HOSA Occupational Therapy study guide 2024-2025

Occupation

The occupational functioning in life roles that are important to the individual patient or client

Occupational Therapy Practice Framework: Domain

and Process, 2nd Edition (OTPF-2)

-Outlines the unique focus of the profession and delineates the issues that OT should address.

-The purpose is to identify

clearly the factors that the OT and occupational therapy assistant (OTA) should consider

Areas of Occupation

ADLs, IADLs, rest and sleep, education, work, play, leisure, social participation

Performance Skills

are the building blocks of performance in occupation. These skills

Patterns

Such as habits, routines, rituals, and roles. Patterns help to make performance more automatic and thus less demanding of conscious attention.

Activity Demands

Take into account all of the parameters of a specific activity.

Figure 1-1

Frame of Reference

-Provides structure to organize thoughts

-Theoretical

Components of MOHO

Habituation

Occupation

Environment

PERSON

Three subsystems of human occupation

Volition

Habituation

Performance Capacity

MOHO: Volition

Personal Causation -Beliefs about personal effectiveness

Values - Internalized images of what is important and meaningful

Interests- Things a person finds enjoyable or satisfying (liking football more than baseball)

MOHO: Habituation

Habits

Internalized roles

Habits

-Automatic routines or patterns of activity

-Completed with little conscious awareness

-Habits and environment are interdependent

Internalized Roles

-Personalization of typical occupational roles

-May reflect values and interests

-Role transition occurs over the life span

MOHO: Performance Capacity

The "ability for doing things"

Dependent on body structures and functions

"Lived body"

-Knowledge of the world is developed through the experience of living in a particular body

-Lived body of a person with physical disability provides a different perception and understanding of the world.

Principles of OT intervention Derived from MOHO

-Client change is the focus of therapy

-Only clients can accomplish their own changes

-Therapeutic doing must involved an occupational form

-For achievement of change the doing must be relevant and meaningful

-Change in therapy involves simultaneous an interacting alteration in the person and the environment, and in the relationship of the two.

Biomechanical approach

-Targets populations with lower motor neuron or orthopedic disorders

-Focus is to remediate range of motion, strength, and endurance

-Also applied in ergonomics and work hardening

-Targets performance capacity, body structures, and body functions

Sensorimotor and Motor Learning Approaches

Developed for people who have central nervous system dysfunction

Sensorimotor approaches

- Use neurophysiologic mechanisms

- May use reflex mechanisms

- Controlled input to stimulate specific response

Motor learning approaches

-Acquisition of motor skills through practice and feedback

Rehabilitative Approach

-Concerned with restoration of a purposeful life

-Focus is on abilities rather than disabilities to compensate for physical limitations

-Aim is to minimize the effect of the residual disability on role performance

-May be used in combination with other treatment approaches

Treatment Continuum

Continuum between the onset of illness and the restoration of maximal independence

Four stages

-Adjunctive methods

- Prepare the person to engage in activity

Enabling activities

-Require more active patient involvement

-Are a step toward performing purposeful activities

-Purposeful activity

-Occupational performance and occupational roles

Evidence Based Practice (EBP)

Using research to provides evidence to support practice

OT profession needs more research to support EBP

Considers both the consumer's an the practitioner's perspectives

Occupational therapy assistant (OTA) may contribute to the research process

cardiovascular accident

What does CVA mean?

ischemia

Lack of blood supply

hemorrhagic stroke

occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed

ischemic stroke

Most common type of stroke in older people, occurs when the flow of blood to the brain is blocked by the narrowing or blockage of a carotid artery.

thrombosis, lacunar, embolism

what are the three types of ischemic strokes?

Atherosclerosis

Rough, irregular fatty deposits from within the intima and inner media of the arteries and often leads to the generation of a thrombus.

Thrombus

a blood clot attached to the interior wall of an artery or vein

Transient Ischemic Attack (TIA)

temporary blockages of an artery, precede actual infarction about have the time, and the risk factors for TIAs are the same as other types of strokes.

Mini Stroke

Transient Ischemic Attack (TIA) is also known as a ____________________.

thrombosis

cerebral _______________ occurs when a blood clot forms in one of the arteries supplying the brain causing vascular obstruction at the point of its formation.

Lacunar stroke

Small infarctions, usually lying in the deep brain structures, such as the basal ganglia, thalamus, pons, internal capsule, and deep white matter.

True

T/F: Because Lacunar infarctions are so small, minimal neurological symptoms are often present, and many such strokes go undetected.

Ebolism

__________ occurs when a clot has formed elsewhere, breaks off, travels up the bloodstream until it reaches an artery too small to pass through, and blocking the artery.

False

T/F: embolic strokes typically occur during the night times activity.

aneurysm

ballooning of a weakened portion of an arterial wall

intracerebral hemorrhage

Which has a higher percentage of deaths?

a. intercerebral hemorrhage

b. ischemic strokes

subarachnoid hemmorhage

bleeding in the subarachnoid space

True

T/F: Some strokes start as ischemic and transforms into hemorrhagic.

psychosocial factors

which is not a non-modifiable risk factor?

a. age

b. ethnicity

c. psychosocial factors

d. gender

e. genetics

second

CVA is the ____________ leading common cause of death in the world after heart disease.

Cerebral Pasly (CP)

what condition in children is the result of an a stroke at a young are or in the womb?

homonymous hemianopsia

The loss of the right or left half of the field of vision in both eyes.

stroke warning signs

Sudden numbness or weakness of the face, arm, or leg

Sudden confusion or trouble speaking or understanding

Sudden trouble walking, dizziness, or loss of balance or coordination

Sudden trouble seeing in one or both eyes

Sudden severe headache

Left-sided stroke

LANGUAGE

aphasia

agnosia (unfamiliar objects)

agraphia

alexia (reading issues)

right hemiplegia/hemiparesis

hemianopsia (visual field)

SLOW CAUTIOUS behavior

ANGER/DEPRESSION

right-sided stroke

affects left side, unilateral neglect, safety impulses, uninhibited & have perceptual deficits

anterior cerebral artery stroke

Contralateral hemiplegia, grasp reflex, incontinence, confusion, apathy and/or mutism

vertebrobasilar

Cerebellar and brain stem ischemia and infarction

wallenberg syndrome

a classic brainstem stroke that also is referred to as lateral medullary syndrome as it occurs as a result from a vertebral or cerebellar artery occlusion.

secondary complications of CVA

-Depression (1/3 of stroke patients)

-Seizures (10% of stroke survivors, brain is scarred during seizures, scar tissue remains)

-Infections (trouble swallowing)

-Bowel and bladder incontinence (UTI)

-Pulmonary Embolism (embolism lodged in lungs)

-Shoulder subluxation

-Painful shoulder

-Shoulder hand syndrome (shoulder, elbow, hand does not coordinate)

-Abnormal muscle tone

-Associated reactions and movements

-DVT (lower extremity hot to touch , calves, painful)

subclavian steal syndrome

Occurs when significant stenosis in the subclavian artery compromises distal perfusion to the inferior mesenteric artery.

neural plasticity

The ability of the brain's networks of neurons and their synapses to change. Allows adaptation to chaining life circumstances as well as memory formation (memory can be stored as changes to networks of neurons)

cardiopulmonary

what term means "pertaining to the heart and lungs"?

oxygen

when blood is pumped through the lungs it picks up ____________ and carries it back to the heart and then to the rest of the body.

vital signs

Measurements of the body's most basic functions and useful in detecting or monitoring medical problems.

pulse rate

the number of pulse beats per minute

respiratory rate

number of breaths per minute

blood pressure

the pressure that is exerted by the blood against the walls of blood vessels

hypertension

high blood pressure is also known as _________________.

oxygen saturation

percentage of hemoglobin that is bound to oxygen

270 million

each red blood cell within the body contains ~_________ molecules of hemoglobin.

hypoxemia

decreased level of oxygen in the blood.

hypotension

low blood pressure

Coronary artery disease

this disorder develops when coronary arteries, the blood vessels that supply the heart with blood, oxygen, and nutrients become damaged over time.

atherosclerosis

condition in which fatty deposits called plaque build up on the inner walls of the arteries

True

T/F: CAD typically progresses slowly and worsens over time, often going unnoticed until arteries have narrowed considerably, and blood flow has been significantly restricted.

angioplasty

the technique of mechanically widening a narrowed or obstructed blood vessel

coronary artery bypass graft

surgical technique to bring a new blood supply to heart muscle by detouring around blocked arteries

congestive heart failure

heart is unable to pump its required amount of blood

dyspnea

difficult or labored breathing

COPD

an umbrella term used to describe a group of progressive lung disorders.

emphysema

a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness.

bronchitis

inflammation of the bronchial tubes

Myocardial infarction

heart attack

False

T/F: Heart attacks look the same in men and women.

Traumatic brain injury

mild or severe trauma that can result from a violent impact to the head

Mild traumatic brain injury

- loss of consciousness for up to a few min

- headache, dizziness, loss of balance

- drowsiness, nausea, vomiting

moderate traumatic brain injury

- Characterized by LOC 30 min- 6 hrs and Glasgow Coma Scale (GCS) 9-12

-Focal or diffuse brain injury may be seen with CT or MRI

-Post traumatic amnesia may last up to 24 hours

-Often requires hospitalization for close monitoring and prevention of secondary injury from brain edema, intracranial bleeding or inadequate cerebral perfusion

severe traumatic brain injury

- Loss of consciousness of more than 24 hours

- Posttraumatic amnesia of more than 7 days

- GCS score of 3-8

Postconcussion syndrome

A delayed condition characterized by persistent headaches, blurred vision, irritability, and an inability to concentrate.

closed brain injury

a head injury where the skull is not cracked.

penetrating brain injury

when an object penetrates the skull and enters the brain (example gunshot)

blast brain injury

damage to the brain caused by energy waves from an explosion, such as a bomb, that creates bulk acceleration of the head, vascular surge in the brain, and dynamic deformation of the skull

True

T/F: males are more likely to sustain a TBI

primary brain tumor

a tumor that originates in the brain

secondary brain tumor

These tumors are metastases. That is, they originate in another part of the body and spread to the brain. Thus, they are always cancerous.

nonmalignant brain tumor

a brain tumor that is benign, not cancerous; does not spread to body tissue; can become life threatening

malignant brain tumor

brain cancer

OPHI

Acronym

Occupational Performance History Interview

OPHI

Age

Not recommended for children under age 12

OPHI

Dx

Any

* Must be able to answer in-depth interview questions

OPHI

Setting

Any

OPHI

Data Collection

Semi-structured Interview

OPHI

What is assessed?

- Roles

- Activity/occupational choices

- Critical life events

- Occupation settings (environment)

- Routines

OPHI

3 rating scales

- Occupational identity

- Occupational competence

- Occupational settings

OPHI

Scoring

4 point rating scale:

(1) extreme occupational dysfunction - (4) exceptional competent occupational functioning

OPHI

What can we learn from it? (How can it be used for treatment planning and discharge recommendations?)

- Graphing of life events

- Develop an occupational profile

- Identify client's strengths and weaknesses

- Understand client's life hx to guide intervention

- Fosters communication and collaboration and a therapeutic relationship between client and OT

OCAIRS

Acronym

Occupational Circumstances Assessment Interview Rating Scale

OCAIRS

Age

Adults

OCAIRS

Dx

- Short-term psychiatric inpatient

* Must be able to participate in interview