Term
| Know why MS presents differently in different individuals |
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Definition
| In MS, the myelin surrounding the nerve axons in the CNS is impacted. Plaques develop in localized areas, interrupting the transmission of signals. The myelin is stripped from the axons. Symptoms depend on where the lesion is occurring within the nervous system. They myelin can also repair over time, resulting in alleviation of symptoms. Different individuals present with different symptoms because the disruption of myelin occurs in different places in the nervous system and may or may not heal over time. Possible courses are: benign, relapsing/remitting, primary progressive, secondary progressive, progressive relapsing. |
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Term
| Know the characteristic symptoms of Huntington’s disease |
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Definition
| Causes uncontrolled movements, loss of intellectual faculties, and emotional disturbance. Problems with voluntary and involuntary movements. Initial symptoms are often changes in behavior (irritability or depression), cognition (forgetfulness, concentration, decision making, sequencing), Chorea (rapid, involuntary, irregular movements). Symptoms get worse as the disease progresses. Eventually impacting even verbal comprehension. Onset is normally in the 30s or 40s. 15-20 prognosis. |
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Term
| Know what parts of the brain are involved in Huntington’s disease |
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Definition
| degeneration of brain cells/neurons in the *corpus striatum*. The corpus striatum plays an important role in motor control. The caudate nucleus is linked to cognitive and emotional function. In later progression, tissue loss can occur in the frontal cortex, globus pallidus and thalamus. |
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Term
| Know the classic symptoms of MS |
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Definition
| Weakness,paraesthesias, abnormal reflexes (slow), cerebellar signs, spasticity/stiffness, fatigue, heat intolerance, decreased alternating movements, cognitive impairment, nystagmus, impotence, pain, muscle wasting, diplopia, Optic neuritis, gait difficulty, ataxia, vertigo. Emotional disturbances ie depression. |
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Term
| Know what symptoms most frequently triggers the diagnosis of MS |
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Definition
| Optic Neuritis is key for differential diagnosis. Plaques affecting the optic nerve. Look for vision problems. |
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Term
| Know what neurological diseases present with general muscle weakness |
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Definition
| MS, ALS, Friedreich’s Ataxia, Lewy body Disease, Spinal muscular atrophy, post polio, primary lateral sclerosis and PSP |
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Term
| Know what to do if someone is having a tonic clonic seizure |
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Definition
| Someone experiencing a tonic clonic seizure will display rhythmic jerking of their body and frozen muscles. They will not be conscious. Make sure that there is nothing around them that they could injure themselves on. If on a hard surface, you can place something soft under their head. Do Not put anything in their mouth. Call 911 if: the episode lasts for more than 5 minutes, if you are unaware of a previous seizure condition, or if the person is pregnant. |
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Term
| Know what an absence seizure looks like as compared to a myoclonic |
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Definition
Absence seizure is focal in the brain. The person may just look like they are not paying attention. You see the eyes unfocus somewhat. The person will not recognize what is happening. It is more common in kids and they may grow out of it.
Myoclonic- sudden, powerful, uncontrolled muscle spasm |
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Term
| Know what eye diseases are associated with the retina |
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Definition
| Retinopathy of of Prematurity, Retinitis Pigmentosa, Retinoblastoma, Macular degeneration, Diabetic Retinopathy |
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Term
| Know the anatomy of the eye as it relates to glaucoma, cataracts, and macular degeneration |
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Definition
Glaucoma- disease of elevated intraocular pressure. fluid builds up in the anterior chamber of the eye and is not able to flow adequately out the angle of the eye. Can be caused by numerous other eye conditions.
Cataracts- The lens of the eye changes from clear to opaque due to the formation of crystals.
Macular Degeneration-degeneration of the central area of the retina ( the macula) categorized as “wet” or “dry”. “wet” involves bleeding and abnormal growth of blood vessels |
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Term
| Know the difference between legally blind, blind, and functionally visually impaired |
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Definition
Legal blindness: legal designation for determining eligibility for government benefits and driver’s license. Visual acuity of 20/200 or less in the better eye with the best correction (blindness). OR a visual field of 20 degrees or less in the widest meridian of the better eye.
Low vision- best corrected visual acuity of less than 20/40 in the better seeing eye
Functional Vision impairment: significant limitation of visual capability resulting from disease, trauma, congenital conditions. Cannont be fully ameliorated by medical procedures. Manifested by: insufficient visual resolution, inadequate field of vision, reduced contrast sensitivity. Prevents or causes difficulty in performing activities of daily living. |
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Term
| Know how glaucoma is treated |
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Definition
| Interocular pressure reduced through medical eyedrops (trimolol), aqueous suppressants, miotic, prostaglandin analogues. Laser surgery, conventional surgery to release fluid. |
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Term
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Definition
| Opacification of the crystalline ocular lens, yellowing. Results in glare-related vision loss and blurring of vision. Person has difficulty seeing when moving from brightly lit to dimly lit settings. Distance and depth perception problems, altered color perception. Sometimes diplopia or triplopia. |
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Term
| Know what retinopathy of prematurity is and what effect it has |
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Definition
| A problem seen in premature infants. severest form causes complete retinal detachment and total blindness.caused by destructive abnormalities in the blood vessels of the developing retina. 85% resolve without treatment. Retinal detachment surgery is usually successful but functional vision loss remains. When looking at the eye. you can see and increase in capillaries and evidence of bleeding. |
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Term
| Know what symptoms a person with Meniere’s disease has |
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Definition
| A person will experience: vertigo (severe dizziness), nausea and vomiting, and tinnitus and hearing loss. |
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Term
| 1. Know the major characteristics of Autistic Disorder |
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Definition
Inability to relate in an ordinary way to people and situations from the beginning of life.
Diagnosed based on clinical findings, prior to age 3
Manifest within broad range of behavioral and communication difficulties
repetitive play
develops rigid routines
appears to drift aimlessly
intense and obsessive interests
tendency to focus on details and not entire object
sensory dysfunction
inability to imitate
problems executing intentional movements |
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Term
| 2. Know what Domains an OT should assess when working with a child with Autism |
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Definition
Neurodevelopmental skills
· Motor skill (gross, fine, visual-motor)
· Sensory processing
· Impact on occupational performance
· Functional skills remedy
· Training imitation
· Play – competence and playfulness |
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Term
| 3. Know the etiologies of autism |
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Definition
-complexity of nervous system
-combination of genetic, epigenetic and environmental factors |
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Term
| 4. Understand the controversies and limitations associated with IQ tests |
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Definition
IQ tests can be culturally biased
IQ scores can change significantly
Intelligence testing is not an exact science
IQ tests measure how a child performs at one point in time
IQ tests have proven to be good predictors of school success
IQ results should never be used as the sole criterion for classifying children. |
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Term
| 5. Know the criteria for diagnosing ADD vs ADHD |
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Definition
Inattention
Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
Often has difficulty sustaining attention in tasks or play activities
Often does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
Often has difficulty organizing tasks and activities
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or housework)
Often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books, or tools)
Is often easily distracted by extraneous stimuli
Is often forgetful in daily activities
- Hyperactivity/Impulsivity (6 or more)
Often fidgets with hands or feet or squirms in seat
Often leaves seat in classroom or in other situations in which remaining seated is expected
Often runs about or climbs excessively in situations in which it is inappropriate (in adolecents or adults, may be limited to subjective feelings of restlessness)
Often has difficulty playing or engaging in leisure acitivities quietly
Is often “on the go” or often acts as if “driven by a motor”
Often blurts out answers before questions have been completed
Often has difficulty awaiting turn
Often interrupts or intrudes on others (e.g. butts into conversations or games) |
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Term
| 6. Know the causes of Intellectual Disability |
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Definition
Genetic Condition
Problems during pregnancy
Problems at Birth
Health Problems |
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Term
| 7. Know what qualifies as a learning disability |
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Definition
It is defined as a disorder in 1 or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations.
DSM-IV definition - Learning disorders are diagnosed when the individual’s achievement on individually administered, standardized tests in reading, mathematics, or written expression is substantially below that expected for age, schooling, and level of intelligence. |
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Term
| 8. Know the risk factors for cardiovascular disease (modifiable and fixed) |
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Definition
Fixed
· Race
· Age
· Sex
· Genetics
Modifiable
· Hypertension
· Hypercholesteremia
· Diabetes
· Physical Inactivity
· Stress
· Obesity
· Tobacco use |
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Term
| Know the symptoms of a myocardial infarction |
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Definition
Pain extending beyond your chest to your shoulder, arm, back, or even to your teeth and jaw
Increasing episodes of chest pain
Prolonged pain in the upper abdomen
Shortness of breath
Sweating
Impending sense of doom
Fainting
Nausea and vomiting
Pressure, a feeling of fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes
MI (Myocardial Infarction aka heart attack) - Is an interruption of blood flow to the heart, causing heart cells to die. Can lead to cardiac arrest.
Cardiac arrest - When someone has a cardiac arrest, their heart stops pumping. This means blood doesn't flow around their body and oxygen doesn't reach their brain and other organs. |
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Term
| 10. Know how a patient with COPD presents (what are their signs/symptoms) |
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Definition
-COPD can cause breathlessness (also called shortness of breath or dyspnea), cough, production of mucus/sputum/phlegm and tiredness (also called fatigue). Symptoms such as breathlessness and fatigue cannot be seen or easily measured because they are sensations or feelings that you experience. Only the person experiencing the symptom can describe these sensations and how badly they make them feel.
-Symptoms - Coughing, shortness of breath, sputum production |
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Term
| 11. Know the symptoms of Parkinson’s disease |
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Definition
Tremor
Rigidity
bradykinesia: slowed movement, shuffling gait
Postural instability
difficulty speaking
skin problems |
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Term
| 12. Know what part of the brain is involved in Parkinson’s disease |
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Definition
-Malfunction of the Basal ganglia
-Decreased Dopamine stores in the Substantia nigra (this is within medulla) |
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Term
| 13. Know the most common medications used to treat Parkinson’s |
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Definition
Levodopa: Dopamine precursor
Sinimet: slows down the uptake of Levodopa so effectiveness doesn’t wear off so quickly
** The standard preparations (Sinemet, Atamet) combine levodopa with carbidopa, which improves the action of levodopa and reduces some of its side effects, particularly nausea. (http://health.nytimes.com/health/guides/disease/parkinsons-disease/levadopa-%28l-dopa%29.html) |
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Term
| 14. Know what dyskinesia is: |
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Definition
side effect of the Levodopia that manifests itself in uncontrolled, squirmy movements
Dyskinesia is a movement disorder which consists of effects including diminished voluntary movements and the presence of involuntary movements, similar to tics or choreia. Dyskinesia can be anything from a slight tremor of the hands to uncontrollable movement of, most commonly, the upper body but can also be seen in the lower extremities. |
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Term
| 15. Know the typical progression of ALS |
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Definition
| gradual degeneration and death of upper/lower motor neurons. Starts with muscle weakness and death typically occurs 3-5 years after breathing becomes compromised. |
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Term
| 31. Know what causes burns |
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Definition
Thermal (scalds, flame, flash, contact; most common type of burn)
Electrical (alternating current versus direct current i.e. lightning)
Chemical (acids or alkalis)
Radiation (ultraviolet or ionizing) |
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Term
| 32. Know the functions of the skin |
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Definition
Temperature regulation
Protection
Sensation
Excretion
Immunity
Metabolism |
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Term
| 33. Know what Total Body Surface Area is and why it is important |
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Definition
Determination of degree: size indicates amount or need for medical management
Used to assess burn severity
Rule of Nines: divides the body surface into 9% or multiples of nine
Head (9%), Upper extremity (18%), Trunk (36%), Lower Extremity (36%), Gentalia (1%) = 100%
Children: Head and Neck (21%), Each Arm (10%), Back (13%), Abdomen (13%), Each Leg (13.5%), Buttocks (5%), Gentalia (1%) = 100%
Palm Method: use patients palm to measure total body surface area
Lund and Browder: used for children- reflects growth chart |
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Term
| 34. Know what necrotizing fasciitis is |
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Definition
A bacterial infection which causes tissue death in skin, muscle, and underlying tissue
A "flesh eating bacteria" |
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Term
| 35. Know what a keloid scar is |
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Definition
| Overgrowth of tissue expanding outside the borders of the burn |
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Term
| 36. Know what causes toxic epidermal necrolysis |
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Definition
| A skin disorder due to allergic reaction or infection (herpes simplex or mycoplasma) |
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Term
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Definition
An increase in pressure which negatively impacts blood, tissue, and nerves
fluid builds up to where pressure increases and pinches off circulation
Treated with escharotomy or fasciotomy to relieve pressure/compression and increase circulation |
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Term
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Definition
Graft from another species
Temporary covering
Rejected by immune system
Must be replaced 7-10 days with autograft (self graft) |
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Term
| 39. Superficial partial thickness burn |
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Definition
Surface covered in blisters
blisters can increase in size
sensitive to temperature
scarring is mild to moderate
if blisters are removed, tissue is wet, shiny, and pink or red in color
Course of treatment: deflate blisters, topical Silvadene |
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Term
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Definition
Appearance hard, dry, tan in color
After healing or grafting, color change may be permanent
Third Degree Burns
Extends into subcutaneous tissue
Complete destruction of epidermis and dermis
Treatment requires wound care, debridement of burn and grafting
Possible scaring, contractures and deformities
Fourth Degree Burns
Damage extends to deep structure such as muscle tendon and bone
High risk for amputation
Prolong contact with agent |
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Term
| 41. Deep Partial Thickness Burn |
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Definition
Waxy and white, but soft and elastic
Sensitive to pressure, but not light touch
Can heal without grafting
Scarring moderate to severe
Can convert to full thickness
Infection can occur if not treated |
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Term
| 42. Know where intravenous lines are placed |
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Definition
Peripheral (PIV)
used for continuous IV therapy. most commonly found in forearm vein.
no restriction for activity
(look for single IV line in either forearm)
Central Venous Catheters - central lines and triple lumens
administers medications that are too caustic or if the infusion rate is too fast for the peripheral line.
May be used when peripheral veins can no longer be accessed, when prolonged IV therapy is needed, when multiple number of IV meds are needed, and when large amounts of fluid are needed.
placed in the subclavian or jugular vein and threaded to the superior vena cava.
no restriction from activity
(look for lines coming from the neck. Central lines may be in the upper chest. Lines are sutured in)
Peripherally inserted central catheter (PICC)
inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access.
same uses as central venous catheters above
no restriction from activity
(look for a line coming from the upper arm. usually has more than one port) |
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Term
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Definition
Patient Controlled Analgesia
patient is able to self-administer pain medication by pushing a button. Rate is set and patient will only receive a certain dosage within a certain time period.
Administered through PIV or epidural catheter |
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Term
| 44. Know what info you get from telemetry(leads attached to the chest and connected to a monitor) |
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Definition
heart rate
heart rhythm
respiratory rate
respiratory rhythm
no restriction to activity if vitals are within acceptable limits
(look for 5 leads on the chest) |
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Term
| 45. Know what the A-Line does (what it detects) and if you know a patient has one what should you do before having them get up. |
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Definition
A-line: catheter is placed in an artery, most commonly radial, used to measure blood pressure continuously or obtain blood samples without needle puncture
(look for a more rigid tubing looped around the thumb) |
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Term
| 46. Know what an endotracheal tube is |
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Definition
tube inserted into trachea via the mouth, which delivers oxygen under pressure to maintain airway.
used in emergency situations or after surgery, for short-term oxygen administration, usually not more than 10 days to avoid damage to vocal cords.
patients usually under some level of sedation
(look for flexible tube coming from mouth. will be hooked up to ventilator) |
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Term
| 47. Know what a nasogastric tube is |
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Definition
Inserted through the nostril to the stomach
May be orogastric (OG) in babies or patients with multiple facial fractures
Provides nutritional support and also removes gas and fluid from the stomach and GI tract
Can also be used to administer medications
Do not lay the patient flat- keep head of bed elevated to 30 degrees
No activity restrictions, but feeds are usually stopped during activity
May or may not be connected to feeding pump |
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