Term
| Etiologies for LE Amputation (5) |
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Definition
Vascular Insuffiency
Complications from diabetes
INfection
Trauma (MVA, War Vets)
Malignancy |
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Term
| 75% of LE Amputations are in what age range |
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Definition
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Term
| Etiology most implicated in 80% of LE amputations |
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Definition
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Term
| ischemic disease is implicated in 80% of LE amputations and has a 50% co-morbiidty with this disease |
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Definition
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Term
| 5 year survival rate for a diabetic with an ulceration |
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Definition
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Term
| Likelihood of death for a diabetic pt with a LE amputation within 5 years |
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Definition
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Term
| Likelihood of death for a diabetic pt with a LE amputation within 30 days |
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Definition
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Term
| Pt's with PVD at risk for amputation usually have evidence of what concurrent disesae |
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Definition
| Concurrent cardiac and cerebral atherosclerotic disease |
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Term
| Cerebral and coronary aa disease manifest their effects earlier in what pt population |
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Definition
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Term
| Ischemic rest pain presents at what site |
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Definition
| metatarsal head level/plantar aspect of foot |
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Term
| Ischemic rest pain may be temporarily relieved by what |
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Definition
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Term
| Ischemic rest pain may be exacerbated by what |
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Definition
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Term
| Pt's with ischemic rest pain benefit from what procedure |
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Definition
| arterial reconstruction/bypass |
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Term
| Level of amputation is determined by what 3 factors |
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Definition
ability to heal successfully at the incision based on adequate circulation
removal of all nonviable tissue/structures especially in the presence of infection
achieve long term functional residual limb/restore pt to some level of activity w/o pain |
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Term
| Most commonly performed levels of amputation (major categories) [6] |
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Definition
hip disarticulation
transfemoral (above knee)
knee disarticulation)
Transtibial
Ankle Disarticulation (Syme's)
Partial foot (pedal) |
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Term
| Most commonly performed levels of amputation: Transfemoral, Transtibial (3) |
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Definition
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Term
| Partial foot dissections subdivisions (5) |
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Definition
transtarsal
tarsometatarsal
Transmetarsal
Metarsal ray resection
Hallux or digit (phalangeal) |
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Term
| Which amputation level will usually not have a prosthetic |
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Definition
| anything amputated below the ankle |
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Term
| Which disarticulation amputations are no longer performed or performed less often |
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Definition
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Term
| Chopart's, Pirogoff's, Boyd's amputation aka |
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Definition
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Term
| Lisfranc's amputation aka |
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Definition
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Term
| 4 types of flaps for transtibial amputation |
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Definition
long lateral flap
equal anterior/posterior flaps
equal sagittal flaps
long posterior flap |
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Term
| Transtibial Amputation: Where is the suture line on a long lateral flap |
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Definition
| distal medial aspect of the residual limb |
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Term
| Transtibial Amputation: suture line for equal anterior and posterior flaps |
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Definition
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Term
| Transtibial Amputation: suture line for equal sagittal flaps |
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Definition
| sagittal plane, front to back across the distal residual limb |
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Term
| Transtibial Amputation: suture line for long posterior flap |
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Definition
| crosses the anterior surface of the residual limb, distal to the end of the tibia |
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Term
| Post op (amputation) complications: (6) |
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Definition
phantom limb sensation
death
pulmonary problems/pneumonia
infection of residual limb
non healing residual limb
pulmonary embolus |
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Term
| Potential Complications: Early Phase (5) |
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Definition
Infection
Delayed Wound Healing
Painful residual limb
Phantom sensations
Pressure sores |
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Term
| Potential Complications: Later Phase (3) |
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Definition
Phantom Pain
Flexion Contractures
Gangrene |
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Term
| 4 factors that influence optimal rehab for amputees |
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Definition
Level of amputation
Skill of the Surgical Team
Appropriate Post-op care
Design/fitting/training of prosthesis |
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Term
| 4 factors that influence optimal rehab for amputees: Level of amputation refers to what |
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Definition
| must be based on the clinical/technical info about wound healing/external medical/infective factors |
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Term
| 4 factors that influence optimal rehab for amputees: skill of the surgical team refers to what |
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Definition
| shaping optimal limb/optimal healing |
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Term
| 4 factors that influence optimal rehab for amputees: appropriate post op care refers to what |
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Definition
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Term
| 4 factors that influence optimal rehab for amputees: design/fitting/training of prosthesis refers to what |
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Definition
| access to comprehensive prosthetic traning |
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Term
| 2 primary goals immediate post op period |
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Definition
Ensuring optimal wound healing
Early preparation of the limb for prosthetic fitting |
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Term
| 2 primary goals immediate post op period: Ensuring optimal wound healing refers to what |
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Definition
Petroleum gauze over suture line/soft dressing/ace wrap
Posterior split to control knee flexion |
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Term
| 2 primary goals immediate post op period: Early preparation of the limb for prosthetic fitting |
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Definition
rigid dressing, inspection of suture line
removable rigid dressing
IPOP (immediate postoperatieve prosthesis) |
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Term
| Immediate Postoperative Prosthesis (IPOP) 3 steps |
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Definition
Application of padding/prep site for unit
Application of rigid dressing
Incorporate prosthetic system/attachment for pylon, foot |
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Term
| Measurement of above knee amputations |
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Definition
| Ischial tuberosity to end of bone/soft tissue |
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Term
| Measurement of below knee amputation |
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Definition
| tibial tuberosity to end of bone/soft tissue |
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Term
| How are circumferential measurements done on the residual limb |
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Definition
| every 4 cm from bony landmark |
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Term
| Shape that the residual limb can take (3) |
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Definition
| conical, cylindrical, bulbous |
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Term
| Skin condition descriptors for the residual limb (2) |
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Definition
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Term
| pain descriptors for residual limb (3) |
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Definition
intrinsic
extrinsic
phantom limb |
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Term
| Purpose of dressings for amputations (4) |
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Definition
protect from infections
contain or reduce edema
protect residual limb from trauma
provide attachment of prosthetic device to permit if early walking |
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Term
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Definition
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Term
| pros of soft dressings (2) |
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Definition
low cost
ease of inspection |
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Term
| cons of soft dressing (2) |
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Definition
poor control of edema
slippage |
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Term
| pros of semirigid dressings (2) |
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Definition
self suspending
better edema control |
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Term
| semirigid dressings cons (2) |
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Definition
hard to apply safely
harder to track wound |
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Term
| how often do semi rigid dressings need to be changed |
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Definition
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Term
| Indications for compression of the residual limb (6) |
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Definition
control edema
reduce adductor roll in transfemoral
shape residual limb
acclimatize to pressure
assist in prevention of contractures
desensitize residual limb |
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Term
| Principles of Compression Ace Wrapping (5) |
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Definition
Distal pressure exceeds proximal
Pressure applied at oblique turns
M-L aspects of end of limb should not be included in same turn
Re-wrap every 4 horus, do not exceed 24
avoid wrinkles, metal clips |
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Term
| compression shirnkers indicators (5) |
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Definition
alternative for ace wraps
indicated after sutures are removed and incisino site is closed
less slippage
increased pressure gradient over ace wrap
commonly used for transfemoral |
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Term
| Exercise/Functional Program should include what (5) components |
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Definition
Positinoing to avoid contractures
Desensitization activities
Strengthening Exercises
Cardiovascular Activities
Functional Mobility |
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Term
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Definition
skin care for residual limb
sound limb guidelines
care of prosthetic shrinkers, inserts, etc |
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Term
| Exercise/Functional Program should include what Strengthening Exercises (4) |
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Definition
LE isometrics-isotonics
UE strengthening (resistance, wc push ups)
PNF rhtyhmic stabilization, slow reversals
core stabilization of ex |
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Term
| Exercise/Functional Program functinoal mobility refers to what |
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Definition
bed mob
transfers
ambulation |
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