NBCOT Registered Occupational Therapists (OTR) Quiz: Prosthetic Selection
20 questions · exam conditions
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Prosthetic SelectionQuestion 1 of 20

A 22-year-old client with a bilateral transhumeral amputation wants to pursue a hobby in photography. The client needs to be able to hold a DSLR camera, adjust lenses with one hand while supporting the camera with the other, and press the shutter button. The client is adept with technology and has excellent cognitive skills for learning complex control schemes.

Which prosthetic configuration would provide the highest level of function for this specific leisure activity?

Bilateral body-powered prostheses with voluntary closing hooks to provide precise, graded pinch force for manipulating camera controls.
A myoelectric multi-articulating hand on the dominant side and a body-powered prosthesis with a C-hook terminal device on the non-dominant side.
Bilateral myoelectric prostheses, with the dominant side using a hand and the non-dominant side using an electric wrist rotator and a specialized camera-cradling terminal device.
A passive, adjustable prosthesis on the non-dominant side to serve as a stable platform, and a myoelectric hand on the dominant side for shutter activation.
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NBCOT Registered Occupational Therapists (OTR) Quiz

NBCOT Registered Occupational Therapists (OTR) Quiz: Prosthetic Selection

Practice Prosthetic Selection in NBCOT Registered Occupational Therapists (OTR) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Prosthetic Selection, giving you a quick way to practice the rules, question types, and explanations that matter most for NBCOT Registered Occupational Therapists (OTR).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A 22-year-old client with a bilateral transhumeral amputation wants to pursue a hobby in photography. The client needs to be able to hold a DSLR camera, adjust lenses with one hand while supporting the camera with the other, and press the shutter button. The client is adept with technology and has excellent cognitive skills for learning complex control schemes.

Which prosthetic configuration would provide the highest level of function for this specific leisure activity?

  1. Bilateral body-powered prostheses with voluntary closing hooks to provide precise, graded pinch force for manipulating camera controls.
  2. A myoelectric multi-articulating hand on the dominant side and a body-powered prosthesis with a C-hook terminal device on the non-dominant side.
  3. Bilateral myoelectric prostheses, with the dominant side using a hand and the non-dominant side using an electric wrist rotator and a specialized camera-cradling terminal device. (correct answer)
  4. A passive, adjustable prosthesis on the non-dominant side to serve as a stable platform, and a myoelectric hand on the dominant side for shutter activation.
Explanation: This task requires complex, coordinated bimanual activity. Bilateral myoelectric prostheses (C) offer the most advanced control for a tech-savvy user. For the non-dominant side, a specialized terminal device designed to cradle the camera body/lens, combined with an electric wrist rotator, provides a stable and adjustable support platform. For the dominant side, a myoelectric hand can be used to grip the camera and activate the shutter button. This specialized, bilateral configuration directly addresses the unique demands of photography. A) While body-powered devices offer feedback, coordinating two of them for this task would be difficult, and hooks are not ideal for holding a camera. B) A hybrid approach is good, but the specialized camera-cradling device in option C is superior to a generic C-hook for this specific hobby. D) A purely passive support is too limiting; the ability to actively reposition the camera with the non-dominant arm is crucial.

Question 2

An OTR® is evaluating a client with a left partial hand amputation, with loss of digits 2 through 5 at the metacarpophalangeal (MCP) joint level. The thumb and carpal bones are intact and fully functional. The client is a skilled woodworker and needs to be able to securely grip tools of varying diameters, such as chisels and sanders, which was previously done with the left (non-dominant) hand.

Which prosthetic solution would best restore the client's ability to perform their vocational tasks?

  1. A passive, silicone restoration prosthesis that fills the void, providing a surface for opposition with the intact thumb. (correct answer)
  2. A body-powered prosthesis with four passive, positionable fingers that can be manually flexed around an object.
  3. An externally powered prosthesis with individual myoelectric finger units to mimic natural grasp patterns.
  4. A static, custom-molded opposition post prosthesis designed to create a three-jaw chuck pinch with the thumb.
Explanation: For this level of partial hand amputation, the primary goal is to restore the opposition surface for the powerful and functional intact thumb. A passive, silicone restoration prosthesis (A) is the most effective solution. It restores the palmar arch and provides a stable, high-friction surface against which the thumb can press, enabling a strong cylindrical or power grasp needed for holding tools. It is durable and requires no external power or harnessing. B) Body-powered fingers would be too cumbersome and lack the sensory feedback of the thumb-on-prosthesis contact. C) Individual myoelectric fingers are extremely expensive, often not durable enough for woodworking, and may be overkill when the primary need is simply a stable post for the thumb. D) An opposition post is a valid concept, but a full silicone restoration provides a larger, more versatile contact surface for gripping tools of various sizes compared to a single post.

Question 3

An OTR® is working with a client who has a Syme's amputation of the right foot. The client is an office worker who walks short distances in the community and wants a prosthesis that is comfortable inside standard dress shoes. The residual limb is bulbous at the distal end but otherwise has good skin integrity. The client occasionally walks on slightly uneven surfaces like grassy areas during lunch breaks.

Which combination of prosthetic socket and foot is most appropriate for this client's anatomical presentation and functional needs?

  1. A patellar tendon-bearing (PTB) socket with a solid ankle cushion heel (SACH) foot to provide maximum stability and ease of use.
  2. A flexible inner socket with a windowed carbon fiber frame and a multi-axial dynamic response foot to accommodate the bulbous end and varied terrain. (correct answer)
  3. A total surface bearing socket with an expandable wall and a single-axis foot to allow for easy donning and controlled plantarflexion.
  4. A silicone sleeve suspension with a carbon fiber energy-storing foot to reduce shear forces and maximize energy return for community ambulation.
Explanation: A Syme's amputation creates a bulbous distal end, which is a key challenge for socket design. A windowed frame with a flexible inner socket (B) is a common and effective solution. The window (opening) in the rigid outer frame allows the bulbous end to pass through during donning/doffing, and then a cover is secured. This provides intimate fit and comfort. For the foot, a multi-axial dynamic response foot is ideal. It accommodates uneven surfaces (like grass) better than a SACH or single-axis foot and provides some energy return, making community walking more efficient and comfortable. A) A PTB socket is for transtibial amputations, not a Syme's. C) An expandable wall socket is a valid concept, but the single-axis foot is less functional on varied terrain. D) Suspension is part of the system, but the core issue is the socket design to accommodate the bulbous end, which this option doesn't address.

Question 4

A 7-year-old child with a congenital transradial limb difference is being evaluated for their second prosthesis. The first prosthesis was a passive, cosmetic hand which the child rarely used, often preferring to use their residual limb for stabilization. The child is very active, enjoys climbing on playground equipment, and is learning to ride a bicycle. The parents are seeking a more functional option but are concerned about maintenance and durability.

Which prosthetic option BEST meets the child's current developmental and functional needs?

  1. A myoelectric terminal device with pattern recognition to encourage intuitive control and bimanual skill development.
  2. A body-powered prosthesis with a voluntary opening, child-sized hook to provide durable, functional grasp for play activities. (correct answer)
  3. An activity-specific terminal device designed exclusively for gripping bicycle handlebars to promote success in a desired leisure task.
  4. A 3D-printed, body-powered prosthesis with an adaptive grip, controlled by wrist flexion, to offer a lightweight and customizable solution.
Explanation: At this age, the child is moving from simple stabilization to active bimanual tasks. A body-powered system is the logical next step after a passive prosthesis. It is highly durable, which is essential for an active child who climbs and plays. The voluntary opening hook (B) allows the child to actively grasp objects like bicycle handlebars or playground bars. The proprioceptive feedback from the harness helps with motor learning. A) A myoelectric device is typically heavier, less durable, and more expensive, making it a poor choice for a very active 7-year-old's primary prosthesis. C) An activity-specific device is a good adjunct but not a primary prosthesis, as it would not be functional for other tasks like schoolwork or general play. D) While 3D-printed options are emerging, they may not yet have the proven durability of traditional body-powered systems for high-impact activities; furthermore, the specific control mechanism (wrist flexion) is more typical for wrist disarticulation levels, not transradial.

Question 5

A 75-year-old client with a transtibial amputation has several comorbidities, including congestive heart failure (CHF), which causes fluctuating edema in the residual limb, and severe osteoarthritis in both hands. The client lives in an assisted living facility and ambulates short distances with a walker. The client has difficulty with tasks requiring fine motor skills and strength in the hands.

Which type of prosthetic suspension system is MOST appropriate for this client?

  1. A suction suspension system with a one-way valve, requiring the client to push their limb into the socket to achieve a seal.
  2. A pin-locking system with a silicone liner, which the client would need to align precisely to engage the lock.
  3. A traditional cuff strap suspension that attaches to a waist belt, distributing weight over a larger area.
  4. A supracondylar/suprapatellar (SC/SP) suspension system that is an integral part of the socket design and requires no manipulation by the client. (correct answer)
Explanation: This client has two key issues that impact suspension choice: fluctuating edema and poor hand function. The SC/SP suspension is a self-suspending design where the socket is molded over the femoral condyles and patella. It requires no straps, sleeves, or locking mechanisms that the client would need to manipulate with their arthritic hands. It is also more forgiving of minor daily volume fluctuations than suction or pin-locking systems. A) and B) Both suction and pin-locking systems would be very difficult, if not impossible, for this client to don independently due to severe hand osteoarthritis. C) A waist belt is cumbersome, often uncomfortable, and is an older style of suspension generally not preferred when better options are available.

Question 6

A client with a right hip disarticulation due to osteosarcoma wants a prosthesis that will allow for community ambulation and sitting with a normal appearance. The client is 25 years old, physically fit, and has excellent core strength and balance. However, the client is concerned about the energy expenditure required for walking with a prosthesis at this level.

Which combination of prosthetic components would best meet the client's goals for ambulation and cosmesis while helping to manage energy expenditure?

  1. A laminated socket (Canadian type) with a manually locking hip joint, a single-axis knee, and a solid ankle cushion heel (SACH) foot.
  2. A thermoplastic ischial containment socket with a polycentric hip joint, a hydraulic swing and stance knee, and a dynamic response foot.
  3. An open-frame socket with a passive, free-motion hip joint, a microprocessor-controlled knee, and an energy-storing foot.
  4. A flexible inner socket with an external frame, an elastic extension-assist hip joint, a weight-activated stance control knee, and a multi-axial foot. (correct answer)
Explanation: Ambulation with a hip disarticulation prosthesis is extremely energy-intensive. The primary goal is to provide stability while maximizing energy efficiency. The components in option D work together to achieve this. The flexible socket provides comfort. An elastic extension-assist hip helps bring the leg forward during swing phase, reducing the muscular effort (energy) required. A weight-activated stance control knee provides crucial stability at heel strike, preventing the leg from collapsing. A multi-axial foot accommodates uneven terrain, further enhancing stability and reducing compensatory movements. A) This option is too basic and unstable for a young, active user. The locked hip would create a very unnatural gait. B) A hydraulic knee and polycentric hip are good, but the extension-assist hip specifically addresses the high energy cost of swing phase. C) A free-motion hip is highly unstable and requires extreme control from the user; it's not a standard or safe option.

Question 7

A 48-year-old client with a left transhumeral amputation is a farmer who needs to operate heavy machinery and perform manual labor involving lifting sacks up to 50 pounds. The client's residual limb is muscular and well-padded. Durability, reliability, and grip force are the client's top priorities. Cosmesis is not a concern.

Which prosthetic system is the most suitable for meeting this client's high-demand vocational needs?

  1. A myoelectric system with a high-performance terminal device and pattern recognition for intuitive control of grip patterns.
  2. A body-powered system with heavy-duty steel components, a figure-of-nine harness, and a voluntary closing terminal device. (correct answer)
  3. A hybrid system combining a body-powered elbow for durability with a myoelectric terminal device for strong grip force.
  4. An activity-specific prosthesis with a custom terminal device designed to interface directly with the controls of the farm equipment.
Explanation: For heavy-duty, demanding work where durability and reliability are paramount, a body-powered system is superior. Option B includes all the necessary components for this user. Heavy-duty steel components withstand abuse. A figure-of-nine harness is designed for heavy use and provides excellent power transmission. A voluntary closing (VC) terminal device is crucial here because the grip strength is proportional to the force exerted by the user, allowing for a very secure hold on heavy objects, which is essential for lifting 50-pound sacks. A) Myoelectric systems are generally less durable and may not be suitable for the dirt, moisture, and vibration of a farm environment. C) A hybrid system is a good compromise, but the grip force of the myoelectric hand might be electronically limited and less reliable under extreme conditions than a VC body-powered device. D) An activity-specific device is too specialized and would not be useful for the variety of tasks a farmer performs.

Question 8

An OTR® is part of a team evaluating a 19-year-old who sustained a traumatic transfemoral-transradial amputation on contralateral sides (right leg, left arm). The client was previously an avid cyclist and wants to return to this activity. The client has good cognitive skills and is learning to manage a wheelchair for primary mobility but is motivated for prosthetic use. The team is deciding on the initial prosthetic prescription.

What is the MOST critical initial consideration when selecting the first set of prostheses for this client?

  1. Prioritizing the lower extremity prosthesis first to establish a stable base of support for subsequent upper extremity prosthetic training.
  2. Fitting the client with a high-activity microprocessor knee and a myoelectric arm simultaneously to accelerate return to desired occupations.
  3. Prescribing a lightweight body-powered upper extremity prosthesis and a lightweight lower extremity prosthesis with a safety knee to manage cognitive load. (correct answer)
  4. Focusing on an activity-specific prosthesis for cycling for the lower extremity and a passive prosthesis for the upper extremity to match the client's goals.
Explanation: This is an extremely complex case of bilateral, multi-level amputation. The initial prosthetic fitting must prioritize safety, simplicity, and managing the immense cognitive load of learning to use two different prostheses. Option C is the most sound clinical approach. A lightweight body-powered arm is simpler to learn than myoelectric and less cognitively demanding. A lightweight leg with a safety knee (like a weight-activated stance control knee) prioritizes stability and fall prevention. This combination allows the client to learn both prostheses concurrently without being overwhelmed. A) While logical, this delays bimanual function. Concurrent fitting is often preferred if managed correctly. B) Introducing two complex, externally powered systems at once would create an overwhelming cognitive and learning burden and is clinically inappropriate for an initial fitting. D) Focusing on a highly specialized activity before basic functional mobility and manipulation are established is premature.

Question 9

A client with a right wrist disarticulation is being evaluated for a prosthesis. A primary advantage of this level of amputation is the preservation of the distal radioulnar joint. The client wants to be able to perform tasks that involve turning a key, using a screwdriver, and opening jars.

To capitalize on the anatomical advantage of a wrist disarticulation, the OTR should recommend a prosthesis that incorporates which feature?

  1. A multi-articulating myoelectric hand.
  2. A harness system that provides maximum stability.
  3. A socket design that allows for active forearm pronation and supination. (correct answer)
  4. An electrically powered wrist rotator unit.
Explanation: The key advantage of a wrist disarticulation is the preservation of the forearm muscles and distal radioulnar joint, which allows for active pronation and supination. The most appropriate prosthetic selection is one with a socket that captures and utilizes this remaining physiological motion. This provides more natural and intuitive control for rotational tasks than an electrically powered wrist rotator (D), which would be indicated for higher-level amputations. While a multi-articulating hand (A) or a stable harness (B) might be components, the crucial feature for this specific amputation level is the utilization of natural forearm rotation.

Question 10

An OTR is evaluating a 45-year-old client who sustained a transradial amputation of the dominant right arm in a farming accident 3 months ago. The client is a self-employed farmer and plans to return to work, which involves heavy manual labor, equipment maintenance, and exposure to dirt and moisture. The client prioritizes durability and reliable grip strength over aesthetics.

Based on the client's vocational needs and priorities, which type of prosthesis would be MOST appropriate to recommend?

  1. A myoelectric prosthesis with a multi-articulating hand.
  2. A body-powered prosthesis with a voluntary opening hook terminal device. (correct answer)
  3. A passive silicone cosmetic prosthesis.
  4. A hybrid prosthesis combining a myoelectric hand and a body-powered wrist.
Explanation: A body-powered prosthesis is the most appropriate choice. It is highly durable, resistant to environmental factors like dirt and moisture, and provides excellent proprioceptive feedback and grip force for heavy tasks. A voluntary opening hook is robust, functional, and easy to maintain, aligning perfectly with the client's farming work. A myoelectric prosthesis (A) is less durable and susceptible to damage from moisture and dirt. A passive prosthesis (C) offers no active grip, which is essential for the client's job. A hybrid prosthesis (D) is unnecessarily complex and expensive for a transradial amputation and does not offer the same level of durability as a fully body-powered system.

Question 11

A 32-year-old client with a transhumeral amputation of the left non-dominant arm works as a high school teacher. The client's goals are to be able to gesture naturally while lecturing, hold papers, and have a prosthesis that is quiet and cosmetically appealing. The client has good muscle strength in the residual limb and demonstrates the cognitive ability to learn complex control schemes.

Considering the client's profession and personal goals, which prosthetic option is the BEST fit?

  1. An externally powered, myoelectric prosthesis with a cosmetic hand. (correct answer)
  2. A body-powered prosthesis with a voluntary closing hook.
  3. An activity-specific prosthesis designed for weightlifting.
  4. A passive, lightweight foam-filled prosthesis.
Explanation: A myoelectric prosthesis is the best choice because it offers more natural, proportional control for gesturing, is quiet in operation (unlike some body-powered systems), and can be fitted with a highly cosmetic hand, meeting all the client's stated goals. The client's cognitive and physical status supports the use of this more advanced technology. A body-powered prosthesis (B) would be more conspicuous due to the harness and less cosmetically appealing. An activity-specific prosthesis (C) is not suitable for the client's daily vocational needs. A passive prosthesis (D) would meet the cosmetic goal but would not allow for active grasping of objects like papers.

Question 12

An OTR is working with a 6-year-old child with a congenital transradial limb difference. The child is entering first grade and is very active. The parents want a prosthesis that is durable, simple for the child to operate, and will facilitate bimanual activities at school, such as stabilizing paper while coloring. They are concerned about the cost and maintenance of a complex device.

Which prosthetic option should the OTR recommend for this child's initial prosthesis?

  1. A myoelectric prosthesis with a child-sized multi-articulating hand.
  2. A passive functional prosthesis with a mitten-shaped hand. (correct answer)
  3. A body-powered prosthesis with a voluntary opening hook.
  4. No prosthesis, as the child has likely adapted to one-handed techniques.
Explanation: A passive functional prosthesis is the most appropriate initial choice. It is lightweight, durable, easy to use for stabilizing objects (a key bimanual skill at this age), and requires minimal maintenance. The mitten shape provides a broad surface for opposition. A myoelectric prosthesis (A) is often too heavy, expensive, and complex for a young, active child as a first device. A body-powered prosthesis (C) requires more complex harnessing and control, which can be challenging for a 6-year-old to master initially. Withholding a prosthesis (D) ignores the potential benefits for bimanual skill development and body symmetry.

Question 13

A 28-year-old military veteran has bilateral transhumeral amputations. The client is highly motivated to return to independent living and is exploring prosthetic options. The client wants to have a prosthesis for fine motor tasks and another for heavy-duty tasks, and is open to using different systems on each arm.

What is the MOST effective prosthetic configuration for this client to maximize overall function?

  1. Two passive cosmetic prostheses for symmetry and social acceptance.
  2. Two body-powered prostheses with hook terminal devices for maximum durability.
  3. A hybrid system: a body-powered prosthesis on one side and a myoelectric prosthesis on the other. (correct answer)
  4. Two advanced myoelectric prostheses with multi-articulating hands.
Explanation: A hybrid system is often the most effective approach for bilateral upper-extremity amputees. This configuration allows the client to use the body-powered prosthesis (typically on the dominant side or longer residual limb) for tasks requiring durability, proprioceptive feedback, and high grip force. The myoelectric prosthesis on the other side can be used for tasks requiring finer motor control and various grip patterns. This combination provides greater versatility than having two of the same type of prosthesis (B, D). Two passive prostheses (A) would not provide the active function this motivated client needs for independence.

Question 14

A 24-year-old with a left transradial amputation is an avid rock climber and cyclist. The client already has a myoelectric prosthesis for daily use but finds it unsuitable for these specific recreational activities. The client is seeking a second prosthesis specifically for sports.

What is the MOST appropriate recommendation for this client?

  1. Modifying the current myoelectric prosthesis with a more durable glove.
  2. A body-powered prosthesis with a standard voluntary opening hook.
  3. An activity-specific prosthesis with interchangeable terminal devices. (correct answer)
  4. A passive cosmetic prosthesis to reduce weight during activity.
Explanation: An activity-specific prosthesis is designed for the unique demands of sports and recreation. It features a durable socket and frame, and crucially, allows for interchangeable terminal devices (TDs) that can be swapped out for specific activities (e.g., a rock climbing hook, a C-shaped TD for holding handlebars). Modifying the expensive myoelectric prosthesis (A) is risky and unlikely to meet the durability demands. A standard body-powered prosthesis (B) is durable but may not be optimized for the specific grips needed in climbing and cycling. A passive prosthesis (D) offers no functional grip for these activities.

Question 15

An OTR is presenting prosthetic options to a client with a new transradial amputation. The client is trying to understand the fundamental difference in operation between the two main types of active prostheses. The client's primary goal is to be able to grasp a delicate object, like a foam cup, without crushing it.

When selecting a terminal device (TD), what is the key advantage of a voluntary closing (VC) TD over a voluntary opening (VO) TD for this client's goal?

  1. VC devices are lighter and require less cognitive effort to use.
  2. VC devices allow for graded grip force and provide better proprioceptive feedback. (correct answer)
  3. VC devices remain closed at rest, which is better for carrying items.
  4. VC devices are more durable and require less maintenance.
Explanation: The primary advantage of a voluntary closing (VC) terminal device is that the user directly controls the closing force. The amount of tension the user puts on the control cable translates directly to the grip strength of the TD. This provides excellent proprioceptive feedback and allows for a graded, delicate grip, which is ideal for handling fragile items like a foam cup. Voluntary opening (VO) devices, in contrast, are closed by rubber bands, providing a consistent but less controllable grip force. VC devices are not necessarily lighter (A) or more durable (D). The resting state (C) is a feature of VO devices, not VC.

Question 16

A client with a transradial amputation has a residual limb with significant scarring and sensitive areas due to a burn injury. The client has had difficulty with previous sockets causing skin breakdown. The prosthetist suggests a new prosthetic design to address this issue.

When selecting a prosthesis for this client, which component is MOST critical to modify to ensure comfort and prevent skin breakdown?

  1. The type of terminal device (hook vs. hand).
  2. The material and design of the prosthetic socket and interface. (correct answer)
  3. The battery size and weight in a myoelectric system.
  4. The type of harness used for suspension.
Explanation: The prosthetic socket and interface are in direct contact with the residual limb and are therefore the most critical components for a client with sensitive skin and scarring. The selection of appropriate materials (e.g., flexible inner socket, gel liners) and a custom socket design that offloads pressure from sensitive areas is paramount to prevent skin breakdown and ensure the client can wear the prosthesis comfortably. While other components (A, C, D) are important for overall function, they do not directly address the primary problem of skin integrity at the human-machine interface.

Question 17

An OTR is completing a pre-prosthetic evaluation for a client with a transhumeral amputation. The client has limited financial resources and no health insurance coverage for durable medical equipment. The client needs a functional prosthesis to assist with basic self-care and home management tasks.

Considering the client's financial constraints, which active prosthetic system is the MOST realistic and cost-effective recommendation?

  1. A myoelectric prosthesis with a multi-articulating hand.
  2. A state-funded vocational rehabilitation program for a body-powered prosthesis. (correct answer)
  3. An activity-specific prosthesis with a custom terminal device.
  4. A cosmetic silicone prosthesis with a passive function.
Explanation: The most appropriate response is not just to select the cheapest device, but to identify a pathway for funding a functional one. Body-powered prostheses are the most cost-effective active option, and state vocational rehabilitation programs are a key resource for helping uninsured or underinsured individuals obtain the DME necessary for employment and independent living. This recommendation addresses both the functional need and the financial barrier. A myoelectric prosthesis (A) is the most expensive option. An activity-specific prosthesis (C) is a specialty item and not for general function. A cosmetic prosthesis (D) is less expensive but does not provide the active function needed for many self-care tasks.

Question 18

A client with a recent transradial amputation is deciding between a hook and a hand terminal device for their first body-powered prosthesis. The client's primary goal is to be able to perform a wide variety of daily tasks, including dressing, cooking, and light home repair, with maximum precision.

From a purely functional standpoint for precision tasks, what is the main advantage of a hook terminal device over a prosthetic hand?

  1. The hook is more socially acceptable and cosmetically appealing.
  2. The hook's shape allows the user to see objects more clearly during manipulation. (correct answer)
  3. The hook provides a greater variety of grip patterns for different objects.
  4. The hook is heavier, providing better balance for the prosthesis.
Explanation: The slender tines of a hook terminal device obscure less of the object being manipulated compared to a prosthetic hand. This improved line of sight allows for greater precision when picking up and interacting with small items, which is a significant functional advantage for tasks like buttoning, writing, and handling small tools. A hook is generally considered less cosmetically appealing (A). A multi-articulating myoelectric hand provides more grip patterns, not a simple hook (C). Hooks are typically lighter than prosthetic hands (D).

Question 19

A client with an acquired transradial amputation has a well-healed residual limb and has demonstrated proficiency in using a body-powered prosthesis. The client now wants to explore a myoelectric option. To determine if the client is a good candidate, the OTR must assess the viability of potential muscle sites.

What is the PRIMARY factor the OTR must confirm when selecting muscle sites for myoelectric control?

  1. The ability to see a visible muscle contraction under the skin.
  2. The client's subjective report of feeling the muscle contract.
  3. The ability to consistently isolate contractions of agonist/antagonist muscle groups. (correct answer)
  4. The size and bulk of the muscle in the residual limb.
Explanation: The key to successful myoelectric control is the client's ability to reliably and independently contract agonist and antagonist muscles (e.g., wrist flexors and extensors) to control opening and closing of the terminal device. The signals must be distinct and repeatable without firing both muscles simultaneously (co-contraction). While visible contraction (A), subjective feeling (B), and muscle bulk (D) are related, the ability to isolate the signals is the essential prerequisite for operating a standard two-site control myoelectric prosthesis.

Question 20

An 82-year-old client sustained a traumatic left transradial amputation and has several comorbidities, including congestive heart failure and peripheral neuropathy. The client lives alone and has mild cognitive impairment. The primary goal for prosthetic use is to assist with simple household tasks like carrying a laundry basket or stabilizing a jar. The client has limited energy and strength.

Given the client's age, comorbidities, and functional goals, which prosthesis is the MOST suitable?

  1. A hybrid prosthesis with switch control.
  2. A heavy-duty body-powered prosthesis.
  3. A lightweight passive functional prosthesis. (correct answer)
  4. An advanced myoelectric prosthesis with pattern recognition.
Explanation: A lightweight passive functional prosthesis is the most suitable option. It is light, easy to don and doff, and requires no complex controls, which is important given the client's cognitive impairment and limited energy. It can effectively serve as a stabilizer for bimanual tasks, meeting the client's primary goals without being burdensome. Hybrid (A) and myoelectric (D) systems are too complex and heavy. A heavy-duty body-powered prosthesis (B) would be too heavy and difficult to operate for a client with CHF and limited strength.