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Burns & Prostheses

per NBCOT Study Guide, 6th ed. pgs 152-156

QuestionAnswer
Transhumeral Prostheses - body powered -- intervention Manually guide patient through motions. Elbow unit locked in 90 degrees flexion, teach TD control first.
Transhumeral Prostheses - body powered -- movement Humeral flexion with scapular abduction (protraction) on side of amputation; bilateral scapular abduction for midline use of TD or when strength is limited
Wrist unit prostheses -- body powered -- movement Rotate TD to supination (fingers of hook up), midposition (fingers toward midline), or pronation (fingers down). For unilateral amputation, patient uses sound hand to rotate TD.
Wrist unit prostheses -- body powered -- intervention Have patient analyze the task and determine the most efficient approach for grasp, avoiding excessive or awkward movements -- TD in midposition for carrying a tray, in pronation for grasping small box from table
Elbow unit prostheses -- body powered -- movement Depress arm while extending and abducting humerus to lock or unlock elbow mechanism. Practice flexing and locking elbow in several planes.
Elbow unit prostheses -- body powered -- intervention Manually guide patient through elbow motions -- begin with elbow unlocked. Patient listens for click as lock activates. Have patient exaggerate mvmts. Use a mirror.
1st Degree Burn - superficial Epidermis only -- min pain and edema, no blisters -- healing time is 3-7 days
2nd Degree Burn -- superficial partial thickness Epidermis & upper portion of dermis (e.g. sunburn) -- red, blistering, and wet -- painful, no grafting needed -- heals 7-21 days
2nd Degree Burn -- deep partial thickness Epidermis & deep portion of dermis, hair follicles, sweat glands -- red, white, & elastic -- sensation may be impaired -- potential to convert to full thickness burn due to infection -- heals 21-35 days
3rd Degree Burn -- full thickness Epidermis & dermis, hair follicles, sweat glands, & nerve endings -- white, waxy, leathery, and non-elastic -- sensation is absent, requires skin graft -- hypertrophic scar -- healing can take months
4th Degree Burn Dermis, Epidermis, fat, muscle, & bone -- electrical burn, destruction of nerve along pathway
Head -- Rule of 9'Assessing Burn Wound Size 9%
Arm -- Rule of 9'Assessing Burn Wound Size 9%
Trunk -- Rule of 9'Assessing Burn Wound Size 36%
Leg -- Rule of 9'Assessing Burn Wound Size 18%
Groin -- Rule of 9'Assessing Burn Wound Size 1%
Resting Hand Splint -- wrist 20-30 deg. ext
Resting Hand Splint -- MCP joints 50-70 deg. flex
Resting Hand Splint -- IP joints full ext
Resting Hand Splint -- thumb abd & ext
Hypertrophic Scar Most common w/ deep 2nd & 3rd degree burns -- 1-2 years to mature -- compression garments should be worn 24 hours daily, applied when wound is healed, worn until scar matures
Forequarter amputation loss of clavicle, scapula, and entire UE
Shoulder disarticulation loss of entire UE
Above Elbow (long or short) amputation above the elbow at any level of the upper arm
Elbow disarticulation amputation of UE distal to the elbow joint
Below-elbow (long or short) amputation belwo the elbow at any level of the forearm
Wrist disarticulation amputation distal to the wrist joint, loss of entire hand
Finger amputation ampuation of digit at any level
Hemipelvectomy amputation of half of pelvis and entire LE
Hip disarticulation amputation at hip joint, loss of entire LE
Above knee OR Transfemoral amputation above knee at any level on thigh
Knee disarticulation amputation at the knee joint
Below knee amputation OR Transtibial amputation below knee at any level of the calf (most common LE amputation)
Complete tarsal amputation at the ankle
Partial tarsal amputation of metatarsals and phalanges
Complete phalanges amputation of toes
Created by: msmaus