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Burns & Prostheses
per NBCOT Study Guide, 6th ed. pgs 152-156
| Question | Answer |
|---|---|
| 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 |