exam 2

a 66 yo pt has bilateral TFA due to a MVA. otherwise, the pt is healthy & has good UE strength & sitting balance. which transfer would be most appropriate & most functional for this pt?

a. assisted standing pivot transfer

b. sliding board transfer

c. hydraulic lift transfer

d. two-person lift transfer

b. sliding board transfer

a 66 yo pt has bilateral TFA due to a MVA. otherwise, the pt is healthy & has good UE strength & sitting balance.

-what is the pt’s current K-lvl?

a. K0

b. K1

c. K2

d. K3

b. K0

a 66 yo pt has bilateral TFA due to a MVA. otherwise, the pt is healthy & has good UE strength & sitting balance.

-what is the pt’s highest possible K-lvl?

a. K0

b. K1

c. K2

d. K3

b. K1

a pt presented to a clinic 3 months after a R TTA. the pt is able to ambulate household distances. based on this info, what is the pt’s K-lvl?

a. K0

b. K1

c. K2

d. K3

b. K1

a pt is 7 months post-op a TTA. the pt can ambulate short distances in the community without varying their cadence significantly. what is the pt’s K-lvl?

a. K0

b. K1

c. K2

d. K3

c. K2

a pt is 7 months post-op a TTA. the pt can ambulate short distances in the community without varying their cadence significantly. what kind of foot might the pt use for ambulation?

a. SACH

b. SAFE

c. Multi-axis

d. STEN

e. A & B only

f. A, B, & C only

g. all of the above

g. all of the above

a pt w R knee ligamentous laxity wears a foot that allows minimal coronal or transverse plane torque absorption & has a durable bumper. what foot is the pt wearing?

a. SACH

b. SAFE

c. single axis

d. multi-axis

c. single axis

a pt w a TTA has 15% residual limb remaining. what would be the MOST beneficial socket for this pt?

a. PTB

b. PTB-SC

c. PTB-SC/P

d. total surface bearing

c. PTB-SC/P

which of the following is NOT a weight sensitive area for a TTA?

a. fibula shaft

b. fibula head

c. anterior tibial crest

d. anterior tibia condyle

a. fibula shaft

Medicare Functional Lvls: K___

-community ambulation & the ability to vary cadence w vocational, therapeutic, or exercise needs

K3

Medicare Functional Lvls: K___

-limited community ambulation

K2

Medicare Functional Lvls: K___

-household ambulation

K1

Medicare Functional Lvls: K___

-high lvls of activity such as demonstrated by active adults & athletes

K4

Medicare Functional Lvls: K___

-not a candidate for a prosthesis

K0

a pt who is a warehouse worker is able to vary their cadence significantly while ambulating community distances & at work. the pt is able to negotiate most environmental barriers. based on this info, which statement is MOST accurate?

a. the pt is a K1 ambulator who could ambulate w a SACH foot

b. the pt is a K2 ambulator who could ambulate w a SACH foot

c. the pt is a K3 ambulator who could ambulate w a SAFE foot

d. the pt is a K4 ambulator who could ambulate w a SAFE foot

c. the pt is a K3 ambulator who could ambulate w a SAFE foot

a new pt, who is post-op a transtibial amputation (TTA), has altered mental status. fortunately, the pt’s spouse is present so that the therapist can educate them in proper positioning of the pt to prevent the typical contractures in the pt. which statement is accurate?

a. the therapist should stress that the pt should, as frequently as possible, maximize out-of-bed time with sitting in a chair

b. the therapist should stress that the pt be positioned in prone-lying w full knee extension

c. the therapist should stress that the pt be positioned in prone-lying w slight knee flexion

d. the therapist should stress that the pt be positioned in supine w a small pillow under the knee

b. the therapist should stress that the pt be positioned in prone-lying w full knee extension

a pt has a short R transtibial residual limb & present w knee instability. the pt tends to hyperextend during the stance phase of gait bc of weak quads. based on this info, what type of socket would provide the MOST knee stability & be MOST beneficial to the pt?

a. total surface bearing (TSB)

b. patella tendon bearing (PTB)

c. PTB supracondylar (PTB-SC)

d. PTB-SC suprapatellar (PTB-SC/P)

d. PTB-SC suprapatellar (PTB-SC/P)

which area is a weight tolerant area for a pt w a short R TTA?

a. anterior tibia condyle

b. anterior tibial crest

c. fibula shaft

d. fibula head

c. fibula shaft

where would you expect weight tolerant areas (bulges/build ups) on a transfemoral (TF) socket?

a. perineum

b. greater trochanter

c. ischial tuberosities

d. distal lateral femur

c. ischial tuberosities

a therapist is educating their patient on positioning to prevent contractures following a transfemoral amputation. which statement provides the BEST advice to prevent contractures from developing in this pt?

a. lie sidelying w 3 pillows between the knees while reading a book

b. lie supine w a bolster under the knees while talking on the phone

c. lie prone on the elbows to watch TV for 30 mins

d. sit in a WC while crocheting a baby hat

c. lie prone on the elbows to watch TV for 30 mins

a pt who has a L transfemoral amputation (TFA) walks household distances. the pt presents w a long leg gait pattern. what type of knee unit is the pt MOST likely using?

a. pneumatic knee

b. hydraulic knee

c. manual locking knee

d. microprocessor knee

c. manual locking knee

a pt who has a L TFA uses 8 ply socks. which statement is MOST accurate?

a. the pt should use one 5-ply sock + one 3-ply sock

• the 5-ply sock should contact the pt’s skin, & the 3-ply sock should be placed over the 5-ply

b. the pt should use one 5-ply sock + three 1-ply socks

• the 5-ply sock should contact the pt’s skin, & the 1-ply socks should be placed over the 5-ply

c. the pt should use one 5-ply sock + one 3-ply sock

• the 3-ply sock should contact the pt’s skin, & the 5-ply sock should be placed over the 3-ply

d. the pt should use one 5-ply sock + three 1-ply socks

• the 1-ply socks should contact the pt’s skin, & the 5-ply sock should be placed over the 1-plys

a. the pt should use one 5-ply sock + one 3-ply sock

• the 5-ply sock should contact the pt’s skin, & the 3-ply sock should be placed over the 5-ply

for the pt w a TFA, which suspension is used for a pt who requires glute med support & has a short residual limb & weak hip ABD?

a. silesian belt

b. hip joint & pelvic band

c. lanyard system

d. seal in liner

b. hip joint & pelvic band

a pt’s socket was donned in malrotation, & the knee bolt was externally rotated. gait analysis showed that the heel travelled medially during the terminal stance phase of gait. what is the patient’s gait deviation/compensation?

a. lordosis

b. terminal impact

c. lateral rotation of the foot at heel strike

d. medial whip

d. medial whip

*the following are prosthetic & anatomic causes of a medial whip:

• prosthetic:

  • faulty socket contour

  • knee bolt externally rotated

  • foot malrotated

  • prosthesis donned in malrotation

  • w sliding friction unit

• anatomic:

  • fast pace

*the following are prosthetic & anatomic causes of a ____ ____:

• prosthetic:

  • faulty socket contour

  • knee bolt externally rotated

  • foot malrotated

  • prosthesis donned in malrotation

  • w sliding friction unit

• anatomic:

  • fast pace

medial whip

*the following are prosthetic & anatomic causes of a medial whip:

• prosthetic:

  • faulty socket contour

  • knee bolt ____ rotated

  • foot malrotated

  • prosthesis donned in malrotation

  • w sliding friction unit

• anatomic:

  • fast pace

externally

*the following are prosthetic & anatomic causes of a medial whip:

• prosthetic:

  • faulty socket contour

  • knee bolt externally rotated

  • foot malrotated

  • prosthesis donned in malrotation

  • w sliding friction unit

• anatomic:

  • ____ ____

fast pace

which of the following is NOT a cause of the following gait deviation:

L lateral trunk lean

a. short prosthesis

b. high medial wall

c. right hip pain

d. ABD contracture

c. right hip pain

*possible causes of gait deviations: lateral trunk lean

• short prosthesis

• high medial wall

• ABD contracture

*pt w hip pain would decrease stress to the hip by leaning TOWARD the painful hip (in this case, would lean to the L)

possible causes of lateral trunk lean:

____ prosthesis

high medial wall

ABD contracture

short

possible causes of lateral trunk lean:

short prosthesis

____ ____ wall

ABD contracture

high medial wall

possible causes of lateral trunk lean:

short prosthesis

high medial wall

____ ____

ABD contracture

T/F: a pt w hip pain would decrease stress to the hip by leaning AWAY from the painful hip

F

*would decrease stress to the hip by leaning TOWARD the painful hip

a pt w a transtibial prosthesis complains of knee instability & an uncomfortable pressure on the medial & proximal aspect of their knee when they’re in the midstance subphase of gait. when standing in midstance, the socket is excessively ADD, & the foot is outset. what gait deviation would the pt MOST likely demonstrate?

a. lateral thrust

b. medial thrust

c. insufficient knee flexion

d. premature knee flexion

b. medial thrust

*w medial thrust, the foot is outset & there is excessive ADD of the socket

• lateral thrust: OPP

*insufficient knee flexion & premature knee flexion mainly affect the socket, foot, & residual limb in the sagittal plane

____ thrust:

-foot is OUTSET

-excessive ADD of the socket

medial

medial thrust:

-foot is ____

-excessive ____ of the socket

foot is OUTSET

excessive ADD of the socket

____ thrust:

-foot is INSET

-excessive ABD of the socket

lateral

lateral thrust:

-foot is ____

-excessive ___ of the socket

foot is INSET

excessive ABD of the socket

insufficient knee flexion & premature knee flexion mainly affect the socket, foot, & residual limb in the ____ plane

sagittal

lateral displacement of socket: foot is ____

inset

which of the following is the MOST appropriate clinical action for a therapist treating a pt w knee instability during stance?

a. maintain the current stiffness [of heel wedge] to preserve stability during terminal stance

b. contact the prosthetist to soften the heel wedge to reduce knee instability

c. replace the plantarflexion bumper w a firmer component to encourage faster knee extension

d. contact the prosthetist to adjust the prosthetic knee alignment into more flexion to compensate for the instability

b. contact the prosthetist to soften the heel wedge to reduce knee instability

*best action would be for the therapist to contact the prosthetist to soften the heel wedge to decrease the anterior tibial translation, which is causing the knee to flex & become unstable