Following a transfemoral amputation, if the amputation site is in the Distal 1/4 to 1/3 of the femur (i.e. Femur Length), what is the percentage of strength reduction? Select only the most correct answer(s).
35% of all movements
25% of all movements
45% of all movements
55% of extensors and abductors
65% of flexors and adductors
75% of extensors and abductors
85% of flexors and adductors
65% of extensors and abductors
85% of extensors and abductors
75% of flexors and adductors
Following a transfemoral amputation, if the amputation site is in the Distal 1/3 to 1/2 of the femur (i.e. Femur Length), what is the percentage of strength reduction? Select only the most correct answer(s).
Following a transfemoral amputation, if the amputation site is in the Mid Femur Region (i.e. Femur Length), what is the percentage of strength reduction? Select only the most correct answer(s).
Following a transfemoral amputation, if the amputation site is in the Proximal 1/3 of the femur (i.e. Femur Length), what is the percentage of strength reduction? Select only the most correct answer(s).
Which of the following are the ADVANTAGES of a SOFT DRESSING?
Ability to inspect wound easily
Provide alternative wound environment, as needed
Good support to the surgical site, improved wound environment.
Amputees demonstrate greater confidence with movement with less chance of injury to healing tissue
Psychological benefits of ambulation
Shorter hospital stay
Reduced severity of phantom pain
Which of the following are the ADVANTAGES of a SEMI-RIGID DRESSING?
Provide alternative wound environment as needed
Good support to the surgical site, improved wound environment
Which of the following are the ADVANTAGES of a RIGID DRESSING?
Which of the following are the ADVANTAGES of an IPOP DRESSING?
Which of the following are the DIS-ADVANTAGES of an IPOP DRESSING?
Difficult to monitor moisture, temperature, sterility of wound surface under the dressing.
Application of the dressing may create tourniquet effect or varied pressure to the limb.
Slippage of the dressing frequently occurs.
Movement of the dressing over underlying wound and soft tissue can create pain and apprehension.
Frequently the elderly and more pain sensitive amputees will restrict movement and activity to avoid further discomfort.
Improper application of the dressing fails to promote adequate circulation.
Limited access to the wound to monitor healing.
Ambulation could be permitted too soon.
The ability to access the wound to monitor healing is a little more difficult.
Which of the following are the DIS-ADVANTAGES of a RIGID DRESSING?
Which of the following are the DIS-ADVANTAGES of a SEMI-RIGID DRESSING?
Which of the following are the DIS-ADVANTAGES of a SOFT DRESSING?
There are some basic similarities between the goals of post-operative treatment and those of pre-prosthetic treatment. Which of the following are unique to Post-Operative Treatment?
Reduce edema
Prevent loss of motion
Assist with the limb loss adjustment
Increase cardiac, pulmonary and other organ system function
Increase activity
Improve balance
Stimulate proprioception
Which of the following activities are appropriate for Post-Op Day 1?
Bed mobility
Positioning
A/PROM to uninvolved joints
Non-amputated limb exercises
Transfer skills
Sitting to tolerance (15-20 min)
PROM and AROM to involved joint
Gluteal and quad sets
Which of the following activities are appropriate for Post-Op Day 2?
AROM to uninvolved joints
Pre-prosthetic ambulation with walker
Dressing education
Contracture and precaution exercises
Which of the following activities are appropriate for Post-Op Day 3?
Sitting endurance
Sound side exercises
HEP
Which of the following activities are appropriate for Post-Op Day 4?
AROM to all joints (involve family)
Gluteal and Quad sets (Home Exercise Program - HEP)
Patient education and reinforcement
Which of the following activities are appropriate for Post-Op Day 5?
Discharge
Prosthetic Gait Training occurs during a follow-up visit. Which of the following is the EARLIEST week in which we should consider it?
Week 3
Week 4
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Week 12
Week 2
When preparing a HEP, you recall from your Prosthetics Lessons that you should include no more than __#__ exercises, in order to maximize patient compliance.
2
3
4
5
If possible – lower extremity amputees should lie __(position)___ with a small towel roll promoting slight __(motion)__ for __(##)__ minutes per day.
position = PRONE
position = SUPINE
position = IN SIDELYING
motion = HIP EXTENSION
motion = HIP FLEXION
## = 30
## = 45
Which of the following are part of the Essential Home Exercise Program (Basic Four)?
Supine AROM alternating hip and knee flexion
Supine AROM hip abduction and adduction
Sidelying AROM hip flexion and extension
Sitting AROM knee flexion and extension
Quad Setting
Prone AROM Hip extension
Manual resistance exercise to hip
PROM and AROM to all joints of the lower extremity
What is the proper order for a prosthetic fitting process? ❌ prosthesis ❌ prosthesis ❌ prosthesis
Which prosthesis is worn only for evaluation?
Diagnostic prosthesis
Temporary prosthesis
Definitive prosthesis
Evaluation prosthesis
Which prosthesis is worn during prosthetic training?
Training prosthesis
Which of the following BEST describes the differences between the Home-Wearing Schedule for a Transtibial (TTA) prosthesis in weeks 2-3 versus that for a Transfemoral (TFA)?
With TTA, the prosthesis is worn for SHORTER periods of time, MORE times per day than a TFA prosthesis.
With TTA, the prosthesis is worn for LONGER periods of time, MORE times per day than a TFA prosthesis.
With TTA, the prosthesis is worn for SHORTER periods of time, LESS times per day than a TFA prosthesis.
With TTA, the prosthesis is worn for LONGER periods of time, LESS times per day than a TFA prosthesis.
There is no difference between the Home-Wearing Schedules for TTA and TFA.
When donning socks, which of the following is correct?
The sock seam (if it has one) should be PARALLEL to the suture line
The sock seam (if it has one) should be PERPENDICULAR to the suture line
socks are commonly made out of which of the following materials (as listed in our course notes).
Wool
Cotton
Lycra
Angora
Mineral oil gel
Silicone
Urethane
If a patient notices a small wound on their stump, it is okay for them to apply a small bandage/dressing and then apply their sock as normal.
While instructing your patient in proper skin care, the presence of which of the following on the residual limb would be considered a warning sign?
Swelling
Erythema lasting longer than 15 minutes
Blisters
Callusses
Dry cracks
Sweat
Heat
Pale skin (pallor)
Signs of inflammation
Select the Principles of Compression
Diagonal turns, when possible
Pressure should be decreased distal to proximal
Pressure should be evenly distributed
Residual limb should be totally enclosed
No folds or wrinkles in wrap
90-degree turns, when possible
Pressure should be increased distal to proximal
Pressure should be increased medial to lateral
A guiding principle in the management of pain is that prevention is more effective than reduction.
What percentage of amputees experience phantom sensations or pain?
50%
20%
85%
95%
The duration of phantom limb sensation is a significant predictor of phantom pain intensity.
According to our lesson notes, which of the following are true regarding phantom pain/sensation?
85% of all amputees experience phantom sensations and pain
33% of employed amputees reported phantom pain interferes with work
82% stated that phantom pain interfered with sleep
Typically, back pain is more bothersome than phantom pain
Synonymous with residual limb pain
Phantom pain is more likely to interfere with work than with sleep.
Phantom sensation can take the form of a feeling of the limb moving, without willful control.
50% stated that phantom pain interferes with sleep
25% of all amputees experience phantom sensations and pain
Phantom pain, if present, always interferes with work.
Which of the following are examples of Kinesthetic Sensation (Phantom Sensation)?
Posture
Length
Volume
Willed movements
Spontaneous Movements
Associated Movements
Touch
Pressure
Temperature
Which of the following are examples of Kinetic Sensation (Phantom Sensation)?
Which of the following are examples of Extroceptive Sensation (Phantom Sensation)?
Which of the following stimuli are likely to PROVOKE pain?
Emotional stress
Exposure to cold
Local irritants to the stump
Auriculotherapy
prosthetic ambulation
Stroking the stump
Distraction
Which of the following stimuli are likely to RELIEVE pain?
According to a study by Jensen, Krebs, and Nielson (1985), stump pain is rather common shortly after amputation, but generally disappears over the course of the next two-years.
According to a study by Jensen, Krebs, and Nielson (1985), stump pain is rather common shortly after amputation, but generally disappears within one year.
Phantom Sensation may take the form of a feeling that insects are crawling all over the skin of the missing limb.
A feeling of coldness in the missing limb is a type of phantom sensation, but a feeling of burning in the missing limb is a type of phantom pain.
According to some study vaguely cited in our lesson notes, what percentage of amputees benefit from pain management treatment?
7%
27%
57%
77%
97%
Analgesics may be effective in the treatment of residual limb pain, but, as the limb doesn't actually exist, they are not effective for treating phantom pain.
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