OCTA 227 Lecture Final Flashcards
- retrovirus that results in a gradual deterioration of the immune system
- Virus attacks the T-cells (specialized cells that direct the immune system)
HIV
slow progressive disease of the nervous system that causes tremors and muscle stiffness
Parkinson’s Disease
a chronic, inflammatory disease of the CNS in which the immune system attacks the myelin sheath most pts incur disability over time
Multiple Sclerosis (MS)
abnormal tissue that grows and spreads or metastasizes
Cancer
progressive, slow deterioration of brain tissue resulting in decreased cognitive abilities including language and memory deficits, disturbances in the sense of time and place, personality changes, and emotional instability
Alzheimer’s Disease
caused by very small strokes over a period of time that affect blood flow to areas of the brain related to memory and thinking
Dementia (vascular)
immune system is severely depressed and its ability to resist infection is impaired
AIDS
causes degeneration of nerve cells connected to the brain that control voluntary motor function
Amyotrophic Lateral Sclerosis (ALS)
cloudiness of lens that dulls color and visual detail
Cataract
caused by dilation and leakage of blood from the retinal vessels or the growth of abnormal blood vessels on the retina
Diabetic Retinopathy
increased fluid pressure inside the eye, leading to loss of vision and eventually total blindness ( can damage the optic nerve)
Glaucoma
results in loss of central vision
Macular Degeneration
What are the compensatory measures for a client with low vision?
- Sighted Guiding
- Hand Trailing
- Protective Techniques
- Assistance Animals
What are the compensatory strategies for the client with visual loss in the areas of mobility?
- Sighted Guiding
- Hand Trailing
- Protective Techniques
- Assistance Animals
trail the surface using the arm closest to the surface
Hand Trailing
Upper Protection- forearm cover chest
Lower Protection- arm cover thigh
Protective Techniques
dog to compensate for vision (guide)
Assistance Animals
Adaptive Equipment devices for low vision:
- Blind cane
- Braille/Talking watch
- Talking prescription recorder
- Low vision magnifier
- Check writing guide
Environmental Factors and adaptations for low vision:
- Lighting: control glare, window coverings
- Contrast: change background ( light against dark)
- Color: bright colors
- Pattern: uncluttered and simple
- Print size: enlarge print, increase contrast
What are the types of Multiple Sclerosis (MS)?
- Relapsing Remitting
- Secondary Progressive
- Primary Progressive
- Progressive Relapsing
- Benign
- Malignant
acute attacks with full or partial recovery and stable remission between attacks (85% of those initially dx with MS)
Relapsing Remitting (MS)
initially follow relapsing/remitting, followed by progression at a variable rate; of those dx with relapsing/remitting, 50% develop secondary progressive within 10 years and 90% within 25 years
Secondary Progressive (MS)
progressive disability without remission from the onset of the disease; 10% dx (no recovery)
Primary Progressive (MS)
progressive from the onset with acute relapses
Progressive Relapsing (MS)
fully functional 15 years after the disease onset
Benign (MS)
rapid progression leading to significant disability or death in a short period of time
Malignant (MS)
Side affects of chemotherapy in cancer pt:
- Neutropenia
- Thrombocytopenia
- Anemia
- Peripheral Neuropathy
- Alopecia
An abnormally low count of a type of white blood cell (neutrophils). Severe impairment of the immune response with decreased resistance to infection (Treatment: protective isolation)
Neutropenia
any disorder where there aren’t enough platelets (cells in the blood that help the blood to clot) associated with abnormal bleeding
Thrombocytopenia
lack of red blood cells. Reduces tolerance for treatment; O2 level in system is depleted because of reduced hemoglobin (Treatment: respect fatigue, pace activities, prioritize activities)
Anemia
weakness, numbness, pain from nerve damage in the feet/hands. Motor and sensory involvement hypo/hyperesthesia; diminished awareness can lead to loss of protective sensation (Treatment: mild compression garments,sensory stimulation (massage), safety education, exposure to graded textures
Peripheral Neuropathy
hair loss, social stigma of cancer: significant element of identification and self image/beauty
Alopecia
Signs of nerve regeneration:
- Skin appearance (color and texture)
- Primitive sensation ( recognition of pain, temp, touch, pressure)
- Parasthesia (tingling distal to lesion site)
- Scattered point of sweating (sweat glands recover function)
- Discriminative Sensation (stereognosis, kinesthesia, etc)
- Muscle tone
- Voluntary muscle function
Stage 1 of Cancer:
localized to region
Stage 2 of Cancer:
spread to adjacent local region of the body (ex: right breast to the axilla)
Stage 3 of Cancer:
spread to another organ (ex. breast to lung)
Stage 4 of Cancer:
spread to multiple organs/systems
TNM:
Tumor: # of tumor sites
Node: # of lymph nodes that have cancer present
Metastasis: may be regional or widespread
What position should the patient be seated in when feeding?
Upright (for stability)
Stage 1 of Alzheimer’s Disease:
No cognitive decline
Stage 2 of Alzheimer’s Disease:
Very mild cognitive decline (c/o memory loss or word finding) not detectable on formal testing
Stage 3 of Alzheimer’s Disease:
Mild decline (word findingand naming deficits, misplacing objects, decrease in planning)
Stage 4 of Alzheimer’s Disease:
Moderate cognitive decline (decreased knowledge of recent events, ability to perform higher level mental calculations, and memory for personal info, inability to participate in complex tasks, socially withdrawn)
Stage 5 of Alzheimer’s Disease:
Moderately severe cognitive decline (major memory gaps, assist for complex ADL, confusion with orientation, inability to do simple calculations, knows own name and names of spouse/child, needs help picking out clothing based on weather/season)
Stage 6 of Alzheimer’s Disease:
Severe cognitive decline (memory worsens, personality changes, extensive help with ADL, occasionally forgets names of spouse, dressing ability, dysfunction of sleep/wake cycle, assist for toileting, incontinence, delusions, hallucinations, compulsion/repetition of behaviors)
Stage 7 of Alzheimer’s Disease:
Very severe cognitive decline (doesn’t respond to environment, mutism, inability to control movement, requires feeding assist, assist with walking/sitting, dysphagia, skeletal muscle rigidity)
What are the 4 degenerative neurologic disease?
- Multiple Sclerosis (MS)
- Parkinson’s Disease
- Alzheimer’s Disease
- Amyotrophic Lateral Sclerosis (ALS)
diseases that cause progressive pathlogic changes in the CNS
Degenerative Neurologic Diseases
Degenerative Neurologic Diseases result in the lost in functioning in one or more of these areas:
- Sensation
- Motor Control
- Cognition
- Compensation/Adaptation (main approach)
What is the role in of OT in the treatment of degenerative diseases?
To assist in managing symptoms, maintaining function, and optimizing quality of life.
OT Intervention for fatigue in pts with MS?
- Cooling vest (lower core body temp)
- Exercise program (time of day)
- Energy Conservation
The first step in eliminating any causes of secondary fatigue are:
Treating coexisting conditions such as:
- Depression
- Adjustments of medications
- Improving sleep patterns
- Managing symptoms that may cause fatigue (tremors)
- Education about energy conservation
Energy Conservation Techniques used by pts with MS:
- Pacing
- Rest periods
- Home/Work modifications
- Power mobility aids
- ADL assistive devices
- DME
- Heat control
- Techniques to control tremor
- Control Spasticity
occurs during voluntary movement, is often intensified at the termination of movement
Intentional Tremor
present in the absence of voluntary movement (occurs while the pt is not moving)
Resting Tremor
Interventions for tremors:
- Orthotics/splinting
- Weights
- Adaptive devices (dycem, long straw, suction devices, etc)
- Assistive technology (speaker phone)
- Minimize # of joints moving during activities
- Control fatigue
- Decrease fine motor coordination demands
Intention Tremor primarily effects:
wrist, hand, and fingers (OT focus on proximal stabilization and support)
Treatments to decrease isolation for pts with Parkinson’s Disease:
- Education regarding importance of timing activities with height of effectiveness of medication
- Modification of leisure activities to encourage participation
- Information on support and advocacy groups
- Caregiver training for modifying communication and social activities
- Writing modifications, including enlarged felt-tip pen and writing when rested
- Communication aides: speed dial, large-key telephones, dictating devices, remotes for lights, tv, etc
- Providing home exercise program to maintain facial movement and expression
Home Modifications recommendations for people with a specific progressive disease diagnosis:
- Bath bench
- Grab bars
- Handheld shower
- Raised toilet seat
- Bedside commodes
- Weighted utensils
- Velcro closures/Elastic waist bands and shoestrings
- Electric toothbrushes
- Longhandled brush
Infection Control Principles:
- Wash hands before and after pts
- Wear gloves
- Wear mask, protective eye wear, and gown during splashes or sprays
- Handle needles & other sharp instruments safely
- Routinely clean and disinfect surfaces
- Clean and disinfect linens & launder them safely
- Place pts with contaminated blood or body fluids in an isolation room
an objective assessment of an individuals ability to perform work related activity
Functional Capacity Evaluation
Components of a Functional Capacity Evaluation (FCE):
- Comprehensive: lifting, standing, walking, sitting, carrying and etc.
- Standardized: minimizes subjectivity
- Objective: free of examiner bias
- Reliable: It is reproducible
- Valid: does it assess what its intended to do; accuracy
impairment in the ability to perform movement
Apraxia
allows the individual to focus on the environmental information and sensations relevant at a particular time
Attention
requires an individual sustain focused attention for a period of time
Concentration
act of beginning something
Initiation
permanent shortening of the muscles, tendons, and ligaments
Contractures
weakening of muscles
Dystrophy
wasting away of muscles
Atrophy
an approach that use intact cognitive skills to compensate for deficits
Adaptive Approach
an approach that seek to improve or restore cognitive skills
Remedial Approach
multidisciplinary programs for rehabilitating the injured worker
Work hardening
static, no joint motion, muscle lengths remains the same.
Isometric
concentric contraction, joint motion, muscle shortens
Isotonic
overload principle, muscles perform more efficiently given a warm up, must be taxed to improve strength, start at low weight then increase
Progressive resistive
means you move a joint through its full ROM
AROM
