Amputation and Prosthesis

  1. Trimester crucial for genesis of limb production
    First trimester
  2. In ISPO classification system, what approximate fraction of the limb is used in categorizing transverse deficiencies?




    B) 1/3
  3. The following are general principles of childhood amputation surgery, except:




    C) Perform transosseous amputation rather than disarticulation
  4. Most common complication following amputation in an immature child
    Terminal overgrowth (spiking)
  5. True or False: Children with congenital limb deficiencies are more likely to experience phantom sensations than those with acquired amputations.
    False

    They are less likely to experience phantom sensations.
  6. Form of ectrodactyly commonly referred to as "lobster claw"
    Central ray syndrome
  7. Major cause of LE amputation




    B) Peripheral vascular disease

    The major cause of LE amputation is peripheral vascular disease secondary to diabetes.
  8. Disarticulation at metatarsal phalangeal joint
    Toe disarticulation
  9. Resection of 3rd, 4th, 5th metacarpals and digits
    Partial foot/ray resection
  10. Amputation through the midsection of all metatarsals
    Transmetatarsal
  11. Level of amputation which involves attachment of heel pad to distal end of tibia and may include removal of malleoli and distal tibial/fibular flares
    Ankle disarticulation (Syme's)
  12. Resection of lower half of pelvis
    Hemipelvectomy
  13. Amputation of both lower limbs and pelvis below L4-L5 level
    Hemicorporectomy
  14. Characteristics of skin flaps
    There are four characteristics of skin flap.
    • 1. Broad
    • 2. Painless
    • 3. Pliable
    • 4. Non-adherent
  15. Skin flap used for most transfemoral and transtibial amputations without vascular impairment




    A) Fishmouth

    There is an equal length of anterior and posterior flaps in fishmouth flap, placing the scar at the distal end of the stump.
  16. Long posterior flaps are often used for transtibial amputations with compromised circulation.
    True

    Long posterior flaps (e.g. Burgess or Bruckner) are often used for transtibial amputations with compromised circulation because the posterior tissues have better blood supply.
  17. Angular medial-lateral incision that places the scar away from bony prominences, a problem encountered with a long posterior flap




    C) Skew flap
  18. A collection of nerve cell ends that forms in the residual limb following severance of peripheral nerves
    Neuromas
  19. In potentially "dirty" (involving foreign substances) amputations, the incision may be left open with the proximal joint immobilized in a function position for _____ days to prevent invasive infection




    D) 5-9
  20. True or False: Cigarette smokers had a 2.5% higher rate of infection and re-amputation than nonsmokers.
    True
  21. This postsurgical dressing provides excellent edema control, pain control, and residual limb protection; but, it does not provide access to incision and requires proper training for use




    D) Immediate post-operative prosthesis (IPOP)
  22. This postsurgical dressing are not used until sutures are removed and requires changing as the residual limb shrinks




    A) Shrinker
  23. This postsurgical dressing is easy to apply and inexpensive, but provides little edema control and residual limb protection




    D) Compressible soft dressing
  24. ISPO classification named after the segment beyond which there is no skeletal portion
    Transverse deficiency
  25. ISPO classification named after affected bone/s
    Longitudinal deficiency
  26. Absence of a limb
    Amelia
  27. Partial absence of a limb
    Meromelia
  28. Flipper-like appendage attached to the trunk
    Phocomelia
  29. Absence of metacarpal or metatarsal
    Adactyly
  30. Absence of half a limb
    Hemimelia
  31. Missing hand or foot
    Acheiria
  32. Absence of finger or toe
    Aphalangia
  33. MC congenital limb deficiency in the upper limb
    Radial ray anomaly
  34. Most functionally critical digit
    Thumb
  35. Results in loss of palmar grip, side-to-side pinch, and tip-to-tip pinch




    A) Thumb amputation
  36. Digit amputation involving digits IV and V with resultant loss of hook grasp
    Ulnar amputation
  37. True or False: In central amputation, a cosmetic substitute is preferred over reconstruction.
    True
  38. How do you estimate residual limb length in transradial amputations?
    • 1. Measure the distance from the longest residual bone (ulna or radius) to the medial epicondyle.
    • 2. Measure the distance from the ulnar styloid to the medial epicondyle on the sound UE. 
    • 3. Compare the two measurements.
  39. Characteristics of long transradial amputation
    Preserved length, pronation and supination, elbow ROM
    • 1. Preserves 55-90% of the length
    • 2. Allows up to 60° of supination and pronation with prosthesis
    • 3. Maintains strong elbow flexion
  40. Characteristics of medium transradial amputation
    Preserved length, pronation and supination, elbow ROM
    • 1. Preserves 35-55% of the length
    • 2. Loss of pronation and supination with a prosthesis
    • 3. Reduced elbow flexion
  41. Characteristics of short transradial amputation
    Preserved length, pronation and supination, elbow ROM
    • 1. Preserves <35% of the length
    • 2. Difficult prosthetic suspension
    • 3. Loss of full ROM at the elbow
  42. Amputation level in which glenohumeral motions are preserved and uninhibited by prosthetic socket




    A) Long transhumeral amputation
  43. Significant injury to at least three of the four tissue groups (skin/soft tissue, nerve, vessel, and bone) which has been shown to be a poor predictor of amputation or salvage with regard to functional outcome




    D) Mangled extremity syndrome
  44. A flap in which a local muscle inclusive of the overlying skin is moved over with its own blood supply to fill a large defect




    A) Pedicle flap
  45. A flap in which the donor is taken from a different site and the microvasculature of the donor tissue is anastomosed to the available vessels in the site of defect




    B) Microvascular free flap
  46. Reconstructive technique in which the web space is deepened between the digits to provide more mobile digits
    Phalangization of the metacarpals
  47. Reconstructive technique in which a finger with its nerve and blood supply is moved to the site of the amputated thumb, allowing fine and gross grasp through opposition
    Pollicization
  48. Transradial amputation which transforms the residual ulna and radius into digits that have significant forceful prehension and retained ability to manipulate because of preserved sensation
    Krukenberg amputation
  49. Immediate post-amputation period goals, except:




    A) None of the above
  50. True or False: Opiates administered at safe doses are often effective against phantom pain.
    False

    Nonsteroidal anti-inflammatory drugs and non-opiate pain relievers are preferred for managing phantom pain because opiates are often ineffective.
  51. Motions to provide tension needed on figure-of-eight harness to open the terminal device




    A) Scapular abduction with humeral flexion
  52. The following are set of movements that operates body-powered, internal-locking elbow of the transhumeral prosthesis, except:




    C) Shoulder flexion
  53. Maintaining the range of these motions is critical for an amputee to be able to position the terminal device as needed without having to manually preposition the wrist unit




    C) Forearm pronation and supination
  54. Motion used by those who have transhumeral, shoulder disarticular, or forequarter amputation to operate their prosthesis




    D) Chest expansion
  55. Maintaining full range of these motions is critical for a transradial amputee for reaching many body locations




    D) Elbow flexion and extension
  56. Prosthetic system which uses the patient's own residual limb or body strength and ROM to control the prosthesis




    D) Body-powered system
  57. Prosthetic system which uses an outside power source, such as battery, to operate the prosthesis




    A) Externally-powered system
  58. Prosthetic system which uses the patient's own muscle strength and joint movement, as well as an external supply for power




    D) Hybrid system
  59. Prosthetic system which is fabricated if the patient does not have enough strength or movement to control a prosthesis or wears a prosthesis only for cosmesis




    B) Passive system
  60. Prosthetic equivalent of the human hand
    Terminal device
  61. A prosthetic component used to assist or replace an anatomic joint
    Hinge
  62. Type of hinge which allows stiff/solid arrow movement in only one plane, usually flexion and extension




    C) Rigid hinge
  63. Type of hinge which allows movement in multiple planes (i.e., flexion, extension, pronation, and supination)




    B) Flexible hinge
  64. Part of the prosthesis which acts as the interface between the residual limb and the prosthetic device as a whole
    Socket
  65. Part of the prosthesis which is designed to distribute forces throughout the residual limb so it has to have a snug and intimate fit around the residual limb




    B) Socket
  66. A prosthetic component, usually cotton, which is worn between the socket and liner to account for volume/size changes in the residual limb
    Prosthetic sock
  67. A prosthetic component made from a silicone gel or similar polymer that rolls onto the residual limb like a sleeve and creates a suction interface between the skin and the socket
    Gel liner
  68. Upper limb prosthetic suspension that does not only operate the terminal device, but also keeps the socket correctly positioned




    A) Figure-of-eight harness
  69. The following are characteristics of Muenster socket, except:




    B) Sets the elbow in pre-flexed position (usually 45°)
  70. Transradial socket of choice for bilateral amputees due to its ease of donning




    A) Northwestern socket
  71. Transradial socket which achieves suspension through anterior-posterior compression around the olecranon




    A) Muenster socket
  72. Transradial socket which uses medial-lateral compression of the arm above the epicondyles, creating a less snug suspension




    D) Northwestern socket
  73. Transradial socket which incorporates design elements from both Muenster and Northwestern sockets, but with more aggressive contouring to maximize load-tolerant areas of the residual limb
    Transradial anatomically contoured (TRAC) socket
  74. MC used mechanism in cable-operated terminal devices
    Voluntary opening mechanism (wherein the patient uses the control-cable motion to open the terminal device against the resistive force of the rubber bands or internal springs or cables)
  75. In a hook terminal device, one rubber band requires ___ lb of force to provide approximately 1 lb of pinch force.




    A) 5 lb
  76. Voluntary-closing terminal devices allows an individual to provide variable and larger prehensile forces. It also provides indirect sensory feedback through the force exerted on the control cable.




    D) Both statements are true.
  77. Type of grip where the pad of the thumb and index finger are in opposition to pick up or pinch a small object




    C) Precision grip
  78. Type of grip where the pad of the thumb is against the pads of the index and middle fingers




    B) Tripod grip
  79. Type of grip where the tips of the fingers and thumb are flexed




    D) Spherical grip
  80. Type of grip where the DIP and PIP joints are flexed with the thumb extended




    A) Hook power grip
  81. Wrist unit design which allows easy swapping of terminal devices that have specialized functions
    Quick-disconnect wrist unit
  82. Wrist unit design with a locking a capacity to prevent rotation during grasping and lifting of heavy objects
    Locking wrist unit
  83. Wrist unit design which provides bilateral amputees with improved function for midline activities




    A) Wrist flexion unit
  84. Wrist units which are easily positioned but can slip when lifting heavier loads
    Friction control wrist units
  85. True or false: Wrist flexion unit is usually used on only one side, most often the shorter of the two residual limbs or on the side the amputee prefers.
    False

    Wrist flexion unit is usually used on only one side, most often the longer of the two residual limbs or on the side the amputee prefers.
  86. Formula used in determining proper limb length in bilateral upper limb amputees




    D) Carlyle formula
  87. Carlyle formula for bilateral transradial amputee
    The distance from apex of the lateral epicondyle to the thumb tip (forearm) is the patient's body height x 0.21.
  88. Carlyle formula for bilateral transhumeral amputee
    The distance from the acromion to the lateral epicondyle (arm) is the patient's body height x 0.19.
  89. Emerging surgical technique for direct skeletal attachment of the prosthesis which may render the socket obsolete
    Osseointegration
  90. Atkin's prosthetic functional adaptation rating scale: wearing all day, using well in bilateral tasks, incorporating well in body scheme




    B) 100%
  91. Atkin's prosthetic functional adaptation rating scale: wearing all day, using in gross and fine motor tasks




    B) 75%
  92. Atkin's prosthetic functional adaptation rating scale: wearing all day (primarily for cosmetic reasons), incorporating in gross activities (used as a leaning surface)




    B) 50%
  93. Atkin's prosthetic functional adaptation rating scale: not wearing or using the prosthesis; choosing to be essentially unilaterally independent




    C) 0%
  94. What component of the prosthesis should be used to hang the prosthesis when not in use




    B) Harness
  95. True or False: Detergents can be used when cleaning the prosthesis.
    False

    Detergents should be avoided because they tend to dissolve the lubricating oils in the hook and wrist unit mechanism.
  96. All of the following lower extremity amputations are considered to be major amputations, except:




    A) None of the above
  97. What lower extremity amputations are not considered to be major amputations?
    • 1. Partial foot (e.g. Chopart, Lisfranc, transmetatarsal, ray)
    • 2. Digit(s)
  98. Which of the following greatly increases the risk of lower extremity amputation?




    D) Diabetes
  99. MC major amputation level in the lower extremity
    Transtibial
  100. 2nd MC major amputation level in the lower extremity
    Transfemoral
  101. A transtibial amputation in the distal third of tibia is not usually recommended because of the following, except:




    C) Provides better self-suspension of residual limb
  102. The following are characteristics of disarticulation level amputations, except:




    A) Good cosmetic outcomes
  103. True or False: In persons with peripheral vascular disease, it is recommended to perform the amputation at a more proximal level.
    True

    Performing the amputation at a more proximal level increases the likelihood of timely and successful healing and may be a better option to facilitate rehabilitation and avoid multiple surgical interventions.
  104. Surgical technique which may enhance the stability of the muscle but may also result to a mobile sling of muscle that creates excessive movement and potential formation of painful bursa




    D) Myoplasty
  105. Surgical technique which provides greater stabilization of muscles and can enhance the contractile effectiveness and efficiency of muscle




    D) Myodesis
  106. Procedure performed after transfemoral amputation to achieve muscle balance and avoid excessive femoral abduction both in standing and during ambulation




    C) Adductor myodesis
  107. When the patient is not wearing a prosthesis, what must be applied to the residual limb to minimize swelling?




    A) Either shrinker or ACE wrap
  108. Erythematous, weeping, and pruritic rash representing up to one third of dermatoses seen in prosthetic wearers




    B) Allergic contact dermatitis
  109. Skin lesion which can occur if there is inadequate socket pressure on the distal end of the residual limb




    B) Verrucous hyperplasia
  110. For how many weeks should the residual limb volume be stable prior to fitting of definitive prosthesis?




    D) 8-12 weeks
  111. True or False: Socket changes are generally required when the amputee needs 10 or more socks to accommodate shrinkage of the residual limb.
    False

    Socket changes are required if 15 or more socks to accommodate residual limb.
  112. For a prosthesis with a pin lock system of suspension, the number of clicks give some clue as to the level of the fit. If the speed of click decreases, this could indicate that the residual limb has shrunk and additional socks should be worn.




    C) First statement is true, but second statement is false.
  113. Which Medicare functional classification level has a potential for cosmetic prosthesis




    B) K0
  114. Which Medicare functional classification level has the ability or potential to ambulate limited community distances at fixed cadence and traverse low-level environmental barriers?




    D) K2
  115. Which Medicare functional classification level has the ability to ambulate unlimited community distances at variable cadence and traverse most environmental barriers?




    D) K3
  116. For K1 level, what is the recommended foot ankle assembly?




    C) SACH heel, single axis
  117. For K4 level, what is the recommended knee unit?




    C) No specific limitations
  118. Which Medicare functional classification level has no ability or potential to ambulate or transfer with use of a prosthesis or a prosthesis does not enhance the quality of life




    D) K0
  119. May have vocation, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion




    C) K3
  120. What is the functional ability of K1 level?




    D) Ability or potential to transfer or ambulate with a prosthesis for household distances on level surfaces at a fixed cadence
  121. Transtibial socket design in which the major weight-bearing area for the residual limb is at the patellar tendon with a counterforce in the popliteal region
    Patellar tendon bearing socket
  122. All of the following are pressure-tolerant areas in a PTB socket, except:




    A) Patella
  123. All of the following are pressure-sensitive areas in a PTB socket, except:




    A) Distal end of residual limb
  124. What is the only difference between the PTB and the PTB-SC/SP socket?




    A) Level of medial-lateral trim line

    By raising the medial-lateral trim line in PTB-SC/SP socket to above the medial condyle, there is additional stabilizing support and suspension for the residual limb.
  125. Which of the following is not true about total surface bearing socket?




    B) Different trim lines from the PTB socket
  126. Transfemoral socket design which is rectangular in shape with the medial-lateral dimension being greater than the anterior-posterior dimension
    Quadrilateral socket (quad socket)
  127. Major weight bearing area of a quadrilateral socket
    Ischial tuberosity
  128. MC used transfemoral socket design
    Ischial containment socket
  129. Transfemoral socket design which is especially helpful for individuals with shorter residual limbs and mild hip abductor weakness




    B) Ischial containment socket
  130. True or False: The distal two thirds of an ischial containment socket have more muscle contouring compared with quadrilateral socket.
    True

    The distal two thirds of a quadrilateral socket is total contact in design, but has little to no muscle contouring.
  131. Which of the following is not true about the subischial socket design?




    A) Proximal trim line falls proximal to the ischial tuberosity
  132. Which of the following is false about suction suspension?




    D) Actively expels air from the socket through a one-way air valve
  133. Derivative of suction suspension which requires a pump (either manual or powered) that draws air out of the prosthetic socket
    Elevated vacuum suspension
  134. Suspension system which offers an audible click to reinforce engagement of the lock, but has potential for shearing forces on the tissues of the residual limb
    Pin lock suspension
  135. Prosthetic limb frame that uses rigid and durable exterior lamination which can help protect the prosthesis in harsh environments
    Exoskeleton
  136. MC used type of prosthetic limb frame
    Endoskeleton
  137. Prosthetic limb frame which uses pipes called pylons to connect the prosthetic components
    Endoskeleton
  138. Which of the following is incorrect about solid ankle cushion heel (SACH) foot?




    C) Has the ability to effectively accommodate to uneven surfaces
  139. The following are correct about solid ankle flexible endoskeleton (SAFE) foot, except:




    A) Has joint articulations
  140. Articulated prosthetic feet which allows controlled motion at the ankle in dorsiflexion and plantarflexion through rubber bumpers
    Single axis feet
  141. Prosthetic feet which allows motion in all three planes, but may require more frequent repairs and maintenance due to its multiple moving parts
    Multi-axial feet
  142. Prosthetic feet made of materials (e.g. plastic or carbon fiber) that have the capacity to store energy during weight-bearing and then return energy once the foot is off-loaded
    Energy-storing or dynamic response feet
  143. True or False: The longer the spring in dynamic response feet, the more energy is returned to the patient to provide push-off.
    True
  144. Prosthetic feet capable of internal power generation to produce dorsiflexion during swing phase of the gait and/or plantarflexion during stance phase
    Microprocessor feet
  145. Most stable design design of prosthetic knee




    A) Manual locking
  146. Which of the following knee units cannot be used in bilateral transfemoral amputees?




    A) Stance control knee
  147. MC congenital limb deficiency




    B) Left terminal transradial
  148. The stability of this knee unit is based strictly on alignment and voluntary control




    B) Single axis knee
  149. For the braking mechanism to function in a weight-activated stance control knee unit, the knee cannot be flexed greater than approximately ___ degrees.




    B) 20
  150. This knee unit is ideal for individuals with knee disarticulation level amputations because of the relatively small distance between its axis of rotation and attachment to the socket




    B) Polycentric knee
  151. Knee unit which include a fluid or air-filled cylinder that provides the ability to adjust to faster or slower gait speeds, making it appropriate for individuals in the K3 functional classification level
    Hydraulic or pneumatic knee
  152. Level of amputation which allows the patient to take limited steps without a prosthesis, but precludes the use of most energy-storing feet
    Ankle disarticulation (Syme's)
  153. With Syme's amputation, the proximal trim line of the prosthetic socket will be at the tibial tubercle if the heel pad is in place and tolerates weight-bearing. However if the patient has no weight-bearing ability, then the trim line will be brought up to the patellar tendon.




    D) Both statements are true.
  154. All of the following foot ankle assembly can be used by K1 transtibial amputees, except:




    B) Flexible keel-type foot
  155. True or False: If an individual with knee disarticulation cannot bear weight on the distal end of his/her residual limb, the recommended socket for his/her prosthesis would be subischial.
    False

    If an individual can fully bear weight on the distal end of his/her residual limb, the recommended socket is subischial. If there is no distal end weight-bearing, then the residual limb is treated as a transfemoral amputation with use of a more traditional ischial containment socket.
  156. Phocomelia is an example of what type of deficiency?




    B) Intercalary deficiency
  157. ISPO classification which refers to absence of any skeletal elements distal to a certain level of the limb
    Transverse deficiency
  158. ISPO classification which refers to a reduction or absence of an element within the long axis of the limb
    Longitudinal deficiency
  159. One of the disadvantages of an adult-acquired knee disarticulation is the inability to match the prosthetic knee center height to the contralateral anatomic knee center. However, this can be readily addressed in pediatric cases via:
    Distal femoral epiphysiodesis
  160. True or False: In uneven stride length seen in transtibial amputees, a shortened prosthetic step is more common than a shortened sound side step.
    False

    A shortened sound side step is more common and it frequently results from the patient's lack of confidence in their prosthesis.
  161. This gait deviation will occur if the foot is excessively dorsiflexed or if the socket is excessively flexed above the prosthetic foot




    A) Abrupt knee flexion in loading response
  162. True or False: Absence of knee flexion during loading response can present suddenly if a patient changes their shoe to one with a higher heel.
    False

    Abrupt knee flexion in loading response can present suddenly if a patient changes their shoe to one with a higher heel, effectively dorsiflexing the angle between the plantar surface of the shoe and the patient's knee.
  163. Abrupt knee flexion in loading response may be seen in patients who fail to eccentrically contract their quadriceps during loading response, either because of weakness or resultant pain in the socket. Softer prosthetic heel mechanisms may also increase the abruptness of stance phase knee flexion.




    D) Only the first statement is true.
  164. True or False: Absence of knee flexion during loading response may be a voluntary compensation by patients with weak quadriceps who are apprehensive about allowing this normal gait event to occur.
    True

    If uncompensated, patients with weak quadriceps will present with abrupt knee flexion during loading response.
  165. True or False: A prosthetic foot with excessive stiffness in the heel will result in absence of knee flexion during loading response.
    False

    A prosthetic foot with excessive stiffness in the heel will result in abrupt knee flexion during loading response. A prosthetic foot with excessive stiffness in the toe will result in absence of knee flexion during loading response.
  166. This gait deviation which is best seen in the coronal plane may result from compromised suspension or from a poorly fitting socket.
    Pistoning
  167. A prosthetic foot positioned relatively outset underneath the socket will create a valgus moment at the knee.
    True

    Similarly, a prosthetic foot positioned relatively inset will create a varus moment at the knee.
  168. All of the following are prosthetic causes of early heel rise, except:




    A) All of the above
  169. All of the following are prosthetic causes of late heel rise, except:




    A) Excessively dorsiflexed foot
  170. An excessively short or flexible prosthetic toe level will cause a patient to roll-over to the toe of the prosthesis and "drop-off" on to the sound side limb. This abrupt loading has been linked to elevated risks for osteoarthritis of the hip and knee, but may be reduced through the use of energy-storing feet.




    D) Both statements are true.
  171. This gait deviation involves a concentric burst of sound side plantarflexors, functionally lengthening the stance limb and ensuring swing phase clearance
    Sound side vaulting
  172. The following are causes of sound side vaulting, except:




    A) None of the above
  173. True or False: In transfemoral amputation, step asymmetry is often characterized by a short prosthetic step followed by a longer sound side step.
    False

    In transfemoral amputation, step asymmetry is often characterized by a long prosthetic step followed by a shorter sound side step. Particularly for the novice walker, apprehension of prosthetic knee instability creates a reluctance to fully load the prosthesis in midstance and terminal stance. In addition, hip flexor tightness can develop and this may also shorten the sound side step.
  174. True or False: The fleshy nature of the transfemoral limb makes this amputation level more prone to rotational instabilities.
    True

    Rotational instabilities can be exacerbated by any of the alignment characteristics which will increase the knee flexion moment during loading response or by an improperly fitting socket.
  175. True or False: Hydraulic knee joints provide variable resistance to knee motion, with decreasing resistance at elevated speeds.
    False

    Hydraulic knee joints provide variable resistance to knee motion, with increasing resistance at elevated speeds.
  176. True or False: When the prosthetic knee is set in excessive external rotation, a lateral "whip" is observed as the heel deviates laterally with prosthetic knee flexion.
    False

    When the prosthetic knee is set in excessive internal rotation, a lateral "whip" is observed as the heel deviates laterally with prosthetic knee flexion. Conversely, a knee joint set in excessive external rotation will create a medial "whip" as the heel of the prosthesis deviates medially with knee flexion.
  177. Pattern of hip motion in which swing phase flexion is coupled with abduction to ensure clearance of the swing leg
    Circumduction
  178. The following are causes of circumduction, except:




    A) None of the above
  179. Possible cause: prosthesis too short or too long




    C) Pelvis drops or elevates
  180. Observed gait abnormality: early knee flexion or "drop-off"




    A) Mid-stance to terminal stance
  181. Suggested modification: shorten limb, modify suspension




    B) Prosthetic foot drags
  182. Possible cause: inadequate toe lever, too much socket flexion




    B) Heel off excessively delayed
  183. Possible cause: inadequate heel lever or heel worn out




    C) Prolonged heel contact
  184. The following are causes for uneven step length:




    A) All of the above
  185. Observed gait abnormality: uneven step length




    D) Successive double support
  186. The following are prosthetic causes of knee buckling in transfemoral amputees, except:




    D) Weak hip extensors
  187. The following causes the prosthetic limb to be abducted, except:




    A) Prosthesis too short
  188. True or False: Heel whips occur during swing phase due to inadequate socket rotation.
    False

    Heel whips occur during swing phase due to excessive socket rotation. Too much internal rotation of the socket produces a lateral heel whip, whereas too much external rotation produces a medial heel whip.
  189. The following are causes of uneven heel rise during initial swing, except:




    D) Knee too stiff
  190. True or False: Lateral trunk bend or shift over the prosthesis during mid-stance occurs either because the prosthetic limb is abducted or there is poor medial-lateral prosthetic control.
    True
  191. Internationally accepted standard transtibial socket
    Patella tendon-bearing (PTB) total contact socket
  192. Variation of PTB socket which have higher medial and lateral sidewalls that extend above and over the femoral condyles, providing enhanced mediolateral stability and self-suspension of the prosthesis
    PTB-Supracondylar (PTB-SC)
  193. Variation of PTB socket which applies force proximal to the patella during stance, providing sensory feedback to limit genu recurvatum
    PTB-Supracondylar/suprapatellar (PTB-SC/SP)
  194. Amputation at this level involves removal of the pelvis, pelvic contents, external genitalia, and lower extremities
    Hemicorporectomy
  195. Indications of hemicorporectomy
    • 1. Advanced pelvic tumors
    • 2. Pelvic osteomyelitis
    • 3. Crushing pelvic trauma
    • 4. Intractable decubiti in pelvic region
  196. Knee unit which does not allow swing phase flexion, resulting in stiff knee gait




    A) Manual lock
  197. Knee unit excellent for pediatrics




    B) Single-axis constant friction
  198. The recommended prosthesis for this amputation level is bucket-shaped with two cut apertures to accommodate the colostomy and ileostomy sites




    B) Hemicorporectomy
  199. True or False: Individuals with a transfemoral amputation with less than 5 cm of residual femur are usually fitted with Canadian hip disarticulation prosthesis.
    True
  200. With average use, a UE prosthesis can be expected to be worn for ____ years before total replacement is necessary.




    C) 3-5
  201. UE prosthetic system with the highest sensory feedback




    C) Body powered
  202. UE prosthetic system which requires extended therapy time




    D) Battery powered
  203. The following are characteristics of Muenster and Northwestern sockets, except: are self-suspending and they have limited lifting capacity compared to harness systems.




    B) Greater lifting capacity than harness systems
  204. True or False: Suction socket with air valve can accommodate residual limb volume changes, making it easier to don than other suspension systems.
    False

    Suction socket with air valve requires stable residual limb volume and it is harder to don than other suspension systems. In addition, the residual limb must have a good soft-tissue cover.
  205. This harness has greater lifting ability and comfort than figure-8
    Shoulder saddle and chest strap
  206. True or False: Extrinsic residual limb pain is caused by mismatch between residual limb tissue tolerance and prosthetic loads imposed on the soft tissues.
    True

    Meanwhile, intrinsic residual limb pain is caused by changes or complications in the underlying neurovascular, bony, or soft tissues of the residual limb.
  207. The following are clinical manifestations of poor fit or excessive local tissue loading, except:




    A) None of the above
  208. All of the following modifications can be made immediately to enhance the comfort of prosthetic socket, except:




    A) Fabricate a replacement socket
  209. Condition which develops when there is simultaneous impairment of venous return from a prosthetic socket that is too tight proximally and a lack of total contact between the residual limb and the socket
    Choke syndrome
  210. The following are characteristics of Choke syndrome, except:




    A) The skin becomes hypopigmented because of hemosiderin deposit.
  211. True or False: For a child with a congenital skeletal deficiency, the initial prosthesis for UE is usually fitted when the child is approximately 6 months of age.
    True

    The initial prosthesis for UE is usually fitted when the child has attained independent sitting balance.
  212. True or False: For a child with a congenital skeletal deficiency, the initial prosthesis for LE is usually fitted when the child begins to walk.
    False

    The initial prosthesis for LE is usually fitted when the child begins to pull to a stand, which is generally between 9 and 14 months.
  213. Prosthetic prescription: externally powered for greater grip strength single control site (voluntary opening, auto close)




    A) 9-15 months
  214. Prosthetic prescription: change to two site control for voluntary opening and closing




    A) 24-36 months
  215. Prosthetic prescription: body-powered - passive mitt, self-suspending socket




    A) 6-7 months
  216. For children with transfemoral amputation, knee unit is not recommended until ages ____.




    D) 3-4
  217. Prosthetic prescription: externally powered terminal device, when terminal device control mastered, activate the elbow




    B) 24-48 months
  218. A 35-year old, right-handed female homemaker sustains a short transhumeral level of amputation following a motor vehicle accident. Which among the following is the most appropriate prosthetic prescription for this patient?




    B) Externally-powered

    Because of the short residual limb, external power may be more comfortable and functional, but will be heavier and more expensive than body power.
  219. A 72-year old retired man with type II diabetes and PVD has a transtibial amputation for an infected non-healing ulcer and gangrenous foot. Which foot ankle assembly is more appropriate for his definitive prosthesis considering that he wants to return to his gardening activities?

    A) Multi-axis foot

    A) Multi-axis foot
    B) SACH foot
    C) Single-axis foot
    D) Energy-storing foot
    A) Multi-axis foot

    A multi-axis foot was chosen because it is more durable and stable on uneven ground.
  220. A 24-year old, right handed man sustains a work-related crush injury to his right hand, resulting in a long transradial level of amputation. He plans to return to work operating a drill press. What is the most appropriate wrist unit for his prosthesis?




    A) Quick-change locking wrist unit
Author
carminaorlino
ID
355339
Card Set
Amputation and Prosthesis
Description
Updated