Prosthetic Limb Fit and Sock Analysis
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Prosthetic Limb Fit and Sock Analysis

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Questions and Answers

What could indicate that a prosthesis is sagging or sitting lower than usual?

  • Too few socks
  • Socket is too large (correct)
  • Excessive pistoning
  • Improper sock thickness

    • Which area is NOT considered a pressure-sensitive area of a transfemoral limb?

  • Ischial tuberosity (correct)
  • Distal femur
  • Greater trochanter
  • Ischial ramis

    • What is a primary benefit of using a gel liner in prosthetics?

  • Increased weight
  • Enhanced rigidity
  • Decreased sock thickness
  • Improved comfort (correct)

    • What happens if there is excessive pressure at the distal end of the limb?

    <p>Causes skin breakdown</p> Signup and view all the answers

    How can limb shrinkage over time be accommodated in prosthetic fittings?

    <p>By adding prosthetic socks</p> Signup and view all the answers

    What is a common consequence of having too few prosthetic socks?

    <p>Short prosthetic limb sensation</p> Signup and view all the answers

    Which of the following describes the pressure-tolerant areas of a transfemoral limb?

    <p>Entire distal end of limb</p> Signup and view all the answers

    Which thicknesses are typically available for prosthetic socks?

    <p>1-ply, 3-ply, 5-ply</p> Signup and view all the answers

    Where should socks be added when using a seal-in liner?

    <p>Proximal to the seal under the flip down ring</p> Signup and view all the answers

    What characterizes the lanyard system in prosthetic assemblies?

    <p>The strap is attached to the socket and feeds through an opening</p> Signup and view all the answers

    Which suspension system allows for direct skin contact with the socket?

    <p>Suction suspension</p> Signup and view all the answers

    What is a disadvantage associated with suction suspension systems?

    <p>Can cause skin irritation due to direct contact</p> Signup and view all the answers

    How does vacuum-assisted suspension (VASS) differ from suction suspension?

    <p>It maintains suction through an external vacuum pump</p> Signup and view all the answers

    What benefit does vacuum-assisted suspension (VASS) provide over traditional suction systems?

    <p>Improved circulation and stability</p> Signup and view all the answers

    Which of the following systems provides additional security for the prosthesis during physical activities?

    <p>Pelvic belt and hip joint</p> Signup and view all the answers

    Which statement is true regarding the need for maintenance in vacuum-assisted suspension systems?

    <p>They demand consistent adjustment for effective suction</p> Signup and view all the answers

    What is the main weight-bearing area in the quadrilateral socket design?

    <p>Ischial tuberosity on a ledge</p> Signup and view all the answers

    Which feature is primarily utilized in the sub-ischial brimless socket to minimize movement?

    <p>Vacuum suspension system</p> Signup and view all the answers

    What is a significant disadvantage of microprocessor knees?

    <p>Cost</p> Signup and view all the answers

    Which of the following features allows a foot to adapt better to uneven surfaces?

    <p>Multi-axis foot</p> Signup and view all the answers

    What sensation might a patient report due to having too few socks?

    <p>Sensation of dropping into a hole</p> Signup and view all the answers

    What is an advantage of the pin shuttle mechanism in prosthetics?

    <p>Provides secure suspension</p> Signup and view all the answers

    What does the term SACH stand for in the context of prosthetic feet?

    <p>Solid Ankle Cushion Heel</p> Signup and view all the answers

    Which type of prosthetic foot provides actual range of motion at the ankle?

    <p>Multi-axis feet</p> Signup and view all the answers

    What discomfort might occur if there are too many socks in the prosthetic socket?

    <p>Feeling of a long prosthetic limb</p> Signup and view all the answers

    What is a common maintenance issue associated with microprocessor knees?

    <p>Requires regular calibration</p> Signup and view all the answers

    What is a disadvantage of passive vacuum with a silicone suction suspension sleeve?

    <p>Bulky behind the knee</p> Signup and view all the answers

    What may describe the sensation caused by improper sock fit in a prosthetic?

    <p>&quot;Hammocking&quot; of the residual limb</p> Signup and view all the answers

    Which feature is beneficial for knee stability when using prosthetic feet?

    <p>Single-axis foot</p> Signup and view all the answers

    What audible feature does the pin shuttle mechanism provide?

    <p>Audible clicks</p> Signup and view all the answers

    What is a drawback related to the weight of microprocessor knees?

    <p>They can be heavier compared to traditional knees.</p> Signup and view all the answers

    Which prosthetic foot type allows for inversion and eversion?

    <p>Multi-axis foot</p> Signup and view all the answers

    What is a notable disadvantage of a constant friction knee?

    <p>Requires voluntary control to remain stable in stance</p> Signup and view all the answers

    What is the primary benefit of using a manual locking knee?

    <p>Provides maximum stability during ambulation</p> Signup and view all the answers

    Which of the following is an advantage of a polycentric knee?

    <p>Improves sitting cosmesis with change in knee center</p> Signup and view all the answers

    What describes a candidate suitable for a hydraulic knee?

    <p>K3 level with ability for ambulation with variable cadence</p> Signup and view all the answers

    What might be a drawback of using a non-liner suspension system?

    <p>May cause pressure in the pelvic area</p> Signup and view all the answers

    What is a common characteristic of a hydraulic knee?

    <p>Changes resistance based on activity level</p> Signup and view all the answers

    How does a polycentric knee benefit toe clearance?

    <p>Increases toe clearance by accommodating knee motion</p> Signup and view all the answers

    Which statement is true regarding manual locking knees?

    <p>They lock during gait and can be manually released</p> Signup and view all the answers

    Study Notes

    Sock Thickness and Fit

    • Socks are used to adjust the fit of prosthetic limbs, with varying thicknesses for customized adjustments
    • Too few socks can lead to pressure points, redness, skin breakdowns, and discomfort
    • Specific areas prone to unwanted pressure with too few socks include the distal end of the limb, distal patella, distal fibula, fibular head, and medial tibial flare
    • Adding socks can redistribute load, improve comfort, prevent skin damage, and accommodate limb shrinkage
    • Too many socks can cause a feeling of a long prosthetic limb, discomfort, pressure on the tibial tubercle, and difficulty donning

    Gel Liners

    • Gel liners improve comfort and aid in suspension by dispersing weight-bearing loads
    • They decrease shear and impact forces, come in multiple thicknesses, and offer different thicknesses for anterior-posterior or proximal-distal adjustment

    Pressure Sensitive and Tolerant Areas of a Transfemoral Limb

    • Pressure sensitive areas on a transfemoral limb include:
      • Greater trochanter
      • Ischial ramis
      • ASIS
      • Adductor tendon
      • Distal femur
      • Inguinal fossa
      • Pubic tubercle
      • Incision line
    • Pressure tolerant areas on a transfemoral limb include:
      • Ischial tuberosity
      • Lateral flare of femur
      • Anterior flare of residual limb
      • Posterior flare of residual limb
      • Entire distal end of limb with total contact socket

    Socket Designs

    • Quadrilateral socket:
      • Utilizes opposing forces to keep the ischial tuberosity on a ledge, providing suction suspension
      • Offers main weight bearing area and accommodates other suspension methods
    • Ischial ramus containment socket:
      • Focuses weight bearing on the medial aspect of the ischium and the ischial ramus
      • Encompasses both the ischial tuberosity and the ramus, with a contour depending on the amputee's musculature, soft tissue, and skeletal structure
    • Sub-ischial brimless socket:
      • Uses a vacuum suspension system and gel liners for constant contact, minimizing movement, maximizing femoral control, and lowering trim lines

    Patient Concerns with Insufficient Socks

    • Short prosthetic limb feeling
    • Sensation of dropping into a hole
    • Excessive pistoning
    • Distal pressure
    • Pressure on distal patella
    • Pressure on distal fibula, fibular head, medial tibial flare
    • Easy donning

    Patient Concerns with Excessive Socks

    • Feeling of a long prosthetic limb
    • Sensation of hill climbing
    • "Hammocking" (excess space resembling a hammock causing distal discomfort)
    • Pressure on tibial tubercle
    • Difficulty donning

    Pin Shuttle Mechanism Advantages

    • Secure suspension
    • No sleeve needed
    • Audible clicks
    • Allows for sock adjustments with volume changes

    Passive Vacuum with Silicone Suction Suspension Sleeve Disadvantages

    • Liner plus sleeve creates bulk behind the knee, limiting flexion
    • Donning difficulty with hand weakness or neuropathy

    Seal-in Liner Sock Placement

    • Socks can only be added proximal to the seal, under the flip-down ring

    Lanyard and Strap Systems

    • Lanyard system:
      • Strap attached to the bottom of a liner, fed through the socket, and attached to the outside
    • Fork strap waist belt:
      • Removable fork strap and prosthetic belt providing additional security

    Transfemoral Suspension Systems Without a Liner

    • Suction Suspension (Direct or Skin Fit Suction):
      • Creates a vacuum seal between the socket and the skin using a one-way valve
      • Provides a close fit and allows for better proprioception
      • Requires stable limb volume
    • Vacuum-Assisted Suspension (VASS) Without a Liner:
      • Uses an external vacuum pump to enhance the seal
      • Provides increased stability, improved circulation, and reduced limb volume fluctuations
      • Requires more maintenance and a consistent fit
    • Pelvic Belt and Hip Joint:
      • Uses a waist belt and a hip joint mechanism connected to the socket
      • Useful for short or irregular residual limbs or difficulty achieving suction

    Constant Friction Knee Disadvantages

    • Requires voluntary control to remain stable in stance
    • Single speed ambulation

    Manual Locking Knee Advantages

    • Maximum stability
    • The knee is locked during gait and the patient releases the lock mechanism to sit down
    • Decreases hip extension strength for stabilization

    Polycentric Knee Advantages

    • Increase stance stability
    • Improve sitting cosmesis with the knee center change
    • Increase toe clearance

    Candidates for Hydraulic Knees

    • K2 and K3 descriptors:
      • K2: Ambulation with the ability to traverse low-level environmental barriers (curbs, stairs, uneven surfaces)
      • K3: Ambulation with variable cadence, traversing most environmental barriers and may have vocational, therapeutic, or exercise needs beyond simple locomotion

    Microprocessor Knee Disadvantages

    • Cost
    • Weight
    • Maintenance
    • Computerized
    • Require charging/battery swap every 24-72 hours
    • Require calibrations
    • Water-proof
    • Limited durability under heavy use or loads

    SACH Foot

    • SACH stands for Solid Ankle, Cushion Heel

    Single Axis Foot Advantages

    • Allows for plantarflexion and dorsiflexion when weighted
    • Assists with knee stability and roll-over
    • Water-friendly depending on the brand
    • Allows for inversion and eversion with a multi-axis ankle

    Foot/Ankle Features for Uneven Terrain

    • Hydrolic ankle
    • Multi-Axis Foot:
      • Conforms to uneven surfaces better than a single-axis foot

    Type of Foot Providing Actual Range of Motion at the Ankle

    • Single-Axis Feet:
      • Hinge allowing plantarflexion and dorsiflexion
      • Limited range of motion in the sagittal plane
      • Improves walking stability, especially for individuals with limited knee stability
    • Multi-Axis Feet:
      • Movement in sagittal (up and down), frontal (side to side), and transverse (rotational) planes
      • More natural range of motion in multiple directions
      • Increases stability on uneven surfaces and provides a natural walking experience
    • Hydraulic and Microprocessor-Controlled Ankles:
      • More advanced options offering customizable responses and adaptability to varying terrain
    • Each type of foot provides different benefits depending on individual needs and preferences.

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    Prosthetics Components Worksheet PDF

    Description

    Explore the relationship between sock thickness and the fit of prosthetic limbs in this comprehensive quiz. Learn about how to adjust fit using different sock thicknesses to prevent discomfort and skin breakdowns while improving comfort with gel liners. Understand the critical areas to consider in a transfemoral limb to ensure optimal performance.

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