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Unit 1: Foundations Flashcards

1
Q

what is disease

A

when there is a disturbance in healthy physical structure (anatomy) and/or function (physiology)

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2
Q

What is onset

A

the first appearance of the signs or symotoms of an illness

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3
Q

what are the two types of onset

A

acute = distinct symptoms that arise rapidly or suddenly like a broken arm
Insidious = where symotoms begin slowly and persist for a long time for example MS

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4
Q

what are the three periods of onset

A

latent period = no symptoms but changes to function or structure in the body and may progress to a disease

incubation period = latent period in someone with infectious disease

prodromal period = a period of minor nonspecific symptoms that appear before more specific severe symptoms

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5
Q

what is course

A

a description of the speed of evolution of the disease

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6
Q

what are the different terms to explain the course

A

acute = severe symptoms that last a defined amount of time

chronic = symptoms last a long time

progressive = symptoms become worse over time

wax and wane = the condition periodically gets better and worse

remission = when the symptoms of a disease re-appear

exacerbation = a period of increased intensity (more or worse symptoms) of disease

recovery = when the disease is no longer present

prognosis = often expressed in percentages

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7
Q

how are disease expressed

A

symptoms = subjective experience of disease expressed by the client

signs = objective findings on assessment

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8
Q

what is a diagnosis

A

a label for what is believed to be the patients issue
based on the signs and symptoms

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9
Q

what are the three different names for drugs

A

chemical name = describes its atomic and molecular structure

generic name = abbreviation of chemical name

trade name = selected by the drug company selling the product

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10
Q

how do drugs work

A

absorption into the bloodstream from administration site

drug travels from its entry point to site of drug action

body works to eliminate drug

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11
Q

what are the inter-personal differences in reactions to drugs

A

genetics
age
disease (liver and kidney)

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12
Q

how do drugs work

A

initiating physiological response
- drug fits into a receptor and works like a lock and key.
- drug may open a receptor or block a receptor

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13
Q

what is polypharmacy

A

the use of more drugs than medically necessary
should be reviewed every 6 months or sooner if a change in function

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14
Q

what is the ot role with drugs

A

drug routines
potential for impaired performance as a result of medications
communicating with multidisciplinary team

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15
Q

what questions should an OT ask about medication

A

frequency (qd means everyday)
method of administration
how many medications
what each medication is for
what is their organizational system

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16
Q

what are the 3 types of cells that undergo mitosis

A

somatic cells
adult stem cells (also somatic cells except those related to reproduction)
cells in embryo

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17
Q

what are 3 types of tissue classification

A

labile = many cells and stem cells in the cycle at any one time the cells are dividing frequently

stable = only a few cells in the cycle at a given moment. the cells do not divide very frequently

permanent = very few to no cells in the cycle because very few or no stem cells. cannot grow new tissue in response to injury

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18
Q

examples of labile tissue

A

epithelium of skin, urinary tract, GI tract, respiratory tract and bone marrow cells

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19
Q

examples of stable tissue

A

liver pancrease kidney smooth muscle cells fibroblasts and other connective tissue cells

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20
Q

examples of permanent tissues

A

brain skeletal muscle and cardiac muscle

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21
Q

what happens with minor injury or stress to cells

A

reversible cellular changes without death of cell
cell function returns to normal when stress relieved

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22
Q

what happens with severe injury to cells

A

irreversible cell death

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23
Q

what can cell injury or death occur from

A

the injury or stress itself
the inflammation and repair process that follows the injury

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24
Q

what are the 9 causes of cell injury

A

inadequate oxygenation
- anoxia = total lack of oxygen
- hypoxia = partial lack of oxygen
- ischemia = inadequate blood flow which can cause hypoxia

physical thermal or chemical agents

ionizing radiation

toxins

microbes

inflammation and immune reactions

nutritional imbalance

genetic and metabolic defects

aging

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25
what does acute mild injury in the cells mean
whether or not cell injury is reversible depends on the duration and severity of injury or stress most common cause of reversible cell injury most common in the liver
26
what does chronic mild injury in the cells mean
there are two main consequences of long term mild injury to cells intracellular accumulations = accumulating in the cell getting in the way of the things that are trying to do their job altered growth and differentiation = we have a typical cell cycle but then we can have altered growth
27
what are the 5 types of altered growth and differentiation that can occur
atrophy = cell decreases in size and function hypertrophy = the cell increases in size and function hyperplasia = enlargement of a tissue or organ due an increase in the number of cells metaplasia = reversible change of a cell type into another dysplasia = disordered growth - can refer to premalignant changes
28
what are two severe injuries to cells
necrosis = pathological death, usually due to ischemic hypoxia or anoxia apoptosis = natural suicide of cells that occurs at the end of the natural lifespan
29
what is inflammation
the cellular reaction to injury purpose is a protective response to limit damage and initiate healing
30
what is acute inflammation
results from short term injury and lasts a few hours or days
31
what are the phases of acute inflammation
injury and immediate vasoconstriction followed by vascular dilation dilation of capillaries causes openings and makes it leaky which is called accumulation of edema then there is infiltration of leukocytes (neutrophils). 48 hours after injury the leukocytes are replaced with macrophages that ingest the injured cells
32
what are the characteristics of acute inflammation
tumor = swelling calor = heat dolor = pain change in skin quality such as redness or purple
33
what is chronic inflammation
result of longer term and milder injury lasts weeks to years starts acute but then evolves into chronic inflammation
34
what is chronic inflammation caused by
persistent infection autoimmune disease persistent exposure to injurious agents
35
what are the characteristics of chronic inflammation
less intense so not as hot swollen or tender the persistent injury invokes as immune response; leukocytes like macrophages to clean up and lymphocytes defender cells may lay down scar tissue
36
what are the two processes in wound healing
regeneration = complete or nearly complete restoration of typical anatomy and function by the regrowth of normal functional cells and supporting tissue healing = mix of regeneration and scarring or scarring alone if regeneration is not possible
37
what two situations does fibrous repair occur
damage to the tissue is extensive supporting framework is destroyed injured tissue is composed of permanent cells such as myocardium skeletal muscle or brain tissue
38
what is the process of scar foramtion
within a few hours leukocytes migrate into the wound to limit damage and clear away debris and foreign material angiogenesis = the growth of new blood vessels to nourish the process scar development = deposit of network of collagen and other fibers to bind together the edges of the wound
39
what are the two types of wound healing
first intention healing = a wound that heals primarily with regeneration second intention healing = a wound with widely separated margins
40
what factors negatively impact wound healing
infection poor nutrition medications poor blood supply foreign bodies in the wound mechanical factors
41
what are types of wounds
skin tears venous ulcers arterial ulcers diabetic ulcers pressure injuries
42
what is dehiscence
when a wound ruptures
43
what is ulceration
the breach of the continuity of skin, epithelium or mucous membrane. essentially the would edges are having difficulty closing
44
deconditioning from bedrest in older adults
loss of an eighth of muscles strength per week of disuse three weeks of bedrest = increase in heart rate of 10 beats/min bedrest increases risk of mortality in following 2 years
45
how do you prevent bedrest
almost all medical conditions do not require bedrest an increase of 100 steps/day will result in a 2-3% decrease risk death in two years post hospital any movement is helpful
46
what is a pressure injury
an injury usually caused by unrelieved pressure that damages the skin and underlying tissue
47
what is the cause (etiology) of pressure injuries
pressure and shear the addition of shear to pressure doubles the impact of pressure
48
what is pressure
the force per unit area exerted perpendicular to the plane of interest pressure can close the capillaries and block blood flow to the tissues
49
what is shear
the force per unit area exerted parallel to the plane of interest
50
what are intrinsic risk factors of pressure wounds
age moisture sensation mobility mental status circulation nutriotion
51
what are extrinsic risk factors of pressure wound
pressure!! shear moisuture friction
52
what initially occurs from too much pressure
tissue hypoxia once the pressure is removed reactive hyperemia
53
what are the 4 stages of pressure injuries
stage 1 = involves epidermis stage 2 = involves epidermis and dermis stage 3 = involves epidermis, dermis and subcutaneous layers stage 4 = involves epidermis, dermis subcutaneous and deep tissue such as tendon muscles and bone
54
describe stage 1 of a pressure injury
skin damaged but not broken reduced blood flow to capillaries
55
describe stage 2 of a pressure injury
partial thickness skin loss involves epidermis and dermis superfical and shallow open ulcer wound bed intact blister or rupture shinny dry and shallow no slough or bruising
56
describe stage 3 of a pressure injury
full thickness skin loss subcutaneous fat may be visible bone/tendon not visible slough may be present tunneling may be present depth varies by anatomical location
57
describe stage 4 of a pressure injury
full thickness tissue loss tissue necrosis exposed bone, tendon muscles damage to tendons/joint capsule slough/eschar often present in wound bed depth varies by anatomical location risk of osteomyelitis
58
how do you prevent pressure injury
identify risk factors prevent by maximizing pressure distribution minimize shear and friction minimize moisture facilitate mobilization
59
what is the treatment for pressure injury
remove the source of pressure employ prevention strategies identify the cause
60
what is a contracture
fibrosis of connective tissue in skin fascia muscle or a joint capsule that prevents normal mobility of the related tissue or joint
61
what is the pathophysiology of a contracture
not year completely understood the underlying cause of muscle contracture may be MSK or neurological or both contractures due to purely immobilization is thought to be due to loss of elasticity of connective tissue and or loss of sarcomeres in the muscle tissue itself
62
how to prevent contracture
identify those at risk maintain ROM positioning in bed and wheelchair strengthening activities including ADL preventative splinting
63
what is treatment for contracture
manual techniques ROM mechanical techniques (continuous passive motion machines) casting or splinting surgery local injections/medications
64
what is thrombus
blood clot that has formed within the vascular system of the body can collect anywhere in the cardiovascular system immobilization promotes development of thrombi in the lower extremity veins serious threat to health
65
what is the etiology of thrombus
how a thrombus developed is interrupted or changed blood flow (venous stasis) tissue damage (vascular endothelial injury) blood coagulates too easily (hypercoagulability)
66
what is a pulmonary embolism
a thrombus that back flows to the lungs typically fatal so prevention of the embolus is important
67
what are signs and symptoms of deep vein thrombosis
may be no signs slight fever distension of superficial veins increase calf/leg warmth and redness edema calf/tenderness/pain worse when standing or walking asymmetrical
68
what is prevention of thrombus
most concern in 72 hours post op move what can be moved facilitate circulation anti-coagulants
69
what is treatment for thrombus
medications such as anti-coagulant or thrombolytic agents early ambulation should be encouraged as soon as possible if a DVT is present symptoms may limit ambulation
70
what is the rule of 9 for burns
9% patient hand is 1% of total body surface area
71
what are the different degrees of a burn
1st degree = superficial which can be painful 2nd degree = superficial partial which may scar and be more painful 2nd degree = deep partial which requires surgery and form more scar and is less painful 3rd degree = full thickness dry, insensitive to light touch, large area requires skin grafting and high risk of infection 4th degree = full thickness, involves muscle or bone and leads to loss of the burned part
72
how quickly does a superficial burn heal
less then 7 days
73
how quickly does a superficial partial burn take to heal
7-14 days
74
how long does a deep partial burn take to heal
14-35 days
75
how long does a 3rd degree full thickness burn take to heal
months to heal
76
how long does a 4th degree full thickness take to heal
may require amputation
77
what are acute medical concerns from a burn
maintain airway manage bleeding and wound care manage pain prevent infection fluid resuscitation (just right otherwise low blood pressure if not enough or edema if too much)
78
what is a escharotomy
full thickness circumferential burn tough non elastic burned tissue will not expand as internal pressure builds from edema can cause ischemia so an incision of eschar to the subcutaneous layer is made to relieve pressure
79
what are the steps of wound healing following a burn
hemostasis inflammatory proliferative remodeling
80
when would a skin graft be used
deep partial or full thickness burns that will take too long to heal leading to infection risk and inevitable scar
81
acute rehab phase for burn healing
day 1 either in ICU or on burn ward prevention of burn contracture main issues are positioning to manage edema and maintain ROM splinting dressing changes psychosocial
82
intermediate rehab phase for burn healing
surgery main issues are mobilizing post surgery, maintaining ROM preventing contracture and promoting healing protection and positioning splinting psycosocial discharge planning
83
long term rehab phase for burn healing
scar management ROM and function main issues are hypertrophic scarring, contracture
84
how does scar location lead to predictable contractures
dorsal hand = hyperextended MCP flexed PIPDIP loss of arches anterior cubital fossa = elbow flexion forearm = limited supination anterior axillary crease = limited shoulder abduction posterior axillary crease = limited shoulder forward flexion anterior neck = flexion contracture (limited extension)
85
what is hypertrophic scaring
overabundant scarring from imbalanced and disorganized processes during healing phases when epithelialized in less then 3 weeks timing of processes proceeds regularly and you get a normal scar in hypertrophic scaring it is vicious cycles where fibroblasts proliferate and there is increased collogen deposition and myofibroblast activity
86
what are the 3 Rs of hypertrophic scarring
red raised rigid
87
what is the definition of a health condition
provides initial information general overview of who what where how
88
what is the classification of a health condition
ensures adequate understanding of the variety of presentations of the condition a condition may be a subtype of a broader classification system or may have sub types of its own (ie neurological disorder which subtype is MS)
89
what is the pathophysiology of a health condition
explains the process within the body that result in the signs and symptoms of a disease what is the change in the body structure or function as a result of this health condition
90
what is the etiology of a health condition
the cause or set of causes or manner of causation the cause of the condition contributors of intrinsic, extrinsic and unknown factors to disease causation
91
what are the different etiology extrinsic factors
inanimate = physical animate = infectious agents iatrogenic = by product of a medical diagnosis
92
what are the different etiology intrinsic factors
mutation of genes (monogenic, polygenic, cytogenic) metabolic degenerative neoplastic immunologic nutritional deficiency psychogenic (neurotransmitter imbalance)
93
what does it mean when the etiology is idiopathic
etiology is unknown
94
what is the epidemiology of a health condition
the frequency distribution and causes of diseases in a population how common is the condition prevalence = proportion of people in the population living with the condition incidence = amount of new causes reported in a time frame
95
what is the onset and course of a health condition
onset is the first appearance of the signs or symptoms of an illness course is a description of the speed of evolution of the disease (acute, chronic, recurrent course)
96
what is the medical management and safety precautions of a health condition
what interventions are provided by non-rehab team members an action taken to avoid a dangerous or undesirable event
97
what are three techniques used to pad distal end of bone and provide muscle stabilization in amputations
myodesis = muscle and fascia of residual limb are suture to the bone myoplasty = suturing the opposing muscle groups together over the transected bone end myofascial closure = suturing close fascia over the muscle
98
what is complications, comorbidities and sequelae in a health condition
complication = a secondary disease or condition developing in the course of a primary disease comorbidity = medical conditions existing simultaneously but independently with another condition or it can indicate related medical conditions sequelae = an abnormal condition resulting from a previous disease

Health Conditions (3 decks)

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