Trans Femoral

Question 1

When donning a TF prosthesis, if the amputee is using a sleeve to pull into the socket, what are the two most important land marks to insure proper rotation?

Answer 1

Adductor longus tendon and ischial tuberosity

Question 2

The correct location of the modular expulsion valve is as follows:

Answer 2

on the anterior medial surface, with the lower edge of the valve as close as possible to the distal end of the model

Question 3

The wallet hollow or lateral sulcus is a good place to compress the residual limb on the transfemoral amputee’s tissue as it is the:

Answer 3

intersection of the gluteus medius, vastus lateralis and the lateral aspect of the hamstring muscle group

Question 4

When the above knee amputee must actively arch his back to maintain center of gravity of his body in the proper position while pressing back with his residual limb, it is an indication that the:

Answer 4

residual limb was fit into a socket without adequate initial flexion

Question 5

In the TF socket, the lateral wall is:

Answer 5

adducted to stabilize the femur at midstance

Question 6

The TF ptient displays an abducted gait at midstance when ambulating with her prosthesis. Which of the following is the best cause for this deviation?

Answer 6

the patient is experiencing excessive ramus pressure

Question 7

One biomechanical reason that flexion is placed into an ischial containment prosthesis is:

Answer 7

to more closely mimic the angle of the limb behind the TA line at toe off

Question 8

The initial placement of the prosthetic knee bolt is usually found to be:

Answer 8

in approximately 5° external rotation relative to LoP

Question 9

Which of the following is not among the adductor group

a) gracilis
b) adductor magnus
c) adductor longus
d) sartorius

Answer 9

sartorius

Question 10

During dynamic alignment, the TF patient is walking on the lateral border of their prosthetic foot and the pylon is leaning laterally. The prosthetist should:

Answer 10

adduct the socket

Question 11

Lateral trunk bending in the TF may be caused by:

Answer 11

painful distal lateral femur pressure

Question 12

During swing phase, a tendency for the TF prosthetic to make marked inward rotation of the knee accompanied by an outward rotation of the heel of the Px foot is called.

Answer 12

Lateral whip

Question 13

If the skeletal M-L dimension of the IC socket is too large

Answer 13

The ischium drops into the socket and the ramus hits the medial wall

Question 14

Circumduction may be caused by:

Answer 14

an uncomfortable medial brim

Question 15

The MTP measurement is taken from:

Answer 15

the medial-tibial plateau to the floor with the amputee sitting

Question 16

Pronounced impact shock at full extension of the prosthetic knee indicates a need for:

Answer 16

more extension dampening controls

Question 17

A possible amputee cause for lateral trunk bending on the prosthetic side would be:

Answer 17

very short residual limb

Question 18

What muscle that is primarily an extensor of the knee becomes a major hip flexor on TF amputations

Answer 18

rectus femoris

Question 19

Which of the following would tend to cause the lateral proximal brim on the ICAK socket to exhibit gapping during static alignment?

Answer 19

All the above

Skeletal M-L too tight
Skeletal M-L too loose
Too much socket adduction

Question 20

Short stride length on the prosthetic side would normally be caused by:

Answer 20

excessive initial socket flexion

Question 21

The starting height for knee center in the transfemoral prosthesis:

Answer 21

Sound side MTP + 1/2”

Question 22

T/F: Based upon his studies of biomechanics and kinematics of the TF amputee’s gait Radcliffe advocates the use of a firm SACH heel cushioned prosthetic foot.

Answer 22

False

Question 23

In late stance phase, when the TF prosthetic foot is placed in excessive dorsiflexion:

Answer 23

The knee is made unstable

Question 24

According to the Atlas, if the TF amputee is having difficulty arising from a straight chair, he should be instructed to:

Answer 24

Place his sound foot under the chair behind his prosthetic foot

Question 25

In order to walk efficiently and with good appearance, the amputee should be able to extend his prosthesis to an angle of 15° back of the perpendicular at push off. Which one of the following examples would meet this criterion:

Answer 25

Anatomic hip flexion + 10°; initial socket flexion + 15°

Question 26

The A-P measurement is the distance between the:

Answer 26

Adductor longus and ischial tuberosity

Question 27

Voluntary knee control refers to:

Answer 27

Knee axis anterior to the TKA line

Question 28

A lateral whip is caused by:

Answer 28

excessive internal rotation of the knee bolt

Question 29

Visual examination of the TF residual will reveal:

Answer 29

abrasions

Question 30

The toe lever in the prosthetic foot substitutes in part for the:

Answer 30

gastrocnemius

Question 31

In normal human locomotion the total distance the pelvis travels medio-laterally during locomotion is:

Answer 31

2"

Question 32

In normal human locomotion, the pelvis rotates in the horizontal plane approximately how far?

Answer 32

8°

Question 33

In normal human locomotion, the normal width of the walking base, from the medial border of the heels of the shoe, in adult males is:

Answer 33

2-4 inches

Question 34

In TF prosthetic gait, what muscle group acts to decelerate the leg before initial contact

Answer 34

hamstrings

Question 35

What is the maximum amount of knee flexion during swing phase of normal human locomotion?

Answer 35

60°

Question 36

A medial whip in the TF prosthesis may be:

Answer 36

excessive external rotation of knee axis

Question 37

When standing still, the amputee's ischial tuberosity in a TF QUAD socket is held in place on the seat chiefly by the:

Answer 37

Anterior wall

Question 38

Amputees with short TF residual limbs generally exhibit lateral bending of the trunk due to:

Answer 38

loss of adequate lever arm

Question 39

If TF suction suspension is inadequate, the first auxiliary suspension that should be tried is a:

Answer 39

SIlesian bandage or TES belt

Question 40

Vaulting on the sound foot by the TF Quadrilateral suction socket prosthesis wearer may be caused by:

Answer 40

prosthesis that is too long

Question 41

The "T" landmark on the lateral wall of the TF Quad socket is established by measuring one inch:

Answer 41

1" anterior from the ischial seat, then at right angles from the medial wall to the lateral wall transferred to the lateral brim

Question 42

Suppose an unmodified ICAK master plaster model doesn't have a line of progression drawn on it. The landmarks and guides used to determine the LoP are:

Answer 42

a line drawn 2-4° internally rotated from a line drawn from the apex of the rectus femoris channel to the apex of the posterior channel

Question 43

Excessive heel rise at pre-swing and into swing phase by the TF suction socket wearer may be caused by:

Answer 43

knee friction set too loose

Question 44

You check the TKA line on a TF prosthesis with a yardstick and find the knee center is 1 1/2" posterior to that line. What is the reult of this alignment?

Answer 44

Excessive alignment stability

Question 45

While observing a TF amputee walking, you note that he vaults on his sound side. What prosthetic factor could cause this gait deficit?

Answer 45

Knee friction control too tight and prosthesis too long

Question 46

According to Radcliffe's stability equation: The muscle moment about the hip joint on the TF amputated side required to maintain the weight bearing knee in a stable position can be reduced to almost zero if the knee mechanism:

Answer 46

is a weight activated stance control knee

Question 47

The origin of the hamstring muscle group is the:

Answer 47

ischium

Question 48

Mediolateral stability of the pelvis is attained chiefly through the contraction of what muscle?

Answer 48

gluteus medius

Question 49

Scarpa's triangle is bounded by:

Answer 49

inguinal ligament, sartorius, adductor longus

Question 50

During swing phase in the TF prosthesis with a hydraulic swing control unit, resistance to ___ stimulates the eccentric action of the quadriceps muscle group in ambulation for the uninvolved person.

Answer 50

knee flexion

Question 51

Referring to knee stability, what would be the effect of lowering the vertical height of the instant center of rotation

Answer 51

increases the hip moment required to maintain prosthetic knee stability

Question 52

Between TF heel contact and push off, Radcliffe describes the 'zone of voluntary stability', which allows considerable variation in the alignment of the prosthetic knee joint. The two major consideration in the alignment are:

Answer 52

Knee stability at heel contact and ease of flexion during push-off

Question 53

Why do the inner medial hamstring wall and medial containment wall form a different angle to the line of progression?

Answer 53

The inner medial hamstring wall forms the medial-distal margin of the inferior containment wall to provide a comfortable radius for the hamstrings, while the medial containment wall is shaped to the ramus angle to contact and stabilize against the medial side of the ischium

Question 54

The anterior-medial quadrant of an ischial containment shaped socket is contoured to provide depression of the femoral angle. All of the following are reasons this depression is in place except: a) relief of adductor longus b) provide rotational control c) insures proper donning d) provides area for weight bearing in early stance

Answer 54

Provide area for weight bearing

Question 55

An ischial containment shape that is too tight in the anterior lateral quadrant would most likely result in:

Answer 55

a swing phase whip | possible loss of ischial containment

Question 56

The height of the lateral wall proximal to the trochanter is important for:

Answer 56

cosmetic appearance

Question 57

Why would a lanyard type suspension be used for a TF prosthesis?

Answer 57

to allow the amputee to pull the residual limb into the socket

Question 58

It is critical that the TF amputee keeps the prosthetic knee joint extended throughout stance phase by the action of the knee unit's inherent stability and the amputee's voluntary control over it. The knee unit characterized by the least inherent stability and requiring the most voluntary control is the:

Answer 58

Constant Friction (single axis) knee

Question 59

According to the Atlas, two distinct advantages to the knee disarticulation amputation as compared to the transfemoral type are:

Answer 59

distal weight bearing and maintains femoral length in growing children

Question 60

Which of the following are advantages to the knee disarticulation amputation for prosthetic fitting?

Answer 60

bulbous condyles may allow non-suction suspension through removable medial plate

Question 61

The two most common knee mechanisms used in the knee disarticulation prosthesis to simulate the anatomic knee center are:

Answer 61

polycentric and outside hinges

Question 62

The terminology used to describe the distance between points A and B is:

Answer 62

bi-ischial diameter

Question 63

What is the angle called?

Answer 63

pubic arch angle

Question 64

In most individuals the angle will be:

Answer 64

greater in females

Question 65

The skeletal M-L is measured

Answer 65

from the medial side of the ischium to just below the greater trochanter laterally, on a perpendicular with the ramus angle

Question 66

The term ischial containment means:

Answer 66

containing the ischium from the medial, posterior, and inferior sides

Question 67

The 'true' silesian bandage has ___ anterior attachment points

Answer 67

two

Question 68

T/F: The silesian bandage has been found a valuable aid in stabilizing the TF prosthesis against rotation and lateral instability in cases of short or excessively flabby residual limbs

Answer 68

True

Question 69

If the silesian bandage does not correct a whip, you conclude that the problem is:

Answer 69

prosthetic caused; knee bolt rotation

Question 70

The starting point for location of the rigid pelvic joint to the socket is:

Answer 70

1/2" anterior and 1" superior to the trochanter mark

Question 71

What is a disadvantage of the TES belt?

Answer 71

tends to be more difficult for arthritis sufferers to don and dof

Question 72

The mauch swing-n-stance cylinder offers a combination of knee mechanisms. They are:

Answer 72

hydraulic swing and stance control, hydraulic swing control only and manual locking mode.

Question 73

Present hydraulic swing control prosthetic knees aim to provide friction from fluid passing through valve orifices or rough channels. The resistance of the fluid flow increases as a ____ of the cadence, so there is very little resistance at slow motion, moderate resistance at normal speed comparable to a well djusted mechanical friction device, yet extremely high resistance to fast motion at hight speed

Answer 73

square

Question 74

A polycentric knee with hydraulic swing phase control may be paid for my Medicare if the patient is classified at what functional level.

Answer 74

K3

Question 75

What socket style allows the gluteus maximus to be outside of the trim lines while stabilizing the prosthesis at midstance in the coronal plane with containment of the medial aspect of the ischial tuberosity

Answer 75

ICAK

Question 76

Which socket style keeps the gluteus medius contained inside the trimlines

Answer 76

CAT-CAM

Question 77

What socket style allows the gluteus maximus to be outside of the trim lines while stabilizing the prosthesis at midstance in the coronal plane with containment of the medial aspect of the Ascending ischial ramus

Answer 77

MAS

Question 78

With a Mauch prosthetic knee of similar SNS hydraulic cylinder, changing the position of the upper ring (hydraulic) will effect

Answer 78

knee flexion resistance

Question 79

During swing phase in the TF prosthesis with a hydraulic swing control unit, resistance to ___ stimulates the action of the eccentric action hamstring muscle group in ambulation for the uninvolved person

Answer 79

knee extension

Question 80

According to Radcliffe's knee stability equation: it is possible to reduce the prosthetic knee alignment stability to exactly zero by aligning the prosthesis in such a manner that the knee center:

Answer 80

lies on the load line

Question 81

According to the academy's online module 'outcome measures in lower limb prosthetics' outcome measures:

Answer 81

all the above answer questions about patients help guide clinical decisions help guide plans of care

Question 82

T/F: According to the academy's online module 'outcome measures in lower limb prosthetics' the AMP cannot be used if the amputee has any medical comorbidities

Answer 82

False

Question 83

According to the academy's online module 'outcome measures in lower limb prosthetics' the product of energy cost and steady-state walking speed is called what?

Answer 83

energy expenditure rate

Question 84

According to the academy's online module 'Alignment secrets' alignment rules and guidelines have been previously established by leaders in the field. they were judged as either practical or impractical based largely on their:

Answer 84

empirical success

Question 85

T/F: According to the academy's online module 'Alignment secrets' a suggestion by the author is to not overstabilize the knee but rather optimize voluntary control, which is the best type of control

Answer 85

True

Question 86

T/F: According to the academy's online module 'liner materials' one advantage of these traditional liner materials is that they are compatible with many socket designs, but two disadvantages are that they may hold bacteria and they are difficult to produce and duplicate

Answer 86

True

Question 87

T/F: According to the academy's online module 'liner materials' one perceived advantage of the TPE liner is that this liner can be heat molded, thus fitting the limb better and being impervious to temperature and pressure changes within the socket. Thus it maintains its thickness over periods of high pressure

Answer 87

False

Question 88

According to the Atlas, postsurgical management evaluation of the lower limb amputee includes all of the following EXCEPT: a) mental status b) ROM c) strength d) ambulation with an assistive device without a prosthesis e) step over step stair descent

Answer 88

step over step stair descent

Question 89

According to the Atlas, a large number of factors affect the prescription, not all of which readily come to mind until one examines all the parameters of a given patient's life. First and foremost, the prosthesis should:

Answer 89

meet the needs and desires of the patient, moth vocationally and non-vocationally