Prosthetics and Orthotics Practice Questions

Q: Taylor's Brace is used for which of the following?

Dorsolumbar immobilization. **Explanation:** **Taylor’s Brace** is a high-yield spinal orthosis in orthopaedics. It is a **thoraco-lumbo-sacral orthosis (TLSO)** designed specifically for **dorsolumbar immobilization**. The brace consists of two vertical posterior bars (paraspinal bars) and a pelvic band. It works on the principle of **three-point pressure**, providing hyperextension to the spine. By limiting flexion and rotation of the thoracolumbar junction, it stabilizes the spine, making it the gold standard for conditions like **Pott’s disease (Spinal TB)** and stable compression fractures of the lower thoracic or upper lumbar vertebrae. **Analysis of Options:** * **A. Cervical immobilization:** This requires a cervical collar (e.g., Philadelphia collar) or a Halo-vest. Taylor’s brace does not extend high enough to stabilize the neck. * **C. Scoliosis:** While some TLSOs are used for scoliosis, the specific brace of choice is usually the **Milwaukee brace** (for high curves) or the **Boston brace** (for lower curves). Taylor’s brace is for immobilization, not for corrective lateral forces. * **D. Fracture femur:** Femur fractures are managed with traction, intramedullary nails, or plates; orthotic management involves a Thomas splint or a Knee-Ankle-Foot Orthosis (KAFO), not a spinal brace. **Clinical Pearls for NEET-PG:** * **Ashman’s/Knight’s Brace:** Used for Lumbo-sacral immobilization (LSO). * **Milwaukee Brace:** A CTLSO used for Scoliosis with an apex above T8. * **Somersault/SOMI Brace:** Used for cervical spine injuries (C4-C5 level). * **Key Component:** Taylor’s brace specifically restricts **flexion and extension** of the dorsolumbar spine.

Q: Which of the following is NOT true regarding the SACH Foot?

It facilitates easy squatting.. **Explanation:** The **SACH (Solid Ankle Cushion Heel) Foot** is the most commonly used non-articulated prosthetic foot. The correct answer is **Option C** because the SACH foot is rigid and lacks a functional ankle joint, which makes **squatting very difficult** for the user. In the Indian context, where squatting is culturally significant, specialized modifications or different prostheses (like the Jaipur Foot) are preferred. **Analysis of Options:** * **A. It has a solid ankle cushion heel:** This is **true**. The SACH foot consists of a rigid internal wooden or plastic keel surrounded by a molded foam rubber shell. The "cushion heel" compresses at heel strike to simulate plantarflexion. * **B. It is a type of prosthesis:** This is **true**. It is a distal component of a lower limb prosthesis used for transtibial (below-knee) and transfemoral (above-knee) amputees. * **D. It does not look like a normal foot:** This is **true**. While it is shaped like a foot, it is a static, cosmetic block. It lacks the realistic texture, toe movements, and flexibility of a natural foot or more advanced lifelike prosthetics. **High-Yield Clinical Pearls for NEET-PG:** * **Mechanism:** It simulates "pseudo-plantarflexion" through heel compression during the early stance phase. * **Indication:** Best for elderly patients or those with low activity levels due to its high stability and low maintenance. * **Contraindication:** Not ideal for uneven terrain or activities requiring squatting/pivoting. * **Comparison:** Unlike the SACH foot, the **Jaipur Foot** allows for squatting and cross-legged sitting, making it more suitable for the Indian lifestyle.

Q: Who invented the Jaipur foot?

P. K. Sethi. The **Jaipur Foot** is a world-renowned prosthetic limb specifically designed to meet the socio-cultural and geographical needs of patients in developing countries. ### **Explanation of Options** * **A. P. K. Sethi (Correct):** Dr. Pramod Karan Sethi, an orthopaedic surgeon, co-developed the Jaipur Foot in 1968 along with **Master Ram Chander Sharma** (a traditional craftsman). Dr. Sethi was awarded the Magsaysay Award and the Padma Shri for this innovation. The design was revolutionary because it allowed for squatting, sitting cross-legged, and walking on uneven terrain—activities difficult with the Western "SACH" (Solid Ankle Cushion Heel) foot. * **B. S. K. Verma:** Dr. S. K. Verma was a prominent figure in Physical Medicine and Rehabilitation (PMR) in India, but he was not the inventor of the Jaipur Foot. * **C. B. L. Sehgal:** Not associated with the primary invention or development of the Jaipur Foot. * **D. H. R. Gupta:** While there are many contributors to Indian orthopaedics, Dr. Gupta is not credited with the design of this specific prosthesis. ### **High-Yield Clinical Pearls for NEET-PG** * **Material:** The Jaipur Foot is made of **rubber** (outer), **wood** (inner), and **polyurethane**. It is waterproof and does not require shoes. * **Key Feature:** Unlike the SACH foot, the Jaipur Foot allows for **multi-axial mobility** (dorsiflexion, plantarflexion, inversion, and eversion), making it ideal for rural Indian conditions. * **Organization:** It is widely distributed by the NGO **Bhagwan Mahaveer Viklang Sahayata Samiti (BMVSS)**. * **Comparison:** While the **SACH Foot** is the most common prosthetic foot globally, the **Jaipur Foot** is the gold standard for barefoot walking and floor-level activities.

Q: Which of the following statements is FALSE about the SACH Foot?

Allows easy movement at the ankle. **Explanation:** The **SACH Foot (Solid Ankle Cushion Heel)** is the most commonly used non-articulated prosthetic foot. The core concept behind its design is that it provides **pseudo-motion** rather than true anatomical movement. 1. **Why Option A is False (Correct Answer):** The SACH foot is a **non-articulated** prosthesis, meaning it has no mechanical ankle joint. It does **not** allow actual movement (dorsiflexion or plantarflexion) at the ankle. Instead, the soft "cushion heel" compresses at heel strike, simulating plantarflexion to allow the forefoot to reach the ground. Because there is no actual joint, the statement that it "allows easy movement at the ankle" is incorrect. 2. **Why Option B is True:** Since the ankle is a solid internal wooden or plastic keel, there is no mechanism for mediolateral tilt. Therefore, **inversion and eversion are not possible**, making it unsuitable for uneven terrain. 3. **Why Option C is True:** SACH stands for **Solid Ankle Cushion Heel**, which accurately describes its components: a rigid internal keel (Solid Ankle) and a compressible foam heel (Cushion Heel). 4. **Why Option D is True:** The SACH foot is designed to be worn with a shoe (usually with a 3/4 inch heel). Without the shoe, the prosthesis loses its alignment and stability, making **barefoot walking impossible** or highly unstable. **High-Yield Clinical Pearls for NEET-PG:** * **Mechanism:** It absorbs shock at heel strike through heel compression. * **Indication:** Ideal for sedentary patients, children, and those requiring a durable, low-maintenance, and inexpensive prosthesis. * **Contraindication:** Not recommended for active individuals or those walking on uneven surfaces (due to lack of inversion/eversion). * **Comparison:** Unlike the **Madras Foot**, which allows barefoot walking and squatting, the SACH foot is restricted to shod (shoed) walking.

Q: Which prosthesis is shown below in the X-ray?

Austin Moore's prosthesis. ***Austin Moore's prosthesis*** - The image clearly shows a unipolar femoral head prosthesis with a **fenestrated stem** for bony ingrowth, which is characteristic of the Austin Moore design. - This prosthesis is typically used in **hemiarthroplasty** for femoral neck fractures or avascular necrosis, where the acetabulum is preserved. *Thompson prosthesis* - While also a unipolar hemiarthroplasty, the Thompson prosthesis has a **collar** and a **solid stem** without fenestrations, which differentiates it from the one pictured. - It is also primarily used in hip hemiarthroplasty. *Articular resurfacing* - Articular resurfacing involves capping both the femoral head and the acetabulum with metallic implants, preserving more bone than traditional hip replacement. - The X-ray shows a stem extending into the femoral shaft, which is not consistent with **acetabular resurfacing**. *Birmingham hip* - The Birmingham hip is a type of **hip resurfacing arthroplasty**, characterized by a metal cap on the femoral head and a metal cup in the acetabulum. - The prosthesis shown has a **femoral stem**, thus it is not a resurfacing implant like the Birmingham hip.

Q: The shown apparatus is used for

Patella tendon bearing brace. ***Patella tendon bearing brace*** - This orthotic device is designed to **transfer weight-bearing load through the patella tendon**, reducing stress on the lower extremity during ambulation. - It features a **molded cuff** that fits snugly below the patella and distributes weight through the **patellar tendon bearing area**, commonly used in **prosthetic applications** and **below-knee amputees**. *Ankle knee stabilizer* - This device provides **combined support to both ankle and knee joints** simultaneously, typically used for **multi-joint injuries** or instability. - It features **dual bracing systems** with straps and supports extending from ankle to knee, unlike the focused patellar tendon bearing design. *Thomas splint* - A **rigid metal-framed splint** used primarily for **femur fracture stabilization** and maintaining **skeletal traction** in emergency situations. - It consists of a **ring that fits around the upper thigh** with extending metal bars, designed for **fracture immobilization** rather than weight distribution. *Knee brace* - A general **knee joint support device** used for **ligament injuries**, **post-surgical recovery**, or **osteoarthritis management**. - Available in various forms (**sleeve, hinged, or wraparound designs**) but lacks the specific **weight-bearing transfer mechanism** of a patella tendon bearing brace.

Q: All the following are advantages of the Jaipur foot over the conventional prosthetic foot except

Jaipur foot is electrically operated. Jaipur foot is electrically operated - The Jaipur foot is a **passive prosthetic device** that relies on mechanical design and material properties for function, not electrical power. - Its advantages stem from its **biomechanical design** and **material composition**, allowing for natural movement and cultural suitability. *Appearance of the Jaipur foot is that of normal foot* - This is an **advantage** of the Jaipur foot, as its cosmetic design closely mimics a natural foot, enhancing body image and social acceptance. - Its **cosmetic cover** and lifelike appearance help amputees integrate into daily life without obvious visual differences. *It is suitable for bare foot walking* - This is a significant **advantage** in regions where barefoot walking is common, as its design is robust enough to withstand uneven terrain and provides good traction. - The materials used make it **durable** and adaptable to diverse walking conditions, including unpaved surfaces. *Allows movement at fore foot and midfoot* - This feature is an **advantage** as it provides great flexibility and natural gait pattern, allowing for activities like squatting, sitting cross-legged, and walking on uneven surfaces. - The multi-axial movement at the **ankle and subtalar joint** mimics the natural foot's adaptability, improving stability and comfort.

Q: Shortest functional level of trans tibial amputation is:

Just distal to tibial tuberosity. **Just distal to tibial tuberosity** - This level allows for a **short residual limb** but still provides sufficient leverage for effective prosthetic control and weight-bearing. - Amputations at this level generally preserve the **knee joint**, which is crucial for maximizing function and ambulation. *Just proximal to tibial tuberosity* - An amputation **proximal to the tibial tuberosity** would result in a **knee disarticulation** or above-knee amputation, leading to a much greater functional deficit. - This level means losing the **knee joint**, which is not considered a trans-tibial amputation. *15 cm distal to joint line* - This level of amputation would result in a **longer residual limb** than necessary, which can be beneficial, but it's not the *shortest functional* level. - While functional, a longer limb might sometimes present challenges with prosthetic fit or bulk in certain situations. *10 cm distal to joint line* - Similar to 15 cm distal, this length is considered a **standard or optimal length** for trans-tibial amputations, resulting in good function. - However, it is not the **shortest possible functional level** while still retaining an effective limb for prosthetic use.

Q: All of the following statements about SACH feet are true, except:

Wooden keel absorbs the impact of heel strike. ***Wooden keel absorbs the impact of heel strike*** - This statement is incorrect because SACH feet do not have a **wooden keel** for shock absorption. - Instead, the **cushioned heel** itself absorbs the impact of heel strike. *May wear out with time* - **SACH feet**, like all prosthetic components, are subject to **wear and tear** from repeated use and environmental factors. - The materials used, such as rubber and foam, can degrade over time, necessitating replacement. *'SACH' stands for 'Solid Ankle Cushioned Heel'* - The acronym **SACH** accurately describes the design of this prosthetic foot. - It features a **solid ankle** component and a **cushioned heel** to provide shock absorption during gait. *Forms the base of a lower limb prosthesis* - The **SACH foot** is a fundamental component of many lower limb prostheses, regardless of the amputation level. - It provides the essential interface with the ground, enabling basic ambulation and stability for the user.

Question 1

The Milwaukee brace is used in the treatment of which of the following conditions?

Accepted Answer

Scoliosis

Answer

Kyphosis

Answer

Cubitus varus

Answer

Genu varum

Question 2

Taylor's Brace is used for which of the following?

Accepted Answer

Dorsolumbar immobilization

Answer

Cervical immobilization

Answer

Scoliosis

Answer

Fracture femur

Question 3

Which of the following is NOT true regarding the SACH Foot?

Accepted Answer

It facilitates easy squatting.

Answer

It has a solid ankle cushion heel.

Answer

It is a type of prosthesis.

Answer

It does not look like a normal foot.

Question 4

Who invented the Jaipur foot?

Accepted Answer

P. K. Sethi

Answer

S. K. Verma

Answer

B. L. Sehgal

Answer

H. R. Gupta

Question 5

Which of the following statements is FALSE about the SACH Foot?

Accepted Answer

Allows easy movement at the ankle

Answer

No inversion and eversion

Answer

Solid ankle cushion heel

Answer

Base foot walking is not possible

Question 6

Which prosthesis is shown below in the X-ray?

Accepted Answer

Austin Moore's prosthesis

Answer

Thompson prosthesis

Answer

Articular resurfacing

Answer

Birmingham hip

Question 7

The shown apparatus is used for

Accepted Answer

Patella tendon bearing brace

Answer

Ankle knee stabilizer

Answer

Thomas splint

Answer

Knee brace

Question 8

All the following are advantages of the Jaipur foot over the conventional prosthetic foot except

Accepted Answer

Jaipur foot is electrically operated

Answer

Appearance of the Jaipur foot is that of normal foot

Answer

It is suitable for bare foot walking

Answer

Allows movement at fore foot and midfoot

Question 9

Shortest functional level of trans tibial amputation is:

Accepted Answer

Just distal to tibial tuberosity

Answer

Just proximal to tibial tuberosity

Answer

15 cm distal to joint line

Answer

10 cm distal to joint line

Question 10

All of the following statements about SACH feet are true, except:

Accepted Answer

Wooden keel absorbs the impact of heel strike

Answer

May wear out with time

Answer

'SACH' stands for 'Solid Ankle Cushioned Heel'

Answer

Forms the base of a lower limb prosthesis

Prosthetics and Orthotics — MCQs

Prosthetics and Orthotics — MCQs

On this page

Practice by Chapter

Want unlimited practice?