CPO Patient Evaluation 3 — Questions and Answers
Question 1: When documenting residual limb shape during initial prosthetic evaluation, which shape is considered ideal for prosthetic fitting?
- Bulbous or redundant tissue distally
- Conical or cylindrical with firm distal tissue (Correct answer)
- Bony prominences with minimal soft tissue coverage
- Pendulous shape with excess skin folds
Correct answer: Conical or cylindrical with firm distal tissue
A cylindrical or conical residual limb with well-healed, firm distal tissue provides optimal socket fit and load transfer.
Question 2: Which K-level classification is assigned to a patient who has the ability to ambulate with variable cadence and has the ability to traverse environmental barriers?
- K1
- K2
- K3 (Correct answer)
- K4
Correct answer: K3
K3 describes a community ambulator who can ambulate with variable cadence and traverse most environmental barriers.
Question 3: A practitioner evaluates a patient with C6 spinal cord injury for upper extremity orthoses. Which wrist-hand orthosis function would be most appropriate to restore?
- Active finger extension
- Tenodesis grasp utilizing wrist extension (Correct answer)
- Intrinsic-plus positioning for edema control only
- Passive wrist flexion
Correct answer: Tenodesis grasp utilizing wrist extension
C6 SCI patients retain wrist extension (radial wrist extensors), which can be harnessed through tenodesis to enable a functional grasp.
Question 4: During evaluation of a patient with a partial foot amputation, which factor most significantly influences the choice of footwear modification versus custom orthosis?
- Patient's age
- Level of amputation and remaining lever arm length (Correct answer)
- Time since amputation
- Contralateral limb condition
Correct answer: Level of amputation and remaining lever arm length
The level of amputation determines the remaining plantar lever arm, which dictates whether footwear modification or a prosthetic device is needed for propulsion.
Question 5: When assessing a patient's skin for suitability for a prosthetic socket, which finding would most urgently delay prosthetic fitting?
- Mild dry skin
- Well-healed surgical scar
- Open wound or active skin breakdown (Correct answer)
- Hyperpigmentation from previous socket wear
Correct answer: Open wound or active skin breakdown
Open wounds or active skin breakdown contraindicate prosthetic fitting until healing is complete to prevent infection and further tissue damage.
Question 6: A practitioner is completing an initial evaluation for a patient who had a transtibial amputation 3 weeks ago. The residual limb is still edematous. What is the most appropriate next step?
- Fit the patient with a definitive prosthesis immediately
- Recommend rigid removable dressing or shrinker sock to shape the limb (Correct answer)
- Delay all intervention for 6 months
- Recommend bilateral forearm crutches as the permanent mobility solution
Correct answer: Recommend rigid removable dressing or shrinker sock to shape the limb
Rigid removable dressings or shrinker socks are used in the post-acute phase to reduce edema and shape the residual limb for eventual prosthetic fitting.
Question 7: Which information from a patient's medical history is most critical for planning an orthosis for a patient with rheumatoid arthritis?
- Family history of autoimmune conditions
- Location of joint involvement, deformity pattern, and current disease activity (Correct answer)
- Patient's employment history
- Dietary habits and supplement use
Correct answer: Location of joint involvement, deformity pattern, and current disease activity
Joint involvement locations, deformity patterns, and disease activity determine which joints need support and the rigidity required of the orthosis.
CPO Patient Evaluation 3
When documenting residual limb shape during initial prosthetic evaluation, which shape is considered ideal for prosthetic fitting?