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OCCUPATIONAL THERAPY > OCTA 226 Lecture Final Exam > Flashcards

OCTA 226 Lecture Final Exam Flashcards

1
Q

Manual muscle testing: Zero (0)

A

No muscle contraction can be seen or felt

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2
Q

Manual muscle testing : Trace (1)

A

Contraction can be felt, but there is no motion

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3
Q

Manual muscle testing: Poor minus (2)

A

Part moves through incomplete ROM with gravity decreased

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4
Q

Manual muscle testing: Poor (2)

A

Part moves through complete ROM with gravity decreased

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5
Q

Manual muscle testing: Poor plus (2+)

A

Part moves through incomplete ROM against gravity or through complete ROM with gravity decreased against slight resistance

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6
Q

Manual muscle testing: Fair minus (3)

A

Part moves through incomplete ROM against gravity

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7
Q

Manual muscle testing: Fair (3)

A

Part moves though complete ROM against gravity

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8
Q

Manual muscle testing: Fair plus (3+)

A

Part moves through complete ROM against gravity and slight resistance

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9
Q

Manual muscle testing: Good (4)

A

Part moves though complete ROM against gravity and moderate resistance

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10
Q

Manual muscle testing: Normal (5)

A

Part moves through complete ROM against gravity and full resistance

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11
Q

Medical complications of spinal cord injury (SCI)

A
  • Skin breakdown
  • Pressure sores
  • Decubitus ulcers
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12
Q

This ASIA classification indicates a complete lesion, no motor/sensory function in the sacral segments S4-S5

A

ASIA classification A

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13
Q

This ASIA classification indicates an incomplete lesion, sensory but no motor function below the neurological level and includes sacral segments S4-S5

A

ASIA classification B

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14
Q

This ASIA classification indicates an complete lesion, motor function below the neurological level, and more than half of the key muscles below the neurological level have a muscle grade less than 3

A

ASIA classification C

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15
Q

This ASIA classification indicates an incomplete lesion, motor function below the neurological level, and at least half of the key muscles below the neurological level have a muscle grade of 3 or more

A

ASIA classification D

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16
Q

This ASIA classification indicates that motor and sensory function is normal

A

ASIA classification E

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17
Q

any degree of paralysis of the 4 limbs and trunk musculature

A

Tetraplegia (quadriplegia)

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18
Q

paralysis of the LE with some involvement of the trunk and hips depending on the level of lesion

A

Paraplegia

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19
Q

PLISSIT stands for

A 
P- Permission giving
L- Limited
I- Information
S- Specific
S- Suggestions
I- Intensive
T- Therapy
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20
Q

Barriers for therapists addressing sexual activities with pts:

A
  • lack of comfort
  • lack of knowledge
  • fear of offending client
  • cultural/religious beliefs
  • older age client
  • negative attitudes
  • embarrassment
  • client ill
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21
Q

Functional outcome of Level C1-3

A
  • Intact muscles: sternocleidomastoid, cervical paraspinal, neck accessories
  • Movement possible: neck flexion, extension, rotation
  • Weakness- total paralysis of the trunk, UE, LW, dependent on ventilator
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22
Q

Functional outcomes of Level C4

A
  • Intact muscles: Trapezius, Partial Levator scapulae, Diaphragm, Cervical paraspinal
  • Movement: neck flexion/extension, rotation, scapular elevation, inspiration
  • Weakness- paralysis of trunk, UE, LE, inability to cough, endurance and respiratory reserve low secondary to paralysis of intercostal
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23
Q

Functional outcomes of Level C5

A
  • Intact muscles: Deltoids, Biceps, Brachioradialis, Brachialis, Partial Serratus Anterior, Rhomboids, Supinator
  • Movement: shoulder flexion/extension/abduction, elbow flexion/supination, scapular adduction/abduction
    Weakness: absence of elbow extension, pronation, all wrist/hand movement, total paralysis of trunk and LE
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24
Q

Functional outcomes of Level C6

A
  • Intact muscles: clavicular, pectoralis, supinator, extensor carpi radialis longus and brevis, serratus anterior, latssimus dorsi
  • Movement: scapular protraction, some horizontal adduction, forearm supination, radial wrist extension
  • Weakness: absence of wrist flexion, elbow extension, hand movement, total paralysis of trunk and LE
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25
Functional outcomes of Level C7-C8
* Intact muscles: latissimus dorsi, sternal pectoralis, triceps, pronator quadratus, extensor carpi ulnaris, flexor carpi radialis, flexor digitorum profundus and superficialis, extensor communis, pronator/flexor/extensor/abductor pollicis, partial lumbricals * Movement: elbow extension, ulnar/wrist extension, wrist flexion, finger flexions/extensions, thumb * Weakness: paralysis of trunk and LE, limited grasp and dexerity secondary to partial intrinsic muscles of hand
26
Functional outcomes of Level T1-T9
* Intact muscles: intrinsic muscles of hands/thub, partial intercostals, upper abdominals, Long muscles of back, erector spinae, lumbricals, flexor/extensor/abductor pollicis * Movement: UE fully intact, limited upper trunk stability, endurance increased secondary to innervation of intercostals Weakness: lower trunk paralysis, total paralysis of LE
27
Functional outcomes of Level T10-L1
* Intact muscles: full intercostal innervation, additional abdominal innervation, external obliques, rectus abdominus * Movement: fair to good trunk stability * Weakness: paralysis of LE
28
Functional outcomes of Level L2-S5
* Intact muscles: hip flexors, knee extensors, ankle dorsiflexors, long toe extensors, ankle plantar flexors, fully intact abdominals, other trunk muscles * Movement: good trunk stability, partial to full control of LE * Weakness: partial paralysis of LE, hip, knees, ankle, foot
29
the tendons of the intrinsic hand muscles are held close to the bones of the wrist and hand by connective tissue
Tenodesis
30
Tenodesis
* wrist extension results in finger flexion | * wrist flexion results in finger extension
31
Why is tenodesis beneficial?
repairs the joints
32
How do we prevent tenodesis from overstretching?
* splinting | * using fist instead of hands opened to do transfers
33
What are the major types of Arthritis?
* Rheumatoid arthritis (RA) * Osteoarthritis * Gout
34
Symptoms of Rheumatoid Arthritis:
fatigue, loss of appetite, fever, weight loss, overall achiness/stiffness
35
Symptoms of Osteoarthritis:
pain, stiffness, swelling, crepitus (cracking sound)
36
Impact of RA on the hands (deformities):
* Swan-neck deformity * Boutonniere deformity * Ulnar drift * Subluxation * Fusiform swelling * Trigger finger
37
PIP hyperextension and DIP flexion,difficulty making a fist or flexing PIP to hold small objects
Swan-neck deformity
38
DIP hyperextension and PIP flexion (pushing button)
Boutonniere deformity
39
Deviation of the MCP joints, distal phalanges sway to the ulnar side (avoid activities that promote forceful use to the ulnar side) opening door-use lever handle
Ulnar drift
40
gap in normal alignment of joint
Subluxation
41
spindle-shaped swelling in the PIP joints, swelling tapers down around base of finger
Fusiform swelling
42
finger is locked in flexed position, fluid around synovial joint that develops into nodule and is treated with a splint or surgery to remove nodule
Trigger finger
43
Impact of Osteoarthritis on hands:
* Heberdens node | * Bouchards node
44
(most common) osteophyte (hard bone spurs) formation at the DIP
Heberdens node
45
osteophyte formation at the PIP
Bouchards node
46
metabolic disease caused by urate deposits causing recurrent acute episodes of arthritis
Gout
47
disease that causes the breakdown of cartilage in joints, leading to joint pain and stiffness
Osteoarthritis
48
Splint for swan-neck deformity
three point finger splint (prevent hyperextension)
49
Splint for boutonniere deformity
extension mobilization or resting splints
50
Splint for trigger finger
trigger finger splint
51
Splint for MP ulnar drift
soft ulnar deviation splint | immobilization splint
52
Splint for subluxation
resting splints | immobilization splints
53
Treatment precautions for arthritis pts:
* avoid fatigue * respect pain * avoid static, stressful, or resistive activities * limit the application of heat to 20 mins * use resistive exercises with caution and never with unstable joints * be aware of sensory impairments
54
Treatment methods for arthritis pts:
* rest * positioning * physical agent modalities (PAMS) * therapeutic activity and exercise * splinting
55
Examples of PAMS:
* heat (paraffin, heat packs) * cold (ice packs) * transcutaneous electrical nerve simulation (TENS) * biofeedback
56
Principles of joint protection:
* respect pain * maintain muscle strength and ROM * avoid positions that put stress on involved joints * use strongest muscles to accomplish task * distribute the load across several joints * use well-designed tools * use wrist and fingers in neutral position * avoid static positions
57
What is used to measure edema?
volumeter or circumferential (opened wound)
58
What is used to measure ROM?
goniometer
59
What is used to measure grip strength?
dynamometer
60
What is used to measure pinch strength?
pinch gauge
61
What is used to measure UE strength?
manual muscle testing
62
What is used to measure two point discrimination or static moving?
monofilament touch test
63
What test is used for assessing regeneration of nerve?
sensibility test (vibratory tests) "Tinel's sign and Phalens Test"
64
Sensory distribution of radial nerve:
* a strip of the posterior upper arm and the forearm * the dorsum of the thumb * the index and middle fingers and radial half of the ring finger to PIP joints
65
Muscles innervated by radial nerve:
extensor and supinator group of muscles of the forearm
66
Weakness of radial nerve:
Triceps | Brachioradialis
67
Sensory distribution of ulnar nerve:
* dorsal and volar surfaces of the little finger | * ulnar half of the dorsal and volar surface of the ring finger
68
Muscles innervated by the ulnar nerve:
* flexor carpi ulnaris * median half of flexor digitorum profundus * intrinsic muscles of the hand
69
Weakness of ulnar nerve:
* ulnar intrinsics | * pinch and grip
70
A syndrome occurring in pt with SCI above T6. Caused by reflex action of the autonomic nervous system in response to some stimulus such as a distended bladder, fecal mass, bladder irritation, etc
Autonomic dysreflexia?
71
A decrease in BP due to pooling of blood in areas of lack of muscle tone including abdominals and LW
Orthostatic hypotension
72
Ramp specifications:
1 inch of vertical rise requires at least 1 foot (12 inches)
73
Treatment planning for paraplegic:
Dressing, Eating, Hygiene/Grooming, Mobility Transfers, Home management Activities, etc
74
Wheelchair access specifications for doorways:
doors must have a clear width of 32 inches from the face of the door to the opposite stop.
75
What do OTA's address in the PLISSIT model?
intensive therapy
76
Sensory distribution of the median nerve:
* volar surface of thumb * index and middle fingers * radial half of ring finger * dorsal surface of index & middle fingers * radial half of ring finger distal to PIP joints
77
Muscles innervated by the median nerve:
* flexors of the forearm and hand
78
Weakness of the median nerve:
* Pronator teres, Quadratus, Thenars, etc
79
Radial nerve splint:
Low profile radial nerve splint- pull MCP joints into extension when wrist flexed and MCP joints into flexion when wrist extended
80
Median nerve splint:
Hand based thumb-positioning splint- preserve we space and position thumb for function
81
Ulnar nerve splint:
Dynamic ulnar nerve splint- blocks hyperextension of MCP joints a;llowing extension of PIP joints
82
Treatment interventions for nerve injury:
* Edema management * ROM * Soft tissue mobility * Sensory Reeducation * Strength improvement * Functional improvement in ADL's
83
Treatment techniques for edema management:
* elevation * contrast baths * retrograde massage * pressure wraps (coban) * PAMs (electrical stimulation, etc)
84
Treatment techniques for soft tissue mobility improvement:
* pressure * massage * active ROM * PAMS
85
Treatment techniques for strength improvement:
* resistive pulley weights * theraband * hand strengthening equipment (hand grips, thera putty)
86
Equipment for C1-3 and C6: Total assist
* ventilators * padded reclining shower/commode chair * electric hospital bed * Transfer board * power lift and sling * pressure relief pillow * handheld shower * recline/tilt wheelchair * mouth stick
87
C7-8
independent to some assist
88
Equipment for T1-9-S5: Independent
* elevated toilet seat or padded tub bench * full/king bed * pressure relief cushion * padded transfed bench or shower/commode chair * manual rigid or folding lightweight wheelchair * forearm crutches or cane (T10-S5)
89
Client expectations for addressing sexual activities:
* initiation of discussion by professional * impact of disability on sexual function * implications on fertility & parenting * clear individualized related to individual needs
90
Therapists considerations when addressing sexual activities:
* educate the client * explain the impact of disability on sexual function * foster a sense of positive body image and self esteem * discuss implications for fertility and parenting
91
Considerations when identifying leisure activities:
* will the activity be meaningful/interesting * is activity age appropriate * what supplies are needed * is there enough staff to assist * does the facility have a budget to accommodate activity * will the intervention fit in the timeframe * where will activity occur

OCCUPATIONAL THERAPY (36 decks)

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