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Health Conditions > Unit 1: Foundations > Flashcards

Unit 1: Foundations Flashcards

1
Q

what is disease

A

when there is a disturbance in healthy physical structure (anatomy) and/or function (physiology)

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2
Q

What is onset

A

the first appearance of the signs or symotoms of an illness

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3
Q

what are the two types of onset

A

acute = distinct symptoms that arise rapidly or suddenly like a broken arm
Insidious = where symotoms begin slowly and persist for a long time for example MS

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4
Q

what are the three periods of onset

A

latent period = no symptoms but changes to function or structure in the body and may progress to a disease

incubation period = latent period in someone with infectious disease

prodromal period = a period of minor nonspecific symptoms that appear before more specific severe symptoms

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5
Q

what is course

A

a description of the speed of evolution of the disease

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6
Q

what are the different terms to explain the course

A

acute = severe symptoms that last a defined amount of time

chronic = symptoms last a long time

progressive = symptoms become worse over time

wax and wane = the condition periodically gets better and worse

remission = when the symptoms of a disease re-appear

exacerbation = a period of increased intensity (more or worse symptoms) of disease

recovery = when the disease is no longer present

prognosis = often expressed in percentages

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7
Q

how are disease expressed

A

symptoms = subjective experience of disease expressed by the client

signs = objective findings on assessment

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8
Q

what is a diagnosis

A

a label for what is believed to be the patients issue
based on the signs and symptoms

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9
Q

what are the three different names for drugs

A

chemical name = describes its atomic and molecular structure

generic name = abbreviation of chemical name

trade name = selected by the drug company selling the product

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10
Q

how do drugs work

A

absorption into the bloodstream from administration site

drug travels from its entry point to site of drug action

body works to eliminate drug

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11
Q

what are the inter-personal differences in reactions to drugs

A

genetics
age
disease (liver and kidney)

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12
Q

how do drugs work

A

initiating physiological response
- drug fits into a receptor and works like a lock and key.
- drug may open a receptor or block a receptor

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13
Q

what is polypharmacy

A

the use of more drugs than medically necessary
should be reviewed every 6 months or sooner if a change in function

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14
Q

what is the ot role with drugs

A

drug routines
potential for impaired performance as a result of medications
communicating with multidisciplinary team

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15
Q

what questions should an OT ask about medication

A

frequency (qd means everyday)
method of administration
how many medications
what each medication is for
what is their organizational system

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16
Q

what are the 3 types of cells that undergo mitosis

A

somatic cells
adult stem cells (also somatic cells except those related to reproduction)
cells in embryo

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17
Q

what are 3 types of tissue classification

A

labile = many cells and stem cells in the cycle at any one time the cells are dividing frequently

stable = only a few cells in the cycle at a given moment. the cells do not divide very frequently

permanent = very few to no cells in the cycle because very few or no stem cells. cannot grow new tissue in response to injury

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18
Q

examples of labile tissue

A

epithelium of skin, urinary tract, GI tract, respiratory tract and bone marrow cells

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19
Q

examples of stable tissue

A

liver pancrease kidney smooth muscle cells fibroblasts and other connective tissue cells

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20
Q

examples of permanent tissues

A

brain skeletal muscle and cardiac muscle

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21
Q

what happens with minor injury or stress to cells

A

reversible cellular changes without death of cell
cell function returns to normal when stress relieved

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22
Q

what happens with severe injury to cells

A

irreversible cell death

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23
Q

what can cell injury or death occur from

A

the injury or stress itself
the inflammation and repair process that follows the injury

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24
Q

what are the 9 causes of cell injury

A

inadequate oxygenation
- anoxia = total lack of oxygen
- hypoxia = partial lack of oxygen
- ischemia = inadequate blood flow which can cause hypoxia

physical thermal or chemical agents

ionizing radiation

toxins

microbes

inflammation and immune reactions

nutritional imbalance

genetic and metabolic defects

aging

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25
Q

what does acute mild injury in the cells mean

A

whether or not cell injury is reversible depends on the duration and severity of injury or stress
most common cause of reversible cell injury
most common in the liver

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26
Q

what does chronic mild injury in the cells mean

A

there are two main consequences of long term mild injury to cells

intracellular accumulations = accumulating in the cell getting in the way of the things that are trying to do their job
altered growth and differentiation = we have a typical cell cycle but then we can have altered growth

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27
Q

what are the 5 types of altered growth and differentiation that can occur

A

atrophy = cell decreases in size and function
hypertrophy = the cell increases in size and function
hyperplasia = enlargement of a tissue or organ due an increase in the number of cells
metaplasia = reversible change of a cell type into another
dysplasia = disordered growth - can refer to premalignant changes

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28
Q

what are two severe injuries to cells

A

necrosis = pathological death, usually due to ischemic hypoxia or anoxia

apoptosis = natural suicide of cells that occurs at the end of the natural lifespan

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29
Q

what is inflammation

A

the cellular reaction to injury
purpose is a protective response to limit damage and initiate healing

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30
Q

what is acute inflammation

A

results from short term injury and lasts a few hours or days

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31
Q

what are the phases of acute inflammation

A

injury and immediate vasoconstriction followed by vascular dilation
dilation of capillaries causes openings and makes it leaky which is called accumulation of edema
then there is infiltration of leukocytes (neutrophils). 48 hours after injury the leukocytes are replaced with macrophages that ingest the injured cells

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32
Q

what are the characteristics of acute inflammation

A

tumor = swelling
calor = heat
dolor = pain
change in skin quality such as redness or purple

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33
Q

what is chronic inflammation

A

result of longer term and milder injury
lasts weeks to years
starts acute but then evolves into chronic inflammation

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34
Q

what is chronic inflammation caused by

A

persistent infection
autoimmune disease
persistent exposure to injurious agents

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35
Q

what are the characteristics of chronic inflammation

A

less intense so not as hot swollen or tender
the persistent injury invokes as immune response; leukocytes like macrophages to clean up and lymphocytes defender cells
may lay down scar tissue

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36
Q

what are the two processes in wound healing

A

regeneration = complete or nearly complete restoration of typical anatomy and function by the regrowth of normal functional cells and supporting tissue

healing = mix of regeneration and scarring or scarring alone if regeneration is not possible

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37
Q

what two situations does fibrous repair occur

A

damage to the tissue is extensive supporting framework is destroyed

injured tissue is composed of permanent cells such as myocardium skeletal muscle or brain tissue

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38
Q

what is the process of scar foramtion

A

within a few hours leukocytes migrate into the wound to limit damage and clear away debris and foreign material

angiogenesis = the growth of new blood vessels to nourish the process

scar development = deposit of network of collagen and other fibers to bind together the edges of the wound

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39
Q

what are the two types of wound healing

A

first intention healing = a wound that heals primarily with regeneration

second intention healing = a wound with widely separated margins

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40
Q

what factors negatively impact wound healing

A

infection
poor nutrition
medications poor blood supply
foreign bodies in the wound
mechanical factors

41
Q

what are types of wounds

A

skin tears
venous ulcers
arterial ulcers
diabetic ulcers
pressure injuries

42
Q

what is dehiscence

A

when a wound ruptures

43
Q

what is ulceration

A

the breach of the continuity of skin, epithelium or mucous membrane. essentially the would edges are having difficulty closing

44
Q

deconditioning from bedrest in older adults

A

loss of an eighth of muscles strength per week of disuse
three weeks of bedrest = increase in heart rate of 10 beats/min
bedrest increases risk of mortality in following 2 years

45
Q

how do you prevent bedrest

A

almost all medical conditions do not require bedrest
an increase of 100 steps/day will result in a 2-3% decrease risk death in two years post hospital
any movement is helpful

46
Q

what is a pressure injury

A

an injury usually caused by unrelieved pressure that damages the skin and underlying tissue

47
Q

what is the cause (etiology) of pressure injuries

A

pressure and shear
the addition of shear to pressure doubles the impact of pressure

48
Q

what is pressure

A

the force per unit area exerted perpendicular to the plane of interest
pressure can close the capillaries and block blood flow to the tissues

49
Q

what is shear

A

the force per unit area exerted parallel to the plane of interest

50
Q

what are intrinsic risk factors of pressure wounds

A

age
moisture
sensation
mobility
mental status
circulation
nutriotion

51
Q

what are extrinsic risk factors of pressure wound

A

pressure!!
shear
moisuture
friction

52
Q

what initially occurs from too much pressure

A

tissue hypoxia
once the pressure is removed reactive hyperemia

53
Q

what are the 4 stages of pressure injuries

A

stage 1 = involves epidermis
stage 2 = involves epidermis and dermis
stage 3 = involves epidermis, dermis and subcutaneous layers
stage 4 = involves epidermis, dermis subcutaneous and deep tissue such as tendon muscles and bone

54
Q

describe stage 1 of a pressure injury

A

skin damaged but not broken
reduced blood flow to capillaries

55
Q

describe stage 2 of a pressure injury

A

partial thickness skin loss
involves epidermis and dermis
superfical and shallow open ulcer
wound bed intact
blister or rupture
shinny dry and shallow
no slough or bruising

56
Q

describe stage 3 of a pressure injury

A

full thickness skin loss
subcutaneous fat may be visible
bone/tendon not visible
slough may be present
tunneling may be present
depth varies by anatomical location

57
Q

describe stage 4 of a pressure injury

A

full thickness tissue loss
tissue necrosis
exposed bone, tendon muscles
damage to tendons/joint capsule
slough/eschar often present in wound bed
depth varies by anatomical location
risk of osteomyelitis

58
Q

how do you prevent pressure injury

A

identify risk factors
prevent by maximizing pressure distribution
minimize shear and friction
minimize moisture
facilitate mobilization

59
Q

what is the treatment for pressure injury

A

remove the source of pressure
employ prevention strategies
identify the cause

60
Q

what is a contracture

A

fibrosis of connective tissue in skin fascia muscle or a joint capsule that prevents normal mobility of the related tissue or joint

61
Q

what is the pathophysiology of a contracture

A

not year completely understood
the underlying cause of muscle contracture may be MSK or neurological or both
contractures due to purely immobilization is thought to be due to loss of elasticity of connective tissue and or loss of sarcomeres in the muscle tissue itself

62
Q

how to prevent contracture

A

identify those at risk
maintain ROM
positioning in bed and wheelchair
strengthening activities including ADL
preventative splinting

63
Q

what is treatment for contracture

A

manual techniques ROM
mechanical techniques (continuous passive motion machines)
casting or splinting
surgery
local injections/medications

64
Q

what is thrombus

A

blood clot that has formed within the vascular system of the body
can collect anywhere in the cardiovascular system
immobilization promotes development of thrombi in the lower extremity veins
serious threat to health

65
Q

what is the etiology of thrombus

A

how a thrombus developed is interrupted or changed blood flow (venous stasis)
tissue damage (vascular endothelial injury)
blood coagulates too easily (hypercoagulability)

66
Q

what is a pulmonary embolism

A

a thrombus that back flows to the lungs
typically fatal so prevention of the embolus is important

67
Q

what are signs and symptoms of deep vein thrombosis

A

may be no signs
slight fever
distension of superficial veins
increase calf/leg warmth and redness
edema
calf/tenderness/pain worse when standing or walking
asymmetrical

68
Q

what is prevention of thrombus

A

most concern in 72 hours post op
move what can be moved
facilitate circulation
anti-coagulants

69
Q

what is treatment for thrombus

A

medications such as anti-coagulant or thrombolytic agents
early ambulation should be encouraged as soon as possible
if a DVT is present symptoms may limit ambulation

70
Q

what is the rule of 9 for burns

A

9%
patient hand is 1% of total body surface area

71
Q

what are the different degrees of a burn

A

1st degree = superficial which can be painful
2nd degree = superficial partial which may scar and be more painful
2nd degree = deep partial which requires surgery and form more scar and is less painful
3rd degree = full thickness dry, insensitive to light touch, large area requires skin grafting and high risk of infection
4th degree = full thickness, involves muscle or bone and leads to loss of the burned part

72
Q

how quickly does a superficial burn heal

A

less then 7 days

73
Q

how quickly does a superficial partial burn take to heal

A

7-14 days

74
Q

how long does a deep partial burn take to heal

A

14-35 days

75
Q

how long does a 3rd degree full thickness burn take to heal

A

months to heal

76
Q

how long does a 4th degree full thickness take to heal

A

may require amputation

77
Q

what are acute medical concerns from a burn

A

maintain airway
manage bleeding and wound care
manage pain
prevent infection
fluid resuscitation (just right otherwise low blood pressure if not enough or edema if too much)

78
Q

what is a escharotomy

A

full thickness circumferential burn
tough non elastic burned tissue will not expand as internal pressure builds from edema
can cause ischemia so an incision of eschar to the subcutaneous layer is made to relieve pressure

79
Q

what are the steps of wound healing following a burn

A

hemostasis
inflammatory
proliferative
remodeling

80
Q

when would a skin graft be used

A

deep partial or full thickness burns that will take too long to heal leading to infection risk and inevitable scar

81
Q

acute rehab phase for burn healing

A

day 1 either in ICU or on burn ward
prevention of burn contracture
main issues are positioning to manage edema and maintain ROM
splinting
dressing changes
psychosocial

82
Q

intermediate rehab phase for burn healing

A

surgery
main issues are mobilizing post surgery, maintaining ROM preventing contracture and promoting healing
protection and positioning splinting
psycosocial
discharge planning

83
Q

long term rehab phase for burn healing

A

scar management ROM and function
main issues are hypertrophic scarring, contracture

84
Q

how does scar location lead to predictable contractures

A

dorsal hand = hyperextended MCP flexed PIPDIP loss of arches

anterior cubital fossa = elbow flexion

forearm = limited supination

anterior axillary crease = limited shoulder abduction

posterior axillary crease = limited shoulder forward flexion

anterior neck = flexion contracture (limited extension)

85
Q

what is hypertrophic scaring

A

overabundant scarring from imbalanced and disorganized processes during healing phases

when epithelialized in less then 3 weeks timing of processes proceeds regularly and you get a normal scar

in hypertrophic scaring it is vicious cycles where fibroblasts proliferate and there is increased collogen deposition and myofibroblast activity

86
Q

what are the 3 Rs of hypertrophic scarring

A

red
raised
rigid

87
Q

what is the definition of a health condition

A

provides initial information
general overview of who what where how

88
Q

what is the classification of a health condition

A

ensures adequate understanding of the variety of presentations of the condition

a condition may be a subtype of a broader classification system or may have sub types of its own (ie neurological disorder which subtype is MS)

89
Q

what is the pathophysiology of a health condition

A

explains the process within the body that result in the signs and symptoms of a disease
what is the change in the body structure or function as a result of this health condition

90
Q

what is the etiology of a health condition

A

the cause or set of causes or manner of causation
the cause of the condition
contributors of intrinsic, extrinsic and unknown factors to disease causation

91
Q

what are the different etiology extrinsic factors

A

inanimate = physical
animate = infectious agents
iatrogenic = by product of a medical diagnosis

92
Q

what are the different etiology intrinsic factors

A

mutation of genes (monogenic, polygenic, cytogenic)
metabolic
degenerative
neoplastic
immunologic
nutritional deficiency
psychogenic (neurotransmitter imbalance)

93
Q

what does it mean when the etiology is idiopathic

A

etiology is unknown

94
Q

what is the epidemiology of a health condition

A

the frequency distribution and causes of diseases in a population
how common is the condition
prevalence = proportion of people in the population living with the condition
incidence = amount of new causes reported in a time frame

95
Q

what is the onset and course of a health condition

A

onset is the first appearance of the signs or symptoms of an illness
course is a description of the speed of evolution of the disease (acute, chronic, recurrent course)

96
Q

what is the medical management and safety precautions of a health condition

A

what interventions are provided by non-rehab team members
an action taken to avoid a dangerous or undesirable event

97
Q

what are three techniques used to pad distal end of bone and provide muscle stabilization in amputations

A

myodesis = muscle and fascia of residual limb are suture to the bone
myoplasty = suturing the opposing muscle groups together over the transected bone end
myofascial closure = suturing close fascia over the muscle

98
Q

what is complications, comorbidities and sequelae in a health condition

A

complication = a secondary disease or condition developing in the course of a primary disease
comorbidity = medical conditions existing simultaneously but independently with another condition or it can indicate related medical conditions
sequelae = an abnormal condition resulting from a previous disease

Health Conditions (3 decks)

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