OCTH 712 exam 2
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| supports head, arms, and trunk (HAT); supplies proximal stability; formed by 2 hip bones; does not always sit flat; symphysis where the 2 meet; twisting, leaning back | pelvis
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| between the 5th lumbar vertebrae and coccyx, 5 vertebrae | sacrum
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| lonest bone in body; varies in approach based on injury; OT may see in acute care, outpatient, hospitals because of fractures or surgeries | femur
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| these absorb and transfer forces from the ground up and trunk down, sacroiliac and coxal are examples | joints of pelvis and hip
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| stabilizes pelvis under strain of opposing forces, synovial joint | sacroiliac joint
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| joint; ball-and-socket; triaxial; movements are flexion, extension, abduction, adduction, internal and external rotation | hip/coxal joint
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| movement of the hip; major muscles: rectus femoris(!), psoas major, iliacus, tensor fasciae latae, sartorius; ex. kicking a soccer ball | flexion
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| movement of the hip; major muscles: gluteus maximus (!), hamstrings (!), adductor magnus, and gluteus medius; ex. ballroom dancing | extension
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| movement of the hip; major muscles: gluteus medius (ant.) (!), gluteus minimus (!), adductor longus, adductor brevis, pectineus, and gracilis; ex. skiing | internal rotation
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| movement of the hip; major muscles: gluteus maximus (!), piriformis, quadratus femoris, obturator internus, obturator externus, superior and inferior gemelli, gluteus medius (post.); ex. line dancing | external rotation
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| movement of the hip; major muscles: gluteus maximus (!), medius (!), and minimus (!), tensor fasciae latae, sartoruis, piriformis; ex. ice skating | abduction
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| movement of the hip; major muscles: adductors magnus (!), longus (!), and brevis (!), pectineus, gracilis, and lower gluteus maximus; ex. gymnastics | adduction
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| can be used to assess movement and strength of hip, knee, ankle, and foot; typically done laying down | goniometry and MMT
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| moving from one place or position to another | functional mobility
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| walking | ambulation
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| shifting weight of body from one leg to another, facilitates positioning and movement of body, done in clinic commonly, need to do this to complete activities | weight-shifting
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| hinge joint; biaxial; movements: flexion, extension, internal and external rotation; rotation mostly driven by hip | tibiofemoral joint
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| gliding articulation between 2 bones, knee extension: bone glides superiorly and medially, knee flexion: bone glides distally and laterally | patellofemoral joint
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| two articulations between 2 bones, ankle stability is mostly distal, slight movement at these joints | proximal and distal tibiofibular joints
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| hinge joint, uniaxial, movements: dorsiflexion and plantarflexion, close-pack position is full dorsiflexion | talocrural joint
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| movement of the knee; major muscles: biceps femoris (!), semitendonosus, semimembranosus, gracilis, and sartorius; ex. running | flexion
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| movement of the knee; major muscles: rectus femoris (!), vastus lateralis, vastus medialis, and vastus intermedius; vulnerable to outside forces; close-pack position; ex. kicking a football | extension
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| movement of the knee; major muscles: semitendonosus, semimembranosus, gracilis, sartorius; ex. juggling a soccer ball | internal rotation
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| movement of the knee; major muscle: biceps femoris (!); at knee and hip simultaneously; ex. getting out of the car | external rotation
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| movement of the ankle; major muscles: gastrocnemius (!), soleus, tibialis posterior, fibularis longus, fibularis brevis; important for gait, dragging feet; ex. cycling | plantarflexion
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| movement of the ankle; major muscles: tibialis anterior (!), extensor digitorum longus, extensor hallucis longus; ex. lifting toes off the ground | dorsiflexion
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| movement of the knee and ankle; major muscles: tibialis anterior (!), tibialis posterior (!), flexor digitorum longus, flexor hallucis longus, extensor hallucis longus; ex. walking on sand | inversion
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| movement of the knee and ankle; major muscles: fibularis longus (!) and brevis (!), extensor digitorum longus; helps to balance foot; ex. hiking | eversion
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| movement of the toes; major muscles: flexor digitorum longus (!), flexor digitorum brevis, lumbricals, quadratus plantae, DABs, PADs, abductor digiti minimi, flexor digiti minimi brevis; degree of flex and extend helps with balance (reduced=bad balance) | flexion of 2-5 toes
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| movement of the toes; major muscles: extensor digitorum longus and brevis, lumbricals; degree of flexion and extension helps with balance (reduced=bad balance) | extension of 2-5 toes
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| keep patient close, keep patient facing you, bend at knees, keep a straight neutral spine, lift with legs and not back, keep BOS wide (shoulder's width), avoid twisting and rotating | therapist's body mechanics with transfers
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| moving a client from one surface to another, goal is generalization, skills developed and learned in one can be applied to others | transfers
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| based on initial OT evaluation you want to select a transfer that can be performed in a way that is... | consistent, safe, effective
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| type of assisted transfer, far supervision, least assistance | stand-by assistance
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| type of assisted transfer, near supervision | close guarding
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| type of assisted transfer, constant contact | contact guard
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| based on size and fear of falling | level of assistance
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| secured around a patient's waist, used to provide a secure point of contact, alternative method to control patient's motion during transfer, should be able to only fit a few fingers under this when on | gait belts
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| move surfaces as close as possible, adjust height of surfaces, flatten surface if beneficial, lock and test brakes, provide instructions to client | transfer set-up
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| adjust patient's body position while laying in bed | bed mobility
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| moving from supine to sitting without rotating back or hips, good for back injuries | logroll
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| includes flexing knees and hips and pushing with feet against bed to elevate and shift pelvis | bridging
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| maximizes strength of upper extremities for bed mobility, hangs over bed, allows client to pull and slide up, not appropriate for all, need upper body strength | trapeze bar
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| part of many transfers but not a transfer itself | sit-to-stand
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| therapist does 1-25% of work | minimal assistance
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| therapist does 26-50% of work | moderate assistance
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| therapist does 51-75% of work | maximum assistance
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| therapist does 76+% of work, usually more than one person helping | dependent assistance
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| assisted stand, pivot on stance leg, sitting on a surface, minimum or moderate assistance | stand-pivot transfer
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| patient does not have strength to come to a complete stand | squat-pivot transfer
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| sliding board placed between 2 functional surfaces; used for individuals with a spinal cord injury, bariatric patients, amputees, lower extremity paralysis | sliding board transfer
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| individuals who can contribute minimal to no assistance to move from one place to another, 2 person squat-pivot transfer or mechanical lift transfer | dependent transfer
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| everything starts where | pelvis
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| backward rotation of pelvis; flattens lumbar spine; increases thoracic flexion; bad for spine, lungs (chest is rounded and constricts lung cavity), not good for eating, makes transport difficult, poor upper limb movement; ex. slumping | posterior pelvic tilt
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| forward rotation of pelvis, increases lumbar lordosis, increases extension of upper trunk, opens up chest, much better for upper extremity activities | anterior pelvic tilt
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| sagittal plane position, pelvis tilts anterior or posterior | pelvic tilt
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| frontal plane position, one side of pelvis is superior or inferior to the other, misalignment | pelvic obliquity
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| transverse plane position, rotation of one side of pelvis is anterior or posterior, misalignment, twisted | pelvic rotation
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| which type of transfer is more difficult when the client is in posterior pelvic tilt | sit-to-stand
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| what movement helps bring a client out of posterior pelvic tilt | rocking
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| general static location of an object or individual in space | position
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| areas of high pressure, often involves a bony prominence | pressure sores
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| relative positions of segments of body that changes in response to demands of an activity; ex. scoliosis, kyphosis, lordosis | posture
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| collective position of body segments at any given moment, necessary for occupational performance, neutral position | postural alignment
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| ability to achieve or maintain a balanced body position for a given activity, voluntary and involuntary adjustments, maintaining trunk control and other things while doing an activity | postural control
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| neutral alignment of joints in the body, level pelvis supporting the natural curvature of spine | standing posture
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| upper body vertically balanced above pelvis; supporting head, neck, and upper extremities | quiet standing
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| small movements from side to side and front to back, helps maintain posture while standing, reduces pressure on feet or other pressure points, clients with strokes or other injuries may not correct like this naturally | postural sway
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| neutral pelvic tilt as well as head and neck, symmetry is important, upright trunk with balanced curvature of spine, ears aligned with shoulders, doing this for a long time can cause back pain | seated posture
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| as part of prep for a transfer individuals need to have seated posture that is as ____ and ____ as possible | upright; symmetrical
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| OTs often work on trunk control, strength, and stability needed to (increase/decrease) upright posture as part of transfer training | increase
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| positioning is important, neutral pelvic tilt, footrests should support legs in approximately 90 degrees of hip and knee flexion | wheelchair mobility
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| ability to maintain control over position or movement of your body | stability
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| come into contact with ground, distance between points, parts of body or mobility device, larger the distance between the points the better, adding an assistive device increases this | base of support
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| BOS constantly changes, varying contact between feet and ground, more points of contact, one is easier on points of contact | walking or running
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| adds points of contact; increases stability; ex. canes, crutches, walkers | mobility devices
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| adds 4 points of contact, greater stability while standing or walking, assist with balance since they increase BOS | walker
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| focal point at which gravity acts and around which the weight of an object is evenly distributed, lower = increased stability, kids have higher ones because of disproportionate heads, as weight distribution changes this changes | center of gravity
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| represents downward force of gravity acting on body, vertical line, if it falls with BOS the body is anatomically stable, extends from COG to ground | line of gravity
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| stability required for an individual to perform a particular task in a specific environmental context; depends on body structure and function; sitting or standing; ex. movement, doing activities, shifting BOS | functional (dynamic) stability
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| increase BOS and maintain LOG within its boundaries, increase surface area and friction of point of contact with ground, carry objects close to body and distribute weight as evenly as possible | ways to enhance stability
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| study of human interaction and efficiency with work environment | ergonomics
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| postural abnormality, one leg is longer than other, lifts are helpful to balance this, causes pelvic obliquity, increases risk of falls | leg length discrepancy
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| curvature of spine, can contribute to pelvic obliquity, affects hips and knees which makes people with this more likely to need surgeries on hip and knee joints as well as their back | scoliosis
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| is ASIS or PSIS higher in posterior pelvic tilt | ASIS
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| tilt of pelvic that increases thoracic kyphosis and rounded back; common in older women; swayback, Dowager's hump, and flat back are types | posterior pelvic tilt
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| type of posterior tilt, posterior tilt and shifting of pelvis relative to feet | swayback
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| type of posterior pelvic tilt, flexion of thoracic spine and orientation of upper body downward | Dowager's hump
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| type of posterior tilt, decrease in lumbar lordosis and general flattening of thoracolumbar spine | flat back
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| type of pelvic tilt, PSIS above ASIS, increases lumbar lordosis and extension of upper trunk | anterior pelvic tilt
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| protraction of head and neck anterior to trunk, common when using phones | forward head posture
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| affected by roles, habits, routines, and rituals; what are they doing and how much are they doing it; prolonged positioning causes issues; consider work position for various jobs | posture and occupation
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| good for minor weakness, impairment in balance, or pain; hold this in the hand opposite of the affected leg; two different types: single-point and quad | standard J-cane
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| one projection on the ground, cane | single-point cane
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| four projections at the base; advantages: broad BOS for increased weight shift, stands alone when not held; disadvantages: slows gait (person will not walk at a normal speed), not used for balance during normal gait | quad cane
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| advantages: very stable BOS, foldable, used for hemiplegia; disadvantages: poor on stairs, used for weight-bearing and not balance, prevents normal gait pattern; more for front of body and not sides | hemi-walker
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| should be done standing, place device 6 inches lateral to toes, top of cane should be level with greater trochanter of femur, elbow should be flexed to 20-30 degrees when grasping, alternative: should line up with crease of wrist | sizing canes
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| advantages: improves balance, provides lateral stability, decreases weight-bearing, able to use on stairs; disadvantages: awkward, safety, underarm pressure, requires good balance | axillary crutches
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| recommended for healthy, younger individuals with acute injuries | axillary crutches
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| advantages: free hands, can use on stairs, can use individually on one side as a cane, balance; disadvantages: less weight-bearing relief and requires arm strength | forearm crutches
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| used with individuals with chronic conditions (especially MS and cerebral palsy) which affect balance but not strength | forearm crutches
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| done while standing, two inches below axilla, handpiece: measure at wrist or elbow with 20-30 degrees of flexion, alternate: subtract 16 inches from patient height | sizing crutches
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| 4 points on the floor, provides anterior-posterior and medial-lateral stability for balance and weight-bearing, most stability, no wheels, can have attachments as needed, used post-orthopedic issues often, fatiguing common | standard walker
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| fixed wheels in front, difficulty with turning, may have hand or compression brakes, most can fold for portability, good for constant balance support, bariatric versions: sturdier metal with wheels in the back | front-wheeled walkers
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| a.k.a. a rollator, not much stability for weight-bearing, best for minor balance and fatigue issues, often has a seat to help with fatigue | four-wheeled walkers
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| a repeating reciprocal pattern of lower extremity movement, there are alternating stance and swing phases (opposite legs are in opposite phases) | gait
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| goal is to propel the body forward | gait
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| phase of gait; involves planting foot and shifting weight to it; 5 components: heel strike, foot flat, midstance, heel-off, toe-off | stance phase
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| phase of gait; moving the leg; 3 components: acceleration, midswing, and deceleration | swing phase
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| part of swing phase, anterior shear force applied to foot from the ground, during heel-off | acceleration
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| part of swing phase, posterior shear force applied to foot from the ground to slow propulsion of lower extremity, part of heel strike | deceleration
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| pelvis tilts and has obliquity back and forth and drops with swing phase into stance normally, abnormally there is lots of or no pelvic movement | gait
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| distance the foot advances in relation to the other | step
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| distance between heels, determines individual's base of support while ambulating | step width
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| number of steps taken per minute | cadence
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| components of measuring gait | step, step width, cadence
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| abnormal gait, pelvis drops excessively on swing leg side with each step, typically caused by a weak gluteus medius, slows down cadence | trendelenburg gait
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| matters for any occupation that includes ambulation | gait
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| abnormal gait, circumducting (swinging) the leg out to the side of the body to propel it forward, trunk and pelvis rotate anteriorly, slows dows cadence | circumduction gait
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| abnormal gait, toes drag against the ground during swing phase, loss of ankle dorsiflexion, common after a stroke or TBI, increases risk of falls and toes getting caught | foot drop
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| abnormal gait, paralysis or weakness of an entire side of the body, results from neurological pathology (ex. stroke, TBI, or cerebral palsy), may include foot drop or spasticity | hemiplegic gait
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| abnormal gait; ambulating against, or to avoid pain; not one way of doing it; slow; may twist or circumduct; have full passive ROM but painful | antalgic gait
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| abnormal gait, ROM and strength are not compromised, lack of coordination causes the impairment, staggering, trying to catch balance, typically seen post-stroke or cerebellar defecits | ataxic gait
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| abnormal gait, narrowing or even crossing-over of the legs as they walk, abnormal muscle tone with tightness of the hip adductors, associated with cerebral palsy or other neurological pathologies, commonly bilateral | scissor gait
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| abnormal gait, shuffling the feet with flexion of the trunk, placing the weight of the body on the balls of the feet | parkinsonian gait
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| cane should be placed opposite of what side of the body, first step involves weak leg and cane at the same time | weaker side
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| weight should be beared on ____ when using cruthces | hands
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| reflects what a doctor will allow the patient to do and not necessarily what is functionally possible for the client based on diagnosis | weight-bearing
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| full, partial, none, toe-touch | types of weight-bearing
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| type of weight-bearing, walker goes first with injured leg, back leg aligned with back of walker, step through with second leg | full weight-bearing with walker
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| type of weight-bearing, walker, then injured leg, then transfer weight to arms and step through with the second leg | partial weight-bearing with walker
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| type of weight-bearing, walker, then transfer weight to arms, involved leg swings through with other leg, injured leg does not touch floor | non-weight-bearing
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| type of weight-bearing, only allowed to put the foot down to guide, better to treat as non-weight-bearing | toe-touch weight-bearing
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