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Midterm Study Flashcards

1
Q

10 enablement skills #1: adapt

A

to fit into situation

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2
Q

10 enablement skills #2: advocate

A

raise critical perspectives (supports or reccommends)

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3
Q

10 enablement skills #3: coach

A

ongoing partnership with client

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4
Q

10 enablement skills #4: colaborate

A

to work jointly

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5
Q

10 enablement skills #5: consult

A

exchange views and information

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6
Q

10 enablement skills #6: coordinate

A

integrate, synthesize, document, link

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7
Q

10 enablement skills #7: design?build

A

products, adaptations

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8
Q

10 enablement skills #8: educate

A

empathsize learning through doing

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9
Q

CVA on left (right hemi)

A
  • Verbal communication problems (aphasia)
  • Decreased analytical and mathematical ability
  • Motor planning problems (Apraxia)
  • Depression more common
  • Cautious
  • Are more likely to achieve self-care independence earlier
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10
Q

CVA on right (left hemi)

A
  • Visual/perceptual deficits
  • Difficulty with tasks requiring spatial analysis
  • Neglect of left side
  • Dressing apraxia (coordinated movement)
  • Slower to become independent
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11
Q

brain stem stroke effects..

A

can effect both sides of the body (depending on severity)

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12
Q

cerebellar stroke effects..

A

can cause lack of balance and coordination (Ataxia), can also cause slurring of speech (Dysarthria)

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13
Q

avoid learned non use syndrome because it leads to..

A

Decrease strength
Decrease ROM
Decrease fine motor skill
contractures

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14
Q

7 stages of recovery

A
  1. Flaccidity; no movement .
  2. Movement patterns emerge (synergies); limited voluntary movement; spasticity begins
  3. Spasticity peaks.
  4. Spasticity declines; movements more functional
  5. More difficult movement patterns are mastered
  6. Individual joints movements are mastered. Continued decline of spasticity.
  7. Normal motor function restored.
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15
Q

typical spastic pattern

A 
Scapular retraction
Shoulder depression and internal rotation
Elbow flexion
Forearm pronation
Wrist flexion
Flexion and adduction of the fingers
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16
Q

if not handled properly the hemiplegic arm can develope

A

pain syndrome

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17
Q

painful shoulder interferes with..

A

Interferes with the rehab.
Makes sleeping difficult
Requires more medication
Client avoids using arm for function

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18
Q

shoulder pain impigement caused by

A

trauma to the joint

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19
Q

shoulder pain immobility cause

A

by not doing anything, soft tissue tightness andloss of ROM

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20
Q

shoulder hand syndrome signs

A

limited shoulder ROM (with or without pain)
swollen, shiny hand with limited finger ROM
pain in even slight wrist extension

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21
Q

why should the hemiplegic shoulder be handled properly?

A

to prevent the development of pain syndrome

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22
Q

how to protect hemiplegic shoulder:

A

Never PULL on the hemi shoulder (to change position, transfer, stand-up)
Do not hold on to the hemiplegic arm to the support the person in sitting, standing &/or walking.
Avoid re-positioning in the w/c by putting your arms under their arms
Do not force painful ROM
Do not raise the arm in flexion or ABduction past 90 degrees without the scapula gliding
Do not raise the arm in flexion or Abduction without some external rotation of the humerus.

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23
Q

bed positioning to prevent shoulder pain and shoulder hand syndrome

A

position on hemiplegic side
check to make sure scapula is in full protraction (should be lying on scapula, NOT glenohumeral joint)
in supine, have affected arm at side on body, palm up (ext rot. of humerus)

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24
Q

how to reduce edema to prevent shoulder pain and shoulder hand syndrome

A

ice slush
retrograde massage
Active ROM

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25
how to encourage movement of involved shoulder to prevent shoulder pain and shoulder hand syndrome
make sure scapula is gliding before ROM to shoulder | ROM only to point of discomfort
26
wrist in slight extension to avoid shoulder pain and shoulder hand syndrome
position on a wheel chair lap tray | possible use of splint
27
Maintain ROM of MCP/PIP/DIP joints to avoid shoulder pain and shoulder hand syndrome by...
gentle PROM; AROM | facilitation of a gross grasp
28
principles of CVA treatment
Make sure client is comfortable If seated- feet flat on the floor Respect pain at all times- never take PROM or AROM into a painful range Work proximal to distal (Example: do not attempt to open a tight hand with out mobilizing proximally first) Monitor for fatigue and frustration Client centered focus is important On-going education of client and family
29
3 ways to incorporate a non functional arm
1. as a weight bearing stabilizer 2. guided movement by assistant 3. bilaterally (use both hands to do a task)
30
treatment activities for gross grasp
Sweeping Holding bowl against body while mixing Hold a phone receiver while dialing Hold dishes while washing them
31
treatment activities for fine grasp
``` Tying knots (progress from thicker to finer yarn) Opening containers (larger to smaller) Bundling pairs of socks Folding paper and stuffing envelopes Picking up coins typing ```
32
functional mobility includes
Rolling Sit to stand Standing and walking
33
functional mobility: rolling
On narrow surfaces (such as sofa) Under a quilt Propping to adjust pillows Rolling in a dark room
34
functional mobility: sit to stand
Different chairs Practice moving from one seat to another : high to low Practice different speeds of movement: getting up and down quickly
35
functional mobility: stand and walking
``` Different textures of flooring Vary speed of movement Incorporate changes in lighting Practice holding/carrying objects while walking Practice skills while standin practice fast reactions. ```
36
define vision
photons reflect off objects and are absorbed by eyes
37
define hearing
objects cause vibrations in air, which travel and are absorbed by ears
38
define touch
stimulates receptors in skin
39
define taste
molecules in substances interact with taste receptors in our tongue
40
define smell
substances in world give off molecules which float through air and interact with receptors in the nose
41
define temperature
Infra-red radiation (heat) picked up by receptors in our skin
42
define position sense
The position of our bodies in space (proprioception), our body movements through space (kinesthesia), balance, equilibrium and righting reactions are sensed through receptors in our joints and muscles and inner-ear
43
define perception
“Perception is the task of determining what is out there in the world from sensory input.” Perception allows us to connect with the world
44
examples of perception:
``` Body Awareness Directionality Figure-Ground Perception Form Constancy Kinesthesia Motor Planning: Proprioception Stereognosis ```
45
define gnosia
is the faculty of perceiving and recognizing.
46
define agnosia
Unable to identify an object by looking at it.
47
define Prosopagnosia
is the inability to recognise familiar faces (usually figures it out when the person speaks)
48
define stereognosis
allows us to “see” with our hands.
49
define body scheme
awareness of body parts in relation to each other. Includes
50
define asomatognosia
severe loss of body scheme. Usually evaluated by having client point to different body parts on command or by imitation.
51
define praxia
the ability to plan and perform movement.
52
define apraxia
is the inability to perform purposeful movement despite normal motor power, and coordination
53
define proprioception
is the sense that tells us where we are in space called the "sixth" sense
54
damage to the optic tract causes...
visual loss
55
what is macular sparing
macral picture
56
signs of homonymous hemianopsia
think of abigail
57
define Unilateral Neglect or Hemi-neglect
is an unawareness of the left side of space, or the left side of the body. May have no insight into the disability
58
define neglect
is the lack of awareness of visual space (usually to the left) PLUS inattention to that side of the body and the environment.
59
what causes neglect?
The lesion in the brain causing neglect usually occurs in the right frontal-parietal lobe, resulting in a left side neglect.
60
C1-3
neck muscles | Breathing: Depends on a ventilator for breathing.
61
c3-c4
diaphragm, trapezius ability to shrug shoulders Breathing: May initially require a ventilator for breathing, usually adjust to breathing full-time without ventilator assistance.
62
c5
``` deltoid, biceps Ability: good head, neck and shoulder control(deltoids). Can bend elbows (biceps) short distances manual chair ```
63
c6
``` wrist extensors Ability: Can shrug shoulders, bend elbows, pronate/supinate, and extend wrists can use manual ```
64
`c7
triceps, extensor digitorum Ability: ability to straighten elbows (triceps). Mobility: Daily use of manual wheelchair. Can transfer with greater ease
65
c8
Flexor digitorum Ability: use of hands. Good to normal UE function. Daily tasks: Can live independently without assistive devices in feeding, bathing, grooming, oral and facial hygiene, dressing, bladder management and bowel management.
66
t1
hand intrinsics | limited walking with leg braces
67
t2-t12
intercostals
68
t7-l1
abdominal
69
define quadriplegic
spinal cord injury above the first thoracic vertebra
70
define paraplegic
the level of injury occurs below the first thoracic vertebra.
71
define orthostatic hypotension
sudden drop in blood pressure caused by moving from a lying to sitting or standing
72
define autonomic dysreflexia
An abrupt onset of excessively high blood pressure; most common in injury levels above T-5
73
temperature regulation with SCI
Most people with complete spinal cord injuries do not sweat below the level of the injury
74
acute phase of SCI
medical stabilization, positioning, ROM etc. (may last days to weeks)
75
Early rehab phase of SCI
out of bed activities, strengthening, ADLs, bed mobility, sitting tolerance, use of assistive devices, determine equipment needs etc.
76
Active rehab phase of SCI
more independence in transfers, mobility, ADLs, community outings.
77
Preparation for discharge phase of SCI
preparing for a smooth discharge to home or residence. Home modifications, driving evaluation etc.
78
Outpatient Follow-up phase of SCI
community re-integration and outpatient services.
79
tenodesis grasp used by
C6 and C7 quadriplegia
80
define occupation
in occupational therapy refers to everything that you do in life – at home, at work, at school and in your community. (self care, productivity and leisure

OTA 2 (2 decks)

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