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Human Occ 2 > Chap 21 > Flashcards

Chap 21 Flashcards

1
Q

According to the WHO, levels of impairment include

A
  • None
  • Mild
  • Moderate
  • Severe
  • Complete
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2
Q

Sensory receptors receive information from two sources

A
  • Internal body structures
  • External environment
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3
Q

Somatosensory systems: Primary senses

A
  • Tactile
  • Deep pressure
  • Pain
  • Proprioception
  • Kinesthesia
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4
Q

Somatosensory systems: Cortical senses

A

*Two point discrimination
* Stereognosis

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5
Q

Special sensory systems

A
  • Visual
  • auditory
  • olfactory
  • gustatory
  • vestibular
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6
Q

Causes of sensory dysfunction

A
  • Damage to the central CNS‏
  • Damage to the PNS or the cranial nerves
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7
Q

Causes of sensory dysfunction: Damage to the central CNS

A

□ More generalized sensory loss, as in multiple sclerosis (MS)‏
□ Contralateral sensory loss, as in cerebrovascular accident (CVA)

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8
Q

Causes of sensory dysfunction: Damage to the PNS or the cranial nerves

A

□ Sensory loss is specific to the affected nerves

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9
Q

Role of the occupational therapist in sensory dysfunction

A
  • Teach compensation
  • Facilitate recovery
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10
Q

Terms related to sensory dysfunction: Anesthesia

A

complete loss of sensation

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11
Q

Terms related to sensory dysfunction: Paresthesia

A

abnormal sensation

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12
Q

Terms related to sensory dysfunction: Hypoesthesia

A

decreased sensation

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13
Q

Terms related to sensory dysfunction: Hyperesthesia

A

increased sensitivity

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14
Q

Terms related to sensory dysfunction: Analgesia

A

complete loss of pain sensation

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15
Q

Terms related to sensory dysfunction: Hypoalgesia

A

diminished pain sensation

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16
Q

Patients with _________ lack protective sensation and are more at risk for injury

A

Patients with hyposensitivity lack protective sensation and are more at risk for injury

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17
Q

CNS Dysfunction: Effects of sensory changes

A
  • Diminished function in all areas of occupation
  • Decreased inclination to move
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18
Q

CNS Dysfunction: Client education

A
  • Safety is the first concern
  • Teach the client to self-monitor and be vigilant about safety
  • Provide opportunities to practice safety skills in daily tasks
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19
Q

CNS Dysfunction: Remedial treatment

A
  • Goal is to promote recovery of sensation
  • Sensory reeducation has not been proven
    □ Graded tactile discrimination
    □ Motor relearning to facilitate sensory integration
  • Must ensure that the sensory input does not increase spasticity
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20
Q

CNS Dysfunction: Compensatory treatment

A

Maximize safe performance by adapting to sensory changes

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21
Q

CNS Dysfunction: Guidelines for compensatory treatment

A
  • Limit exposure to potentially dangerous items
  • When using tools, be conscious of the force involved, change tools frequently, and rest involved areas
  • Test the temperature with the uninvolved area
  • Use vision for guidance and safety
  • Observe the skin for signs of redness or stress
  • Avoid wearing restrictive clothing or jewelry
  • Have caregivers check for pressure sores
  • Follow a daily routine of skin care
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22
Q

PNS Dysfunction

A

○ Peripheral nerve injury (PNI) may affect different parts of the nerve
* Cell body, myelin sheath, axons, or neuromuscular junction

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23
Q

Several causes of PNI

A

Injury, entrapment, ischemia, metabolic diseases, infections, or inflammation

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24
Q

Symptoms of PNI

A
  • Weakness
  • hyperesthesia
  • hypoesthesia
  • lack of sensation
  • pain
  • atrophy
  • inability to perspire
  • changes in the skin and nails
25
Q

Client education for PNI

A
  • Reinforces information about recovery from PNI
  • Use of the involved body part during functional tasks
  • Teaches movement with less discomfort
  • Teaches protection of the involved body part
26
Q

Remedial treatment for PNI

A

□ Desensitization first
□ Graded program, including massage, vibration, tapping, or rolling over involved areas
□ Goal is to normalize the pain threshold
□ Sensory reeducation
□ Instruct the client to reinterpret sensory impulses
□ Enhance the potential for functional recovery

27
Q

Compensatory treatment for PNI

A

□ Increase the client’s awareness of sensory deficits
□ Safety is the major focus
□ Compensatory guidelines presented under the section on CNS dysfunction also apply to PNS dysfunction

28
Q

Visual acuity is:

A

discrimination of detail and contrast

29
Q

Visual acuity is affected by:

A

Affected by:
* near-sightedness
* far-sightedness
* presbyopia
* astigmatism
* eye disease
* trauma
* CNS dysfunction

30
Q

Occupational therapist evaluation for visual impairment

A
  • Visual history
  • Visual acuity
  • Oculomotor control
  • Visual field testing
31
Q

What is Visual acuity

A

visual information is sharp, clear, and accurate

32
Q

Oculomotor control

A

effective control of eye movements

33
Q

Visual fields

A

reception of complete information

34
Q

Visual attention

A

fixing the gaze for as long as is required and shifting the gaze when needed

35
Q

Visual scanning

A

shifting attention from one visual target to another in smooth succession

36
Q

Pattern recognition

A

ability to distinguish an object from its surroundings

37
Q

Visual memory

A

create and retain a visual image
□ Temporarily in short-term memory
□ Stored in long-term memory

38
Q

Visual cognition

A

manipulate visual information mentally and integrate it with other sensory information
□ Serves as a foundation for all learning

39
Q

Visual Disorder

A

anatomical change in the visual system-optic atrophy, cataract

40
Q

Visual Impairment

A

functional changes in vision resulting from the disorder-visual acuity, visual field, ocular motility

41
Q

Visual Disability

A

resulting from the impairment that limits performance of ADL

42
Q

Visual Handicap

A

need for extra support

43
Q

Optical defects reducing acuity:
Presbyopia

A

far-sightedness associated with aging

44
Q

Condition or disease that affects vision: Age-related macular degeneration

A
  • leading cause of loss of central vision for older adults
    □ Dry (90%) or wet (10%) type
    □ Also reduces the ability to distinguish details and color
    □ No cure; drug and laser treatments can slow the progression
45
Q

Condition or disease that affects vision: Diabetic retinopathy

A

□ Starts with floaters; progresses to blurred vision and visual loss
□ Control of blood sugar slows the progression
□ Laser surgery can be an effective treatment

46
Q

Compensatory strategies to adapt for Visual Acuity

A
  • Use of contrast
  • Increase light for better illumination
    □ Reduce glare and minimize shadows
  • Use of solid background colors
  • Increase print size
  • Space objects further apart
47
Q

What is Oculomotor control

A
  • control of eye muscles
  • Skills include alignment, range of motion (ROM), speed, and coordination
  • Deficits cause images to be blurred or appear as double
    □ Closing one eye can help with double vision
  • Treatment should be guided by a vision specialist
48
Q

Visual fields:
Homonymous hemianopsia

A

loss of the right or left half of the visual field in each eye; common after a CVA

49
Q

Visual fields ‏fun facts

A
  • Visual field loss results in narrowing of the scope of scanning
  • Person is unaware of the absence of vision
    □ May be unaware of the boundary between seeing and nonseeing fields
  • Less aware of objects in the environment
  • Reading presents a challenge
  • May have difficulty with tasks that require near vision
50
Q

Treatment strategies for visual field deficit

A
  • Increase awareness of the deficit
  • Teach head movement for compensation
  • Special lenses may help with compensation
  • Reading: use of boundary markers; teaching head and eye movement
  • Writing: visual fixation on the hand; use of black felt-tip markers, boldly lined paper, and talking pens
  • Driving: requires specialized assessment
  • Environment: add color contrast, solid backgrounds; reduce clutter
51
Q

Visual attention: two categories

A
  • Focused: selective visual attention
    □ Used for structured tasks
  • Ambient: peripheral visual attention
    More useful in unstructured tasks
52
Q

Visual scanning: disrupted by brain injury

A
  • Avoidance in shifting the eye toward the opposite half of the visual space
  • Normal scanning is organized, systemic, and efficient
53
Q

Visual inattention: visual neglect

A
  • Also called left unilateral spatial neglect, hemi-inattention, or hemispatial neglect
  • Primarily occurs with right-sided brain injury
  • Distinctly different from visual field deficit
  • Client acts as if the left visual space does not exist
54
Q

Pattern recognition with CNS Visual skills

A
  • Right injury: client fails to recognize any object because he or she does not perceive all of it
  • Left injury: client is aware of the object but cannot identify it
55
Q

Visual cognition

A
  • Integration of foundation skills
  • Types of deficits:
    □ Spatial agnosia – inability to appreciate spatial relationships, distance, motion
    □ Alexia – loss of reading ability
    □ Impaired visual closure
    □ Figure-ground discrimination – objects stand out from the background
56
Q

Treatment strategies

A
  • Aim is to teach the client to take in visual information in a consistent, systematic, and organized manner
  • Teach clients to recognize and correct errors
    □ Provide immediate feedback
    □ Use activity prediction to teach self-monitoring
  • Practice skills within context
    □ Clients with a brain injury have difficulty with generalization of information
57
Q

Treatment strategies: Scanning strategies

A

□ Left-to-right rectilinear pattern for reading
□ Left-to-right circular pattern for unstructured scanning
□ Require patients to physically manipulate objects scanned
□ Games and sorting activities can be used
□ Scanning of as broad a visual space as possible

58
Q

Treatment strategies: Selective attention

A

□ Teach clients to study an object consciously; emphasize an object placed in the impaired space
□ Use matching activities that require discrimination of subtle details

59
Q

Vision Loss: Compensatory Techniques for Activities of Daily Living (ADLs)

A

○ Use the remaining senses to gather and filter information
○ Teach safety techniques first
○ Break activities into small parts
○ Organize materials before starting an activity
○ Strategies for various ADLs are covered in the book

Human Occ 2 (2 decks)

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