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Ess Hum Dis/Cond ch2

OTH 2410 FALL 2012 Conditions SM

What are the stages of the developmental process? Fertilization & Conception; Prenatal; Perinatal ; Postnatal
What are the 2 prenatal stages: Embryonic & Fetal
Embryonic describes what period? Initial 2 mo. of gestation
Fetal describes what period? from embryonic until birth
What stage is Perinatal? During the birthing process
What stage is Post/Neonatal? Up to 1 mo. after birth
What are the main causes of Congenital Anomalies? Genetic, non-genetic, or both
True/False: You can always see congenital defects immediately at birth False. Some may be present at birth but not present until later.
True/False: Congenital defects only affect the physical False. Many anomolies are neurological or both and can affect more than one system.
What are 2 tests that are effective at early intervention of congenital abnormalities? Amniocentesis & Ultrasound
What is considered Premature? Any birth under 37 weeks gestation.
What are the symptoms of Prematurity? Low birth wt>5.8 lbs; incomplete organ development; respiratory/immune issues/infection/HBP: Leading cause of death in NeoNatal Period-can have cerebral bleeds,weak reflexes, Brachiopulmonary displasia, Necrotizing enterocolitis, Retinopathy
List some reasons/etiology for premature birth: Incompetent cervix, bicornate "horned" uterus, multi's, fetal growth retardation, prem. membrane rupture (trauma),toxic cond's, maternal infections, chronic HBP
List 6 main diseases of the nervous system: Down's Syndrome; Cerebral Palsy CP; Muscular Distrophy MD; Spina Bifida; Myelomeningocele;
What is Down's Syndrome? Cause/Etiology? Symptoms? Nervous disease-mild to sev. retardation-may have seizures. Caused by xtra chromo on Trisomy#21 /+35 prego's. See flat nose, sm mouth, stub fing, low ears, slant eye, simian hand lines;skeletal musc, heart & GI devel issues
Describe Cerebral Palsy (CP): more common to males & premie's;affects motor but also cognitive.
Spasticity Resistance to movement
Flaccidity No resistance to movement (Hypotonic)
Name the 5 types of CP: Spastic (Di/Quad); Athetoid; Ataxic; Mixed; Hypotonic
Which 2 CP are High functioning mentally? Spastic & Athetoid
Which CP's are Low Functioning mentally? Ataxic, Mixed, & Hypotonic
Describe the motion of an Athetoid CP: Writhing, worm-like motions-uncontrolled in fine motor skills
Describe the motion of an Ataxic CP: Uncoordinated in gross motor funtions such as walking, etc.
What is mixed CP? When patient cannot be dx under just one category
What is Hypotonic CP? Where patient has almost no muscle tone control.
OT Interventions for Prematurity: Improving motor skills, sensory input, attending behaviors, Positioning, Calming, Activity, Muscle tone
TX for Prematurity: Prevention/early prognosis--advances in technology=more survival, Supplemental O2, Laser Sx for Retinopathy, Enterocolitis-Med's or Sx.
What is Hemiplegia CP? Affecting One Arm/Leg on same side.
What is Diplegia CP? Lower more affected than upper.
What is Monoplegia CP? One Extremity
What is Quadriplegia? All extrimities
OT Interventions for CP? Healthy activity programs if can for lung function & other syst's, Swimming best(low impact), Assist fam to make most of short life span & resources for Genetic testing
What parts does CP affect? Lungs, Liver, Pancreas, Intestines, glandular-exocrine, multi-systematic
What medical Tx are used to Treat CP? Med's to thin mucus, Sx for occlusions, Breathing Tx, chest percussions (Fatal disease-early 30's)No Cure.
Describe Muscular Dystrophy MD? Genetic degenerative disease affecting skeletal muscle fibers. mostly boys age 3-7: waddling gait, toe walking, freq falls, diff. climbing/reaching or developing milestones, lordosis, contractures, pulm infect's.Duchenne's most common=mental impairment.
List Etiology for CP: usually due to lack of blood/O2 to brain, Recessive-genetic/aquired nonprogressive paralysis due to irreversible damage to CNS before, during, or after birth (non life threatening)
List Etiology for MD: Genetic defect caused by absence of the protein Dystrophin. Female=carrier, males affected.
What tests are used to Dx MD? Muscle biopsy & EMG (electromyography);elevated serum CK (creatine kinase) found in blood, DNA blood testing
What Medical Tx are used for MD? Duchenne's has no successful Tx's. PT, Exercise, Sx, & Ortho Appliances minimize deformities/preserve mobility. Corticosteroids slow muscle degen. Anticonvulsants, immunosuppressants, antibiotics. Death w/in 10-15 yrs of onset
OT Interventions for MD: Range of motion, Orthotic devices/adaptive shoes; wheelchair positioning; modifying ADLs
Describe Spina Bifida SB: Malformation of the spine where the post. vertb arches/processes fail to form-allow herniation (L/S).Spinal Cord Part/Completely absent aka Neural Tube Defects. 3 levels: Occulta, Menengocele, Myelomeingocele
Etiology of SB: Congenital specific unknwn; Lack of Vit A/Folic Acid InVitro, expo to Rad. In most severe form-Cord defects more common when prior offspring of mom had similar defect & poss Agent Orange
Parts affected with SB: CSF/Spinal Cord; Menenges; Lumbar-L5/S1; Legs, Bowels; Repro; Hydrocephalus in Mod/Sev
Med Tx for SB: Occulta-observation/poss Sx. Meningocele-Sx 24-48hrs(no cord involv) norm develop. Myelomeningocele-Sx 24hrs w/addtl Sx as needed-hydroceph./may lack bowel/bladder control/lower limb usage. May die before age 2.
OT Interventions for SB: AFO (Ankle-foot ortho's), Transfers, Mobility-shared role, Behavioral modifications.
Describe Hydrocephalus: Enlarged head due to blockage or increased CSF (pressure!) affects both Ped's & Adults.
Etiology of Hydrocephalus: Impairment or blockage of flow of CSF for reabsorbtion. or Increased production of CSF
Parts affected with Hydrocephalus: Intracranial Hemorrhage, blood clots, meningitis, bulging fontenelles, projectile vomiting, irritable/high-pitched cry; downward displacement of eyes. abnorm muscle tone in legs
Med Tx for Hydrocephalus: Ventricular or subarachnoid shunt or peritoneal catheter (preferred-longer)to drain excess CSF
OT Interventions for Hydrocephalus: Do not have upside down for extended periods of time; watch for complaints of headaches, vision issues, nausea
Describe Downs Syndrome DS: Presents with small head/flat skull, slant eyes, flat nasal bridge, low set ears, protruding tongue, small weak muscles. Stubby hands/short fingers, Simian line on palm, exaggerated space between big/little toes. Affectionate/placcid
Etiology for DS: Congenital. Additional Chromo 21 (Trosomy). Common in births to women 35+
Med Tx for DS: No known cure. Test by amniocentesis/ ultrasound invitro.Sx for cardiac defects; antibiotics pulmonary dx
OT Interventions for DS: Developmental Functions from 1st yr of life on, ADLs, IADLs, Play, Education
Describe Asthma: Chronic reversible obstructive disease cause:increased reactivity of lower respir syst-tracheobronchial tree;Expire wheeze, dry cough; anxiety,pallor, rapid pulse, acute; constriction/bronchioles & Inflammation/airway
Asthma Etiology: Hereditary; also enviro; Hyperactive/sensitive bronchi-extrinsic (allergy)-mold, dander, pollen; or Instrinsic (nonallergy)-stress, infect, exercise, emotions
Asthma Tx: Inhalers or allergy shots, O2,prophylactic meds-avoid smoking/2nd hand
OT Interventions for Asthma: Encourage proper use of med's; avoidance of triggers;Importance of Med Tx when attack doesn't resolve w/normal intervention
Describe Fetal Alcohol Syndrome (FAS): Birth defects/other assoc prob's w/infants born to alcoholic moms who drink during pregnancy. Low birth wt,small eye openings spaced wide apart, thin upper lip, CNS prob's, Cardiac septal defects,w/draws: mental retard/vis/aud/comm/memory/attn span
FAS Etiology: Caused by chronic & excessive alcohol intake by mother during gestation
FAS Med TX: Cannot be reversed.Proper nutrition vital; phychosocial needs addressed;dependant upon needs of newborns deficiencies-adaptive equip for feeding/suckling
OT Interventions for FAS: Balance,gross/fine motor skills, mobility, muscle tone/strength, neuro/cognitive, behaviors, coping,time mgmt, processing
Created by: RadGirl13
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