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Conditions II > Quiz & Test 1 > Flashcards

Quiz & Test 1 Flashcards

1
Q

Describe the rehab effect and how long does it last?

A

It’s when most of the UE recovery occurs.

Occurs within the first 6 months

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2
Q

What is paraplegia?

A

Impaired movement in both lower extremities.

Impairment at thoracic, lumbar and sacral segments of cord.

Upper extremity movement is preserved. Trunk may also be impaired depending on level of injury.

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3
Q

What is tetraplegia or quadriplegia?

A

Impaired movement in all four limbs.

Changed from quadriplegia because of impairment in cervical segments.

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4
Q

Describe a complete SCI?

A

No muscle preservation at or below level of injury. Absence of sensory and motor function below injury.

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5
Q

Describe an incomplete SCI?

A

There is partial preservation of sensory and/or motor function below the level of injury.

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6
Q

When is there the greatest amount of recovery of those with a SCI?

A

The first three months after injury

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7
Q

Describe Spinal Shock?

A

The time immediately after injury where there are symptoms of areflexia at or below the level of injury.

Areflexia = loss of reflexes.

Last 24 hours - 6 weeks

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8
Q

What area of the cord is damaged when there is issues with respiration?

A

Cervical Cord Segment in C4 and above.

C4 and above require mechanical ventilation

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9
Q

Describe symptoms of an Anterior Spinal Cord Injury?

A

Loss of all sensation (except proprioception) and motor function below the injury

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10
Q

Describe Brown-Sequard Syndrome?

A

Lateral damage to cord.

Motor paralysis and loss of proprioception on ipsilateral side of injury.

Pain, Temp and Touch loss on contralateral side of injury.

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11
Q

Describe Cauda Equina Syndrome?

A

Occurs in fractures below L2 and exhibit flacid paralysis.

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12
Q

Describe Central Cord Syndrom?

A

Paralysis and sensory loss greater in upper extremity than in lower.

Common in elderly because of narrowing of spine.

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13
Q

Describe Conus Medullaris syndrome?

A

Injury to sacral cord and lumbar nerve roots.

Loss of bowel and bladder function.

Loss of LE function.

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14
Q

What is a Spinal Cord Infarct?

A

Stroke within spinal cord

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15
Q

What is Transverse Myelitis?

A

Myelin sheath is attacked at one level of spinal cord. Paralysis below level of inflammation.

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16
Q

What is the initial goal of Spinal Cord Injury?

A

Relieving pressure on spinal cord.

Done through:

  • removing portions of vertebrae.
  • surgery removing masses that are causing pressure.
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17
Q

What is the second goal of Spinal Cord Injury?

A

Stabilize the Spine! If vertebrae is weak from fracture or infection may not be able to support weight of body.

Can be done with:

  • Screws, Rods, Plates
  • Fusing
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18
Q

What is the Physical Evaluation with Spinal Cord Injuries consist of?

A

Muscle Evaluation: ROM, MMT

Sensory Evaluation: Dermatome, Pin Prick, Muscle Tone.

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19
Q

What is the ASIA Scale?

A

Measures the disruption of motor and sensory pathways at the site of the lesion.

Tests 10 key muscles and 28 Sensory Points on each side of body.

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20
Q

What is the functional level on the ASIA scale?

A

Key muscles graded 3+ or above

Sensation is Intact

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21
Q

What is the difference between the Neurological Assessment Motor Index and MMT?

A

All testing is done in Supine.

Scale of 1-5

0 No movement
1 Visible Movement
2 Muscle is able to move at least once in GE
3 Muscle is able to move at least once AG
4 Muscle is able to move with some resistance
5 Muscle is able to exert normal force

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22
Q

Describe the 5 Scores on the ASIA impairment Scale?

A

A, B, C, D, E

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23
Q

What is an ASIA - A?

A

Complete impairment.

No motor or sensory is preserved in sacral segments. S4 - S5

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24
Q

What is an ASIA - B?

A

Incomplete Impairment

Sensory Function Intact

No Motor Function below level of injury

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25
Q

What is an ASIA - C?

A

Incomplete Impairment

Motor Function Intact below level of injury

Muscle Grade of 3 or Less

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26
Q

What is an ASIA - D?

A

Incomplete Impairment

Motor intact below level of injury

Muscle Grade of 3 or more

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27
Q

What is an ASIA - E?

A

Normal

All motor and Sensory Function

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28
Q

What is Autonomic Dysreflexia and what level of damage is this exhibited?

A

Sudden onset of high blood pressure.

T6 and above.

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29
Q

What is Orthostatic Hypotension and what level of damage is it exhibited?

A

Sudden drop in blood pressure

T6 and below

Associated with prolonged supine positioning.

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30
Q

What is the clinical tip when dealing with someone with high or low blood pressure?

A

Face turns red – Raise the head

Face turns pale – Rase the tail

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31
Q

What things can break down skin?

A

Heat, Friction, Moisture.

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32
Q

At what level of the cord is there bowel and bladder management issues after injury?

A

S2 - S5 spinal segments

Lose the ability to defecate voluntarily.

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33
Q

What are the Functional Expectations at an Injury at C1-C3?

A

Can use face and neck muscles, also can use mouth.

Total Paralysis in trunk and extreminities

Dependent on all ADLs

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34
Q

What are the functional expectations at an injury at C4?

A

Has neck function, scapular elevation, and can use diaphragm for respiration.

Paralysis of trunk and extremities.

Cannot cough

Dependent with all ADLs

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35
Q

What are the functional expectations at an injury at C5?

A

Has preserved Elbow Flexion, Supination, External Rotation, Shoulder Abduction to 90 Degrees.

No elbow extension, No hand function.

Total paralysis of trunk and LE

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36
Q

What are the functional expectations at an injury at C6?

A

Has shoulder movement, Horizontal Adduction, Supination, Radial Wrist Extension.

HAS TENDONISIS GRASP!!!!

No wrist flexion, elbow extension,

Total Paralysis trunk and LE

INDEPENDENT WITH BASIC ADLs

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37
Q

What are the functional expectations at an injury at C7 - C8?

A

HAS TRICEP FUNCTION!

Has full use of hands and UE, Limited grasp strength.

Full paralysis in trunk and UE.

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38
Q

What are the functional expectations at an injury at T1- T9?

A

Some intact spinal muscles.

Limited trunk stability

Paraplegia

INDEPENDENT WITH ADLs

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39
Q

What are the functional expectations at an injury at T10 - L1?

A

Good trunk stability

Weak LE, MAY BE ABLE TO WALK

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40
Q

What are the functional expectations at an injury at L2 - L5?

A

May have hip, knee and ankle function.

Weak LE, MAY BE ABLE TO WALK

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41
Q

What is the main function of acute care

A

Stabilize the patients medical status and address any threats to his or her life and loss of function.

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42
Q

What is the average length of stay in the acute care?

A

4.8 days

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43
Q

What is the range of normal blood pressure?

A

90/60 - 140/90

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44
Q

What is the range of normal respiratory rate?

A

12-20 breathes a minute

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45
Q

What is the range of normal resting heart rate?

A

60-100 bpm resting

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46
Q

What is albumin and what is the implications if it is too high or too low?

A

Hyperalbuminemia - severe dehydration

Hypoalbuminemia - liver disease

Take care when handling: altered mental status, balance issues, risk of bleeding.

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47
Q

What is the clinical implications if ammonia is out of range?

A

High levels: Severe liver dysfunction, altered mental status.

Decreased: Not significant

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48
Q

What are the implications for OT if the Blood Urea Nitrogen level is increased?

A

Dizziness during exercise/activity

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49
Q

What is the marker that can determine whether the patient had a heart attack?

A

Cardiac Enzymes

May want to wait for OT until the level are within normal limits and they haven’t had a heart attack.

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50
Q

What is the normal range for glucose?

A

Reference Range 70-100

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51
Q

What are the medical terms for increased and decreased glucose?

A

Hyperglycemia = Increased glucose

Hypoglycemia = Decreased glucose

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52
Q

What is the clinical implications if the glucose level is below 60 mg?

A

Patient may have low activity tolerance and overexertion may cause hypoglycemic reaction.

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53
Q

What are the clinical implications if the Hematocrit level is too low?

A

Light activity only and light or no resistance during exercise.

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54
Q

What machine measures hemoglobin and what are the normal ranges?

A

Pulse Oxymeter

Range = 12 - 18

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55
Q

What do low hemoglobin values mean for occupational treatment?

A

Result in decreased exercise tolerance.

8-10 light exercise

Less than 8 = exercise is contraindicated

could pass out if do exercise at this low rate

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56
Q

What is the clinical implications for increased INR and ranges?

A

2-3 = Therapeutic Range

3 - 4 = Activity Modification (increased risk for bleeding)

5 + = Check with Dr

57
Q

What is the reason for platelet count and what is its normal range?

A

Primary role in clotting

Reference Range = 150,000 - 450,000

58
Q

What are the terms for increased platelet count and decreased platelet count?

A

Thrombocytosis = Increased Platelet Count

Thrombocytopenia = Decreased Platelet Count

59
Q

What are the clinical implications for low platelet count?

A

80 - 150 = Moderate resistance, ambulation, ADL’s

50 - 80 = Minimal resistance, ambulation, ADL’s

20 - 50 = No resistance, ambulation, ADL’s

10 - 20 = Light ADL’s only

Less than 10 = Consult Dr

60
Q

What is the short hand for Blood Count?

A

WBC Count (On left)

Platelet Count (On right)

Hemoglobin (On top)

Hematocrit (On bottom)

61
Q

What is the impact if potassium is too low?

A

Affects neuromuscular function

Range = 3.5 - 5.0

62
Q

What is normal range for PT time and when is OT contraindicated?

A

11 - 15 is normal range

Contraindicated if 2.5 times the normal.

63
Q

What is the normal range for WBC?

A

4,500 - 11,000 Normal Range

64
Q

When should the OT take caution with clients WBC?

A

If too high - use caution when exercising

If too low - Exercise is contraindicated and don’t treat while you are sick.

65
Q

What is a stroke?

A

An interruption of blood flow that causes an inadequate supply of oxygen to the brain.

66
Q

What is an infarction?

A

An area of dead tissue

67
Q

What are the main types of stroke?

A

Hemorrhagic - bleeding

Ischemic - clot

Lacunar - Small infarcts in brainstem.

68
Q

What are the warning signs of a stroke?

A 
Numbness or weakness of face, arm, leg. 
Sudden confusion, trouble speaking.
Trouble Seeing 
Dizziness, loss of balance 
Severe headache 
FAST (Face, Arm, Speech, Time)
69
Q

What is the function of the frontal lobe?

A

Emotional Expression, memory, judgement, voluntary eye movement.

Contain’s Broca’s Area (expressive language)

70
Q

What is the function of the temporal lobe?

A

Wernicke’s area for receptive speech

Understanding what someone says to you

71
Q

What is the function of parietal lobe?

A

Sensory cortex

Proprioception

72
Q

What is the function of the occipital lobe?

A

Visual processing

73
Q

What areas of the brain does the MCA supply?

A

Frontal, Temporal and Parietal

74
Q

What areas of the brain does the ACA supply?

A

Portions of the frontal lobe

75
Q

What is the most common abnormality in blood flow?

A

No posterior communicating artery.

Detrimental because brain doesn’t have as many options for rerouting.

76
Q

What is a hemorrhagic CVA?

A

Rupture of blood vessel around cerebral tissue.

77
Q

What are the two types of hemorrhagic CVA’s?

A

Intracerebral Hemorrhagic CVA = Release of blood into brain tissue.

Subarachnoid Hemorrhagic CVA = Blood releasing into subarachnoid space.

78
Q

What is an Ischemic Stroke?

A

Sudden loss of function due to a loss of blood to brain. Caused by blockage of artery.

Cell death occurs in 5 - 10 minutes.

79
Q

What are the 3 types of Ischemic Stroke?

A

Thrombotic

Embolic

Crytogenic

80
Q

What is a thrombotic stroke?

A

Blood clot forms and obstructs artery. Mostly due to atheroslerosis.

81
Q

What is an embolic stroke?

A

A clot breaks off and travels until it blocks artery.

MCA is most common artery blocked by embolism.

82
Q

What is a Transient Ischemic Attack?

A

Brief episode of neurologic dysfunction.

No evidence of infarct

83
Q

What is the symptoms of a Left Middle Cerebral Artery Infart (MCA)

A

Loss of voluntary movement and coordination on RIGHT side of face, trunk and limbs.

Impaired Sensation

Aphasia

SLOW AND CAUTIOUS PERSONALITY

84
Q

What is the symptoms of a Right Middle Cerebral Artery Infart (MCA)

A

Loss of voluntary movement and coordination on LEFT side of face, trunk and limbs.

Impaired Sensation

IMPULSIVE BEHAVIOR AND ERRORS IN JUDGEMENT

85
Q

What is the symptoms of a Anterior Cerebral Artery Infart (ACA)

A

CONTRALATERAL hemiplegia or hemiparesis LEG

Loss of Bladder Control

LACK OF EMOTION, SLOWNESS and DISTRACTIBILITY

86
Q

What is the symptoms of a Posterior Cerebral Artery Infart (PCA)

A

CONTRALATERAL hemiplegia or hemiparesis ARM

Intention tremor

87
Q

What is the symptoms of a Vertebrobasilar CVA?

A

Paralysis of face, limbs, or tongue

Dysphasia

88
Q

What is the cause of traumatic brain injury?

A

Caused by external force

89
Q

What is the most common cause of TBI?

A

Falls 32% and Motor Vehicle Accident (17%)

90
Q

What are some factors that contributed to an increase survival rate for those with TBI?

A

Faster Emergency Response

EMT and Paramedic

Better understanding

Improved Treatment

91
Q

What are the common ages for TBI?

A

0-4 because of skill frailty

Young males 15-24

65 and older because of falls

92
Q

How are TBI and substance abuse related?

A

It’s a contributing factor related to TBI’s because of car accidents and falls.

93
Q

Describe a severe TBI

A

Loss of consciousness longer than 6 hours.

94
Q

Describe a moderate TBI?

A

Called Post traumatic amnesia.

Lasts 1-24 hours.

Don’t remember events of and after incident.

95
Q

Describe a mild TBI?

A

Any loss of consciousness and loss of memory.

96
Q

What is an acceleration Injury that results in the TBI.

A

Brain moves forward and then backward.

Called Coop Force.

Brain sloshes into front of skull and then back of skull.

97
Q

What is a deceleration injury that results in the TBI?

A

When there is a sudden stop and the brain hits the front of the skull.

98
Q

What is a rotation injury that results in the TBI?

A

Brain rotates and sheers the pathways into the brain, especially brain stem.

99
Q

What is the difference between a diffuse and focal TBI

A

Diffuse = damage over more than one part of the brain.

Focal = Pinpoint damage.

100
Q

What is the difference between and concussion and a contusion?

A

Concussion is a jarring or shaking of the brain resulting in disturbance in brain function.

Contusion is a brain bruise that is more focal and has bleeding. Associated with skull fracture.

101
Q

What is anoxia?

A

Loss of O2 to the brain

Has diffuse symptoms.

102
Q

What are some symptoms of anoxia?

A

Unconsciousness

Memory Loss

103
Q

What are symptoms of a concussion and a contusion?

A

Short loss of consciousness

Headache

Nausea

104
Q

This type of injury comes from rotation of the brain and causes coma due to damage in midbrain?

A

Diffuse Axonal Injuries.

105
Q

What are some cognitive impairments as a result of TBI?

A

Decreased Arousal, Orientation and Attention.

Decreased Memory

Decreased reasoning, planning and problem solving.

Behavioral Issue

106
Q

What happens as a result of a TBI with orbitofrontal damage?

A

Impulsivity

107
Q

What happens as a result of TBI with Frontolateral cortex damage?

A

Hemiparesis

Impulsivity

Decrease attention and mental flexibility

108
Q

What are some common conditions that accompany TBI?

A

Fractures

SCI

Abdominal Trauma

Amputation

109
Q

What are the 4 phases of life for TBI survivor?

A

Preinjury

Medical
-acute and intensive phases.

Rehabilitation

Survivorship

110
Q

Describe the Glasgow Coma Scale

A

Score = (E+M+V)

Eyes

Motor

Verbal

111
Q

What are the scales for Eye Opening in the Glasgow Coma Scale?

A

4 - Spontaneous eye opening

3 - Open in response to speech

2 - Open in response to pain

1 - No eye opening response

112
Q

What are the scales for motor response in the Glasgow Coma Scale?

A 
6 - Obeys 
5 - Localizes 
4 - Withdraws
3 - Abnormal Flexion 
2 - Abnormal Extension
1 - No Response
113
Q

What are the scales for verbal response in the Glasgow coma Scale?

A 
5 - Oriented, Normal Convo
4 - Confused Conversation 
3 - Inappropriate Words
2 - Incomprehensible Sounds
1 - No Speech
114
Q

What are the 3 alterations to consciousness?

A

Coma

Vegetative State

Minimally Conscious State

115
Q

Describe Coma

A

Absence of sleep wake cycle

No eye opening

No command following

No verablization

May have reflexes

116
Q

Describe Vegetative state

A

Has sleep wake cycle

Spontaneous eye opening

117
Q

Describe a Minimally Responsive state

A

Severely Disabled

Capacity for environmental interaction

Inconsistent responses

118
Q

What are the first 6 Levels of the Ranchos Los Amigos Levels of Cognitive Functioning?

A 
I - No Response
II - Generalized Response 
III - Localized Response 
IV - Confused Agitated 
V - Confused Inappropriate
VI - Confused Appropriate
119
Q

What are the last 4 levels of the Ranchos Los Amigos Levels of Cognitive Functioning?

A

VII - Automatic Appropriate
VIII - Purposeful Appropriate w/ assistance
IX - Purposeful Appropriate w/ assistance if needed
X - Purposeful and Appropriate

120
Q

What is ALS?

A

Progressive degeration of upper and lower motor neurons

121
Q

What is the symptoms of ALS?

A

Weakened muscles that eventually lead to paralysis

Does not affect cognition, eye movement or sensation.

122
Q

What is the muscle group progression with ALS?

A

Progresses from small muscle groups to larger muscle groups.

Progresses distally to proximally.

123
Q

What is the difference between Upper Motor Neuron Symptoms and Lower Motor Neuron Symptoms?

A

Upper Motor Neuron - Spasticity, loss of strength, stiffness

Lower Motor Neuron - flaccidity, decreased tone, fasciculations, bulbar symptoms (hoarseness, speech issues)

124
Q

What are the stages of ALS?

A

Stage 1: Ambulatory, Mild weakness.

Stage 2: Ambulatory, moderate weakness

Stage 3: Ambulatory, severe weakness

Stage 4: Wheel Chair confined, Almost independent, LE weakness.

Stage 5: Wheel Chair, Dependent, UE & LE Weakness.

Stage 6: Bedridden, No ADLS, Max assist.

125
Q

What is multiple sclerosis?

A

Progressive demyelinating neurological disorder that affects the CNS.

Bodies own defense system attacks myelin sheath.

126
Q

What are some symptoms of MS?

A

FATIGUE

Sensory disturbances - abnormal sensation

Motor Symptoms - balance, spasticity, weakness

Cognitive Issues - memory, attention, concentration, mood.

Communication Disturbances - slurred speech

127
Q

What are the 4 Types of MS?

A

Relapse-Remitting

Primary-Progressive

Secondary Progressive

Progressive-Relapsing

128
Q

Describe Relapse-Remitting MS

A

Most common

Episodes of worsening function followed by partial or complete remission periods.

129
Q

Describe Primary and Secondary Progressive MS?

A

Primary-Progressive - Slow worsening onset of disease.

Secondary-Progressive - Steady worsening

130
Q

Describe Progressive-Relapsing MS?

A

Steady worsening of disease from beginning.

131
Q

What are the 2 most important precautions with MS and ALS?

A

Avoid Fatigue

Avoid Resistive Excercise

132
Q

What is Guillain-Barre?

A

An inflammatory disease resulting in demyelination of peripheral nerves.

133
Q

What are the symptoms of Guillain-Barre?

A

Paralysis starting with the feet.

Pain

Fatigue

Mild sensory loss

134
Q

What are the 3 Phases of Guillain-Barre?

A

Acute Inflammatory Phase

  • Weakness in 2 limbs.
  • 2 - 4 weeks

Plateau Phase

  • Greatest impairment
  • Lasts days or weeks

Recovery Phase

  • Remyelination
  • 12 weeks-2 yrs
135
Q

What is Parkinson’s Disease?

A

Neurodegenerative disorder caused by loss of dopaminergic neurons in the substantia nigra.

136
Q

What are some of the signs and symptoms of Parkinkson’s?

A

Resting Tremor

Shuffling Gait

Decrease Fine Motor Skills

Cogwheel Rigidity

137
Q

Describe LOUD/BIG and occupational therapy with Parkinson’s Disease?

A

LOUD = Encouraging loud verbalization (Used by speech therapist)

BIG = Encouraging big movement in order to limit deficits in movement.

138
Q

What are the 5 Stages of Parkinson’s?

A

Stage I: Resting Tremor. Min impairment.

Stage II: Mild impairment related to trunk mobility.

Stage III: Balance Issues. Moderate impairment.

Stage IV: Increased balance and postural impairments.

Stage V: Confined to wheelchair or bed.

Conditions II (4 decks)

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