NBCOT review
Terms
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How many pairs of spinal nerves?
How many of each? -
31
- How many of each type of spinal nerves
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- 8 cervical
- 12 thoracic
- 5 Lumbar
- 1 coccygeal - dorsal root
- afferent or sensory
- ventral root
- efferent or motor
- Dermatome distribution is
- a section of skin that is supplied by the sensory compnenet
- Damage to the peripheral nerve may result in_______
- motor or sensory impairment or a combination of both
- Injuries to the sentral nervous system may result in -----------------------
- wide variations on the distribution and types of sensory loss
- Anesthesia
- a complete loss of sensation
- Paresthesia
- a sensation that is typically described as pins and needles, tingling or an electric shock
- hyperalgesia
- increased pain sensation
- allodynia
- a painful response to a nontissue damaging stimulus that would not be expected to evoke pain
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Spinal cord injury function:
C1-C3 - talking, chewing, sipping, blowing
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Spinal cord injury function:
C4 - shoulder shrug, respiration
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Spinal cord injury function:
C5 - head and neck control, elbow flexion, palmar supination
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Spinal cord injury function:
C6 - palmar pronation, wrist extension, tenodesis grasp
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Spinal cord injury function:
C7 - elbow extension, wrist flexion, finger extension
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Spinal cord injury function:
C8- T1 - full upper extremity use
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Spinal cord injury function:
T2- T6 - increased trunk control and respiration
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Spinal cord injury function:
T9- T12 - increased abdominal function and endurance
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Spinal cord injury function:
L2- L4 - hip flexion, hip adduction, knee extension
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Spinal cord injury function:
L4- L5 - strong hip and knee flexion
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Spinal cord injury function:
S1- S5 - varying degrees of bladder, bowel and sexual function
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Degree of ROM
shoulder flex - 0-180
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Degree of ROM
shoulder ext - 0-60
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Degree of ROM
ahoulder abd. - 0-180
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Degree of ROM
shoulder horitzontal abd - 0-90
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Degree of ROM
shoulder horizontal adduction - 0-45
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Degree of ROM
shoulder internal roatation - 0-70
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Degree of ROM
shoulder external roation - 0-90
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Degree of ROM
elbow flx/ext - 0-150
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Degree of ROM
supination - 0-90
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Degree of ROM
pronation - 0-90
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Degree of ROM
wrist ext - 0-70
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Degree of ROM
wrist flex - 0-80
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Degree of ROM
ulnar deviation - 0-30
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Degree of ROM
radial deviation - 0- 20
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Degree of ROM
Thumb MP Flex/Ext - 0-50
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Degree of ROM
Thumb IP Flex/Ext - 0-80
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Degree of ROM
Thumb Abd. - 0-70
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Degree of ROM
Finger MP Flex/Ext - 0-90
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Degree of ROM
MP Hyperext. - 0-45
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Degree of ROM
PIP Flex/Ext - 0-110
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Degree of ROM
Finger DIP Flex./Ext. - 0-90
- MMT is contraindicated when__________________________
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- inflammation or pain prevents movements
- dislocation or unhealed fx
- sublux of join
- cardiac Pt
- RA - Dexterity Hand function tests
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- 9 hole peg test
- Box and Block
- Purdue Pegboard
- Minnesota Rate of manipulation
- Jebsen Test of Hanf Function
- TEMPA - Dysmetria
- is the undershooting (hypometria) or overshooting (hypermetria) of a target
- Dyssynergia
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is a breakdown in movement resulting in joints being moved separately to reach a desired target as opposed to moving in a smooth trajectory; decomposition of movement
- Dysdiadochokinesia
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is impaired ability to perform rapid alternating movements.
- Ataxia
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is loss of motor control including tremors, dysdiadochokinesia, dyssnergia, and visual nystagmus
- Bradykinesia
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is an overall slowing of movement patterns
- Akinesia
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is the inability to initiate movements
- Athetosis
- is a dyskinetic condition that includes inadequate timing, force, and accuracy of movements in the trunk/limbs; movements are writhing and worn-like.
- Dystonia
- is an involuntary sustained distorted movement or posture involving contraction groups of muscles
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Chorea
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consists of involuntary movements of the face and extremities which are spasmodic and short duration
- Hemiballisums
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is unilateral chorea characterized by violent, forceful movements of the proximal muscles
- Asterognosis
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- the inability to recognize objects, shapes, forms, and size by touch alone
- A failure of tactile recognition although sensory testing (tactile and proprioceptive) is intact
- Ideation Apraxia
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- A breakdown in the knowledge of what is to be done or how to perform
- A lack of knowledge regarding object use
- The neuronal model about the concept of how to perform is lost although the sensorimotor system is in tact.
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Motor Apraxia/ideomotor apraxia
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Loss of access to kinesthetic memory so that purposeful movement cannot be achieved because of ineffective motor planning although sensation, movement, and coordination are intact
- Asomatoagnosia
- is a body schema disorder that results in diminished awareness of body structure, and failure to recognize body parts as one's own
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Anosognosia
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- An unawareness of motor deficit
- May be related to a lack of insight regarding disabilities
- Anomia
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is the loss of ability to name object or retrieve names of people
- ________ distribution occur when clients sustain TBI
- CNS
- OT treatment for low vision includes
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- environmental adaptation
- compensatory techniques
- Assistive devices
- client/family education - Glaucoma leads to loss of?
- peripheral vision or tunnel vision
- Cataracts leads to loss of?
- visual acuity
- Diabetic retinopathy leads to loss of?
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- decreased contrast sensitivity and color discrimination
- decreased night vision
- fluctuation in vision - Age-related macular degeneration (ARMD) leads to?
- central vision
- Myopia
- nearsightedness
- hyperopia
- farsightedness
- Presbyopia in people who______?
- need a bifocal
- what is figure grounding?
- ability to recognize the foreground from the background based on differences in color, luminance, depth, texture or motion
- Higher level cognition includes
- decision making, planning, sequencing, executing
- Ecology of human performance model (Dunn)
- In this model the interaction between the person and the environment affects his or her behavior and performance, and human performance can only be understood through context, which operated on the person external
- Person-Environment Occupation Model of human performance
- This model emphasizes the interdependence of persons and their environments and the changing nature of Occupational role over time
- (WHO) International Classification of functioning, Disability and health (ICF)
- Personal factors are internal influences on functioning like age, gender, etc. Environmental factors are external influences on functioning that include features of the physical, social, and attitudinal world.
- Occupational Performance history interview II (OPHI)
- Assesses occupational adaptation over time (adolescence to adulthood), with a focus on critical life events, daily routines, and occupational behavior roles and settings
- Canadian Occupational Performance Measure (COMP)
- A client centered tool for persons aged 7 years and older that evaluates clients perceptions of their occupational performance over time
- Barthel Index
- assessment of patient's ADL status
- Ischemia
- Loss of blood flow through a vessel resulting in an insufficient supply of blood and oxygen to surrounding tissues, as when a blood clot block a cerebral artery.
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CVA effects
Left Hemisphere -
- Receptive and expressive language
- difficulty with reading and writing and arithmetics
- difficulties in learning new info
- Apraxia left/ right confusion
- Behavior: slow, cautions, easily frustrated, decreased motivation -
CVA effects
Right Hemisphere
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- visual-spatial and perception
- left side neglect
- swallowing deficits, slurred speech
- difficulty with abstract thinking
- short attention span
- Behaviors: impulsivity, denial, inappropriate comments, excessive talking -
CVA Effects
Cerebellar -
- coordination and balance
- eye movement deficits: nystagmus, ocular dysmetria, poor pursuit
- abnormal head and torso reflexes
- dysarthric and monotonous speech
- ataxic movements
- dizziness, nausea, vomiting, headache - C5 deficits and adaptive equipment needed
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- complete tetrapalegia need away to grasp and gold objects since their wrist must be stabilized with a splint
- universal cuff - what type of activities can a patient with a C5 SCI perform?
- table top
- Patients with C5 spinal cord injury are mostly dependent in what ADL's
- dressing and bathing
- In C6 the addition of ________ allow patient to _______ ?
- radial wrist extensors allow the Pt to close their fingers with a tenodesis grasp
- Pt's with C6 SCI can ___________ needed for bed mobiltiy
- roll in bed
- What is key in C7
- - the ability to use triceps
- Pt's with a C7 SCI can do what with a wheel chair?
- manually push
- In Pt's with C8 SCI ________ is significantly improved with the addition of _________ and ________
- Hand function is significantly improved with the addiction of extrinsic finger muscles and thumb flexors
- Intention is what? and is most commonly seen in what patients?
- Occurs during motor performance and is most commonly seen in MS patients
- Three signs of Parkinson's (PD)
- tremor, rigidity and bradykinesia
- What type of tremor is common with PD
- resting- pill rolling
- What three things are NOT affected in ALS
- sensory, cognition, and vision
- Ulnar drift of the MCP joints is common in?
- RA
- Boutonniere deformity is what?
- PIP flex. with DIP hyperext.
- Swan-neck deformity is what?
- PIP hyperext. and DIP flex.
- The key intervention in Pt's with OA is?
- Pt education conerning unloading and protecting involved joints and strenthening muscles around the joint
- what activities should be avoided with arthritis Pt's?
- resistive activities
- Anti-deformity, intrinsic-plus position
- position of the digital MP flexion and IP ext. that maintains the length of the collateral ligaments and volvar plate
- Carpal tunnel syndrome
- Nerve entrapment of the median nerve at the wrist
- Claw deformity
- Position of MP hyperextension and PIP flexion associated with muscle imbalance in ulanr-innervated structures
- Cubital tunnel
- Nerve entrapment involving compression of the Ulnar nerve at the elbow between the medial epicondyle and olecranon
- de Quarvains disease
- Tenosynovitis involving the abd. pollicis longus and EPB tendons at the first dorsal compartment
- Lateral Epicondylitis involves _____________ at their origin and specifically _________ is most commonly involved
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- extrinsic extensors
- Carpi radialis brevis - Medial Epicondylitis involves ________ at their origin. The ____ is most commonly involved
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- extrinsic flexors
- FCR - What test shows a positive sign for De Quervains?
- Finkelsteins
- Cryotherapy
- Application of superficial cold agent
- Boutinerre deformity is a ______ slip
- central
- Swan neck deformity is a _______ slip
- lateral slip
- a ramp should be __ feet for every __ of rise
- 1 foot for every inch of rise
- ANSI guidelines for counter height
- 31 inches
- Radial nerve palsy causes?
- wrist drop
- what is preserved in an anterior spinal artery injury?
- proprioception
- Froments test for _______ palsy specifically of the _____
- Ulnar nerve palsy specifically the abductor pollicis