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68 Cards in this Set
- Front
- Back
basic foundation: shoe , plastic insert, or metal stirrup component
insert: plastic insert or metal insert or foot plate.provides control for foot. helps with donning , light weight
stirrup: riveted through shoe shank |
what are the parts of an AFO? |
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what is an AFO stirrup? |
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medial-lateral control straps
-stiffness of material -contoured edges -valgus correction or varus correction leather straps |
how can you gain lateral stability of the ankle using an AFO? |
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pt weight falls anterior to offset jt -stabilizes the knee in ext during stance -hinge is set posteriorly
does not interfere with knee flexion during swing or sitting. Go to bend it bends with you
disadvantage: can dis-engage during stair climbing or walking on ramps |
what is the alignment of WB for use of KAFO? |
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offset jt,drop ring lock and pawl lock with bail release |
what are the different locks of a KAFO? |
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in standing , ring drops into place.-prevents uprights from bending
disadvantage: have to manually put the lever up to sit. |
what is a drop ring lock? |
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unlock by pulling on posterior bail. can be intentionally activated by nudge against chair
disadvantage: bulky, can release unexpected against an object |
what is the pawl lock with bail release? |
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metal hinge-drop ring lock
most appropriate |
what type of lock is used at the hip jt for a HKAFO? |
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THKAFO with hips joined with a metal cable or rod.
components: offset knee jts, pre tibial bands, solid AFO |
what is a reciprocating gait orthoses? |
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1. shift weight onto RLE 2.tuck pelvis by extending upper thorax 3. press on crutches 4. allow LE to swing through 5. reverse for next step |
what is the gait pattern w/ RGO? |
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increase intra-abdominal pressure , decrease frontal mvmnt.
-not rigid, no horizontal rigid structure -some have rigid vertical structure (stays)
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what is the purpose of a LS corset? |
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TLS corset |
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TL corset |
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short sitting or supine to wrap |
what position should a BKA pt be in to wrap? |
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sideline to wrap |
what position should a AKA pt be in to wrap? |
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two 4 inch bandages |
what type of bandage is used for a BKA? |
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two 6 inch bandages |
what type of bandage is used for a AKA? |
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longest bone length.preserving as many its as possible. vascular supply. skin flaps, preserve max muscles
flaps: long posterior-allows better blood supply skew flap,
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what does the surgeon take into account when performing amputations? |
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to break up scar tissue -friction |
what is the purpose of massage following amputation? |
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advantage: allows early WB, reduce edema and pain, enhance healing
disadvantage: expensive, application requires special training, must learn use, limits examination, close supervision during early healing
types: IPOP, rigid removeable |
what are rigid dressings? |
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advantages: better edema control than soft dressings .promotes better heeling than soft. some have impregnated compounds
disadvantages: may loosen, not rigid
types: Unna dressing( gauze has compound of zinc oxide , gelatin, glycerin,and calamine-applied in OR |
what is a Semi rigid dressing? |
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advantages: inexpensive, lightweight, easily cleaned
disadvantages: poor edema control, easily slip off.elastic requires skill to apply.expense of purchasing new shrinkers as edema decreases.cannot use shrinker until sutures or staples removed
types: elastic wraps applied over dressing to provide compression .shrinkers are easier to apply but more expensive |
what are soft dressings?
right-soft left-rigid |
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generally good potential.most common problem-knee flexion contracture.
contraindication- if the contracture influences ambulation
not contraindications with todays prosthetics -flexion contractures -scars -poorly shaped residual limb -adherent skin (impaired pliability) |
what is a BKA candidate prosthetic potential? |
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greater requirements: energy, balance, strength
computerize knee components decrease energy consumption
can impede successful ambulation -hip flexion contracture -weakness/paralysis of hip muscles -obesity -poor balance -poor coordination |
what is a AKA candidate prosthetic potential? |
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young, agile
to use - need strength , coordination, balance, cardio respiratory |
what is a B amp prosthetic potential? |
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ankle disarticulation amp. just above malleoli retain calcaneal fat pad long lever arm- increases prosthetic control might be able to WB on end of residual limb bulky or bulbous end of residual limb |
what are the advantages of a SYMES amp? |
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harder to produce a prosthesis for this type of amputation |
what is the disadvantage of a symes amp? |
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foot ankle assembly,shank, socket, suspension
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what are the components of a prosthesis ? |
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non articulated and articulated |
what are the different types of feet for a prosthesis ? |
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most common- non articulated
-heel cushion provides a small amount of medial -lateral and transverse motion -available in many sizes -varying heel cushions -several PF angles for different heel heights |
what is a SACH foot? |
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key feature: simulated sub talar jt.-non articulated
-rigid ankle block joins the heel at a 45* angle -provides more medial-lateral ROM in rear foot -allows ambulation on uneven terrain
disadvantage : more expensive, heavy |
what is a SAFE foot? |
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key feature: energy storing carbon plates- non articulated
-2 longitudinal carbon flexible plates -during gait, distal plate bends and springs back -during running, both plates bend and spring back |
what is a Carbon Copy II foot? |
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key feature: energy storing plastic heel- non articulated
-flexible plastic keel bends at heel contact, to store energy -late stance (unloading), keel recoils- releasing energy at termination of stance |
what is a Seattle foot? |
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key feature: energy storing long carbon bands- non articulated
-long band of carbon extending from toe to proximal shank to heel -stores energy in early and mid stance. -good for athletes -covered for cosmosis -expensive |
what is a flex foot / springlite foot? |
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most common- articulated
motions permitted: DF,PF, toe break action
motions not integrated : medial lateral , transverse plane motion |
what is a single axis foot? |
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slight movement in all planes-articulated
purpose: maintain max surface contact during ambulation, including uneven terrain
disadvantage: heavy, less durable than single axis or non articulated feet. |
what is a multi axis foot? |
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absorbs shock in the transverse plane-articulated
prevents skin chaffing -allows socket to rotate in skin
used w/ -active individuals -single axis foot -AKA |
what is a rotator foot? |
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concavities
pressure from sensitive areas
-fibular head, tibial crest, tibia condyles, anterior distal tibia |
what are prosthetic reliefs? |
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convexities
-contact of pressure tolerant areas
-belly of gastric , patellar tendon, proximal medial tibia, pes anserinus, tibial fibular shafts |
what are prosthetic build ups ? |
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holds prosthesis in place
types: cuff variant, distal attachment, brim variants, thigh corset, vacuum assisted socket system |
what are the different suspension mechanisms for a prosthesis? |
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supracondylar cuff, fork strap and waist belt, rubber sleeve |
what are the different cuff variants? |
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leather strap above the femoral condyles .can adjust snugness with the straps |
what is a supracondylar cuff suspension? |
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added to the supracondylar cuff to add more support.strap attaches anteriorly to the prosthesis |
what is the fork strap and waist belt suspension? |
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tubular.covers proximal prosthesis and distal thigh.
disadvantages: requires two strong hands. will not accommodate large quantities of tissue |
what is the rubber sleeve for a prosthetic suspension? |
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silicone sheath with distal pin
-sheath clings to pin -pin inserts into prosthesis
osseous integration |
what is the distal attachment suspension? |
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medial and lateral walls extend over femoral epicondyles. plastic wedge insert in medial wall
advantages: increase medial lateral stability. cosmosis of knee , eliminates straps and buckles
disadvantage: harder to fabricate and expensive |
what is a supracondylar brim variant suspension? |
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anterior wall extends over patella
disadvantage: high anterior wall can interfere with kneeling. prosthetic knee more prominent in sitting |
what is a supra patellar brim variant suspension? |
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leather or plastic attach to hinges on the prosthesis.
advantage: increase frontal plane stability, increase WB load distribution
disadvantage: heavier, increase piston action, pressure atrophy of thigh, difficult to don laces and velcro |
what is a thigh corset suspension? |
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use a pump liner and sleeve to create air tight environment
advantages: decrease edema, regulate fluctuations in edema, decrease moisture accumulation, increase proprioceptive awareness |
what is a vacuum assisted suspension? |
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ant-medial: for pressure sensitive add longs tendon
post medial: HS tendons and sciatic nerve
post lateral: allow glute max to contract
ant lateral: rectus femoris |
what is a quadrilateral socket? |
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walls over ischial tuberosity |
what is the ischial containment socket? |
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locks the ischium and pubic ramis into the socket |
what is the comfort flex socket? |
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patellar tendon |
where does WB occur when using a below knee prosthesis? |
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stairs and curbs |
what activities make it difficult for people with higher amputations? |
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frame with pelvic girdle, 2 posterior uprights, anterior upright, superior ring that lies on upper chest |
what is the Milwaukee brace? |
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mass produced, can be customized |
what is the Boston brace? |
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custom made, TL jacket |
what is the Wilmington Brace? |
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axillary straps, 3pt system limits flexion and ext. |
what is the Taylor Brace? |
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increase knee flexion, decrease knee stability |
what is the affect of increase DF with foot control? |
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increased knee extension and increased knee stability |
what is the of increased PF with ankle control? |
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never goes above the fibular head, height provides longer lever arm and increased stability.
components: uprights , shell, band , brim |
what is the superstructure of an AFO? |
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9x more energy used when ambulating than normal adult |
what is a SCI pt with an orthosis during ambulation? |
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energy expenditure is proportional to the amount of spasticity |
what is the energy expenditure of a CVA pt with an orthosis? |
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smoking and diabetes |
leading causes of PVD? |
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skin flap, edema and shaping residual limb, potential for prosthetic use, mourning the loss of body part |
what are the components of rehab after an amputation? |
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sensation that extremity is still there
often: tingling, itching, pressure, numbness
tell pt its normal, prosthesis can regulate |
what is phantom limb sensation? |
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cramping, squeezing, shooting, burning
intervention: prosthesis, US,icing , TENS, massage |
what does phantom pain feel like and what are the interventions used to control it? |
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ankle disarticulation prosthesis |
what is the Symes prosthesis? |