Nbcot Exam

Front 1

What are the 3 aspects of service delivery in the OT process?

Back 1

Evaluation, intervention, and outcomes

Front 2

What is a screening?

Back 2

Measures broad performance areas, Acquisition of information to determine need for in-depth eval and to obtain basic understanding of individual's needs, limitations, assets, and resources.

Front 3

What is an evaluation?

Back 3

Comprehensive process of obtaining and interpreting data to understand individual, system, or situation.

Front 4

What are the aspects of educational performance for OT?

Back 4

Academic, mobility, psychosocial, behavioral, and self care

Front 5

What is a standardized assessment?

Back 5

One that is uniform and well-established; always the same in content, administration, and scoring; contains description of purpose, administration and scoring protocol, and established norms and validity

Front 6

What are the types of normative data?

Back 6

Age, gender, or diagnostic groupings

Front 7

What are norms?

Back 7

used for comparative analysis of an individual's score; individual's characteristics must match characteristics of population used to establish norms.

Front 8

What is validity?

Back 8

measures the assessment's accuracy to determine if the tool measures what it's supposed to

Front 9

What is face validity?

Back 9

how well the assessment appears to meet its intended purpose

Front 10

What is content validity?

Back 10

the content included in the eval is representative of what could be measured.

Front 11

What is criterion validity?

Back 11

compares assessment of another one with already established validity

Front 12

What is concurrent validity?

Back 12

compares results of two assessments given at the same time

Front 13

What is predictive validity?

Back 13

compares the degreee to which an instrument can predict performance on future criteria

Front 14

what is reliability?

Back 14

the consistency and stability of the eval; if reliable, results are the same from time to time, place to place, and eval to eval

Front 15

What is inter-rater reliability?

Back 15

different raters using the same assessment will achieve the same results

Front 16

What is test-retest reliability?

Back 16

The same results will be obtained when the eval is administered by the same administrator

Front 17

What are the different ways to assess an individual?

Back 17

Observation, interviews, self-report, checklists, rating scales, Goal Attainment Scale, performance tests, norm-referenced assessments, criterion-referenced assessments

Front 18

What is prevention and what are the three different types?

Back 18

Prevention: interventions designed to promote wellness, prevent disability/illness, and maintain health

Primary: focuses on general population that is currently well but could potentially be at risk

Secondary: early detection of at-risk population

Tertiary: reduction of impact of dysfunction for those who already have disability/illness

Front 19

What are some areas to be addressed in intervention planning?

Back 19

values, interests, and needs, current and expected roles, environmental contexts, treatment setting's characteristics, likelihood of change of problem after intervention

Front 20

What content should be included in intervention plan?

Back 20

LTGs, STGs, Intervention methods: occupations and activities to be used, metods of intervention, home programs and family ed, adaptive equipment; evidence to support interventions

Front 21

What are OT intervention methods?

Back 21

purposeful activities, meaningful occupations, environmental modifications, promotion of engagement, adaptive equipment, physical agent modalities, ergonomic principles,

Front 22

What are the reasons for individual vs group intervention

Back 22

Individual: learning capacity of person, amount of attention and skill required, need for privacy, need for greater control over environment, complexity of occupation/activity, inappropriate or dangerous behaviors of person

Group: develop interpersonal skills, engage in socialization, receiving feedback from others, being motivated by peers, placing condition in perspective, develop norms in group

Front 23

What are reasons for discharge of a pt?

Back 23

goals have been met, functional plateau, individual no longer requires skilled services, exacerbation of illness leading to higher level of care needed, length of stay has expired

Front 24

What are general principles of discharge?

Back 24

begins at initial evaluation, interventions planned with discharge in mind, collaboration with family and individual, discharge to which setting must be considered, include home programs and community resources if appropriate

Front 25

What is the definition of occupation?

Back 25

goal-directed pursuits which extend over time, have purpose, value, and meaning, involve multiple tasks, occur in different contexts

Front 26

What are purposeful activities?

Back 26

doing process that are directed to an outcome and require energy and thought to complete, fundamental to developing performance skills, holistic, can be manipulated and adapted,

Front 27

What is activity analysis?

Back 27

breaking down and identification of component parts of activity

Front 28

What is activity synthesis?

Back 28

process of designing activity for OT evaluation or intervention, often requires grading/adapting, can be used to teach an activity

Front 29

What are principles of learning?

Back 29

influenced by individual's interests, age, sex, and SES, source of motivation must be identified, goals made by individual more likely to be met, learning enhanced when individual understands purpose, meet person's functional level, move at a comfortable pace, active participation in learning, reinforcement and feedback, frequent repetition, adjust environment

Front 30

What are the different types of teaching methods?

Back 30

demonstration and performance, exploration and discovery, explanation and discussion, role play, simulation, problem solving, audiovisual aids, repetition and practice, behavioral management, consumer/family education

Front 31

What are the different types of clinical reasoning?

Back 31

procedural: ID problems, goals, and treatment

Interactive: how the disability/disease affects the person, therapeutic relationship

Narrative: individual's occupational story

Pragmatic: contexts and environments

Conditional: integration of other types of reasoning

Front 32

What is the purpose of therapeutic use of self?

Back 32

provide reassurance or information, give advice, alleviate anxiety or fear, obtain needed information, improve/maintain function, promote growth and development, increase coping skills

Front 33

What are the different phases of group development?

Back 33

origin: leader composes group protocol

orientation: members learn what group is about

intermediate: develop interpersonal bonds and norms

conflict: members challenge structure, process, or purpose of group

cohesion: regrouping after conflict

Maturation: being productive to accomplish goals

Termination: end of group

Front 34

What are the three different types of group roles?

Back 34

instrumental: help group select, plan, and complete tasks

expressive: support and maintain group

individual: dysfunctional and contrary to group goals

Front 35

What are the three different types of group leadership styles?

Back 35

directive: therapist responsible for planning and structuring group

facilitative: therapist shares responsibility with group members

Advisory: therapist functions as a resource

Front 36

What are the different types of activity groups?

Back 36

evaluation group, thematic group, topical group, task-oriented group, developmental group, and instrumental group

Front 37

What are the 6 principles in the OT code of ethics?

Back 37

Beneficence: demonstrate concern for safety and well-being of recipients

Nonmaleficence: refrain from actions that cause harm

Autonomy: right of individual to self-determination, privacy, confidentiality, and consent

Justice: promote fairness and objectivity in provision of services

Veracity: provide comprehensive, accurate, and objective info when representing profession

Fidelity: treat all with respect, fairness, discretion and integrity

Front 38

What is the difference between ethical distress and an ethical dilemma?

Back 38

distress: OT knows the correct action but existing barrier prevents taking that course of action

dilemma: two or more potentially correct ways to solve problem but choosing one prohibits acting on other choices

Front 39

What are the components of ethical decision making?

Back 39

ID ethical issues and dilemmas, gather relevant info, determine conflicting values and areas of agreement, ID relevant alternative courses of action, determine all possible positive and negative outcomes, weigh consequences of each outcome, seek input from others, apply professional judgment, contact all agencies that need to be involved, determine desired outcome

Front 40

What is the ethics commission?

Back 40

component of AOTA that is responsible for code of ethics and standards of practice, responsible for informing and educating about current ethical issues, upholding practice and education standards, monitor behavior of members, and review allegations of unethical conduct

Front 41

What is the ethical jurisdiction of SRBs?

Back 41

Provide description of ethical behavior, monitor profession closely, have authority to discipline members, intervene in illegal acts

Front 42

What are the different levels of disciplinary actions for ethical violations?

Back 42

reprimand: private communication of disapproval of conduct; censure: public statement of disapproval of conduct; Ineligibility: removal of eligibility for membership etc. for indefinite or specific time period; Probation: requirement to meet certain conditions to maintain membership; suspension: loss of membership etc. for specified time period; revocation: permanent loss of membership etc.

Front 43

What is negligence?

Back 43

failure to do what other reasonable practitioners would have done under similar circumstance

Front 44

What are the primary roles of OTAs?

Back 44

Implement treatment, cannot independently evaluate or initiate treatment prior to OT eval, can contribute to development and implementation of intervention plan under OT supervision

Front 45

What are the primary roles of OT aides?

Back 45

perform specific non-skilled tasks, non-client tasks include routine maintenance and clerical work, client tasks can only be done if anticipated result is known, pt situation is stable, aide has been appropriately trained

Front 46

What are the different types of supervision?

Back 46

direct: face-to-face contact, indirect:non face-to-face contact; close: daily, direct contact at the site of work, routine: direct contact at least every two weeks at the site of work, general: at least monthly direct contact with supervisor, minimal: provided only on a as needed basis

Front 47

What are other OT roles?

Back 47

educator, fieldwork educator, supervisor, administrator, consultant, academic fieldwork coordinator, faculty, program director, researcher/scholar, entrepreneur,

Front 48

What are the different types of teams?

Back 48

intradisciplinary: members work with pt but other other disciplines are not involved and communication is limited.

multidisciplinary: number of professionals from different disciplines work independent of each other

interdisciplinary: all disciplines agree to collaborate for decision making

Transdisciplinary: same as interdisciplinary but with more role blurring

Front 49

What are other professionals that OTs may collaborate with?

Back 49

alternative practitioners, athletic trainer, audiologist, biomedical engineer, certified orthotist, certified prosthetist, chiropractor, dietician, expressive therapist, job coach, nurse practitioner, registered nurse, optometrist, pastoral care, physiatrist, PT, PTA, physician's assistant, primary care physician, psychiatrist, psychologist, rec therapist, respiratory therapist, social worker, special ed teacher, SLP, substance abuse counselor, voc rehab counselor

Front 50

What is the Center for Medicare and Medicaid Services?

Back 50

Federal agency that develops rules and regulations pertaining to medicare and medicaid programs, monitors compliance with regulations

Front 51

What is the occupational safety and health administration?

Back 51

creates standards related to safety and enforces these standards, includes structural standards and building codes and the safety of employees and consumers when handling infectious materials, blood products, operating machinery, and handling hazardous substances

Front 52

What is accreditation?

Back 52

status awarded for compliance with established standards, ensures the public that a facility is adequately equipped and meets high standards, affirms competence of practitioners, voluntary; includes Joint Commission, Healthcare Facilities Accreditation Program, Commission on Accreditation of Rehab Facilities

Front 53

What are the steps to the accreditation process?

Back 53

initiated by organization by submitting application for review, self study conducted, on-site review is conducted, accreditation process involves all staff to prepare documents, host site visit team, and participate in interviews with accreditors, undergoes review every 3 years

Front 54

Diagnostic Related Groups

Back 54

the descriptive categories established by CMS that determines the level of payment at a per case rate

Front 55

Fee for Service

Back 55

the payment system under which the provider is paid the same type of rate per unit of service

Front 56

Prospective payment system

Back 56

the nationwide payment schedule that determines the medicare payment for each inpatient stay of a medicare beneficiary based on DRGs

Front 57

Treatment Authorization Request

Back 57

the medicaid form a primary care provider must complete to document the need for requested medically necessary covered services with a supporting rationale

Front 58

What are federal regulations for private insurance coverage?

Back 58

insurers must provide benefits including: mental health, substance abuse, and behavioral health, disease management, and preventative and wellness services, cannot refuse coverage for people with pre-existing conditions, cannot raise premiums based on different characteristics

Front 59

What does medicare part A and medicare part B cover?

Back 59

Part A: inpatient hospital, SNF, home health, rehab facilities, and hospice; automatically provided; based on DRG

Part B: outpatient services; must be purchased by beneficiary;

Front 60

What is reimbursement for medicare in SNFs based on?

Back 60

Resource utilization groups

Front 61

Describe home health reimbursement for medicare?

Back 61

reimbursed under prospective payment system; Home Health Resource Groups used to determine episode payment rate; initial assessment is Outcome and Assessment Information Set

Front 62

What are mandated medicaid services?

Back 62

inpatient and hospital services, outpatient and physician services, home health, screening diagnosis for under 21, services identified to treat a condition, SNFs providing skilled rehab,

Front 63

What is the purpose for documentation?

Back 63

provides legal, serial record of client condition, eval and re-eval results, course of therapeutic intervention, and response to intervention, justifies necessity of skilled services, serves as information resource for client care, enhances communication among health care team members

Front 64

What is in the content of documentation?

Back 64

Identification and background info: name, age, gender, date of admission, diagnosis; eval and re-eval info: assessments, summary and analysis, problem list, client understanding; intervention plan: goal statements related to problem list; short and long term goals: specific, measurable, attainable, relevant, time limited; intervention implementation: activities used, client response, goal modification, participation; discharge plan: summary of eval and intervention, number of sessions, reason for discharge

Front 65

What does intervention documentation for medicare reimbursement need to include?

Back 65

content must show that treatment shows level of complexity that needs skilled services, care must match diagnosis and physician's order, services must be unique to OT, in home health homebound status must be clearly delineated, document honestly, document functional change

Front 66

What does HIPAA cover?

Back 66

ensures privacy and security of health records, all persons must be notified of privacy policies, prior to discussing health info with family etc. permission must be obtained, protect confidentiality in all forms, individual has right to see records

Front 67

What are some key legislation related to disability rights?

Back 67

medicare: established medicare and SSI; Rehab act of 1973: prohibits discrimination of disability in anything that receives fed funding; fair housing act: prohibits discrimination for housing and allows people to make reasonable accommodations; omnibus budget reconciliation act of 1981: provided medicaid financing for community services for those with DD; Ticket to work and work incentives improvement act: make it easier for those with disabilities to work by allowing them to keep their benefits; work investment act: established one stop delivery system for employment services

Front 68

What is the Americans with Disabilities Act?

Back 68

Employment: prohibits employers from discriminating against those with disabilities, reasonable accommodations must be made; public services: no discrimination in public services, programs, and activities including transportation; Public Accommodations: public places must comply with accessibility standards

Front 69

What is some legislation specific to pediatric practice?

Back 69

Child abuse prevention and treatment act; early intervention and education acts; IDEA; No child left behind act

Front 70

What is some legislation specific to geriatric practice?

Back 70

Age discrimination in employment act; freedom to work act: retired people with SS benefits can still work and continue to receive SS; Omnibus budget reconciliation act of 1990: resident rights, autonomy, self-determination, quality of care, and quality of life in nursing homes;

Front 71

What is the major difference between the medical model, the educational model, and the community model?

Back 71

Medical: focus on identifying and improving dysfunction; education: individual with disability is lacking knowledge or skills that can be taught; community: individual with disability lacking skills, resources, and supports in the community

Front 72

Describe OT in acute care hospitals?

Back 72

admission based on illness that cannot be treated in outpatient; LOS 1 to 7 days; eval: quick screening of major difficulties; intervention: stabilization, engagement, discharge planning, education

Front 73

Describe OT in sub-acute care?

Back 73

admission for diagnosis that has progressed from acute but not stabilized enough for outpatient; LOS 5 to 30 days; eval: more in-depth assessment; intervention: functional improvements, active engagement, discharge planning

Front 74

Describe OT in long-term acute care hospitals

Back 74

admission for catastrophic illness that require extensive medical care; LOS greater than 25 days; eval and intervention limited by complex medical needs, focus on palliative care and prevention of complications, mastery of environment and establish client centered goals

Front 75

Describe OT in rehab hospitals

Back 75

admission for disability that is stable but still requires skilled services; LOS 1 week to months; eval can be extensive to focus on all performance skills and patterns and occupations; intervention: functional improvement, compensatory strategies, adaptive equipment, modification of environment, education

Front 76

Describe OT in long-term hospitals?

Back 76

admission for chronic conditions that cannot be treated in outpatient, LOS range from months to years; eval: extensive; intervention: functional improvement, compensatory strategies, maintain QOL, development of discharge skills

Front 77

Describe OT in SNFs

Back 77

admission for chronic condition that requires skilled care but no acute symptoms; LOS range 1 month to lifetime; eval and intervention based on medicare standards

Front 78

Describe OT in forensic settings?

Back 78

those engaged in criminal activity; LOS varies depending on court ordered directives; OT eval and intervention: competency to stand trial, develop community living skills, structured programs

Front 79

Describe OT in early intervention settings?

Back 79

at risk infants/toddlers under age of 3; eval based on cognitive, physical, communication, social-emotional, and adaptive skills, consider current development of play and ADLs; intervention: development of above skills, development of play and ADLs, family education, advocacy, transition planning

Front 80

Describe OT in schools?

Back 80

for students that require special ed services and ot will facilitate child participation; eval: client factors, performance skills and patterns, and occupations, developmental level; intervention: based on educational model, student functional performance with academic performance, address goals in IEP, assistive technology, transition services, performance skill deficits

Front 81

Describe OT in supported education programs?

Back 81

adults who need to develop skills to succeed in post secondary education; d/c based on entry into or completion of educational program; eval based on occupational role of student; intervention: performance skills and patterns needed to fulfill role of student, compensatory strategies, educational interests

Front 82

Describe OT in prevocational programs?

Back 82

adults who require intervention to develop prerequisite skills for work; d/c to vocational program; eval based on task skills, social skills, work habits, interests, and abilities; intervention: improvement in task and social skills, development of work habits and abilities, exploration of interests

Front 83

Describe OT in vocational programs?

Back 83

develop specific vocational skills; d/c to workshops or employment programs; eval: functional skills and deficits related to work in vocational environment; intervention: remediation of deficits, compensation, development of work abilities and job skills, supervision of vocational staff, referral to state offices

Front 84

Describe OT in residential programs?

Back 84

functional deficits impede independent living but don't need hospitalization; continuum of support; eval: assessment of living skills; intervention: consultation, remediation of deficits, compensation, ADL training, activity adaptation, environmental modification, referral to appropriate residential services, education

Front 85

Describe OT in partial hospitalization programs?

Back 85

person sufficiently stabilized to enable discharge home but skill needs active treatment; treatment usually 5 days per week with multiple interventions per day; LOS 1 week to 6 months; eval based on functional skills and deficits and occupational roles; intervention: functional improvements, remediation and compensation, development of skills for community living

Front 86

Describe OT in clubhouse programs?

Back 86

adults with current mental illness, all members have access to all clubhouse functions, responsibilities shared between members and staff; LOS indefinite; OT not provided in formalized manner and functions more to support members' recovery

Front 87

Describe OT in adult day care?

Back 87

adults/edlers with impairments but semi-independent, provided in group setting; LOS is indefinite; eval: functional skills and deficits, occupations, home environment; intervention: maintenance of healthy aspects, engagement, education, consultation, modification of environment

Front 88

describe OT in outpatient care?

Back 88

illness not serious enough for hospitalization and condition stabilized but sill requires active treatment; eval: functional assets and deficits in performance skills and patterns, occupations, and environments; intervention: active engagement, remediation, functional improvements, compensatory strategies, education

Front 89

Describe OT in home health care?

Back 89

condition not serious enough for hospitalization but requires active treatment and pt is homebound; treatments usually 60 minutes for 5 days a week; eval: client factors and functional skills/deficits in performance skills and patterns, occuapations, and environment; intervention: active engagement, functional improvement, remediation, compensation, education, environmental modifications, activity adaptations, resume roles, prevent hospitalization

Front 90

Describe OT in hospice care?

Back 90

those with terminal illness with life expectancy 6 months or less; eval: occupational functioning and contextual needs most important to them; intervention: maintenance of individual's control of life, facilitate engagement in meaningful occupations and activities, reduction of distressing symptoms, environmental adaptations and activity adaptations, education

Front 91

Describe OT role in Wellness and Prevention programs?

Back 91

self-referral, serve populations determined at-risk; LOS determined by individual; eval focuses on risk factors, functional skills/deficits, occupations, and environments; intervention: disease prevention and health promotion

Front 92

What are the different steps to program development?

Back 92

Needs assessment: describe community/ target population, establish needs of population, identify resources; program planning: define focus based on needs assessment, adopt FOR, establish objectives and goals, integrate into existing system; Implement program: initiate program according to timetable, document activities, communicate with other programs; evaluate program

Front 93

What are the major personnel management tasks?

Back 93

design work roles and write job descriptions, recruit, select, and orient personnel to perform roles, supervise and evaluate personnel, support ongoing professional development, deal with difficult personnel issues

Front 94

What are major marketing tasks?

Back 94

analyze market activities, develop marketing strategies to address 5 Ps (product: thing/service, price: costs, place:distribution method, promotion: communicating info, position: relationship to similar products/services), implement and evaluate marketing plan

Front 95

What is the purpose of research?

Back 95

enhance theoretical and philosophical foundations, improve clinical reasoning and critical thinking, increase professional knowledge and skills, facilitate evidence based practice

Front 96

What are the different types of quantitative design types?

Back 96

true experimental: 2 group design with random selection and assignment to control and experimental group, explores cause and effect of ind and dep variables; quasi experimental: ind variable manipulated to determine effect on dep variable but no randomization; correlational: no manipulation or randomization, explores potential relationships between variables

Front 97

What are the different types of qualitative designs?

Back 97

phenomenological: study of persons and how they make sense of their experiences; ethnographic: patterns and characteristics of cultural groups; heuristic: complete involvement of researcher in experience of subject; case study: subject or small group intensely studied

Front 98

What does trustworthiness criteria include?

Back 98

credibility: level of confidence that findings truthfully reflect reality of participants and context; transferability: how well other studies fit with findings; dependability: inclusion of full range of data; confirmability: how much conclusions are based on data

Front 99

What are the essential steps of the research process?

Back 99

formulate philosophical foundation, ID broad topic, review literature, utilize FOR, develop specific question, select research design, formulate methodology, determine study length, ID sample (random, systematic, stratified, purposive, convenience, snowball), collect data (observation, interview, questionnaires, surveys, record review, tests/assessments), analyze data using inferential and descriptive statistics, report findings (results, conclusion, summary), disseminate research

Front 100

Describe the development of sensorimotor integration from prenatal to 7 years?

Back 100

neonatal: responds first to tactile stimuli, develops reflexes; neonatal: visual and auditory continuing to develop; first 6 months: visual and tactile more integrated as infant reaches for objects, reflexive to voluntary movements; 6-12 months: development of FM and motor planning, midline skills, primitive self feeding; 13-24 months: increased complexity of motor planning, ideation; 2-3 years: improved balance and posture control, tactile discrimination and localization, praxis ideation; 3-7 years: play, games, activities, school, chores

Front 101

When does crossing midline and bilateral integration occur?

Back 101

9-12 months

Front 102

What are the lower skills of visual-motor integration?

Back 102

visual attention, visual memory, visual discrimination, kinesthesia, position in space, figure ground, form constancy, and spacial relations

Front 103

What are general principles of motor development?

Back 103

occurs cephalocaudal/proximal to distal, gross to fine motor, stability to controlled mobility, occurs with periods of equilibrium and disequilibrium

Front 104

What are important aspects in the development of UE function?

Back 104

head and trunk control, eye/hand interaction, shoulder stability/mobility, humeral control, elbow control, forearm control, wrist control, thumb opposition and stability, palmar arches of hands, isolated finger control

Front 105

Describe development in prone position for infants to 9 months?

Back 105

0-2 months: turns head side to side, lifts head momentarily, bends hips with bottom in air, lifts and maintains head up , bear weight on forearms; 5-6 months: shifts weight on forearms and reaches forward, legs closer together, hips flat, equilibrium reactions present; 5-8 months: chest and thighs lift off surface; 7-8 months: pivots in prone and moves to prone to sit; 9 months: dislikes prone

Front 106

Describe development in supine position for infants to 8 months?

Back 106

0-3 months: head held to 1 side, able to turn head side to side; 3-4 months: holds head in midline, chin tucked, legs come together, lower back flattens; 4-5 months: head lag gone, hands together in space; 5-6 months: lifts head independently, brings hands and feet to mouth, reach for toys; 7-8 months: equilibrium reactions present

Front 107

Describe development of sitting in infants to 24 months?

Back 107

0-3 months: held in sitting, head bobs, back rounded, hips apart; 5-6 months: supports self in sitting, increased back extension, props forward on arms, wide base with legs bent; 5-10 months: sits alone steadily, plays with toys in sitting; 6-11 months: gets to sitting from prone; 7-8 months: equilibrium reactions present, rotates upper body; 8-10 months: sits well without support, legs closer with knees straight, 9-18 months: rise from supine; 10-12 months: protective extension backwards, moves into other sitting positions; 11-12 months: trunk control and equilibrium fully developed; 11-24 months: rises from supine by rolling and pushing up.

Front 108

Describe development of standing in infants to 12 months?

Back 108

0-3 months: takes some weight on legs when held in standing; 2-3 months: legs may give way when held in standing; 3-4 months: bears more weight on legs, head in midline; 5-6 months: bounces in standing; 5-10 months: stands while holding to furniture; 6-12 months: pulls to standing on furniture; 8-9 months: pulls to standing by kneeling; 12 months: equilibrium reactions present; 9-13 months: pulls to standing with legs only

Front 109

Describe the development of walking in infants from 8 months to 18 months?

Back 109

8 months: cruises sideways; 8-18 months: walks with 2 hands held; 9-10 months: cruises around furniture; 9-17 months: takes independent steps; 10-14 months: walking; 11 months: walks with 1 hand held, reaches for furniture; 15 months: starts and stops in walking; 18 months: seldom falls, runs stiffly

Front 110

Describe development of release in infants to 15 months?

Back 110

0-1 month: no release, grasp reflex strong; 1-4 months: involuntary release, 4 months: mutual fingering in midline; 4-8 months: transfer object from hand to hand; 5-6 months: two stage transfer (taking hand grasps before releasing hand lets go); 6-7 months: 1 stage transfer; 7-9 months: volitional release, 7-10 months: presses down on surface to release, 8 months: releases above surface with wrist flexion; 9-10 months: releases into container with wrist straight; 10-14 months: clumsy release into small container; 12-15 months: precise controlled release into small container

Front 111

Describe development of fine motor grasp?

Back 111

natal: no grasp or visual attention; 3 months: visually attends to object but no attempt to grasp; 6 months: raking and contacting object; 7 months: inferior scissors grasp, rakes object into palm, 8 months: scissors grasp, between thumb and side of curled index finger; 9 months: inferior pincer grasp; 10 months: pincer grasp, 12 months: fine pincer grasp

Front 112

Describe development of grasp of larger objects?

Back 112

neonate: visually attends to object, grasp reflexive; 3 months: visually attends and swipes; 4 months: primitive squeeze grasp against body; 5 months: palmar grasp, press cube into center of palm; 6 months: radial-palmar grasp, press against opposed thumb; 8-9 months: radial-digital grasp, object held with opposed thumb and fingertips

Front 113

What is quality improvement?

Back 113

System oriented approach that views limitations and problems pro-actively as opportunities to increase quality; prevention emphasized

Front 114

What is total quality management?

Back 114

creation of organizational culture that enables all employees to contribute to an environment of continuous improvement to meet consumer needs

Front 115

What is performance assessment and improvement?

Back 115

systematic method to evaluate the appropriateness and quality of services

Front 116

What is statistical utilization review?

Back 116

reimbursement claims data are analyzed to determine the most efficient and cost-effective care

Front 117

What is a professional review organization?

Back 117

groups of peers who evaluate the appropriateness of services and quality of care under reimbursement and state licensure requirements

Front 118

Describe the Moro reflex?

Back 118

when infant's head is rapidly dropped backwards first phase: arms extend and abduct; second phase: arm flexion and adduction

Front 119

Describe the galant reflex

Back 119

when infant is in prone suspension and spine is gently scratched, the trunk laterally flexes on stimulated side

Front 120

What is the symmetrical tonic neck reflex?

Back 120

when infant is in crawling position and head extended, hips and knees flex

Front 121

Describe neck righting reflex?

Back 121

When infant is in supine and head turned to one side, the entire body will log roll to maintain alignment with head

Front 122

Describe body righting reflex?

Back 122

when infant is in supine and one hip and knee is flexed, the infant will segmentally roll upper trunk to maintain alignment

Front 123

describe the supine tilting and sitting tilting reflex?

Back 123

when infant is in supine or sitting and one side of table is lifted, the spine curves toward the raised side to maintain equilibrium without arm support

Front 124

Describe the progression of manipulating skills in development

Back 124

finger to palm translation: (12-15 months) move objects from fingers to palm; palm to finger translation (2-2 1/2 years) move objects from palm to fingers; shift: (3-5 years) separate 2 pieces of paper, shifting on marker or pen (5-6 years); simple rotation: (2- 2 1/2 years) rolling object held in fingers 90 degrees; complex rotation: (6-7 years) rotate object 360 degrees; in hand manipulation with stabilization: (6-7 years) several objects held in hand and manipulation of 1 object occurs

Front 125

Describe the progression of pre-writing skills in development?

Back 125

palmar supinate grasp: (1-1 1/2 years) fisted hand and arm moves as unit; digital pronate grasp: (2-3 years): forearm pronated and writing utensil held in fingers; static tripod posture: (3 1/2-4 years) crude approximation of finger position but no fine localized movements; dynamic tripod posture: (4 1/2-6 years) precise opposition to form stable arch with fine and localized movements

Front 126

Describe the development of scissor skills

Back 126

2-3 years: interest in scissors, holds and snips with scissors, opens and closes in controlled fashion, 3-4 years: manipulates scissors in forward motion, coordinates lateral direction of scissors, cut in a straight line, cut simple geometric shapes; 3 1/2-4 1/2 years: cut circles; 4-6 years: cut simple figure shapes; 6-7 years: cut complex figure shapes

Front 127

What are Erik Erikson's 8 stages of development?

Back 127

1: basic trust vs mistrust, birth-18 months; 2: autonomy vs doubt and shame, 2-4 years; 3: initiative vs guilt, preschool age; 4: industry vs inferiority, elementary school age; 5: self-identity vs role diffusion, teenage years; 6: intimacy and solidarity vs isolation, young adulthood; 7: generativity vs self absorption, middle adulthood; 8: integrity vs despair, older adulthood

Front 128

What is Lawrence Kohlberg's 3 stages of moral development?

Back 128

1: preconventional morality, 0-8 years, punishment and obedience, make basic moral decisions; 2: conventional morality, 9-10 years, social conformity, law and order; 3: postconventional morality, age varies, following social contracts

Front 129

What are abraham Maslow's hierarchy of human needs?

Back 129

physiological, safety, love and belonging, self-esteem self-actualization

Front 130

Describe Piaget's stages of cognitive development?

Back 130

Sensorimotor: (0-2 years) reflexes, cause and effect, voluntary movements, seeks new schemes and begins to problem solve; Preoperational (2-7 years) classification, seriation, conservation, symbolic representations, imitates what is seen; Concrete operations (7-11 years): reversibility, rules, empirical-inductive thinking; formal operations (11-teen years): hypothetical thinking, logic and hypotheses

Front 131

Describe the development of problem solving skills from 6 months to 60 months

Back 131

6-9 months: finds objects, movement as means to end, anticipates movement, attends to consequences; 9-12 months: use tools after demo, more goal directed behavior; 12-15 months: asks adult for help, turns and inspects objects, trial and error; 18-21 months: think before actingto achieve goal; 21-24 months: matches shapes in small openings; 24-27 months: discriminates size; 24-30 months: relates multiple experiences; 36-48 months: organize by size and build from mental image; 48-60 months: spatial awareness, cause and effect and mental images

Front 132

Describe the developmental categories of play

Back 132

exploratory play: (0-2 years) child explores properties and effects of objects and people; symbolic play: (2-4 years) formulates, tests, classifies, and refines actions, associated with language development, parallel play; creative play (4-7 years): cooperative peer groups; games (7-11 years) play with rules, competition, social interaction, and development of skills

Front 133

Describe the stages of oral motor development

Back 133

35 weeks gestation: jaw and tongue movements strong enough for feeding; 40 weeks gestation: rooting, cough, and gag reflexes; 4-5 months: munching on soft cookie, 6 months: up and down movements of tongue; 7-8 months: mastication of soft foods with diagonal movements; 9 months: lateral tongue movements, drinks from cup; 12 months: rotary chewing, good bite on hard cookie; 24 months: can chew most meats and veggies

Front 134

Describe OT eval for feeding

Back 134

parent interview, medical and developmental history, observation of feeding (postural control, oral sensitivity, motor control, coordination, and endurance), recommendation for swallow study

Front 135

Describe intervention for oral motor control

Back 135

appropriate positioning, hand positioning of caregiver, facilitate lip and jaw closure, inhibit tongue thrust, facilitate chewing, integrate preventative measures (downward pressure, prevent tongue retratction, lip closure, tactile sensitivity), texture of foods, create pleasant atmosphere during feedings

Front 136

Describe development of self-dressing skills

Back 136

1 year: cooperates with dressing, pulls off shoes and socks, pushes arms through sleeves; 2 years: removes coat, helps down pants, finds armholes in shirt; 2 1/2 years: assists pulling on socks, puts on coat, unbuttons large buttons; 3 years: puts on pullover shirt with minA, puts on shoes w/o fasteners, puts on socks, zips jacket; 3 1/2 years: finds front of clothes, snaps fasteners, puts on mittens, unbuckles belt; 4 years: removes shirt ind., buckles belt, laces shoes; 4 1/2: puts belt in loops, 5 years: ties and unties knots, dresses unsupervised; 6 years: snaps, buttons, etc. back garments

Front 137

Describe development of toileting skills

Back 137

1 year: indicates discomfort when wet/soiled; 1 1/2 years: sits on toilet when placed there; 2 years: urinates regularly; 2 1/2 years: regulated toileting with occasionally accidents, may need assistance; 3 years: goes to bathroom ind., may need help with wiping; 4-5 years: ind. in toileting

Front 138

What are some developmental assessments of neonates?

Back 138

Assessment of Preterm Infants' Behavior (APIB): assesses infant's pattern of developing behavior organization in response to increasing sensory and environmental stimuli; Neurological Assessment of Pre-term and Full-Term New-born Infant (NAPFI): rating scale consisting of brief neuro exam incorporated into routine assessment

Front 139

What are some overall developmental assessments?

Back 139

Denver Developmental Screening Test II, Bayley Scales of Infant Development 3rd ed, First STEP Screening Test for Evaluating Preschoolers, Hawaii Early Learning Profile Revised (HELP), Miller Assessment for Preschoolers (MAP), Pediatric Evaluation of Disability Inventory (PEDI)

Front 140

What are some motor developmental assessments?

Back 140

Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), Erhardt Developmental Prehension Assessment, Peabody Developmental Motor Scales (PDMS-2), Toddler and Infant Motor Evaluation (TIME)

Front 141

What are some visual motor and visual perception assessments?

Back 141

Beery-Buktenica Developmental Test of Visual Motor Integration (VMI), Developmental Test of Visual Perception, Erhardt Developmental Vision Assessment (EDVA), Preschool Visual Motor Integration Assessment (PVMIA), Motor-Free Visual Perception Test (MVPT-3), MVPT-Vertical, Test of Visual Motor Skills (TVMS), Test of Visual-Perceptual Skills (TVPS3)

Front 142

What are some sensory processing assessments/

Back 142

Sensory Profile (Infant/Toddler) (Adolescent/Adult)

Front 143

What are some psychological and cognitive assessments?

Back 143

childhood Autism Rating Scale (CARS), Coping Inventory and Early Coping Inventory,

Front 144

What are some play assessments?

Back 144

Play History, Revised Knox Preschool Play Scale (RKPPS), Test of Playfulness (ToP) Revised, Transdisciplinary Play-Based Assessment (TPBA)

Front 145

What are some social participation assessments?

Back 145

Participation Scale (P scale), School Function Assessment (SFA)

Front 146

What are Havighurst's 6 stages of development and tasks?

Back 146

Infancy and childhood: walk, take solid food, talk, control body wastes, understand right from wrong; middle childhood: develop skills for games, healthy self-concept, make friends, read, write, and calculate; adolescence: establish relationships, develop gender social role, prepare for marriage and career; early adulthood: choose partner, start family, raise kids, manage home, occupation; middle adulthood: progress in career, guide teens, relate to partner, accept aging parents; later adulthood: cope with decreased health, adjust to retirement, adjust to death, change social roles

Front 147

What are Anne Mosey's 6 Adaptive Skills?

Back 147

sensory integration, cognitive skills, dyadic interaction skills, group interaction skills, self identity skills, sexual identity skills

Front 148

What are muscular changes, implications, and strategies for older adults?

Back 148

changes: loss of strength, power, muscle mass, and endurance (mostly due to decreased activity levels); implications: slower movements, increased fatigue, increased injuries, loss of ROM, decreased functional mobility, gait changes, increased fall risk; strategies: improve health, increase physical activity levels, provide strength training, provide flexibility for ROM

Front 149

What are skeletal system changes, implications, and strategies for older adults

Back 149

changes: cartilage stiffens, fragments, and erodes, loss of bone mass and density, intervertebral discs flatten, posture changes (forward head, kyphosis, flattening of lumbar spine); implications: maintain weight bearing, increased fall risk; strategies: posture exercises, weight bearing, nutrition, hormone and medical therapies

Front 150

What are neurological system changes, implications, and strategies for older adults?

Back 150

changes: atrophy of nerve cells, changes in brain, decreased cerebral blood flow, synaptic transmission, peripheral nerves, tremors; implications: decreased speed and coordination, decreased processing speed, problems in homeostatic regulation; strategies: correct med problems, improve health, increase activity, provide effective strategies for learning

Front 151

What are sensory system changes, implications, and strategies for older adults?

Back 151

Vision changes: visual acuity, adapting to light and dark, sensitivity to glare, color discrimination, implications/strategies: max function, allow extra time for visual discrimination, work in adequate light, high contrast, magnify; Hearing changes: buildup of ear wax, changes in bony joints, sound sensitivity, implications/strategies: minimize auditory distractions, speak slowly and clearly, nonverbal communication, written instructions, assistive devices; Balance changes: delayed reaction time, more reliance on vision, disorganized postural responses; implications: increased fall risk; Somatosensory changes: decreased touch sensitivity, proprioception, pain threshold increased, implications/strategies: use touch to communicate, teach compensatory strategies; taste and smell changes: overall decrease, implications/ strategies: poor diet, decreased home safety

Front 152

What are cognitive changes, implications, and strategies for older adults?

Back 152

changes: no uniform decline, longer time to complete tasks, short term memory impaired, difficulties with new learning; implications: use different strategies for memory; strategies: improve health, increase physical activity, increase mental activity, provide enriching environment, reduce stress

Front 153

What are cardiopulmonary system changes, implications, and strategies for older adults?

Back 153

changes: due more to inactivity, decreased blood flow, change in blood vessels, resting blood pressure rises, decline in lung capacity; implications: decreased stroke volume, reduced exercise capacity, increased recover time, orthostatic hypotension, increased fatigue, cough and gag impaired, prolonged recovery from illness; strategies: individualized exercise program, aerobic training, increase daily activity levels

Front 154

What is the OT assessment, goals, and interventions for nutrition?

Back 154

assessment: dietary history, psychosocial, body composition, olfactory and gustatory function, dental status, ability to feed self, integumentary status, compliance with special diets; goals and interventions: monitor adequate nutritional intake, maintain nutritional support through recommendations, promote adequate activity levels, maintain independence in food prep and feeding

Front 155

What are the leading causes of death in people over 65?

Leading causes of disability over 65?

Back 155

death: coronary heart disease, cancer, stroke, COPD, pneumonia/flu

disability: arthritis, hypertension, hearing impairments, heart impairments, cataracts, orthopedic impairments, diabetes

Front 156

What is dupuytren's disease and what is the OT intervention?

Back 156

disease of fascia of palm and digits leading in flexion deformities; OTI: wound care, edema control, extension spling, A/PROM, progress to strengthening, scar management, O based tasks that emphasize flexion and extension

Front 157

What is skier's thumb and what is the OT intervention?

Back 157

rupture of ulnar collateral ligament of MCP joint of thumb, OTI: thumb splint for 4-6 weeks, AROM and pinch strengthening, ADLs that require opposition and pinch strength

Front 158

What is complex regional pain syndrome and what is OT intervention?

Back 158

may follow trauma, severe pain, edema, discoloration, osteoporosis, sudomotor changes, temp changes, trophic changes, and vasomotor instability; OTI: modalities to decrease pain, edema management, AROM, pain-free ADLs, stress loading, splinting, encourage self-management

Front 159

What is the OT eval and intervention for fractures?

Back 159

eval: mechanism of injury and fracture management, results of special tests, edema, pain, AROM, sensation, occupational profile; OTI: immobilization phase->AROM of other joints, edema control, light ADLs, mobilization phase-> edema control, AROM, light ADLs, pain management, and strengthening

Front 160

What is the treatment for de Quervain's?

Back 160

pain and swelling over radial styloid; treatment: thumb spica splint, activity modification, ice massage over wrist, gentle AROM of wrist

Front 161

What is the treatment for lateral and medial epicondylitis?

Back 161

lateral: extensors, medial: flexors; treatment: elbow strap, wrist splint, ice massage, stretching, activity modification, strengthening

Front 162

What is the treatment for trigger finger?

Back 162

tenosynovitis of finger flexors; treatment: finger trigger splint, scar massage, edema control, tendon gliding, activity modification

Front 163

What are the two early mobilization programs for flexor tendon repairs? What are the three programs for extensor tendon repairs?

Back 163

Kleinart: passive flexion using rubber band traction and active extension to hood of splint; Duran: passive flexion and extension of digit. EXTENSION: mallet finger: DIP extension splint, Boutonnier deformity: PIP extension splint, wrist: volar splint

Front 164

What is the OT intervention for rotator cuff tendonitis?

Back 164

activity modification, educate sleeping posture, decrease pain, ROM, strengthening below shoulder, occupation and role training; post op: PROM to AAROM to AROM, decrease pain, strengthening, activity modification, leisure and work activities

Front 165

What is the OT intervention for adhesive capsulitis/frozen shoulder?

Back 165

encourage active use, PROM, modalities; Post op: PROM, pain relief, encourage active use

Front 166

What are the two different types of arthritis, OT eval, and intervention for arthritis?

Back 166

rhematoid: systemic, symmetrical, affects hands, osteoarthritis: degenerative, large joints; eval: occupational profile, AROM, muscle strength, grip strength, ADL and roles, pain, edema; Intervention: splinting, joint protection, energy conservation, AROM, heat, strengthening, occupation based activities, education

Front 167

What is osteogenesis imperfecta, OT eval, and intervention?

Back 167

genes responsible for producing bone collagen are dysfunctional; eval: activity interests, environmental risk factors; intervention: activity adaptation, assistive devices, environmental modification, preventative positioning, activities to increase strength, weight bearing, health education, family education

Front 168

What is ot eval and intervention for hip fractures?

Back 168

eval: review precautions and weight bearing status, occupational role expectations, ADLs, ROM and strength; intervention: bed mobility, UE strengthening, functional ambulation and transfers, instruct assistive device use, occupation based activities

Front 169

What is eval and intervention for total hip replacement?

Back 169

eval: review precautions and weight bearing, complete occupational profile, assess ADLs, assess ROM and strength; intervention: posterolateral precautions (no flexing or adducting, no pivoting), antereolateral precautions (no ext rotation, no hip extension), practice use of long-handled equipment, transfer training, occupation based activities

Front 170

Describe preprosthetic treatment, prosthetic treatment, and LE amputation treatment for OT

Back 170

pre: change dominance of activities if needed, ROM, prepare limb for prosthesis, desnsitization, wrapping, ADL training, education in skin care, supportive counseling; prosthetic: functional training with prosthesis, donning/doffing prosthesis, increase wearing tolerance; LE: wrapping, desensitization, strengthening, transfer training, ADL training, standing tolerance, wheelchair mobility

Front 171

What is OT eval and intervention for burns?

Back 171

eval: occupational profile, ROM, sensation, strength, ADLs and meaningful activities; OTI 2nd degree: wound care, gentle A/PROM, splinting, ADLs and roles, 3rd degree: wound care, AROM, edema control, splinting, occupational roles, strengthening; 4th degree: splinting, dressing wounds, AROM, light ADLs, PROM, massage, compression garments, strengthening

Front 172

Describe the types of pain, ot eval, and ot intervention?

Back 172

types: acute, chronic, myofascial, fibromyalgia, lower back pain; eval: location, intensity, onset and duration of pain, functional assessment (McGill Pain Questionnaire, Pain Disability Index, functional Interference Estimate); Intervention: modalities, proper positioning, splint, ROM, relaxation, proper body mechanics, correct environmental factors, correct standing/seated posture, modify activities, provide alternative exercise

Front 173

What are the intrinsic muscles of the hand innervated by the median nerve and what are their functions?

Back 173

abductor pollicis brevis: palmar abduction, opponens pollicis: opposition, flexor pollicis brevis: thumb mcp flexion, radial lumbricals: MCP flexion and extension of IP joints

Front 174

What are the intrinsic muscles innervated by the ulnar nerve and what are their functions?

Back 174

abductor digiti minimi: abduction of 5th digit, opponens digiti minimi: opposition of 5th digit, flexor digiti minimi: flexion of MCP joint and opposition of 5th digit, adductor: adducts CMC joint of thumb, ulnar lumbricals: MCP flexion and extension of IP joints of IV and V, palmar interossei: adduction and MCP flexion and extension, dorsal interossei: abduction and MCP flexion and extension of IPs,

Front 175

What are the extrinsic flexor muscles of the hand innervated by the median nerve?

Back 175

flexor digitorum superficialis: flexion of PIPs, flexor digitorum profundus: flexion of DIPs, flexor pollicis longus: flexion of thumb IP,

Front 176

What are the extrinsic extensor muscles of the hand innervated by the radial nerve?

Back 176

extensor digitorum communis: extension of MCPs, extensor digiti minimi: extension of MCP of 5th digit, extensor indicis proprius: extension of MCP of 2nd digit, extensor pollicis longus: extension of IP joint of thumb, extensor pollicis brevis: extension of MCP and CMC joint of thumb, abductor pollicis longus: abduction and extension of CMC joint

Front 177

What are the wrist flexors innervated by the median nerve?

Back 177

flexor carpi radialis: flexion of wrist and radial deviation, palmaris longus: flexion of wrist

Front 178

What are the rotator cuff muscles and what are their function?

Back 178

subscapularis: subscapular nerve, internal rotation; supraspinatus: suprascapular nerve, abducation and flexion; infraspinatus: suprascapular nerve, external rotation, teres minor: axillary nerve, external rotation

Front 179

What are the upward and downward rotation muscles of the scapula?

Back 179

upward rotation: trapezius and serratus anterior; downward rotation: levator scapulae, rhomboids, serratus anterior, latissimus dorsi

Front 180

What are the different types of fractures and medical treatment?

Back 180

intraarticular vs extraarticular, closed vs open, dorsal vs volar displacement, mdishaft vs neck vs base, complete vs incomplete, transverse vs spiral vs oblique, cominuted; med treatment: closed reduction, open reduction internal fixation, external fixation, fusion, joint replacemetn

Front 181

Describe Carpal tunnel syndrome, treatment, and post op treatment?

Back 181

median nerve compression causing numbness and tingling of thumb, index, middle, and ring finger; treatment: wrist splint, nerve gliding, activity modification, ergonomics; post op: edema control, AROM, nerve and tendon gliding, sensory re-education, strengthening thenar muscles, work/activity modification

Front 182

Describe pronator teres syndrome, treatment, and post op treatment?

Back 182

median nerve compression between 2 heads of pronator teres caused by repetitive pronation and supination; treatment: elbow splint with forearm in neutral, avoid supination and pronation; post op: AROM, nerve gliding, strengthening, sensory re-education, work/activity modification

Front 183

Describe Guyon's canal, treatment, and post op treatment?

Back 183

ulnar nerve compression at wrist causing numbness in ulnar distribution of hand; treatment: wrist splint, work/activity modification; post-op: edema control, AROM, nerve gliding, strengthening, sensory re-education

Front 184

Describe cubital tunnel syndrome, treatment, and post-op treatment?

Back 184

ulnar nerve compression at elbow caused by leaning on elbow, causes numbness and tingling along ulnar distribution of forearm and hand; treatment: elbow splint, elbow pads, activity/work modification; post-op treatment: edema control, scar management, AROM, nerve gliding, strengthening

Front 185

Describe radial nerve palsy, treatment, and post op treatment?

Back 185

radial nerve compression causing weakness of extensors; treatment: dynamic extension splint, work/activity modification, strengthening extensors; post op: ROM, nerve gliding, strengthening, ADLs

Front 186

Describe a median nerve laceration?

Back 186

sensory loss to palm, thumb, index, middle, and ring finger, motor loss to lumbricals, opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis; deformity: ape hand; functional loss: thumb opposition, weakness of pinch; treatment: dorsal protection splint, A/PROM of digits, scar management, strengthening

Front 187

Describe ulnar nerve laceration?

Back 187

sensory loss: ulnar aspects of hand, motor loss: palmar and dorsal interossei, lumbricals, flexor pollicis brevis, adductor pollicis, digiti minimi muscles; deformity: claw hand; functional loss: power grip and pinch strength; treatment: MCP flexion block, sensory re-education

Front 188

Describe a radial nerve laceration?

Back 188

sensory loss: dorsal forearm and hand; motor loss: wrist extension, functional loss: inability to extend digits to release and manipulate them, deformity: wrist drop, treatment: dynamic extension splint, ROM, sensory re-education, activity modification

Front 189

What are anterior, lateral, and posterior horns of the spinal cord?

Back 189

anterior: motor neurons, posterior: sensory neurons, lateral: autonomic nervous system

Front 190

What is the blood supply of the brain?

Back 190

Carotid system, vertebrobasilar system, circle of willis, and venous drainage

Front 191

Describe the structures and symptoms of lesions of lower motor neurons and upper motor neurons?

Back 191

LMN structure: cell bodies in anterior horn, spinal nerves, LMN lesion: flaccidity, absent deep tendon reflexes, atrophy; UMN structure: any nerve cell in spinal cord, brain, and nuclei, UMN lesion: increased reflexes, spasticity, clonus, autonomic reflexia

Front 192

What are the spinal level reflexes?

Back 192

stretch reflex: maintains muscle tone, support agonist muscle contraction, provide feedback about muscle length; Inverse stretch reflex: provides agonist inhibition, diminuation of force in agonist contraction; Gamma reflex loop: allows muscle tension to come under descending pathways; flexor withdrawal: withdrawal to remove body part from harmful stimuli; crossed extension reflex: coordinates reciprocal limb actions such as gait

Front 193

What are the symptoms of a CVA?

Back 193

abrupt onset of unilateral neuro signs, symptoms progress over several hours, Middle Cerebral Artery: contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia, apraxia, unilateral neglect, spatial dysfunction; anterior cerebral artery: contralateral hemiplegia, grasp reflex, incontinence, confusion, apathy, mutism; posterior cerebral artery: homonymous hemianopsia, thalamic pain, hemisensory loss, alexia; vertebrobaislary: dysarthria, dysphagia, emotional instability, tetraplegia

Front 194

What are the hemisphere specializations?

Back 194

Left: movement and sensation of R side of body, visual reception of R field, visual verbal processing, bilateral motor praxis, verbal memory, bilateral auditory reception, speech, process of verbal auditory info; Right: movement and sensation of L side of body, visual recpetion of L field, visual spatial processing, nonverbal memory, attention, emotion, nonverbal auditory info, interpretation of abstract info, interpretation of verbal inflections

Front 195

What are the risk factors of stroke?

Back 195

modifiable: hypertension, cardiac disease, atrial fibrillation, diabetes, smoking, alcohol abuse, hyperlipidemia; nonmodifiable: older age, male gender, african americans and latinos, heredity

Front 196

What are the symptoms of a TBI?

Back 196

concussion resulting in loss of consciousness, cerebral contusion/ laceration/ edema, hemiplegia/ monoplegia, abnormal reflexes, rigidity, fixed pupils, coma, changes in vital signs,

Front 197

Describe the Glasgow Coma Scale

Back 197

measures conscious state of individual, measures eye response (1-4), verbal response(1-5), and motor response (1-6), highest score is 15 which is oriented person

Front 198

Describe the ASIA impairment scale?

Back 198

A: complete, no sensory or motor function

B: incomplete, sensory but no motor function

C: incomplete, motor function less than 3/5

D: incomplete, motor function more than 3/5

E: normal, no sensory or motor deficits

Front 199

What are the symptoms of SCI?

Back 199

spinal shock(4-8 wks) no reflex activity, sensory deficits, loss of bowel/ bladder control, loss of temperature control below lesion, decreased respiratory function, sexual dysfunction, changes in muscle tone, loss of motor function

Front 200

Describe the Rancho Level of Cognitive Functioning?

Back 200

1: no response, total assist; 2: generalized response, total assist, reflexive activity; 3: localized response: total assist, responds directly related to type of stimuli; 4: Confused/ agitated, max assist; 5: confused, inappropriate non-agitated, max assist; 6: confused, appropriate, mod assist, follows simple tasks that are familiar; 7: automatic, appropriate, min assist for ADLs, consistently oriented, attends to familiar tasks; 8: purposeful, appropriate, stand by assist, ind attends to familiar tasks; 9: purposeful, appropriate, stand by upon request; 10: purposeful, appropriate, mod ind

Front 201

Describe central cord, Brown-Sequard, Anterior cord, posterior cord, conus medularis, and cauda equina syndromes

Back 201

central cord: more UE deficits than LE deficits; Brown-Sequard: ipsilateral paralysis, proprioception, discriminative touch, and contralateral loss of pain and thermal; Anterior cord: loss of bilateral motor function, pain, pinprick, and temp; posterior cord: proprioceptive loss, conus medularis:LE motor and sensory loss, areflexive bowel and bladder, cauda equina: LMN lesion

Front 202

Describe cerebral palsy, the types, and complications of cp?

Back 202

caused by injury/disease prior to, during, or shortly after birth resulting in brain damage and secondary neurological and muscular deficits; prognosis is dependent on severity and location of injury, nonprogressive disorder; types: spastic, dyskinetic, and ataxic; complications: seizures, cog deficits, visual impairments, feeding disturbances, and diminished sensation

Front 203

What is Parkinson's disease?

Back 203

hypokinetic CNS movement disorder that is slowly progressive and degenerative, begins insidiously with pill-rolling tremor of 1 hand, cardinal signs: tremor, rigidity, resistance to PROM, akinesia, postural instability, festinating gait, falling backwards/forwards, mask face, and micrographia

Front 204

Describe the Hoehn and Yahr 5 stage scale for parkinsons?

Back 204

stage 1: unilateral tremor, rigidity, akinesia, minimal/no functional impairment; stage 2: bilateral tremor, rigidity or akinesia with or without axial signs, ind with ADL, no balance impairment; stage 3: worsening of symptoms, first signs of impaired righting reflexes, onset of disability in ADLs but can still remain ind; stage 4: requires assist with ADLs, unable to live ind, able to walk and stand unaided; stage 5: confined to wheelchair, max assist

Front 205

Describe spina bifida and the different types?

Back 205

failure of spinal column's vertebral arches to fully form to enclose and protect neural tube; classification: occulta: bony malformation, dysraphism: external manifestations over site, cystica: exposed pouch comprised of SC and meninges, meningocele: sac contains CSF but no SC, myelomeningocele: contains CSF and SC; symptoms: vary depending on type, may cause motor/sensory deficits below injury; Tethered cord syndrome: SC is stretched causing bladder/bowel problems, gait issues, and deformities

Front 206

What are the major types of muscular dystrophies/atrophies?

Back 206

Duchenne's: 2-6 years, sex linked in males, pseudohypertrophy of calves, forearms, and thighs, weakness of proximal joints causing mobility impairments, weakness of voluntary muscles, life expectancy 20 years; Becker: less severe form of Duchenne's, loss of motor function at hips, thighs, pelvis, and shoulders; Arthrogryposis multiplex congenita: loss of anterior horn cells, detected at birth, waiter's tip deformity; Limb girdle: progresses slowly, hips and shoulders most affected; Fascioscapulohumeral: teens, face, UE, and scapula causing weakness and decreased mobility, slow progression; spinal muscular atrophy: decrease in motor neuron protein, 3 types;

Front 207

Describe progressive supranuclear palsy, Huntington's chorea, cerebellar disorders, cerebellar lesions, and spinocerebellar degenerations?

Back 207

PSP: loss of voluntary movements, rigidity, and dementia, Huntington's: choreiform movements and progressive intellectual deterioration; cerebellar d/o: ataxia, dysmetria, hypotonia, and movemetn decomposition; cerebellar lesions: caused by stroke or tumors; spinocerebellar degeneration: progressive ataxia due to degeneration of cerebellum, brain stem, SC, and nerves

Front 208

What is amyotrophic lateral sclerosis?

Back 208

motor neuron disease characterized by progressive degeneration of corticospinal tracts and anterior horn cells, death occurs in 2-5 years, symptoms: muscle weakness and atrophy, cramps precede weakness, dysarthria and dysphagia

Front 209

What is brachial plexus disorder and what are the two major types?

Back 209

secondary to traction or radiation, mixed motor and sensory d/o of corresponding limb; Erb's palsy: paralysis of upper brachial plexus, arm cannot be raised, no elbow flexion, waiter's tip deformity; Klumpke's Palsy: less common, paralysis of lower brachial plexus, paralysis in hand and wrist with limp hand and nonmoving fingers

Front 210

What is Guillain-Barre Syndrome?

Back 210

acute, rapidly progressive polyneuropathy that is characterized by symmetrical muscle weakness, and distal sensory loss/paresthesias

Front 211

Describe myasthenia gravis and post-polio syndrome?

Back 211

Myasthenia gravis: autoimmune attack characterized by episodic muscle weakness in cranial nerves, fluctuating symptoms; post-polio: new weakness and fatigue after recovery from polio

Front 212

What is multiple sclerosis?

Back 212

myelin damage caused by immune system, characterized by remissions and exacerbations, paresthesias, weakness, visual disturbances, emotional disturbances, balance loss, bladder dysfunction, cognitive features; 4 patterns: relapsing remitting, secondary progressive, primary progressive, progressive relapsing

Front 213

Describe the OT eval and general intervention process for neuro disorders?

Back 213

Eval: develop occupational profile, analysis of areas of O, determine sensory and motor function, determine cog/perceptual function, eval impact of deficits, determine psychosocial function, eval cultural, architectual, and societal barriers as well as home and work environments; Intervention: positioning, postural control, motor learning, motor retraining, ADL training, AT, splinting, cog-perceptual training, visual skills training, sexual dysfunction, bowel and bladder training, skin care, sensory re-ed, developing coping strategies, community re-integration, return to work

Front 214

Describe the OT assessment and intervention for pain?

Back 214

Assessment: history, localization of pain, nature of pain, irritating stimuli, use pain rating scales, physical exam, assess degree of suffering, assess functional changes, assess consequences, behavioral impact, and secondary gains, depression and anxiety, drug misuse, motivational components; intervention: education, assist indivual in identifying and responding to pain behaviors, develop strategies to manage pain, refer to other professionals, establish daily activity program, family education

Front 215

What are the 4 categories of sensory processing? What are the major sensory processing disorders?

Back 215

4 categories: Poor registration (high threshold, passive behavior), sensory seeking (high threshold, active behavior), sensory sensitivity (low threshold, passive behavior), sensory avoiding (low threshold, active behavior

Major d/o: sensory modulation disorder: sensory over-responsivity/under-responsivity/seeking-craving, sensory-based motor disorder, sensory discrimination disorder

Front 216

What are the general symptoms of sensory processing disorders and OT eval?

Back 216

symptoms: fluctuating responsiveness, difficutly interacting with environment, difficulty planning, sequencing, organizing, poor initiation, tactile, proprioceptive, and vestubular symptoms; Eval: parent/caregiver interview, formal assess of sensory processing, observation in natural environments

Front 217

What are the different types of seizures?

Back 217

tonic-clonic/grand mal: aura, loss of consciousness with stiffening of body, rigidity and relaxation of muscles, period of drowsiness after seizure; myoclonic-akinetic seizure: brief jerking of extremities w/o loss of consciousness, petit mal: loss of consciousness w/o loss of tone, partial focal: jerking of parts of body w/o loss of awareness, complex partial: alterations in consciousness, infantile spasms: 100xper day, dropping head and flexing arms, landau-Kleffer: progressive encephalopathy, status epilepticus: prolonged or rapid succession of seizures

Front 218

What are OT interventions for seizure d/o?

Back 218

first aid: stay calm, remove dangerous items, protect individual from harm, don't place anything in mouth, turn on side if risk of aspiration, allow seizure to happen, monitor mental state, call for medical attention; post seizure: allow individual to rest, call physician, notify caregivers, observe safety precautions; OT intervention: assess and intervene for developmental delays, observe all medical precautions, document seizure activity

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What is atherosclerosis and the risk factors for it?

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Thickening of intimal layer of blood vessel wall from accumulation of debris. Risk factors: age, sex, race, family history, smoking, high BP, high cholesterol, stress, diabetes, obesity, sedentary lifestyle

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What is angina pectoris?

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mild to moderate chest pain lasting 20 minutes, types: stable, unstable, and variant

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What is a myocardial infarction?

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prolonged ischemia injury and death of area of myocardium. Symptoms: severe pain, dyspnea, rapid respiration, SOB, indegestion, nausea, pain unrelieved by rest

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What is heart failure?

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Left sided: blood not pumped to systematic circulation, dry cough, wheezing, hypotension, dizziness, fatigue; Right sided: blood not returned from systemic to heart, edema, weight gain, nausea, cyanosis; biventricular: severe pathology producing back up into lungs, increased pressure

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What are the different types of peripheral vascular disease and their characteristics?

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arterial: occlusive (diminished blood supply to extremities, pain when walking, affects LEs), thromboangitis obliterans (chronic, common in men who smoke, begins distally), diabetic angiopathy, Raynaud's phenomenon; Venous: varicose veins, superficial vein thrombophlebitis, deep vein thrombosis, chronic venous insufficiency; lymphedema: chronic disorder with excessive acuumulation of fluid due to obstruction of lymphatics

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What are acute pulmonary diseases?

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bacterial pneumonia, viral pneumonia, aspiration pneumonia, tuberculosis, pneumocystis pneumonia: caused by fungus, severe acute respiratory syndrome: caused by coronavirus

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What are chronic obstructive pulmonary diseases?

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peripheral airways disease: inflammation in airways from smoking, chronic bronchitis, emphysema: permanent abnormal destruction of air spaces in bronchioles; asthma, cystic fibrosis, respiratory distress syndrome

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What does an OT cardiopulmonary assessment look like?

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review medical record, interview patient and caregivers, document presenting symptoms (angina, dyspnea, palpitations, dizziness, edema), past med history, review diagnostic tests, gather social history, determine discharge environment

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How may activity tolerance be assessed?

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graded exercises test, observation of activities, periodic monitoring of physical condition, monitor exertion using Borg rate of perceived exertion, metabolic equivalent levels

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Describe phase 1, inpatient rehab/acute hospitalization OT for cardiopulmonary conditions?

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begins when pt determined to be medically stable, program focus: pt and family ed on energy conservation and work simplification, knowledge of METs, improve self-care, decrease anxiety, promote risk factor modification, discharge. Eval and intervention: initiated t bedside, MET levels 1-2, energy conservation, breathing exercises, monitor vital signs and exertion; discharge: 5-14 days

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Describe phase 2, outpatient rehab/subacute stage for OT cardiopulmonary rehab?

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begins after discharge from hospital, focus: educate about importance of exercise, build up activity tolerance, improve performance in IADLs, improve work performance, support efforts in smoking cessation and lifestyle changes; Eval and intervention: home eval, consumer education, graded exercise program, METs 3-4, practice functional activities, use energy conservation, community activities, work site eval

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Describe phase 3, maintainence/training, community stage for OT cardiopulmonary rehab?

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attend once a week after phase 2, OT intervention provided as necessary, maintenance gym program including weight and cardiovascular training

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What are rehab guidelines for lymphatic disease?

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Phase 1: management, short stretch compression bandages worn 24 hrs, manual lymph drainage, massage and PROM, functional activities; phase 2: self-management, skin care, compression bandages, exercise, education about skin and nail care, bandaging, infection management, maintain exercise, and home program

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Describe cystic fibrosis, eval, intervention?

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chronic progressive lung disease characterized by production of abnormal mucous, causes exercise intolerance and poor nutrition; Eval: assess for developmental delays, assess environment to determine adaptations needed, assess psychosocial status; Intervention: energy conservation, environmental adaptations, positioning, neurodevelopmental treatment, parent education

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Describe Respiratory Distress Syndrome, OT eval and intervention?

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lungs collapse after each breath, effect on function: intellectual development may be affected, motor, sensory, cognitive impairments; Eval: assess for developmental delays, assess the environment; Intervention: monitor development, facilitate sensorimotor and cognitive development, address psychosocial issues, provide parent education on handling, positioning, and energy conservation, adapt environment

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Describe bronchopulmonary dysplasia, OT eval and intervention?

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respiratory disorder caused by barotrauma, exchange of oxygen and carbon dioxide is more difficult, effect on function: poor autonomic and sensory state regulation, poor activity tolerance, reduced socialization, isolation and stress, attachment disorder; Eval: assess for developmental delays and environment; Intervention: facilitate development, address psychosocial issues, provide ed regarding handling, positioning, feeding, energy conservation, and environmental adaptations, pt advocacy