Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuromanagement > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Indication of mechanical ventilation

A

acute respiratory failure, protection of airway, relief of upper airway obstruction, and Improvement of pulmonary toilet in patients with excessive secretions or inability to clear secretions by coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lines of an EKG monitor in order from top down

A 
HR
BP
arterial line blood pressure
central venous catheter 
O2 sat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of artificial airways

A

tracheostomy, endotracheal tube (both oral and nasal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types of ventilatory support

A

hand controlled ventilation (bag) and mechanical ventilators (ICU ventilator and PAP ventilators)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type of artificial airway used for someone who needs help breathing for a longer period of time (longer than a week)

A

tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 3 things you need to do with a trach tube

A

Make sure to secure straps around the neck.
Make sure inner cannula is locked in place.
Make sure the cuff is fully deflated before placing a passy muir valve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Airway pressure at the end of expiration that forces alveoli open and maintains greater lung volume.

A

PEEP (Positive End-Expiratory Pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If PEEP is greater than ___ then typically you won’t see the pt

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Each spontaneous respiratory effort generated by patient, machine delivers pre-set tidal volume

A

CMV (controlled mechanical ventilation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pressure support is to be added to augment patients tidal volume

A

CPAP (continuous positive airway pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patient is able to breath spontaneously between ventilator breaths
On each spontaneous breath, patient will receive as much volume as he can generate

A

SIMV – Synchronized Intermittent Mandatory Ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Applies to spontaneous breaths only

Once pt triggers vent, pre-set positive pressure is delivered

A

PSV – Pressure Support Ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What activity restrictions are there for a patient with an arterial sheath

A

strict bedrest (while catheter is in place and for several hours after sheath is removed). No ROM!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what should you do if an arterial line becomes dislodged

A

apply pressure with sterile gauze immediately and alert the RN.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

catheter that runs directly to the heart to measure cardiac output

A

Pulmonary Artery Catheter aka Swan-Ganz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What activity restrictions are there for a patient with a Swan Ganz catheter

A

Patients with a PA catheter are usually not candidates for mobilization because of the risks
Avoid full ROM and therapeutic exercise to the ipsilateral shoulder

You CAN manually move the scapula or passively move them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

feeding tube that is interested through a surgical opening through the skin into the stomach through abdominal wall

A

G Tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

type of G tube where tube is placed endoscopically under local anesthesia using the PEG method

A

PEG Tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

feeding tube that goes directly into the jejunum

A

J Tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

catheter tube inserted through mouth down esophagus to stomach, usually positioned just past stomach with weighted tip in duodenum

A

Dobhoff Feeding Tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

temporary small thin tube inserted through nose, throat and down into stomach – held in place with tape. Don’t push it back down if it becomes dislodged

A

NG Tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

tube inserted through the mouth into stomach usually used for patients with poor gastrointestinal function

A

OG Tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

tube inserted via patients nasopharynx and esophagus with distal tip in stomach or duodenum

A

Nasoenteric Feeding Tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Are you allowed to see a patient receiving dialysis on the same day

A

NO!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

long term. Tunneled catheter that goes into the arteries

A

dialysis catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Restrictions for pacemakers that are placed via the jugular or subclavian vein

A

No ROM assessment or therapeutic exercise to the involved shoulder

If cleared for mobilization, use caution avoid dislodging the wires
Have the RN reinforce the dressing over the wires
Keep the temporary pacing box in a safe location close to the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Restrictions for pacemakers that are placed via the femoral vein

A

Strict bedrest while the pacemaker is in place.

No ROM assessment or therapeutic exercise to the involved hip.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Restrictions for epicardial pacer

A

No UE ROM restrictions as the wires are transthoracic

When epicardial pacing wires are removed through skin: Typically on bedrest for 1-2 hours before being able to do OT(check post procedure orders or check with MD/RN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

catheter that measures the pressure inside the head

A

ventriculostomy catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What types of activities would you want to avoid with a patient who has a ventriculostomy catheter

A

Laying flat supine and trendelenburg (head down, feet up)
Valsalva maneuver (forcing exhalation against closed airway i.e. plugging nose)
Isometric exercises (due to holding breath)
Coughing (stop movement)
Pain
Agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the usual positioning of someone with a ventriculostomy catheter

A

bed rest with head of bed locked at ~30 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Device that increases cardiac output and coronary blood flow

A

IABP: intra-aortic balloon pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

With an IABP inserted via femoral artery, what are the restrictions

A

Strict bedrest

Do not flex the involved hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

With an IABP inserted via subclavian artery

A

Able to mobilize with caution
Requires a perfusionist (the person who runs the heart/lung machine during cardiothoracic surgery) with you at all times.
No ROM/exercises of ipsilateral shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Therapeutic Intensity in the ICU

A

Therapeutic Intensity
15 to 30 minute sessions
1-2 X day
3-5 X a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the goals of OT in an acute setting

A

Prevent secondary complications
Improve functional mobility
Prevent falls & improve balance
Improve sensorimotor function & facilitate return of movement
Promote cognitive & perceptual performance needed for basic functional activities
Improve or relearn BADL skills through remedial or compensatory techniques
Recognize affective issues (depression) institute coping strategies; make referrals
Promote participation in valued occupation & leisure
Recognize client & family as integral components of intervention process
Promote interdisciplinary collaboration & d/c planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Therapeutic intensity in a rehabilitation and skilled care environment

A 
Therapeutic Intensity
30 to 90 minute sessions 
1-2 X day
5-7 X a week
Average LOS ~ 10 to 35 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Goals of OT in Rehab Environments

A

Promote independence in areas of occupation
Prevent secondary complications
Improve functional mobility
Prevent falls & improve balance
Improve sensorimotor function & facilitate return of movement
Promote cognitive & perceptual performance needed for basic functional activities
Dysphagia management
Recognize affective issues & institute coping strategies; make referrals
Recognize client & family as integral components of intervention process
Patient/support system education
Interdisciplinary collaboration & d/c planning
Facilitate patient directing their own care
Prepare for next stage of recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Therapeutic Intensity in the Community Setting

A

30 to 90 minute sessions

1-2 X a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Potential barriers to engaging in occupation and social participation

A 
Falls
Lack of access to community mobility
Environmental distractions
Socio-economic limitations
Personal biases (
Home accessibility issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Goals of OT in community environments

A

Explore more fully independence in areas of occupational performance
Prevent secondary complications & manage the effects of secondary complications
Improve functional mobility
Prevent falls & improve balance
Improve sensorimotor function & facilitate return of movement
Promote cognitive & perceptual performance needed for basic functional activities
Dysphagia management
Recognize affective issues & institute coping strategies; make referrals
Patient/support system/community education
Facilitate patient directing their own care
Environmental modifications
Address barriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Symptoms of low Hgb and/or low HCT include

A

weakness, fatigue, tachycardia, dyspnea on exertion, decreased activity tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Therapy considerations for low platelet count

A

Use soft bristle toothbrush only
Avoid flossing
Use an electric razor for shaving
Don’t allow pt. to blow their nose, only wipe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Useful screening tool for renal disease and diabetes

Measures electrolyte levels, acid-base balance, renal function and blood sugar levels

A

BMP: Basic Metabolic Panel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

If you mobilize a patient whose vital signs fall outside of the “normal” parameters, treatment should be terminated if any of the following symptoms are observed:

A

Numbness or tingling in any body part.
Dizziness not resolved within 60 seconds of obtaining upright.
Nausea
Blurred vision
Dilated pupils
change in patient’s heart rate of 30 bpm over baseline.
A change in the patient’s systolic blood pressure of 30 mmHg or a change in the diastolic blood pressure of 10 mmHg.
Anginal pain
Shortness of breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Complaints specific to neurology

A

pain, headaches, vertigo, and nausea/vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Types of questions you ask about pain

A

location, quality, severity, duration, precipitating factors, associated symptoms, exasperation/diminished pain, onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Sensation of moving around in space or objects moving around them

A

vertigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

associated symptoms of vertigo

A

nausea, light-headed, off-balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What do you asses for cerebral function

A 
Mental status 
Intellectual function
Thought content
Emotional status
Perception
Motor ability
Language ability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Level of consciousness

Rostral-caudal Progression

A

mental status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Open eyes spontaneously
Responds appropriately, briskly
Oriented

A

alert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Opens eyes to verbal stimuli
Slow to respond, but appropriate
Short attention span
Obtunded (sleepy, mentally dulled from some sort of head trauma)

A

lethargic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Responds to stimuli (usually physical) with moans and groans
Never fully awake
Confused
Conversation unclear

A

stupor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Responds to painful stimuli
No conversation
Protective reflexes present

A

semi-comatose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Unresponsive EXCEPT to severe pain
Protective reflexes absent
Pupils fixed
No voluntary movement

A

Coma

57
Q

No cognitive brain function
Wake sleep cycles
Very poor prognosis (if in state > 3-6 months)

A

persistent vegetative state

58
Q

Types of stimulus for coma

A 
Voice
Touch
Shaking
Voice + Shaking
Noxious/painful stimuli
(Rubbing on sternum w/knuckles
Pen on nailbed )
59
Q

No brain function

Only reflexive movements

A

brain dead

60
Q

Types of nature of response

A

Eye opens
Remove stimuli
Abnormal posturing
No response

61
Q

Glasgow Coma Scale GCS

A 
Eye Opening
Spontaneous – 4
To speech – 3
To pain – 2
Nil – 1
Best Motor Response
Obeys -6
Localizes – 5
Withdraws – 4
Abnormal flexion – 3
Extension response – 2
Nil - 1
Verbal response
Oriented – 5
Confused conversation – 4
Inappropriate words – 3
Incomprehensible sounds – 2
Nil - 1

A strong predictor of outcome
13: mild brain injury
9-12: Moderate brain injury
< 8: Severe brain injury (coma)

62
Q

General Appearance Evaluation

A 
How do they look?
Grooming
Dress
Aids
Eye deviation
Skin integrity
63
Q

Bruising over the Mastoid, behind ear.

Suggests skull fracture

A

Battle sign

64
Q

Periorbital edema and bruising
Suggests frontal- basal fracture
Can affect vision

A

Raccoon’s eyes

65
Q

Drainage of CSF from the nose

Suggests Fracture of the cribiform with torn meninges

A

Rhinorrhea

66
Q

Drainage of CSF from the ear
Suggests:
Fracture of the temporal bone with torn meninges

A

Otorrhea

67
Q 
Flexed Posturing
Flexed arm/elbow
Flexed wrists/fingers
Adducted arms
Legs with internal rotation
Foot: Plantar flexed
Suggests
Damage to the cortico-spinal tract
A

decorticate posture

68
Q 
Extension posturing
Extended arm/elbow
Flexed wrist/fingers
Adducted arm
Pronation of arm
Foot: Plantar flexed
Suggests
severe injury to the brain at the level of the brainstem
A

Decerebrate posture

69
Q

severe muscle spasm of the neck and back

More ominous posture: extension posturing back with arched back and extended neck

A

opisthotonos

70
Q

when we look at someone bottom up we measure ____

A

component skills

71
Q

when we look at someone top down we look at _____

A

performance in task

72
Q

Where should you gather data for an evaluation

A

Medical Record / Chart Review
Observation of client including with family, staff, other clients
Interviews with client and family
Quantitative Assessment

73
Q

occupation based evaluations

A

Doing performance tasks

FIM

74
Q

Critical Evaluations

A 
Sensation
Head and neck ROM
Upper Extremity ROM
Head and UE motor control
Wrist and hand function
Trunk Control
Deformity control
Activities of daily living (FIM scoring)
75
Q

Assess ability to tolerate activity in following positions:

A

Bed
Sitting edge of bed
Sitting in chair
Standing

76
Q

Evaluate disturbances in what 3 areas

A

Thinking
Memory
Personality

77
Q

Evaluation of psychosocial elements

A 
Client’s understanding of the situation
Coping skills available
Problem solving skills
Ability to direct others
Family involvement
Discharge plans/options
Motivation/Participation in goal setting
78
Q

ability to regulate and direct the mechanisms essential to movement

A

motor control

79
Q

Damage to any of these areas will impact motor movement

A

Cerebral cortex: motor, visual, auditory, cognition, intellect
Basal ganglia: coordination, tone, equilibrium
Cerebellum: coordinated movements
Brain stem (midbrain, pons, medulla): righting reactions

80
Q

what do we look at in persons with CNS insults when trying to evaluate how well movement is regulated and directed

A

selective movements
tone
postural control and mechanisms (balance, reflexes)
coordination

81
Q

resistance of a muscle to passive elongation or stretching

A

tone

82
Q

characteristics of normal tone

A

Effective co activation of axial and proximal joints
Ability to move against gravity and resistance
Can maintain position of limb passively placed and released
Balanced agonist and antagonist muscle tone
Ease of shifting from stability to mobility & vice-versa
Ability to use muscles in groups or separately
Resilience or slight resistance in response to passive movement

83
Q

Muscle Tone Continuum

A 
(high tone to low tone)
Rigidity
Spasticity 
Normal 
Hypotonia 
Flaccidity
84
Q

Complete loss of muscle tone

A

flaccidity

85
Q

Reduction in muscles stiffness

Characterized by low tone, weak neck & trunk control, poor muscular co-contraction, limited stability

A

hypotonia

86
Q

Hypertonicity

A

spasticity

87
Q

Hypertonicity with heightened resistance to passive movement

A

rigidity

88
Q

what type of activity can stop clonus

A

weight bearing

89
Q

uncontrolled oscillations in spastic muscle groups

repetitive contractions in the antagonistic muscles in response to rapid stretch

A

clonus

90
Q

jerky resistance

A

cogwheel rigidity

91
Q

severe rigidity – sustained stretch will relax muscle group & give way (like when you’re returning the blade on a pocket knife)

A

clasp knife syndrome

92
Q

What is tone like following an insult

A

Typically, flaccid first 48 hours
Followed by increasing resistance to PROM
Spasticity pronounced in UE flexor muscles and LE extensors
Treatment: encourage voluntary movement, ROM, meds, splinting (elbow, resting hand)
Normalize tone

93
Q

Ability to maintain a steady position in weight bearing, antigravity posture

A

postural control

94
Q

What is postural control influenced by

A

Neuromuscular mechanisms—postural alignment, muscle tone & postural tone
Musculoskeletal mechanisms e.g. ROM, strength
Sensory mechanisms-vision, vestibular, somatosensory
Perceptual mechanisms e.g. body image, laterality
Cognitive mechanism e.g. attention, judgement

95
Q

Automatic movements: provide an appropriate level of stability & mobility

A

normal postural control

96
Q

Controlling the center of mass (COM) in relation to the base of support (BOS). Maintaining an appropriate relationship between body segments and between the body, the environment and task—orientation

A

balance

97
Q

first response against falling or first line of defense

A

equilibrium reactions

98
Q

ability to produce accurate, controlled movement

A

coordination

99
Q

Coordination problems

A 
Synergy
(Abnormal or disordered motor control)
Coactivation
(Agonist &amp; antagonist muscles both fire, preventing functional movement (extremity will lock out))
Timing problems
100
Q

accuracy without making corrective movements

A

precisision

101
Q

quality of movement

A

smoothness

102
Q

what is incoordination caused by

A

trauma to muscles or peripheral nerve diseases

103
Q

lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand, arm, leg, or eye

A

dysmetria

104
Q

inability to perform rapid alternating movements

A

ataxia

105
Q

involuntary quick movements of the feet or hands are comparable to dancing

A

chorea

106
Q

slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue

A

athetoid movements

107
Q

uncontrolled sustained muscle contraction

A

dystonia

108
Q

violent flinging of extremities

A

ballism

109
Q

Secondary effect factors that may impair purposeful coordinated movement

A 
Contractures
Pain
Edema
Subluxation
Decreased endurance—muscular and cardiovascular
110
Q

The study of the acquisition and/or modification of movement
A set of processes associated with practice and experience that leads to permanent change in behavior or capacity to respond

A

motor learning

111
Q

therapeutic intervention structure

A

instruction, feedback, opportunities for practice, encouragement/ feedback

112
Q

temporary change that occurs when performer is provided with solutions to problems

A

training

113
Q

relatively permanent change in capability for responding that occurs as a result of practice or experience

A

learning

114
Q

most potent factors that influence motor learning

A

feedback and practice

115
Q

stages of motor learning

A

cognitive, associate, autonomous

116
Q

stage of motor learning where Info gathered about task demands (learn elements)
Movement slow with lots of errors
Explanations & demonstrations valuable

A

cognitive

117
Q

stage of motor learning where Distinguish between correct performance and error
Attention to finer details

A

associative

118
Q

stage of motor learning where Skill automatic, does not require attention
Performance is stable

A

autonomous

119
Q

feedback offered during movement

A

concurrent

120
Q

feedback offered offered at the end of movement

A

terminal

121
Q

feedback from individual’s sensory systems as a result of movement

A

intrinsic

122
Q

feedback from the environment (e.g. therapist or a device)

A

extrinsic

123
Q

knowledge of what the movement produces (outcome) in terms of achieving goal or result

A

knowledge of results

124
Q

knowledge about the movement pattern or process used during task performance

A

knowledge of performance

125
Q

effort to become proficient

A

practice

126
Q

types of practice

A

Physical: direct experience of them doing it
Mental: motor imagery

127
Q

practice condition where practice time is greater than amount of time between trails (fatigue)

A

massed

128
Q

two practice conditions that focus on building endurance

A

massed and distributed

129
Q

practice condition where rest time between trials equals or is greater than time in trial

A

distributed

130
Q

practice condition where performance of task in same way (may improve performance but fatiguing, less effect)

A

constant

131
Q

practice condition where perform task in different way by varying characteristics of the task (improves ability to generalize to various situations)

A

variable

132
Q

practice condition where practicing each task in a block before progressing to a new task (better for cog. impair)

A

blocked

133
Q

practice condition where you’re practicing a series of tasks in a random order

A

random

134
Q

practicing a subset of task component (maybe they don’t have endurance or get frustrated)

A

part practice

135
Q

what type of feedback and practice should you give for acquisition (learning new skill)

A

Feedback: frequent extrinsic, concurrent
Practice: physical & mental, repetition, consistency
Provide manual & verbal cueing

136
Q

what type of feedback and practice should you give for retention and transfer (such as getting ready to go home)

A

Feedback: less frequent, terminal
Practice: promote entire pattern, encourage problem solving, variable
Allow for error & refinement; don’t over cue

137
Q

Therapeutic considerations for motor learning

A 
Therapeutic Environment
(TV’s, family members, lighting, yourself)
Arousal and Attention
(Inquire about their day, sleep schedule, etc.)
Motivation and Meaning
Instruction
(Prepping them ahead of time. Game plan)
Feedback
Practice
138
Q

process therapists use to facilitate learning

A 
Therapeutic intervention:
Select tasks/activities to use during session
Provide instruction
Provided feedback about performance
Always leave on a positive note
Structure opportunities for practice
Provide encouragement
139
Q

treatment assumptions

A

Return is cephalo-caudal & proximal-distal & medial-lateral
Mobility established 1st, then proximal stability, then controlled mobility, & finally distal skilled movement
Mass patterns replaced by selective voluntary movement
Gross to fine
Large mass movements before discrete
Undifferentiated to specific

Neuromanagement (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions