the process.

Question 96

When fabricating a TH prosthesis it is important to add pre-flexion to the prosthetic elbow, why is this: A. to ensure full ROM will be available in the prosthetic elbow B. to decrease force necessary to initiate elbow flexion C. to maintain a natural hang angle D. to decrease premature wear on the elbow lock notches

Answer 96

B. Pre-flexing the prosthetic elbow in TH applications, a mechanical advantage is placed into the prosthetic system that will decrease the force necessary to initiate elbow flexion whereby increasing the ease of operation on the amputee

Question 97

Transverse tarsal joints allow inversion and eversion of the foot. Choose the other joint(s) that allow inversion and eversion: A. talocrural joint B. subtalor and talocalcaneonavicular C. superior and inferior tibiofibular joints D. all of the above

Answer 97

B. Inversion and eversion occur at subtalor, talocalcaneonavicular and transverse tarsal joints. Superior and inferior tibiofibular joints assist with plantarflexion and dorsiflexion.

Question 98

With respect to TF quadrilateral socket measurements, which measurement would the following calculations be used for? (Measure the ischial level circumference and divide it by three, then subtract 6mm). A. anterior/posterior measurement B. lateral A/P measurement C. medial A/P measurement D. medial/lateral measurement

Answer 98

D. By measuring the ischial level circumference, dividing by 3 and then subtracting 6mm you are determining the M/L measurement for a quadrilateral socket.

Question 99

A TR patient needing the ability to vary grip forces on small delicate objects would benefit from which terminal device: A. voluntary closing prosthetic hook B. voluntary closing prosthetic hand C. voluntary opening prosthetic hand D. voluntary opening prosthetic hook

Answer 99

A. A voluntary closing hook offers ease of sight to the object as well as a variable "graded" grip force which can allow the patient to determine the exact amount of grip force they intend to use on the object

Question 100

Injury to the superior gluteal nerve will result in what gait deviation: A. absent push off B. absent heel strike C. circumducted gait D. trendelenburg gait

Answer 100

D. superior gluteal nerve innervates gluteus medius and minimus. With injury these muscles are inactive causing the pelvis to fall on the raised limb (Trendelenburg sign).

Question 101

A force of 9lbs is applied at the harness in a TR prosthesis, in order to maintain the minimum acceptable efficiency of the cable/cable housing, how much force must be needed in order to open the prosthetic hook:

Answer 101

C. 70% is the minimum accepted calbe/cable housing efficiency. (9 lbs * .7 = 6.3 lbs).

Question 102

When modifying a TF quadrilateral plaster mold, if you are trying to increase the amount of adduction on the mold what must you do to maintain a level posterior shelf: A. apply plaster laterally B. apply plaster medially C. shave plaster off medially D. shave plaster off laterally

Answer 102

D. by increasing the adduction angle the medial posterior shelf is relatively raised by then removing plaster laterally you can level out the posterior shelf and maintain proper ischial tuberosity-distal end length

Question 103

The talus does not articulate with the: A. cuboid B. tibia C. navicular D. fibula

Answer 103

A. cuboid does not articulate with the talus.

Question 104

When fabricating TF socket with a hip joint, the hip joint should be located where in relation to the greater trochanter: A. 12mm inferior & 25.4mm posterior B. 10mm inferior & 20mm anterior C. 12mm superior & 25.4mm posterior D. 12mm anterior & 25.4mm superior

Answer 104

D. Socket hip joint location should match anatomical hip joint location for proper articulation. The anatomical hip joint location is 12mm anterior and 25.4mm superior to the greater trochanter.

Question 105

In TF applications, when inadequate socket flexion is incorporated into the prosthesis what will the patient be unable to do without a gait deviation: A. stand with decreased lumbar lordosis B. sit with prosthetic knee and sound side knees level in the coronal plane C. have symmetric step lengths D. fully extend the prosthetic knee

Answer 105

C. Proper flexion angle must be incorporated into the TF prosthesis in order to allow even step lengths when compared to the sound side

Question 106

The tibial nerve innervates muscles to the _____ portion of the leg, while the deep fibular nerve innervates muscles on the ______ portion of the leg: A. posterior, anterior B. anterior, posterior C. anterior, lateral D. posterior, lateral

Answer 106

A. The tibial nerve supplies posterior muscles of the leg and knee joint while the deep fibular nerve supplies anterior muscles of the leg and dorsum of foot.

Question 107

A TT patient is seen in clinic. The patient has been utilizing a TT prosthesis without problems for years. The patient has PVD and has been experiencing ischemic pain within his prosthetic socket in what seems to be his gastroc muscles. What should be the most logical plan of action: A. decrease pressure on the medial tibial flare B. decrease pressure posterior and adjacent to the popliteal artery C. recommend the patient be seen by a vascular specialist D. flex the prosthetic socket

Answer 107

B&C B. By decreasing pressure adjacent to the popliteal artery we can minimize ischemic pain as blood flow will be less restricted C. all patients with new medical symptoms should be referred to a physician for evaluation.

Question 108

T/F: With regards to initial post operative prostheses and rigid dressings, removing the device is indicated if the patient is running a temperature because it is a hallmark sign of infection: A. True B. False

Answer 108

A-True Often you will be asked to remove an IPOP or Rigid dressing if a patient spikes a fever as it is a sign of infection which merits wound examination. Note: in instances where more frequent wound checks are needed for a patient with infection a bi-valved design can be more convenient, or a thermoplastic Rigid Removable Dressing (RRD)

Question 109

You place a shrinker on a below knee amputee patient 3 weeks post op and notice that he keeps a pillow under his knee. What joint(s) would you expect a contracture if this persists: A. knee flexion contracture B. knee flexion and hip flexion contracture C. hip flexion and hip adductor D. knee extensor and hip flexor contracture

Answer 109

B. Hip and knee flexion contractures are common in below knee amputees. It should be reinforced immediately post op that the patient should not place a pillow just under the knee as this promotes knee and hip flexion. Patients should be preforming hamstring stretches and hip flexor stretches or positions such as prone to promote joint flexibility.

Question 110

T/F: When performing plaster mold modifications for lateral stabilization bar in a TT PTB style socket, it is imperative that it does not extend too superior so as to avoid the common peroneal nerve: A. True B. False

Answer 110

A-True Lateral stabilization bar is located in between the fibular head and the cut end of fibula. It should be located distal to the fibular head and proximal to the cut end to avoid pressure adjacent to the cut end and common peroneal nerve.

Question 111

T/F: A pull sock is often used to don a TF suction suspension to draw tissue into the socket and to facilitate hydrostatic loading: A. True B. False

Answer 111

A-True By drawing soft tissue into a fixed space it relatively solidifies the tissue allowing for hydrostatic loading

Question 112

If the sciatic nerve is severed at the level of the ischial tuberosity, muscle function will NOT be impaired at the: A. knee joint B. ankle joint C. hip joint D. subtalor joint

Answer 112

C. The sciatic nerve will still be able to innervate the hip joint but will contribute to weakness in the knee, ankle and foot. The sciatic nerve innervates posterior muscles of the hip and knee and divides into the tibial nerve and common fibular nerve which innervates the ankle and foot muscles.

Question 113

T/F: A silesian belt is used to increase coronal plane stability in TF prosthesis applications: A. True B. False

Answer 113

B. With regards to TF prostheses, silesian belts are utilized to decrease socket rotation and assist in suspension. A hip joint would be indicated for coronal plane stabilizations.

Question 114

At heel strike the knee joint is at _____ while the ankle joint is at ______: A. at neutral/full extension, 90 degrees/neutral B. 10 deg flexed, 5 deg plantarflexed C. neutral, 10 degrees dorsiflexion D. neutral, 5 degrees dorsiflexion

Answer 114

A. At heel strike the knee is at neutral or full extension while the ankle is a 90 deg/neutral

Question 115

In normal gait, maximum knee flexion reaches approximately: A. 30-35 degrees B. 35-40 degrees C. 45-50 degrees D. 60-65 degrees

Answer 115

D. Knee flexion during swing phase is 60-65 degrees in the normal gait cycle

Question 116

T/F: the duration of double support varies inversely with the speed of walking and in running double support is absent: A. True B. false

Answer 116

A-True In slow walking double support increases compared to swing phase. The above statement is true.

Question 117

The stance phase of gait makes up what percent of the gait cycle during ordinary walking speeds: A. 40% B. 60% C. 80% D. 20%

Answer 117

B. Stance phase makes up 60% of the gait cycle while swing phase makes up the other 40%

Question 118

Your patient has a transtibial amputation and was just fitted with a PTB socket. During your session with the patient for initial fitting, you have him walk in the parallel bars. After which you inspect the skin of the residual limb. You would not expect redness in what area(s): A. distal residual limb B. anterior tibial and tibial crest C. fibular head and cut end of the fibula D. tibial tuberostiy and patellar bone

Answer 118

A,B,C&D A PTB socket should have reliefs over bondy prominences, or sensitive areas. All of the above areas should not have redness that persists longer than 20 minutes post prosthetic use.

Question 119

When external rotation of the prostheic foot is needed, the toe lever or keel of the foot is relatively: A. lengthened B. shortened C. softened D. hardened

Answer 119

B. The keel would be relatively shortened when the prosthetic foot is externally rotated.

Question 120

T/F: Unilaterally BK amputees should be instructed to ascend stairs with the prostheses leading first and to descend stairs with the sound limb leading first: A. True B. False

Answer 120

B-False "Lead with the good, go down with the bad" is often used to teach patients that they should lead with the sound limb as it is strong to ascend stairs, then to descend stairs leading with the "bad" side (amputee) as their sound limb will be needing to perform the eccentric contraction to safely step down.

Question 121

During swing phase of the gait cycle what muscles are achieve dorsiflexion: A. anterior tibialis, extensor hallucis longus, extensor digitorum longus B. anterior tibialis, peronous brebis, extensor digitorum longus C. anterior tibialis, gastroc soleus, extensor hallucis longus D. anterior tibialis, extensor hallucis longus, tibialis posterior

Answer 121

A. These muscles are slightly active during the swing phase to prevent the foot and toes from dragging

Question 122

The sciatic nerve innervates all these muscles except: A. semitendinosis B. biceps femoris C. semimembranosis D. gluteus medius

Answer 122

D. The sciatic nerve provides sensation to most of the leg and motor function to most of the posterior leg muscles, there is a tibial division and the common fibular division that innervates the biceps femoris. The gluteus medius is innervated by the superior gluteal nerve.

Question 123

You are seeing a patient with diagnosis of peripheral vascular disease. What is the common artery that you can palpate to assess blood flow: A. dorsalis pedis B. ulnar artery C. femoral artery D. radial artery

Answer 123

A. Clinicians at times will want to assess blood flow in a patients foot. One way is to palpate the dorsalis pedis pulse along with capillary refill.

Question 124

What is the primary function of brachioradialis: A. elbow flexion B. elbow flexion and forearm pronation C. elbow flexion and wrist extension D. elbow flexion and wrist flexion

Answer 124

A. Brachioradialis muscle serves to flex the elbow

Question 125

You have a patient that presents for evaluation for an above knee prosthesis. You notice he has a forward flexed psture. What positive muscle length test would you expect to see associated with this posture: A. ober test B. thomas test C. hip extensor tightness D. plantar flexion tightness

Answer 125

A. the Thomas test tests for iliopsoas (hip flexion) tightness. Often with hip flexor contractures the patient will present with a forward flexed posture when standing. Ober test assesses ilio tibial band tightness; hip extensor tightness would have opposite effect on the patient's posture.