OPC Orthotics Written flashcards

31 cards. Read the term and the definition here. The deck at the top of this page is optional.

Manual muscle test grade 3

The patient moves the joint through full available range against gravity but cannot tolerate added resistance. Grade 3 indicates antigravity strength and is the threshold often used when deciding whether an orthosis can supplement rather than substitute for muscle.

Ten-gram monofilament interpretation

Testing ten plantar sites, intact protective sensation is typically recorded when the patient feels most sites. Perception lost at the majority of sites signals high risk for neuropathic ulceration and supports accommodative or offloading design.

True versus apparent leg length

Apparent discrepancy is measured with the pelvis leveled and reflects posture or contracture. True discrepancy is measured between fixed bony landmarks, such as anterior superior iliac spine to medial malleolus, and reflects actual limb shortening.

Dependent rubor significance

A foot that reddens when hanging down, together with absent pedal pulses and delayed capillary refill, suggests arterial insufficiency. Circumferential or compressive devices are then avoided because they can further compromise perfusion.

Fixed contracture documentation

A contracture is recorded as degrees of motion lost that do not change with passive force, distinguishing it from weakness or spasm. Fixed deformity limits how much correction a device can achieve and must be accommodated in the model.

Gait observation elements

Inspection records foot contact pattern, stance and swing timing, step and stride symmetry, and compensatory trunk or pelvic motion. Each finding is paired with the anatomical or biomechanical cause before a device is selected.

Three-point pressure principle

Angular control of a segment requires forces applied on the convex side at the apex and on the opposite side proximal and distal to it. A single opposing force cannot control a joint; at least three points are needed.

Preset ankle angle in an AFO

The ankle angle built into a solid ankle-foot orthosis determines its function: neutral resists plantar flexion at loading, while a plantar-flexed setting accommodates a tight heel cord or aids push-off depending on design intent.

Total contact casting indication

Total contact casting is the reference standard for offloading a plantar neuropathic ulcer in a patient with protective sensation loss, distributing pressure while restricting weight bearing and activity during healing.

Risser sign in scoliosis bracing

The Risser sign grades iliac apophysis ossification from 0 to 5 as a marker of skeletal maturity. Greater remaining growth, meaning a lower Risser grade, raises the likelihood that a curve will progress and that bracing can influence it.

Measurable orthotic goal statement

Goals are written as observable outcomes, such as independent ambulation for a stated distance or a specified ankle angle at contact, so that follow-up can objectively judge whether the plan succeeded.

Contraindications before device fabrication

Fabrication is deferred when there is unmanageable fixed deformity, severe arterial insufficiency, infected or ulcerated tissue at the interface, or inability to don the device, because the device would cause harm or fail.

Positive model modification purpose

The positive model is modified to relieve bony prominences, build in the prescribed correction, and preserve the weight-bearing surface. Each modification is documented so the resulting fit can be reproduced or revised.

Delivery fit criteria

At delivery the device should show no red marks persisting beyond about fifteen minutes after removal, no distal migration, and trim lines that clear joints and do not contact the opposite limb.

Thermoplastic drape and temperature

Forming temperature and drape are matched to sheet thickness and material. Overheating degrades the polymer and shortens fatigue life, while underheating produces poor conformity and weak bonds.

Break-in wear schedule

Wear begins with short daily intervals that increase gradually, with skin inspected after each interval during the first week. This detects interface problems before they progress to breakdown.

Donning and doffing competence

Before the patient leaves with a device, they or their caregiver demonstrate independent donning and doffing correctly. This demonstration is documented as part of delivery, not assumed from verbal instruction.

Alignment verification on level surface

The finished device is placed on a level surface and the patient's joint angles are checked against the prescribed angles. Verification occurs before delivery so corrections are made while the device is still adjustable.

Risk-based follow-up intervals

Patients with insensate skin, neuropathy, or a recent ulcer are seen within days to weeks; stable patients are seen at three to six months and annually, with the interval documented in the plan.

Erythema fade test

Erythema that resolves within roughly fifteen to twenty minutes of device removal is generally acceptable. Erythema that persists, or any open lesion, indicates the device must be modified or discontinued.

Volume change and fit

Edema, weight change, or post-surgical change alters limb volume and therefore fit. Liners and padding are adjusted first; structural revision is reserved for problems that adjustment cannot resolve.

Pediatric growth re-evaluation

Children are re-evaluated on a scheduled basis because growth changes limb length and alignment. A device is typically replaced when the change exceeds the adjustment range built into it.

Device traceability requirement

Lot or serial numbers are recorded in the patient record so a delivered device can be traced back to the patient if a recall or failure occurs. Traceability is a required documentation element.

Prescription-device match documentation

The delivered device is compared with the prescription. Any deviation is documented with clinical justification and communicated to the prescriber, keeping the record consistent with what was actually provided.

Reimbursement documentation chain

Reimbursement documentation links the diagnosis, the functional deficit, the specific device and components provided, and the expected functional gain. Each element is stated separately rather than implied.

Laterality and repair modifiers

Billing modifiers communicate which limb was fitted and whether the service was a repair or a replacement. Accurate modifiers prevent claim denial and misrepresentation of the service provided.

Release of patient records

Patient records are released only with the patient's authorization or as required by law. Confidentiality obligations continue after the episode of care ends and apply to all staff with record access.

Patient welfare primacy

When financial interest and patient benefit conflict, patient benefit governs. This principle underlies disclosure of conflicts of interest and prohibits arrangements that reward referrals inappropriately.

Informed consent elements

Consent requires disclosure of the proposed device, reasonable alternatives including no treatment, material risks and benefits, and the right to refuse. The discussion is documented before implementation begins.

Scope of practice limit

A practitioner provides only services within their training and credentials and refers when the patient's need exceeds that scope. Exceeding scope is a professional conduct violation even when the intent is to help.

Truthful representation of outcomes

Claims about device capabilities, credentials, and expected outcomes must be accurate and supportable. Unsubstantiated benefit claims mislead patients and are a conduct violation regardless of the device's actual quality.