OTD: 5050 Health conditions final (not finished)

What is health?

To reach a state of complete physical, mental, and social wellbeing, an individual or group must be able to identify and to realize aspirations, to satisfy needs and to change or cope with the environment

What are health disparities?

They are systemic and not random, unfair and unjust, avoidable and unnecessary, not inevitable, and due to the vulnerabilities created by social structures and institutions

What is health inequality?

Systematic, avoidable, and unfair differences in health outcomes that can be observed between populations, between social groups within the same population or as a gradient across a population ranked by social position

Factors contributing to health disparities

Economic factors and poverty, education and literacy, access to healthcare services, physical environment and neighborhood conditions, and social and community support

Examples of health disparities

Racial and ethnic disparities, gender disparities, geographical disparities (urban vs. rural), and age-related disparities

Social determinants of health

They are found in the environment and examples are:

• Economic policies & systems

• Development agendas

• Social norms

• Social policies

• Racism

• Climate change

• Political systems

• Economic stability

• Education Access and quality

• Health Care access and quality

• Neighborhood and built environment

• Social and community context (HHS)

What are the 5 domains of SDOH?

1. Economic stability

2. Education access and quality

3. Health care access and quality

4. Neighborhood and built environment

5. Social and community context

T/F: Racial disparities are considered to be one of the 5 domains of SDOH

False

30 y/o M, recently diagnosed with MS, lives in a rural community with limited healthcare access. what SDOH is impacted?

neighborhood and built environment

T/F: the international classification of functioning, disability, and health (ICF) was developed by the AOTA

False, it was developed by WHO

What are core values of OT?

Altruism, Equality, Freedom, Justice, Dignity, Truth, and Prudence

Philosophical assumptions

Occupations are purposeful activity, occupations are fundamental, performance skills have an impact on function, body structures and functions are important

Person first language

Emphasizing the individual before their disability or condition

Example: A 5th grade child with autism

ICF

International Classification of Functioning, Disability and Health is a framework that organizes information about health, disability, and how they affect a person’s ability to function

*It was endorsed by the WHO in 2001 as the international standard for measuring health and disability

Etiology of prenatal CP

Premature birth

• Periventricular leukomalcia (PVL)

• Intraventricular hemorrhage

• Cerebral dysgenesis

Intrauterine

• Maternal infections

• Hypoxic-ischemic encephalopathy (HIE) fetal stroke, a disruption of blood supply to the developing brain

Mutations in genes that lead to abnormal brain development

Etiology of perinatal CP

Lack of oxygen to the brain related to difficulties during labor or delivery with:

• umbilical cord

• detachment of the placenta

• uterine rupture

• perinatal hypoxia

Etiology of postnatal CP

Infant infections that cause inflammation in or around the brain (e.g. encephalitis, meningitis)

Traumatic head injury to an infant from a motor vehicle accident, fall, child abuse

Developmental events

• endocrine- hypoglycemia, hypothyroidism

• respiratory distress syndrome

Data prevalence of CP

• It is the most common motor disability in childhood

• Globally: 1 to 4 per 1,000 live births

• Prevalence is higher for: boys, non-hispanic black children, children born preterm or with low birthweight, and twins (higher among triplets)

Is CP more common in boys or girls?

Boys

Signs and symptoms of CP

poor coordination of movements, muscle stiffness, fatigue, seizures, balance issues, late developmental milestones, spasticity, muscle tremors, speech impairments, contractures and deformities

Is spastic pyramidal or extrapyramidal?

Pyramidal

Pyramidal vs extrapyramidal

Pyramidal tracts originate in the cerebral cortex and carry motor signals to the spinal cord and brain stem. They are responsible for voluntary control of muscles in face and body

Extrapyramidal tracts originate in the brain stem and carry motor signals to the spinal cord. They are responsible for involuntary and automatic control of muscles, such as balance, posture, and muscle tone

Is CP progressive or nonprogressive?

Non-progressive but permanent condition

Medical management of CP

Medications can decrease spasticity- diazepam, dantrolene, botox injections

Surgery- joint fusions, tendon lengthening, tendon transfers

Splinting and orthotics- AFO and TLSO

PT, OT, and SLP

Aging with CP

Weak muscles get even weaker over time

Abnormal muscle patterns often place joints in abnormal positions

• This can lead to increased fall risks (greater injury with falls)

• Health management tasks become more difficult

• Severe arthritic changes

T/F: The OTPF is organized into 5 aspects: occupations, contexts, performance patterns, performance skills, and client factors

True

What is the most severe form of CP

spastic quadriplegic

T/F: CP can occur during any stage of brain development

True

What is spinal shock?

altered reflex activity immediately after a traumatic SCI

Dyskinesia or uncontrollable movements is associated to damage of the

basal ganglia

The Gross Motor Functional Classification System (GMFCS) is associated with

CP

T/F: Diagnosis of CP usually happens between ages 3-5 years old

False

Is macular degeneration loss of central or peripheral vision?

central

what type of macular degeneration is inherited from both parent recessive genes

juvenile MD

what is the leading cause of severe vision loss?

macular degeneration

T/F: fatigue is a common sign and symptom of all types of CP

False

Which type of low vision involves an increase in intraocular pressure?

Glaucoma

Decorticate posturing is extensor posture due to damage to brainstem

False, flexion of arms and damage to cerebral cortex

Swan neck deformity involves

dorsal migration of lateral bands

T/F: primary brain injury occurs at any time of injury

True

T/F: Falling is the most common and preventable cause of SCIs

False

T/F: Dyspnea, fatigue, and orthopnea are all associated with L sided HF

True

Which fracture has one side of the fracture a complete break and the other side bends rather than snaps?

greenstick

What are signs and symptoms of COPD

shortness of breath, hypertension, and persistent cough

T/F: fatigue is a sign and symptom of COPD

False

T/F: lupus is hereditary

True

T/F: cognitive domains are the most affected when it comes to NCDs

True

T/F: fatigue is the most debilitating factor of cancer

True

All are common sites for metastatic disease except:

1. Lungs

2. liver

3. ovaries

4. bone

ovaries

what is autonomic dysreflexia/hyperreflexia

exaggerated response of ANS

______ is a classic brainstem stroke

Wallenberg syndrome

what artery is the most affected in pediatric stroke?

MCA (middle cerebral artery)

“Plaques and tangles” is associated with which condition

Alzheimer’s

which area of the brain is responsible for coordination, balance, and fine motor movements?

cerebellum

what is the process of a reflex arc

producing a response without brain function

which is a common comorbidity for Autism

Fragile X

Left side of the brain is associated with:

difficulties with verbal memory and language/speech

infants with ____ will display CNS damage and ID

Fetal alcohol syndrome

Which hormone is associated with the brain’s reward system?

dopamine

T/F: ACE scores do not correlate with health risks and social problems later in life

False