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OCTA 226 > Final > Flashcards

Final Flashcards

1
Q

Muscle Grade Definitions

A

0-No palpable muscle contraction 1-Trace muscle contraction 1+-GE through 1/2 ROM 2-GE through full ROM 2+-AG through 1/2 ROM 3-Full ROM AG No R 3+-AG Min R 4-AG Mod R 5-AG Max R

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2
Q

Medical Complications of SCI AH, OH, etc

A

Spinal shock may last 24 hrs – 8 weeks Spasticity- below level of injury Heterotrophic ossification Osteoporosis Autonomic dysreflexia Orthostatic hypertension Decubitus ulcer/pressure sore Deep vein thrombosis/DVT Posttraumatic syringomelia/syrinx Limits/total deficits in respiratory function, sexual functioning/response, bowel and bladder functioning depending on level of injury

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3
Q

Hetetrotrophic Ossification

A

abnormal bone development in soft tissue in or around a joint

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4
Q

Autonomic Dysreflexia

A

sudden and significant increase in blood pressure in response to noxious stimuli

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5
Q

Ramp specifications (1:12)

A

Maximum slope of a ramp in new construction should be 1:12 — meaning that every 1 inch of vertical rise requires at least 12” of ramp.

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6
Q

W/C access specifications for doorways

A

Minimum clear width for a wheelchair is 36 inches for a hall and 32 inches for a door. and radius of 5’x5’

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7
Q

Rheumatoid arthritis

A

Autoimmune: acute and non acute stages. Thickened synovial membranes, cartilage erosion leading to joint weakness, misalignment and pain. Fatigue, loss of appetite, fever, overall achiness or stiffness, weight loss.

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8
Q

Osteoarthritis

A

pain, stiffness, swelling, and crepitus, due to the breakdown of cartilage in the joints. NOT inflammatory or systemic.

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9
Q

Gout

A

metabolic disease cause by urate deposits, causing recurrent acute episodes of arthritis (diet/crash-dieting related, often men 40-50 yrs of age).

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10
Q

Impact of RA on the hands (types of deformities) and splinting options

A

Swan-neck Boutonniere Ulnar drift Subluxation Fusiform swelling Trigger finger In the acute stages RA can cause hypermobility so avoiding exercise can be helpful. Splinting options include the silver ring splints to help correct finger deformities in a functional and attractive way.

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11
Q

Swan-Neck Deformity

A

PIP hyperextension and DIP flexion

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12
Q

Fusiform Swelling

A

swelling which narrows towards the distal end

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13
Q

Boutonniere Deformity

A

tendonal misalignment leading to DIP hyperextension and PIP flexion

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14
Q

Trigger Finger

A

swollen flexor tendon/sheath limiting flow of synovial fluid

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15
Q

Treatment precautions for arthritis

A

Avoid fatigue Respect pain Avoid static/stressful/resistive activities Limit application of heat to 20 mins Use resistive exercises with caution and never with unstable joints Be aware of sensory impairments

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16
Q

Focus of treatment for patients with arthritis

A

Reengagement of meaningful activity—ADLs but also IADLs of significance.

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17
Q

Principles of joint protections

A

• use strongest/largest joints available; • use each joint in its most stable anatomical and functional plane; • avoid holding or staying in one position for prolonged periods of time; • avoid activities that cannot be stopped immediately if they become stressful; • do use assistive equipment and splinting

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18
Q

Equipment modifications/adapted equipment for individuals with arthritis

A

Consider before the presence of deformity Equipment needs vary over course of the day and may affect other joints Activities and equipment involving strong grasp are contraindicated for patients with MCP involvement Some patients with wrist or hand involvement are unable to grip standard transfer assist equipment “Convenience” appliances are not always convenient for patients with arthritis A change in ambulation aids requires instruction in ADL include built up utensils and crochet needles

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19
Q

Considerations for exercise and activities

A

Consider how joint disease affects ROM Type of exercise to use Min # of reps necessary to maintain or increase mobility Time of day to exercise Post-treatment or post-discharge followthrough on pts behalf

20
Q

Test for assessing regeneration of nerve Tinel’s Sign

A

performed to produce a reaction Tapping along nerve to elicit pins and needles/tingling sensation, to determine whether a peripheral nerve has regenerated.

21
Q

Test for assessing regeneration of nerve Phalen’s Sign

A

produce the nerve paresthesis present in compression of the median nerve. The pt is asked to hold the wrist in a fully flexed position for 60 seconds and the test is considered positive if tingling occurs within this time

22
Q

Sensory distribution of Radial nerves

A

strip of posterior upper arm and forearm, dorsum of thumb, index and middle fingers and radial half of ring finger to PIP joints. Sensory loss typically not disabling to functional hand use.

23
Q

Sensory distribution of Ulnar nerves

A

dorsal and volar surfaces of little finger; ulnar half of the dorsal and volar surface of the ring finger. Sensory loss results in frequent injury, especially burns, to ulnar side of hand and small finger.

24
Q

Sensory distribution of Median nerves

A

volar surface of the thumb, index, and middle fingers; dorsal surface of index and middle; and radial half of ring finger distal to PIP joints. Sensory loss affects all pinch patterns due to inability to judge force required.

25
Q

Muscles innervated, weakness patterns, splinting for Radial nerves

A

MI: Extensor and supinator group of muscles of the forearm. WP: wrist/finger drop (inability to extend fully at wrist or fingers) Dorsal splint: wrist extension, MCP extension, and thumb extension

26
Q

Muscles innervated, weakness patterns, splinting for Ulnar nerves

A

MI: Flexor carpi ulnaris, median half of the flexor digitorum profundus, and the intrinsic muscles of the hand. WP: weakness and clawing of the 4th and 5th fingers. Splint: MCP block of IP of ring and small fingers

27
Q

Muscles innervated, weakness patterns, splinting for Median nerves

A

MI: Flexors of the forearm and hand. WP: difficulty/inability to oppose fingers and thumb. Splint: thumb in palmar abduction and slight opposition If clawing, MCP block splint is indicated for index and long finger

28
Q

Treatment interventions for nerve injury

A

Edema management ROM Sensory Re-ed Strength and function

29
Q

Edema Managment (nerve injury)

A

Elevation Retrograde massage Compression AROM Contrast baths

30
Q

ROM (nerve injury)

A

Splinting (progressive) AROM Modalities to improve tissue elasticity Joint mobilization techniques PROM

31
Q

Sensory Re-ed (nerve injury)

A

Emphasize a variety of stimuli used in a repetitive manner to bombard the sensory receptors (Sequence of eyes- closed, eyes-open, eyes –closed…) to provide feedback

32
Q

Sensory Desensitization (nerve injury)

A

Rubbing, Vibration, Active motion, Pressure, transcutaneous electrical nerve stimulation (TENS), percussion. Hypersensitivity is sometimes the result of a lacerated nerve, but a too tight cast or splint may also cause nerve irritation.

33
Q

Strengthening activities (nerve injury)

A

Computerized evaluation and exercise equipment Resistive pulley weights Theraband Hand-strengthening equipment.

34
Q

Functional Activities (nerve injury)

A

Crafts and games Dexterity activities ADLs Work samples Vocational and avocation interests Goals

35
Q

Assessment tool to measure edema

A

volumeter OR circumferential measurement

36
Q

Treatment interventions to address edema (4 methods)

A

Compression garments/wrapping Retrograde massage Elevation AROM/activity

37
Q

Definitions for PLISST model, what areas are appropriate for OTA’s to address?

A

Permission giving Limited Information Specific Suggestions Therapy OTAs address permission giving and limited information

38
Q

Treatment planning for a para

A

ROM/Strength/Sensation Positioning Transfers Mobility ADL Patient/Caregiver Training

39
Q

Tenodesis

A

the passive, functional grip available to patients with SCI at lvl C6. A wrist-driven flexor hinge hand splint or tenodesis splint helps prevent the involved muscles/tendons from overstretching and helps to preserve funtion.

40
Q

C1-C3 Spinal Injury

A

FO: Neck flexion, extension, ant. flexionand rotation; shrug shoulders (C3 only) ROM is WFL and painfree Patient is able to direct PROM program RE: Mechanical ventilator, commun mouth sticks or env. control units, w/c sip/puff tech

41
Q

C4 Spinal Injury

A

FO: Neck flexion, ext, rot; scap. elevation (shoulder shrug) and inspiration May breathe w/o ventilator RE: Power W/C, keyboard, mounted smartphone,commun mouth sticks or env. control units

42
Q

C5 Spinal Injury

A

FO: Shoulder flexion, abd, ext; elbow flexion and sup; scap. add & abd Bed mobility w some assist UE D w some assist RE: Power W/C, hand splint, dorsal wrist support, wash mit

43
Q

C6 Spinal Injury

A

FO: Scap. protractor, some horiz. Add, forarm sup, radial wrist ext. Some bed mobility, indp eating, indp UE D,assist grooming, UE B RE: Power or manual W/C, move from universal cuff to built-up utensils, adapted cups/mugs, AE for dressing & eating, hydraulic standing frame

44
Q

C7-C8 Spinal Injury

A

FO: Elbow ext, wrist flex/ext, finger flex/ext, thumb flex/ ext/abd Ind-assit bladder and bed mob, ind transfers and press relief, ind eating and UED/UEB, ind-assist LED/LEB RE: Manual W/C, padded tub bench or shower commode chair, handheld shower, modified vehicle

45
Q

T1-T9 Spinal Injury

A

FO: UEs fully intact, ltd. upper trunk stability, endur. Ind bowel/bladder, bed mo, trans, press relief, eat, UE/LE bath/dress, ind stand w frame, ind homemaking, driving RE: Manual W/C, standing frame, hand controls (vehicle), elevated padded toilet seat or padded tub bench, shower/commode chair, handheld shower

46
Q

T10-L1 Spinal Injury

A

FO: Good trunk stability. Paralysis of LEs Ind bowel/bladder, bed mo, trans, press relief, eat, UE/LE bath/dress, ind standing w frame, assit-ind walk w crutches, ind homemaking, driving RE: Manual W/C, standing frame, forearm crutches or walker, KAFO, hand controls (vehicle), padded std or raised padded toilet seat, padded tub transfer bench, hand-held shower

47
Q

L2-S5 Spinal Injury

A

FO: Good trunk stability, partial to full control of LEs. Partial paralysis of LEs, hips, knees, ankle, foot Ind bowel/bladder, bed mo, trans, press relief, eat, UE/LE bath/dress, ind standing w frame, assit-ind walk w crutches, ind stand w frame, ind homemaking, driving RE: Padded toilet seat, padded tub bench, handheld shower, forearm crutches or cane, KAFO or AFO

OCTA 226 (2 decks)

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