midterm 1 Flashcards
1
Q
core values
A
altruism
dignity
equality
freedom
justice
truth
prudence
2
Q
philosophical assumptions
A
each individual has the right to a meaningful existence
is influenced by the biological and social nature of species
can only be understood within the context of family, friends, community
has the need to participate in a variety of social roles and have periodic relief from participation
has the right to seek potential through purposeful interaction within the human and nonhuman environment
OT promotes functional interdependence
3
Q
domain
A
areas of human activity
occupations, client factors, performance skills, performance patterns, context and environment
4
Q
process
A
use of enhancement of engagement in occupations
type of OT interventions, treatment approaches, activity and occupational demands, type of outcomes
5
Q
most cited conditions treated by OTs
A
neurological
development
cardiopulmonary
orthopedic
general medical
psychosocial/mental illness
6
Q
spread vs stigma
A
spread is assuming someone with a disability has other disabilities
stigma is thinking that someone with a disability can’t achieve something
7
Q
stages of adjustment
A
shock
denial
anger/depression
adjustment/acceptance
8
Q
evidence-based practice
A
clinical expertise, client perspectives, external scientific evidence
9
Q
unselfish concern for welfare of others. reflected in actions and attitudes of commitment, caring, dedication, responsiveness, understanding
A
altruism
10
Q
valuing the inherent worth and uniqueness of each person. demonstrated by an attitude of empathy and respect for self and others
A
Dignity
11
Q
all individuals be perceived as having the same fundamental human rights and opportunities. demonstrated by an attitude of fairness and impartiality
A
equality
12
Q
allows individual to exercise choice and demonstrate independence, initiative, and self-direction
A
freedom
13
Q
plays value on upholding moral and legal principles as fairness, equity, truthfulness, and objectivity
A
justice
14
Q
be faithful to facts and reality. demonstrated by being accountable, honest, forthright, accurate, authentic in attitudes and actions
A
truth
15
Q
ability to govern and discipline oneself through the use of reason. value judiciousness, discretion, vigilance, moderation, care, and circumspection in one’s affairs. rational thought
A
prudence
16
Q
client factors
A
values, beliefs, spirituality, body functions, body structures of a person
influence participation on occupations
17
Q
performance skills
A
observable elements of action that have an implicit functional purpose
motor, process, social interaction
18
Q
performance patterns
A
habits, routines, roles, and rituals of a person when engaging in occupations
can enhance or hinder
19
Q
context and environment
A
interrelated conditions about a person, cultural, personal, temporal, virtual
20
Q
risk factors and causes of CP
A
disorders of coagulation
low birth weight
intrauterine exposure to infection and disorders of coagulation
periventricular leukomalacia
hypoxic-ischemic encephalopathy (perinatal asphyxia)
intraventricular hemorrhage (blood in ventricular system, hydrocephalus)
cerebral dysgenesis (undeveloped brain)
premature birth
21
Q
symptoms of CP
A
hypertonicity
hypotonicity
hyperreflexia
clonus: rhythmic rocking
enhanced stretch reflex
absence of primitive reflex
atypical posture
delayed motor development
atypical motor performance
22
Q
types of CP
A
spastic
athetoid
ataxia
23
Q
contractures
A
permanent shortening of a muscle or joint, losing ROM
24
Q
spastic CP
A
hypertonicity: restricted movement, contractures
accounts for 80% of CP
hemiplegia, diplegia, quadriplegia, triplegia, monoplegia
25
periventricular leukomalacias
premature birth before 23 weeks
damage in white matter in brain adjacent to lateral ventricles
26
hypoxic-ischemic encephalopathy
loss of oxygen leads to damaged brain tissue
causes fetal stroke and other delivery complications
27
intraventricular hemorrhage
not present at birth
first few days of life
bleeding in brain
hydrocephalus
28
cerebral dysgenesis
critical first 20 weeks
brain didn't develop normally
29
hypertonicity
muscles wound too tightly
30
hypotonicity
muscles wound too loosely
31
spastic hemiplegia
asymmetrical hand use
dragging of one side of body
late walking milestone
lack of righting and equilibrium reactions
avoidance of weightbearing
32
spastic diplegia
both lower extremities or less severe arms
lumbar lordosis, dorsal spine kyphosis
scissoring while walking
plantar flexion of ankles
contractures
90% walk independently
33
spastic quadriplegia
4 limb movement
arms: spasticity in flexors
legs: spasticity in extensors
tonic labyrinthine reflex
dysarthria
scoliosis
34
athetoid CP
dyskinetic
most common type of dyskinesia
slow, writhing, involuntary movements
jerky distal movements
dysarthria
35
ataxic CP
wide-based, staggering, unsteady gait
intention tremors
hypotonicity present
poor balance/cerebellum issues
36
visual and hearing impairments in CP
strabismus, nystagmus, visual fixation and tracking, paralysis of upward gaze, lack of depth perception
sensorineural hearing loss, conductive hearing loss
37
cognitive impairment of CP
30-50%
1/3 mild
mixed types and severe spastic quadriplegia
otherwise average intelligence
38
seizure disorder in CP
25-60%
dependent on type of CP, most common in spastic hemiplegia and quadriplegia
epilepsy in 38%
most commonly partial seizures
39
oral motor in CP
dysarthria
aspiration
malnutrition
swallowing impairments
drooling from impaired motor control and swallowing
enamel dysplasia
mouth breathing
periodontal diseases
40
gastrointestinal in CP
gastroesophageal reflux
constipation
dehydration
41
types of medical management for CP
diazepam/valium
dantrolene/dantrium
baclofen
botox injections
orthotics
splinting
casting
42
surgical management of CP
tendon lengthening (more common on legs)
selective dorsal rhizotomy: stimulating lumbrosacral nerve roots
43
goals of medical management for CP
decrease spasticity
reduce tone
increase ROM
reduce deformities
prevent contractures
no long term effectiveness
44
goals of surgical management of CP
reduce spasticity and improve function
SDR goal in diplegia to improve gait and leg function, in quadriplegia to allow sitting for longer and reducing spasticity
highly successful
45
prognosis for CP
may require physical assistance, additional training, or assistive technology
46
ASD impact on occupational performance
difficult with conversation or making friends
highly sensitive to changes in environment
overly dependent on routines
47
abnormalities in brain from ASD
increased brain volume and head circumference
decreased number of Purkinje cells in cerebellum
deviations in inferior olive in brainstem
reduced activation of frontal lobe
larger areas of frontal lobe
abnormally large amygdala
decreased size of neurons in limbic system
48
environmental factors of ASD
prenatal/postnatal exposure: viruses, infections, drugs/alcohol, endocrine factors, CO, maybe lead
49
physiological abnormalities in ASD
gastrointestinal disorders: reflux, gastritis
abnormal digestion of gluten and casein due to lack of enzymes
maybe increased vulnerability to immune system disorders
may not be able to verbalize physical discomfort and pain
50
ASD incidence and prevalence
1(+)% of world population
1 in 68 children in 2010
fastest growing developmental disability
more often in white boys
can vary by community
51
core symptoms of ASD
difficulty in social interaction
echolalia, pronoun reversal
restrictive and repetitive behaviors
poor auditory processing (comprehend verbal language)
52
theory of mind in ASD
ability to understand another person's thoughts, feelings, and then being able to predict actions
53
co-occurring conditions with ASD
sensory processing disorder
food selectivity: disruptive behaviors, picky
fine and gross motor impairment: hand-eye coordination, posture, gait abnormalities, ambiguous hand preference
sleep disturbance: poor sleep quality, resist sleeping
intellectual disability
54
medical management of ASD
not much medication. risperidone can decrease aggression
early intervention for 0-3
supplements : vitamin A-C, liver oil, magnesium
gluten-free and casein-free diet maybe
secretin, chelation, antibiotics, antifungal treatment
55
ASD impact on occupational performance
dressing
eating
independence at school
regulating emotions
toileting
sensory processing: hyper/hypo sensitivity, vestibular system
GI: reflux, gastritis, gas
56
types of intervention for ID
psychotropic medications
Tegretol: help with seizures
botox or baclofen for comorbid CP
access to remedial programs: increases adaptive functioning
57
presentation of ID
low intellectual functioning
58
symptoms of ID
with another diagnosis like CP, epilepsy
limited adaptive skills (self-care, communication)
low IQ
mental illness (psychotic, avoidant)
59
causes of ID
no defined cause
gene/chromosome mutation: down syndrome, fragile x syndrome, Hunter's syndrome
maternal factors: low birth weight, syphilis, rubella, poor nutrition, lack of prenatal care, OTC prescriptions
perinatal factors: mechanical injuries during labor, perinatal hypoxia, mom has herpes, child abuse, head trauma, meningitis
single gene disorder, chromosomal aberrations
60
types of MD
duchenne muscular dystrophy
myotonic muscular dystrophy
becker muscular dystropy
facioscapulohumeral muscular dystrophy
limb-girdle muscular dystrophy
emery-dreifuss muscular dystropy
61
inheritance conditions of duchenne muscular dystrophy
mother passes affected gene onto son from X-liked recessive gene
62
age of onset for duchenne muscular dystrophy
genetically present at birth
symptoms not present until 3-4 years old
63
symptoms of duchenne muscular dystrophy
delayed motor development
proximal weakness
increased fatigue
waddling gait
enlarged calf muscles
valley sign: depressed area on posterior axillary fold
64
causes of duchenne muscular dystrophy
absence or deficiency of dystrophin
65
characteristics of duchenne muscular dystrophy
bilateral
symmetrical
affects all voluntary skeletal muscles and cardiac/pulmonary muscles
contractures
possible cognitive impairments
proximal to distal
legs first them arms
66
inheritance conditions for becker muscular dystrophy
x-linked recessive inherited condition
present at birth
primarily males
67
typical age onset of becker muscular dystrophy
genetically present at birth
symptoms vary from 2-40 but appear most often at 6-18
68
symptoms of becker muscular dystrophy
delayed ambulation
difficulty climbing stairs
toe walking
muscle cramps
fatigue
69
characteristics of becker muscular dystrophy
muscle wasting proximal to distal
symmetric starting in pelvic girdle and thighs
lumbar lordosis
70
causes of becker muscular dystrophy
partially functional dystrophin
71
inheritance conditions of limb-girdle muscular dystrophy
autosomal recessive (more severe)
both parents carry and pass on affected gene
10% autosomal dominant, child inherits normal gene from one parents and affected gene from other parent
affects males and females equally
72
characteristics of limb-girdle muscular dystrophy
lower dystrophin levels
not always symmetrical
first affects the muscles of the pelvis and shoulders
waddling gait
usually slow muscle wasting
positive gower's sign: walking up the thighs
73
typical age onset of limb-girdle muscular dystrophy
autosomal recessive onset usually in childhood
sometimes later into adulthood, less severe
74
causes of limb-girdle muscular dystrophy
lack of structural, dystrophin-associated glycoproteins
75
symptoms of limb-girdle muscular dystrophy
enlarged calves
severe lordosis with scoliosis
proximal muscle weakness
76
inheritance conditions of myotonic muscular dystrophy
autosomal dominant inherited
both males and females
77
typical age of onset of myotonic muscular dystrophy
teen or adult onset
50% lived beyond 50
78
symptoms of myotonic muscular dystrophy
muscles weakness begins in face, lower legs, forearms, hands and neck
delayed reaction after muscle contraction
79
characteristics of myotonic muscular dystrophy
affects gi system, vision, heart, respiratory system
30% die from cardiac complications
sometimes cognitive impairments
80
inheritance of facioscapulohumeral muscular dystrophy
autosomal dominant inherited
both males and females
81
typical age of onset of facioscapulohumeral muscular dystrophy
varies 7-20
earlier more severe/progresses faster
82
characteristics of facioscapulohumeral muscular dystrophy
not usually symmetrical
depressed shoulders
initially affects facial, shoulder and upper arm muscles
weakness begins with facial muscles, progresses down
sometimes affects gait
without cognitive impairments
83
symptoms of facioscapulohumeral muscular dystrophy
difficulty closing eyes
asymmetrical smile
pucker inability
atrophy (wasting of tissue from decrease muscle mass)
winged scapula
84
inheritance condition of emery-dreifuss muscular dystrophy
x-linked recessive inheritance
primarily affects boys
85
characteristics of emery-dreifuss muscular dystrophy
less common
significant cardiac complications (usually causes death)
generally symmetrical
86
typical age onset of emery-dreifuss muscular dystrophy
boys by age 10
87
symptoms of emery-dreifuss muscular dystrophy
formation of muscle contractures (heal cords, elbows, posterior neck muscle) first
toe walking
90 degree elbows
88
3 typical diagnostic tests
blood work for genetic testing
emg
muscle biopsy
89
medical management of muscular dystrophy
no cure
treatment goal: independence maintenance, respiratory maintenance, skin integrity, monitor pain, maintain nutrition, ot/pt, drug intervention (corticosteroids)
gene replacement
gene modification therapy
90
surgical management of muscular dystrophy
contracture release
scoliosis repair
cardiac stability
respiratory assist
spinal stabilization
feeding tubes
91
MD impact on occupational performance
toileting
dressing
grooming
driving
meal preparation
daily school tasks
maintaining employment
playing with peers
92
ADHD prognosis
lifelong
50% continue into adulthood
overactivity/impulsivity decrease with age
30-50% receive special education
higher school dropout rate, lower GPA average
workplace problems
93
ADHD treatments
stimulant medications, methylphenidate (increases dopamine and norepinephrine), adderall, concerta, decedrine, ritaline (anxiety, headaches)
psychological counseling
problem-solving strategies
accommodations
self-regulation strategies
CBT
peer or life coaching
parent education
94
ADHD symptoms
persistent and maladaptive inattention, hyperactivity, impulsivity
95
inattentive ADHD symptoms
careless mistakes
difficulty managing sequential tasks
avoids tasks that require sustained mental effort
difficulty with sustaining attention
distracted by extraneous or unimportant stimuli
96
hyperactice-impulsive ADHD symptoms
fidgety
feels restless
difficulty engaging in leisure activities quietly
talks excessively
97
ADHD impact on ADL
children: learning, self-care routines, play skills
adults: driving
98
OT interventions for ADHD
modifying or addressing environmental and/or contextual elements
99
OT treatments of MD
provision of splints and orthotics to prevent joint contracture
100
subtypes of SPD
sensory modulation disorder
sensory-based motor disorder
sensory discrimination disorder
101
sensory modulation disorder
problem in regulating responses to sensory inputs resulting in withdrawal or strong negative responses to sensations that usually don't bother others
102
signs of sensory modulation disorder
easily distracted by noises or visual stimuli
overly sensitive to sounds
dislikes nail/hair cutting
dislikes clothing textures
seams in socks >:(
difficulty sleeping
103
sensory discrimination disorder
problem in recognizing/interpreting differences or similarities in qualities of stimuli
104
signs of sensory discrimination disorder
jumps on beds
bumps/pushes others
tight grasping/too much force
droppings things
chewing on things
movement like spinning
afraid of heights
poor balance
105
sensory based motor disorder
postural-ocular disorder: posture problems, vestibular and proprioceptive problems
dyspraxia: problems with planning, sequencing, executing. poor motor skills
106
signs of sensory-based motor disorder
weaker
fatigue
slumping
flat feet
poor handwriting
dislikes sports
problems with daily life tasks
107
causes of SPD
no specific cause
hereditary
prenatal stress
perinatal complications
sensory deprivation
alcohol exposure
108
subtypes of sensory modulation disorder
sensory overresponsivity: responses to stimuli are more intense, inflexibility
sensory underresponsibity: requires more intense stimulation to be aroused
sensory craving: seek sensory input with an approach that results in disorganized behavior, fearless
109
subtypes of sensory-based motor disorder
postural disorders: compromised smooth muscle control, poor balance reactions, slumped position, deficits in smooth oculomotor control
dyspraxia: difficulty with motor planning, clumsy
110
impact of ADHD on occupational performance
gross motor play
fine motor play
recreational activities
eating/feeding
toileting
tying shoes
bathing
shopping
sleeping
driving
interpersonal relationships
111
case history
narrative focused on clinical problem, course of treatment, and outcome
contextualizes clinical problem in terms of person's daily life and personal identity
written for clinicians based on observations over time, conversations and interviews
112
life-chart
linear diagram of patient's life indicating key life events and suggesting possible relationships over time to illnesses and impairments
prepared by clinician to assist in clinical reasoning. based on interviews and clinical records
113
life history
narrative of a person's life over time from birth
stresses coherence of personality development and adaptation within a particular culture
naturalistically unfolds, could be topical and chronological
researcher's reconstruction and interpretation on the bases of person's life story, interviews, observations, clinical records
114
life story
temporally discontinuous discourse unit that includes all stories person tells about themselves
analysis usually based on topics, fragments, or short versions of person's life story
based on oral discourse. analysis/interpretation is usually made by someone other than the life story subject
115
hermeneutic case reconstruction
narrative analysis for comparing life history with life story
life story elicited from life history subject with minimal intervention. based strictly on comparing life history with life story rather than imported theories
116
therapeutic emplotment
narrative interpretation of clinical practice in which patients and OTs are viewed as characters who together create an unfolding story
intuitive perceptions elicited through discussions with clinical colleagues on bases of ongoing observations and interactions with patients
