OTA 130 Final Exam
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| Increase in muscle tone, increase resistance to passive stretch | Spasticity
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| Decrease in muscle tone | Flaccidity
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| interferes with patients positions and the components of postural control. Flexor hypertonicity affects UE and Extensor hypertonicity affects LE | Spasticity
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| Voluntary motion is limited to total limb movements in flexion or extension. the pt is unable to isolate individual joint motion | Flexioin Synergy
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| Pts with CVA, CP, other neurological disorders/diseases | Flexion syngery
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| No motion stage of Brunstrom's | Stage 1
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| Reflex responses (limited to localized motor response to specific stimuli)stage of Brunstrom's | Stage 2
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| Associated reactions (activity requires intensive effort of unaffected limb)stage of Brunstrom's | Stage 3
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| Mass responses (synergistic) (patient is unable to isolate individual joint motion or deviate from stereotypical movement pattern)stage of Brunstrom's | Stage 4
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| Deviation from pattern (example is a patient may be able to actively extend the wrist when asked but unable to use wrist extensors while shoulder is flexed)stage of Brunstrom's | Stage 5
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| Wrist stability stage of Brunstrom's | Stage 6
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| Individual finger movement (opposition)stage of Brunstrom's | Stage 7
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| Selected pattern with overlay (joint movement is isolated with voluntary control) stage of Brunstrom's | Stage 8
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| Selective movement (normal) stage of Brunstrom's | Stage 9
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| Why are Brunstrom’s stages helpful? | Provides a framework for the anticipated motor recovery in stroke patients
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| Soft tissue shortening around a joint | contracture
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| How does a contracture occur? |
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| Why are contractures a concern? |
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| Who might have a contracture? | A patient with CVA or CP, any neurological condition
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| How do we prevent contractures? | Perform ROM. If contracture is already present, splinting to reduce further contractures
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| No muscle contraction can be felt or seen; flaccid, full paralysis | MMT Grade 0
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| Trace, contraction can be felt but there is NO motion | MMT Grade 1
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| Poor, part moves through complete ROM with gravity decreased | MMT Grade 2
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| Fair, part moves through complete ROM against gravity | MMT Grade 3
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| Good, part moves through complete ROM against gravity and moderate resistance | MMT Grade 4
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| Normal, part moves through complete ROM against gravity and full resistance | MMT Grade 5
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| Measures Joint ROM | Goniometer
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| Joint ROM –documentation |
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| understand that the ROM at the joint is the same ROM no matter what position the body may be in (supine, sit, prone) | Joint ROM
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| What do we compare a person’s joint ROM to? | standard tables, unaffected side
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| Functional ROM – how do we measure? | At least 90 shoulder flexion (ROM needed to complete ADL and IADL tasks
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| Client will compensate to get their full ROM by leaning, twisting, and rotating their body | Substitution
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| abnormal formation of true bone within extraskeletal soft tissues | Heterotrophic ossification
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| For a client with decreased ROM, what therapeutic interventions do we use to increase ROM? | Active and passive stretching, resistive exercise, exercise using equipment, reaching, catching a ball, table
top activities (washcloth on table and extend arm), throwing a bean bag, using clothespin to reach to something higher to clip it on to
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| What is the proper sequence of applying therapeutic interventions for a client during a treatment session with decreased ROM? | Assess occupational goals and needs (holistic)
Functional ROM
Functional MMT
Stretch
Purposeful activity
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| List 20 pieces of adaptive equipment we have used or have seen in lab | wheelchair, walker (hemi, rolling, standard), cane (standard, quad), reacher, sock aid, long-handled shoe horn, dressing stick, button hook, leg lifter, elastic shoe laces, universal cuff, scoop place, swivel utensils, built-up handles, weighted utensils
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| What adaptations do we use for decreased ROM? | Long handled reacher, long handled sponge, hand held shower head for shampooing hair, position adjustable hair dryer, place the affected arm in first while donning a shirt, adapt cabinets if possible, place food on bottom shelves, lower clothes rod
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| What adaptations do we use for shoulder weakness? | Long Handled reacher, long handled sponge, lower closet poles, adapt cabinets to lower reach
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| What adaptations do we use for weak grasp? | Universal cuff, built up eating utensils, long plastic straws, clip type receiver for phone, built up pens and
pencils, Wanchik writing aid, slip on typing aid, built up faucets
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| How do we teach a client to use adaptive equipment? | demonstrate the task, client practice, allow for questions, verbal understanding, teach back
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| What adaptations would be beneficial for dressing for a client with the use of only one UE? | Adapt the clothing, add Velcro instead of buttons, elastic shoelaces, buttonhook, pants with Velcro flies,
using pants with elastic waistband, don affected arm first when donning shirt, slip on shoes, sock aid
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| What adaptations would be beneficial for cooking for a client with the use of only one UE? | Rocker knife, Dycem or shelf liner, plate guard or scoop dish, cutting board with nails or built up side
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| What adaptations would be beneficial for bathing for a client with the use of only one UE? | Position adjustable hair dryer, suction brush to clean fingernails, electric razor,soap on a rope
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| sensation received through skin or hair receptors (allows you to feel the toothbrush) | Tactile
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| tactile sensation of force applied to the skin, EX. ischial tuberosities pressing into a seat(helps to grip the toothbrush) | Deep Pressure
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| unpleasant or noxious tactile sensation (allows you to avoid brushing a sensitive area) | Pain
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| tactile sensation of heat or cold ( is water too hot or too cold) | Thermal Sensation
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| info about joint position and motor conveyed at an unconscious level from receptors in the muscles, joints, ligaments (guides the joint of the arms and hand to complete motion of brushing) | Proprioception
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| Which type of nerves supply sensation? | Peripheral
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| ability to tell what you are touching without vision. An example would be identifying a quarter in your pocket or reach into purse and find keys without vision | Stereognosis
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| A deficit in the ability to copy, draw, or construct a design., whether on command or spontaneously. You cannot assemble parts into a whole Would be seen in CVA or TBI. Patient will not know how to dress sequentially, stack a dishwasher or assemble a to | Constructional apraxia
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| The inability to plan and perform the motor acts necessary to dress oneself. Linked with problems of body scheme, spatial orientation and constructional apraxia. Client will dress with clothes inside out or put clothes on the wrong side of the body | Dressing apraxia
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| allows individuals to use and process sensed and perceived information and thus is intimately connected to sensation and perception | Cognition
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| Which diagnoses most likely have residual problems with cognition? | CVA, TBI, AD
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| How does the OTA assist with assessing cognition? | By observing client performance in functional activities, By reporting meaningful observations (presence or absence of cognitive skills).
The OTA may administer structured assessments if service competent
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| Principles of Cognitive Evaluation | discussion of the OT eval results with other health care disciplines,testing environment will influence the results,optimal test battery involves a selection of tests,avoid a condescending attitude
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| active process (you have to be involved) that allows the individual to focus on the environmental information and sensations relevant at a particular time. It involves the simultaneous engagement of alertness, selectivity | Attention
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| subcortical (subconscious) Example is walking and talking to a friend and not having to pay attention to where your feet are | Automatic Attention
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| when new information is considered | Controlled attention
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| Is the highest level of attention and it refers to the ability to respond simultaneously to multiple tasks or multiple task demands | Divided Attention
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| A person’s ability to store, retain, and recall information and experiences | Memory
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| corresponds approximately to the initial 200–500 milliseconds after an item is perceived. The ability to look at an item, and remember what it looked like with just a second of observation, or memorization | Sensory Memory
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| ability to store much larger quantities of information for potentially unlimited duration(sometimes a whole life span) | Long-term Memory
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| recall for a period of several seconds to a minute without rehearsal | Short-term Memory
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| memory for a skill or series of actions | Procedural Memory
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| ability to recite or reproduce information. Divided into two categories | Declaritive Memory
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| ind. History and lifetime experiences | Epsodic Memory
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| general fund of knowledge shared by groups of people, such as language and rules of social behavior | Semantic Memory
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| Sensory Input – moves to a temporary storage location (working memory) – then moves to Long term memory location where encoding and consolidation occurs | What is the memory process? (How are memories made?)
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| Responsible for planning, cognitive flexibility, goal formation, abstract thinking, rule acquisition, initiating appropriate actions and inhibiting inappropriate actions, and selecting relevant sensory information | executive functioning
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| An inclination of an individual to initiate behavior without adequate consideration as to the consequences of their actions. Someone who has just experienced a THP who moves around without thinking, possibly breaking their precautions | Impulsivity
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| The repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury | Perseveration
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| What pieces of adaptive equipment are in a “hip kit”? | Raised toilet seat
Sock aid
Shoe horn
Reacher
Long handled bath sponge
Dressing stick
Elastic laces
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| What are the primary rules of good body mechanics for therapists? | Keep the load close to the body
Move with your feet first
Avoid forward bending and twisting at the waist
Maintain your 3 back curves
Use a wide base of support and a staggered stance
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| assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them | Assistive Technology
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