NPTE - MSK > Amputation > Flashcards

Amputation Flashcards

(53 cards)

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1
Q

Primary etiology of amputations

A

peripheral vascular disease

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2
Q

Hemicorporectomy

A

surgical removal of the pelvis and both lower extremities

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3
Q

Hemipelvectomy

A

surgical removal of one half of the pelvis and the lower extremity

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4
Q

Symes

A

surgical removal of the foot at the ankle joint with removal of the malleoli

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5
Q

Transverse tarsal

A

amputation through the talonavicular and calcaneocuboid joints. preservation of the plantarflexors, but severs the dorsiflexors (results in a equinus contracture)

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6
Q

Tarsometatasal

A

surgical removal of the metatarsals. preservation of the dorsiflexors and plantarflexors

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7
Q

Transradial - socket

A

Standard: covers 2/3 of forearm, can be shortened for increased pronation/supination
Supracondylar: self-suspending and require no additional harness

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8
Q

Transhumeral - socket

A

Standard: extends to acromion level
Modified design: allows for more stability with rotational movements
Lightweight friction: used with passive prosthetic arms

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9
Q

Transradial - suspension

A
  • triceps cuff
  • harness
  • cable system
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10
Q

Transhumeral - suspension

A
  • harness
  • cable system
  • suction
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11
Q

Transradial - elbow unit

A

attaches to triceps cuff or upper arm pad, flexible or rigid hinge connects socket to proximal component

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12
Q

Transhumeral - elbow unit

A

internal or external locking unit

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13
Q

Transradial/Transhumeral - wrist unit

A
  • quick change unit
  • wrist flexion unit
  • ball and socket
  • constant friction
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14
Q

Transradial/Transhumeral - wrist unit

A
  • voluntary opening or closing
  • body-powered, externally powered, myoelectric or hybrid
  • hook, mechanical hand, cosmetic glove
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15
Q

Transfemoral - socket

A
  • quadrilateral socket
  • ischial containment socket
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16
Q

Transtibial - socket

A
  • patella tendon bearing socket (PTB)
  • supracondylar patella tendon socket (PTS)
  • supracondylar - suprapatella socket (SC-SP)
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17
Q

Transfemoral - suspension

A
  • landyard strap
  • shuttle lock
  • suction (seal in, skin fit)
  • partial suction (silesian bandage, pelvic belt)
  • vacuum
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18
Q

Transtibial - suspenstion

A
  • supracondylar cuff
  • thigh corset
  • supracondylar brim
  • rubber sleeve suspension
  • waist belt with fork strap
  • suction with sleeve
  • shuttle lock
  • vacuum
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19
Q

Transfemoral - knee

A
  • single axis
  • polycentric
  • hydraulic
  • microprocessor
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20
Q

Transfemoral/transtibial - shank

A
  • exoskeleton (rigid exterior)
  • endoskeleton (pylon covered with foam)
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21
Q

Transfemoral/transtibial - foot system

A
  • solid ankle cushion heel (SACH)
  • stationary attachment flexible endoskeleton (SAFE)
  • single axis
  • multi-axial
  • hydraulic
  • powered
  • dynamic response
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22
Q

Rigid dressing

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A

(+) early ambulation, stimulates proprioception, provides soft tissue support, ability to use immediate post-operative prosthesis
(-) cannot immediately inspect wound, cant do daily dressing changes, professional application

23
Q

Semi-rigid dressing

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A

(+) easily changeable, protection, soft tissue support
(-) does not protect as well as rigid, requires more changing, may loosen (develop edema)

24
Q

Non-weight bearing rigid removable dressing

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A

(+) removable, easily applied, prevents contracture, provides protection
(-) not for ambulatory purposes

25
Soft dressing
(+) inexpensive, easily removed, allows for AROM (-) tissue healing is interrupted by frequent changes, AROM may delay healing times, less control of residual limb, risk of tourniquet effect
26
K-level 0
Prothesis will not enhance QOL - not eligible
27
K-level 1
Transfers, ambulate on level surfaces, household ambulator Knee: single axis Foot: SACH
28
K-level 2
Limited community ambulator, low level barriers Knee: polycentric Foot: flexible kneel, multi-axial foot/ankle
29
K-level 3
Community ambulator, variable cadence, tranverse more than simple locomotion Knee: hydraulic, microprocessor Foot: energy storing, dynamic response
30
K-level 4
Higher level (child/athlete) - any knee/foot
31
Prosthetic Training Considerations - forequarter
- loss of shoulder/arm/hand function - most commonly caused by malignancy - light weight prosthetic
32
Prosthetic Training Considerations - shoulder disarticulation
- most commonly caused by malignancy or electrical injuries - external prosthetic shoulder joint in typically required
33
Prosthetic Training Considerations - transhumeral
- most commonly caused by trauma - second most common UE amputation
34
Prosthetic Training Considerations - elbow disarticulation
- self-suspending socket - external prosthetic elbow typically required
35
Prosthetic Training Considerations - transradial
- most common UE amputation
36
Prosthetic Training Considerations - wrist disarticulation
- uncommon
37
Prosthetic Training Considerations - partial hand
- limb sparing technique utilized when functional pinch can be preserved
38
Prosthetic Training Considerations - digit
- preserved function is variable
39
Prosthetic Training Considerations - hip disarticulation
- commonly caused by malignancy - no activation of prosthesis through residual limb - prosthetic limb advancement through pelvic motion
40
Prosthetic Training Considerations - transfemoral
- length of limb effects energy expenditure - susceptible to hip flexor contracture - stance control not activated until WBing
41
Prosthetic Training Considerations - knee disarticulation
- susceptible to hip flexor contracture
42
Prosthetic Training Considerations - transtibial
- susceptible to knee and hip flexion contractures
43
Prosthetic Training Considerations - symes
- diminished toe off during gait
44
Prosthetic Training Considerations - transmetatarsal
- loss of forefoot leverage - tendency to develop equinus deformity
45
Complications
- DVT - contractures - hypersensitivity - neuroma - phantom pain - phantom limb - psychosocial - infections
46
Lateral bending
prosthetic causes: - too short - high medial wall - aligned in abduction amputee causes: - abduction contracture - short residual limb - weak abductors
47
Abducted gait
prosthetic causes: - too long - high medial wall - aligned in abduction amputee causes: - abduction contracture - weak hip flexors/adductors
48
Circumducted gait
prosthetic causes: - too long - excessive pf amputee causes: - abduction contracture - weak hip flexors - inability to initiate hip flexors
49
Excessive knee flexion
prosthetic causes: - too long - socket set too forward - excessive df - stiff heel amputee causes: - knee flexion contracture - hip flexion contracture - decreased quad strength
50
Vaulting
prosthetic causes: - too long - excessive pf amputee causes: - short residual limb - pain
51
Rotation of forefoot at heel strike
prosthetic causes: - excessive toe-out - excessive pf amputee causes: - poor muscle control - weak medial rotators
52
Forward trunk flexion
prosthetic causes: - too big - knee instability amputee causes: - hip flexor contracture - weak hip extensors - inability to initiate knee flexion
53
Medial or lateral whip
prosthetic causes: - excessive knee rotation - tight socket - valgus amputee causes: - weak hip rotators - knee instability
NPTE - MSK
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