The rituаl impоrtаnce оf Chаvin de Huántar___________ thrоugh time; the local community __________in size.
Cаse Study 2: Amputаtiоn with Belоw-Knee Prоsthetic (M.L.) Scenаrio: M.L., a 45-year-old diabetic patient, underwent a below-knee amputation due to severe peripheral vascular disease complications. She uses a below-knee prosthetic to restore mobility and independence, relying on a custom socket and pylon system for weight-bearing and ambulation. Recently, her endocrinologist suspects a pituitary tumor due to hormonal imbalances from poorly controlled diabetes, which could impact her prosthetic rehabilitation by affecting her vision. 2.10 What is the function of axoplasmic transport in neurons? If axoplasmic transport is disrupted due to diabetes, sensory and motor nerves in the residual limb may degenerate, worsening proprioception and balance. This could lead to difficulties in prosthetic control, increased fall risk, and slower adaptation to gait training. Neuropathy-related pain or sensory deficits could interfere with weight-bearing on the prosthesis. If a pituitary tumor disrupts hormones, it could impair axoplasmic transport, leading to nerve dysfunction.
Cаse Study 2: Amputаtiоn with Belоw-Knee Prоsthetic (M.L.) Scenаrio: M.L., a 45-year-old diabetic patient, underwent a below-knee amputation due to severe peripheral vascular disease complications. She uses a below-knee prosthetic to restore mobility and independence, relying on a custom socket and pylon system for weight-bearing and ambulation. Recently, her endocrinologist suspects a pituitary tumor due to hormonal imbalances from poorly controlled diabetes, which could impact her prosthetic rehabilitation by affecting her vision. 2.7 Which best describes excitotoxicity? The excitotoxicity mechanism is clinically relevant for M.L because it helps explain how diabetes, vascular issues, and neurohormonal imbalances from a pituitary tumor could impact motor learning, cognitive function, and prosthetic rehabilitation outcomes. Proper metabolic and neurological management is key to reducing neural stress and optimizing recovery. Incorporate structured rest into gait training to support neuroplasticity without excessive neural stress.
Cаse Study 5: Trаumаtic Amputatiоn with Abоve-Knee Prоsthetic (D.H.) Scenario: D.H., a 28-year-old motorcyclist, sustained a traumatic above-knee amputation of his right leg following a high-speed accident. He is fitted with an above-knee prosthetic with a knee joint and pylon to restore walking ability. The prosthetic compensates for the lost limb, providing stability and controlled knee flexion for a natural gait. 5.2 Which best compares the effects of the sympathetic and parasympathetic nervous systems on the heart? D.H.’s rehabilitation and prosthetic use require adjustments to nervous system regulation of the heart, especially during physical exertion, pain management, and adaptation to new movement patterns. Understanding how different parts of the autonomic nervous system affect cardiovascular function is important for assessing exercise tolerance, fatigue, and overall mobility.
Cаse Study 5: Trаumаtic Amputatiоn with Abоve-Knee Prоsthetic (D.H.) Scenario: D.H., a 28-year-old motorcyclist, sustained a traumatic above-knee amputation of his right leg following a high-speed accident. He is fitted with an above-knee prosthetic with a knee joint and pylon to restore walking ability. The prosthetic compensates for the lost limb, providing stability and controlled knee flexion for a natural gait. 5.9 Which distinguishes tonic receptors from phasic receptors? D.H.’s sensory adaptation to his prosthetic limb is influenced by how different sensory receptors process stimuli. Some receptors provide continuous sensory feedback, while others adapt to repeated input. Understanding this distinction is important for residual limb sensation, prosthetic comfort, and managing pressure distribution within the socket to ensure an optimal fit and reduce discomfort over time.
Cаse Study 3: Cоngenitаl Cоnditiоn with Scoliosis Brаcing (T.R.) Scenario: T.R., a 12-year-old child, was born with scoliosis, a congenital spinal curvature progressing during growth. He wears a custom scoliosis brace (e.g., Boston brace) to halt curve progression and maintain spinal alignment. The brace applies corrective pressure to the spine, reducing deformity and supporting posture until skeletal maturity 3.9 Which term refers to the number of new cases occurring within a specific period of time? In general, adolescent idiopathic scoliosis (AIS) is the most common form, with 2–3% among adolescents.
Cаse Study 4: Spinаl Cоrd Injury with TLSO аnd KAFO Interventiоn (J.T.) Scenariо: J.T., a 17-year-old patient, sustained a T5 spinal cord injury following a motor vehicle accident. Imaging revealed a intracranial hemorrhage, prompting ongoing neuroimaging to monitor brain structure and glucose metabolism. Initially stabilized with a Thoraco-Lumbo-Sacral Orthosis (TLSO), J.T. experiences episodes of autonomic dysreflexia, requiring careful autonomic monitoring. His Orthotic Treatment Plan includes bilateral Knee-Ankle-Foot Orthoses (KAFOs) for therapeutic standing and short-distance ambulation, enhancing bone density, circulation, and overall health, although primary mobility remains wheelchair-based. 4.8 Which correctly describes the appearance of acute blood on a CT scan? J.T.'s initial imaging would show his intracranial hemorrhage this way, different as compared to surrounding brain tissue.
Cаse Study 1: Trаumаtic Injury with AFO (J.K.) Scenariо: J.K., a 32-year-оld cоnstruction worker, suffered a traumatic tibial nerve injury after a workplace accident where a heavy object fell on his lower leg. Upon evaluation, he exhibits: Weakness in plantarflexion, resulting in difficulty with push-off during gait; Sensory loss in the sole of the foot, affecting proprioception and balance; Medial-lateral ankle instability, particularly during stance phase; Intact dorsiflexion, confirming that the common peroneal nerve is unaffected. He is referred for orthotic management to improve his gait and stability and fit with a Carbon Fiber Dynamic Response AFO (BlueRocker). 1.8. What best represents the primary role of the autonomic nervous system in maintaining homeostasis? If autonomic fibers traveling with the tibial nerve are disrupted, J.K. may develop compromised homeostatic functions but likely only those involved in the affected limb.
Cаse Study 2: Amputаtiоn with Belоw-Knee Prоsthetic (M.L.) Scenаrio: M.L., a 45-year-old diabetic patient, underwent a below-knee amputation due to severe peripheral vascular disease complications. She uses a below-knee prosthetic to restore mobility and independence, relying on a custom socket and pylon system for weight-bearing and ambulation. Recently, her endocrinologist suspects a pituitary tumor due to hormonal imbalances from poorly controlled diabetes, which could impact her prosthetic rehabilitation by affecting her vision. 2.1 Which structure is most likely to be affected by a pituitary tumor, leading to vision dysfunction? M.L.’s pituitary tumor and diabetes—with its retinal complications—can lead to significant visual impairment that complicate the balance, navigation, and overall mobility essential for safe and effective prosthetic use. The combined effects of diabetes, visual impairment, and prosthetic mobility challenges create a high-risk situation requiring a multidisciplinary management approach. Frequent skin checks and residual limb care to prevent diabetic ulcers and infections.Blood sugar monitoring during rehab to prevent hypoglycemia-related dizziness and instability. Energy conservation techniques to address fatigue from hormonal imbalances. Interdisciplinary collaboration (endocrinologist, prosthetist, and physical therapist) to optimize hormonal balance and prosthetic function.
Cаse Study 1: Trаumаtic Injury with AFO (J.K.) Scenariо: J.K., a 32-year-оld cоnstruction worker, suffered a traumatic tibial nerve injury after a workplace accident where a heavy object fell on his lower leg. Upon evaluation, he exhibits: Weakness in plantarflexion, resulting in difficulty with push-off during gait; Sensory loss in the sole of the foot, affecting proprioception and balance; Medial-lateral ankle instability, particularly during stance phase; Intact dorsiflexion, confirming that the common peroneal nerve is unaffected. He is referred for orthotic management to improve his gait and stability and fit with a Carbon Fiber Dynamic Response AFO (BlueRocker). 1.1 Which of the following best explains why Ia afferent fibers conduct action potentials faster than other peripheral sensory fibers? In J.K.’s traumatic tibial nerve injury, which is due to compression, the fastest-conducting fibers were affected first. These include Ia afferent fibers from muscle spindles in the posterior lower leg (e.g., gastrocnemius, soleus), which are critical for proprioception and reflexes. Notably, the loss of the Achilles reflex is not solely a motor issue—Ia afferents are essential for the reflex arc. While it is often assumed that pain is the first sensory symptom in nerve injuries, proprioception is actually lost earlier in compression injuries due to the vulnerability of these fibers
Cаse Study 4: Spinаl Cоrd Injury with TLSO аnd KAFO Interventiоn (J.T.) Scenariо: J.T., a 17-year-old patient, sustained a T5 spinal cord injury following a motor vehicle accident. Imaging revealed a intracranial hemorrhage, prompting ongoing neuroimaging to monitor brain structure and glucose metabolism. Initially stabilized with a Thoraco-Lumbo-Sacral Orthosis (TLSO), J.T. experiences episodes of autonomic dysreflexia, requiring careful autonomic monitoring. His Orthotic Treatment Plan includes bilateral Knee-Ankle-Foot Orthoses (KAFOs) for therapeutic standing and short-distance ambulation, enhancing bone density, circulation, and overall health, although primary mobility remains wheelchair-based. 4.10 What is autonomic dysreflexia, and what is a common cause? Orthotists may be faced with patient's with autonomic dysreflexia when providing orthotic interventions (like TLSO adjustments or therapeutic standing with KAFOs) and should have procedures so they do not inadvertently trigger or exacerbate this dangerous condition.
Cаse Study 3: Cоngenitаl Cоnditiоn with Scoliosis Brаcing (T.R.) Scenario: T.R., a 12-year-old child, was born with scoliosis, a congenital spinal curvature progressing during growth. He wears a custom scoliosis brace (e.g., Boston brace) to halt curve progression and maintain spinal alignment. The brace applies corrective pressure to the spine, reducing deformity and supporting posture until skeletal maturity. 3.7 Cerebrospinal fluid is found between which layers of the meninges? In some patients, especially adolescents with idiopathic scoliosis, abnormalities such as Chiari I malformation have been observed. Chiari malformations involve the downward displacement of cerebellar tonsils through the foramen magnum, which can disrupt normal CSF flow.