Term
| What is the goal of a functional orthotic device? |
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Definition
| Control foot motion and position during locomotion. Re-establish normal fx within physical limits of the patient. |
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Term
| T/F You give the same orthotic to everyone? |
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Definition
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Term
| In what position do you try to capture the foot? |
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Definition
| Midstance, at the end when the STJ is neutral and MTJ is locked, fully pronated. |
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Term
| What are you NOT trying to capture in the foot when casting? |
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Definition
| The fx of the foot with out the orthotic control. |
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Term
| When casting the AJ should be plantarflexed? |
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Definition
| FALSE, it should be neither plantarflexed or dorsiflexed. |
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Term
| What does maximally pronated MTJ mean in the LMTJ and OMTJ? |
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Definition
| Maximally dorsiflexed and abducted MTJ and Maximally everted LMTJ. |
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Term
| What does a fx orthotic device do? |
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Definition
| Controls RF or STJ around neutral. Maximal pronation of MTJ. |
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Term
| T/F Patient must be functional or Propulsive for a fx orthotic device? |
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Definition
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Term
| What is the position of patient during the Suspension Technique of casting? |
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Definition
| Supine or Seated. Prone who cannot relax. |
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Term
| What do you grab in the Suspension Tech? |
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Definition
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Term
| T/F The patient needs to relax and not "help you"? |
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Definition
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Term
| What muscle do patients usually fire to "help you"? |
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Definition
| Tibialis Anterior (This causes supination of the MTJ, may also dorsiflex the hallux. Plantarflexes the first ray.) |
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Term
| What should you do prior to casting? |
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Definition
| Loot at the foot. Not abnormaities that will appear in the cast. (Necessary to later identify cast as a good cast or a bad cast) |
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Term
| T/F Water in casting should be Cold? |
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Definition
| FALSE, it should be neither hot (fast setting) or cold (slow plaster) |
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Term
| How long are the Plaster Spints? |
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Definition
| 5" x 30" commonly used (2 per foot, splint is folded in half, thus 15") |
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Term
| Where is the 1st splint positioned? |
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Definition
| Around the heel while the foot hanges in a relaxed attitude. Just inferior to the malleoli. Lateral side over the plantar surface. Medial side over the plantar over the lateral side. |
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Term
| Where is the 2nd splint positioned? |
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Definition
| Same as 1st, but remove a little more water first and place it around the anterior portion of the foot. |
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Term
| T/F Any excess should be pushed under the toes so as not to deform the met heads impression in the cast. |
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Definition
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Term
| T/F Some plaster will be on the dorsum of the 3, 4 and 5th met heads? |
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Definition
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Term
| T/F After splinting, you need to dorsiflex the FF to resitance while applying anterior splint? |
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Definition
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Term
| T/F After splinting, you need to plantarflex the medial and lateral column while smoothing the laterar or medial side? |
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Definition
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Term
| Where should the exess plaster from the 2 splints go? |
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Definition
| Posteriorly behind the heel. Anteriorly under the toes. |
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Term
| Where do you specifically never put plaster? |
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Definition
| Dorsum of the 3rd, 4th, 5th met head, makes the cast difficult to remove. |
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Term
| Where should you Avoid placing any finger pressure? |
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Definition
| Other toes but the 4ht and 5th. |
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Term
| How should you rotate you had to plantarflex the 4th and 5th digits? |
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Definition
| Away from the dorsum of the foot (look at you watch) |
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Term
| T/F Loading the lateral column dorsiflexes the ankle. Slight plantarlexed AJ is okay. If you attempt to dorsiflex ankle to 90 degrees you will pronate the STJ? |
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Definition
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Term
| What is the Thenar Eminence? |
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Definition
| Between the thumb and the Index Finger. |
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Term
| T/F In The FF will be everted after loading, in a FF Varus you may need to evert (step into the foot) to evert a little further? |
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Definition
| FALSE, seen in FF Valgus. |
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Term
| What is the final loading of the lateral coumn? |
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Definition
| Applying a lifting force to the foot. This will dorsiflex the ankle. |
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Term
| What always needs to be in the neutral position though out the whole dang thing? |
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Definition
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Term
| Occasionally you may need to do what to the FF because loading the lateral column did not accomplish this? |
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Definition
| Abduct the FF, Root Technique (but do not pronate) |
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Term
| How do you know if abduction is needed? |
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Definition
| Grasp the heel with you free hand and abduct the FF on the EF with the STJ in neutral. If there is abductory motion available then it is needed. |
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Term
| What is Talar Congruency? |
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Definition
| Method of assuring that the STJ is neutral, by placing fingers anterior to the malleoli. |
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Term
| How do you assure that the STJ is in neutral? |
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Definition
| 2nd Met Shaft is in line with Anterior Tibial Crest |
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Term
| What to ensure before you remove the cast? |
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Definition
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Term
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Definition
| Pinch skin of foot on the dorsum so that plaster pulls away from the skin. Grasp heel at posterior surface and guid the cast down and away from the heel. |
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Term
| How do you evaluate if the Cast is a good one? |
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Definition
| Bisect the posterior surface of the heel. |
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Term
| If the patient had a 5 degree FF Varus, then the heel of the cast should have what? |
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Definition
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Term
| What type of a cast have we made? |
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Definition
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Term
| Should the Plantar surface of the cast at the area of the MTJ be convex or concave? |
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Definition
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Term
| Is the Lateral or Medial convexity sharper? |
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Definition
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Term
| T/F Supination makes the lateral 1/2 of the convexity ever sharper and more lateral, flattening out the medial convexity? |
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Definition
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Term
| T/F The lateral border of the foot cast should be rectus? |
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Definition
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Term
| Where should the thumb print be? |
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Definition
| Sulcus of the toes. Parallel to the plantar plane of the lesser met heads. Only contact 4th and 5th toes. Distal aspect of the thumb should not touch cast. |
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Term
| What should not be present on the lateral side of the cast? |
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Definition
| Imprint from the thenar eminece. |
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Term
| The thumb should only contact what? |
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Definition
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Term
| What should the lateral arch look like? |
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Definition
| Should have a smooth plantar concavity when viewed from the lateral side on a flat surface witht heel vertical. Best to view cast a eye level. |
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Term
| T/F You should compare the Left and Right negative casts? |
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Definition
| TRUE, (though if there is an abnormal unilateral pathology they should be different) |
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Term
| What does a lateral C-shaped cast mean? |
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Definition
| Supinated the foot too much. |
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Term
| What are the signs of over pronation in the cast? |
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Definition
| Concavity below the lateral malleolus looking at the cast on the frontal plane. Prominent bulge of the talonavicular articulation on the medial side of the cast. Flattened plantar surface of the heel of the crest. Decreased height of the lateral archat the CCJ. Abducted FF on the RF |
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Term
| What do you want to make sure about the 4th and 5th toes in the cast? |
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Definition
| Examin in the Sagttal plane. They should be straight or parallel to the ground. |
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Term
| T/F It is common to have plantarflexed toes? |
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Definition
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Term
| What are some reasons for dorsiflexed toes? |
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Definition
| Gripping the toes too far distally. Failure to rotate palm away from the dorsum. Attempt to dorsiflex the foot beyond resistance. Attempt to ever the FF beyond its fully pronated posistion causing heel eversion. |
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Term
| What is the main reason people fail to get a successful cast? |
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Definition
| Failure to rotate palm away from the dorsum of the foot (so you can see your watch) |
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Term
| What will plantarflexed digits cause (rare)? |
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Definition
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Term
| What are some advantages and disadvantages to Suspension Technique, Supine? |
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Definition
| Good locking of MTJ. Elongates the lateral ST which occurs in gait. Easy palpate of neutral STJ. Takes practice Difficult for patients to relax. |
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Term
| What are some advantages and disadvantages to Suspension Technique, Prone? |
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Definition
| Can assess FF to RF positon. Easier for the patient to relax. Does not elongate lateral ST as well. More difficult to maximally pronate and lock the MTJ. |
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Term
| What is the Semi weight bearing casting? |
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Definition
| Patient seated. Place bio foam on ground. Hip flex 90 degrees and ankle flex 90 degrees. |
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Term
| What is a Semi weight bearing casting for? |
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Definition
| Great for Accomadative Orthotic |
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Term
| What are some advantages and disadvantages for Semi weight bearing casting? |
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Definition
| Easier to master. OMTJ locked by GRF. Will get lateral expansion of ST. Easy to supinate LMTJ, and pronate STJ |
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Term
| What is the Burns Technique? |
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Definition
| Take the thumb and load 4th and 5th met, by applying plantar to dorsal force on met met head, instead of bases of proximal phalanges. |
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Term
| What is the Advantage of the Burns Technique? |
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Definition
| Avoids pronation of the STJ. |
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