NBCOT 2 Flashcards

Deltoid muscle
Terms Definitions
-ula, -ule
Splints(External Link)
Running 7mph
11.5 MET
loin (lower back)
above or excessive
Cerebellar stroke
intention tremorsAtaxiaincordination
S1 to S3
bowel, bladder
primary muscles of inspiration
swollen or twisted vein
Shoulder flexion measurement
0 to 180º
Cranial nerve 3

purely motor
carry parasympathetic fibers of ANS

eyelid and eyeball movement
TBI symptoms
concussion characterized by post-traumatic loss of consciousnesscerebral contusion/laceration/edema accompanied by surface wounds and skull fracturesvariety of symptoms: 1. hemiplegia or monoplegia or abnormal reflexes 2. decoritcate or decerebrate rigidity 3. fixed pupils 4. coma 5. changes in vital signs
Myasthenia gravis
chronic autoimmune neuromuscular disease characterized by muscle weakness that increases during periods of activity and improves after periods of restmuscles often involved: muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing; sometimes muscles that control breathing and neck and limb movements are involved
MET 3-4
Occupational: bricklaying, plastering, wheelbarrow, machine assembly, trailer trunk in traffic, welding, cleaning windowsRecreational: walking (3mph), cycling (6mph), horseshoe pitching, volleyball, golf, archery, sailing, fly fishing, horseback, badminton, pushing light power mower, energetic musician
insula (location, description)
deep within lateral sulcus

associated with visceral functions
Thumb radial ABduction measurement
0 to 50º
Level I
no response; unresponsive to stimuli
L3 to L4
location: anterior kneemuscles facilitated: quadriceps, tibialis anterior, detrusor urinaefunction: hip flexion, extensors of knee, ABductors of thigh
revascularization surgery
surgical circumvention of an obstruction in a coronary artery using an anastomosing graft (saphenous vein, internal mammary graft)
left, or on the left side
totally dependent in self-care, but can instruct othersable to drink from glass with long straw
To increase ROM (PROM)...
contract/relax and hold/relaxsplinting: dynamic serialCAUTION: myositis ossifican can result from overstretching (especial elbow flexors)
CN 12- Motor/sensory fibers to/from tongue, movement of tongue- Ask person to stick out tongue, positional abnormalities are noted
Spinal segment C3
Dermatome: neck regionMuscle facilitation: sternocleidomastoid, upper trapFunction: head control
ACA stroke deficits
Contralateral hemiplegia and hemiparasthesia, cognitive involvement, apraxia,affective involvement
Ankle and foot eversion measurement
0 to 20º
Structural cerebellar lesions
etiology: includes vascular lesions (stroke) and tumor deposits, producing symptoms and signs appropriate to their locus within the cerebellumalcoholism and nutritional deprivation can cause degeneration of vermis and anterior cerebellum
Normal (N)
5part moves through complete ROM against ROM against gravity and full resistance
Constraint induced movement
* massed practice
* provide practce ( i.e. homework, circuit training)
* use contemporary motor learning principles
   - random and variable practice
   - help client develop problem solving skills
   - decrease cueing
Intermediate-level OTR/Ls can supervise who?
OT aidestechnicianscare extendersall levels of OTAsvolunteersOTR Level I and IIsEntry-level OTR/Ls
Palmaris longus (PL) (origin, insertion, function)
origin: medial epicondyle

insertion: palmar aponeurosis

function: flexion of wrist
Myositis ossificans
Pain, tenderness, focal swelling, and joint/muscle contractions occur.Tender mass, with or without cutaneous erythemaAssociated joint motion abnormalitiesIn Hereditary Form:Ossification progresses from proximal to distal and cranial to caudal.
Anterior Deltoid (origin, insertion, function)
origin: clavicle

insertion: deltoid tuberosity

function: shoulder flexion
C-P tx of ideational apraxia
step-by-step instructionhand-over-hand guidingopportunities for motor planning and motor execution
Tonic Labyrinthine-Supine Reflex
Onset: >37 weeks gestationIntegration: 6 monthsStimulus: place infant in supineResponse: increased extensor toneRelevance: facilitates total-body extensor tone
Spinal Segment CN V
Dermatome: anterior facial regionMuscle facilitated: masticationFunction: ingestion
Spinal segment C6
Dermatome: thumb and radial forearmMuscles facilitated: extensor carpi radialis, bicepsFunction: shoulder abduction, wrist extension
Which sensations return FIRST following a nerve injury?
Pain and temperature
In mental health, planning for discharge involves evaluating what?
Occupational performance
Thoracic and lumbar spine flexion measurement
0 to 80º
Decubitis ulcers (types)
Stage I: redness, edema, superficial epidermis and dermis involved(partial thickness ulcer)Stage II: redness, edema, blistering and hardening (induration) of tissue, skin is open and inflammation extends to the fat layer with superficial necrosis in advanced stage II lesions(partial thickness ulcer)Stage III: full thickness skin lesion extending down to the muscle, the ulcer margin is thickenedStage IV: ulcer extends down to the bone and includes bone destruction
1 MET (definition)
energy expenditure at rest, equivalent to approximately 3.5mL of oxygen/kg of body weight per min of activity
Cataracts (definition)
opacity, clouding of lens due to changes in lens proteins; results in gradual loss of vision (central first, then peripheral), problems with glare; general darkening of vision; loss of acuity, distortion
Left atrium (LA)
receives oxygenated blood from the lungs (from pulmonary veins); during systole, blood is sent to left ventricle
expiratory muscles used when quicker, fuller experation is desired or in disease
quadratus lumborumintercostalsrectus abdoministriangularis sterni
ABductor pollicis brevis (origin, insertion, function)
origin: scaphoid, trapezium, flexor retinaculum, and tendon of the ABductor pollicis longus

insertion: base of proximal phalanx, radial side of thumb

function: palmar ABduction
heat cramps
characterized by a normal body temp, nausea, diaphoresis, muscle twitching or spasms, weakness, and/or severe muscle cramps
Acute phase of SCI
first 1 to 2 weeks
To increase ROM (AROM)...
AROMax: wall walking, can exercisesCAUTION: myositis ossifican can result from overstretching (especial elbow flexors)
What shoulder ABductor muscles are innervated by the axillary nerve?
Middle deltoidPosterior deltoid
Spinal Segment T2 - T12
Dermatome: ThoraxMuscles facilitated: IntercostalsFunction: Respiration
Rancho Los Amigos Level VIII
Purposeful-Appropriate- Realize that he has a problem in his thinking/memory- Begin to compensate for his problems- Be more flexible and less rigid in his thinking- Be ready for driving/job training eval- Be able to learn new things at a slower rate- Still become overloaded with difficult, stressful situations- Show poor judgment in new situations, may require assistance- Need some guidance making decisions- Have thinking problems that may not be noticeable to others
Intervention strategies for memory loss
*use rehearsal strategies*"chunk" information*use memory aids*use "temporal tags"- focus on when event to be remembered occured
What is ataxia?
______ describes a lack of coordination while performing voluntary movements. It may appear as clumsiness, inaccuracy, or instability.
At what Ranchos level can an individual perform self care with minimal assist?
Level VI
What group format is most appropriate for eating and adjustment disorders?
Psychoeducation groups
Typical w/c dimensions
width: 24-26 rim to rimlength: 42-43"height from floor 36"height to seat 29-30"
Caudate vs. putamen loops
caudate loop (complex loop): functions in association with associative cortex in formation of motor plansputament loop (motor loop): functions in association with sensorimotor cortex to scale and adjust movements
Flexor digitorum superficialis (FDS) and profundus (FDP) are innervated by what 2 cervical levels?
cervical levels 7 and 8
Erhardt Developmental Vision Assessment (EDVA) AND Short Screening Form (EDVA-S)
(focus, method, scoring/interpretation, population)
- behavior rating scale
- determine visuomotor development
- assesses INVOLUNTARY visual patterns: eyelid reflexes,  pupillary reactions, doll's eye responses
-assesses VOLUNTARY patterns: fixation, localization, ocular pursuit, gaze shift
- response is scored for each eye
- birth to 6 mths
- short form can be used for older children
S2 (location, muscles, function)
location: narrow band of posterior thighmuscles facilitated: small muscles of foot (flexor digitorum, flexor hallucis)function: bladder retention
Class I Heart Disease
no limits on activityno complaintsmax MET 6.5
ethical distress (definition)
whena therapist knows the correct action to take but an existing barrier prevents the therapist from taking this course of action
Palmar interossei (origin, insertion, function)
1st palmar= ulnar surface of 2nd metacarpal.
2nd palmar= radial surface of 4th metacarpal.
3rd palmar= radial surface of 5th metacarpal.

1st palmar= ulnar surface of 2nd proximal phalanx.
2nd palmar= radial surface of 4th proximal phalanx.
3rd palmar=radial surface of 5th proximal phalanx.

function: ADduction and assistance with MCP flexion and extension of IP joints of digits II through V
Stage VI (exercise)
standing = continue exercises in stage IV progressively increasing repetitions and speed of repetitionsmay add additional exercises to increase workload up to 4.0 METambulation = as in stage V, increasing speed to 3.5 mph on level surfaces (per MD)stairs = as in stage IV and progressively increasing patient's tolerancetreadmill = 1.5 mph at 5 to 6% grade progressing to 3.5 mph at 0% grade (per MD)cycling: up to 10 mph without resistancemay use up to 10 to 15lb weight in UE and LE exercises in sitting
unilateral spatial neglect
inattention to, or neglect of, the extrapersonal space contralateral to the lesion
Teres Minor (origin, insertion, function)
origin: axillary border of scapula

insertion: greater tuberosity

function: external rotation
Maximum Assistance
The need for 75% assistance by one person to physically perform any part of a functional activity and/or cognitive assistance to perform gross motor actions in response to direction
Cranial Nerves XI and XII
Pure motor - innervating sternocleidomastoid, trapezius, and tongue
What is tardive dyskinesia?
Tardive dyskinesia is a neurological syndrome caused by the long-term use of neuroleptic drugs. Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking. Involuntary movements of the fingers may appear as though the individual is playing an invisible guitar or piano.
At what Ranchos level can a patient follow a schedule, but get confused by changes in the routine?
Level VI
What are the normal ROM limits of thoracic and lumbar spine flexion?
0-80 degrees
What are the normal ROM limits of lateral flexion of the spine?
0-40 degrees
What is ideational apraxia?
The disability of carrying out complex sequential motor acts. Caused by a disruption of the conception, rather than execution. (Loss of tool function knowledge)
What is somatognosia?
Lack of awareness of one's body parts.
What are supportive splints?
Supportive splints are static splints used to:- relieve pain- position and maintain join alignment- prevent adaptive shortening of soft tissues
What is Broca's Aphasia?
-Characterized by frontal lobe damage resulting in speech apraxia and agrammaticism -The individual has good auditory comprehension, but reading and writing are severely affected
Of Broca's and Wernicke's, which is expressive and which is receptive aphasia?
-Broca's: Expressive Aphasia-Wernicke's: Receptive Aphasia
Left hemisphere specialization (controls what?)
movement of R side of bodyprocessing of sensory information from R side of bodyvisual reception from R fieldvisual verbal processingbilateral auditory receptionspeechprocessing of verbal auditory information
Guillain-Barre Syndrome (etiology, onset of recovery, prevalence, prognosis, symptoms)
etiology: unknown (may occur after an infectious disorder, surgery, or an immunizations)onset of recovery: 2 to 4 weeks after symptomsprevalence: affects both sexes at any ageprognosis:50% exhibit mild neurological deficits15% exhibit residual functional deficits80% are ambulatory in 6 months5% die of complicationssymptoms:acute, rapid progressive form of polyneuropathy characterized by symmetric muscular weakness and mild distal sensory loss/paresthesiasweakness is always more apparent than sensory findings and is at first more prominent distallydeep tendon reflexes are lostsphinctors are sparedrespiratory failure and dysphagia (in some cases)
Denver Developmental Screening Test II
(focus, method, scoring/interpretation, population)
- STANDARDIZED task performance and observation SCREENING tool for early id of children at risk for developmental delay in PERSONAL-SOCIAL, FINE MOTOR ADAPTIVE, LANGUAGE, GROSS MOTOR SKILLS
- 125 test items, items below chronological age administered with sequential progression until child FAILS 3 TIMES
- allows for interpretation of child's performance being normal, abnormal, questionable, or unstable
- 1 month to 6 yrs
Principle 5: justice (definition)
Ot personnel shall comply with laws and Association policies guiding the profession of OT
Scleroderma sequelae and recommendations
1. poor circulation (as in Raynaud's phenomenon) - dressing in layers of clothing and clothing style modifications for neutral warmth - biofeedback: guided imagery to concentrate on improving distal circulation - education to encourage skin inspection - ax modifications to prevent trauma to finger and toes2. contractures - splinting @ optimal resting length - use of silicone gel in palms of hands - use of electrical/mechanical vibration (muffled) to stimulate rapidly adapting type A-nerve fibers and decrease burning sensation in hands3. Facial disfigurement and alteration in body image and self-identity - "look good/feel better" programs - work with people to help them choose adaptations and new accessories to ease their adjustment to their changing appearance - support groups4. Thoracic spinal lesions can result in paraparesis, neurogenic bowel/bladder, altered mobility, altered ADL - neuro rehab and biomechanical approaches to indicate5. space occupying lesions in brain procedure stroke-like symptoms - rehab for functional deficits
Knott and Voss' Proprioceptive Neuromuscular Stimulation (PNF) Approach
relies on quick stretching manual resistance of muscle activation of the limbs in functional directions, which are often spiral and diagonal in direction.
Typical Developmental Sequence of Toileting at 3 years
- Goes to bathroom independently; seats himself on the toilet- May need help with withing and fasteners/difficult clothing
Self-care abilities at SCI level C8-T1
Independent with self-care, performs depression transfers, can transfer from wheelchair to floor and back to chair with standby assist
Bathing abilities at SCI level C5
Requires mod to min assistance
What is anterior cord syndrome?
Often associated with a lesion causing variable loss of motor and sensation function. Proprioception preserved.
Intervention strategies for sequencing and organization deficits
*use external cues*grade tasks from simple to complex
What are the 4 stages of motor control
1. reciprocal inhibition/innervation:governed by reflexes2. Co-contraction: able to hold a position or object in space3. Heavy work: distal stability with proximal mobility3. Skill: proximal stability with distal mobility
Blood supply to brain
brain 2% of body weight18% of total blood volume
Tonic labyrinthine - prone reflex (onset age, integration, stimulus, response, relevance)
>37 weeks gestation to 6 monthsstimulus: place infant in proneresponse: increased flexor tonerelevance: facilitates total-body flexor tone
Visual motor and visual perceptual assessments
1. Beery VMI-5
2. DTVP-2
5. MVPT-3
8. TVPS3
Splint used for person with proximal weakness ( amyotrophic lateral sclerosis, gullian barre, ms with pts having 1 -3 /5 muscle grades?
Splint to use for pts with weak proximal muscles to utilize available trunk control and shoulders?
Used to su
1. overhead suspension sling
2. balanced forearm orthoses ( mobile arm supports or ball bearing forearm orthoses)
3. shoulder sling
Dorsal interossei (origin, insertion, function)
origin: all 4 arise from adjacent sides of the metacarpals

insertion: proximal phalanx ont he radial aspect of the index, radial and ulnar sides of the middle, and ulnar side of rign finger (all into extensor digitorum)

function: ABduction and assists with MCP flexion and extension of IP joints of digits II through V
What wrist extensors are innervated by the radial nerve?
Extensor carpi radialis brevis (ECRB)Extensor carpi radialis longus (ECRL)Extensor carpi ulnaris (ECU)
Terminal devices (function, types)
function to grasp and maintain hold on an object2 types: hook and hand
Development of Self-dressing skills at 2 years
- Removes unfastened coat- Removes shoes if laces are untied- Helps pull down pants- Finds armholes in pullover shirt
What are the brain behavioral characteristics of damage to the frontal lobe?
The frontal lobes order information and sort out stimuli. Damage to the frontal lobe affects:-Concentration and attention-Abstract thinking-Concept formation-Foresight-Problem solving-Broca's Aphasia
What is the function of the occipital lobe?
processes visual informationvisual reception, visual recognition of shapes and colors
What are the objectives of dynamics splints?
- prevent progressive deforming changes as a result of muscle imbalance- substitute for or assist lost or weakened muscles- increase ROM- minimize formation of adhesions
backward parachute reflex (onset age, integration, stimulus, response, relevance)
9 to 10 months -- persistsstimulus: quickly but firmly tip infant off-balance backwardresponse: backward arm extension or arm extension to one siderelevance: protects body to prevent a fall; unilaterally facilitates spinal rotation
3 to 4 MET (occupational activities; recreational activities)
occupational: brick laying, plastering wheelbarrow (220lb or 100kg load) machine assembly trailer-truck in traffic welding (moderate load) cleaning windowsrecreational: walking (5km or 3mi/hr) cycling (10km or 6mi/hr) horseshoe pitching volleyball (6 person noncompetitive) golf (pulling bag cart) archery sailing (handling small boat) fly fishing (standing in waders) horseback (sitting to trot) badminton (social doubles) pushing light power mower energetic musician
What are testing procedures for oral motor when testing CN?
2 visual field test
3 visual tracking/ pupillary reflex test
4 visual tracking - CN 3
5 pain/touch temp/ corneal reflex with cotton ball/ mvt of jaw
6 move eye laterally
7 sweet/salty/sour tastses
8 tuning fork
9 gag /swallow reflexes
10 Cn 9
11 sternocleoidmastoid and trap muscle testing
12 ask pt to stick out tounge
Early attention to wound management (diabetes)
1. teach skin care and inspection techniques2. teach person to self advocate quickly when changes are observed
Self-care abilities at SCI level C4
Totally dependent in self-care but can instruct others in preferences for care. Can drink from a glass with a long straw.
What food consistency is most difficult to swallow?
Foods that have liquid and solid consistencies are hardest to chew and swallow.
Test of Visual Motor Skills (TVMS) and Test of Visual Motor Skills Upper Level (TVMS- UL)
(focus, method, scoring/interpretation, population)
- assesses EYE HAND COORDINATION skills for copying geometric designs
- includes motor accuracy, motor control, motor coordination, and psychomotor speed
- TVMS: 2-13 yrs
- TVMS-UL: 12-45 yrs
Primary difference between Parts A and B
- The frequency in which the individual relieves services, - Part A coverage requires services for a minimum of 5 days per week, Part B covers 3 day per week outpatient
What is the focus of the Rivrmead Inattention Test>
Activity based looking at how unilateral neglect impacts function
6 to 7 MET (occupational activities; recreational activities)
occupational: shoveling 10 mi (22lb or 10kg)recreational: walking (8km or 5mi/hr) cycling (17.5km or 11mi/hr) badminton (competitive) tennis (singles) splitting wood snow shoveling manual lawn mowing folk (square) dancing light downhill skiing ski touring (4km or 2.5mi/hr). loose snow water skiing
Development of self-feeding at 15-18 months
- Scoops food with spoon and brings it to mouth- Shoulder and wrist stability demonstrate precise movements- Experiments to learn rules of how object works and solves problems- Internalizes standards imposed by others for how to play with objects
What is a bunny hop pattern?
A bunny hop pattern is a result of symmetric tonic neck reflex utilization in order to elicit movement at the hips and elbows for mobility.
What is the best way to obtain detailed information about an individual's job requirements?
By examing a job analysis. A job analysis is a detailed description of the physical, sensory, and psych demands of a job.
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