Upper Extremity Prosthetics Flashcards

1
Q

BE Harnessing Housing Installation

A
  • length between retainer and cross bar assembly => housing will be neither stretched nor unduly slack at any forearm position
  • proximal to crossbar => about 1/2’’
  • distal to base plate => long enough to prevent the cable from rubbing on the socket in any position of the terminal device, but not to interfere with the operating stroke of the device
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2
Q

BE Harnessing Retainer Placement

A

Goal is to

  • minimize angulation between retainer and hook or hand anatomy
  • give adequate clearance for hook or hand connections
  1. the plate may be placed as far as the proximal third of the forearm
  2. VO- just lateral to the top
    VC-just lateral to the bottom
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3
Q

What Orientation Should OB Electrode Cables Be Installed

A

GREY up
BLUE down

When using software
R: Red
E: Extensor
O: Open

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4
Q

Measurements to Take for Transradial Assessment

A

Stump

  • circumferences at intervals beginning @cubital fossa
  • length from med. epicondyle OR olecranon to distal end
  • M/L diameters @condyles and proximal to condyles and maybe A-P

Other side

  • length from same landmark=> thumb tip
  • cosmetic measurements
  • hand size

Also
-any needed for suspension (ie. axilla loop)

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5
Q

Forearm Lever Loop Attachment

A
  • typically: housing is gripped on the lever loop about 1’’ from its attachment point
  • lever loop is attached 1.25’’ distal to the elbow centre
  • cable housing extend 0.5-1’’ proximal to lever loop
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6
Q

Measurements to Take for Transhumeral Assessment

A

Stump

  • circumferences @intervals beginning at axilla
  • length from acromion => distal end
  • diameter for wings; infrascapular fossa => pectoral fossa

Contralateral

  • length; acromion =>med epicondyle
  • length of forearm; med epicondyle => thumb tip
  • cosmetic measurements
  • hand size

Also- any needed for suspension (harness)

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7
Q

BE Harnessing: Cable Assembly

A

-once the housing has been properly adjusted
-cut cable length so that the hanger does not contact the proximal cable housing when the VO hook is closed and fully pronated
(maximum cable length)

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8
Q

Weak Signals and interferences of EMG

A

Chart

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9
Q

Internal vs. External Batteries

A

Chart

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10
Q

Transradial Socket Design Styles

A

Muenster

  • narrow A/P
  • high anterior trimline
  • might reduce flexion ROM
  • good for short limb but poor for bilateral

Northwestern

  • self suspending
  • supraconydlar
  • good for long stumps due to lower anterior trimline=>easier flexion

3/4 socket; Northwestern w/ olecranon cut out, less constriction, more air flow, ability to ‘feel’ with elbow

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11
Q

How to Calculate Forearm or Humeral length with a Bilateral Amputee

A

Forearm; height x 0.14

Upper arm; height x 0.19

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12
Q

Body vs. External Power

A

Comparison

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13
Q

Body vs. External Power

A

Comparison

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14
Q

Body Motions for Control of a Below-Elbow Harness

A
  • to control the relative displacement between the proximal retainer or the cuff and the attachment strap of the harness

1) Arm Flexion
2) Shoulder Depression
3) Scapular Abduction
4) Scapular Abduction (sound side)

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15
Q

Fair Lead Cable Control

A
  • used for transhumeral prosthesis
  • consists of a cable held in place and guarded by separate lengths of housing
  • provides elbow flexion and TD control
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16
Q

Battery Types

A

Nickel Cad

  • old
  • rarely used tech
  • memory effects
  • low capacity

NiMH

  • newer
  • less memory
  • mid range expense and capacity

Lithium Ion

  • newest
  • small and high capacity
  • no memory
17
Q

Hooks Canted vs. Lyre

A

CANTED: objects more visible when grasping

  • object is rolled into its grasp
  • cannot pick up pins well

LYRE

  • more applicable for bottle or cylindrical shapes
  • object is pinched
  • can pick up pins
18
Q

Transhumeral Amputation Levels

A

LONG

  • condyles remaining
  • primary control is from humeral

MED

  • distal to deltoid insertion
  • primary control from humerus but assisted by shoulder girdle

SHORT

  • proximal to deltoid insertion
  • primary control from shoulder girdle but assisted by humerus
19
Q

Bowden Control Cable System

A
  • single purpose; to operated the TD
  • consists of a continuous length of housing
  • housing is fastened by retainer to forearm and cross-bar assembly to triceps pad
20
Q

Partial Hand Device Designs

A

MILBRANT

  • for missing digits 2-5
  • finger bar provides opposition to the thumb
  • heavy duty and high friction material

OPPOSITION POST

  • also for missing digits 2-5
  • smaller piece of material to provide opposition to thumb
  • better suited for lighter tasks and fine detail

SPATULA

  • light duty device used when there are no fingers present
  • provides opposition to the palm
  • wrist motion needed
21
Q

Harness Components

A
  • northwestern or BAHA rings
  • hanger
  • quick release buckle
  • 4 bar buckle
  • cable and housing
  • ferrel
  • cross bar
  • triceps cuff/triceps plate
  • retainer
  • base plate and bumper
  • tripe swivel/ball terminal
  • ball receiver
22
Q

Wrist Options

A

QUICK DISCONNECT
-easy to swap terminal devices, locking option, more function, heavier, more mechanical parts, more costly, longer build height required

FRICTION

  • lighter and lower build height
  • can be oval for cosmesis, adjustable resistance to pronation/supination

FLEXION/RADIO-ULNAR DEVIATION

  • lockable at different angles
  • weight and build height increase
  • more mechanical parts
  • can be used to get TD closer to midline
  • good for bilateral
23
Q

Functional Loss of Partial Hand Amputation

A

-THUMB
@IP = 20%
@MCP = 40%

  • 2ND OR 3RD DIGIT
    @DIP = 9%
    @PIP = 16%
    @MCP = 20%
  • 4TH OR 5TH DIGIT
    @DIP = 5%
    @PIP = 8%
    @MCP = 10%