- elevating extremities - positioning - retrogade massage - coban wrap - AROM or PROM - Ice - Oral cortisone - Assisted lymph drainage

OCTA 227 Midterm Flashcards by Mykia Woolridge

Sudden loss of blood supply to the brain that damages & kills brain cells resulting in neurological deficits related to the involved areas of the brain

Stroke (CVA)

How well did you know this?

Not at all

Perfectly

paralysis on one side of the body

hemiplegia

How well did you know this?

Not at all

Perfectly

partial motor loss on one side of the body

hemiparesis

How well did you know this?

Not at all

Perfectly

Warning Signs of a stroke:

*Numbness/Weakness
*Confusion
*Slurred Speech
*Blurred vision
*Dizziness
*

How well did you know this?

Not at all

Perfectly

Right sided hemiplegia & sensory loss
Right visual field cuts
Impaired R/L discrimination, verbal apraxia
Decreased analytical thinking, impaired logic, time concepts, memory, aphasia

Left CVA

How well did you know this?

Not at all

Perfectly

Left sided weakness & sensory loss
Left field cuts, visual neglect
Unilateral neglect
Impaired attention span, understanding of whole, decreased creativity
Impulsivity, emotional lability
-Decreased ability to differentiate between gesture, decreased learning for familiar info

Right CVA

How well did you know this?

Not at all

Perfectly

low muscle tone

hypotonicity

How well did you know this?

Not at all

Perfectly

high muscle tone

hypertonicity

How well did you know this?

Not at all

Perfectly

Synergy Patterns (Flexion)

Scapular adduction & elevation
Humeral abduction & external rotation
Elbow flexion
Forearm supination
Wrist flexion
Digit flexion

How well did you know this?

Not at all

Perfectly

Synergy Patterns (Extension)

Scapular abduction & depression
Humeral adduction & internal rotation
Elbow extension
Forearm pronation & wrist & finger flexion or extension

How well did you know this?

Not at all

Perfectly

Role of OT with Stroke pts

Improving motor function on affected side
Integrating sensory, visual perceptual, & cognitive functions
Facilitating maximal level of functional independence
Encourage return to life roles as possible
Promote health management & maintenance behaviors to prevent recurrent stroke

How well did you know this?

Not at all

Perfectly

Signs of Reflex Sympathetic Dystrophy (RSD)

-Pain, irregular blood flow, EDEMA, changes in skin temperature/color

How well did you know this?

Not at all

Perfectly

Treatment for RSD

elevating extremities
positioning
retrogade massage
coban wrap
AROM or PROM
Ice
Oral cortisone
Assisted lymph drainage

How well did you know this?

Not at all

Perfectly

Acquired language disorder that may result in variety of deficits in verbal comprehension, reading comprehension (alexia), oral expression, written expression (agraphia), ability to interpret gestures, or mathematical skills (acalculia)

Aphasia

How well did you know this?

Not at all

Perfectly

can usually understand what words mean, but have trouble performing motor or output aspects

Broca Aphasia (expressive)

How well did you know this?

Not at all

Perfectly

difficulty understanding language

Wernicke’s Aphasia (receptive)

How well did you know this?

Not at all

Perfectly

loss of both language skills; ability to speak in usually gone; may appear to respond to gestures, voice tone changes, & facial expressions

Global Aphasia

How well did you know this?

Not at all

Perfectly

The ability to plan and perform purposeful movement

Praxis

How well did you know this?

Not at all

Perfectly

An impairment in praxis, deficit in the ability to perform purposeful movement despite normal motor power, sensation, coordination, and general comprehension

Apraxia

How well did you know this?

Not at all

Perfectly

What are the 3 types of Apraxia?

Ideomotor
Constructional
Ideational

How well did you know this?

Not at all

Perfectly

A type of apraxia that involves the inability to perform a motor act on command

Ideomotor Apraxia

How well did you know this?

Not at all

Perfectly

A type of apraxia that is a deficit in the ability to copy, draw, or construct a design, whether on command or spontaneously

Constructional Apraxia

How well did you know this?

Not at all

Perfectly

A type of apraxia that involves the inability to comprehend concept of movement or execute act automatically or in response to a command (difficulty sequencing, etc)

Ideational Apraxia

How well did you know this?

Not at all

Perfectly

A medical scale used to assess individuals after a closed head injury, including traumatic brain injury, based on cognitive and behavioral presentations as they emerge from coma

Rancho Los Amigos Scale

How well did you know this?

Not at all

Perfectly

An injury that results from a penetrating (open) or nonpenetrating (closed injury to the brain

Traumatic Brain Injury (TBI)

direct trauma to the head by an object that penetrates the skull and brain

Open Brain Injury

caused by acceleration, deceleration, and rotational forces are applied to the head that cause brain tissue to shear (tear apart)

Closed brain injury

What are the 6 types of attention?

* Focused * Sustained * Selective * Alternating * Divided * Concentration

A type of attention that gives you ability to respond to different kinds of stimulation

Focused Attention

A type of attention that gives you the ability to maintain attention for a long time (vigilance)

Sustained Attention

A type of attention that gives you the ability to activate and inhibit responses selectively

Selective Attention

A type of attention that gives you the ability to alternate back and forth between mental tasks

Alternating Attention

A type of attention that gives you the ability to do several things at once

Divided Attention

A type of attention that gives you the ability to do mental work while attending tasks

Concentration

disorder that causes lasting pain, usually in an arm or leg, and it shows up after an injury, stroke, or even heart attack

Reflex Sympathetic Dystrophy (RSD)

used to asses edema

Volumeter

What are some ways to manage edema:

* Elevation * Massage * Compression * AROM

a response on the rancho los amigos scale where the pt appears to be in deep sleep, completely unresponsive to any stimuli

No response

a response on the rancho los amigos scale where the pt reacts inconsistently and non-purposefully; responses may be delayed

Generalized response

a response on the rancho los amigos scale where the pt responds specifically but inconsistently with delays to stimuli; turns head to sound (not consistent)

Localized response

a response on the rancho los amigos scale where the pt has a heightened state of activity with decreased ability to process info; responds primarily to their own internal confusion; may be euphoric or hostile; may overreact to stimuli

Confused-Agitated Response

a response on the rancho los amigos scale where the pt appears alert and is able torespond to simple commands fairly consistently; as complexity increases, responses become non-purposeful, fragmented; maybe agitated as a result of external stimuli; out of proportion to stimuli

Confused-Inappropriate, Non-Agitated

a response on the rancho los amigos scale where the pt appears to have goal-directed behavior but is dependent on the external input for direction

Confused- Appropriate

a response on the rancho los amigos scale where the pt follows simple directions consistently and shows carry-over for relearned task (self-care) ; increased awareness of self, family, and basic needs

Automatic- Appropriate

a response on the rancho los amigos scale where the pt appears appropriate and oriented within hospital and home setting; completes ADLs automatically(robot-like) with supervision due to decreased insight and reactional activities; need routine

Purposeful- Appropriate

humerus drops and supraspinatus and other muscles stretch

Subluxation

Treatment for subluxation:

Affected extremity supported at all times: Bed- proper support to achieve alignment W/C- lapboard Ambulating/Transferring- Kinesiotaping, sling

Modified Diet Progression:

Food: Puree, fine chopped, mechanical soft, regular Liquids: Pudding, honey thick, nectar thick, thin

Dressing sequence for Hemiplegia Pts: Shirt

Putting shirt on (dress): affected extremity first and then unaffected extremity Taking shirt off (undress): unaffected extremity first and the the affected extremity

Dressing sequence for Hemiplegia Pts: Pants

Cross affected leg over unaffected leg and put affected leg in first followed by unaffected leg

Considerations for feeding candidates:

Decrease: Distractions, Increase: complexity of task, short step directions, arranging items, how much time

levels 1-3: Total assistance levels 4-6: Confused/Agitated levels 7/8: Automatic/Purposeful

Ranch Los Amigos Scale

an approach that seeks to improve and restore cognitive skills

Remedial approach

an functional approach that uses intact cognitive skills to compensate for deficits

Adaptive approach

An adaptive approach that normally would use rehabilitation model to promote adaptation of/to the environment so pt is successful in occupations

Top Down Approach

An remedial approach that normally would use the biomechanical model to restore function, working on lower level skills, and focusing on impairment to be successful in occupations

Bottom Up approach

Remedial approach for Memory Deficits:

* organization facilitates recall | * attention training results in improved memory

Adaptive approach for Memory Deficits:

* Active listening * Note taking (lists, schedules, direction) * Rehearsal (retaining through mental repetition; working memory)

Remedial Approach for Problem Solving Deficits:

* Have pt read & reread directions * Train pt to generate alternatives * Teach pt to evaluate and select most effective alternatives

Adaptive Approach for Problem Solving Deficits:

* Instruct pt to check for errors before proceeding * Provide external cues to reduce pts use of inappropriate strategies * Teach pt importance of asking for help when unable to solve a problemy

Remedial Approach for Visual Perception Organization & Processing Skills:

* Assumes the adult brain can repair/reorganize after injury * Seeks to cause CNS function * Can use these approaches: sensory-integrative, neurodevelopment, transfer-of-training

Adaptive Approach for Visual Perception Organization & Processing Skills:

* Tx is repetitive; relies on the intact portions of the brain to compensate * Make pt aware of deficit & teach pt to work with deficit & adapt the environment

When grading an activity what are the cognitive considerations?

* Environment * Complexity of task * Directions * Spatial Arrangement of items * Time

What are the different remedial approach?

* Bottom up approach * Sensory integrative * Neurodevelopmental * Transfer-of-learning

an remedial approach that integrates sensations into normal activity

Sensory Integrative

an remedial approach that restore normal movement through handling techniques & repetitive movements

Neurodevelopmental

an remedial approach that assumes practice in specific perceptual skill drills will generalize to better performance in daily activities that require the same perceptual skills; generalization

Transfer-to-learning

Pt will complete toilet transfers Pt will Self feed Pt will complete lower body dressing

LTG's

Pt will perform toilet transfers with MOD assist from bed to BSC using grab bars PRN within one week

STG

Pt will perform self feeding with min assist within one week

STG

Therapeutic activity for muscle strength and resistance

Have pt seated upright in a chair. Pt will place theraband under feet & use the affected forearm to pull up with multiple reps followed by the affected arm and repeat

Therapeutic activity for sitting balance

Have pt seated on firm surface with mirror in front. Have therapist use verbal and physical cues for pt to sit upright. If pt slouch he can use hand to push body upright. Once pt can sit upright and maintain the position the therapists will push pt sided to side, front to back. Pt cant tip over

Therapeutic activity for reaching and stretching

* Have pt seated in a chair at a table and place a physio ball in front of him. Have pt roll ball back and forth and side to side crossing the midline on the table. switch arms * Grabbing velcro balls off wall behind him and placing them in bin in front of him

Therapeutic activity for ROM

* Have pt seated in between an elevated table and a regular table. Have pt grab cones off regular table and place on elevated table repeatedly until cones are all on the elevated table. * Graded arc seated

Therapeutic activity for core strength & endurance

* have pt seated in chair playing ball toss | * seated tossing bean bags in 3 bins

Therapeutic activity for balance

* have pt practice sit to stands with out hands | * ring toss seated EOB

OCTA 227 Midterm Flashcards

(76 cards)