Term
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Definition
| damage to the CNS due to a disruption in circulation. |
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Term
| What are the risk factors of a CVA? |
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Definition
| hypertension, diabetes, heart disease, obesity, smoking |
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Term
| What are the 2 basic types of stroke? |
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Definition
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Term
| What is an Ischemic stroke? |
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Definition
- mechanical obstruction
- most common form
- means "to keep blood back"
- artery to the brain is blocked |
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Term
| What is thrombotic infarction? |
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Definition
-components of blood
- atherosclerotic plaques (thrombus/clot)
- travel and dislodge in an artery, producing a blockage.
- damage to the brain due to LACK of circulation |
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Term
| What is an embolic infarction? |
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Definition
- plug of a thrombus, fat, cholesterol, or air in the heart or major vessels,
- damage to the brain due to LACK of circulation |
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Term
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Definition
-arteries rupture
- blood flows into the brain
- compression
- blood irritates structures adjacent to the bleed
- ruptured aneurysm
- arterioventricular (AV) malformation |
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Term
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Definition
Transient Ischemic Attack
- short term vascular insufficiency (usually 2-15 min)
- produce a period of neurological signs/symptoms that typically resolve within hours/days |
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Term
| What are the signs and symptoms of a CVA? |
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Definition
Motor:
- hemiplegia: one sided paralysis
- difficulty with GMF, postural control and balance
- dysarthria- difficulty with speech
- dysphagia- difficulty swallowing
- apraxia
Sensory:
- decreased or absent sensation on one side of the body, U/E, L/E, face |
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Term
| What is the difference between right hemiplegia and left hemiplegia? |
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Definition
Right: LCVA
- speech and language difficulties which may include reading, writing, and speaking
Left: RCVA
- spatial/perceptual difficulties, neglect, trouble with new learning. May do better with general commands vs detailed instructions. |
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Term
| What are some major complications Post CVA? |
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Definition
- Hypotonia: lack of tone (flaccidity)
- Hypertonia: excessive tone (spasticity)
- Spasticity due to the missing inhibitory influence from the brain
- Problem further compounded by disruption of normal sensory input to the brain |
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Term
| What is shoulder subluxation? |
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Definition
- separation of the gleno-humeral joint
- common due to abnormal muscle tone in the shoulder girdle (flaccidity)
Treatment:
- use of a cuff, sling, or lap tray to support the UE and decrease the pull on glenohumeral joint
- position on pillows in bed to support arm and shoulder |
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Term
| What are the 7 stages of the Brunnstrom Stages of Recovery? |
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Definition
1. Flaccidity- no active movement
2. Spasticity begins to develop
3. Spasticity increases and reaches a peak
4. Spasticity begins to decrease
5. Spasticity continues to decrease
6. Spasticity is essentially absent
7. Return to normal movement. |
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Term
| What are the synergy patterns for the scapula in flexor and extensor? |
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Definition
Flexor: elevation and retraction
Extensor: protraction and depression |
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Term
| What are the synergy patterns for the shoulder? |
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Definition
Flexor: abduction and external rotation
Extensor: horizontal adduction and internal rotation |
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Term
| What are the synergy patterns for the elbow? |
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Definition
Flexor: flexion
Extensor: extension and pronation |
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Term
| What are the synergy patterns for the forearm? |
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Definition
Flexor: supination
Extensor: pronation |
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Term
| What is Parkinson's Disease? |
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Definition
- slowly progressive degenerative neurological disorder of the brain
- characterized by tremors and difficulty with mobility, movement, and coordination |
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Term
| What is Parkinson's Disease caused by? |
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Definition
| - destruction of neurons in the basal ganglia, loss of pigmented cells in the substantia nigra, and depletion of dopamine in the nucleus of the brain. Without dopamine, the nerve cells in the part of the brain cannot send proper messages, which results in the loss of muscle funtion |
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Term
| What are some signs and symptoms of Parkinson's disease? |
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Definition
- shaking, tremors
- automatic movements slow or stop
- constipation
- difficulty swallowing
- drooling
- impaired balance and walking
- muscle aches and pains
- slowed, quieter speech and monotone voice |
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Term
| What is the role of the OT/OTA in Parkinson's disease |
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Definition
- provide various arm and hand therapy sessions, handwriting aids
- home modification info
- cooking and homemaking adaptations
- leisure skill development
- ADL aids
- wheelchair use
- fall prevention |
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Term
| What is the role of the PT/PTA in Parkinson's Disease? |
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Definition
- assist with issues such as balance, delayed or slowed movements, rigidity, tremors, lack of coordination, fatigue, pain, gait, immobility, weakness
- ROM exercise, IFC, diathermy, |
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Term
| What is Multiple Sclerosis? (MS) |
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Definition
- disease of the CNS. Attacks the myelin sheath, the protective covering wrapped around teh nerves of the CNS
- cause is unknown |
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Term
| What are the signs and symptoms of MS? |
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Definition
| - bladder dysfuntion, constipation, incontinence, cognitive impairment, depression, dry mouth, dysarthria, dysphasia, fatigue, difficulty walking, pain, spasticity, tremors, weakness |
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Term
| What is the role of the OT/OTA with MS? |
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Definition
| - provides training in energy conservation techniques and the use of adaptive tools and devices to simplify tasks at home and in the office |
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Term
| What is the role of the PT/PTA with MS? |
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Definition
| - achieves and maintains the optimal functioning and prevents unnecessary complications such as de-conditioning, muscle weakness from lack of mobility, and muscle contractures related to spasticity |
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Term
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Definition
| - neural tube defect caused by the failure of the fetus's spine to close properly during the first month of pregnancy |
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Term
| What are the 3 common types of Spina Bifida? |
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Definition
1. myelomeningocele (severe)
2. meningocele (medium)
3. occulta (mildest form) |
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Term
| What are the common medical complications of Spina Bifida? |
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Definition
- clubfoot
- dislocated hips
- paralysis
- hydrocephalus
- damage to bowel and bladder |
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Term
| What is the role of the OT/OTA in Spina Bifida? |
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Definition
- assist parents iwth handling and positioning techniques and teaching orthotics use
- work on fine motor skills such as eye-hand coordination
- proper use of adaptive equipment |
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Term
| What is the role of the PT/PTA in Spina Bifida? |
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Definition
- work on mobility skills
- work with the child on therapeutic exercises to develop and promote head and trunk control |
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Term
| What is Guillian Barre Syndrome? |
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Definition
| - acute inflammatory condition that involves spinal nerve roots, peripheral nerves, and in some cases cranial nerves |
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Term
| What are some symptoms of Guillian Barre? |
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Definition
- parethesia (usually in the legs and progressing to arms)
- sensory loss
- muscle atrophy
- muscle weakness always more prominent than sensory loss |
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Term
| What is the role of the OTA/PTA in Guillian barre? |
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Definition
- aid in exercise for strength and endurance
- ensure client is performing exercises from easiest to difficult
- help client to relearn ADLs to regain independence
- help don assistive devices
- assist patient to learn how to modify tasks |
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Term
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Definition
- Amyotrophic Lateral Sclerosis
- also know as Lou Gehrig's disease
- progressive disease characterized by the degeneration of motor neurons in the anterior horn cells of the spinal cord, brain stem |
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Term
| What are the symptoms of ALS? |
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Definition
- muscle cramps, muscle twitching
- spasticity
- hyperactive reflexes
- low tone, weakness, atrophy
- eventually muscles become flaccid |
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Term
| What is the role of the OTA/PTA in ALS? |
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Definition
- general conditioning
- postural training
- AROM and PROM
- breathing exercises
- gait training
- improve participation in areas of occupation
- mobility and positioning
- assistive technology |
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Term
| What is the Glasgow Coma Scale? (GCS) |
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Definition
| - use to assess and monitor level of consciousness/awareness. Assess severity of ABI/TBI |
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Term
| What are the 3 domains of the Glasgow Coma Scale? |
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Definition
- motor performance
- eye opening
- verbal response |
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Term
| What are the levels in the Glasgow Coma Scale? |
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Definition
- 13-15: mild injury
- 9-12: moderate injury
- 3-8: severe injury |
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Term
| What is the Rancho los Amigos Level of Cognitive Functioning Scale? LCFS |
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Definition
| describes eight levels of post-brain injury cognitive function. These levels describe a person's reliance on assistance to carry out cognitive and physical functions. |
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Term
| What are the 8 levels in the Rancho Los Amigos LCFS? |
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Definition
1. No Response
2. Generalized Response
3. Localized Response
4. Confused and Agitated
5. Confused and Inappropriate
6. Confused and Appropriate
7. Automatic and Appropriate
8. Purposeful and Appropriate
9. Purposeful and Appropriate w/ standby assistance on request
10. Purposeful and Appropriate. Modified independence. |
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Term
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Definition
| - an insult to the brain caused by an external physical force that may produce a diminished or altered state of consciousness and which results in an impairment of cognitive and/or physical functioning |
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Term
| What is medical management used for in an ABI? |
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Definition
| - to minimize/prevent secondary brain damage and secondary events |
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Term
| Regarding psychosocial aspects of disability... what do reactions depend on? |
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Definition
- nature of the illness/disability
- pre-illness/ disability personality
- social support
- current life circumstances
- meaning of illness/disability |
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Term
| Regarding psychosocial aspects of disability... what does disability and illness threaten? |
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Definition
- life and physical well being
- body integrity and comfort
- independence, privacy, autonomy and control
- self concept, fulfillment of usual roles
- life goals and future plans,
- relationships
- ability to remain in familiar circumstances
- roles in society
- quality of life |
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Term
| What are common reactions to disability and illness? |
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Definition
- grief
- fear/anxiety
- anger
- denial
- low mood/depression
- guilt
-acceptance |
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Term
| What are some coping mechanisms after disability/illness? |
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Definition
Adaptive Behaviours
- confront the situation, learn new skills behaviours, become active in care and treatement
Maladaptive Behaviours:
- avoid or deny the situation, regress/ become dependent, over compensate, disengage, become isolated |
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Term
| What are some helpful approaches when dealing with someone faced with disability and illness? |
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Definition
- be aware of your own biases and assumptions
- ask and listen for...fears, anxieties, vulnerabilities, goals, dreams, capabilities, strengths, interests, supports
- treat the person as capable
- acknowledge both losses and successes
- facilitate access to support |
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Term
| What is the remediation approach? |
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Definition
- bottom up treatment
- focus on person
- try to fix a problem. Focus on the impairment causing the disability or OPI |
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Term
| What is the compensation approach? |
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Definition
- top down treatment- to reduce or work around the dysfunction/physical performance limitation
- not trying to fix it, look at remaining abilities and use those. |
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Term
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Definition
increasing demands or challenges that the client goes through to improve
- involves sequentially increasing the demands of the task to stimulate improvement in function |
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Term
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Definition
- accommodating those abilities that are remaining
- allows continued involvement in an occupation by accommodating residual abilities |
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Term
| What is therapeutic use of self? |
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Definition
| - use your skilled presence therapeutically to create a safe and affirming climate that encourages a patient engagement in the intervention. |
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Term
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Definition
- use the teaching learning process to transfer specific knowledge to the patient
- use individual or group intervention |
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Term
| Why would you use group intervention/treatment? |
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Definition
- research evidence supports the outcome of group use
- facilitates patient participation communication and self-expression |
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Term
| What is the task-orientated group model? |
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Definition
| - create a working and sharing environment |
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Term
| What is a developmental group model? |
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Definition
| to repeat the normal course of development and specifically address group interaction skills |
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Term
| What are the 3 types of leadership? |
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Definition
- directive; sets goals, determines structure
- facilitative; guide the individual or group to accomplish goals
- advisor; most passive, offers expertise as need on request. |
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Term
| What are the 3 goals of OTs and PTs in intervention? |
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Definition
1. promoting
2. preventing
3. resolving |
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