NBCOT 4 Flashcards

visual perceptual skills
Terms Definitions
condition of
a net
Cerebellar/Spinocerebellar disorders (symptoms)
ataxiadysmetriadysdiadochokinesiahypotoniamovement decomp tremordysarthrianystagmus
out or away
diaphragm (also mind)
alveolus (air sac)
Cranial nerve 8
purely sensory

vestibulocochlear (auditory)

hearing, equilibrium sensation
brief, purposeless, involuntary movements of the distal extremities and face.usually considered to be a manifestation of dopaminergic over-activityin the basal ganglia.
less than 60 bpm
What are SOAP notes?
hip ABduction measurement
0 to 40º
Shoulder extension measurement
0 to 60º
Level VI
confused-appropriate: response more goal directed, but cues are necessaryappropriate and goal-directed but can become confused
transport oxygenated blood from areas of high pressure to lower pressures in body tissues
rod shaped or striated (skeletal)
MET 4-5
Occupational: painting, masonry, paperhanging, light carpentryRecreational: walking (3.5mph), cycling (8mph), table tennis, golf, dancing, badminton singles, tennis doubles, raking leaves, hoeing, many calisthenics
Cervical Spine flexion measurement
0 to 45º
hemi-section of the cord resulting ipsilateral spastic paralysis and loss of position sense and contralateral loss of pain and thermal sense
Glaucoma (definition)
increased intraocular pressure, with degeneration of optic disc, atrophy of optic nerve; results in early loss of peripheral vision (aka tunnel vision)
increased reactivity of the trachea and bronchi to various stimuli (allergens, exercise, cold)manifests by widespread narrowing of airways due to inflammation, smooth muscle constriction, and increased secretions
"exploratory actions"testing: able to imitate single cordovan stitching using overt (physical) trial-and-error, 3 stitchesnew learning occursmay be usual level of function for 20% of population
for use in treatment of sexualityPermissionLimited InformationSpecific SuggestionsIntensive Tx
Supraspinatus (origin, insertion, function)
origin: supraspinatus fossa

insertion: greater tuberosity

function: ABduction and flexion
Spinal Segment L5
Dermatome: great toeMuscles facilitated: lateral hamstringsFunction: flexion at knee, toe extension
What is the Phalen's test?
Phalen's Test
Cervical spine lateral flexion measurement
0 to 45º
Ankle and foot dorsiflexion measurement
0 to 15º
L5 (location, muscles, function)
location: great toemuscles facilitated: lateral hamstringsfunction: flexion at knee, toe extension
heart-lung transplant
removing both organs and replacing with donor organs
accessory muscles of inspiration used for deep breaths or rapid breathing
sternocleidomastoidscaleneslavator costarumserratustrapeziuspectorals
extensor digitorum communis (EDC) (origin, insertion, function)
origin: lateral epicondyle

insertion: medial band to middle phalanx and lateral band to distal phalanx

function: extension of MCPs and contributes to extension of IPs
T6 to L4 Self-care
I in all self-care
What elbow extensors are innervated by the radial nerve?
What muscles are innervated by the suprascapular nerve?
Forward Parachute (protective extension forward) Relfex
Onset: 6-9 monthsIntegration: persistsStimulus: suddenly tip infant forward toward supporting surface while vertically suspendedResponse: sudden extension of the upper extremities, hand opening, and neck extensionRelevance: allows accurate placement of upper extremities in the anticipation of supporting surface to prevent a fall
CN 2: Sensory- Carries impulses for vision- Eye chart testing, visual field testing
CN 10:- Sensory motor impulses for larynx and pharynx, parasympathetic motor fibers supply smooth muscles of abdominal organs; sensory impulses from viscera- Tested in conjunction with CN 9
Contraindications for use of ultrasound
DVTbleedingedemaimpaired sensationvery old/very youngcancernear area of pacemakerpregnancyinfectiongrowthplateover heart, eyes, testes, headspinal column
MCA stroke (left hemisphere) functional deficits
contralateral hemiplegia, contralateral hemiparesthesia, aphasia, cognitive involvement, affective involvement
Avoidant personality disorder
*sensitivity to rejection*show an extreme desire for companionship*need unusually strong and repeated guarantees of acceptance*inferiority complex
Finger MCP hyperextension measurement
0 to 15º - 45º
Decubitis ulcers prevention
1. use wheelchair cushions, flotation pads, and pressure-relief bed aids to distribute pressure over a larger skin surface2. train individual and/or caregivers in positioning and weight-shifting techniques and schedules and in proper skin care3. train in proper skin care - keep skin free of excessive moisture, dryness, and heat - skin checks at least x2 per day4. encourage adequate intake of fluids and food to maintain nutrition, promote healing and achieve a recommended body weight
C4 (location, muscles, function)
location: upper shoulder regionmuscles facilitated: trapezius (diaphragm)function: head control
Fair minus (F-)
3-part moves through incomplete ROm (more than 50%) against gravity
Class II heart disease
slight activity limitcomfort at restorindary activity results in fatigue, pain, dyspnea, palpitationsmax MET 4.5
An entry-level OTA can supervise who?
OT aidestechnicianscare extendersvolunteers
extensor pollicis brevis (EPB) (origin, insertion, function)
origin: radius, middle 1/3

insertion: proximal phalanx of thumb

function: extension of MCP and CMC of thumb
acute hospitalization rehab for immunological system disorders
early mobilizationpreservation of functionpositioningpsychological/emotional supportprevention of long term disability
C1 to C3
totally dependent in self-care, but can instruct others able to chew and swallow
Biceps (origin, insertion, function)
origin: carocaoid process and supraglenoid tubercle

insertion: radial tuberosity

function: elbow flexion with forearm supination
Dynamic Interactional Approach
** requires intact auditory processing skills **emphasis: transfer of info from 1 situation to the nextpractice of a target strategy with varied tasks and situations (multicontextual)transfer of learning ≠ automatic, must be taughtmetacognitive skills (self-awareness of strengths and deficits) as basis of learningtransfer of learning through graded series of tasks that decrease in similarityutilizes awareness questions ("how do you know that is right?") to help detect errors, estimate task difficulty, and predict outcomes
Sheltered workshops, supported employment programs, and transitional employment programs
- A multidisciplinary or interdisciplinary approach is used- Real work activities are used - participants are payed per piece at sheltered workshops, paid at competitive wage for supported employment and TEPs- A transition between program participation and competitive employment is provided according to each clients functional level- Can be the final/permanent employment goal for a client- Considered as employees with supports as needed
CN 9- Motor fibers for pharynx and salivary glands, sensory fibers for pharynx and posterior tongue, taste sensation for sweet, bitter, sour- Gag and swallow reflexes are checked, posterior one third of tongue is tested for taste
What is extrapyramidal syndrome?
Extrapyramidal syndrome is a neurological side effect of anti-psychotic medication that mimics the effects of Parkinson's disease. This can cause rigidity, bradykinesia, cogwheel and leadpipe rigidity, loss of postural mechanisms, and a resting, pill-rolling tremor.
What is the minimum doorway width for a wheelchair?
Intervention strategies for ideomotor/ motor apraxia
*Use generalized cues*decrease manipulation demands*use HOH input*use visual cues
What are intention tremors?
Occurs during voluntary movement. Intensified at the termination of the movement and often associated with MS.
Finger extension requires innervation of what 2 cervical levels?
cervical levels 7 and 8
Spina bifida occulta
a bony malformation with separation of vertebral arches of one or more vertebrae with no external manifestations
Play History
(focus, method, scoring/interpretation, population)
- primary caregiver provides info about a child in 3 categories: general info, previous play exprerience, actual play over 3 days
- materials, action, people, and setting included
-children and adolescents
Presbyopia (definition)
visual loss in middle and older ages characterized by inability to focus properly and blurred images, due to loss of accommodation (elasticity of lenses)
Chronic obstructive pulmonary disease (COPD)
disorder characterized by poor expiratory flow rates 1. chronic bronchitis: lasting at least 3 months for 2 consecutive years 2. peripheral airways disease: inflammation of distal conducting airways; association with smoking 3. emphysema: permanent abnormal enlargement and destruction of air spaces distal to terminal bronchioles
Principle 1: beneficience (definition)
OT personnel shall demonstrate a concern for the well-being of the recipients of their services
What extrinsic flexor muscles are innervated by the median nerve?
Flexor digitorum superficialis (FDS)Flexor digitorum profundus (FDP)Flexor pollicis longus (FPL)
heat stroke
hot, dry red skin; a body temperature higher than 104 degrees; slow, deep respiration; tachycardia; dilated pupils; confusion; progressing to seizures and possibly loss of consciousness
What are used to test grip strength in individuals with arthritis?
C-P tx of motor/ideamotor apraxia
general verbal cues (NOT specific)decreased manipulation demandshand-over-hand tactile-kinesthetic inputvisual cues
Work hardening program characteristics
- An interdisciplinary approach is used- Real or simulated work activities are used- Transition between acute care and return to work is provided- Issues of productivity, safety, physical tolerance, and worker behaviors are addressed
Stage 6 Cardiopulmonary
ADL: showering in hot water, hanging and/or wringing clothes, mopping, stripping, and making beds, rakingExercise: ambulation up to 3.5 mph, stairs, treadmill 1.5 at 5-6% grade > 3.5 mph at 0% grade, cycling up to 10 mph, 10-15 lbs of weightRec: swimming, slow dancing, ice/roller skating, volleyball, badminton, table tennis, light calisthenics
Stage IV cardiac rehab
3-4 MET level*standing to bathe, dress, groom*homemaking with energy conservation*unlimited ambulation on level surface, mild resistancewalking 3 mph, canoeing, golf putting, light gardening, driving, pushing lawn mower,
What are the normal ROM limits of elbow flexion?
0-140 degrees
What is rotation?
A type of in-hand manipulation that is displayed when an individual turns a nut on a bolt.
What are corrective splints?
Corrective splints are static splints used to:- maintain improvement obtained through therapy- correct soft tissue contractures
Labyrinthine/optical (head) righting reflex (onset age, integration, stimulus, response, relevance)
birth to 2 months -- persistsstimulus: hold infant suspended vertically and tilt slowly (about 45degrees) to the side, forward, or backwardresponse: upright positioning of the headrelevance: orients head in space; maintains face vertical
Parkinson's Progression - Hoehn & Yarh's Stage I
unilateral tremor, rigidity, akinesia, minimal or no functional impairment
routine supervision (definition)
direct contact at least every 2 weeks at the site of work, with interim supervision occurring by other methods (ie: phone or written communication)
Flexor digiti minimi (origin, insertion, function)
origin: hook of hamate and flexor retinaculum

insertion: proximal phalanx of 5th digit

function: flexion of MCP joint and opposition of 5th digit
symptoms of vocal cord paralysis
inefficient closure of vocal folds during pharyngeal phase of swallow: 1. vocal cords in paramedian position; swallow may be safe 2. vocal cords fail to meet/close to protect airway; aspiration may occur
Remedial, Restorative, Transfer of Training Approach
restoration of components, to increase skilldeficit specifictargets CAUSE of symptoms (NOT symptoms)assume cerebral cortex is malleable and can reorganizeaxs: tabletop and computer axs ie: memory drills, block designs, parquetry
Development of Self-dressing skills at 4.5 years
- Puts belt in loops
Feeding abilities at SCI level C6
Independent using adaptive equipment, including u-cuff or tenodesis splint, rocker knife, and cup with large handles
What are resting tremors?
Occurs at rest and subsides when voluntary movement is attempted.Seen in Parkinson's disease.
What is reflex sympathetic dystrophy?
__________ is caused by trauma, post-surgical inflammation, infection, or laceration to an extremity. Characterized by pain, edema, shiny skin, blotchy skin, and excessive sweating or dryness.
What muscles does C8 innervate?
C8: Finger extensors, finger flexors, hand intrinsics
What are the behavioral charcteristics of damage to the thalamus?
-Communications relay station for all sensory information-Damage can alter states of arousal, memory defect, speech deficits, apathy, and disorientation
Galant reflex (onset age, integration, stimulus, response, relevance)
32 weeks gestation to 2 monthsstimulus: hold infant in prone suspension, gently scratch or tap along spine with finger, from shoulder to buttocksresponse: lateral trunk flexion and wrinkling of the skin on the stimulated siderelevance: faciliates lateral trunk movements necessary for trunk stabilization
spina bifida with meningocele
protrusion of a sac through the spine, containing cerebral spinal fluid and meninges; however, does not include spinal cord
Test of Playfulness (TOP)
(focus, method, scoring/interpretation, population)
- assesses a child's playfulness based on observations according to 4 aspects of play: intrinsic motivation, internal control, disengagement from constraints of reality, & framing
- extent, intensity, and skillfulness of play also observed and rated
- 15 months- 10 yrs
DeGangi-Berk test of sensory integration
1. Ages
2. Measures what and categorzied areas include?
3-5 years of age
* SI and vestibular system
  - bilateral motor cordinatino, postural control, reflex
Opponens digiti minimi (origin, insertion, function)
origin: hook of hamate and flexor retinaculum

insertion: 5th metacarpal

function: opposition of 5th digit
symptoms of penetration of the bronchioles/bronchi by bolus when aspiration occurs
food enters lung (true aspiration occurs): 1. bacteria can cause pneumonia (aspiration pneumonia) 2. if person's immune system is functioning well, he/she may not experience pneumonia
Cranial Nerves III, IV, VI
Pure motor - controlling eye movements and pupillary constrictions
Typical Developmental Sequence of Toileting at 4-5 years
- Is independent in toileting - tearing toilet paper, flushing, washing hands, managing clothing
Can someone with receptive aphasia participate in sensory testing?
Individuals with this disorder cannot comprehend spoken or written words or symbols. Individuals cannot understand verbal directions or respond to sensory stimuli.
What is a Laissez-Faire leadership style?
Laissez-Faire is a "hands off" approach. Goals are not stated, the purpose is not clear, members are not discouraged or encouraged. This is for a high-functioning group.
What is total quality management? (TQI)
empowerment of employees to take responsibility for their own tasks in a way that encourages both continuous learning and personal responsibility.Often in the form of a committee
quadruped tilting reflex (onset age, integration, stimulus, response, relevance)
9 to 12 months -- persistsstimulus: after positioning infant on all fours, slowly raise one side of the supporting surface.response: curving of the spine toward the raised side (opposite to the pull of gravity); ABduction/extension of arms and legsrelevance: maintain equilibrium without arm support; facilitate posture adjustments in all positions
Test of Visual Perceptual Skills (3rd ed)
(focus, method, scoring/interpretation, population)
- assesses visual perceptual skills; NO MOTOR RESPONSE
- seven visual perceptual skills: visual discrimination, visual memory, visual-spatial relationships, visual form constancy, visual sequential memory, visual figure-ground, and visual closure
- multiple choice format
- 4-19 yrs
When is intermittent OT Aide supervision: appropriate?
when OT aide is completing non-patient related tasks. This requires periodic discussion, demonstration, or contact between the supervisor and aide on at least a monthly basis.
interventions for activity levels for immunological system disorders (self-care, work, leisure/sports, rest)
1. adaptations and training to do self-care tasks with greatest ease while conserving energy - alter grasp and pinch patterns and level of demand of UE - alter size of feeding utensils and tooth brushes to accommodate decreased ability to open mouth - prevent shearing forces on skin during specific personal ADL tasks2. work - work capacity evals - modifications to work site to allow participation in component tasks and ax - counseling and intervention for transition to disability status when work is no longer possible3. leisure/sports - modify specific tasks and axs - eval interests and skills to introduce new leisure or sports axs of interest to the person to transition to less physically demanding tasks as a disease process4. rest - monitor and intervene to maximize the ability to be well positioned during sleep - monitor sleep habits and patterns and intervene when strategies are needed to relax and unwind or to schedule time and opportunity for relaxation
Self-care abilities with SCI at C1-C3
Totally dependent in self-care but can instruct others in preferences for care. Can chew and swallow.
What functionality does a person with C6 SCI have?
-Complete paralysis of legs and torso.-Able to extend wrist and flex the elbow.-Independent in transfers from toilet to wheelchair.-Able to reach forward.-Benefits from splint to promote wrist tenodesis.-Able to do some ADLs, such as shaving and dressing upper body. -Assistance may be required to dress lower body.-Needs assistance to transfer from bed to wheelchair.
What is the Allen Cognitive Level Number 4?
"goal directed actions" testing: able to imitate whip stitch, 3 stitches ability to carry out simple tasks through
completion relies heavily on visual cues may be able to perform established routines but cannot cope with
unexpected events
What is the Standards and Ethics Commission (SEC)?
the component of AOTA that is responsible for the Code of Ethics, and the Standards of Practice of the profession.
Development of self-feeding at 12-14 months
- Dips spoon in food, brings spoonful of food to mouth, but spills food by inverting spoon before it goes into mouth- Likely to use pronation grasp on spoon- Recognizes that objects have a function and uses tools appropriately- Has interest in watching family routines
What behavior would a child with poor modulation of tactile input display?
Children with autism often are unpredictable, both craving and avoiding sensory stimuli at various times.
body righting reflex (BOB) (onset age, integration, stimulus, response, relevance)
4 to 6 months -- 5 yearsstimulus: place infant in supine, flex one hip and knee toward the chest and hold brieflyresponse: segmental rolling of the upper trunk to maintain alignmentrelevance: facilitates trunk/spinal rotation
Is an OT aide an OT practitioner?
No, according to the AOTA Standards of Practice they are not.
Development of self-feeding at 6-8 months
- Attempts to hold bottle but may not retrieve it if it falls (object permanence is emerging)- Needs to be monitored for safety reasons- Is easily distracted by stimuli in environment
What is the Subjective component of a SOAP note?
-What a patient or significant other states-What the patient or significant other states about their medical history, emotions, lifestyle, home situation, -Patient-stated goals "I want to work again"-Complaints-Patient's assessment of treatment
What is a FIM level of "Moderate Assistance," or level 3?
The person puts forth between 50% and 75% of the effort necessary to do a task, and requires no more than helping or touching.
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