NBCOT Study Cards Flashcards

Primitive reflexes
Terms Definitions
C7
triceps
narc/o
stupor
xanth/o
yellow
ather/o
fat
audi/o
hearing
acous/o
hearing
fibr/o
fiber
dips/o
thirst
xer/o
dry
-penia
abnormal reduction
bronch/o
bronchus (airway)
Running 10mph
17 MET
phag/o
eat or swallow
fasci/o
fascia (a band)
alexia
inability to read
Level VII
Automatic-appropriate: response robot-like, judgment and problem solving lackingcommunity reentry activities
angioplasty


under fluoroscopy, surgical dilation of a blood vessel using a small balloon-tipped catheter inflated inside the lumen
phob/o
exaggerated fear or sensitivity
Developmental Levels of Grasping(External Link)
http://www.flashcardexchange.com/flashcards/view/362966
Knee flexion measurement
0 to 145º
Cranial nerve 6


abducens

purely motor

turns eye laterally
C6
wrist controlno hand functionwrist extenders
speech impairment?
 
swallowing impairment?
 
examples to use for airway protection?
1. dysarthria
 
2. dysphagia
 
3. gag reflex (expels bolus), volitional/spontanous cough ( clear pharynx of matter) , vocal fold adduction ( close airway to prevent food from entering larynx), reflexive inhibition of respiration ( prevents inhaled food entering airway)
C7 Feeding
ITRICEPS CONTROLDEXTERITY PROBLEMS WITH HANDS AND FINGERS
Rancho Los Amigos Cognitive Scale(External Link)
http://www.flashcardexchange.com/flashcards/view/362940
Hip external rotation measurement
0 to 45º
Cranial nerve 7


facial

mixed sensory and motor

controls most facial expressions
secretion of tears & saliva
taste
Central cord
resulting from hyperextension injuries and presenting as more UE deficits vs. LE
intravascular stent


an endoprosthesis (pliable wire mesh) implanted postangioplasty to prevent restenosis and occlusion in coronary or peripheral arteries
If an OTA demonstrates service competency, do they become independent and no longer require supervision by an OTR/L?
No
ACL 4
"goal directed actions"testing: able to imitate whip stitch, 3 stitchesability to carry out simple tasks through completionrelies heavily on visual cuesmay be able to perform established routines but cannot cope with unexpected events
anosognosia
unawareness of motor deficitmay be related to lack of insight
Infraspinatus (origin, insertion, function)


origin: infraspinatus fossa

insertion: greater tuberosity

function: external rotation
Landau Reflex
Onset: 3-4 monthsIntegration: 12-24 monthsStimulus: hold infant in horizontal prone suspensionResponse: complete extension of head, trunk, and extremitiesRelevance: breaks up flexor dominance, facilitates prone extension
Galant Reflex
Onset: 32 weeks gestationIntegration: 2 monthsStimulus: hold infant in prone suspension, gently scratch or tap alongside the spine with finger, from shoulders to buttocksResponse: lateral trunk flexion and wrinkling of the skin on the stimulated sideRelevance: facilitates lateral trunk movements necessary for trunk stabilization
Suck-swallow Reflex
Onset: 28 weeks gestationIntegration: 2-5 monthsStimulus: place examiners index finger inside infant's mouth with head in midlineResponse: strong, rhythmical suckingRelevance: allows ingestion of nourishment
Project Groups
Consist of common, short-term activities requiring some interaction and cooperation
Precautions for thermal agents
EdemaDiminished sensationCompromised circulationuse of anti-coagulations
Forearm radial deviation (ABduction) measurement



0 to 20º
Cranial nerve 5


trigeminal

mixed motor and sensory

chewing, face and mouth, touch and pain
C7 (location, muscles, function)
location: middle fingermuscles facilitated: triceps, extensors of wrist and fingersfunction: wrist flexion, finger extension
Blood Flow pattern


systemic circulation to RA
from RA to RV
from RV to lungs for oxygenation

LA receives oxygenated blood from lungs
from LA to LV

LV pumps blood to body via aorta
optimal respiration
occurs when ventilation and perfusion (blood flow to lungs) are matched
normal heart rate for an infant
120 bpm
T9 to T12
aka Lower Thoracic InjuryTRUNK CONTROLGOOD SITTING BALANCE
What shoulder flexion muscles are innervated by the axillary nerve?
Anterior deltoid
Cognitive Disabilities Model
** dx: psychosocial dysfx, neurological impairments, dementia **cognition perceived to be on a continuum: 1 = profoundly impaired 6 = normalafter functional level is established: practice routine tasks that CAN be performed or ADAPTED tasks so they can be performedfocus: adaptive approaches strengthening residual abilities
Sideward Parachute (protective extension sideward) Reflex
Onset: 7 monthsIntegration: persistsStimulus: quickly but firmly tip infant off balance to the side while in seated positionResponse: arm extension and abduction to the sideRelevance: protects body to prevent a fall; supports body for unilateral use of opposite arm
Palmar Grasp Reflex
Onset: 37 weeks gestationIntegration: 4-6 monthsStimulus: place examiners finger in infants palmResponse: finger flexion, reflexive graspRelevance: increases tactile input on the palm of the hand
Spinal Accessory
CN 11- Sensory/motor fibers for sternocleidomastoid, traps, muscles of soft palate, pharynx, and larynx; movement of neck and shoulders- Sterno and trap muscle testing
Abducens
CN 6- Motor and proprioceptor fibers to/from lateral rectus muscles, lateral eye movements- Tested in conjunction with cranial 3 relative to moving eye laterally
What muscles does T1 innervate?
T1: Hand intrinsics
Thoracic and lumbar spine lateral flexion measurement


0 to 40º
myoclonus
a brief and rapid contraction of a muscle or group of muscles
C8 (location, muscles, function)
location: little finger, ulnar forearmmuscles facilitated: flexor of wrist and fingersfunction: C8 finger flexion
Poor plus (P+)
2+part moves through incomplete ROM (less than 50%) against gravity ORpart moves through complete ROM with gravity decreased against slight resistance
hetertropic heart transplant


involves leaving natural heart and piggy-backing donor heart
reprimand (definition)
a formal expression of disapproval of conduct communicated privately and retained in the individual's certification file
Extensor carpi ulnaris (ECU) (origin, insertion, function)


origin: lateral epicondyle

insertion: 5th MCP

function: extension of wrist and ulnar deviation
C7 Dressing
I, but may need button hookTRICEPS CONTROLDEXTERITY PROBLEMS WITH HANDS AND FINGERS
Early Neurologic Recovery components
resolution of cerebral edemathe absorption of damaged tissueimprovement on local circulation
Subscapularis (origin, insertion, function)


origin: anterior surface of scapula

insertion: lesser tuberosity

function: internal rotation
C-P tx of decreased alertness/arousal
increased environmental stimuligross motor activitiesincreased sensory stimuli
Advanced level OT
- Refining specializing skills with ability to understand complex issues affecting role functions- Supervision not required, min supervision by another advanced OT recommended- Supervises everyone
Egocentric cooperative groups
Require joint interaction on a long-term tasks; however completion of the task is not the focus. The members are beginning to express their needs and address those of others
Spinal Segment T1
Dermatome: axilla and proximal medial armMuscles facilitated: hand intrinsicsFunction: abduction and adduction of fingers
What is medial epicondylitis?
-AKA Golfer's Elbow-Caused by forceful and repeated flexion of the wrist and fingers
What is spinal shock?
Transient physiological reaction to depression of the cord below the SCI level. Associated loss of sensorimotor function and flaccid paralysis. Flaccid paralysis symptoms last several days.
What characterizes severe spastic CP?
Characterized by:-Severe increased tone-Flexion and extension cocontraction-High tone always-More proximal than distal
What are orthosis?
Orthosis are permanent devices that replace or substitude for loss of muscle function
At what Ranchos level are patients aware of the month and year?
Level VI
lateral central fissure (Sylvian fissure)


separates temporal lobe from frontal and parietal lobes
C7 to T1
can straighten arms but may have dexterity problems with hands and fingersC7: tricepsC8: hand dexterity
Progressive Supranuclear Palsy (etiology, onset, prevalence, prognosis)
etiology: manifested by loss of voluntary, bu preservation of reflexive eye movements, bardykinesia, rigidity, axial dystonia, pseudobulbar palsy, and dementiaonset: later middle lifeprevalence: affects 6.5/100,000prognosis: death occurs approximately 15 years after onset
Cranial Nerve V (location, muscles, function)
location: anterior facial regionmuscles facilitated: masticationfunction: ingestion
Zero (0)
0no muscle contraction can be seen or felt
Who may supervise OTR Level Is?
entry-level OTR/Ls and OTAs
What extrinsic flexors are innervated by the ulnar nerve?
Flexor digitorum profundus (FDP)
normal respiratory rate for an adult
12 to 18 breaths/min
Symptoms of facial paralysis
incomplete closure of mouthloss of bolus out of front of oral cavity
Contemporary Task-orient approach
based on systems model of motor control and contemporary motor learning theories. The application in rehabilitation emphasizes that effective therapeutic intervention depends on identification of the system that is critical to controlling the occupational performance at a specific time.
Rancho Los Amigos Level VII
Automatic-Appropriate - Follow set schedule- ADL routine with help- Have problems planning, starting, and following through with activities- Have trouble paying attention in distracting or stressful situations- Not realist how his thinking and memory problems may affect future plans and goals- Continue to need supervision due to decreased safety awareness and judgment- Think slower in stressful situations- Be inflexible, stubborn, or rigid- Be able to talk about doing something, but will have problems actually doing it
Muscle grade 5
Normal - part moves through complete ROM against gravity and full resistance
Tonic Labyrinthine - Prone Reflex
Onset: >37 weeks gestationIntegration: 6 monthsStimulus: place infant in proneResponse: increased flexor toneRelevance: facilitates total-body flexor tone
What is lateral epicondylitis?
-AKA Tennis Elbow-Insertion point of the extensor carpi radialis brevis becomes inflammed-If left untreated, can tear requiring surgical repair
What are the normal ROM limits of cervical rotation?
0-60 degrees
What are protective splints?
Protective splints are static splints used to:- immobilize a joint or limb following trauma are fracture and some post-surgical conditions
Describe the RAPS assessment: components and population appropriate for using
Evaluates performance in: work, education, household tasks, relationships, leisure, hygiene, and ADL performance.Appropriate for treatment planning with adult psychiatric population
Intervention strategies for spatial relations deficits
*use activities that challenge underlying spatial skills (up/down, front/back, over/under)*utilize tasks that require discrimination for right/left
When should sensory testing be avoided?
-Receptive aphasia-Atrophic (aptropy) skin
Cauda equina syndrome
injury at the L1 level and below resulting in a lower motor neuron lesion; flaccid paralysis with no spinal reflex activity
Motor Free Visual Perception Test (MVPT-3)
 
(focus, method, scoring/interpretation, population)
- STANDARDIZED, quick eval
 
- assesses visual perception: spatial relationships, visual discrimination, figure-ground, visual closure, and visual memory
 
- items 1-40 for ages 4-10
- items 14-65 for ages 10 and older
 
- children and adults 4-95 yrs old
Close supervision (definition)
daily, direct contact at the site of work
Extensor carpi radialis longus (ECRL) (origin, insertion, function)


origin: supracondylar ridge of humerus

insertion: 2nd MCP base

function: extension of wrist and radial deviation
C5 Grooming
A with setupcan be I in brushing teeth and hair with splint with universal cuffI with electric shaver that fits around handAble to use shoulders and bicepsNO WRIST OR HAND CONTROL
LE treatment for disarticulations
wrapping to shape residual limb and decrease swellingdesensitizationstrengthening (UE) with the focus on tricepstransfer training, stand pivotADL training (LE dressing is most difficult)standing tolerancew/c mobility
Muscle grade 4
Good - part moves through complete ROM against gravity and moderate resistance
What is visual agnosia?
Lack of ability to recognize common objects and demonstrate their use in an activity.
What is the focus of the Rivermead Behavioral Memory test?
Alterations with memory
What is olecranon bursitis?
-When the olecrenon bursa of the elbow becomes inflammed due to contact pressure or overuse
What are the methods used to treat hyposensitivity?
-Sensory retraining-Compensation (Such as testing hot water with the other hand, padding objects)
What is De Quervain's Syndrome?
-Tendonitis of the first dorsal compartment near the anatomical snuffbox-Caused by overuse of the thumb-Tested with finklestein's
Downward parachute reflex (onset age, integration, stimulus, response, relevance)
4 months -- persistsstimulus: rapidly lower infant toward supporting surface while suspended verticallyresponse: extension of LErelevance: allows accurate placement of LE in anticipation of a surface
spina bifida with myelomeningocele
protrusion of a sac through the spine, containing cerebral spinal fluid and meninges as well as the spinal cord or nerve roots
Hawaii Early Learning Profile, Revised (HELP)
 
 
(focus, method, scoring/interpretation, population)
- NON STANDARDIZED SCALE of developmenatal levels
 
- assesses 6 areas: cognitive, language, GM, FM, social-emotional, self-help
 
- administered in child's natural environment, in context of family and during typical routines
 
- warm up with structured play and snack time is recommended
 
- dev age range levels can be APPROX. in each of the 6 areas
 
- dev structuring of skills is provided in the form of a sequence; therefore, skills needed as a foundation of more advanced skills are provided
 
- birth - 3yrs with dev delay, disabilities, or at risk
- another form for 3-6 yrs with and without delay
 
what are pecific techniques directed at agonist and reversal of antagonist
* Repeated contractions: increase ROM and endurance
* Rhythmic initiation: improves mvt initation
 
* Slow reversal: gains ROM
* Rhythmic stabilization: promotes stability
 
Stage VI (ADL and mobility, recreation)
ADL and mobility:standing = showering in hot water, hanging and/or wringing clothes, mopping, stripping and making beds, rakingrecreation:swimming (no advanced strokes)slow dancing ice or roller skating (slowly)volleyballbadmintontable tennis (noncompetitive)light calisthenics
Therapy strategies during flaccid phase
- proper positioning- support of the arm within a wheelchair throughout sitting- PROM to all affected joints at least x1/day* traction should be avoided when moving patient in and out of bed *
Rancho Los Amigos Level III
Localized Response- Be awake on and off during day- Make more movements- React more specifically to what he sees, hears or feels- React slowly and inconsistently- Begin to recognize friends/family- Follow some simple directions - "look at me"- Begin to respond inconsistently to simple questions with yes or no head nods
Typical Developmental Sequence of Toileting at 1 year
- Indicates discomfort when wet or soiled- Has regular bowel movements
What is trigger finger?
-Caused by a nodule or thickening of the flexor tendons of the finger or thumb as they pass through the digital pulleys-Hinders gliding motion, resulting in catching or "triggering" during flx/ext
What is functional skill training?
Focuses on mastery of a specific task. Requires client to repeatedly practice the substeps of a task with the # of cues for each task gradually faded out.
What is the Allen Cognitive Level Number 2?
"postural reactions" Testing: unable to imitate running stitch movement is associated with comfort some
awareness of large objects in environment may assist caregiver with simple tasks
Parkinson's Progression - Hoehn & Yarh's Stage V
confined to a wheelchair or bed, maximally assisted
Revised Knox Preschool Play Scale (RKPPS)
 
(focus, method, scoring/interpretation, population)
- observations of play skills to differentiate developmental play abilities, strengths, and weakness, and interest areas
 
- administered in natural indoor and outdoor env with peers
 
- 2, 30 min periods of observation
 
- 4 dimensions assessed: space management, material management, pretense/symbolic play, and participation
 
- 0-6 yrs
- useful for children whom standardized testing may not be appropriate
Who may supervise OTA Level IIs?
OTAs with 1 year of practice experience
symptoms of clinical aspiration
food enters airway: 1. person can clear airway by coughing (reflex intact) 2. person silently aspirates - bolus enters lung and person does not react - bolus enters lung and person experiences respiratory distress - person coughs too weakly to raise bolus in order to expel it
Cranial Nerves I, II, VIII
Pure sensory - carry special senses of smell, vision, hearing, and equilibrium
What functionality does a person with C1-C3 SCI have?
-Individuals required to use a respirator-Individuals might have limited head and neck movement-Able to use "sip and puff" wheelchair-Completely dependendent in ADLs and transfers
Asymmetric tonic neck relfex (ATNR) (onset age, integration, stimulus, response, relevance)
37 weeks gestation to 4 to 6 monthsstimulus: fully rotate infant's head and hold for 5 secondsresponse: extension of extremities on the face side, flexion of extremities on skull siderelevance: promotes visual hand regard
symptoms of weakness of tongue/base of tongue structures
inefficient propulsion of bolus at an efficient rate of speed past the base of tongue to pharyngeal cavitylack of closure @ cricopharyngeal junction: 1. sub-optimal propulsion of bolus 2. interference with normal timing of swallow sequence 3. failure to trigger closure of vocal folds during swallow (aspiration)
What is Ranchos Los Amigos Cognitive Scale Level I?
NO RESPONSEPerson does not respond to sounds, sights, touch or movement.
neck righting reflex (NOB) (onset age, integration, stimulus, response, relevance)
4 to 6 months -- 5 yearsstimulus: place infant in supine and fully turn head to one sideresponse: log rolling of entire body to maintain alignment with the headrelevance: maintains head/body alignment; initiates rolling (first ambulation effort)
Play/leisure skills at SCI level C8-T1
Can do the same as C7 but performance is easier due to good functional use of both upper extremities
What is a FIM level of "Supervision or setup," or level 5?
The person only needs someone to standby and cue or coax him/her (without physical contact) so that he/she can do a task.
2 to 3 MET (occupational activities; recreational activities)
occupational: auto repair radio, TV repair janitorial work typing, manual bartendingrecreational: level walking (3.25km or 2mi/hr) level bicycling (8km or 5mi/hr) riding lawn mower billiards, bowling skeet, shuffleboard woodworking (light) powerboat driving golf (power cart) canoeing (4km or 2.5mi/hr) horseback riding (walk) playing piano and many musical instruments
At what Ranchos Los Amigos level do individuals begin to begin to remember events before the accident better than their daily routine?
Level V. At this level, patients also confabulate in order to fill in gaps in memory
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