Final

Question 1

Treatment: Pushers Syndrome

What is it?

What are signs?

Answer 1

Occurs when the pt pushes heavily to the affected side and resists passive correction

Signs:
Holding on to bed or mat as if they were falling

Head turned away from affected side

Decreased ability to detect stimuli from affected side

Resistance to attempts to transfer weight to stronger side

Question 2

Assessment: PASS
Postural Assessment Scale for Stroke (PASS)

What’s assessed in the PASS?

Answer 2

12 items scored from 0 to 3
Higher scores = better performance

Sitting without support, standing with and without support,
standing on nonparetic leg, standing on paretic leg, supine to affected side, supine to non affected side, standing and picking up a pencil on the floor

Question 3

What is neuroplasticity?

Answer 3

Neuroplasticity is the brain’s ability to change (for better or worse)

Question 4

Cortical Maps:

Answer 4

Adult stem cells can generate new differentiated neurons in the hippocampus, dentate gyrus, and olfactory bulbs

Question 5

Synaptogenesis

Answer 5

The formation of synapses between neurons in the nervous system

Question 6

What’s Hebb’s rule?

Answer 6

Hebb’s Rule: it is a learning rule that describes how the neuronal activities influence the connection between neurons, i.e., the synaptic plasticity

“Neurons that fire together, wire together”

Question 7

Competitive Plasticity

Answer 7

Natural selection process that occurs with use or disuse.

“Use it or lose it”

Question 8

Positive Plasticity

Answer 8

take place at the cellular and molecular level that form new pathways for function (ex: taxi drivers- different route compare to bus drivers)

Question 9

Negative Plasticity

Answer 9

Negative plasticity: learn things negatively, rigidity, neurons that fire out of sync and fail to link ( fear of falling after 1st fall, follow the same routine/rutt/increase tone/)

Question 10

Competitive Plasticity

Answer 10

Natural selection process that occurs with use or disuse.

Question 11

Cerebellum: critical for …

Answer 11

communicating with frontal lobe

Question 12

Basal ganglia: critical for …

Answer 12

habit formation

Question 13

Procedural learning

Answer 13

Occurs for tasks that are particularly automatic (without attention or consciousness).

Question 14

Declarative Learning

Answer 14

Created knowledge that can be recalled.

Question 15

What’s CVA/ Stroke

Answer 15

a disease of the cerebral vasculature where there is a failure to supply oxygen to the brain

Question 16

What’s TIA: Transient Ischemic Attack?

Answer 16

Either thrombic or embolic with reversible defects, effects must resolve in less than 24 hrs

Question 17

Define Infarct:

Answer 17

a localized area of tissue that is dying or dead, having been deprived of its blood supply because of an obstruction by.

Question 18

Describe a Hemorrhagic stroke

Answer 18

A hemorrhagic stroke is when blood from an artery begins bleeding into the brain.

Question 19

Bleeding from an arteriovenous malformation

Answer 19

Found throughout the body and can occur in any part of the brain.

Usually congenital.

Headaches and seizures are common

Question 20

Ruptured saccular aneurysms

Answer 20

Characterized by acute,

abrupt onset of a severe headache,

brief loss of consciousness, nausea, vomiting, focal neurologic deficits, and stiff neck.

Question 21

Spontaneous Lobar

Answer 21

Occur outside of the basal ganglia and thalamus in the white matter of the cerebral cortex.

Often associated with clients with AVMs (arteriovenous malformation), bleeding diatheses, tumors, aneurysms in the circle of Willis.

Acute onset of symptoms, coma/stupor much less common, headaches common

Question 22

Deep Hypertensive Intracerebral

Answer 22

Small penetrating arteries in the deep brain that have damage from HTN.

Develops in minutes to an hour. Rapid recovery in first 2-3 months.

Pt usually awake and under emotional distress when it occurs. Vomiting and headache common.

Question 23

What does FAST stand for?

Answer 23

F: Facial drooping
A: arm weakness
S: Speech difficulties
T: Time (call 911 ASAP)

Question 24

What is an OT’s role in acute care hospital ?

Answer 24

OT role:

1. Evaluate and make recommendations for d/c
2. Patient and family education
3. Decrease risk of complications
4. Initiate OT rehabilitation

Question 25

What’s dyad training?

Answer 25

Dyad training in which the person can observe and practice a task is beneficial to learning a new task

Question 26

Define random practice:

Answer 26

-Random practice: (repetitive practice of several tasks in varied sequence, varied context, whole task) is better for motor learning than blocked practice (repetitive practice of the same task, same context, part of task)

Question 27

Define Self controlled practice:

Answer 27

-Self controlled practice (person decides when and how feedback is given and if AD is used) is better than instructor-controlled practice.

Question 28

Feedback:

Answer 28

Feedback: can interfere with long term learning, decreased feedback better than increasing, summary feedback after multiple trials is better than feedback after every trial

Question 29

What’s the 5 steps for Using a top down approach

Answer 29

Step 1) Role Performance

Step 2) Occupational Performance Tasks

Step 3) Task Selection and Analysis
critical control parameters

Step 4) Perform specific assessments of client factors, performance skills, and performance patterns

Step 5) Evaluation of the environment: context and activity demands

Question 30

pathologic joint condition

Answer 30

limiting factor be if evaluating extrinsics and no change in available digit extension occurs while the wrist is flexed

Question 31

anterograde amnesia

Answer 31

unable to form new memories, days, weeks, or months after event

Question 32

retrograde amnesia

Answer 32

loss of memory prior to event, can be days, weeks, or months prior

Question 33

decorticate rigidity

Answer 33

internal roation of shoulders, elbow, wrist, and digits flexed, hips extended and IR, knees flexed, plantar flexion. Increased rigidity when awake. Lesion to cortical white matter, internal capsule, thalamus, cerebral penacal, and basil ganglia

Question 34

decerebrate rigidity

Answer 34

extended and external rotation in shoulders, elbows extended, flexed wrist and digits, hip extension/IR, knee extension, ankle and plantar flexion. Increased rigidity when awake. Is due to a lesion in the midbrain pons or diancephalons

Question 35

Chronic Traumatic Encephalopathy (CTE)

Answer 35

A neurodegenerative disease associated with repeated head trauma (football) Results in generalized global atrophy of the brain, ventricular dilation, thinning of the corpus collosum, and neurofibrillary bundles similar to AD (Alzheimer’s) Symptoms include headaches, difficulties with attention and memory, mood disorders, motor dysfunction, and dementia

Question 36

Second impact syndrome (SIS)

Answer 36

Occurs when an individual suffers a second head injury before the initial injury has fully healed…leads to diffuse cerebral swelling

Question 37

where consciousness, breathing, and heart rate are controlled, sometimes compromised by intercranial pressure (ICP), damage here can result in coma or death

Answer 37

brainstem

Question 38

coma

Answer 38

absence of awareness of self and the environment there is no period of wakefulness this rarely lasts more than 4 weeks without medications, some people are placed into medical comas.

Question 39

vegetative state

Answer 39

Wakefulness without awareness Characteristics: no awareness of self or environment, inability to interact with others, no sustained or voluntary behavioral responses, no language comprehension, sleep wake cycle varies, ability to regulate temp, breathing, and circulation with medical care, incontinence of bowels and bladder, variably preserved cranial nerves and spinal reflexes prognosis worst if lasts more than 12 months

Question 40

minimally conscious state (MCS)

Answer 40

Evidence of awareness of self and/or environment. Must have 1 of the following: ability to follow commands, gesture or verbal yes/no responses, intelligible verbalization, and purposeful movement

Question 41

secondary injury

Answer 41

Occur as a result of the effects of brain swelling in a closed space, loss of perfusion, and decreased delivery of oxygen

Question 42

minimize secondary injury

Answer 42

Resuscitation of blood pressure and oxygenation, management of elevated intracranial pressure, nutrition after acute trauma and seizure prophylaxis

Question 43

Multifocal and diffuse brain injury

Answer 43

Ataxia Diplopia Dysarthria Impulsivity, irritability Apathy, poor initiative Decreased mental processing speed & efficiency Impaired attention Impaired abstract reasoning, planning, problem solving

Question 44

Diffuse axonal injuries (DAIs)/Traumatic axonal injury (TAI)

Answer 44

prototypic lesions caused by rapid deceleration and rotation of the brain in the skull

Question 45

Intraventricaluar hemorrhage (IVH)

Answer 45

Large ones can block flow of cerebrospinal fluid that can result in hydrocephalus occur when the pia or arachnoid is torn

Question 46

Subacrachnoid Hemorrhage (SAH)

Answer 46

caused by trauma less frequently associated with vasospasms and by ruptured aneurisms occur when the pia and arachnoid is torn

Question 47

Intracerebral hemorrhage (ICH)

Answer 47

nearly always present with missile wounds and common after falls and assault

Question 48

multifocal and diffuse injury

Answer 48

often caused by sudden deceleration of the body and head with variable forces and deeper portions of the brain