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Prosthetic Board Preparation Exam
Content Flashcards
Ertl procedure An osteomyoplastic amputation reconstruction that performs a bone bridge between the tibia and fibula. Below knee amputee A patient who has undergone amputation below the knee. Equinus gait deformity A gait deformity that may result from certain levels of amputation. Myodesis The suturing and permanent attachment of a muscle to a bone. PTB style endoskeletal prosthesis A type of prosthesis designed for below knee amputees. Posterior knee or hamstring discomfort A common issue for below knee amputees that may require justments to the prosthetic socket. Distal end pressure Pressure felt at the distal end of the residual limb, often leing to discomfort.
Gastroc p A pding ded to the prosthetic socket to alleviate pressure on the gastrocnemius muscle. Prosthetic socket The part of the prosthesis that fits over the residual limb. Plantar flexing the prosthetic foot justing the foot position to help alleviate discomfort in the prosthetic socket. Redness on the distal tibia A sign of pressure or irritation on the residual limb, often requiring intervention. Lower the posterior socket brim An justment me to the prosthetic socket to alleviate anterior/distal discomfort. Extend the prosthetic socket An justment that may be me to dress discomfort in the socket. Flex the prosthetic socket An justment that may help alleviate discomfort in the socket.
New liner for prosthesis A recommendation for patients experiencing discomfort due to inequate cushioning. 1 ply prosthetic sock A type of sock that can be ded over the liner to help with comfort. Calcification of muscle fibers A condition associated with myodesis. Atrophy A condition where muscle decreases in size, which can be related to myodesis. Doffing prosthesis The act of removing the prosthesis and liner for examination. Symes amputation procedure Removal of the malleoli 'distal aspect' Myoplasty The suturing and permanent attachment of a muscle to a bone vantages of myodesis over myoplasty
Decreased rate of infection related revisions Normal heel strike hip flexion 10 deg flexed Muscular tissue management in TH amputation Myodesis Cause of lateral/proximal loss of contact in stance The posterior wall does not have ischial containment Krukenberg procedure muscle driver Supinator Quality for TT amputee prosthetic foot Foot that progresses rapidly into plantar flexion during loing response First clinical action for TT patient Plantar flex the prosthetic foot Krukenberg procedure patient population Blind patients with bilateral below elbow amputations
Circumducted gait causes in TF patients Possible causes for a TF patient exhibiting a circumducted gait. Prosthetic foot smearing cause Prosthetic cause for a foot that 'smears' externally while the patient abducts the prosthesis and vances forward in the sagittal plane. Knee instability causes in above knee amputation Suspected causes of knee instability while standing in a patient with an above knee amputation. Excessive pressure areas in TT prosthetic sockets Areas where TT prosthetic sockets that are excessively extended cause excessive pressure. Outsetting prosthetic foot effect Effect of outsetting the prosthetic foot on a TT prosthesis regarding socket pressure. Forequarter amputation structures removed Structures removed during a forequarter amputation. Extension moment cause in TT patient gait
Possible cause of a mild extension moment at the knee in stance phase for a TT patient. Gel liner candidate assessment factors Factors to consider when determining if a prosthetic patient is a gel liner candidate. Forearm lift tab location for prosthetic elbow Have the forearm lift tab located distally/anterior. Forearm lift tab movement for prosthetic elbow Have forearm lift tab moved proximal/anterior. Proximal base plate movement for prosthetic elbow Move proximal base plate and retainer on humeral section posterior. Cable housing resistance check Check the level of resistance in the cable housing. Pubic rami Bony landmark utilized for weight bearing in hip disarticulation.
Increase knee stability Choosing a SACH foot with a firm heel durometer will increase knee stability. Decrease knee stability Choosing a SACH foot with a firm heel durometer will decrease knee stability. Increase shock absorption Choosing a SACH foot with a firm heel durometer will increase shock absorption at heel strike. Not enough keel resistance Choosing a SACH foot with a firm heel durometer will not provide enough keel resistance. Transmetatarsal amputation gait deviation Absent push off Dorsiflexing the prosthetic foot Flexing the prosthetic socket Berkeley alignable componentry necessity This will allow alignment changes in the final prosthesis Weakest muscle group in above knee amputee
Hip flexors Alignment justment for AK socket flexion Dorsiflex the prosthetic foot Knee instability alignment change Flex the prosthetic socket Cosmetic concern for knee disarticulation amputee Knee extends too far out when sitting or kneeling Angular change with endoskeletal componentry Loosen the bolt opposite the direction of desired angulation and tighten the opposing bolt on the side of desired angulation Benefits of knee disarticulation over above knee amputation Socket rotational control Saving original alignment when removing endoskeletal componentry Completely back out two opposing bolts Polycentric prosthetic knees stability
Myoplasty definition Myoplasty consists of the surgical attachment of muscle to muscle. TR figure of eight harness elastic materials When fabricating a TR figure of eight harness, it is necessary to incorporate elastic materials in the control strap. Inverted Y-strap location When fabricating a TR figure of eight harness, the inverted Y-strap should be located in the delto- pectoral groove. Muscle responsible for scapular elevation The muscle responsible for scapular elevation is the trapezius muscle. Condition with red wart-like formation The condition with a red, wart-like formation and cracked skin distally is called verrucous hyperplasia. Best terminal device for broom handle For holding a broom handle, the best suited terminal device for a TH patient is the #7. Suspension for hip disarticulation prosthesis For a hip disarticulation prosthesis, the suspension is provided by the ischial tuberosity.
vantage of NW ring location Locating the NW ring slightly toward the sound side and at the level of C7 increases the comfort of the user. Biomechanical goals of ischial containment TF socket The biomechanical goals of an ischial containment TF socket include providing a weight-bearing surface with the ischial seat. Supination and pronation joints Supination and pronation occur at the distal rioulnar and proximal rioulnar joints. Ischial-tuberosity location in socket In a TF patient, if the ischial-tuberosity is not located on the seat but further down in the socket, it indicates a poor socket fit. Prosthetic sock An dition to a prosthesis to improve fit and comfort. Ischial seat justment Dropping the ischial seat 1cm distally to improve alignment. Scarpas triangle p A p ded jacent to Scarpas triangle for better support.
TT total surface bearing socket One characteristic is emphasizing pressure equalization across all residual limb surfaces. Knee disarticulation ductor muscle The ductor magnus muscle is transected during a knee disarticulation. Typical deformity in trans-metatarsal amputation Pes plano valgus is a typical deformity of the foot and ankle complex without tendon transfers. Hydraulic single axis knee A hydraulic single axis knee utilizes fluid resistance to modify TF prosthetic swing. Pes anserinus muscles All of the following muscles make up the pes anserinus except the semimembranosus. Fluid TF prosthetic knees resistance Hydraulic resistance is most versely affected by cold environmental temperature changes. TF prosthetic alignment The relationship between the posterior socket shelf and the lateral wall is referred to as TKA alignment.
Bony landmark not used for prosthesis length The iliac crest is not used in determining the correct length of the prosthesis. SACH prosthetic foot gait deviation At heel strike, external rotation of the SACH prosthetic foot may be caused by the prosthetic heel durometer being too soft. Force exerted on lever arm A force of 2 lbs. is exerted on a 1.5 foot lever arm. Force on a 2 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 Biceps femoris motion 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 Medial whip justment A TF client is seen in clinic, a medial whip is noted in prosthetic gait. What justment would be appropriate to normalize swing phase alignment: A) Externally rotate the prosthetic knee B) Internally rotate the prosthetic knee C) Internally rotate the prosthetic foot D) Externally rotate the prosthetic foot
Prosthetic socket alignment 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 Socket fabrication for children 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 Trendelenburg sign evaluation 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) ductor Magnus C) Vastus lateralis D) Gluteus Medius Cane usage in rehabilitation 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 Palpable bony landmarks All are bony landmarks that are easily palpable in the lower limb except: A) Lateral malleolus B) Tibial tuberosity C) Lesser trochanter D) Ischial tuberosity Socket pressures during phases
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, Positive C) Dynamic, Static D) Positive, Negative Elbow articulation for disarticulation 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 Prosthetic socket fabrication T/F: When fabricating a prosthetic socket in general it is necessary to have all 'like' fibers directly jacent to aid in strength: A) True B) False Cross back strap material The best material to fabricate the cross back strap is inelastic strapping. Flexible elbow hinges for TR amputees Recommended because they allow better pre-positioning, durability, improved residual limb comfort, and allow the patient to maintain natural pronation/supination. Options for partial foot amputees Options that assist with lack of controlled third rocker late in stance include rigid sole shoe, rocker dition to shoe sole, carbon insert, and OTS carbon AFO. Bilateral TR patient suspension recommendation
