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OCCUPATIONAL THERAPY > OCTA 226 Lecture Final Exam > Flashcards

OCTA 226 Lecture Final Exam Flashcards

1
Q

Manual muscle testing: Zero (0)

A

No muscle contraction can be seen or felt

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2
Q

Manual muscle testing : Trace (1)

A

Contraction can be felt, but there is no motion

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3
Q

Manual muscle testing: Poor minus (2)

A

Part moves through incomplete ROM with gravity decreased

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4
Q

Manual muscle testing: Poor (2)

A

Part moves through complete ROM with gravity decreased

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5
Q

Manual muscle testing: Poor plus (2+)

A

Part moves through incomplete ROM against gravity or through complete ROM with gravity decreased against slight resistance

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6
Q

Manual muscle testing: Fair minus (3)

A

Part moves through incomplete ROM against gravity

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7
Q

Manual muscle testing: Fair (3)

A

Part moves though complete ROM against gravity

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8
Q

Manual muscle testing: Fair plus (3+)

A

Part moves through complete ROM against gravity and slight resistance

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9
Q

Manual muscle testing: Good (4)

A

Part moves though complete ROM against gravity and moderate resistance

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10
Q

Manual muscle testing: Normal (5)

A

Part moves through complete ROM against gravity and full resistance

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11
Q

Medical complications of spinal cord injury (SCI)

A
  • Skin breakdown
  • Pressure sores
  • Decubitus ulcers
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12
Q

This ASIA classification indicates a complete lesion, no motor/sensory function in the sacral segments S4-S5

A

ASIA classification A

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13
Q

This ASIA classification indicates an incomplete lesion, sensory but no motor function below the neurological level and includes sacral segments S4-S5

A

ASIA classification B

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14
Q

This ASIA classification indicates an complete lesion, motor function below the neurological level, and more than half of the key muscles below the neurological level have a muscle grade less than 3

A

ASIA classification C

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15
Q

This ASIA classification indicates an incomplete lesion, motor function below the neurological level, and at least half of the key muscles below the neurological level have a muscle grade of 3 or more

A

ASIA classification D

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16
Q

This ASIA classification indicates that motor and sensory function is normal

A

ASIA classification E

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17
Q

any degree of paralysis of the 4 limbs and trunk musculature

A

Tetraplegia (quadriplegia)

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18
Q

paralysis of the LE with some involvement of the trunk and hips depending on the level of lesion

A

Paraplegia

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19
Q

PLISSIT stands for

A 
P- Permission giving
L- Limited
I- Information
S- Specific
S- Suggestions
I- Intensive
T- Therapy
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20
Q

Barriers for therapists addressing sexual activities with pts:

A
  • lack of comfort
  • lack of knowledge
  • fear of offending client
  • cultural/religious beliefs
  • older age client
  • negative attitudes
  • embarrassment
  • client ill
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21
Q

Functional outcome of Level C1-3

A
  • Intact muscles: sternocleidomastoid, cervical paraspinal, neck accessories
  • Movement possible: neck flexion, extension, rotation
  • Weakness- total paralysis of the trunk, UE, LW, dependent on ventilator
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22
Q

Functional outcomes of Level C4

A
  • Intact muscles: Trapezius, Partial Levator scapulae, Diaphragm, Cervical paraspinal
  • Movement: neck flexion/extension, rotation, scapular elevation, inspiration
  • Weakness- paralysis of trunk, UE, LE, inability to cough, endurance and respiratory reserve low secondary to paralysis of intercostal
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23
Q

Functional outcomes of Level C5

A
  • Intact muscles: Deltoids, Biceps, Brachioradialis, Brachialis, Partial Serratus Anterior, Rhomboids, Supinator
  • Movement: shoulder flexion/extension/abduction, elbow flexion/supination, scapular adduction/abduction
    Weakness: absence of elbow extension, pronation, all wrist/hand movement, total paralysis of trunk and LE
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24
Q

Functional outcomes of Level C6

A
  • Intact muscles: clavicular, pectoralis, supinator, extensor carpi radialis longus and brevis, serratus anterior, latssimus dorsi
  • Movement: scapular protraction, some horizontal adduction, forearm supination, radial wrist extension
  • Weakness: absence of wrist flexion, elbow extension, hand movement, total paralysis of trunk and LE
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25
Q

Functional outcomes of Level C7-C8

A
  • Intact muscles: latissimus dorsi, sternal pectoralis, triceps, pronator quadratus, extensor carpi ulnaris, flexor carpi radialis, flexor digitorum profundus and superficialis, extensor communis, pronator/flexor/extensor/abductor pollicis, partial lumbricals
  • Movement: elbow extension, ulnar/wrist extension, wrist flexion, finger flexions/extensions, thumb
  • Weakness: paralysis of trunk and LE, limited grasp and dexerity secondary to partial intrinsic muscles of hand
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26
Q

Functional outcomes of Level T1-T9

A
  • Intact muscles: intrinsic muscles of hands/thub, partial intercostals, upper abdominals, Long muscles of back, erector spinae, lumbricals, flexor/extensor/abductor pollicis
  • Movement: UE fully intact, limited upper trunk stability, endurance increased secondary to innervation of intercostals
    Weakness: lower trunk paralysis, total paralysis of LE
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27
Q

Functional outcomes of Level T10-L1

A
  • Intact muscles: full intercostal innervation, additional abdominal innervation, external obliques, rectus abdominus
  • Movement: fair to good trunk stability
  • Weakness: paralysis of LE
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28
Q

Functional outcomes of Level L2-S5

A
  • Intact muscles: hip flexors, knee extensors, ankle dorsiflexors, long toe extensors, ankle plantar flexors, fully intact abdominals, other trunk muscles
  • Movement: good trunk stability, partial to full control of LE
  • Weakness: partial paralysis of LE, hip, knees, ankle, foot
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29
Q

the tendons of the intrinsic hand muscles are held close to the bones of the wrist and hand by connective tissue

A

Tenodesis

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30
Q

Tenodesis

A
  • wrist extension results in finger flexion

* wrist flexion results in finger extension

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31
Q

Why is tenodesis beneficial?

A

repairs the joints

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32
Q

How do we prevent tenodesis from overstretching?

A
  • splinting

* using fist instead of hands opened to do transfers

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33
Q

What are the major types of Arthritis?

A
  • Rheumatoid arthritis (RA)
  • Osteoarthritis
  • Gout
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34
Q

Symptoms of Rheumatoid Arthritis:

A

fatigue, loss of appetite, fever, weight loss, overall achiness/stiffness

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35
Q

Symptoms of Osteoarthritis:

A

pain, stiffness, swelling, crepitus (cracking sound)

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36
Q

Impact of RA on the hands (deformities):

A
  • Swan-neck deformity
  • Boutonniere deformity
  • Ulnar drift
  • Subluxation
  • Fusiform swelling
  • Trigger finger
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37
Q

PIP hyperextension and DIP flexion,difficulty making a fist or flexing PIP to hold small objects

A

Swan-neck deformity

38
Q

DIP hyperextension and PIP flexion (pushing button)

A

Boutonniere deformity

39
Q

Deviation of the MCP joints, distal phalanges sway to the ulnar side (avoid activities that promote forceful use to the ulnar side) opening door-use lever handle

A

Ulnar drift

40
Q

gap in normal alignment of joint

A

Subluxation

41
Q

spindle-shaped swelling in the PIP joints, swelling tapers down around base of finger

A

Fusiform swelling

42
Q

finger is locked in flexed position, fluid around synovial joint that develops into nodule and is treated with a splint or surgery to remove nodule

A

Trigger finger

43
Q

Impact of Osteoarthritis on hands:

A
  • Heberdens node

* Bouchards node

44
Q

(most common) osteophyte (hard bone spurs) formation at the DIP

A

Heberdens node

45
Q

osteophyte formation at the PIP

A

Bouchards node

46
Q

metabolic disease caused by urate deposits causing recurrent acute episodes of arthritis

A

Gout

47
Q

disease that causes the breakdown of cartilage in joints, leading to joint pain and stiffness

A

Osteoarthritis

48
Q

Splint for swan-neck deformity

A

three point finger splint (prevent hyperextension)

49
Q

Splint for boutonniere deformity

A

extension mobilization or resting splints

50
Q

Splint for trigger finger

A

trigger finger splint

51
Q

Splint for MP ulnar drift

A

soft ulnar deviation splint

immobilization splint

52
Q

Splint for subluxation

A

resting splints

immobilization splints

53
Q

Treatment precautions for arthritis pts:

A
  • avoid fatigue
  • respect pain
  • avoid static, stressful, or resistive activities
  • limit the application of heat to 20 mins
  • use resistive exercises with caution and never with unstable joints
  • be aware of sensory impairments
54
Q

Treatment methods for arthritis pts:

A
  • rest
  • positioning
  • physical agent modalities (PAMS)
  • therapeutic activity and exercise
  • splinting
55
Q

Examples of PAMS:

A
  • heat (paraffin, heat packs)
  • cold (ice packs)
  • transcutaneous electrical nerve simulation (TENS)
  • biofeedback
56
Q

Principles of joint protection:

A
  • respect pain
  • maintain muscle strength and ROM
  • avoid positions that put stress on involved joints
  • use strongest muscles to accomplish task
  • distribute the load across several joints
  • use well-designed tools
  • use wrist and fingers in neutral position
  • avoid static positions
57
Q

What is used to measure edema?

A

volumeter or circumferential (opened wound)

58
Q

What is used to measure ROM?

A

goniometer

59
Q

What is used to measure grip strength?

A

dynamometer

60
Q

What is used to measure pinch strength?

A

pinch gauge

61
Q

What is used to measure UE strength?

A

manual muscle testing

62
Q

What is used to measure two point discrimination or static moving?

A

monofilament touch test

63
Q

What test is used for assessing regeneration of nerve?

A

sensibility test (vibratory tests) “Tinel’s sign and Phalens Test”

64
Q

Sensory distribution of radial nerve:

A
  • a strip of the posterior upper arm and the forearm
  • the dorsum of the thumb
  • the index and middle fingers and radial half of the ring finger to PIP joints
65
Q

Muscles innervated by radial nerve:

A

extensor and supinator group of muscles of the forearm

66
Q

Weakness of radial nerve:

A

Triceps

Brachioradialis

67
Q

Sensory distribution of ulnar nerve:

A
  • dorsal and volar surfaces of the little finger

* ulnar half of the dorsal and volar surface of the ring finger

68
Q

Muscles innervated by the ulnar nerve:

A
  • flexor carpi ulnaris
  • median half of flexor digitorum profundus
  • intrinsic muscles of the hand
69
Q

Weakness of ulnar nerve:

A
  • ulnar intrinsics

* pinch and grip

70
Q

A syndrome occurring in pt with SCI above T6. Caused by reflex action of the autonomic nervous system in response to some stimulus such as a distended bladder, fecal mass, bladder irritation, etc

A

Autonomic dysreflexia?

71
Q

A decrease in BP due to pooling of blood in areas of lack of muscle tone including abdominals and LW

A

Orthostatic hypotension

72
Q

Ramp specifications:

A

1 inch of vertical rise requires at least 1 foot (12 inches)

73
Q

Treatment planning for paraplegic:

A

Dressing, Eating, Hygiene/Grooming, Mobility Transfers, Home management Activities, etc

74
Q

Wheelchair access specifications for doorways:

A

doors must have a clear width of 32 inches from the face of the door to the opposite stop.

75
Q

What do OTA’s address in the PLISSIT model?

A

intensive therapy

76
Q

Sensory distribution of the median nerve:

A
  • volar surface of thumb
  • index and middle fingers
  • radial half of ring finger
  • dorsal surface of index & middle fingers
  • radial half of ring finger distal to PIP joints
77
Q

Muscles innervated by the median nerve:

A
  • flexors of the forearm and hand
78
Q

Weakness of the median nerve:

A
  • Pronator teres, Quadratus, Thenars, etc
79
Q

Radial nerve splint:

A

Low profile radial nerve splint- pull MCP joints into extension when wrist flexed and MCP joints into flexion when wrist extended

80
Q

Median nerve splint:

A

Hand based thumb-positioning splint- preserve we space and position thumb for function

81
Q

Ulnar nerve splint:

A

Dynamic ulnar nerve splint- blocks hyperextension of MCP joints a;llowing extension of PIP joints

82
Q

Treatment interventions for nerve injury:

A
  • Edema management
  • ROM
  • Soft tissue mobility
  • Sensory Reeducation
  • Strength improvement
  • Functional improvement in ADL’s
83
Q

Treatment techniques for edema management:

A
  • elevation
  • contrast baths
  • retrograde massage
  • pressure wraps (coban)
  • PAMs (electrical stimulation, etc)
84
Q

Treatment techniques for soft tissue mobility improvement:

A
  • pressure
  • massage
  • active ROM
  • PAMS
85
Q

Treatment techniques for strength improvement:

A
  • resistive pulley weights
  • theraband
  • hand strengthening equipment (hand grips, thera putty)
86
Q

Equipment for C1-3 and C6: Total assist

A
  • ventilators
  • padded reclining shower/commode chair
  • electric hospital bed
  • Transfer board
  • power lift and sling
  • pressure relief pillow
  • handheld shower
  • recline/tilt wheelchair
  • mouth stick
87
Q

C7-8

A

independent to some assist

88
Q

Equipment for T1-9-S5: Independent

A
  • elevated toilet seat or padded tub bench
  • full/king bed
  • pressure relief cushion
  • padded transfed bench or shower/commode chair
  • manual rigid or folding lightweight wheelchair
  • forearm crutches or cane (T10-S5)
89
Q

Client expectations for addressing sexual activities:

A
  • initiation of discussion by professional
  • impact of disability on sexual function
  • implications on fertility & parenting
  • clear individualized related to individual needs
90
Q

Therapists considerations when addressing sexual activities:

A
  • educate the client
  • explain the impact of disability on sexual function
  • foster a sense of positive body image and self esteem
  • discuss implications for fertility and parenting
91
Q

Considerations when identifying leisure activities:

A
  • will the activity be meaningful/interesting
  • is activity age appropriate
  • what supplies are needed
  • is there enough staff to assist
  • does the facility have a budget to accommodate activity
  • will the intervention fit in the timeframe
  • where will activity occur

OCCUPATIONAL THERAPY (36 decks)

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