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7/13/15 NBCOT Exam > Physical Rehab > Flashcards

Physical Rehab Flashcards

1
Q

Treatment of contractures

A

1) superficial and deep heat to increase tissue extensibility
2) slow stretch
3) static splinting

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2
Q

Posterolateral hip precautions

A
  • no hip flexion greater than 90 degrees
  • no internal rotation
  • no adduction
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3
Q

Anterior Hip precaution

A
  • no external rotation
  • no hip extension
  • no adduction
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4
Q

Fibromyalgia

A

widespread pain affecting the entire musculoskeletal system

OT Intervention
s-Client education to avoid pain triggers/manage stress
-gentle regular aerobic exercise, gentle daily stretching, strengthening activities, cognitive-behavioral therapy
-fatigue management
-memory aids

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5
Q

Low Back Pain

A

Result of poor physical fitness, obesity, reduced muscle strength and endurance

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6
Q

Sciatic pain

A

when the nerve is trapped by a herniated disc

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7
Q

facet joint pain

A

inflammation or changes of the spinal joints

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8
Q

spondylolisthesis

A

slippage of a vertebra out of position

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9
Q

Lower back pain - OT Intervention

A
  • neutral spine back stabilization techniques to decrease pain
  • AE-increase strength and endurance
  • pain management, stress reduction, coping
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10
Q

Rheumatoid Arthritis (RA)

A

chronic, systemic, inflammatory condition of the synovial membrane of the joints that can lead to destruction of ligament, tendon, cartilage and bone.

Most common joints affected: PIP, MCP, all thumb joints, wrist, elbow, ankle

Symptoms
-pain, redness, warmth, tenderness, stiffness, ROM limitations, muscle weakness, weight loss, fatigue and depression

OT Interventions

  • AE to compensate for ROM
  • Superficial heat/cold

-ROM exercises:
-AROM can be used through full pain-free range.
-PROM used during acute flare ups to prevent stress
on inflamed joints
-Isometric exercises
-Isotonic exercises can be used during remission of RA
-Aerobic exercises=low impact such as walking, stationary bicycling, dancing-Splinting

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11
Q

osteoarthritis

A

noninflammatory condition that causes a breakdown in cartilage resulting in reduced joint space and eventually painful bone-on-bone contact.

OT Interventions

  • paraffin, fluid therapy, hot packs, Estim=reduce pain and increase ROM
  • AROM
  • Isometric/isotonic strengthening

Precautions
-pinching exercises w/CMC joint causes stress on the joint

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12
Q

Osteoporosis

A

progressive condition characterized by low bone mass/density leading to fragile/fractured bones

OT Interventions

  • Adaptations/Modifications to compensate for pain, stiffness, decreased ROM (devices w/built-up or extended handles)
  • Encourage low-impact WB activities=walking
  • Encourage good positioning/posture during activities
  • Home visit=to reduce chance of falls
  • Energy conservation/joint protection
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13
Q

Cerebrovascular Accident (CVA) - Stroke

A

neurological dysfunction caused by a lesion in the brain

Symptoms

  • trunk/postural control-fall risk
  • limits functional activity
  • dependence for ADLs
  • impairment in standing, WB, weight shifting, stepping activities
  • communication impairment
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14
Q

Feeding TBI - OT Intervention

A
  • isolated/quiet room to prevent distraction

- rocker knife, plate guard, non-spill mug

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15
Q

Ataxia - OT Intervention

A

compensatory strategies for control such as weighting body parts-hand-over-hand exercise
-follow steps/pictures or words on a note card

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16
Q

Client’s w/abnormal tone or posturing should…

A

lay on their side or semiprone to help normalize tone/provide sensory input.

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17
Q

Decorticate rigidity

A

UE are in spastic flexed position w/internal rotation and adduction. LE are in spastic extended position, internally rotated, and adducted

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18
Q

Decerebrate rigidity

A

UE/LE are in spastic extension adduction, and internal rotation. Wrist/fingers flex while plantar portions of the feet flex/invert, the trunk extends and the head retracts.

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19
Q

ataxia

A

abnormal movement resulting from cerebellum damage

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20
Q

Burn size on Adults

A

Rule of nines head/neck

  • 9%
  • 9% arm (you have two so 18%)
  • 18% trunk
  • 18% leg (you have two so 36%)
  • 1% groin
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21
Q

Superficial (1st degree) burn

A

involves superficial epidermispain is min to modhealing time is 3-7 days

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22
Q

Superficial partial-thickness (2nd degree) burn

A

upper epidermis and upper dermis layersPain is significant, wet blistering w/erythemahealing time is 1-3 weeks

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23
Q

erythema

A

redness of the skin or mucous membranes

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24
Q

Deep partial-thickness (deep 2nd-degree) burn

A

Involves the epidermis/deep dermis layers, hair follicles and sweat glands

  • Pain is severe - even to light touch
  • can turn into a full-thickness burn due to infection
  • Grafting may be considered to prevent infection
  • Impairment of sensation
  • Potential for hypertrophic scar
  • Healing time is 3-5 weeks
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25
Q

hypertrophic scar

A

excessive amounts of collagen which gives rise to a raised scar (over cut or burn)

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26
Q

Full-thickness (3rd-degree) burn

A

Involves epidermis/dermis, hair follicles, sweat glands, and nerve endings

  • Pain free!
  • No sensation to touch!
  • Burn is pale w/no blanching
  • Requires skin graft!
  • Hypertrophic scarring is high!
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27
Q

Blanching

A

when you touch your skin near a burn a white spot means you have good circulation

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28
Q

Subdermal Burn

A

Full-thickness burn to tissue, fat, muscles and bone-charring is present, destruction of nervePeripheral nerve damage
-Needs surgical intervention for wound closure/amputation

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29
Q

escharotomy

A

surgical incision into the burn tissue to relieve pressure on extremities

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30
Q

homograft

A

human cadaver graft (temporarily)

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31
Q

heterograft

A

pig skin graft (temporarily)

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32
Q

Autograft

A

Own skin (permanent)

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33
Q

Cultured epithelial autografts (CEA)

A

own skin is grown and then grafted (permanent)

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34
Q

OT Intervention: Splinting in antideformity positions

A
  • Intrinsic plus for hands
  • Opposite client’s posture
  • Generally in extension for neck, elbows and knees
  • Shoulder in abduction
  • Hip in extension
  • Anti-frog leg and anti-foot drop for lower extremity
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35
Q

OT Interventions - Burns - Acute Phase

A

ROM, muscle strength and pain

-Splinting, positioning in anti-deformity positions, edema management

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36
Q

How long do you wait until you can do passive/active ROM w/exposed tendons or recent grafts

A

5-7 days

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37
Q

How long should you wait after pain meds have been given?

A

30 minutes

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38
Q

Heterotopic Ossification

A

Formation of bones in abnormal areas.

  • Loss of ROM is rapid
  • Use AROM exercise within the pain-free range to preserve as much joint movement as possible
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39
Q

Are silastic gel sheeting used on open wounds?

A

NO

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40
Q

What are silastic gel sheeting used for?

A

Temporary use in the management of both old and new hypertrophic scars or keloid scars

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41
Q

Pressure garment purpose

A

To provide pressure at the burn sight to decrease scarring and help circulation so less swelling is observed and to decrease a risk of infection

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42
Q

How often a day should you wear your pressure garment

A

24 hours a day and remove for washing

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43
Q

What is the initial skin treatment after a burn?

A

moist gauze wraps

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44
Q

How long do patients wear gauze wraps?

A

Depends on skin healing. Some pts may need to wear the gauze for 2-3 weeks…

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45
Q

What do you place on the skin that has adequately healed?

A

Xeroform

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46
Q

What is xeroform?

A

Is placed on any small burn that has the potential for cracking or bleeding. This is placed on the area under the pts tubigrip

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47
Q

What is tubigrip?

A

Helps to decrease swelling, prevent keloid scarring, decrease pain to sensitivity to the air, and to prepare the skin for a custom-made Jobst compression garment

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48
Q

keloid scarring

A

firm, rubbery lesions or shiny, fibrous nodules

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49
Q

What does a Jobst compression garment do?

A

Provide additional pressure and therefore serve to further decrease swelling, pain, scarring, skin sensitivity and remodeling of skin.

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50
Q

Order of garments for burn pts

A

wet gauze wraps
tubigrip
Jobst compression garment

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51
Q

OT Intervention: Coronary Artery Disease

A

Sternal precautions

-home program guidelines

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52
Q

Chronic obstructive pulmonary disease

A

damage to the alveolar wall and inflammation of the conducting airways

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53
Q

Cerebral Palsy (CP)

A

Difficulty maintaining normal muscle postures because of a lack of muscle coactivation and the development of abnormal compensatory movement patterns.

OT Interventions

  • Using AE-Maintain AROM/PROM
  • Instruct on seating/positioning
  • Constraint-induced movement therapy
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54
Q

Hemiplegia

A

Affects the upper and lower extremities on one side of the body

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55
Q

Quadraplegia

A

Affects the upper/lower extremities (all 4 limbs) on both sides of the body

56
Q

Diplegia

A

Mild in both arms are affected while both legs affected more (top half vs. bottom half of body)

57
Q

Age-related macular degeneration (AMD) - Dry

A

Causes deposits of yellow-colored extracellular material within the macula of the eye, causing possible atrophy of the retina and a gradual loss of central vision.

58
Q

Primary open-angle Glaucoma

A

When the optic nerve is damaged from increased pressure.

59
Q

Angle closure glaucoma

A

Acute condition which fluid becomes blocks, quickly raising intraocular pressure.

60
Q

Diabetic retinopathy

A

changes in the blood vessels of the retina.

61
Q

Avulsion Injury

A

When the tendon separates from the bone and its insertion and its insertion and removes bone material w/the tendon

62
Q

Is mallet finger an avulsion?

A

Yes - is splinted in full extension for 6 weeks

63
Q

Describe (inflammation) part of fracture healing

A

provides cellular activity needed for healing

64
Q

Describe (remodeling) part of fracture healing

A

deposits bone

65
Q

When does controlled AROM begin after fracture?

A

3-6 weeks

66
Q

What is the most severe complication of hand fractures?

A

Complex regional pain syndrome

67
Q

Colles Wrist Fracture

A

Complete fracture of the distal radius w/dorsal displacement

68
Q

Smith’s Wrist Fracture

A

Complete fracture of the distal radius w/palmar displacement

69
Q

Bennet’s Wrist Fracture

A

Fracture of the first metacarpal base

70
Q

Median Nerve Injury is?

A

Produces carpal tunnel-like symptoms such as palmar numbness and numbness of first digit to half of the fourth digit w/generalized weakness and pain

71
Q

Ulnar Nerve Injury is?

A

Results in ulnar claw deformity and numbness of the ulnar side of the hand and the fifth and half of the fourth digits w/generalized weakness of the ulnar side of the hand and pain.

72
Q

Radial Head Fractures (elbow fracture) - Type 1

A

Nondisplaced-treated w/a long arm sling

73
Q

Radial Head Fractures (elbow fracture) - Type 2

A

Displaced w/a single fragmenttreated nonoperatively w/immobilization for 2-3 weeks and early motion w/medial clearance

74
Q

Radial Head Fractures (elbow fracture) - Type 3

A

Comminuted-treated operatively, w/immobilization and early motion within the first postoperative week

75
Q

Radial Head Fractures (elbow fracture) - Interventions

A

Orthotics - for immobilization as neededROM within the 1st weekA sling for type 1 fractures

76
Q

Proximal humeral fractures - Interventions

A
  • Orthotics (humeral fracture brace)-ROM as early as 2 weeks
  • Sling to immobilize the fracture
  • ROM consists of aggressive stretching and can start 4-6 weeks after the fracture as by MD
  • Home exercise program
77
Q

What is complex regional pain syndrome (CRPS) or called reflex sympathetic dystrophy?

A

pain to an injury

Symptoms

  • edema
  • contractures
  • bluish/red shiny skin
  • abnormal sweating

OT Intervention

  • Gentle, pain free AROM
  • (NO PROM or PAINFUL TREATMENT!)
  • Stress loading - scrubbing floor, carrying a weighted handbag)-Pain control - TENS, splinting
78
Q

OT Intervention to CTD - Acute Phase

A

Reduction of inflammation and pain through static splinting, ice, contrast baths, ultrasound, Estim

79
Q

OT Intervention to CTD - Subacute Phase

A

Slow stretching, myofascial release, progressive resistive stretch exercise, proper body mechanics, static splint during activity

80
Q

OT Intervention to CTD - Return to Work

A

Assessment of Job site, tools, body positioning-Work simulator, elastic bands, putty, functional activities, strengthening-Work hardening

81
Q

myofascial release

A

soft tissue therapy for pain

82
Q

Radial Nerve Injury

A

Symptoms
-posture of hand is wrist drop, possible lack of finger/thumb extension

Nonoperative treatment
-Wrist cock-up splint with or without dynamic finger/thumb extension assist, passive/active ROM, isotonic strengthening exercises

Operative Treatment
-Static wrist extension splint 30 degrees, after 4 weeks adjust splint to 10-20 degrees

83
Q

Radial Tunnel Syndrome

A

Entrapment of the radial nerve in an area extending from the radial head to the supinator muscle

Symptoms
-Burning pain the lateral forearm

Nonoperative treatment
-Long arm splint, elbow flexed, forearm supinated, wrist netural, Massage/TENS for pain, ROM, nerve glide

Operative treatment
-Long arm splint, elbow flexed, forearm supinated, wrist neutral for 2 weeks, then wrist cock up for 2 more weeks

84
Q

Anterior Interosseous Syndrome

A

Compression to the anterior interosseous Nerve

-Results in a motor loss involving the flexor digitorum longus, flexor profundus and pronator quadratus

85
Q

Pronator Syndrome

A

Entrapment of the proximal median nerve between the heads of the pronator muscles

Symptoms

  • Deep pain proximal forearm w/activityNonoperative treatment
  • Splint elbow 90-100 degrees flexion, forearm neutral, TENS for pain, gentle stretchingOperative
86
Q

Median Nerve Injury

A

Causes Ape hand deformity

Symptoms
-Ape hand deformity, sensory loss in index, middle, and radial side of ring finger, loss of pinch, thumb opposition

Nonoperative treatment-Static thenar web spacer splintOperative treatment-Dorsal wrist blocking splint worn

87
Q

Double crush syndrome

A

Occurs when a peripheral nerve is entrapped in a more than one location

Symptoms
-Intermittent diffuse arm pain and paresthesias w/specific postures

Nonoperative treatment

  • avoid movements/postures that aggravate symptoms-nerve gliding exercises
  • exercises for scapular stability-posture/core trunk strengthening
88
Q

Carpal Tunnel syndrome

A

Entrapment of the median nerve as it courses through the carpal tunnel.

Sensory impairment involves numbness/tingling in the thumb/index/middle fingers
Diminished fine motor coordination

Nonoperative treatment

  • Wrist cock-up splint= to relive pressure on the median nerve in the carpal tunnel and control edema.
  • Nerve/tendon gliding exercises
  • Activity modification=ergonomic handles, gel pads, or padding on handles
  • Client education=avoidance of postures/activities that aggravate the condition (wrist flexion).
  • Postural retraining/proximal conditioning exercisesPostoperative Treatment-wound care/scare mobilization-pain management-splinting
  • AROM of wrist, thumb, fingers (1-2 days after surgery)
  • Nerve/tendon gliding exercises
  • Strengthening begins 3-6 weeks
89
Q

Cubital tunnel syndrome

A

Proximal ulnar nerve compression at the elbow between the medial epicondyle and the olecranon process.

  • Sensation is decreased in the little finger/ulnar half of the ring finger
  • Motor problems such as decreased grip/pinch strength

Nonoperative treatment

  • Edema control-pain management
  • elbow splint-ulnar nerve gliding-proximal conditioning activities-posture/ergonomic training

Postoperative treatment
-splint the elbow, wound care, edema control, pain management

90
Q

de Quervain syndrome

A

cumulative microtrauma resulting in tenosynovitis of the thumb muscle tendon unit

Caused by forceful, repetitive thumb abduction

Nonoperative treatment
-corticosteroid injections
-forearm-based thumb spica splint w/wrist in neutral/thumb radially abducted-
computer ergonomics education

Operative treatment

  • gentle ROM/tendon gliding exercises
  • Splinting
  • Grip/pinch strengthening begins at 2 weeks
  • Scar management/desensitization techniques
91
Q

Claw Deformity

A

The distal ulnar nerve compression or lesion at the wrist

Sensory loss occurs in the little finger/ring finger and the palmar ulnar hand

Nonoperative treatment

  • anticlaw splint
  • padded antivibration glove can be used during activity to avoid further nerve irritation
  • Activity modification: ergonomic handles, gel pads, padding on handles of vibratory equipment (lawnmower)
  • Client education: avoid postures, activities that aggravate the condtion

Postoperative treatment

  • bulky dressing is applied for 3-10 days
  • Dorsal blocking splint is used to maintain the wrist flexion.
  • AROM of the wrist/hand begins at 6 weeks.
  • Sensory reeducation begins at 10-12 weeks.
92
Q

Digital stenosing tenosynovitis (trigger finger)

A

Treatment

  • Splinting the MCP at zero degrees for 3-6 weeks.
  • Protective reeducation for clients to compensate for sensory loss.
  • Desensitization of applying different textures/tactile stimulation to reeducate the nervous system.
93
Q

Cryotherapy (ice massage, ice, cold packs, cold water immersion baths)

A

Pain relief decrease edema decrease muscle spasms decrease inflammation

Precautions/contraindications:

  • clients w/impaired circulation
  • peripheral vascular disease
  • hypersensitivity to cold-impaired sensation
  • open wounds/infections
94
Q

Thermotherapy (warm whirlpools, fluidotherapy, hot packs, contrast batths, and paraffin baths)

A

Increase blood flow increased cell metabolism increased inflammation increased muscle contraction increased oxygen consumption decreased muscle spasms decreased pain

Precautions/contraindications:

  • clients w/acute inflammation
  • edema
  • sensory impairment
  • cancer
  • blood clots
  • infection
  • cardiac problems
  • impaired cognition
95
Q

Ultrasound heats tissue (1-5 cm depth)

A

Thermal effects - increase tissue extensibility and blood flood, decrease pain, joint stiffness, muscle spasms, chronic inflammation.

Nonthermal effects - increase protein synthesis and bone healing and decrease inflammation

Precautions/contraindications: avoid w/pregnancy, over eyes, pacemaker, bleeding, infections, cancer, over blood clots, cognitive impairments, sensory impairments.

96
Q

Electrical Stimulation

A

NMES - wound healing, maintains muscle mass, increase ROM, decrease edema, facilitates voluntary muscle control, decrease spasm/spasticity.

TENS - controls painIontophoresis - decreases inflammation and controls pain

Precautions/contraindications: do not use over pacemaker, eyes, clients w/epilepsy, cancer, infection, decreased sensation, cardiac disease/stroke.

97
Q

Low-level laser/Light therapy

A

decreased pain, edema, inflammation, increased wound healing and decrease scar tissue.

Precautions/contraindications: wear protective eyewear, eyes, infection or cancer.

98
Q

Wound closure - Remolding phase

A

wearing pressure garments helps collagen fibers realign. dynamic splinting, serial casting, passive motion, stretching, NMES and silastic gel pads can help decrease hypertrophic scarring

99
Q

What are neurodegenerative diseases?

A

progressive and usually chronic conditions resulting from damage to the peripheral nervous system, central nervous system or both

100
Q

Multiple sclerosis (MS)

A

chronic/progressive disease of the CNS. your body attacks the myelin sheath around the brain/spinal cord. This produces scar tissue/plaque of the nerve fibers.

Symptoms

  • weakness/fatigue
  • impaired balance/coordination (ataxia)
  • partial/complete paralysis of a part of the body, muscle spasticity in LE
  • Intention tremors (when a person attempts to engage in activity
  • Dysphagia
  • Paresthesia
  • Vertigo
  • Pain
  • Diplopia
  • Slurred speech
  • Incontinence
  • Short term memory loss
  • Attention deficits
  • Decreased processing speed
  • difficulty w/new learning, abstract reasoning, problem solving

OT Rehabilitation Treatment: to minimize the severity, amount, and length of exacerbations in order to improve function.

OT Interventions

  • AE= optical devices, large-print material, large button tech, talking watches, audiobooks
  • Sensory reeducation
  • bladder training/educate on self-catheterization or use of sanitary pads, absorbent underwear
  • body mechanics to avoid stressing joints
  • yoga/group exercise classes-stress importance of resting/avoid fatigue
  • Aquatic therapy can reduce the effects of weakness

-proximal stabilization for improved distal movements!!!!

  • hand-over-hand techniques for fine motor tasks (unaffected arm over the hand w/tremor to dial phone)
  • external memory aids (day planners)
  • step-by-step instructions
  • allow for increased time,delegation, and repetition when learning new ideas
  • stress management/relaxation tech
  • coping strategies
  • AE equipment w/built-up handles, weighted utensils for feeding or wrist weights during self-care activities to reduce tremors!!!!!

OT Contraindications
-Hot temperatures, heat modalities, fluidotherapy, increased emotional/physical stress, excessive physical activity or overexertion,

101
Q

Paresthesia

A

is a sensation of tingling, tickling, pricking, or burning of a person’s skin

102
Q

Dysphagia

A

difficulty swallowing

103
Q

MS Stage: Relapse-Remitting

A

fluctuating course of relapses w/associated neurologic deficits, followed by periods of relative quiet

104
Q

MS Stage: Secondary Progressive

A

cessation of fluctuations w/slow deterioration

105
Q

MS Stage: Secondary progressive w/relapses

A

fluctuation w/relapses and deterioration between relapses

106
Q

MS Stage: Primary progressive

A

deterioration from beginning

107
Q

MS Stage: Progressive relapsing

A

progressive w/relapses

108
Q

Parkinson’s Disease (PD)

A

Progressive condition. Degenerative changes occur in the basal ganglia (gray matter that contributes to complex movements). Also the substantia nigra becomes depigmented affecting dopamine production (a neurotransmitter that influences the speed/accuracy of motor skills, postural stability, cognition and affect and expression.

Symptoms

  • Tremor= resting tremor which affects one side and is called a ‘‘pill-rolling’’ movement of the hand. Tremors disappear when the person is asleep or calm and increase w/stress/cognitive tasks.
  • Muscle rigidity/stiffness= tone is increased affecting movement. Pts demonstrate cogwheel motions (jerky, painful movements). Fatigue is a big issue because of an increased effort to produce voluntary movements.
  • Bradykinesia= extreme slowness when initiating/performing volitional movements (shuffling gait, moving from sitting to standing, freezing, increased time for fine motor tasks (shaving/fastening clothes).
  • Posture= is stopped, with a lack of arm swing during mobility, fall risk when balance is challenged.
109
Q

Secondary parkinsonism

A

a condition in which people experience symptoms similar to those of PD caused by ingestion of drugs/toxic chemicals

110
Q

5 Clinical Stages of PD

A

Stage 1: unilateral symptoms, typically resting tremor, no/minimal loss of function

Stage 2: bilateral symptoms, trunk mobility/postural reflexes problems

Stage 3: impaired balance secondary to postural instability resulting in mild/mod impairment in function

Stage 4: decrease in postural stability, decrease in function, impaired mobility, need for assistance w/ADLs, poor fine motor/dexterity

Stage 5: total dependence for mobility/ADLs

111
Q

Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease) (ALS)

A

A progressive, degenerative disease in which motor neurons in the brain, spinal cord, and peripheral system are destroyed and replaced by scar tissue. This results in plaques that lead to progressive muscle atrophy.

Symptoms

  • progressive and move distal to proximal.
  • weakness of the small muscles of the hand
  • muscle atrophy (from distal to proximal)
  • Cramping/twitching of muscles
  • dysphagia
  • dysarthria
  • Cognition/sensation, vision/hearing, bowel/bladder control are typically not affected!!!!
  • Life expectancy is 1-5 years!!!!

OT Interventions

  • compensatory “focusing on adapting to disability and preventing secondary complications.
  • positioning, transfers, skin integrity, safety education
  • Augmentative communication equipment
  • Neck collar or universal cuff is used for UE stability during self-care or fine motor tasks.
  • Mobility aids (foot-drop splint, cane, walker) minimize exertion during ambulation, compensate for LE weakness/reduce risk of falls
  • Ideal W/C=high backed, reclining
  • Adapt food=thicken liquids, downgrade to diet to soft foods
  • Manual swallowing techniques
112
Q

dysarthria

A

poor articulation

difficulty w/speech

113
Q

muscle atrophy

A

when muscles waste away

114
Q

ALS 6 Stages

A

Stage 1: person can walk, is Indep w/ADLs, some weakness

Stage 2: person can walk and has mod weakness

Stage 3: person can walk but has severe weakness

Stage 4: person requires a w/c for mobility, needs some assistance w/ADLs, has severe weakness in the legs

Stage 5: Person requires a w/c for mobility, in dependent for ADLs, has severe weakness in the arms/legs

Stage 6: person is confined to bed/dependent for ADLs and most self-care tasks.

115
Q

Guillain-Barre Syndrome

A

Inflammatory disease that causes demyelination of axons in peripheral nerves.

Symptoms

  • Acute weakness occurs in at least two extremities
  • Plateau phase: Most disabling symptoms
  • Recovery Phase: Tends to start at the head/neck and travel distally.
  • Pain, fatigue, edema, mild sensory loss
  • Autonomic Nervous System

OT Intervention

  • Plateau Phase
  • Communication tools=signs/picture boards
  • Adjust supine/sitting positions that optimize function/comfort and reduce risk of skin breakdown.
  • Position pt for trunk, head, UE stability OT Intervention
  • Recovery Phase
  • Dynamic splints to help ROM-AE-Energy conservation/fatigue management
116
Q

Autonomic Nervous System (ANS)

A

result in postural hypotension (when someone rises from a horizontal position, blood pressure drops to low levels

-facial flushing, diarrhea, impotence, urinary retention, increased sweating

117
Q

Huntington’s Disease (HD)

A

Hereditary neurological disorder that leads to severe physical/mental disabilities. Progressive loss of nerve cells in the brain, affecting movement, cognition, emotions and behavior.

Symptoms

  • Choreiform movements of hands
  • later stages=hypertonicity
  • gait/balance problems=wide
  • based gait pattern
  • smaller movements of hand-eye coordination
  • forgetfulness
  • difficulty concentrating
  • difficulty w/mental calculations, sequencing of tasks/memory
  • irritability/depression
  • dysphagia

OT Intervention
-Early Stages
address cognitive components of memory/concentration-establish daily routine, checklists, tasks analysis to break down tasks into manageable steps-avoid open-ended questions to pts

OT Intervention
-Middle stages
engagement in purposeful activities
-simple written cues/words to promote completion of self-cares
-walker or w/c
-routine breaks to deal w/fatigue
-positioning techniques/AE-wrapping legs around the chair legs to stabilize the pelvis and placing the elbows on the table to stabilize the upper trunk
-Utensils w/built-up handles
-nonskid placement
-covered cups/mugs
-switch to soft foods to accommodate changes in oral-motor function-ring on zipper for easier fastening
-built-up handle on toothbrush
-sitting in a sturdy chair
OT Intervention
-Final stages
attention to positioning
-splinting to prevent contractures
-tube feedings
-daily schedules/routines constant
118
Q

Chorea

A

rapid, involuntary, irregular movements, increasing during stressful situations and lessening or absent during voluntary motor activities/sleep

119
Q

Akathisia

A

motor restlessness

120
Q

Dystonia

A

abnormal, sustained posturing of a body part, typically in the arms, head or trunk

121
Q

hypertonicity

A

excessive tone, tension

122
Q

Dementia - Alzheimer’s Disease (AD)

A
  • progressive Impairment of memory, executive function, attention, language, visual processing, praxis
  • behavioral disturbances
  • slow/progressive until death
  • decline in Cognitive abilities=decision making, language skills, problems recognizing family/friends
123
Q

Dementia - Vascular Dementia

A

series of small strokes leading to lesions on the brain

  • cognitive decline similar to AD but often less severe memory involvement
  • gait disturbance
124
Q

Dementia - Frontotemporal Dementia

A

-progressive aphasia, symptoms similar to AD or PD

125
Q

Dementia With Lewy Bodies

A
  • decline in acetylcholine and dopamine levels
  • deficits in attention/executive function, memory Impairment, visual hallucinations, parkinsonism, autonomic dysfunction, rapid eye movement
  • aphasia, apraxia, spatial disorientation
126
Q

aphasia

A

inability to speak, read, or write

127
Q

apraxia

A

inability to perform particular actions because of brain damage

128
Q

spatial disorientation

A

inability of a person to correctly determine their body position in space.

129
Q

recent memory

A

recall of recent events

130
Q

Procedural memory

A

recall information on how to perform a task, such as knowing how to write/ride a bike

131
Q

Personal episodic memory

A

recall of time-related information about oneself, such as where/whether one ate breakfast

132
Q

Semantic memory

A

ability to remember the names of objects

133
Q

hyperflexia

A

overflexion of a limb

134
Q

paratonia

A

involuntary resistance to passive movement of the extremities

135
Q

sundowning behaviors

A
  • adequate lighting
  • reassurance in a calm/caring manner
  • reduce noise/clutter
  • avoid Using restraints
136
Q

wandering OT Interventions

A
  • calm approach
  • rocking chair
  • walk w/the client

7/13/15 NBCOT Exam (12 decks)

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