AOTA/POT SCI/MUSCU Diseses Flashcards
What type of burn involves dry, peeling, redness, with mild to moderate pain and leaves no scarring?
1st degree or superficial
healing time is between 3-7 days
due to sunburn, hot liquid burn
What type of burn involves the epidermis and upper Demis layer and is characterized with wet, blisters and erythema?
2nd degree: superficial partial thickness
healing time sis less than 2 weeks, due to hot metal or hot liquid
What type of burn involved the hair follicles, sweat glands, and other superficial layers and is characterized as the MOST PAINFUL?
2nd degree, partial deep
healing time is 3-5 weeks due to contact with flame or extent heat
may involve skin graft
What type of burn involves contact with chemicals, pain free, with high potential for hypertrophic scarring?
3rd degree, full thickness burn
healing time months
What type of burn involves all the underlying tissue, bone, fat under the skin usually cause by electrical burn?
4th degree, subdermal
What is the focus of medical management during the emergent phase?
Sustaining life, controlling infection, managing pain
What is the focus of medical management during the acute phase?
infection control, grafting, biological dressing, psychological support,
What is the OT intervention for 1st degree burn?
Typically heals on its own so avoid extra sun exposure
What is the OT intervention for 2nd degree burn superficial ?
ROM, assess wound/scar, edema control, splinting, sensation, MMT, grip strength, being ADL tx after onset of injury or surgery
What is the OT intervention for 2nd degree burn deep?
ROM, (72 hours post/op), wound care, edema control, splinting (serial casting or dynamic splint), sensation and introduce strengthening after wound heals, begin ADL ASAP.
What is the OT intervention for 3rd degree burn deep?
Evaluation, prevent contractures (anti-contracture positioning), PROM within 24 hours, edema control, education, adaptive ADL techniques
What are some key points to rememberer with skin conditioning?
Skin lubrication should be performed several times a day and use skin massage to desensitize grafted sites.
What are some key points to rememberer with scar management?
initiate compression therapy for both edema control and scar compression, create custom-made compression garment insert.
What is the recommended wear time for a patient to wear his/her pressure garment?
wear 24 hours a day for garment except bathing and massage.
How should you distribute pressure evenly in a pressure garment?
Add flexible inserts (gel or air cushioned) or conformers
What is the ideal anti-contracture positioning?
Positioning to the opposite of patient’s greatest comfort
What is the protocol for post-op immobilization period?
After skin graft, immobilization between 3-10 days until graft adherence is confirmed.
Immobilization period for donor size is 2-3 days.
Walking n0t resumed 5-7 days.
Exercise protocol after immobilization?
Start with gentle AROM to avoid shearing
What is hypertrophic scar and how should you treat it?
Most apparent between 6-8 weeks after wound closure and scar matures after 1-2 years.
Apply compression therapy early and continue until scar matures.
What is heterotrophic ossification?
bone formation in abnormal areas. Loss of ROM and pain is common.
What is pruritis/
persistent itching and may lead to skin maceration and reopening of the wound.
What should an OT do if the burned area is along the head and neck?
- Position to stretch affected areas
- use mouth and neck splint
- use compression garment
- education of healing appearance/appearance changes
What should an OT do if the burned area is along the UE (axillary, elbow)?
- Airplane position (90 degrees ABD position splint)
- Manage edema with positioning, wrapping, compression garment
- AROM
- begin ADL training asap after onset
What should an OT do if the burned area is along the trunk?
Position to place affected areas in prolonged stretch
What are some post-op/pre-prosethetic symptoms?
pain, skin complications, edema of residual limb, bone spurs, neuroma, phantom limb and sensation
what are some post-prosthetic signs and symptoms?
skin ulcers, sebaceous cyst, edema, sensory changes
What are the types of UE prosthesis training?
- Prosthesis control training
- Prosthesis use training
- preposition
- prehension
- Functional Training
What is prosthesis controls training?
how each component of upper limb prosthesis operates.
What is prosthesis use training?
Teaching how to integrate functional use
What is preposition training?
teach how to identify optimal position for functional activities
What is prehension training?
teaching how the terminal device controls during grasp activities
What is functional training?
Incorporating the Terminal device as functional assist or problem-solve approach
What is intrinsic burn splint?
MCP Flex 60-70,
IP full EXT
Wrist EXT 10
How would you teach the patient pain management and desensitization pre-prosthetic phase?
Tapping, light or deep tissue massage, fluidotheraphy
OT interventions of strengthening for pre-prosthetic phase?
Isometric exercises to strengthen the muscles that will be involved in operating a prosthesis.
How would an OT teach motor learning or muscle re-education for amputee patients?
Incorporate residual limb to bilateral activities and provide biofeedback to use muscle groups to operate.
This type of prosthesis is relatively light, cost affective and provides sensory feedback, but need harness on the body?
Body-powered (body motion used to apply tension)
This type of prosthesis increases grip force, offers minimal effort needed to control, improved cosmesis, and no need for harness.
Myoelectric (uses EMG signals)
but $$$$ and lack of sensory feedback.
This type of disease is characterized as widespread pain and affecting entire muscle.
fibromyalgia
What are some common interventions for fibromyalgia?
Education, myofascial release, fatigue management, pacing activities, energy conservation, memory aids, environment modification
what type of hip fracture is mostly associated with women with osteoporosis?
Femoral neck hip
Non-weight bearing?
no weight place on affected extremity
Toe-touch Weight Bearing
Only toe can touch the ground for balance. 90% of weight is on unaffected limb
Partial Weight bearing
50% of body weight
Weight Bearing as tolerated?
based on pain response
What are the hip precautions for posterolateral approach?
No internal rotation (toes inwards) No bending (hip flex at 90) No crossing (adduction)
What are the hip precautions for anterolateral approach?
No external rotation
No hip flexion beyond 90
No adduction
When can the OT begin out of bed activities with a patient who had a hip replacement injury?
1-3 days post op
What are the precautions for Total knee replacement?
No squatting, no kneeling on affected knee, no twisting on knee
How should you position knee when lying in bed for TKA?
Knee must be flat when lying, no pillow under bed
What are some spinal precautions?
No bending at waist
no lifting more than 10 lbs
no twisting trunk
What are some standard body mechanics to teach a person low back pain/conditions?
Neutral spine bend from hip avoid twisitng Carry loads COG Lift with legs Lift with Wide BOS and in saggital plane
What type of lift is safest lift for the back and ideal for heavy loads?
Semisquat
what type of arthritis is progressive, non-inflammatory, and isolated to a specific joint?
Ostheoarthritis
What are some intervention to osteoarthritis?
heat modalities (to decrease stiffness and relax muscles) and joint protection/energy conservation, AROM, light strengthening/aerobic exercises
What are contraindications for arthritis?
MMT for pain and resistive exercise
What type of arthritis is chronic and inflammatory?
Rheumatoid Arthritis
What are some interventions to RA during acute period?
positioning, AE, AROM, Fx activity education
What is some intervention to RA during flare-up?
PROM
What type of splint is recommended for RA?
Soft neoprene
What type of splint is recommended during exacerbation period of RA?
Resting hand splint
What are some common RA deformities?
Boutonniere, swan neck, ulnar drift, mallet finger, trigger finger
