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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
- 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
Spinal cord injury function:

C1-C3

talking, chewing, sipping, blowing
Spinal cord injury function:

C4

shoulder shrug, respiration
Spinal cord injury function:

C5

head and neck control, elbow flexion, palmar supination
Spinal cord injury function:

C6

palmar pronation, wrist extension, tenodesis grasp
Spinal cord injury function:

C7

elbow extension, wrist flexion, finger extension
Spinal cord injury function:

C8- T1

full upper extremity use
Spinal cord injury function:

T2- T6

increased trunk control and respiration
Spinal cord injury function:

T9- T12

increased abdominal function and endurance
Spinal cord injury function:

L2- L4

hip flexion, hip adduction, knee extension
Spinal cord injury function:

L4- L5

strong hip and knee flexion
Spinal cord injury function:

S1- S5

varying degrees of bladder, bowel and sexual function
Degree of ROM

shoulder flex

0-180
Degree of ROM
shoulder ext
0-60
Degree of ROM
ahoulder abd.
0-180
Degree of ROM

shoulder horitzontal abd

0-90
Degree of ROM

shoulder horizontal adduction

0-45
Degree of ROM

shoulder internal roatation

0-70
Degree of ROM

shoulder external roation

0-90
Degree of ROM

elbow flx/ext

0-150
Degree of ROM
supination
0-90
Degree of ROM
pronation
0-90
Degree of ROM

wrist ext

0-70
Degree of ROM

wrist flex

0-80
Degree of ROM

ulnar deviation

0-30
Degree of ROM

radial deviation

0- 20
Degree of ROM

Thumb MP Flex/Ext

0-50
Degree of ROM

Thumb IP Flex/Ext

0-80
Degree of ROM

Thumb Abd.

0-70
Degree of ROM

Finger MP Flex/Ext

0-90
Degree of ROM

MP Hyperext.

0-45
Degree of ROM

PIP Flex/Ext

0-110
Degree of ROM

Finger DIP Flex./Ext.

0-90
MMT is contraindicated when__________________________
- inflammation or pain prevents movements
- dislocation or unhealed fx
- sublux of join
- cardiac Pt
- RA



Dexterity Hand function tests
- 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
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

is impaired ability to perform rapid alternating movements.


Ataxia
is loss of motor control including tremors, dysdiadochokinesia, dyssnergia, and visual nystagmus

Bradykinesia
is an overall slowing of movement patterns

Akinesia
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
Chorea

consists of involuntary movements of the face and extremities which are spasmodic and short duration

Hemiballisums
is unilateral chorea characterized by violent, forceful movements of the proximal muscles

Asterognosis

- 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
- 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.



Motor Apraxia/ideomotor apraxia

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
Anosognosia

- An unawareness of motor deficit
- May be related to a lack of insight regarding disabilities


Anomia
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
- 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?
- 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.
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





- 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
- 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
- extrinsic extensors

- Carpi radialis brevis

Medial Epicondylitis involves ________ at their origin. The ____ is most commonly involved
- 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

Deck Info

115

Sara Friedel

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