disease ch 1

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disease ch 1
2012-01-26 05:58:26

disease ch 1
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  1. where do OTs work:
    birth to death; NICU, early intervention,
  2. 5 approaches to intervention
    Domain and Process
    1. prevention of disability

    2. health promotion

    3. establish or restore a skill or ability

    4. adapt or compensate

    5. maintain current functional abilities
  3. Reed: approaches to intervention
    1. prevention

    2. developmental/acquisitional

    3. learning, educating, training

    4. remedial/remediation

    5. restorative, cure

    6. adaptation, substitution, supportive

    7. compensatory, environmental adaptation

    8. humanistic, phenomenlogical, client-centered

    9.maintain, sustain

    10. palliative-pain

    11. advocate, advocacy-ex. back pack day
  4. OTPF(practice form)
    a tool developed by the profession to more clearly articulate and enhance the understanding of what OT practitioners do and how they do it (domain vs process)

    identitfies OT, separates us from other profession, and assures outr medical neccessity to payer's

    everything that OT does or is concerned about, as depicted in the domain of the OTFP, is directed at supporting the client's engagement in meaningful occupation that ultimately affects the health, weel-being, and life satisfaction of that individual
  5. 6 broad areas or categories that comprise of OT domain
    1. performancein areas ofoccupation

    2. performance skills

    3. performance patterns

    4. context

    5. activity demands

    6. client factors
  6. Success of the OT process(evaluation, intervention, outcome)
    is incumbent upon the OT expert knowledge in all aspects of the domain
  7. OTPF:
    outlines the language and constructs that describe the occupational therapy profession's domain of concerns
  8. Domain:
    the area of human activity to which the occupational therapy process is applied
  9. Process:
    facilitates engagement in occupation to support participation in life.

    the focus of the process is on the use of and the enhancement of engagement in occupation

    performance in areas of occupation

    performance skills

    performance patterns


    activiity demands

    client factors
  10. motor control
    plasticity-muscle back and forth

    normal muscle tone: continuous state of mildcontraction or state of preparedness in the muscle
  11. abnormal muscle tone
    flaccidity-no muscle tone

    hypotonus-lower tone-down syndrome

    hypertonus-too much muscle

    spasticity-too tight

    clonus-neurological, ex.put foot down and foot pulsates

    • rigidity
    • lead pipe-stuck, can't break, parkinson's

    cogwheel-jerkey motion

    decorticate-tucked in

    decerebrate-brain dead

    cerebral hypertonia-brain injury, spastic

    spinal hypertonia-nerve damage
  12. incoordination
    cerebellar(brain stem) disorders: can affect any body region and cause a variety of clinical symptoms.

    Symptoms include: slouching, learning, spinal curvature, wide-base standing and:

    ataxia- can't start to walk. Ex. parkinson's

    dysarthia-huntington's disease, tremors
  13. extra-pyramidal disorders:
    chorea-tremors, huntington's disease

    athetoid movements-plans one thing but hand does something else

    dystonia-motor planning-walking backwards

    • tremor(use weighted items):
    • intention
    • resting
    • essential-fine until they do something
  14. visual perception disorders
    agnosia-look at cup but can't say

    visual-spatial perception-planning, knkowing where things are

    figure-ground discrimmation-knowing the screen from the wall, picture in a picture

    form constancy-4oz-8oz they are all cups

    spatial relations-close eyes, know how close people are
  15. tactile(touch) perception disorders
    • stereognosis-blind folded, touch and know what it is
    • . finding something in your purse

    • body schema-one side neglected (stroke)
    • ex. drew body and painted, one kid took all red paint and colored it blood red. anarexia-they still think they are fat
  16. motor perception disorders
    praxis-disturbture from brain to muscle. motor term

    apraxia-language- want to say but can't

    ideational apraxia-ex. the process to make a sandwhich
  17. cognitive information-processing
    short term memory-30 sec

    working memory-day

    long-term memory-week
  18. reasoning and problem solving
    abstract thinking-starts in 13 yr old boys, campus to manatee memorial, plan in ur head

    deductive reasoning-filter info out to get to answer
  19. treatment
    adaptation of activity-brush teeth, pullwheel chair up to sink, next have them stand at sink

    grading of activity-simple to harder


    range of motion-

    endurance and tolerance


    perceputal, cognitive and social skill

    modalities-ice packs, cold packs, parafin

    ADL's-bath, dress, groome

    stretching-with and w/o assistance

    neuromuscular control-getting brain and muscles to work together

    thermal modalities

    electrical modalities


    etiology-study of the cause of disease

    pathology-the study of disease, study of the nature and cause of disease which involves changes in structure and function

    sign-(something you see)abjective, evidence or manifestation of an illness or disordered function of the body. signs are definitive, obvious, and apart fromthe patient's impression

    symptom-any perceptible, subjective, change in the body or its function that indicated disease or the kind of phases in disease
  20. diagnosis
    the term denoting name of the disease, the use of scientific and skillful methods to establish the cause and nature of sick person's disease
  21. prognosis
    the prediction of course and outcome of disease and the estimate of chance for recovery
  22. pathogenesis
    origination and development of a disease and the manner by which a disease delveops, may affect another part of the body than was first affected
  23. complication
    added difficulties or secondary diagnosis
  24. sequela
    • condition following and resulting from disease
    • ex. obese=diebetites
  25. inflammation
    a nonspecific by predictable response of living tissue, or the entire body to injury
  26. infection
    invasion and multiplication of microorganism in or on body tissue that produce signs and symptoms as well as immune responses
  27. immune disorders
    because of their complexity, the process involved in host defense and or depressed the result may be a hypersensitivity disorder----autoimmunity
  28. genetic/hereditary disorders
    disorders transmitted from parent to children
  29. congenital
    disease present at birth:

    • ongenital heart disease
    • congenital hip dysplasia
    • cerebral palsy

    in the US, 2000 infants each year are born with an overt genetic abnormality
  30. endocrine disorder
    together with the nervous system, the endocrine system regulates and integrates the body's metabolic activities.

    the hypothalamus is the main integrative center for the endorine and autonomic nervous systems; it controls the function of the endocrince organs by neural and harmonal pathways

    ex. diebeties
  31. metabolic disorders
    diseases that affect the physiologic process that allows cells to transform food into energy and continually rebuild body cells

    ex. dairy iintolerant, allergece to vit K,
  32. degenerative disorders
    degenerative changes that occur in the tissues and organs; a characteristic of aging

    ex. alz, dementia
  33. neoplastic disease
    the proliferation of neoplastic cells leads to the formation of masses called tumors
  34. necrosis
    involves breadkown of the cellular membrane, which leads to leakage of intracellular proteins to the extracellular space and subsequently inflammation. usually affects large groups of cells.

    ex. gangrene then amputate
  35. apoptosis
    involves single cells that undeergfo organized destructrion of the cellular cytoskeleton and formation of apototic bodies, which are phagocytosed without an inflammatory reaction.

    they eat the other cells
  36. hyposia
    a reduced availability of oxygen
  37. anoxia
    complete lack of oxygen
  38. cell injury
    work overload

    increased metabloic demands, whichincludes: chemical and physical agents
  39. chemical cell injury
    drug, chemical agent, too much glucose-acts on vital functions of the cell
  40. cell injury-physical agent

    bruise, a blow with a blunt instrument that doesn't penetrate the surgace


    swelling or mass or blockied (clot) confined to an organ, tissue, or space, caused by a break in a blood vessel

    sudden change in atmospheric pressure-

    bubbles of nitrogen in the blood/tissue. the bends


    wound or tear of the flesh, jagged edges


    clean cut wound, cutmade with a knife such as surgical procedure


    a hole or wound made by a sharp pointed instrument


    increased metabolism-unusually high fever, and hyperthermia


    slows metabolism-hypothermia
  41. disease
    pathological condition of the body that presents a group of symptoms peculiar to it and which set the condition apart as an abnormal entity, differing from other normal or pathological body states
  42. organic disease
    disease resulting from recognizable anatomical changes in an organ or tissue of the body

    • ex. baby born early have lung diseases
    • born with holes intheir hearts
  43. functional disease
    disease in which no anatomical changes can be observed to account for the symptoms present

    chronic heart disease
  44. neoplasm
    abnormal mass of proliferating cells which grow at a rate that is uncoordinated with the needs of the host and functions independently of the usual homeostatic controls over most other cells of the body

    ex. turns into cancer
  45. homeostatis
    state of equilibrium of the body
  46. ischemia
    lack of circulation to a body part
  47. hypoxia
    decreased oxygen supply
  48. necrosis
    death of cells, tissue or bones surrounded by healthy parts
  49. adaptation
    change/ability of an organism to adjust to a change in environment

    ex. hospitalised infection.
  50. hypertrophy
    enlargement of tissue/organ without change in number of cells

    ex. big muscle builder
  51. atrophy
    decrease in cell size, tissue, organ or entire body. functional deficits are proportional to the degree of atrophy

    • ex. little ole ladies
    • spinal cored, doesn't use their legs any more
  52. physiologic atrophy
    occurs with age and invlolves the entire body

    decreased number of brain cells

    decreased density of bones

    thymus atrophies in childhood

    after menopause-ovaries, uterus and breast atrophy
  53. pathologic atrophy
    occurs as result of inadequate nutrition or stimulation

    atherosclerosis affects kidneys (smaller due to ischemia)

    nerve loss in muscles after SCI

    muscle wasting and atrophy Cachexsia seen in cancer or malnutrition
  54. inflammation
    reaction/predictable response of all living tissue to all forms of injury including death (necrosis) of a part of the tissue
  55. infections are classified as
    bacterial, viral, fungal, and parasitic. of which infections can be local or systemic
  56. local response
    in region of injury there is increased local blood flow, vascular, neurologic, humoral and cellular responses at the sight of injury occurs.

    characterized by:

    • swelling
    • pain
    • increased temperature
    • redness
  57. it is
    suffix that is added to the name of a tissue denoting inflammation
  58. inflammation
    manifest's as changes in increased capillary size (dilation) and permeability
  59. exudate
    protein rich fluid in the interstitial spaces or body cavity that contains leukocytes and is usually caused by inflammation

    ex. cut yourself, the clear fluid that comes out first
  60. types of inflammation
    dependent on duration
    acute or chronic

    • short duration that usually clears without residual scar. onset is rapid and the course to inflammation is relaively short (hours to days).
    • characteristics:
    • swelling(edema)
    • redness
    • warmth/hear(due to increased blood flow and dilation of capillaries
    • pain(pressure on the nerve endings or chemical reaction)

    loss of function(immobility or metabolic changes)


    • acute inflammation which occurs in "bouts"
    • ex. arthritis, gout


    response progresses slowly. longer in duration than acute and fibrous repair are needed resulting in scar at the injury.

    • characteristics:
    • extension of acute inflammation
    • prolonged healing
    • persistence of causative agent
  61. stages of inflammation
    • injury
    • vasicibstriction(last few seconds)
    • vasodilation and permeability changes (relaxation of blood vessels with increased redness and mild swelling of the tissue)

    exucation and consolidation

    neutralization or repairs (neutrophils)

    resolution or repairs (phagocytosis)

    regeneration (old cells replaced by new cells)

    repairs (fibrous tissue forms scar)
  62. symptoms of inflammation
    • hormonal changes
    • fever
    • leukocytosis(increased WBC)
    • alteration in serum protein (gamma globulin and fibrinogen ability to resist infection)
    • REC sedimentation rate: RBC separate from plasma faster
  63. older adults
    frail elder

    person over 65 or older adult with significant physical and congitive health problems

    older adult

    an adult over 55 years of age, usually over 65 years of age

    young-old adult

    individuals 65-74 years of age

    old-old adult

    indiviuals over the age of 80

    • successful aging includes:
    • avoiding disease and disability
    • sustaining high cognitive and physical function
    • engaging with life
  64. LEARN Method
    Listen with sympathy and understanding to the cleint's perceptions

    Explain your perception of the problem

    Acknowledge and discuss the differences and similarities

    Recommend treatment

    Negotiate agreement
  65. Psychiatric disorders
    22% of individuals over 65 meet the criteria for a mental disorder

    • ex. depression
    • anxiety
  66. alcohol abuse
    hidden disease later in life since most older adults consume unknown amounts of alcohol at home daily
  67. depression
    8-20% of older adults report depressive symptoms(imagine how many older adults deny depression? the % would drastically increase)
  68. OT treatment considerations

    • fatigue
    • cognition
    • sequencing
    • home layouts habits

    prior level of function

    social and cultural context

    expectations and beliefs

    spititual, personal and temporal context

    physical and virtual context

    client's prognosis (potential)