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OTA 140 Final Exam 2

QuestionAnswer
What are the three main effects (areas affected by) TBI? Physical Deficits, Cognitive, & Emotional/Behavioral
Could someone have physical changes after TBI and not cognitive changes? Yes
What is a functional example of decreased safety awareness following TBI? Touching a hot stove
What is a functional example of impaired initiation following TBI? Not being able to decipher what to do after given a shirt
What is dysarthria? Difficulty with speech. Speech that is slowed, slurred or difficult to produce
What is disinhibition? What is an example? lacks proper social awareness of the environmental requirements and consequently acts inappropriately, urinating in public, removing clothing, taking food off others trays, shouting obscenities, and making indiscriminate sexual advances to staff members
Through which method does OT accomplish cognitive retraining for TBI clients? graded programming through a variety of functional task. Ex: sequencing activities like dressing or assembling a sandwich
List functional treatment ideas for a TBI patient for each of the following planning, organizing, money mgmt., and problem solving
How do we interact with a client exhibiting difficult behaviors? By environmental and interactive. taking the client to a quiet , isolated room, turn tv & radio off
How do we use backward chaining to teach a client how to prepare a meal?
How do we grade social interaction for clients with TBI? List examples
Why is group treatment helpful for client with TBI? learning experiences not available in individual therapy; also provides structured socialization in which clients can develop more appropriate communication/interaction and psychosocial skills
What is community integration and why is it important for a client with a TBI? increases likelihood of successful transfer of training from rehab setting to home and community
What is topographical orientation? List a treatment idea to use with a TBI client who is in outpatient rehab Awareness of position of self in environment. Talk with client, or caregiver, of clients home environment. Draw pictures and signs to label each room. Draw a map and label the purpose of each room. Use simple words and short sentences
Degenerative diseases of the CNS – why are they called this? How are they different from other diseases? Progressive pathological changes in the CNS. these changes result in loss of functioning in one or more of the following areas: sensation, motor action & control, and cognition. They are different from other disease because there is NO cure
What is the role of OT in degenerative diseases of the CNS? Assist in managing symptoms, maintaining function, and optimizing quality of life
What are appropriate OT goals for these clients? Give examples ability to engage in meaningful occupations. Prevent decubitus ulcers, contractures, pain, or injury. Maximize quality of life, self-manage the effects of the disease process. Teach caregivers safe and effective ways to provide assistance to the client
What is the role of OT in a SNF for these clients? Why? Prevent contractures, splinting, ROM, ulcer prevention. WHen a client can no longer manage advancing symptoms
What is a decubitus ulcer? Know the stages and what areas are at risk
What do you do to prevent decubitus ulcers? Positioning and skin checks
ALS- why is it important to think ahead when working with a client with ALS? To enable the client to adapt and to maintain the maximal level of functioning throughout the course of the disease as well as to assist care providers with the necessary skills to safety and effectively assist with daily care issues
What muscles are affected by ALS? Voluntary muscles including head, eye muscle & breathing
What is upper motor neuron? What are symptoms of a disease affecting these? UMN- brain Primary Lateral Sclerosis, ALS, Pseudobulbar Palsy. Increase reflexes, muscle hyper aware and hyper sensitive
What is lower motor neuron? What are symptoms of disease affecting these? LMN- spinal cordProgressive Muscular Atrophy, Progressive Bulbar Palsy. Weakness, decrease reflexes, atrophy
What are bulbar signs of ALS? Why are they a problem? What can be done for client? Speech deficits, swallowing difficulties, and respiratory involvement They are a problem because these symptoms just get progressively weaker and cause complications. Ventilator support, palliative care & AT
What is spared with ALS? eye muscles,external sphincter controlling bowel and bladder management, the five senses, the heart liver and kidneys
What are early signs of ALS? What can OT do? Loss of fine motor coordination, and hand weakness, assistive devices such as built up utensils, writing devices. OT should: ambulation devices or braces to prevent falls, ambulation devices in functional situations, Energy conservation tech, adl issues
What happens in the later stages? What can OT do? UE weakness continues to progress. Functional splints , communication devices, sliding boards, mechanical lifts and/or home modifications
How do you empower clients? Why? Give an example. enable the clients to adapt and thp maintain the maximal level of functioning throughout the course of the diesase as well as assist care givers wtih the necessary skills to safely and effectively assist with daily care issues. AE and assistive technolo
Parkinsons & Parkinsonism – what are classic signs? resting tremor, rigidity in skeletal muscle, bradykinesia and postural instability
What part of brain is impacted? What major neurotransmitter involved? NS, basal ganglia, major neurotransmitter=dopamine
What is a resting tremor? a tremor that occurs while the patient isnt moving
What is rigidity? How does it impact function? Rigidity increased resistance to passive motion. Typically affects shoulder and nexk first and becomes more severe decreasing ability to move easily Cogwheel-jerky, rachetlike Leadpipe- more sustained resistance w/no function
slowness of movement Bradykinesia
Impaired body movement; without movement (or without much movement). Freezing Akinesia
slow moving-mask like face Hypokinesia
Difficulty or distortion in performing voluntary movements wringgling or writing movements(w/ meds) Dyskinesia
Why do most clients with Parkinson’s use a mobility device? Gait and balance is affected. Postural dysfunction and rigidity result in shuffling gait and fast steps with are hard to stop causing falls
What are the major therapy interventions for PD? Focus on ADLS, IADLS, Work, and Leisure. Flexibility strength, quality of movement, rigidity, standing and sitting balance, cognitive skills, and coordination
MS – what is it? How does it occur? autoimmune disease that affects the CNS, brain spinal cord and optic nerve, Myelin surrounding and protecting the nerve is lost in areas leaving scar tissue or sclerosis (lesions) which impede the transmission of nerve impulses to the brain
MS – what is the most common type Relapsing-remitting
What are the classic signs and symptoms of MS? Fatigue, pain, mild paresis to total paralysis, ataxia, intention and Postural tremors visual disturbances, cognitive disturbances, tingling sensation, loss of postural control, heat intolerance, spasticity, weakness and bowel bladder dysfunction
Why do heat and humidity need to be avoided in patients with MS? Due to heat intolerance
What type of exercise do you need to recommend for a client with MS? Why? What is an example? Submaximal exercise so the pt does not overheat or fatigue and cause loss of function a secondary to fatigue. 30 min of combined UE and LE ergometry plus 5 min of warm up and cool down 3 x per week
What are suggestions for OT treatment for clients with MS? ROM adaptive equiptment, strengthening, gait training, balance training, SUB-MAXIMAL exercise, stopping while you still have energy.Problemsolve easiest way to do ADLS and IADLS
SCI – What are causes? What is it? What structures are affected? MVA, Gunshots or stab wounds, Falls, driving accidents,sports injuries. SCI is Spinal cord injury SCI designates the last fully functioning neurological segment of the spinal cord that is damaged
What are types of SCI? (complete and incomplete) C1-8- Cervical T1-12- Thoracic L1-5- Lumbar
no nerve signals coming or going BELOW level of lesion- total paralysis, loss of sensation, permanent Complete SCI
some sensory, or motor nerves below level are preserved, not total severing of cord, certain segments may have differences between sensory and motor function, May make gains only to a certain extent Incomplete SCI
Will a complete injury be able to recover muscles and sensation below level of injury? What does that mean for rehabilitation? No, rehab only muscles above or at lesion
Know what muscle weakness (problems)occur at each level of SCI and how that loss impacts FUNCTION
What is tenodesis? How do you use it? Why? The action of the hand in a C-6 -Wrist is extended when fingers are passively flexed. Wrist is flexed when fingers are passively extended. Used for self-care activities, keyboard use, work with universal cuff
Why are weight shifts important? When do we teach them? Weight shifts are for pressure relief to prevent decubitus ulcers.this happens after the acute phase when the mobilization phase of rehab begins
Which levels need assistance with grooming? How much? C1-C5 all total assistance with grooming C-6 can do it some A with adaptive equipment (universal cuff, adaptive handles)
What are common aids and treatment ideas for grooming? adaptive equipment (universal cuff, adaptive handles)
Which levels need assistance with feeding? How much? C1 – C4 are total assist, C5 total assist with set, then independent, C6 independent, but total assist with cutting, C7 and lower is independent
What are common aids and treatment ideas for feeding? Universal cuff, tendinosis splint, adapted utensils, plate guard, extended straw with straw clip
Which levels need assistance with bathing? How much? C1-C5 total assist, C6 independent UB/some to total assist LB, C7 independent UB/some assist LB, T1 and lower are independent
What are common aids and treatment ideas for bathing? Handheld showerhead, tub bench, shampoo tray, padded reclining shower/commode chair
Which levels need assistance with dressing? How much? C1 – 4 total assist, C5 total assist LE/some assist UE, C6 independent UE/some to total assist LE, C7 independent UE/independent to some assist LE, T1 and lower are independent
What are common aids and treatment ideas for dressing? lower clothes rods in closet, use reachers, dressing sticks, button hooks, long handled shoe horns, loose fitting clothing, slip on shoes
Which levels need assistance with toileting? How much? C1-C5 total assist, C6 some total assist to independent with leg bag emptying, C7-8 some total assist with bowel/independent to some assist with bladder, T1 and lower is independent
What are common aids and treatment ideas for toileting? Catheters, scheduled voiding, raised toilet seat
Created by: NCBuckeye11 on 2012-04-30



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