Chunk Five Flashcards
tummy time
placement of infant in prone position during periods of wakefulness to facilitate development or oral, fine and gross motor skills
adaptive positioning
modifications made to the position of a client during an activity to optimize trunk stability and postural alignment intended to improve:
upper extremity control
range of vision
swallowing ability
interactions within the environment
pursed lip breathing
technique used to control dynspnea/SOB by inhaling through the nose, with mouth closed, followed by slow exhale through pursed lips
diaphragmatic breathing
breathing technique used to control SOB with the following steps;
place hand on abdomen
inhale to fill the lungs with a slow and deep breath
pay attention to chest moving slightly and abdomen rising
exhale while abdomen relaxes
relaxation breathing
breathing technique used to control SOB and decrease rate of respiration with the following steps:
exhale completely
deeply inhale while counting
exhale slowly while counting at a rate greater than during inhalation
repeat at comfortable rate then return to normal breathing
body mechanics
application of kinesiology to promote proper alignment, position, and efficient use of the body during physical task activities,
principles include of body mechanics include:
plan movement
load close to body and bend knees when lifting
ensure solid base of support and use inertia when appropriate
myoelectric prosthesis
type of prosthesis used for a person following amputation that uses electrical signals from existing muscles to control the movement of the artificial limb
body-powered terminal device
component attached to the distal end of prosthesis that is operated by forces generated by the body and enables a person to hold and stabilize objects, types include hand and hook designs with voluntary opening or voluntary closing features
body powered prosthesis
type of upper limb prosthetic device that is operated using a harness and the movement of the body to generate forces through a cable control system
serial casting
specialized intervention technique used to increase ROM of a joint, inolves applying a series of well-padded casts to the limb to hold the target joint in a sub-maximal stretch
requires changing the cast at scheduled intervals to progressively increase ROM
orthosis
custom-made or prefabricated device used to immobilize, mobilize, or restrict one or more joints, typically used to
maintain alignment promote healing improve function restrict motion prevent contractures correct deformities
restriction orthosis
classification of an arthosis intended to limit partial mobility of one or more joints while allowing free movement through the remaining arc of motion typically used to
allow controlled motion
decrease risk of scar adhesions
mnimized risk of contracture
improve functional use
immobilization orthotic
classification of a custom-made or prefabricated orthosis intended to prevent movement of one or more joints, typically used to:
maintain tissue length
preserve joint alignment
maintain/protect a fracture reduction
protect a healing/repaired nerve or tendon
mobilization orthosis
classification of a custom made or prefabricated orthosis intended ot move one or more joints using applied, controlled tension, typically used to
promote tissue remodeling
elongate/stretch adhesions
substitute for weak or absent motion
provide resistance for strengthening
orthotic nomenclature: design descriptors
terms traditionally used to describe characteristics of orthotic devices that may be included as part of an orthotic prescription to help identify an orthosis using non -modified orthosis classification system nomensclature ie:
digit based hand based thumb based forearm based arm based
ON: modified orthosis classification system
system used to describe an orthosis for outpatient billing and reimbursement purposes based on the HCPCS typically corresponds to a specific “L-code”
replaces the traditional term “splints” with “orthotics”
ON: anatomical descriptors
naming convention used to describe the anatomical location of an orthosis for outpatient billing and reimbursement purposes, based on the HCPCS
ie:
EWHFO: elbow wrist hand finger orthosis
WHFO: wrist hand finger orthosis
HFO: hand finger orthosis
common names of restriction orthoses
names commonly used to describe this category of orthotic device include:
buttonhole PIP extnesion orthosis
anticlaw buckle orthosis
MCP joint ulnar deviation orthosis
meunster orthosis
may be included as part of an orthotic prescription to help identify an orthosis using non-modified orthosis classification system nomenclature
mobilization orthoses
names of comonly used to describe this category of orthotic device include:
tenodesis orthosis radial nerve pasly orthosis palmar ABduction orthosis dynamic flexion assist orthosis interphalangeal flexion orthosis
may be included as part of an orthotic prescription to help identify an orthosis using non-modified orthosis classification system nomenclature
common names of immobilzation orthoses
names commonly used to describe this catergory of orthotic device include:
volar wrist orthosis thumb spica orthosis dorsal blocking orthosis resting hand orthois metacarpal fracture brace
may be included as part of an orthotic prescription ot help identify an orthosis usign non-modfiied orthosis classification system nomenclature
palmer crease
a crease on the hand that indicates areas of joint mobility and must be considered when fabricating and fitting an orthosis
types of palmer creases
distal
proximal
thenar
hypothenar
handling characteristics of thermoplastic material: memory:
capacity of thermoplastic material to retain its original properties when reheated, recommended when frequent re-molding may be necessary
HCOTM: drapability
property of thermoplastic material that indicates its ability to conform, contour and shape to the underlying structures, material effective for:
small orthoses
experienced orthotic makers
HCOTM: bonding
capacity of thermoplastic material to adhere to itself, beneficial characteristic when attaching dynamic orthotic components to an orthotic base
PCOTM: rigidity
capacity of thermoplastic material to maintain its strength and to prevent a change in the integrity of the custom fit against force and repetitive stress, material effective to stabilize a large joint
PCOTM: perforations
small holes distributed throughout thermoplastic material that allow for air flow to minimize risk of skin rash, sweating, and maceration
angle of application
force or torque applied to a joint using the dynamic component of a mobilization orthosis, ideally 90* to body segment being moved
mechanical advantage
application of a three class lever system to achieve efficiency and promote effectiveness of an orthosis
typically described in terms of the length of the effort arm and the length of the resistance arm
elastic force
used as part of a mobilization orthosis to influence tissue response
common devices used for this purpose include
rubber bands
wrapped elastic cord
spring coils
friction force
term used in orthotic fabrication that describes the amount of force generated by the orthotic materials and the amount of contact force, typically lessened by using
smooth thermoplastics proper fitting straps rounded edges foam-lining or gel padding stockinette
orthotic pattern
necessary first step of orthotic fabrication to ensure custom fit and design that includes
tracing the shape/size of extremity on paper prior to cutting the material
using an anatomical landmarks
intrinsic plus position
term used in orthotic positioning, commonly referred to as the “anti-deformity” or “safe position” of the hand, intended ot place the MCP joint collateral ligaments in an elongated position to reduce contracture risk
intrinsic plus position consists of :
wrist neutral or slight extension
finger MCP joint 75-90* of flexion
finger IP joints in complete extension
thumb in ABduction and opposition
anticontracture position: anterior neck burn
characteristics of this anitcontracture positon includes:
neck in extension
do not use a pillow when supine in bed
use a neck collar or neck extension orthosis
Anticontracture position: burn of the axilla
characteristics of this anticontracture position includes:
shoulder joint in 120* if ABduction with slight external rotation
use of an orthosis or wedge to prevent shoulder adduction
anticontracture position: anterior elbow burn
characteristics of this anticontracture position includes;
elbow joint in 5-10* of flexion
use of wrist extension orthosis to prevent flexion
anticontracture position: burn on the dorsum of the hand
characteristics of this anticontracture position includes:
MCP joint in 70-90* in flexion with IP joints in full extension and thumb in opposition
maintain ROM of first web space
use of a functional hand orthosis to avoid claw hand deformity
anticontracture position: burn on the dorsum of the wrist
wrist joint in neutral
use of an immobilizaiton orhtosis to prevent wrist extension
anticontracture position: burn on the volar surface of the hand
MCP joint in slight hyperextension use of a palm extension orthosis to prevent cupping of the hand
proshetic functional use training
intervention program for clients who have an upper limb deficiency or amputation, includes education on the use of harness and cable controls or myoelectric components and terminal device, emphasizes activites for:
bilateral and unilateral use of limbs
automatic movement patterns
spontaneous movements
performance indaily activites
manual wheelchair
self-propelled or attendant-pushed wheel chair available with a wide variety of customizable options
light weight manual wheelchair
manual wheelchair style frame that typically weighs between 25 -40 pounds
benefits include:
enhanced self-propulsion
decreased strain on upper extremity
ease of loading and unloading for transportation
bariatric w/c
specialized w/c with weight capacity and size width options greater than the standard w/c frame
specialized frame include:
reinforced cross braces and frame
padded reinforced upholstery
heavy duty wheels
beach w/c
type of specialized w/c with oversized wheels that allows for ease in movement in the sand
sports wheelcahir
wheeled mobility specifically designed to enhance maneuverability and speed during athletic and leisure activities feature may include:
light weight frame
specially designed wheels
all terrain options
overall stability
rear-wheel drive w/c
feature of a powdered w/c in which the casters are located at the front of the chair and the drive wheels located toward at the rear of the chair, designed to enhance maneuverability when using hand-operated controls
good option for use over rough terrain
mid-wheel drive w/c
feature of a powered w/c that requires a third set of stabilizing caster wheels, designed with smaller turning radius which increases overall maneuverability
front wheel drive w/c
feature of a powered w/c in which the casters are located toward the rear of the chair and teh drive wheels located at the front of the chair, designed to enhance maneuverability up and down sloped terrain
may be more difficult to maneuver at higher speeds
drive wheel position
features of a powered w/c that influences the maneuverability stability traction and performance of the chair on a variety of terrains/surfaces, types include:
rear wheel
mid wheel
front wheel
w/c accessories
customized components consdiered during the w/c assessment and prescription process to ensure the w/c fits the indivdiualized needs of the client
options of w/c accessories
style of armrest and footrest lap tray, seat belt, anti-tip devices brake style and extensions trunk and neck support cushion and pressure relief systems
planar foam w/c seat cushion
type of w/c seat cushion with the following characteristics :
composed of viscoelastic material light weight adn inexpensive absorbs moisture multiple density and thickness options least effective option for pressure distribution
air filled w/c seat cushion
bladder design with adjustable inflation level
provides even distribution of pressure relief
lightweight design feature
potential for air pressure variability inherent in overall design
feeder chair
positioning aid that provides trunk support for feeding or other short term activity
adjustability allows for upright or reclined position
trunk support ring
device used in the bathtub to provide external stability of the torso for children seated upright during bathing, typically used in the presence of mild hypotonicity
hammock chair
device used in the bathtub to safety position of a child in supine for bathing typically used in the presence of poor trunk and head control
