1. What are some criteria for adult prosthetics?
    • condition of limb
    • ROM in proximal jt
    • non-tender slump
    • desire to wear prosthesis <- most important
    • fairly good general health
    • well healed stump
    • free of metastatic CA
  2. What type of prosthesis is used very early in the rehab procedure when youre making modifications?
  3. What are some classifications of a preparatory/tempory prosthesis?
    • cosmetically unfinished
    • sound biomechanics
    • less costly
    • help in assessment of prosthetic candidancy/feasibility/indications for a permanent prosthesis
    • promote shape for permanent prosthesis
  4. What type of prosthesis is cosmetically finished, comfortable, and has adequate function?
  5. What are some characteristics of a foot-ankle assembly?
    • general contour of wearers foot
    • absorb shock at heel contact
    • simulates MTP hyperext in latter part of stance
    • may provide slight motion in the frontal and transverse plane
  6. What are rotators?
    • component that is placed above the prosthetic foot to absorb shock in the transverse plane (inv/ever)
    • not in all prosthetics
    • protects wearer from chafing
    • most often used with single axis feet anf by very active wearers with transfemoral amputations
  7. What restores the length and shape of a prosthetic and is adjacent to the foot-ankle assembly (or rotators)?
    • shank
    • transmits the wearers body weight from the socket to the foot
  8. What are the 2 types of shanks?
    • endoskeletal
    • exoskeletal
  9. What type of shank is central aluminum, or rigid plastic pylon covered with foam?
    • endoskeletal
    • rubber and a sturdy stocking
  10. What are the advantages of an endoskeletal shank?
    • more life like
    • permits changes in angulation of the prosthesis which increases comfort and eas of gait
  11. What type of shank is usually made of wood or plastic and presents a rigid exterior?
    • exoskeletal
    • shaped to simulate the contour of the lg
  12. What are the advantages of an exoskeletal shank?
    • very durable
    • impervious to liquids and most abrasives
  13. What are the disadvantages to an exosketal shank?
    • less life-like
    • does not provide for change in angulations of the prosthesis
  14. What is the recepticle for which the amputated limb fits into?
    • socket
    • designed to contact all portions of the residual limb for maximum load distribution
    • allows for venous blood circulation
    • provides tactile feedback
  15. What do sockets have for sensitive/tolerant areas?
    reliefs and build ups
  16. What are the characteristics of an unlined socket?
    • good for wearer whos limbs have no stabilzed yet
    • wear uses socks or a sheath for a soft interface
    • a pad can be placed in the bottom to cushion the distal end of the limb
  17. What are the characteristics of a lined socket?
    • usually resilient polyethylen foam liner
    • cushions the limb
    • facilitates alteration of socket size by adding material to the outside of the liner

    *when a pt is up to 15ply of sock, the socket should be altered or replaced
  18. What are the 4 most common transtibial suspension types?
    • supracondylar cuff suspension
    • neoprene/rubber sleve
    • neoprene/rubber with screw
    • supracondylar/suprapateller
  19. What type of suspension is a cuff (leather strap) that encircles the thigh immediately above the femoral epicondyles?
    • supracondylar cuff
    • user can easily adjust the snugness
  20. What are the advantages of a supracondylar cuff?
    • allows normal knee motion
    • easy to don and doff
    • relatively inexpensive
    • durable and easy to replace

    good for house ambulation pts
  21. What are the disadvantages of a supracondylar cuff?
    • does not eliminate pistoning (sliding up and down with amb)
    • no mediolateral knee stability (not good for bad knees)
    • may interfere with circulation of distal thigh in obese clients (bad for circulatory problems)
    • may cause pinching in distal thigh when sitting
  22. What are the characteristics of a neoprene/rubber sleeve?
    • sleve covers the proximal socket and distal thigh
    • provides excellent suspension
    • streamlines the users silhouette in sitting
    • requires 2 strong hands to don
    • cannot be used with a thigh that has excessive subcutaneous tissue
  23. What are the advantages of a neoprene/rubber sleeve?
    • better suspension than all other types except suction
    • no circumferential constriction

    good for younger/more active pts
  24. What are the disadvantages of a neoprene/rubber sleeve?
    • increased perspiration and heat
    • no mediolateral stability
    • not as durable as a cuff
    • more expensive than a cuff
  25. What are the characteristics of a neoprene/rubber with a screw/pin (shuttle lock)?
    • silicone sheath with special hardware
    • provides secure suspension
    • sheath clings to pts skin during gait
  26. What type of suspension has the medial and lateral walls extend above the femoral epicondyles?

    • increases medial/lateral stability
    • more difficult to fabricate (more expensive)
    • less readily adjustable
  27. What are the advantages of a supracondylar/suprapatellar suspension?
    • improves cosmesis
    • no circumferential constrictions
    • aids in mediolateral stability
    • better suspension for short residual limbs

    good for jacked up knees
  28. What are the disadvatages of a supracondylar/suprapatellar suspension?
    • enclosed patella can limit kneeling
    • difficult to suspend over heavy thighs
  29. What are the advantages of a waste belt?
    • provides auxillary suspension
    • some weight bearing on iliac crests
  30. What are the disadvantages of a waist belt?
    • may be uncomfortable, esp for the obese
    • uneven suspension and swing
    • fork strap does not resist knee ext
    • more difficult to don
    • uncosmetic
  31. What are the advantages of suction?
    • reduces pistoning
    • minimizes shear forces on residual limb
    • does not limit knee flexion

    good for younger/active pts
  32. What are the disadvantages of suction?
    • may be difficult to don
    • increased perspiration and heat
    • most expensive of all suspensions
  33. What are the 3 types of transfemoral suspensions?
    • total suction
    • partial suction
    • no suction
  34. What type of suction has the internal socket pressure less than the external?
    total suction
  35. What are the advantages of total suction?
    • gives max control of the prosthesis
    • allows full freedom of hip motion
    • good proprioceptive feedback through intimate fit
  36. What are the disadvantages of total suction?
    • socket must fit very snuggly-difficult to get a good fit
    • cannot accommodate changes in limb volume well
    • suction can be lost through perspiration
    • potential for skin shear and abrasions
    • potential for skin irritation in a closed medium
    • requires good balance and coordination for donning
  37. What type of suction does the user wear a sock, and must use silesian bandage/belt or pelvic belt/band to aid in the suspension?
    • partial socket
    • internal socket pressure is less than external
  38. What are the advantages to the partial suction pelvic band?
    • easy to don
    • provides rotational control
    • provides mediolateral pelvic stability
  39. What are the disadvantages of the partial suction pelvic band?
    • adds weight to the prosthesis
    • usually not very comfortable
  40. What are the advantages to the partial suction silesian belt/bandage? (sling around the waist)
    • lightweight additional suspension
    • provides some rotational control
  41. What are the disadvantages to the partial suction silesian belt/bandage? (sling around the waist)
    • difficult to keep clean, unless detachable
    • can irritate waist
  42. With what type of suction is a silicone liner or neoprene sleeve used? total elastic suspension
    no suction
  43. What are the advantages to no suction suspension?
    • provides excellent suspension
    • adjusts to the size of the individual
    • generally comfortable
    • adds less weight than pelvic belt
    • provides for rotational control
  44. What are the disadvantages to no suction suspension?
    • retains body heat which can lead to skin irritation and discomfort
    • wears out easily
    • difficult to keep clean
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