Prosthetics and Orthotics

Prosthetics and Orthotics Indian Medical PG Question 1: Match List-I with List-II and select the correct answer using the code given below the Lists:

• A. A→1 B→2 C→3 D→4
• B. A→4 B→3 C→2 D→1 (Correct Answer)
• C. A→3 B→4 C→1 D→2
• D. A→4 B→1 C→2 D→3

Prosthetics and Orthotics Explanation: **List Mapping:** - List-I: A = Pinard's maneuver, B = Lovset's maneuver, C = Mauriceau-Smellie-Veit maneuver, D = External cephalic version - List-II: 1 = Breech presentation at term, 2 = After-coming head, 3 = Extended arms, 4 = Extended legs ***A→4 B→3 C→2 D→1*** - This is the **correct matching** of each maneuver to its primary indication. - **Pinard's maneuver (A→4)** is used for delivery of **extended legs** in breech presentation by flexing the legs at the knee. - **Lovset's maneuver (B→3)** is used for delivery of **extended arms** in breech by rotating the fetus. - **Mauriceau-Smellie-Veit maneuver (C→2)** is used for controlled delivery of the **after-coming head** in breech. - **External cephalic version (D→1)** is performed to convert **breech presentation at term** to cephalic presentation. *A→1 B→2 C→3 D→4* - This incorrectly matches Pinard's maneuver with breech at term (should be a conversion procedure, not delivery technique). - Lovset's is incorrectly matched with after-coming head instead of extended arms. - Mauriceau-Smellie-Veit is incorrectly matched with extended arms instead of after-coming head. - External cephalic version is incorrectly matched with extended legs instead of breech at term. *A→3 B→4 C→1 D→2* - This incorrectly matches Pinard's with extended arms (Lovset's indication). - Lovset's is incorrectly matched with extended legs (Pinard's indication). - Mauriceau-Smellie-Veit is incorrectly matched with breech at term (ECV indication). - External cephalic version is incorrectly matched with after-coming head (Mauriceau-Smellie-Veit indication). *A→4 B→1 C→2 D→3* - While Pinard's maneuver (A→4) is correctly matched with extended legs, the other matches are incorrect. - Lovset's is incorrectly matched with breech at term instead of extended arms. - External cephalic version is incorrectly matched with extended arms instead of breech at term. - Only Mauriceau-Smellie-Veit (C→2) is correctly matched with after-coming head.

Prosthetics and Orthotics Indian Medical PG Question 2: The ideal synthetic material used for femoropopliteal bypass when autologous vein is unavailable is:

• A. Dacron
• B. Xenograft
• C. Saphenous vein
• D. PTFE (non-expanded)
• E. Cryopreserved vein graft
• F. ePTFE (Correct Answer)
• . Polyethylene terephthalate (PET)
• . Allograft

Prosthetics and Orthotics Explanation: ***ePTFE (Expanded Polytetrafluoroethylene)*** - **ePTFE** is the preferred synthetic graft for femoropopliteal bypass when autologous vein is unavailable - Offers good **biocompatibility** and relative resistance to **thrombosis** - Provides superior patency rates in above-knee femoropopliteal bypasses compared to other synthetic materials (5-year patency ~50-60%) - The expanded structure allows tissue ingrowth and better integration *Dacron (Polyethylene terephthalate)* - Generally used for **larger diameter vessels** (e.g., aortoiliac grafts) - Has **inferior patency rates** in smaller diameter femoropopliteal position compared to ePTFE - More prone to kinking and associated with higher rates of intimal hyperplasia in peripheral circulation *Saphenous vein* - The autologous saphenous vein is the **gold standard** for femoropopliteal bypass with superior long-term patency (5-year patency ~70-80%) - However, this question specifically asks for synthetic material when vein is unavailable or unsuitable - Not always available or of adequate quality in all patients *PTFE (non-expanded)* - **Non-expanded PTFE** lacks the porous structure of ePTFE - Not used for vascular grafts due to absence of tissue ingrowth capability - The **expanded** form is specifically engineered for vascular applications

Prosthetics and Orthotics Indian Medical PG Question 3: What is the condition commonly known as jumper's knee?

• A. Inflammation of the patellar tendon at its insertion on the patella.
• B. Tendinopathy of the quadriceps tendon.
• C. Injury to the hamstring tendon.
• D. Patellar tendonitis due to overuse of the patellar tendon. (Correct Answer)

Prosthetics and Orthotics Explanation: ***Patellar tendonitis due to overuse of the patellar tendon.*** - **Jumper's knee** is the common term for **patellar tendonitis**, which specifically refers to inflammation of the patellar tendon. - This condition is frequently caused by **overuse**, especially in activities involving repetitive jumping and landing. *Inflammation of the patellar tendon at its insertion on the patella.* - While jumper's knee does involve inflammation of the patellar tendon, it is more commonly at its insertion on the **tibial tubercle** or specifically its origin at the **inferior pole of the patella**, not necessarily at the patella itself. - This option is less precise as it describes only one aspect of the condition without mentioning the critical role of overuse. *Tendinopathy of the quadriceps tendon.* - **Tendinopathy of the quadriceps tendon** is a distinct condition affecting the tendon above the patella, known as **quadriceps tendinopathy**. - It presents with pain proximal to the patella, differentiating it from jumper's knee, which involves the tendon distal to the patella. *Injury to the hamstring tendon.* - An **injury to the hamstring tendon** would cause pain and symptoms on the posterior aspect of the knee or thigh. - This is completely unrelated to jumper's knee, which is characterized by anterior knee pain.

Prosthetics and Orthotics Indian Medical PG Question 4: A pole vaulter had a fall during pole vaulting and had paralysis of the arm . Which of the following investigations gives the best recovery prognosis -

• A. Electromyography (Correct Answer)
• B. Strength Duration Curve
• C. Creatine phosphokinase levels
• D. Muscle biopsy

Prosthetics and Orthotics Explanation: Electromyography - **Electromyography (EMG)** can help assess the extent of nerve damage and reinnervation, providing insights into the potential for recovery [1]. - The presence of **spontaneous activity** (fibrillations, positive sharp waves) indicates denervation, while the appearance of **motor unit action potentials (MUAPs)** suggests reinnervation [1]. *Creatine phosphokinase levels* - **Creatine phosphokinase (CPK)** levels primarily indicate **muscle damage**, not the extent of nerve injury or recovery potential. - While muscle damage can occur with nerve injury, CPK does not provide specific prognostic information for nerve regeneration. *Strength Duration Curve* - The **strength duration curve** assesses the excitability of a nerve or muscle to electrical stimulation. - While it can differentiate between **nerve and muscle damage**, it provides less comprehensive prognostic information compared to EMG regarding the status of nerve regeneration. *Muscle biopsy* - A **muscle biopsy** would directly evaluate muscle pathology, such as atrophy or regeneration. - However, it is an **invasive procedure** and provides less direct information about nerve recovery compared to EMG, which directly assesses nerve and muscle electrical activity.

Prosthetics and Orthotics Indian Medical PG Question 5: What is the classification of intelligence corresponding to an IQ score of 90-109?

• A. Below average
• B. Average (Correct Answer)
• C. Slightly below average
• D. Above average

Prosthetics and Orthotics Explanation: ***Average*** - An **IQ score** range of **90-109** is traditionally classified as **Average** intelligence. - This range represents the **mean** and surrounding **standard deviation** of IQ scores in the general population. *Below average* - This classification usually corresponds to IQ scores in the range of **70-79** or **80-89**, depending on the specific scale. - It does not represent the central tendency of the population's intelligence. *Slightly below average* - This category typically corresponds to IQ scores in the range of **80-89**. - It falls just below the average range but is not as low as the "below average" classification. *Above average* - This classification is typically assigned to IQ scores that are in the range of **110-119** or higher. - It signifies cognitive abilities that are greater than the majority of the population.

Prosthetics and Orthotics Flashcard 1 of 5

Question: Knuckle bender splint which is used in the management of _____ nerve palsy.

Answer: ulnar

Prosthetics and Orthotics Flashcard 2 of 5

Question: Boston brace works by applying corrective pressure on the _____ side of the curve

Answer: convex (concave/convex)

Prosthetics and Orthotics Flashcard 3 of 5

Question: _____ foot allows dorsiflexion, eversion/inversion movements at the ankle

Answer: Jaipur (Jaipur/SACH)

Prosthetics and Orthotics Flashcard 4 of 5

Question: The outer bar of the Thomas splint has a curvature near its junction to ring to accommodate _____.

Answer: greater trochanter

Prosthetics and Orthotics Flashcard 5 of 5

Question: _____ foot is not aligned for walking barefeet

Answer: SACH (Jaipur/SACH)