Human Occ II: Final

T/F: The nervous system, muscular system, & skeletal system interact to influence & produce movement. Disruption to any of these may result in motor control dysfunction.

True

The presence of tonus or muscle tension in the neck, trunk, & limbs is referred to as:

Postural tone

When muscles feel soft, there is no resistance to passive movement, & PROM is excessive, how is its tone best described?

Hypotonic

Stereognosis is defined as:

The ability to identify objects through proprioception, cognition, & touch

Because certain cognitive skills depend on others, they are evaluated in a particular order. Which of the following is listed in order of recommended progression of testing?

Orientation, attention, memory

An individual, who recently had a CVA, is practicing transfers to a bath bench. The OTA notices that the individual is unable to regain balance after weight shifting. The OTA should:

Be positioned to protect the individual

During a hygiene activity, the OTA observes the patient overreaching for the toothpaste & knocking over the mouthwash. The OTA should inform the OT supervisor that the individual may have deficits related to:

Dysmetria

An OTA is working in a home health setting & is teaching a patient's family member about safe positioning & joint protection for an individual with hypotonia. The OTA should emphasize the importance of:

Preventing trauma to joint structures

An OTA with 20 yrs of experience is asked to use neuromuscular electricity stimulation before having an individual prepare a light meal. The OTA should:

Provide the procedure only if service competency has been established

During a meal preparation activity, the OTA observes that a patient cannot reach into a bag of potato chips without crushing the contents. The OTA should document problems related to:

Ataxia

An OTA is working with a patient who lacks thermal sensation & will be living alone. The OTA should plan intervention with a focus on:

Compensatory strategies to avoid burns & precautions against injury in ADLs

An individual who uses a wheelchair is unable to detect pain sensations. The OTA should:

Educate & train the patient about the importance of repositioning & checking the skin for breakdown

An OTA is developing a presentation for a head injury support group with a focus on sensory loss. The OTA should:

Educate participants about safety issues related to diminished/absent smell & taste

An OTA is working with an individual with a brain injury in a rehab setting. During a homemaking activity, the individual puts the blankets on before the sheets & laid the pillowcases on top of the pillows. This would indicate a deficit in:

Constructional apraxia

An OTA is contributing to evaluating an individual with cognitive deficits. During the evaluation, the individual has difficulty identifying family members & what state they reside in. The OTA should:

Document the disorientation observed & provide assistance only when needed

An individual with stroke is not able to complete the task of looking up a number in the phone book while the OTA asks her a question. This individual may have deficits in:

Divided attention

An OTA is working with an individual in a rehab setting. While in the cafeteria, the patient cuts in line in front of other people. The individual may be experiencing deficits in:

Semantic memory

An OTA is working with an individual in a home health setting. The family reports that the individual can't remember details about a recipe from 2 min ago, but remembers the names of family members. The OTA suspects that the individual may have deficits in:

Working memory, but long-term memory is intact

An individual with a head injury is nearing their discharge date & has consistently exhibited unsafe behavior & is unable to make decisions in response to the environment. The OTA should:

Discuss with the family the patient's potential need for 24 hr supervision in the home environment for safety

An OTA is working with an individual who enjoys listening to music. The individual is able to turn on a CD player & insert a CD, but does not attempt to find a solution when there is no music. The individual may have deficits in:

Problem solving

Motor Learning: Clients in this stage may "talk through" motor steps

Cognitive

Motor Learning: Clients in this stage do not consciously think about steps in the motor sequence

Autonomous

Motor Learning: Clients in this stage make connections between current motor tasks & prior experiences

Associative

Motor Learning: What is the final stage of this progression?

Autonomous

In order of occurrence, 4 steps of instruction are:

Preparation, demonstration, return demonstration, follow up

Type of Learning: The client practices the entire task at one time

Whole learning

Type of Learning: The client practices part of the task within the context of the entire task

Whole to part to whole learning

Type of Learning: The client practices a motor skill that generalizes to other tasks or areas of performance

Pure part learning

Type of Learning: The client practices procedural programs or steps to complete the task

Progressive part learning

Motor learning skills occur in the following sequence:

Acquisition, refinement, retention

This stage of motor learning is characterized by the client demonstrating inconsistent & inefficient motor behavior:

Acquisition

The block (massed) practice method of motor learning:

Provides limited learning & generalization; Improves motor performance quickly; Requires the client to repeat patterns of movement- ALL OF THE ABOVE

Which of the following concerning practice methods is correct?

Random sequence practice leads to slower motor learning with more functional gain

The purpose of guiding motor learning is to:

Provide familiar sensory input

Arises from sensory stimulation to tactile receptors, proprioceptors, visual & vestibular systems during task performance, & after task completion:

Intrinsic feedback

Contextual domains are:

Environmental & Personal

Activities that restore normal movement patterns, muscle strength, endurance, & coordination, such as having a patient use a dressing frame fitted with laces, buckles, buttons, & zippers to increase manual dexterity is an example of:

Therapeutic activity

Compensation consists of:

Modifying, upgrading, or downgrading activities

During an initial dressing session with a hemiplegic patient, the OT practitioner has the patient adjust his shirt himself after donning with assistance from the OTA throughout all preceding steps. The practitioner is using:

Backward chaining

Performance patterns are defined as:

Habits, roles, rituals, routines

T/F: Preparatory methods are passive intervention applications used to improve a specific client factor in order to increase participation in occupation.

True

Remediation is defined as:

Facilitating skill development; Improving participation; Increasing the likelihood of success; ALL OF THE ABOVE

Therapeutic exercise, like using theraputty to increase hand strength/dexterity is an example of:

Preparatory tasks

To reason & practice holistically, the OT/OTA must consider these 3 components:

Person, Environment, Occupation

What are types of performance skills?

Completing daily occupations; Completing mobility tasks; Completing ADL tasks while standing, statically & dynamically; ALL OF THE ABOVE

Which are 3 types of OT intervention?

Activity adaptations, environmental modification, advocacy

Brunnstrom based her intervention on the concept that:

The damaged CNS has undergone an evolution in reverse & regressed to former patterns of movement

Brunnstrom follows an ontogenic process, usually:

Proximal to distal, shoulder movement can be expected before hand movement

_____ is an early mobility phase that serves a protective function.

Reciprocal inhibition

Define limb synergies:

A group of muscles acting as a bound unit in a primitive & stereotypical manner. The muscles acting in synergy are linked & cannot act alone

List 3 types of cutaneous stimulation as described by Rood:

Fast brushing, Icing, Slow stroking, Light moving touch

List 3 ontogenic movement patterns:

Supine withdrawal, roll over, pivot prone, neck co-contraction, on elbows, all fours, static standing, walking

List 2 principles of treatment for the Rood Approach:

Muscles have different duties, heavy-work muscles should be integrated before light-work muscles

List 2 basic assumptions of the Rood Approach:

Normal muscle tone is a prerequisite to movement, treatment begins at the developmental level of functioning

PNF motor learning requires a multisensory approach; _____, _____, & _____, systems are all used to achieve the desired response.

Auditory, visual, tactile

NDT is geared toward encouraging the use of _____ _____ _____ _____ _____. Development of alignment & symmetry of the trunk & pelvis are emphasized.

Both sides of the body

According to Rood, proprioceptive stimulation refers to the:

Facilitation of joint & muscle receptors, & the vestibular system

Reflexes are defined as:

Stereotypical, automatic movements present in all individuals

The goal of neurotherapeutic treatment approaches are to normalize _____ _____, reduce _____ _____ _____, & induce changes in the _____ _____.

Muscle tone, abnormal posture reaction, sensorimotor cortex

Thermal physical agent modalities include:

Hot pack, cryotherapy (BOTH A & C)

Mechanical physical agent modalities include:

Traction

Selecting the appropriate PAM is influenced by:

Acuity of the condition; Desired therapeutic outcomes; Evidence based practice; ALL OF THE ABOVE

Which of the following is not an OT goal when using PAMs for pain management?

Influence body structures inferring these changes will promote function

Which of the following best describes chronic pain?

Continues past normal healing parameters

Nerves that transmit sensory info to the spinal cord are:

Afferent

Signs of inflammation include all of the following EXCEPT:

Preserved function (Warmth, redness, edema are all signs of inflammation)

The COTA is treating a 65 y/o patient who c/o back pain that interferes with functional activities. On assessment, it is determined that a MHP is safe & appropriate for the individual & may assist with pain management. Appropriate positioning & draping for the patient is:

Prone with a gown open in the back

Which sensory assessment is most relevant to complete with a patient being considered for thermal PAMs?

Pain perception

When applying MHPs, it is generally safe to insulate with:

6-8 layers of dry insulation

In applying a cold pack treatment, the most effective insulation is:

A single layer of wet insulation

What does CBAN stand for?

Cold, Burning, Aching, Numb

Special sensory systems include:

Vision, hearing, smell, taste, & balance

What is the definition of hyperestheia?

Increased sensitivity

What is the definition of hypoanalgeisia?

Diminished pain sensation

What may a peripheral nerve injury (PNI) affect?

Cell body; Myelin sheath; Neuromuscular junction; ALL OF THE ABOVE

An OTA is working with an individual who has sensory loss in the hand due to a CNS dysfunction & enjoys working with hand tools. The OTA should teach the individual to:

Apply light force, rest involved areas, & change tools frequently

Visual acuity refers to:

Sharp, clear, & accurate info

Visual scanning refers to:

Shifting attention from 1 visual target to another with smooth succession

Visual attention incorporates the following:

Focused attention, including selective attention used for structured tasks; Ambient attention, including peripheral vision used for unstructured tasks; BOTH A & B

An individual who develops far-sightedness associated with aging would have which of the following diagnoses?

Presbyopia

An individual who has variations in curvature of the cornea would have which of the following diagnoses?

Astigmatism

An OTA is working with an individual who has blurred vision. During a cooking activity, the OTA should:

Teach safety techniques first

An individual who has difficulty with visual acuity would benefit from this compensatory strategy:

Increased lighting for better illumination

When treating visual field loss, which of the following ideas applies:

Using safety tape around the home to mark boundaries

An individual who enjoys reading has a visual scanning deficit. The OTA should:

Teach the individual to physically manipulate the object scanned; Teach the individual left to right scanning patterns; Use matching games & sorting activities with the individual; ALL OF THE ABOVE

Which of the following is true in relation to interventions addressing deficits in cognition & perception?

Client factors cannot be observed directly; Deficits are inferred based on observation of behavior; Clients in all practice settings can present with deficits in cognition & perception; ALL OF THE ABOVE

Figure ground perception is:

Ability to distinguish an object from its background

The adaptive approach for cognitive impairment works towards which of the following:

Modifying a task or the environment

A person presenting with memory deficits could have difficulty with which of the following memory functions?

Difficulty paying attention; Storing of information; Retrieval of information; ALL OF THE ABOVE

The definition of visual agnosia is:

Failure to recognize common items that can be seen

The remedial approach for cognitive impairment works towards which of the following:

Establishing or restoring cognitive skills

An OTA is working with an individual who has ideational apraxia & has difficulty with donning clothes. The OTA should:

Break down the task into small steps

The "4" in A & O X4 stands for which of the following:

Alert & oriented to self, place, time, & situation

Higher level cognitive functions, such as insight/judgment, attention, & memory are components of:

Specific mental functions

An individual with an attention dysfunction is able to tolerate therapy in a low stimulus environment. The OTA should:

Provide therapy to the person in an environment with more distractions

A person with visual discrimination deficits may present with which of the following:

Spatial relations; Depth perception; Figure ground perception; ALL OF THE ABOVE

Working memory is:

Actively using information with the intention of retaining it

An individual who has a head injury frequently displays behavioral problems. The individual would benefit from:

Consistent, specific, direct feedback regarding the inappropriateness of the behavior from all people working with the individual

When applying TENS, pain management treatment goals include:

Modify patient perception of pain

Tissues that are excitable respond to electric current. Excitable tissues include:

Muscle, blood, nerve