Conditions Flashcards
Neurodegenerative condition
- progressive neurological disease of CNS, structural or neurochemical, advances according to characteristic stages
Examples:
1) Parkinson’s Disease (PD)
2) Multiple Sclerosis (MS)
3) Amyotropic lateral sclerosis (ALS)
Parkinson’s Disease
Neurodegenerative
- deterioration in substantia nigra
- rigidity
- bradykinesia
- resting tremor
- festinating gait
Multiple Sclerosis
Neurodegenerative condition
- white matter lesions in CNS & demyelination process
- fluctuate changes in energy level, sensation, weakness, cognition, vision, mobility
Guillain-Barre syndrome
Acute demyelinating condition
- symmetrical & progressive paralysis
- ascending weakness starting at the feet
- possibility cranial nerve & respiratory muscle involvement
Typical course includes
- acute phase: 2-4 weeks: progressive increase in symptoms
- plateau phase: few days to few weeks: no change occurs
- progressive recovery phase (up to 2 years): gradual improvement
Amyotropic Lateral sclerosis
Neurodegenerative condition
- progressive death of upper & lower motor neurons
- muscle weakness in one or more extremity
- difficulties with speech, swallowing, &/or breathing
Huntington’s disease
- genetically-inherited degenerative neurological disease
- begins between 30 and 50 years
- choreiform movements, decline in thinking & reasoning skills, alterations in mood
Interventions: support engagement in occupation (e.g. environmental modification, assistive devices, augmentative communication devices, dysphasia management, cognitive strategies, seating & mobility, caregiver training)
Duchenne’s muscular dystrophy
Inherited genetic disorder
- muscle weakness & atrophy of proximal musculature of pelvis & shoulder girdle
- symptoms more common in males, detected around 3 years of age
- gradual loss of independent ambulation, progressive deterioration of musculature of trunk, neck, & distal extremities
- cognition unaffected
Systemic lupus erythematosus
Autoimmune inflammatory disease affecting joints, skin, blood cells, vital organs
- characterized by distinct butterfly-shaped facial rash that crosses both cheeks
- symptoms may be acute, chronic, or episodic & may include
1) joint pain & swellling
2) skin lesions
3) fatigue
4) Raynaud’s phenomenon
5) dyspnea
6) alterations in cognition
Alzheimer’s Disease
Most common form of dementia
- decline in memory, thinking, & performance skills with 3 stages
1) mild
2) moderate
3) severe
Alzheimer’s Disease: mild stage
- difficulty remembering new information
- getting lost
- challenges with money management
- increased time to complete ADL & routines
- mood & personality changes
Alzheimer’s Disease: moderate stage
- increased memory loss & confusion
- impulsive behavior
- difficulty in completing daily activities
- poor problem solving & judgement
- may experience hallucinations, delusions, & paranoia
Alzheimer’s disease: severe stage
- inability to communicate
- dependent with ADLs
- dysphasia & increased risk of aspiration
- incontinence
Macular degeneration
Progressive, age-related visual condition
- atrophy of macula (posterior part of retina)
- decrease in central visual acuity
- blurry, distorted or low vision
Interventions: magnification devices, lighting recommendations, color & contrast enhancements, visual skills training
Myasthenia gravis
Autoimmune motor unit disorder
- ptosis & double vision
- possible difficulty with chewing, swallowing, & speech
- weakness & fatigue that increases throughout the day
Interventions: energy conservation, work simplification education, sleep hygiene strategies, recommendation of adapted & assistive devices, activity modification
Chronic obstructive pulmonary disease (COPD)
Pulmonary condition associated with limited airflow from the lungs
- difficulty breathing
- shortness of breath during activities
- dyspnea & fatigue that influence occupational performance
- persistent cough
- includes emphysema & chronic bronchitis
Dyspnea
Shortness of breath due to impaired breathing in response to activity or at rest & may require
- medical attention
- modification to activity demands
- instruction in breathing techniques
- dyspnea control postures
Orthopnea
Shortness of breath due to impaired breathing while in supine
Recommendations: client sleep in upright position
Myocardial infarction
Emergency medical condition
- blocked flow of blood to heart muscle resulting in damage to the heart
Angina
Chest pain/pressure in response to exertion or at rest radiating to
- arms
- neck
- jaw
- back
Modifiable risk factors for cerebrovascular accident
- smoking
- hypertension
- diabetes Mellitus
- obesity
- sendentary lifestyle
- stress
- high cholesterol
Nonmodifiable risk factors for cerebrovascular accident
- family history
- age (late adulthood)
- gender
- post-menopausal
- history of heart disease
Neurological deficits associated with R hemisphere dysfunction
- L hemiparesis/hemiplegia
- sensory impairment on L side
- unilateral body & spatial neglect
- visual field cut on L side
- decreased insight into deficits
- deficits depend on specific area of R hemisphere that is damaged
Neurological deficits associated with L hemisphere dysfunction
- R hemiparesis/hemiplegia
- sensory impairment on R side
- language impairment (expressive &/or receptive aphasia)
- bilateral motor apraxia
- frustration
- deficits depend on specific area of L hemisphere damaged
Cerebral palsy
Neurological condition caused by brain injury or brain malformation that occurs while brain is developing before, during, or immediately following birth, characterized by impaired:
- body movements & gross motor skills
- muscle control & tone
- muscle coordination & fine motor skills
- reflexes, posture, & balance
- oral motor functioning
Down syndrome
Genetic disorder associated with chromosome 21
- characterized by mild to moderate intellectual disability
- physical developmental delay
- low muscle tone
- characteristic facial features
Diaphoreses
sweating, especially to an unusual degree as a symptom of disease or a side effect of a drug.
Emergent awareness
Difficulty or inability to recognize & correct errors in performance
Selective attention
the processes that allow an individual to select and focus on particular input for further processing while simultaneously suppressing irrelevant or distracting information
Constructional disorder
Difficulty/inability to assemble separate parts to build an end-product
Autism spectrum disorder
Neurodevelopmental disorder with symptoms including
- social dysfunction
- stereotypical behavior patterns
- perseverative thoughts or interests
- sensory processing deficits
- executive dysfunction
Developmental dyspraxia
Neurodevelopmental disorder (also called developmental coordination disorder)
- clumsiness and poor coordination
- motor planning deficits
- learning difficulties
- perceptual difficulties (visual and motor)
Attention deficit hyperactivity disorder (ADHD)
Neurobehavioral disorder
- inattention
- restlessness
- impulsivity
- emotional dysregulation
- sensory processing
- social immaturity
Fetal alcohol spectrum disorder
Congenital birth defect secondary to gestational exposure to alcohol resulting in mild to severe impairment in one or more of these developmental areas
- physical
- cognitive
- social
- behavioral
Torticollis
Dystonic disorder either congenital or acquired: defined by abnormal, asymmetrical head or neck position
Interventions:
- ROM exercises
- positioning
- environmental adaptations
Major depressive disorder (MDD)
Mood disorder
- persistent low mood
- anhedonia
- changes in sleeping/appetite
- decreased energy
- feelings of hopelessness
Bipolar disorders
Mood condition that manifests as manic, depressive, or mixed episodes:
- type I = primarily manic
- type II = primarily depressive
Cyclothymic disorder
- less severe form of bipolar disorder
- duration of symptoms does not meet criteria of major maniac or depressive disorder
Schizophrenia
Psychotic thought disorder with altered sense of reality
- hallucinations and delusions
- disturbance in thinking and behavior
- emotional blunting, social isolation, cognitive changes
Anxiety disorders
Emotional condition characterized by abnormal reaction, overwhelming fear, and uncontrollable thoughts resulting in physiological response impacting daily function
Personality disorders
Psychological condition
- disturbance of personality traits
- behaviors inconsistent with societal norms/expectations
- problems with interpersonal relationships
Addiction
Condition impacting personal, social, occupational functioning with physical or uncontrollable dependence on a
- substance (drug, alcohol)
- behavior (gambling)
Substance use disorder
Individual reliant on use of substances for non-medical purposes, leading to physical/psychological addiction
Intervention:
- cognitive behavioral therapy
- 12 step programs
- recovery programs
- pharmacology
Eating disorders
Serious emotional and physical disorders including extreme preoccupation with food, body image, and weight
Intervention:
- cognitive behavioral therapy
- group therapy’
- family therapy
Anorexia nervous
Eating disorder
- fear of gaining weight
- inability to maintain adequate nutritional intake due to distorted perception of body weight and body image
Bulimia nervosa
Eating disorder
- fear of gaining weight
- binge eating followed by purging (vomiting, use of laxatives/diuretics) secondary to excessive concern about body weight
Binge eating disorder
Eating disorder
- excessive intake and weight gain
- maladaptive coping mechanism to deal with stress, anxiety, and/or depression
Hallucination
Perceived sensory experiences (visual, auditory, tactile, gustatory, and somatic) without an actual stimulus, may be associated with psychosis, schizophrenia, or brain injury
delusion
False & unfounded belief contrary to the reality of the situation/environment
- may be symptom in schizophrenia
Perseveration
Thinking/talking about the same thing repeatedly without ability to independently redirect
- may occur following brain injury or cognitive dysfunction
Obsession
Persistent, unwanted, and intrusive thoughts that create feelings of urgency and anxiety
- psychological state commonly seen in OCD
Compulsion
Repetitive behaviors performed in response to obsessive thoughts used to minimize anxiety
- psychological state commonly seen in OCD
Depersonalization
DSM-5 classification of dissociative disorders characterized by
- retreating into a dreamy world with unrealistic feelings
- impaired self-awareness
- disconnecting from the physical being
Splitting
Strain between therapist-client relationship and/or interprofessional team members where staff response to manipulative behaviors of a client include
- blurring professional boundaries
- creating team division
Affective instability
Emotional state commonly seen in borderline personality disorder characterized by rapid mood swings usually between negative emotions such as
- anger
- anxiety
- depression
Self-mutilation
Maladaptive coping mechanism to express feelings, includes intentional acts of self-injurious behaviors of
- burning
- cutting
- pricking
- scratching
Restlessness
Neurobehavioral impairment
- results in decreased ability to remain still/relax
Irritability
Neurobehavioral impairment
- results in feelings of agitation or annoyance
Emotional lability
Neurobehavioral impairment
- rapid change in mood often disproportionate to circumstances or expected emotion
Frustration
- emotional response results in resistance to participate in activity and provokes desire to stop engagement in an activity
Confabulation
Memory impairment that causes individual to share false details of situations, memories of past events, or personal information without intention to deceive
Apathy
Lack of interest in purposeful activities or events in the environment
- associated with impairment in prefrontal cortex
Cognitive flexibility
Component of executive functioning that involves ability to think about various ideas simultaneously and switch between different ideas
Expected functional outcome: SCI levels C1-C3
- ventilator dependent
- total physical assistance for BADL and IADL
- able to direct care needs
Expected functional outcome: SCI level C4
- initially ventilator dependent, progress to breathing independently with reduced vital capacity
- total physical assistance for BADL and IADL
- able to direct care needs
- power wheelchair with adaptations for independence in mobility
- total assistance for bed mobility and transfers
Expected functional outcome: SCI level C5
- independent respiratory function with reduced vital capacity; may need assistance for productive cough
- total assistance for bowel/bladder management
- independent self-feeding with adaptive devices
- assistance for grooming with adaptive devices
- total assistance for bathing
Expected functional outcome: SCI level C6
- independent respiratory function with reduced vital capacity; may need assistance for productive cough
- min to total assistance for bowel/bladder management with adaptive devices
- may need some assistance for basic ADL, transfers, bed mobility with adaptive devices & outdoor WC propulsion in manual WC
- total assistance for standing
Expected functional outcome: SCI level C7-T1
- independent respiratory function
- assistance for bowel management
- MI for basic ADL
- some assistance for standing
- MI for bed mobility & transfer
- independent driving with modifications
Expected functional outcome: SCI level T2-T12
- independent to MI for basic ADL
- MI for bowel/bladder management
- MI for bed mobility, transfer, standing
- independent WC mobility
Expected functional outcome: SCI level L1-L5
- independent in ADL & bed mobility
- ambulate with assistive devices
- may use WC for distance; independent with loading/unloading from vehicle
- independent driving with hand controls
Rheumatoid Arthritis (RA)
Autoimmune, chronic, inflammatory disease associated with synovitis of the joints
- acute pain, erythema, swelling during disease exacerbation
- symmetrical joint involvement
- chronic pain secondary to progressive joint damage
- prolonged morning stiffness lasting up to 1-2 hours
- swan neck & Boutonniere deformities
- wrist radial deviation & MP ulnar deviation
Boutonnière deformity
Joint deformity consisting of
- PIP flexion, DIP hyperextension
Associated with RA and PIP joint trauma
Interventions:
- fabrication of orthosis to support PIP in extension while allowing DIP movement
Swan neck deformity
PIP hyperextension, DIP flexion
Associated with RA and tendon trauma
Intervention
- tri-point orthosis to prevent PIP hyperextension
Mallet finger
Inability to extend DIP joint due to rupture at distal end of extensor tendon
Intervention
- static orthosis to maintain DIP in extension
Ulnar drift
Hand deformity where MCP joints deviate to ulnar side, associated with RA
- intensified by functional activities requiring power grasp & lateral pinch
Trigger finger
Catching/locking of digit due to inflammation/thickening of flexor tendon sheath during grasping activities
Carpal tunnel syndrome
Pain, numbness, parenthesia in thumb, index, and ring fingers associated with median nerve compression w/symptoms often waking client from sleep
conservative intervention
- activity modification
- orthotic positioning
- neural gliding exercises
- ergonomic education
Cubical tunnel syndrome
Pain, numbness, parethesia in ring and small fingers due to ulnar nerve compression at the elbow
- symptoms associated with direct compression of the nerve or repetitive or sustained flexing at the elbow beyond 90 degrees
Conservative intervention
- activity modification
- orthotic positioning
- neural gliding exercises
- ergonomic education
Lateral epicondylitis
Pain/tenderness at supracondylar ridge of elbow, associated with irritation at origin of extensor carpi radialis breves (ECRB) tendon (tennis elbow)
Conservative treatment
- activity modification & ergonomic education
- orthotic bracing/positioning
- transverse friction massage
- stretching exercises
Brachial plexus injury
UE nerve injury w/signs/symptoms impacting arm, hand, or wrist depending on severity, mechanism, & anatomical location of injury
- loss of sensation/numbness
- decreased shoulder ROM
- weakness/paralysis
- pain
Axillary nerve injury
Peripheral nerve injury
- hyperesthesia on lateral aspect of shoulder
- weakness of deltoid & teres minor
Long thoracic nerve injury
Peripheral nerve injury
- weakness in serratus anterior
- winging of scapula
Classification of peripheral nerve injuries
- neuropraxia (1st degree)
- axonotmesis (2nd degree)
- neurotmesis (3rd degree)
Neuropraxia
Seddon’s classification of a nerve compression
- disruption of the myelin and spontaneous recovery expected
Interventions:
- pain relief
- orthotic positioning
- A/AA/PROM exercises
- activity modification
- patient education
Axonotmesis
Seddon’s classification of a nerve compression that recovers spontaneously, more severe compared to neuropraxia
- axon & myelin sheath disruption occurs
- endoneurium remains intact
- valerian regeneration occurs during healin
Interventions same as neuropraxia
Neurotmesis
Seddon’s classification of a completely severed nerve where recovery will not occur unless surgically repaired
Interventions:
- pain relief
- orthotic positioning
- controlled motion exercises & neural gliding exercises
- scar & edema management
- compensatory techniques
- patient education
Complex regional pain syndrome
Disorder of sympathetic nervous system
- triggered by surgery/trauma
Results in pseudomotor and vasomotor changes & disproportionate pain beyond region of surgery/injury
Three characteristic stages:
- stage 1: traumatic stage
- stage 2: dystrophic stage
- stage 3: atrophic stage
Complex regional pain syndrome: stage 1
Traumatic stage of CRPS that lasts up to 3 months
- extreme pain with/without movement
- decreased AROM
- hypersensitivity to light touch or deep pressure
- pitting Dede a
- blotchy-looking skin discoloration
- shiny skin appearance
- skin temperature fluctuation
Complex regional pain syndrome: stage II
Dystrophic stage of CRPS, lasts 6-9 months after injury/trauma
- extreme pain with/without movement
- hypersensitivity to light touch or deep pressure
- brawny edema
- skin redness & warmth to touch
- bony demineralization
- muscle atrophy
- joint contractures
Complex regional pain syndrome: stage III
Atrophic stage of CRPS, lasts several years or more after injury or trauma
- decrease in pain intensity
- irreversible changes in skin & joints
- persistent edema- unresponsive to intervention
- bony demineralization
- severe muscle atrophy
- joint contractures
DeQuervain’s tenosynovitis
Inflammation of abductor pollicis longs & extensor pollicis breves, resulting in pain, crepitation, & swelling over radial styloid
- positive finklestein’s test
Conservative intervention
- activity modification
- orthotic position
- tendon gliding exercises
- ergonomic education
Claw-hand deformity
Secondary to ulnar nerve injury
- atrophy of hypothener eminence
hyperextension of MCP joints
- flexion of IP joins & 4th & 5th digits
Intervention:
- orthotic positioning to prevent overstretching of intrinsic muscles by restricting MCP joint hyperextension
Ape hand deformity
Secondary to median nerve injury in proximal forearm or at wrist
- presents with atrophy of thenar eminence
- inability to abduct & oppose thumb
Intervention
- orthotic positioning to maintain palmar abduction & opposition
Spinal stenosis
Narrowing of intervertebral foramen often compressing the nerve as it exits the spinal column
- pain
- paresthesia
- muscle weakness
- sensory changes
Spondylosis
Degenerative process in the spine, typically associated with osteoarthritis
- pain
- neurological changes
- motor impairment
Kyphosis
Excessive posterior curvature of the spine
Lordosis
Excessive anterior curvature of the spine
Scoliosis
Sideways curvature of the vertebral column (the spine)
Compression fracture
Vertebral column collapse
- decreased bone density
- trauma from vertical force
- spinal tumors
- infection
Transfemoral amputation
LE amputation (above knee amputation)
- resulting from either surgical or traumatic removal of LE above the knee
Classification of UE amputations
Used to classify level of congenital deficiency or traumatic loss of upper limb
- interscapular
- shoulder disarticularion
- transhumeral (long/short)
- elbow disarticulation
- transracial (long/short)
- wrist disarticulation
- transmetacarpal
Phantom limb
Following amputation, experience of feeling part of the limb that is no longer present
Intervention:
- mirror therapy
- early preparatory techniques for use of prosthetic
- education and support
Phantom sensation
Following amputation, experience of perceiving sensory input from residual limb that is no longer present
- may include constant or intermittent itching, pain, or burning
Synovectomy
Surgical procedure to remove synovial membrane that lines a joint
Osteotomy
Surgical procedure to change the length or position of a bone
Resection
Surgical procedure to remove pathological tissue, bone, or organ
Arthrodesis
Surgical procedure to fuse a joint
Arthroplasty
Surgical procedure to rebuild/replace a synovial joint
Arthroscopy
Endoscopic surgical procedure to examine & treat joint injuries
Aphasia
Receptive and/or expressive language impairment secondary to a brain lesion
Broca’s, Wernicke’s, global, atomic, conduction, or transcortical
Raynaud’s phenomenon
condition that causes the blood vessels in the extremities to narrow, restricting blood flow
- usually affects fingers and toes
Dysphasia
Impairment in production of speech resulting from brain disease or damage
Ataxia
Abnormal movement pattern secondary to cerebellar lesion, resulting in lack of smooth-coordinated muscle movements
Behavioral manifestations
- slurred speech (dysarthria)
- difficulty with alternating movements (dysdiadochokinesia)
- staggering gait (ataxic gait)
- swallowing difficulties (dysphagia)
- overshooting/undershooting during reach (dysmetria)
