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Test 1 Flashcards

1
Q

6 steps to OT process

A

Theory, evaluation, problem definition, intervention plan, intervention implementation, re-evaluation

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2
Q

What is a FOR?

A

Vehicle for putting abstract ideas into practice, pieces theories together

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3
Q

Restorative approach

A

remediate, BOTTOM UP, restore brain pathway, specific foundational skills- CIMT, RESTORE SPECIFIC PROCESSES

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4
Q

Adaptive approach

A

adapt task or environment - TOP DOWN, increase time to complete, practice, LESSEN FXNAL DEFICITS

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5
Q

WHICH MODELS APPLY TO ADAPTIVE APPROACH>

A

MOHO, OA, EHP, PEO

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6
Q

WHEN A PERSON IS LETHARGIC, HOW DO THEY PRESENT?

A

OPENS EYES TO VERBAL STIM
SLOW BUT APPROPRIATE RESP
SHORT ATTN SPAN
OBTUNDED

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7
Q

WHEN A PERSON IS AT AN ALERTNESS LEVEL OF STUPOR, HOW DO THEY PRESENT?

A

RESPOND TO PHYSICAL STIM WITH GROANS, NEVER FULLY AWAKE, UNCLEAR, CONFUSED

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8
Q

SEMICOMATOSE

A

PAINFUL STIMULI, NO VERBAL RESP, PROTEXTIVE REFLEXES PRESENT

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9
Q

COMATOSE

A

ONLY RESPONDS TO PAINFUL STIM, NO PROTECTIVE REFLEXES, PUPILS FIXATED, NO VOLUNTARY MOVEMENT

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10
Q

UNCONCIOUS

A

STUPOR - COMATOSE

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11
Q

PERSISTENT VEGETATIVE STATE

A

NO COGNITIVE BRAIN FUNCTION, NO SLEEP-WAKE CYCLES

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12
Q

BRAIN DEAD

A

ONLY REFLEXIVE MOVEMENTS

NO COG FX

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13
Q

WHAT ARE THE FIVE DIFFERENT TYPES OF STIMULI

A

VOICE, TOUCH, SHAKE, SHAKE AND VOICE, NOXIOUS

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14
Q

GLASGLOW - EYE OPENING

A

SPONTANEOUS - 4, TO SPEECH-3, PAIN-2, NIL-1

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15
Q

GLASGLOW - BEST MOTOR RESPONSE

A 
6- OBEYS
5- LOCALIZE
4 - WITHDRAWS
3-ABNORMAL FLEXION
2- EXTENSOR RESPONSE
1 - NIL
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16
Q

Glasglow - verbal

A 
5 - oriented
4 - confused conversation
3 - inappropriate words
2 - incomprehensible sounds
1 - Nil
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17
Q

Glasglow predictors

A

13 - mild
9-12 - moderate
<8 - severe (coma)

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18
Q

What appearance aspects should you asses when first seeing a pt?

A

grooming, aids, dress, eye deviation, skin composure

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19
Q

What is Battle’s sign?

A

bruising over mastoid - skull fx

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20
Q

Raccoon’s eyes

A

peri- orbital bruising and swell - frontal-basal fx

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21
Q

rhinorrhea

A

CSF draining from nose, fx of cribriform with torn meninges

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22
Q

ottorhea

A

drainage of CSF from ears, fx temporal bone with torn meninges

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23
Q

Decorticate posturing

A

fl, fl, fl, add, internal rotation, pf

critic-spinal tract

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24
Q

Which posturing is more preferable?

A

decorticate because decelerate means brain stem

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25
Decerebrate posturing
ext, fl, add, pronation w/pf | brainstem
26
what is opisthotonus?
severe m spasm of neck and back
27
Orientation x 4
person, place, time, why?
28
bottom up
component skills
29
top down
performance in task
30
Where would an injury be if a pt showed these primitive reflexes; MORO, GRASP, FLEXOR WITHDRAWAL?
SPINE
31
Where would an injury be if a pt showed these primitive reflexes; ATNR, STNR, Tonic lab, positive supporting, associated reactions?
brainstem
32
Which reflex would occur if injury was at the mid-brain
righting-reaction
33
Which reflex would occur if injury was at the basal ganglia?
protective extension
34
UMN
motor cortex to brainstem / interneurons in ventral horn spasticity hyperactive reflex
35
LMN
vetral horn to skeletal muscles, link btw UMN and muscles flaccidity, hypotonia hypoactive reflex
36
tone
resistance of a muscle to passive elongation or stretching
37
Muscle tone continuum
rigidity > spasticity > normal > hypotonia > flaccid
38
High tone
rigidity
39
low tone
flaccidity (complete loss of muscle tone)
40
Ashworth scale 0
no increase
41
Ashworth scale 1
slight increase in tone with catch at end of ROM
42
Ashworth scale 1 +
slight increase in tone with catch at end of ROM, minimal resistance throughout motion
43
Ashworth scale 2
more marked tone, resistance throughout movement but easily moved
44
Ashworth scale 3
considerable tone, PROM difficult
45
Ashworth scale 4
rigid in flexion and extension
46
Ashworth scale 9
unable to test
47
clonus
uncontrolled oscillations
48
cogwheel rigidity
jerky resistance
49
clasp knife
prolonged stretch will stretch muscle
50
coordination
ability to produce accurate, controlled movement
51
Problem with synergy?
abnormal or disordered motor control
52
Co-activation problems?
Agonist & antagonist muscles both fire, preventing functional movement
53
What are the stages of motor learning?
Cognitive - Associative - autonomous cognitive - slow, errors, demonstrations valuable associative - correct and error distinction, finer details autonomous - automatic, stable
54
NDT
Tactile stim normal sequences and balance Treatment focuses on inhibiting or eliminating patterns, normalizing postural tone, promoting active control of movements
55
NDT Facilitation
when tone has normalized autonomic postural control wt bearing
56
NDT Inhibition
abnormal tone and coordination decrease spasticity reflex inhibiting patterns
57
NDT techniques
weight-bearing trunk rotation trunk elongation encourage scapular protraction
58
PNF
auditory, visual, tactile proximal to distal entire movement patterns
59
UE D1 Flex and ext
PNF midline cross pick apple midline cross throw away
60
UE D2 flex and ext
PNF midline cross unbuckle seatbelt midline cross put it away
61
Rood
tactile: light touch and brushing, thermal Proprioceptive: quick stretch, vibration, heavy jt comp, resistance
62
What are inhibitory techniques?
``` Slow stroking Neutral warmth Prolonged cooling Prolonged stretch Joint approximation Tendon pressure Gentle rocking ```
63
Brunnstrom's Movement Therapy
development in reverse - reflexes
64
STNR
flex head - flex UE, Ext LE
65
TLabR
supine - extend | prone - flex
66
Tonic Lumbar
R trunk rot, R UE flex, R LE ext, L UE ext, L LE flex
67
synergy
group of muscles acting together in a stereotyped manner
68
UE Flexion synergy - Brunnstrom's
``` scapulas - add and elev shoulder - external rotation, 90 abduction xx elbow flex **** forearm sup wrist flex fingers flex ```
69
UE Extension synergy - Brunnstrom's
``` scapulas - dep and abd shoulder - internal and add **** elbow ext XXX forearm pron wrist flex/ext fingers flex/ext ```
70
Associated Reactions - Brunnstrom's
UE - direct | LE - inverse
71
Homolateral limb synkinesis
UE flexion evokes LE flexion
72
Ramiste’s Phenomenon
resisted abd evokes contralateral abd
73
Soque’s Phenomenon
Automatic extension of the fingers when the shoulder is abducted or flexed beyond 90 degrees.
74
Brunnstrom's Recovery Stages UE
Stage 1 Flaccid Stage 2 basic limb synergies weak, spasticity starts Stage 3 basic limb synergies voluntary, spas marked stage 4 spastic stage 5 relative synergy independence stage 6 coordination Stage 7 normal
75
What are the two stages of the True Grasp Reflex?
catching phase - weak contractions of flexors & adductors of the digits holding phase - occurs only if traction is made on the tendons activated during the catching phase, as long as traction is maintained, it will continue
76
What are the fxs of the sensory systems?
``` Vision Hearing Smell and taste Touch Pain Proprioception – where your body is in space Vestibular Functioning ```
77
Special senses?
Olfaction Vision Gustation - taste Audition, balance and equilibrium
78
Sensory modalities?
light, sound, taste, temperature, pressure, and smell.
79
What are the two types of sensory systems?
Special and somatosensory (sensory)
80
If there is no pain or temperature, will fine touch be resent?
no
81
Graphesthesia
ability to recognize writing on the skin purely by the sensation of touch.
82
fovea
takes signals from light and send neural signals to the brain to stimulate visual recognition Greatest ability to process detail
83
macula
Where vision is most highly developed within retina
84
What are the four primary spatial components for visual acuity?
frequency? Orientation? Contrast? Intensity?
85
WBC
5-10
86
Hemoglobin
M 14-17.4 | F 12-16
87
hematocrit
M 42-52 | F 37-47
88
Na
134-142
89
K
3.7-5.1
90
CA
8.6-10.3
91
Glucose
70-100 fasting 90-130 diabetes >126 >200
92
A1C
norm<5.7 pre 5.7-6.4 DM >6.4
93
HDL
M >40 | F >50
94
LDL
<100
95
Triglycerides
<150
96
Chol
<200

Neuromanagement (9 decks)

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