OTHA 103 exam 2 Flashcards
(105 cards)
1
Q
3 zones of tissue damage
A
- zone of coagulation
- zone of stasis
- zone of hyperemia
2
Q
zone of coagulation
A
point of most damage
irreversible tissue destruction
3
Q
zone of stasis
A
surrounds zone of coagulation
damage results in decreased perfusion
4
Q
zone of hyperemia
A
outer zone
tissue at risk but should recover and heal with proper care
5
Q
eschar
A
residual layers of skin destroyed by direct heat damage
6
Q
superficial burn
A
only epidermis
redness and pain
dry and does not blister
heals within 3-6 days without scarring
7
Q
partial thickness burn
A
destroys epidermis and part of dermis large, thick blisters that increase in size deep red to waxy white in color leaks body fluid, moist heals in 7-20 days with scarring
8
Q
full thickness burn
A
epidermis and dermis and part of hypodermic layer
usually won’t heal by itself
small, thin blisters that won’t increase in size
can be black, tan, red, white
dry and leathery in texture
healing depends on donor sites and will leave scarring
severe risk for contractors
9
Q
deep full thickness burn
A
destroys all layers of skin and extends to bone/muscle
charred or mummified appearance
can result in loss of function
amputation may be needed
10
Q
decreased risks for morbidity/mortality
A
early excision
skin grafting
antibiotics
11
Q
criteria for burns that should be transferred to a burn center
A
partial thickness burns of 10% TSBA or higher
chemical burns
electrical burns
burns involving face, genitals, hands, feet, major joints
all full thickness burns
pulmonary/inhalation injury
pt with complicating preexisting medical conditions
12
Q
Burn injuries affect 2 major body systems
A
pulmonary
cardiac
13
Q
pulmonary complications
A
carbon monoxide poisoning
upper airway obstruction
restrictive defects
14
Q
cardiac complications
A
burn shock, burn wound edema, organ failure, tissue hypoxia
15
Q
burn wound management
A
the acute phase
debridement
grafting
16
Q
the acute phase of treatment
A
after emergency phase
sepsis is the most common cause of death during this phase
pt vulnerable to infection
17
Q
debridement
A
cleansing and removal of dead tissue-painful process
18
Q
grafting
A
skin taken from another part of its body, priority influenced on size of location of burn, hands given priority
19
Q
allograft
A
donor skin taken from another person
20
Q
autograft
A
surgical transplantation of patients own skin from one area to another
21
Q
cultured epithelium
A
biopsy of unburned skin that is sent to a lab to grow skin for grafting
22
Q
phases of rehab activities
A
emergency phase
acute phase
rehab phase
23
Q
emergency phase
A
preservation of joint function, ROM exercises, splinting
24
Q
acute phase
A
reconditioning exercises, ROM exercises, splinting, ambulation and ADL participation
25
rehabilitation phase
reconditioning, ROM, scar revision, contracture release, reconstruction, scar education
26
impact on occupational performance influenced by
size, location, depth of burn
27
greatest potential to impact occupational performance
deep partial thickness burn
full thickness burn
burns involving major joints
larger burn areas
28
RA (Rheumatoid arthritis)
leading cause of disability in the US
29
common symptoms of RA
redness
warmth
swelling/inflammation of joints
general feeling of sickness, fatigue, weight loss
usually affects same joints on both sides of body
may develop suddenly, within weeks, or months
most often begins between ages 25 and 50
30
joint guarding
self bracing, frequent response with RA and JRA due to pain with movement
31
specific characteristics of RA
```
subcentral cysts
erosions/sinuses in affected joints
rebuilding of osteophytes
ulnar deviation in MCP joints
multiple joints that are bilaterally affected
```
32
swan neck
PIP joint into hyperextension, and DIP into flexion
33
boutonniere
inability to extend the PIP joint, PIP flexion and DIP hyperextension. appearance of a buttonhole
34
JRA (juvenile rheumatoid arthritis)
onset must occur before age 16, with involvement of one or more joints for at least 6 weeks
typical onset occurs between ages 1 and 6, no gender bias
35
RA impact on occupational performance
fatigue, difficulty with fine motor ADLs, pain and lifestyle changes, energy conservation needed, using joint protection
36
SPINAL CORD INJURY
leading cause is MVA
| followed by falls and acts of violence
37
incidence and prevalence of SCI
80 percent are male
| mean age for SCI is 34.7 years old
38
Complete SCI
complete transection of spinal cord, all pathways are interrupted, total loss of motor and sensory function below the injury
39
UMN injury
- loss of voluntary movement below injury
- spastic paralysis
- no muscle atrophy
- hyperactive reflexes
40
LMN injury
loss of voluntary function below injury
- flaccid paralysis
- muscle atrophy
- absence of reflexes
41
Incomplete SCI
damage to spinal cord does not cause a total transection. Still some degree of sensation and movement below level of injury.
42
UMN and LMN injuries can be...
complete or incomplete
43
spinal shock
period of altered reflex activity lasting 1 week to 3 months after injury.
flaccid paralysis or absence of reflexes
bladder is flaccid resulting in catheterization
44
Respiratory complications with SCI
R. complications are most common cause of death following a SCI
45
deep vein thrombosis
can be a serious complication in SCI because
1. reduced circulation caused by decreased tone
2. frequency to direct trauma of legs causing vascular damage
3. prolonged bed rest
greatest risk of DVT is within 2 weeks post injury
46
signs of DVT
swelling in LEs, redness, low grade fever
47
thermal regulation
```
function of ANS that can be disturbed post SCI
maintaining body temperature is often a problem for injury above T6
```
48
spasticity
almost all SCI experience spasms
triggered by pressure sores, positioning, infections, UTIs
excessive spasticity results in contractures
49
heterotopic ossification
abnormal formation of bone deposits on muscles, joints, and tendons. occurs mostly at hips and knees
signs are heat, pain and swelling
50
spastic bowel
can use touch to encourage the bowel to relax, sometimes a suppository is also needed to get the job done
51
flaccid bowel
cannot be stimulated to relax farther. it will not push the stool out on its own. manual removal of the bowel
52
dermal complications
SCI loss sensation and feeling in areas. Wont be able to feel pain, heat, pressure etc. People are not immediately aware they are being injured
53
pathologic fracture
bone weakened by conditions such as osteoarthritis and osteoporosis that can't sustain normal forces, fractures during daily activities
54
incidence of fractures
falls are leading cause of fractures in older adults
55
malunion
fracture heals in abnormal position. factors include muscle imbalance, inadequate protection/positioning
56
nonunion
bone is not healing, significant functional deficits in ROM, strength and coordination
57
Osteoarthritis (degenerative joint disease)
non inflammatory joint disease resulting in deterioration of articular cartilage and formation of new bone on joint surface
58
signs and symptoms of OA
joint pain, inflammation, stiffness, tender, limited ROM, crepitus
59
osteoporosis
low bone density and deterioration of bone, common in post menopausal women due to low estrogen
60
signs and symptoms of osteoporosis
gradual with few symptoms, pain, height loss, kyphosis
61
osteopenia
reversible weakening of bone, once osteopenia turns into osteoporosis bone regeneration is no longer reversible
62
signs and symptoms of osteopenia
predecessor to osteoporosis with no signs, diagnosed through bone density scan
63
unipolar depression
without mood variances
64
major depressive episode
min 2 week period of depressed or irritable mood
65
Bipolar 1
extreme mood swings, mania-depression, may present with delusions and hallucinations
66
bipolar 2
history of MDD (major depressive disorder) and at least 1 hypomanic episode. less intense mood and energy elevation
67
cyclothymia
chronic but less severe mood disturbance. hypomanic and depressive symptoms
68
flight of ideas
rapidly changing, disconnected thoughts
69
psychomotor agitation
increased physical movements that are purposeless and reflective of agitated state
70
psychosis
delusions and hallucinations without insight
71
anhedonia
lack of interest in previous pleasurable activities
72
euphoria
highly elevated exaggerated mood
73
avolition
lack of drive or ambition
74
major depressive disorder
depressed mood, altered sleep, feelings of worthlessness, thoughts of suicide
childhood symptoms: clingy, overly needy, irritable, behavior problems in school
75
bipolar disorder
grandiosity, min need for sleep, flight of ideas, dangerous behavior, excessive goal directed activity, talkative
76
co-occurring conditions in MDD and BPD
obesity, anxiety, diabetes, cardiovascular and pulmonary disease
more likely to abuse alcohol and drugs
77
bipolar disorder prodromal period
1-7 years pre onset noted by fluctuations in energy increase and dysregulated mood, recovery from 1st episode is uncommon, first 2 years high risk of relapse
78
SCHIZOPHRENIA
most severe, complex of all mental health disorders.
| progressive brain disorder that can be treated, not cured
79
schizophrenia signs and symptoms
affects impulse control, judgement, social skills, affects ones self awareness that they have a disability, delusions, hallucinations, disorganized thinking, catatonia
80
hallucinations
experience of particular sensations that are not real to others and can experience while awake. auditory (most common type) visual, tactile
81
catatonia
loss of responsiveness to environmental cues
82
negative symptoms of schizophrenia
diminished emotional expression, avolition, impoverished speech, anhedonia
83
cognitive symptoms of schizophrenia
abstract reasoning and planning skilled affected, language, attention, ability to process visual stimuli decreases, mean IQ of 80-85
84
schizophrenia course and prognosis
onset can be gradual or acute, some people can still work, others require 24 hr care, delusions and hallucinations decline intensity in late middle ages, cognitive impairment, shorter life span by 12-25 years, high risk of death from MVA
85
schizophreniform disorder
similar to schizophrenia except 1. total duration of illness is more than 1 month but less than 6 months and 2. occupational performance deficits may not be present
86
schzioaffective disorder
clinical symptoms of schizophrenia are present including delusions and hallucinations but at some point a MDD, manic or mixed episode occurs.
87
delusional disorder
delusions lasting longer than 1 month
88
brief psychotic disorder
average onset mid 30s, sudden onset of psychotic symptoms or highly disorganized behavior lasting between 1 day and 1 month. episode is followed by return to normal behavior
89
psychotic disorder due to another medical condition
delusions or hallucinations due to other medical condition such as epilepsy.
90
substance/medical induced psychotic disorder
delusions or hallucinations due to medications or exposure to toxin
91
Multiple sclerosis (MS)
chronic inflammation and demyelination of the neurons in the CNS resulting in scar tissue formation that reduce axons ability to conduct impulses
92
MS symptoms
numbness, disturbance in pain sensation, hypersensitivity, spasticity, low energy, weakness, tremor, visual disturbances, short term memory loss, depression or euphoria
93
MS rule of thumb
MS does not significantly decrease pt life expectancy. complications result from inactivity or reoccurring infections can cause premature death.
94
MS diagnosis
pt has episodes of exacerbation and remission and slow or step by step progression over 6 months
95
MS medical treatment
antispasmodics, muscle relaxants, and anticonvulsants
96
PARKINSON'S DISEASE (PD)
depigmentation of the dopamine located in basil ganglia. decrease in dopamine leads to deficits in speed and quality of motor movements, cognitive skills and affective expression
97
major symptoms of parkinson's
secondary symptoms
resting tremor, muscle rigidity, bradykinesia, postural instability
festinating gait, dexterity and coordination problems, involuntary immobilization
98
Course and prognosis of parkinson's
slow, progressive disorder that progresses in 3 phases
progression is not a linear progression
99
phase 1: preclinical period
neurons have begun to degenerate, but no symptoms yet
100
phase 2: prodromal period
can least months or even years, depression, anxiety, fibromyalgia
101
phase 3: symptomatic period
symptoms are evident
102
AMYOTROPHIC LATERAL SCLEROSIS (ALS)
also known as lou gehrigs disease, fatal progressive, degenerative motor neuron disease in which scars form on the spinal cord
103
symptoms of ALS
weakness of hand muscles, asymmetrical foot drop, high cramps in calf muscles
104
ALS signs and symptoms
progressive, most commonly in a distal to proximal pattern
105
ALS course and prognosis
progressive and rapid, duration of survival after diagnosis is usually 1 to 5 years, with a mean survival of 3 years.
