CVA
occurs when a blood vessel ruptures or leaks, most commonly because of hypertension bleeds, malformed blood vessels or veins, aneurysms (blood vessel weakness), or it may be spontaneous. Hemorrhagic stroke causes the excess blood to come in contact with other brain tissue
hemorrhagic stroke
an insult to the brain from an external source
TBI
Jon has a T4 AIS A SCI/D. As a result of this condition, where would the OTA suggest he check for water temperature when bathing?
a. His feet
b. His hands
c. His thighs
d. His stomach
b. His hands
the opposite of spasticity, a person has no muscle tone or resistance to passive stretch; the limb appears floppy
flaccidity
most common type of stroke and occurs when there is some type of blockage of blood flow
ischemic stroke
It measures three parameters—eye movements, verbal responses, and motor responses; overall scores can range from 3 to 15
Glasgow Coma Scale (GCS)
It is critical that clients with this level of injury/disease avoid inadvertently stretching out the finger flexors and thumb by stretching incorrectly.
C6
refers to an abnormally strong skeletal muscle that is resistant to stretch and is velocity dependent.
Hypertonicity, or “spasticity,”
pattern presents as:
■ Scapula adducted
■ Shoulder externally rotated and abducted
■ Elbow in flexed position
■ Forearm supinated
■ Wrist flexed
■ Fingers flexed
flexor synergy
It is not caused by a blow or impact to the head, but by the brain moving with acceleration and deceleration as well as compression and stretching inside the skull, often causing injuries to many parts of the brain
Diffuse Axonal Injury
exaggerated, reflexive sympathetic response, generally in an individual with a complete SCI/D at T6 or above. This response causes a very high blood pressure and potentially life threatening symptoms that happen due to stimuli such as pain, irritation, constipation, or a full bladder, which would not be an issue for an individual without an SCI/D.
Autonomic dysreflexia (AD
3 types of Sensory stimulation to facilitate muscle tone
brushing, vibration, tapping
is seen when a person does not display any emotional expressions or body gestures. He or she appears to have a stony expression, with little reaction to things around them.
flat affect
The client responds in a specific manner to stimuli, but responses may be delayed and inconsistent. The client may be in an acute care hospital or may have transitioned to an inpatient rehabilitation facility. At this point, the client is considered to be in a minimally conscious state and OT is focused on sensory stimulation and family education.
Clients with this level of injury have no strength in or control of their arms, trunk, or legs. Due to paralysis or weakness of the diaphragm, clients injury this level and above complete SCI/D require constant breathing assistance from an external ventilator, a pneumatic electric machine that forces room air into the lungs (inspiration) and the client passively exhales (expiration
C3
3 ways to assess muscle tone
is defined as a disorder of purposeful skilled movement, which is not the result of sensory or motor deficits (weakness, abnormal muscle tone, decreased proprioceptive sense, etc.) or deficits in comprehension.
Apraxia
The OTA sees a client in the acute hospital 2 days after he was thrown from his motorcycle. He sustained a TBI, left tibial fracture, and is in a medically induced coma state. Which of the following areas would be a good place to begin with OT education and training with his family members?
a. Medication management
b. Behavior and overstimulation
c. ADLs and transfers
d. PROM UE exercises
b. Behavior and overstimulation
Because of this lack of wrist and hand strength, clients can use a ________with a _________ attachment for increased independence with self-feeding and grooming activities
dorsal wrist support | universal cuff
During PROM, resistance is felt at various points throughout the range followed by points of release/easy movement (can be seen in Parkinson’s disease).
Cogwheel Rigidity