Question 1

Following early gait training,a patient with a transtibial prosthesis is instructed in skin inspection of the residual limb.On which of the following anatomical structures is it acceptable for the patient to observe some redness?

A)Medial flare of the tibia
B)Anterior-distal tibia
C)Distal fibula
D)Head of the fibula

A

Accepted Answer

The medial flare of the tibia is a weight-bearing area when using a transtibial prosthesis, so some redness in this area after prosthesis use is acceptable and expected due to pressure distribution.

Question 2

A patient with right transtibial amputation (3 months ago)and right hemiparesis (6 years ago)has weakness in the right quadriceps and diminished balance.Which of the following types of suspension is MOST appropriate?

A)Fork strap and waist belt
B)Supracondylar
C)Thigh corset with a manual knee lock
D)Distal attachment-pin locking

C

Accepted Answer

A thigh corset with a manual knee lock provides the most appropriate suspension for a patient with right transtibial amputation (3 months ago) and right hemiparesis (6 years ago) who has weakness in the right quadriceps and diminished balance. This type of suspension provides support and stability to the residual limb and helps to prevent hyperextension of the knee.

Question 3

Which of the following is the MOST effective strategy during gait training for gaining control of the prosthetic knee in a patient with a transfemoral prosthesis?&#10;A)Bending the trunk forward at initial contact to bring the center of gravity anterior to the knee joint&#10;B)Extending the residual limb against the posterior wall of the socket at initial contact&#10;C)Bending the trunk laterally over the prosthesis at midstance&#10;D)Flexing the residual limb against the anterior wall of the socket at initial contact

Accepted Answer

Extending the residual limb against the posterior wall of the socket at initial contact helps in controlling the prosthetic knee by creating a stable position and preventing the knee from buckling under the weight of the body during the initial contact phase of gait. This technique is effective in providing the necessary stability for the prosthetic knee during the stance phase of gait.

Question 4

A patient with a transfemoral prosthesis walks with a lateral trunk bend over the prosthetic limb during stance.Which of the following is the MOST likely cause of this deviation?&#10;A)Prosthesis too short&#10;B)Insufficient toe out of the prosthetic foot&#10;C)Medial socket wall too low&#10;D)Misalignment of the knee bolt in the horizontal plane

Accepted Answer

A lateral trunk bend over the prosthetic limb during stance phase is often caused by a prosthesis that is too short. This deviation occurs as the patient tries to lower their body to reach the ground with the shorter prosthetic limb.

Question 5

A patient with a transfemoral prosthesis walks with a whip at the end of the stance phase.Which of the following is the MOST likely cause of this deviation?&#10;A)Too stiff a heel cushion on the prosthetic foot&#10;B)Misalignment of the knee bolt in the horizontal plane&#10;C)Insufficient toe out of the prosthetic foot&#10;D)Not enough flexion built into the socket

Accepted Answer

Misalignment of the knee bolt in the horizontal plane can cause the prosthetic knee to whip outward at the end of the stance phase. This can happen due to an incorrect alignment of the knee joint or an improperly set knee bolt. The other options are less likely to cause this particular deviation.

Question 6

A patient with a hip disarticulation prosthesis is having difficulty with toe clearance during the swing phase of gait.Which of the following prosthetic changes is MOST effective for eliminating this gait deviation?

A)Increasing friction in the knee
B)Lengthening of the prosthesis
C)Tightening the extension aid in the knee
D)Shortening of the prosthesis

Accepted Answer

Shortening the prosthetic limb will increase the height of the prosthetic foot during swing phase, allowing for improved toe clearance. Increasing friction in the knee or tightening the extension aid may provide more stability during stance phase but will not directly address the issue of toe clearance. Lengthening the prosthesis would exacerbate the problem by requiring more energy to lift the entire limb, including the foot, during the swing phase.

Deck 31: Prosthetics