Comprehensive Occupational Therapy Exam Review: Terminology, Theory, and Clinical Practice

Flashcards covering essential terminology, models, assessments, and clinical interventions from the Occupational Therapy board review lecture notes.

Primary Prevention

The reduction of the incidence of a disease or disability within a population that is currently well or considered to be at risk, utilizing create/promote approaches and enrichment activities.

Secondary Prevention

The early detection of problems within a population to reduce the duration and minimize the impact of the condition.

Tertiary Prevention

Intervention focused on eliminating or reducing the impact of dysfunction on an individual after an injury or diagnosis.

Occupation as Ends

The client's functional goal carried out within a given environment and life role, using whatever capacities the client possesses along with necessary adaptations (e.g., cooking to maintain the role of mother or partner).

Occupation as Means

The use of an occupation as a treatment medium to improve or remediate impaired capacities and abilities to enable eventual occupational functioning.

Grading

Adjusting the intensity, duration, or difficulty of an activity to facilitate client improvement.

Adapting

Changing the way a task is performed to facilitate better performance and overcome functional limitations.

Altruism

An occupational therapy core value defined as the demonstration of unselfish concern for the welfare of others.

Dignity

An occupational therapy core value defined as valuing, promoting, and preserving the inherent worth and uniqueness of each person.

Beneficence

The ethical principle requiring occupational therapy personnel to demonstrate a concern for the well-being and safety of the client through evidence-based, timely, and relevant services.

Nonmaleficence

The ethical principle mandating that occupational therapy personnel refrain from actions that cause harm, neglect, abandonment, or conflicts of interest.

Autonomy

The ethical principle stating that occupational therapy personnel shall respect the right of the person to self-determination, privacy, confidentiality, and consent.

Procedural Justice

The ethical principle requiring compliance with rules, laws, and institutional policies, including refraining from accepting inappropriate gifts.

Veracity

The ethical principle requiring occupational therapy personnel to provide comprehensive, accurate, objective, and truthful information in documentation and communication.

Fidelity

The ethical principle mandating that occupational therapy personnel treat clients and coworkers with respect, fairness, discretion, and integrity.

Ethical Temptation

A situation where a person knows the right course of action but is tempted to go against it for personal benefit (e.g., continuing treatment for monetary gain when a client is ready for discharge).

Moral Distress

A situation where an individual knows the right course of action but is prevented from carrying it out due to organizational policies or procedures (e.g., a facility closing before evening treatment can occur).

Ethical Dilemma

A situation involving two or more correct but conflicting courses of action where selecting one compromises another (e.g., honoring family wishes versus answering a patient truthfully regarding a terminal diagnosis).

Reprimand

A private, written communication of formal disapproval sent directly to an individual by the Ethics Commission chairperson.

Censure

A formal, publicly published statement of disapproval of an ethical violation.

Americans with Disabilities Act (ADA) - Title I

Section of the ADA that prohibits discrimination against qualified individuals with disabilities in employment practices.

Americans with Disabilities Act (ADA) - Title II

Section of the ADA that prohibits discrimination by public entities and ensures accessibility to state and local government programs and services.

Americans with Disabilities Act (ADA) - Title III

Section of the ADA prohibiting discrimination in public accommodations, commercial facilities, and public businesses.

Transdisciplinary Team

A team structure where members from different disciplines share knowledge, cross discipline boundaries, and train each other to perform specific tasks across traditional roles.

Interdisciplinary Team

A team composed of professionals from different disciplines who collaborate, interact, and work toward a shared, common goal within the same setting.

Close Supervision

Supervision that requires daily, direct, face-to-face contact at the work site.

Routine Supervision

Supervision requiring direct contact at the site at least once every 2 weeks.

General Supervision

Supervision requiring direct face-to-face contact at least monthly.

Tier 1: Universal Instruction

School-based intervention tier focused on early screening and high-quality instruction with social supports provided to the entire school population.

Tier 2: Targeted Intervention

School-based intervention tier where services are provided for small groups of students who need targeted support to address specific needs.

Tier 3: Intensive Intervention

School-based intervention tier involving intensive, individualized $1:1$ interventions for specific identified student deficits.

Model of Human Occupation (MOHO)

An occupation-based model focused on volition (motivation), habituation (patterns and roles), and performance capacity (skills) and how they interact with the environment.

Ecology of Human Performance (EHP)

A model focusing on how the person, context, and task interact to affect performance, utilizing intervention strategies: establish/restore, modify/adapt, alter, prevent, and create.

KAWA Model

An occupational therapy model that uses the metaphor of a river to represent life flow and an individual's unique life experiences and barriers.

Allen Cognitive Level 1

Level characterized by automatic actions; attention span lasts seconds; the individual requires total assistance and sensory stimulation for treatment.

Allen Cognitive Level 2

Level characterized by postural actions and gross motor movements; attention lasts approximately 3 minutes; requires maximum assistance (hand-over-hand) to prevent wandering danger.

Allen Cognitive Level 3

Level characterized by manual and repetitive actions; evaluated with the running stitch; attention span is up to 30 minutes; requires moderate assistance and task setup/redirection.

Allen Cognitive Level 4

Level characterized by goal-directed actions; evaluated using the whipstitch; attention span is 1 hour; requires minimum assistance and visual cues; client can live alone with supervision at level 4.4.

Allen Cognitive Level 5

Level characterized by exploratory actions, trial-and-error learning, and impulsivity; evaluated using the cordovan stitch; attention span lasts weeks; requires standby assistance for safety.

Allen Cognitive Level 6

Level characterized by planned actions, self-awareness, and anticipation of errors without requiring external supervision or assistance.

Assessment of Motor and Process Skills (AMPS)

An observational assessment where a client performs chosen functional tasks, and motor and process performance skills are rated for ease, efficiency, independence, and safety.

Cognitive Performance Test (CPT)

A standardized assessment evaluating functional performance across ADL/IADL tasks (dressing, shopping, making toast, making a phone call, washing, traveling) scored according to Allen Cognitive Levels.

Parallel Group

A developmental group where members complete individual tasks alongside one another with minimal verbal interaction; the occupational therapist provides structure and unconditional positive regard.

Project Group

A developmental group where members perform a shared, short-term activity involving some interaction and cooperation; the therapist selects and structures the activity.

Egocentric-Cooperative Group

A developmental group where members collaboratively select a long-term activity, create group goals, and test social roles; the therapist functions as a collaborative facilitator.

Cooperative Group

A developmental group where members engage in an activity that allows free expression of feelings, building trust and mutual gratification; the therapist acts in a standby role.

Mature Group

A developmental group where members take on all social, emotional, and task roles necessary to accomplish goals; the occupational therapist functions as an equal peer.

Directive Leadership

Leadership style where the occupational therapist defines the group, selects activities, structures the process, and directs group members with low cognitive and functional levels.

Facilitative Leadership

Leadership style where the therapist shares responsibility, collaborates with members, and guides individuals with moderate cognitive abilities to acquire new skills.

Advisory Leadership

Leadership style where the occupational therapist acts as a consultant or resource, while high-functioning group members select their own goals and agenda.

Rule of Nines

A method to calculate Total Body Surface Area (TBSA) of burns in adults: head and neck = $9\%$, each arm = $9\%$, each leg = $18\%$, anterior trunk = $18\%$, posterior trunk = $18\%$, and genitals = $1\%$.

Superficial Partial-Thickness Burn

Second-degree burn involving the epidermis and upper dermis, marked by blistering, erythema, and moderate pain; heals within 1 to 3 weeks with minimal scarring risk.

Deep Partial-Thickness Burn

Second-degree burn destroying the epidermis and most of the dermis, sweat glands, and hair follicles; presents with severe pain and high scarring risk; heals in 3 to 5 weeks.

Full-Thickness Burn

Third-degree burn destroying epidermis, dermis, nerve endings, and hair follicles; presents with a pale, non-blanching appearance, absence of pain sensation, and requires surgical grafting.

Subdermal Burn

Fourth-degree burn extending through the full skin thickness into underlying fat, muscle, and bone; presents with charring and requires surgical excision or amputation.

Antideformity Burn Hand Splint

Orthosis positioning the wrist in neutral to $30^\circ - 45^\circ$ extension, metacarpophalangeal (MCP) joints in $70^\circ - 90^\circ$ flexion, interphalangeal (IP) joints in full extension, and thumb in abduction (intrinsic plus position).

Heterotopic Ossification

The abnormal formation of bone tissue in soft tissues and joints following trauma or burns, characterized by a hard end-feel and sudden loss of range of motion.

Figure Ground

The visual perceptual ability to perceive a foreground form or object against a competing, busy background.

Form Constancy

The ability to recognize and identify forms, shapes, and objects regardless of changes in their environment, orientation, size, or viewing angle.

Visual Closure

The visual perceptual skill of identifying an object or form when only incomplete parts or fragments are visible.

Supraglottic Swallow Technique

A compensatory swallowing maneuver designed to close the airway by instructing the client to hold their breath, swallow, and immediately cough before inhaling.

Mendelsohn Maneuver

A swallowing technique where the client voluntarily prolongs elevation of the larynx during swallowing to facilitate upper esophageal sphincter opening.

Pelvic Obliquity

A seated postural deformity where one side of the pelvis rests lower than the contralateral side, named for the lower side.

ADA Ramp Slope Ratio

The maximum acceptable ramp incline standard established by the ADA, requiring $1\,\text{inch}$ of vertical rise for every $12\,\text{inches}$ ($1\,\text{foot}$) of ramp length ($1:12$).

Clear Doorway Width

The minimum accessible doorway clearance required under ADA guidelines, which is $32\,\text{inches}$ ($36\,\text{inches}$ being ideal).

Work Hardening

A highly structured, outcome-focused, individualized program using real or simulated work activities to address physical, cognitive, and psychosocial barriers to return to work.

Work Conditioning

An intensive conditioning program focused primarily on physical conditioning, aerobic capacity, strength, and endurance to prepare for return to work.

Sedentary Work

Work level exerting up to $10\,\text{pounds}$ of force occasionally, negligible force frequently, with sitting most of the time and standing less than $\frac{1}{3}$ of the workday.

Heavy Work

Work level requiring lifting $51 - 100\,\text{pounds}$ occasionally, $26 - 50\,\text{pounds}$ frequently, and $11 - 25\,\text{pounds}$ constantly.

Iontophoresis

A physical agent modality that uses a continuous low-voltage direct electrical current to deliver ionized topical anti-inflammatory medication into local tissue.

Asymmetrical Tonic Neck Reflex (ATNR)

A primitive reflex elicited by rotating the infant's head to one side, resulting in extension of the arm and leg on the face side and flexion of the limbs on the skull side.

Symmetrical Tonic Neck Reflex (STNR)

A primitive reflex where neck flexion produces upper extremity flexion and lower extremity extension, while neck extension produces upper extremity extension and lower extremity flexion.

Tonic Labyrinthine Reflex (TLR)

A reflex where prone positioning increases total body flexor tone, while supine positioning increases total body extensor tone.

Gowers Sign

A clinical sign of proximal muscle weakness where a child uses their hands to 'walk up' the thighs and legs to stand upright from the floor, characteristic of Duchenne muscular dystrophy.

Autonomic Dysreflexia

A life-threatening medical emergency in individuals with SCI at $T6$ or above, triggered by noxious stimuli (e.g., full bladder or bowel impaction), presenting with severe headache, hypertension, profuse sweating, and facial flushing.

Brown-Séquard Syndrome

An incomplete spinal cord injury from a hemi-section lesion, causing ipsilateral loss of motor function, proprioception, and vibration, and contralateral loss of pain and temperature sensation below the lesion.

Anterior Cord Syndrome

An incomplete cord injury caused by a flexion injury, resulting in bilateral loss of motor function, pain, and temperature sensation below the lesion, while preserving light touch, proprioception, and vibration.

Decorticate Rigidity

An abnormal posturing response indicating brainstem/cortical tract injury, characterized by spastic flexion and internal rotation of the upper extremities with extensor spasticity of the lower extremities.

Decerebrate Rigidity

An abnormal posturing response to painful stimuli indicating brainstem damage, characterized by rigid extension, adduction, and internal rotation of both the upper and lower extremities.

Mallet Finger

An extensor tendon injury at Zone I resulting from terminal tendon rupture, causing involuntary DIP joint flexion; splinted in continuous DIP extension for 6 weeks.

Boutonnière Deformity

A finger deformity caused by rupture of the central extensor slip at Zone III, presenting with PIP flexion and DIP hyperextension; managed with a PIP extension splint.

Swan Neck Deformity

A digital deformity characterized by hyperextension of the PIP joint combined with flexion of the DIP joint; managed with an orthosis that restricts PIP hyperextension.

Ape Hand Deformity

A distal median nerve injury deformity characterized by flattening of the thenar eminence and loss of thumb palmar abduction and opposition.

Claw Hand Deformity

A distal ulnar nerve injury deformity resulting in hyperextension of the fourth and fifth metacarpophalangeal (MCP) joints and flexion of the interphalangeal (IP) joints.

Finkelstein's Test

A provocative clinical test for De Quervain's tenosynovitis performed by having the client make a fist with the thumb tucked inside the fingers, followed by passive or active ulnar deviation of the wrist.

Froment's Sign

A test for ulnar nerve motor impairment where the patient attempts to pinch a piece of paper using lateral pinch and compensates for a weak adductor pollicis by flexing the thumb IP joint via the median-innervated flexor pollicis longus.

Colles' Fracture

A complete fracture of the distal radius characterized by dorsal displacement of the distal bone fragment, typically resulting from a fall onto an outstretched hand (FOOSH).

Smith's Fracture

A complete fracture of the distal radius characterized by volar (palmar) displacement of the distal fragment, typically occurring from a fall onto a flexed wrist.

Modified Ashworth Scale Grade 1

A slight increase in muscle tone manifested by a catch and release or by minimal resistance at the end of the range of motion when the limb is moved in flexion or extension.

Modified Ashworth Scale Grade 4

The affected part or joint is rigid in flexion or extension during passive movement.

Heberden's Nodes

Hard, bony outgrowths or osteophytes that develop at the distal interphalangeal (DIP) joints of the fingers in osteoarthritis.

Bouchard's Nodes

Hard, bony outgrowths or osteophytes that form on the proximal interphalangeal (PIP) joints of the fingers in osteoarthritis.

Circumstantiality

A pattern of speech that is delayed in reaching the central point due to the inclusion of excessive, tedious, and irrelevant details, although the speaker eventually reaches the goal.

Flight of Ideas

A continuous flow of accelerated speech with rapid and abrupt shifts from one topic to another, typically connected by superficial associations or plays on words.

Tangentiality

A communication disturbance where a person's thoughts veer off topic onto a loosely related subject and never return to the initial question or point.