Random Study Flashcards
1
Q
knox preschool play scale
A
scale tests for play skills with others inside/outside environments- measures play in contexts of space management, material management, pretense/symbolism+ participation (0-6)
Ecological assessment; assessment of play skills that can be used in various performance contexts
2
Q
Denver developmental screening test
A
Tests for potential developmental delays – tests ability to complete age appropriate tasks
3
Q
Bayley Scales of Infant Development-
A
Set a Baseline of child’s abilities as well as continued progress throughout treatment (5 areas)
4
Q
An r value less than 0.70 indicates the correlation is
A
unacceptable or inadequate.
Anything close to 1.00 to +1.00 = strong correlation
5
Q
interrater
A
more than 2 raters
6
Q
intrarater
A
1 rater
7
Q
Back belt
A
does not prevent pain and is not work place modification
8
Q
Precision work=
Light work-
Heavy work-
A
Precision work= above elbow
Light work- at elbow level
Heavy work- below elbow
9
Q
Top down approach
A
Compensatory strategies
10
Q
Ecology of human performance
A
Person, context, environment
11
Q
MOHO
A
What motivates the person ; 3 dimensions of doing
These are participation, performance and skill.
- Volition
- Habituation
- Performance capacity
12
Q
Grasp - after raking grasp what comes next
A
-inferior scissors grasp
13
Q
Child has CP in dining room. Extends LE and slides down, when asked the parents they said they didn’t see any difficulty at home.
If hypotonia with poor oral skills position=
A
slightly reclines w/ trunk supported with neck in midline
-wedge cushion in the chair to raise distal portion up
14
Q
Lateral epicondylitis
A
-tennis elbow- repetitive use of extensor muscles
15
Q
Medial epicondylitis
A
golfer elbow- repetitive use of the flexor muscles
16
Q
Precautions for AIDS
A
-AIDs is STANDARD Precautions spread thru blood/FLUID…
17
Q
How do you make a door more accessible for a wheelchair
A
Hinges
18
Q
what position for hands/dorsal burn
A
volar intrinsic plus if dorsal burn -
MCP joint in 60° – 70° flexion, IP joint in 0° – 5° flexion and wrist in 25° – 30° extension
19
Q
when do you early mobilization when do you do AROM and PROM for Burns
A
PROM after 7 days/ AROM is best after immobilized period
20
Q
Decrease hypertrophic scarring through
A
- dynamic splinting, serial casting, frequent PROM, positional stretching, NMES/silastic gel pads
21
Q
Acute phase- edema=
A
ROM if tolerated; elevate/wrap with elastic bandage
22
Q
Wound Healing=
1) Inflammatory phase= clotting
A
clotting, vasoconstriction, white blood
-acute phase= first 24-48 hrs
23
Q
Wound Healing= 2) Proliferative phase
A
phase (fibroplastic/granulation/epithelization)= synthesize collagen; linage of collagen increases TENSILE strength up to 80%!
24
Q
Wound Healing= 3) Remodeling phase=
A
as scar matures, collagen broken down to REMODEL= scar is more elastic, smoother/stronger
-can be 2wks to 2 years!
25
Flexor tendon injury
- dorsal blocking splint
26
PAMS CONTRAINDICTION
| Tendon Injury:
NO TENS or Ultrasound until weeks 6-8!
27
PAMS CONTRAINDICTION:
RA:
NO HOT PACKS/STRENGTHEN/MMT/ LIMIT ADL (inflammatory phase)- don’t want to stress joints;
28
PAMS CONTRAINDICTION:
OA
Hot packs before excerise; NO MMT if severe OA; NO PROM; NO pain during AROM
29
Interventions for RA/OA=
Pain management, AROM (pain free); joint protection; energy conservation
30
Contraindications for:
| Cryotherapy:
impaired circulation, Hypersensitivity to cold, impaired sensation, peripheral vascular disease, open wounds/infections (ACUTE PAIN)
31
Contraindications for:
| Thermotherapy:
: acute inflammation/edema; cancer, blood clot, sensory impairment, cardiac problems, impaired cognition (CHRONIC PAIN/INJURY)
32
Contraindications for:
| Ultrasound:
cancer, pregnant, pacemaker, bleeding, infection, no eyes/blood clots, or growth plate for kids
33
```
Contraindications for:
Electrical Stimulation (TENS; NMES; Iontophoresis
```
TENS= pain management
NMES= muscle contraction
Iontoporesis- inflammation
don’t use over pacemaker, carotid sinus, pregnant uterus, eye, CTs w/ epilepsy, cancer, infection, decrease sensation, cardiac disease, stroke
34
Contraindications for:
Low Level Laser Light:
vagus nerves, carotid sinus, pregnant uterus, eyes, endocrine glands, cancer/infection
35
Most PAMS take cautions with
with abnormal sensation (hyper/hypo); cardiac pts, cancer, infection/ wounds, pregnant***
36
Schizophrenia on anti-psychotic with tremor -
Tremors= side effect of drug / long-term effect of drugs can be tardive dyskinesia (IV movement)
37
Narrative reasoning
focuses on the abilities of the person to complete occupations in the past and their personal desires for their functional performance in the future (goals)
38
Pragmatic reasoning
focuses on particular setting which the therapy is occurring along with therapists personal skills to provide highest quality intervention
39
Procedural reasoning
act of OT treatment (evaluation, goals, treatment)
40
Interactive reasoning
focuses on interaction between the disease/disability of the person; therapist identifies motivational factors to encourage performance
41
DeQuervains - what splint do you use
- short opponent splint, or forearm long splint
- Forearm-based thumb spica splint
– CMC blocks- IP free/ thumb and wrist both need to be immobilized.
42
Median Nerve Injury
Characterized by decreased thumb opposition, abduction and flexion
43
Carpal Tunnel Splint
Opponent splints – focuses on thumb position
44
radial nerve injury
- Positive in extension- if wrist/elbow/supination an issue it’s a radial nerve injury
- Out trigger splint (radial nerve splint)
45
Ulnar nerve injury - what type of splint
MCP blocking splint
46
Wernicke’s aphasia - what type of clues do you give child for home program
- Hand gestures and tactile cues
- Communicate with drawings, gestures, writing and facial expressions in addition to speech.
- non-verbal communication
47
Alzheimer’s 1) Early (mild)=
function largely IND, engage in many occupations of daily life w/o A. Forgetful
48
Alzheimer’s 2) Middle (moderate)=
frequent forgetfulness, mood changes; wanders/become loss, poor decision on choosing clothing
49
Alzheimer’s ) Late (severe)
unable to engage w/ the environment, cant carry on conversations, SIGNIFICANT levels of assistance for daily living
50
mild cog decline
1-3 = mild cog decline – simple memory loss
51
Mild cog decline **
Stage 3 Alzheimer's
Mild cog decline-
camouflaging exit doors, occupy with structured activities during the day/ benefit from contextual recommendations such as simplifying the home environment and reducing stimuli.
52
mod cog decline
4= mod cog decline-
IADLs become difficult (mild/early Alzheimer’s disease)
53
mod severe cog decline
5= mod severe cog decline- begins to have difficulties with ADLS (moderate Alzheimer’s disease)-
does not have the ability to use cognitive compensatory strategies but would benefit from environmental cues and modifications.
54
severe cog decline
6= severe cog decline- requires assist with ADLS (moderately severe/mid stage Alzheimer’s disease)
55
very severe cog decline
7= very severe cog decline- needs TA (very severe/late stage Alzheimer’s disease)
56
Extrinsic Flexor Tendon Adhesion
Extrinsic Extensor Tendon Adhesion
IF there's an Adhesion what will you see?
Passive flexion is greater than active flexion.
Passive extension is greater than active extension
57
If there's tightness in the intrinsic/extrinsic muscles what will you see?
PIP extension/flexion will be greater when the MCP is in flexion/extension.
Ex: Intrinsic tightness= PIP flexion is greater with the MCP in flexion than when the MCP joint is in extension
Extrinsic tightness= PIP extension is greater with the MCP in extension than when the MCP joint is in flexion
58
Parkinson Stages: 1
```
unilateral involvement (mild)
none/min. loss of function
```
59
Parkinson Stages: 2
bilateral involvement (early stage);
resting tremors/Rigidity begins and continues throughout disease, no/min. loss of function , slowness in ADLS/ trunk mobility/postural reflexes give issues)
60
Parkinson Stages: 3
motor symptoms becomes worse (mid stage);
loss of balance/slowness/balance compromised
61
Parkinson Stages: 4
symptoms severe and limiting- walker
| IND living- impossible, A w/ ADLS/poor FM and dexterity
62
Parkinson Stages: 5
advanced/debilitating stage- wheelchair
| rigidity, oral motor deficits) (Round the clock care A w/ADLS- TA
63
Multiple Sclerosis
| Relapse-remitting
acute/worsening of neuro function -> then some improvements – stability between attacks
64
Multiple Sclerosis
| Secondary progressive
10-15 yrs later continue neurological deterioration
65
Multiple Sclerosis
| Primary progressive
continue decline
66
Multiple Sclerosis
| Progressive relapsing
continued progression with super-imposed relapses
| *focus is better in the morning*
67
ALS aka Lou Gehrig’s
| Stage 1
walk, IND w/ ADLs, some weakness
68
ALS aka Lou Gehrig’s
| Stage 2
walks; mod weakness
69
ALS aka Lou Gehrig’s
| Stage 3
walks with SEVERE weakness; CG A w/ ADLs due to increase level of fatigue
70
ALS aka Lou Gehrig’s
| Stage 4
w/c with some A with ADLS
71
ALS aka Lou Gehrig’s
| Stage 5
w/c and TA w/ ADLS; severe weakness in arms/legs ; pain becomes a factor ; ulcer prevention begins
72
ALS aka Lou Gehrig’s
| Stage 5
confined to bed w TA with ADLS and BADLS; pain becomes a factor
73
GBS- phase 1
| Onset & acute inflammatory phase
acute weakness in 2 extremities, pain, fatigue swallowing issues
– mainly splinting and PROM in this stage
74
GBS- phase 2
| Plateau phase
symptoms are MOST DISABLING
– language is impaired
75
GBS- phase
| Progressive recovery phase
recovery begins at the head/neck travels distally
76
Huntington Disease
motor difficulties; deterioration of cog/behavior; saccadic eye movement; dysphagia) – difficult to complete any functional activities IND
77
Huntington Disease : Early Stage:
cognitive/emotional disability; close-end questions only; establish routine, checklists, breakdown tasks
78
Huntington Disease :Middle Stage:
: focus on leisure activities use Written cues to promote completion of BADL; shower bench, mitt,, built up handle
79
Huntington Disease : Final Stage:
positioning, splinting (avoid contractures); feeding tube, consistent daily schedule/routine
80
When do you do serial casting -
Serial casting= if contracture exists (multiple splints
Inhibiting casting= to prevent contracture= 1 splint
81
Fire safety - what is “R” in RACE –
```
Rescue, Alarm, Confine, Extinguish/Evacuate
R-rescue and remove all patients,
A-activate alarm,
C-confine fire,
E-extinguish fire.
```
```
PASS
P-pull in,
A-aim at base of fire,
S-Squeeze handles,
S-sweep side to side to coat area evenly
```
82
What do you give for weak UE (Fair -)
- mobile arm support if fair -
83
adaptive equipment :
Rocker knife
Upper arm support
Swivel spoon and elongated utensils
Rocker knife- 1 arm
Upper arm support= weakness/ fair-
Swivel spoon and elongated utensils= limited ROM (e.g. heterotopic bone in elbow)
84
Switches:
Pneumatic switch
Phonation switch
Plate switch
Pneumatic switch= airflow switch
Phonation= voice activated
Plate switch = minimal force needed
85
Patient has B amp above knee in WC- what do you add to w/c
tippers on wheelchair (think about balance if BLE amp)
- ergonomics – lower counter tops?
86
```
METs Level (slouching fwd= easier breathing)
Cardiac Phases?
```
```
1-2
2-3
3-4
4-5
5-6
```
Phase 1- inpt
Phase 2- outpt 3-4 (standing, household chores, warm shower)
Phase 3- lgterm rehab
1-2 = on cardiac care unit – seated activities
2-3= think can dress/undress/dust- light activity standing; avoid UE movements
3-4= think making the bed, sweeping- standing is ok for longer
4-5= HOT showers, changing bed linen, raking/weeding- add some resistance to standing
5-6= Sex, shoveling/digging – more weight can be tolerated
87
INR > 5
at risk for bleeding and is typically placed on bedrest or activity restrictions.
88
Someone experiencing autonomic dysreflexia- what do you do?
Remove any restrictive clothing, including thromboembolic stockings, and check catheter tubing.
89
Someone experiencing Hypo orthostatic- what do you do?
return to supine / recline
90
long-term acute care setting
setting high level of medical complexity including the need for a ventilator for respiratory support. Palliative care / prevention and treatment of complications
91
Acute care hospitals:
stabilization, engagement, education, discharge planning
92
Acute care hospitals: stabilization, engagement, education, discharge planning
Sub-acute care/ intermediate care facilities (ICFs)-
focus: functional improvements, engagement, discharge planning; usually housed in hospitals or SNFs
93
Inpatient Rehab:
functional improvement, compensatory strategies, adaptive equipment, modification of discharge env., education
94
The Dynamic Interactional Model
Model focuses on multicontextual tasks and environmental conditions that are similar. Consistent cognitive strategies are used throughout intervention activities.
95
Dialectical Behavior therapy=
Group skills training modules in mindfulness, interpersonal effectiveness, emotion modulation, and distress tolerance
96
Deep vein thrombosis DVT
edema, pain, localized warmed, flaccid extremity
97
Activities for Grasp Pattern:
Power grasp
Cylindrical Grasp
Spherical Grasp
Hook Grasp:
Power grasp: used when stability and strength are required (hammer/holding a bat/toothbrush)
Cylindrical Grasp: holding cup/ steering wheel, picking up children/animals
Spherical Grasp: holding a ball/ spherical object
Hook Grasp:
- Holding purse
- Picking up box filled with books
- Opening fridge/latch/car door
98
Myelomeningocele
spinal cord and nerves develop outside of the body and are contained in a fluid-filled sac that is visible outside of the back area.
These babies typically have weakness and loss of sensation below the sac.
99
Motivational interviewing
counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior.
100
Moderate intellectual disability
Unlikely progress past second grade, but can handle routine and daily workshops.
101
Erb's palsy
paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5–C6 nerves.
Weakness in one arm.
Limited motion in the shoulder, bicep, elbow, forearm, wrist, or hand causing the “waiter's tip”
Arm hangs by the side and rotated inward.
Decreased grip strength in hand of the affected side.
Numbness in arm.
102
Conversion disorder
mental condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical
*treat pain, muscle weakness, relaxation techniques, healthy work/life balance*
103
Central cord syndrome
injury results in weakness in the arms more so than the legs.
Pain and stiffness in the neck, back, or lower back.
Burning pain that spreads to the arms, buttocks, or down into the legs (sciatica)
Numbness, cramping, or weakness in the arms, hands, or legs.
Loss of sensation in the feet.
Trouble with hand coordination.
104
Aphonia
Dysphonia
Hyphonia
Aphonia- loss ability to speak
Dysphonia- difficulty in speaking due to physical disorder of the mouth
Hyphonia- soft speech
105
Septic phlebitis
presence of an endovascular thrombus in the setting of associated bacterial or fungal infection. (can be inflamed/swollen)
106
Peripheral artery disease
circulatory problem in which narrowed arteries reduce blood flow to your limbs
mainly legs
healthy lifestyle, exercise, massage can help
**no compression stockings can impede blood flow in people with PAD.**
107
Goal attainment Scale
(much less than outcome)-2 to +2 (much more);
0= goal (outcome met)
108
Volitional Questionnaire
observational method of gathering data on motivation that is designed for persons who are unable to self-report their own motives
109
Supraglottic Swallow
a technique that involves simultaneous swallowing and breath-holding, closing the vocal cords and protecting the trachea from aspiration.
110
Stages of Play:
Unoccupied- lots of movement, discovering body movements
Solitary- child plays alone
Spectator- around 2 looks onto others play
Parallel- play along side others
Associate: 3-4 begins to interact with others
Cooperative : 4+ plays together with others, interest in playing with others and the activity
111
Difference between screening, assessment, Index tools
Screening is a process for evaluating the possible presence of a particular problem.
Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis.
Index: will give you quantitative data
112
Vertical anchoring techniques
Anchors are the strategy of using a target to visually seek on the left side. Bright lines can be drawn down the left side of a paper. Bright post-it notes may be stuck to the left side of a computer screen. Edges of tables or walls can be used in the environment. The person is taught to return his or her eyes to that target to assist with scanning to the left.
