OCTA 227 Midterm Flashcards
1
Q
STROKE (CVA)
A
Sudden loss of blood supply to the brain that damages & kills brain cells resulting in neurological deficits related to the involved areas of the brain
2
Q
paralysis on one side of the body
A
hemiplegia
3
Q
partial motor loss on one side of the body
A
hemiparesis
4
Q
Warning Signs of a stroke:
A
*Numbness/Weakness
*Confusion
*Slurred Speech/Severe Headache
*Blurred vision
*Dizziness
*
Never…..SCBDD
5
Q
- Right sided hemiplegia & sensory loss
- Right visual field cuts
- Impaired R/L discrimination, verbal apraxia
- Decreased analytical thinking, impaired logic, time concepts, memory, aphasia
A
Left CVA
6
Q
- Left sided weakness & sensory loss
- Left field cuts, visual neglect
- Unilateral neglect
- Impaired attention span, understanding of whole, decreased creativity
- Impulsivity, emotional lability
- -Decreased ability to differentiate between gesture, decreased learning for familiar info
A
Right CVA
7
Q
low muscle tone
A
hypotonicity
8
Q
high muscle tone
A
hypertonicity
9
Q
Synergy Patterns (Flexion)
A
- Scapular adduction & elevation
- Humeral abduction & external rotation
- Elbow flexion
- Digit flexion
- Forearm supination
- Wrist flexion
10
Q
Synergy Patterns (Extension)
A
- Scapular abduction & depression
- Humeral adduction & internal rotation
- Elbow extension
- Digit flexion or extension
- Forearm pronation
- Wrist flexion or extension
SHED FIELD WORK
11
Q
Role of OT with Stroke pts
A
- Improving motor function on affected side
- Integrating sensory, visual perceptual, & cognitive functions
- Facilitating maximal level of functional independence
- Encourage return to life roles as possible
- Promote health management & maintenance behaviors to prevent recurrent stroke
12
Q
Signs of Reflex Sympathetic Dystrophy (RSD)
A
Skin-texture Skin-color Skin-temperature Swelling Stiffness Pain Motor disability Hypersensitive to cold Hair/nail growth patterns EDEMA, IRREGULAR BLOOD FLOW
Treatments (C R I M P L W)
13
Q
Reflex Sympathetic Dystrophy
Treatment for RSD
A
Chronic pain syndrome that develops in upper and lower extremities especially after brain injuries.
C. R. I. M. P. L. W
- Coban wrap, compression , cortisone(oral)
- Retrogade massage
- Ice
- Movement…..AROM or PROM
- Positioning——Elevating
- Lymph drainage
- Wrist flexion (AVOID)
14
Q
APHASIA DEFINED
TREATMENTS
TYPES OF APHASIA
A
DEFINED
Communication disorder resulting in impaired Speech….Writing……Reading…..Listening
Speech Production
Language Comprehension
DOES NOT IMPAIR I.M.P.S
Intellectual
Motor
Psychiatric
Sensory
******************************************************************
TREATMENT
C——COLLABORATE WITH SLP
R—. REPHRASE
I—. INCLUDE FAMILY
M—. MESSAGES SHORT AND SIMPLE
P—. PRAISE EFFORTS AND ATTEMPTS
E- EYE CONTACT
R—- RESPONSE TIME
G—-Gestures
I——Instructions
F—Face to Face
******************************************************************
SEVERAL TYPES:
Broca’s
Wernicke’s
Global
15
Q
Broca’s Aphasia
A
(expressive, non fluent )
Understanding of language is in tact Difficulties with spoken language Difficulty with speech production Choppy, slow and labored sentences Mispronunciations Alert and oriented Give responses
16
Q
Wernicke’s Aphasia
A
(receptive, fluent)
Weird erroneous speech output language
Reduced comprehension
Anosognosia—-unawareness of erroneous
language
Paraphasic—wrong word substitution
Neologism— made up words/mixed language
17
Q
Global Aphasia
A
loss of both language skills
ability to speak in usually gone
may appear to respond to gestures
voice tone changes
facial expressions
18
Q
Praxis
A
The ability to plan and perform purposeful movement
19
Q
Apraxia
A
An impairment in praxis, deficit in the ability to perform purposeful movement despite normal motor power, sensation, coordination, and general comprehension.
20
Q
What are the 3 types of Apraxia?
A
- Ideomotor
- Constructional
- Ideational
21
Q
Ideomotor Apraxia
A
A type of apraxia that involves the ability to perform a motor act on command.
22
Q
A type of apraxia that is a deficit in the ability to copy, draw, or construct a design, whether on command or spontaneously
A
Constructional Apraxia
23
Q
A type of apraxia that involves the inability to comprehend concept of movement or execute act automatically or in response to a command (difficulty sequencing, etc)
A
Ideational Apraxia
24
Q
A medical scale used to assess individuals after a closed head injury, including traumatic brain injury, based on cognitive and behavioral presentations as they emerge from coma
A
Rancho Los Amigos Scale
25
An injury that results from a penetrating (open) or nonpenetrating (closed injury to the brain
Traumatic Brain Injury (TBI)
26
direct trauma to the head by an object that penetrates the skull and brain
Open Brain Injury
27
caused by acceleration, deceleration, and rotational forces are applied to the head that cause brain tissue to shear (tear apart)
Closed brain injury
28
What are the 6 types of attention?
* Focused
* Sustained
* Selective
* Alternating
* Divided
* Concentration
29
A type of attention that gives you ability to respond to different kinds of stimulation
Focused Attention
30
A type of attention that gives you the ability to maintain attention for a long time (vigilance)
Sustained Attention
31
A type of attention that gives you the ability to activate and inhibit responses selectively
Selective Attention
32
A type of attention that gives you the ability to alternate back and forth between mental tasks
Alternating Attention
33
A type of attention that gives you the ability to do several things at once
Divided Attention
34
A type of attention that gives you the ability to do mental work while attending tasks
Concentration
35
disorder that causes lasting pain, usually in an arm or leg, and it shows up after an injury, stroke, or even heart attack
Reflex Sympathetic Dystrophy (RSD)
36
used to asses edema
Volumeter
37
What are some ways to manage edema:
* Elevation
* Massage
* Compression
* AROM
38
a response on the rancho los amigos scale where the pt appears to be in deep sleep, completely unresponsive to any stimuli
No response
39
a response on the rancho los amigos scale where the pt reacts inconsistently and non-purposefully; responses may be delayed
Generalized response
40
a response on the rancho los amigos scale where the pt responds specifically but inconsistently with delays to stimuli; turns head to sound (not consistent)
Localized response
41
a response on the rancho los amigos scale where the pt has a heightened state of activity with decreased ability to process info; responds primarily to their own internal confusion; may be euphoric or hostile; may overreact to stimuli
Confused-Agitated Response
42
a response on the rancho los amigos scale where the pt appears alert and is able torespond to simple commands fairly consistently; as complexity increases, responses become non-purposeful, fragmented; maybe agitated as a result of external stimuli; out of proportion to stimuli
Confused-Inappropriate, Non-Agitated
43
a response on the rancho los amigos scale where the pt appears to have goal-directed behavior but is dependent on the external input for direction
Confused- Appropriate
44
a response on the rancho los amigos scale where the pt follows simple directions consistently and shows carry-over for relearned task (self-care) ; increased awareness of self, family, and basic needs
Automatic- Appropriate
45
a response on the rancho los amigos scale where the pt appears appropriate and oriented within hospital and home setting; completes ADLs automatically(robot-like) with supervision due to decreased insight and reactional activities; need routine
Purposeful- Appropriate
46
humerus drops and supraspinatus and other muscles stretch
Subluxation
47
Treatment for subluxation:
Affected extremity supported at all times:
Bed- proper support to achieve alignment
W/C- lapboard
Ambulating/Transferring- Kinesiotaping, sling
48
Modified Diet Progression:
Food: Puree, fine chopped, mechanical soft, regular
Liquids: Pudding, honey thick, nectar thick, thin
49
Dressing sequence for Hemiplegia Pts: Shirt
Putting shirt on (dress): affected extremity first and then unaffected extremity
Taking shirt off (undress): unaffected extremity first and the the affected extremity
50
Dressing sequence for Hemiplegia Pts: Pants
Cross affected leg over unaffected leg and put affected leg in first followed by unaffected leg
51
Considerations for feeding candidates:
Decrease: Distractions,
Increase: complexity of task, short step directions, arranging items, how much time
52
levels 1-3: Total assistance
levels 4-6: Confused/Agitated
levels 7/8: Automatic/Purposeful
Ranch Los Amigos Scale
53
an approach that seeks to improve and restore cognitive skills
Remedial approach
54
an functional approach that uses intact cognitive skills to compensate for deficits
Adaptive approach
55
An adaptive approach that normally would use rehabilitation model to promote adaptation of/to the environment so pt is successful in occupations
Top Down Approach
56
An remedial approach that normally would use the biomechanical model to restore function, working on lower level skills, and focusing on impairment to be successful in occupations
Bottom Up approach
57
Remedial approach for Memory Deficits:
* organization facilitates recall
| * attention training results in improved memory
58
Adaptive approach for Memory Deficits:
* Active listening
* Note taking (lists, schedules, direction)
* Rehearsal (retaining through mental repetition; working memory)
59
Remedial Approach for Problem Solving Deficits:
* Have pt read & reread directions
* Train pt to generate alternatives
* Teach pt to evaluate and select most effective alternatives
60
Adaptive Approach for Problem Solving Deficits:
* Instruct pt to check for errors before proceeding
* Provide external cues to reduce pts use of inappropriate strategies
* Teach pt importance of asking for help when unable to solve a problemy
61
Remedial Approach for Visual Perception Organization & Processing Skills:
* Assumes the adult brain can repair/reorganize after injury
* Seeks to cause CNS function
* Can use these approaches: sensory-integrative, neurodevelopment, transfer-of-training
62
Adaptive Approach for Visual Perception Organization & Processing Skills:
* Tx is repetitive; relies on the intact portions of the brain to compensate
* Make pt aware of deficit & teach pt to work with deficit & adapt the environment
63
When grading an activity what are the cognitive considerations?
* Environment
* Complexity of task
* Directions
* Spatial Arrangement of items
* Time
64
What are the different remedial approach?
* Bottom up approach
* Sensory integrative
* Neurodevelopmental
* Transfer-of-learning
65
an remedial approach that integrates sensations into normal activity
Sensory Integrative
66
an remedial approach that restore normal movement through handling techniques & repetitive movements
Neurodevelopmental
67
an remedial approach that assumes practice in specific perceptual skill drills will generalize to better performance in daily activities that require the same perceptual skills; generalization
Transfer-to-learning
68
Pt will complete toilet transfers
Pt will Self feed
Pt will complete lower body dressing
LTG's
69
Pt will perform toilet transfers with MOD assist from bed to BSC using grab bars PRN within one week
STG
70
Pt will perform self feeding with min assist within one week
STG
71
Therapeutic activity for muscle strength and resistance
Have pt seated upright in a chair. Pt will place theraband under feet & use the affected forearm to pull up with multiple reps followed by the affected arm and repeat
72
Therapeutic activity for sitting balance
Have pt seated on firm surface with mirror in front. Have therapist use verbal and physical cues for pt to sit upright. If pt slouch he can use hand to push body upright. Once pt can sit upright and maintain the position the therapists will push pt sided to side, front to back. Pt cant tip over
73
Therapeutic activity for reaching and stretching
* Have pt seated in a chair at a table and place a physio ball in front of him. Have pt roll ball back and forth and side to side crossing the midline on the table. switch arms
* Grabbing velcro balls off wall behind him and placing them in bin in front of him
74
Therapeutic activity for ROM
* Have pt seated in between an elevated table and a regular table. Have pt grab cones off regular table and place on elevated table repeatedly until cones are all on the elevated table.
* Graded arc seated
75
Therapeutic activity for core strength & endurance
* have pt seated in chair playing ball toss
| * seated tossing bean bags in 3 bins
76
Therapeutic activity for balance
* have pt practice sit to stands with out hands
| * ring toss seated EOB
