Prosthetics Exam 2: Transfemoral Amputation Flashcards by Madelynn Kahl

What are the four socket designs for transfemoral amputees

quadrilateral
ischial containment
Marlo Anatomical
Elevated Vacuum

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What type of socket is used with a subischial amputation

elevated vacuum

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A quadrilateral socket has ___ distinct walls

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A quadrilateral socket has a _____ ____ which is an ischial seat or the primary weight-bearing surface

posterior shelf

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The (anterior/posterior) wall contours direct forces (anterior/posterior) to try to stabilize ischium on its prosthetic seat

anterior; posterior

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True or False:

A quadrilateral socket is narrower M-L than it is A-P

false, more narrow AP

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Why is a quadrilateral socket more narrow AP than it is ML

Because its trying to push the ischium back to its shelf/ischium seat

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What type of socket was made to try to control an abducted residual femur

Ischial containment

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An ischial containment socket was created to control a femur that is (adducted/abducted)

abducted

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Long’s line, CAT-CAM, and ischial ramal containment are what type of transfemoral sockets

ischial containment

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Which type of socket attempts to encapsulate the ischial tuberosity as well as portions of the ramus with a very distinguishable containment buttress

marlo anatomical socket

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A Marlo anatomical socket has a (lower/higher) posterior trim line to make it easier to sit on the glute instead of the posterior socket

lower

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A Marlo anatomical socket has a low (anterior/posterior) trim line as well as a low (medial/lateral) trim line

to make it easier to sit on the glute instead of the socket

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Why does a Marlo anatomical socket have a low medial trim lines and a high lateral trim line as opposed to a high medial and low lateral trim lines

The high lateral trim line helps control/contain the ischium and the low medial trim line aid in the flattening of the thigh while seated

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A Marlo anatomical socket (does/does not) limit ER, so there (is/is not) a need for a rotation unit proximal to the knee joint

does not, is not

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What is another name for an elevated vacuum socket

subischial socket

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An elevated vacuum/subischial socket has (low/high) trim lines, (decreased/increased) patient comfort, (decreased/increased) patient ROM, and proximal trim lines that are lowered by __-__ inches

low; increased; increased; 2-4

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An elevated vacuum/subischial socket has ___ trim lines
Increased ____ ____
Increased patient ____
and (proximal/distal) trim lines that are lowered 2-4 inches

low
patient comfort
ROM
proximal

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A weaker limb will need a prosthetic with a (lower/higher) design

higher

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In general, what are the two types of socket materials

rigid and flexible

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(rigid/flexible) socket material is usually resin-laminated or thermoformed plastic that is intended to have an intimate, total contact fit

rigid

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What are the five characteristics of a rigid socket material

durable
easy to clean
less bulky (not really though)
less expensive
difficult to adjust

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True or False:

A socket with rigid material leaves little to no room for additional socks or cushion outside of what the socket provides

true

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(rigid/flexible) socket material is vacuum formed with any number of flexible thermoplastic materials

flexible

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Flexible socket material is incased in a rigid frame that provides support with ___ and helps keep socket ___

WB; shape

is rigid or flexible material more comfortable, especially in sitting

flexible

Which type of socket material is used if suction suspension is desired

flexible

Which type of socket material is more durable than the other

rigid is more durable than flexible

Which type of socket material is bulkier than the other

flexible is more bulky than rigid

Which socket material is more expensive than the other

flexible is more expensive than rigid 9

What are the 6 types of suspension

``` pull in suction roll on suspension liners elevated vacuum silesian belt total elastic belt pelvic belt and hip jont ```

What type of suspension has negative air pressure, skin to socket contact, and muscle tension used to hold the limb on

pull in suction

What is the most common type of pull in suction

a pull sock or sleeve - sometime lubricant is used instead of a pull sock

A patient with pull in suction must be ____ and have ____.

agile; balance

How is air released in a pull in suction suspension

there is an air expulsion valve at the bottom to release air as limb enters socket

What type of patient is a pull in suction suspension not appropriate for

Recent amputees that will have fluctuation in limb volume, or those with a history of fluctuating edema or unstable weight

True or False: A pull in suction suspension is appropriate for those with fragile skin

False, it is not appropriate because of the high friction with donning

Roll on suspension liners are essentially like ___ liners

gel

What are three types of roll on suspension liners

shuttle lock, lanyard, cushion liner with air expulsion valve

Which type of roll on suspension liner is a pin lock system

shuttle lock

Which type of roll on suspension liner uses a strap or cord to help pull the limb into the socket

lanyard

Which type of roll on suspension liner has a rubber ring that makes close contact with socket and expulses air through valve and then creates the suction

cushion liner with air expulsion valve

Shuttle lock, lanyard, and cushion liner with air expulsion valve are all types of what suspension category

roll on suspension liners

(pin lock/lanyard) is common with transfemoral amputees

lanyard

An elevated vacuum suspension system has negative pressure (when the limb is load/all the time)

all the time

Which type of suspension system uses leather or a lightweight webbing for belt

silesian belt

Describe what a silesian belt suspension systems looks like

A belt is attached to lateral aspect of socket, encircles pelvic and then attaches to a loop or buckle on the anterior side of the prosthesis

When is a silesian belt often used for

as a backup for a traditional suction system

True or False: A silesian belt system does not control rotation of a limb

true

Which is more common, a silesian belt or a total elastic suspension belt

total elastic suspension belt

What type of material is a total elastic suspension belt

elastic neoprene material

Which type of suspension system is great for auxiliary suspension

total elastic suspension belt

Which type of suspension system is used a lot with new amputees who may have fluctuation in limb volume and need a little extra suspension as limb shrinks

total elastic suspension belt

What type of suspension system has a belt with a metal hip joint and is traditionally used for short residual limbs

pelvic belt and hip joint

A pelvic belt and hip joint helps (increase/limit) rotation and (increase/decrease) M-L stability

limit; increase

A pelvic belt and hip joint helps limit ____ and increases (AP/ML) stability

rotation; ML

What are the drawbacks of a pelvic belt and hip joint suspension system

bulky, heavy, uncomfortable when sitting

What are some special considerations with a knee disarticulation

1. Bulbous distal end of residual limb can make intimate fit difficult as donning and doffing must not be too difficult or the patient may not wear device 2. Special fit liners help with this problem

What are the 8 types of prosthetic knee units

``` single axis polycentric weight activated manual locking hydraulic pneumatic microprocessor next generation ```

What type of prosthetic knee unit is a simple hinge that allows the prosthesis to swing freely

single axis knee

How much mechanical stability does a single axis knee have

not much

True or False: A single axis knee is not good for a short residual limb

true

In a single axis knee, friction can be set for tibial advancement, and (will/won't) change swing speed for change in cadence

won't

A _____ knee has a moving center of rotation to more closely mimic the human knee

polycentric

A polycentric knee has a (stable/moving) center of rotation to more closely mimic the human (foot/knee)

moving; knee

Which phase of gait does a polycentric knee support stability through the center of rotation

stance phase

A polycentric knee is good for (short/long) residual limbs or _____

long; disarticulation

Why is a polycentric knee good for long residual limbs or disarticulations

Because the knee tucks back under the thigh when sitting and allows a more natural cosmesis

Why is a polycentric knee good for short residual limbs or pts with significantly weak hips

Because of the stability it has during stance

List the types of patients that a polycentric knee is good for

patients with a short residual limb, long residual limb, disarticulations, and prs with significantly weak hips

What is the disadvantage of polycentric knees

it has multiple mechanical joints and durability

Which type of prosthetic knee unit is used for stance control that has a locking mechanism that is activated when weight is placed through the knee during stance

weight activated stance control units

What is another name for a weight activated stance control unit

the safety knee

True or False: A weight activated stance knee will buckle if the knee is not straight at initial contact

false, it is a safe knee and will NOT buckle if the knee is not straight

What type of patient will benefit from a weight activated stance control unit

recent amputees, short residual limbs, or hip extensor weakness

What type of prosthetic knee unit is a single axis knee with a locking pin

manual locking knee

A manual locking knee will lock automatically when the knee is fully (flexed/extended)

extended

Although a manual locking knee provides maximum ____ stability, it often causes gait deviations like increased circumduction or vaulting

stance

What type of gait deviations does a manual locking knee promote

circumduction, vaulting, stiff legged gait

A manual locking knee compromises (mobility/stability) and ____ _____

mobility and toe clearance

True or false: A manual locking knee is often shorter than the sound limb to help in toe clearance

true

A manual locking knee automatically locks when the knee is fully extended, explain how it unlocks

Manually unlock knee with pulley system one knee is unloaded

Patients using a manual locking knee will often experience ____ pain

back

What type of prosthetic knee unit uses hydraulic fluid flow through channels for resistance

hydraulic knees

Can you have variable cadence with a hydraulic knee

yes

Will a hydraulic knee buckle

yes, but it is slower so it gives a patient more time to react

A hydraulic knee with (increase/decrease) in weight, require (lower/higher) maintenance, and (less/more) costly

increase weight higher maintenance more costly

What type of prosthetic knee unit allows variable cadence and uses air pressure dynamics like hydraulics uses fluid dynamics

pneumatic knees

pneumatic knees provide (less/more) precision with cadence control than hydraulics and require (less/same/more) maintenance

less precision, same maintenance

What type of prosthetic unit has sensors that monitor knee position during swing and pressure sensors evaluating ground reaction forces during stance

microprocessor

A microprocessor knee provides a ___ recovery and a more natural gait down ___ and ___

stumble; ramps and steps

A microprocessor knee has (increased/decreased) energy expenditure

decreased

Microprocessor knee users can have symmetrical gait going down stairs but will have to use a (1/2/3) gait pattern to go up stairs

A single axis knee cannot have more than ___ degrees of flexion or it will buckle

What are the two names of microprocessor knees in the powerpoint

C-leg and Rheo

Which type prosthetic knee unit has actuators that actively life and simulate the users own muscles for ascending stairs, inclines, and ramps

next generation knee

What type of knee can cause a generated force to help lift a person up

next generation knee

What are three additional components that can be added to prosthetics

extension aids, torque absorbers, transverse rotation units

When choosing a prosthetic foot, what is the main consideration to take into account

The influence the foot has on knee stability during stance

When choosing a prosthetic foot, why is it important to choose a foot that reaches foot flat quickly

This enhances stability, especially is short residual limbs or weak hip musculature

When choosing a prosthetic, what type of feet are great for active individuals that want to walk at faster speeds

dynamic response

A change in ___ height will totally change how a patient is able to walk or clear the prosthesis

heel

What type of prosthetic alignment ensures knee stability

bench alignment

What type of prosthetic alignment focuses on a level pelvis, socket fit, knee stability and BOS with the pt in standing

static alignment

What type of prosthetic alignment checks iliac crests

height of prosthesis

What type of prosthetic alignment must a pt be able to easily extend the knee and keep it locked

knee stability

How many inches should be between the heels to provide optimum BOS

2-3 inches

What type of prosthetic alignment uses a laser line in static alignment

LASAR posture

When checking lateral prosthetic alignment, what are the four key areas to look at

1. Knee stability in stance 2. Transition from IC to foot flat 3. Symmetry of step length and step duration 4. Quality of knee flexion during late stance and swing phase

When checking anterior prosthetic alignment, what are the four key areas to look at

1. suspension 2. width of bos 3. control of pelvis during stance 4. quality and pattern of swing

What are the 9 areas of prosthetic alignment

``` bench alignment static alignment height of prosthesis knee stability base of support LASAR posture dynamic alignment lateral anterior ```

Prosthetics Exam 2: Transfemoral Amputation Flashcards

(111 cards)