881 - Physical Determinants

midterm one

Draw the COTIPP diagram 

COTIPP diagram

Step one in COTIPP

seek understanding about context

what is involved in seeking understanding about context

1. listen to personal histories, identities, and experiences

2. use critical reflexivity and humble self-reflection

3. seek to understand layers of structural factors that impact occupational participation

step two of COTIPP 

reflect, critically reflect, and reason

what is involved in reflect, critically reflect, and reason

1. reflect on OT practice

2. critically reflect on systems and structures

3. reasoning guides what OTs say and do from their values and beliefs 

third step in COTIPP

Justice, equity and rights based lenses

what is involved in justice, equity, and rights-based lenses 

1. recognize occupational rights as human rights 

2. taking action to remove barriers to participation  

3. advocacy to uphold the rights of clients and collectives

fourth step in COTIPP

connect 

what is involved in the connect stage

rapport building, considering referal, discuss benefits of OT, obtain consent, determine to continue or refer

fifth step in COTIPP

seek to ounderstand and define purpose 

what is involved in seek to undertsand and define purpose?

client sharing their story, ensuring you have the knowledge required before continuing, ensure their is a role for OT, obtain consent

sixth step of COTIPP

explore occupational partiicaption 

what is involved in exploring occupational participation

co-creating assesment plan for occupational participation

seventh step of COTIPP

co-design priorities, outcomes, goals, and plans 

what is involved in co-desigining priorities, outcomes, goals, and plans

co-create priorities, goals, and outcomes, co-design a treatment plan, involve family and community

what are sternal precautions?

no lifting more than 10 pounds, no reaching behind the back or above head, no pushing or pulling the arms

what is the order of blood flow through the heart and lungs? 

right atrium, tricuspid valve, right ventricle,  pulmonary valve, pulmonary artery, lungs, pulmonary veins, left atrium, bicuspid valve, left ventricle, aortic valve, aorta, body  

isometric contraction

contration occurs with no muscle shortening

isotonic contraction

muscle contraction occurs, causing movement of the body

agonist 

prime mover responsible for concentric contraction 

antagonist

opposite of agonist, controls, slows and resists movement using eccentric contraction

synergist

additional muscles that assits agonist muscles

what is the central nervous system made of

brain and spinal cord 

basic unit of nervous system

neuron

myotome vs dermatome

myo - muscle, derma - skin

How can damage to a peripheral nerve produce loss of sensation and movement to the
skin and muscles it supplies?

nerve sends information from peripheral systems (sensory) to the brain which allows them to respond in the peripheral (motor) systems, damage causes a break in this system 

label this diagram

superior vena cava, right atrium, tricuspid valve, right ventricle, pulmonary valve, pulmonary arteries, pulmonary veins, left atrium, bicuspid valve, left ventricle, aortic valve, aorta, inferior vena cava chordae tendinae, papillary muscle,

label the diagram

coronary sinus

label the diagram 

right and left coronary artery

label this diagram

superior, middle, inferior lobes, horizontal and oblique fissures

label this diagram

trachea, primary, secondary, tertiary bronchi

label this diagram 

bronchioles, alveoli 

what are the segements of the spinal cord and nerves

C1-C8, T1-T12, L1-L5, S1-S5, 1 coccygeal segment

where is their differences in spinal nerve entry and exit? 

C1-C7 exit above the vertebrae, C8 and below exit below the verterbae 

label the diagram

filum terminale, conus medullaris, cauda equina

what is remediation 

restoring a skill or ability that was impaird 

what is adaptation

modifying the activity to faciliate performance

what is compensation

use of alternative strategies or devices when skills are not possible

what is grading 

increasing or decreasing difficulty of an intervention based on client response 

what does occupation as means mean?

us of occupation as treatment to improve a clients capacities which enables another occupational function

what is occupation as end?

using the occupation as the therapy activity

which approaches are bottom up and top down 

biomechanical/person focused = bottom up 

rehabilitative approach/occupation focused = top down 

what is the biomechanical frame of reference?

remediation or prevention of limitations in ROM, strength, and endurance

what is the rehabiliation frame of reference?

looks at overall client functioning and performance including context to teach compensation or adaptations while collaborating with the client

what is an activity analysis?

an assesment which focuses on understanding an activities components and the skills required for participation

what are the 4 steps of an activity analysis?

activity, steps, activity demands, analysis for intervention

what is a performance analysis?

observing the client perform an activity and grading it based on their performance

what is a frame of reference?

perspective or paradigm based on theoretical principles that guide the evaluation and treatment of impairments and injuries

what does the SMART acronym stand for? 

Specifc, Measureable, Achievable, Realistic, Time-bound  

what is an occupational performance problem?

an occupation a person wants to do, needs to do or is expected to do but cant do, doesnt do, or isnt satisfied with

what is the 2 minute walk test? What type of measure is it?

the client walks for two minutes without assistance and the distance is measured, biomechanical

what is the borg rate of percieved exertion test? what type of measure is it?

a measure used to rate the clients percieved exertion in relation to exercise intensity, biomechanical

what is the scale for the borg test? list the levels

what is the minnesota living with heart failure questionnaire? what type of measure is it? 

a measure to asses physical and emotional quality of life of those with heart failure, rehabilitative 

what are the ranges for the minnesota living with heart failure questionnaire?

less than 24 is good quality of life, 24-45 is moderate quality of life, greater than 45 is poor quality of life

what is the health promting activities scale? what type of measure is it?

asseses participation in leisure that promtoes or maintains well-being, rehabilitative

what is the Barthel index? what type of measure is it? 

it asseses activities of daily living for acute or rehabilitative contexts, rehabilitative

what is the Katz scale? what type of measure is it?

is a graded assesment scale for six primary and psychosocial functions, rehabiliataive

what are the six things the katz tests

bathing, dressing, going to the toilet, transferring, feeding, contienence

how is the barthel index scored?

using increments of 5, which are then totaled

how are the katz assesments scored

1 for independant, 0 for dependant, then totaled

draw the basic units of a muscle 

what must occur for movement to happen? 

the muscle must cross the joint 

label these structures

acromion, coracoid process, spine of scapula, medial and lateral borders, gelnoid fossa, inferior angle 

which joint is commonly dislocated? what is it called?

acromioclavicular joint, shoulder seperation

where is the scapulothoracic joint? why is it not a true joint?

between the scapula and thoracic cage, it is an articulation

what is the ratio of scapulohumeral rhythm

2:1 of glenohumeral to scapulothoracic movement

what is subluxation? what are the three types at the glenohurmeral joint? 

when the bone comes partially out of its socket, anterior, posterior, inferior 

which muscles are these? functions?

which muscles are these? functions?

Pectoralis Major - glenohumeral flexion, internal rotation and adduction

which muscles are these? functions?

Subclavius - depression of clavicle

Pectoralis minor - depression of scapula

which muscles are these? functions?

serratus anterior - protraction of the scapula

what muscle is this? functions? 

deltoid - Glenohumeral flexion, extension, and external rotation

what muscles? Function?

teres major - extension, adduction, internal rotation of arm at GH joint

what muscles? function?

levator scapulae - elevation of scapula

rhomboid major and minor - retraction of scapula

what muscles? function? 

trapezius - elevation of scapula, retraction of scapula, upward rotation of scapula 

what muscles? function?

latissimus dorsi - extension, adduction, internal rotation of arm at GH joint

what is the brachial plexus? where is it located?

network that carries motor and sensory information to the chest, shoulder, arm, and hand, from the anterior rami of c5 to T1

draw the brachial plexus

what does the long thoracic nerve inneravte? if this is imparied what is caused? 

serratus anterior, winged scapula 

what is the axilla? what are its borders?

area of the armpit, where many important structures pass through

what is adhesive capsulitis? what does it cause?

frozen shoulder, stiffness and pain in the shoulder joint with a loss of range of motion

what are the characteristics of adhesive capulitis? 

ROM loss greater than 25% in two movement planes, with 50% loss of passive external rotation, sudden or gradual onset, impacts flexion, abduction, and external rotation

what is the DASH assesment? what type of assesment? 

the disability of arm, shoulder, and hand assesment which measures the difficulty, ability to use the extremity, and pain, rehabilitative 

what is ROM testing? what type?

range of motion testing, biomechanical

what is manual muscle testing? what type of test?

testing the strength and tension of muscles, biomechanical

what is the visual analogue scale (VAS)? what type of measure? 

it is the numercal pain rating scale 1-10, biomechanical 

what are the steps to a job analysis? what type of test is this?

rehabilitative

what is the most common type of arthritis?

Osteoarthritis

what is oseoarthritis 

the slow onset of bony formations or spurs form on the affected joint causing pain and stiffness, resulting from wear and tear on joints, particularly in the protective cartilage that cushions ends of bones 

how long does it take to develop osteoarthritis? what interventions can be used?

it is a gradual condition that develops over years, treatments include self-management, education, muscle strengthening, exercise, ergonomic education, medication and assitive devices

how many people with osteoarthritis have to leave work? or have issues with ADLS

1 in 5 have to leave work or retire early, 82% report having difficulty with ADLs

what is rheumatoid arthritis? causes? 

it is an inflammatory autoimmune disease, which causes the body to attack the lining of joints, causes thickening of synovial memebrane and increased synovial fluid which causes stretching and swelling, weakening the ligaments and the joints 

how long does it take to develop rheumatoid arthritis?prevalance?

rapid or sudden onset, 1 in 100 canandians have it, more common in women

symptoms of rheumatoid arthritis

pain, fatigue, discomfort, swelling

how to manage rheumatoid arthritis? 

medication, education, ergonomic education, exercise, fatigue management, assistive devices 

what joints are most affected by rheumatoid arthritis?

wrist, mcp, elbow, pip, shoulder

which bones are these? Label them

What does the Penn Shoulder Score measure? what type of measure is it?

Activities of daily living and pain of shoulder assesment, rehabilitative

what is the rapid upper limb assesment (RULA)? What type of assesment?

measures posture, muscle use, and force of the upper body, biomechanical