Rehabilitation Assistant Terminology Rehabilitation Assistants 1 Acknowledgments Winnipeg Technical College and the Department of Labour and Immigration of Manitoba wish to express sincere appreciation to all contributors. Special acknowledgments are extended to the following individuals: Manola Barlow, Independent contractor Recognition of Prior Learning Coordinator, Winnipeg Technical College Lynette Allison, Instructor, Rehabilitation Assistant Program (PT, OT, SLP), Winnipeg Technical College Funding for this project has been provided by The Citizenship and Multicultural Division, Manitoba Department of Labour and Immigration Disclaimer Statements and opinions in this document do not reflect those of Winnipeg Technical College or the project funder, Citizenship and Multicultural Division, Manitoba Labour and Immigration. The information is gathered from a variety of sources and is current and accurate as of the revision date noted. This information is subject to change and will not be further updated. It is the responsibility of the reader to seek current statistics and information. Please contact Winnipeg Technical College at 989-6500 or www.wtc.mb.ca if you have any questions or comments about this document. 2 Table of Contents Introduction………………………………...………………………………………………….4 Interdisciplinary Team: Crossword…............................................................................8 Body Systems: Matching..............................................................................................9 Physical Medicine & Rehabilitation Word List A-Z .....................................................11 Word List A-C: Classifying..........................................................................................14 Word List D-J: Crossword...........................................................................................18 Word List K- Q: Matching………………………………………………………………….23 Word List R-X: Crossword…………………………………………………………………28 Answer Key………………………………………………………………………………….29 References…………………………………………………………………………………..31 3 Introduction To become a skilled Rehabilitation Assistant you first need to learn the technical vocabulary (language) of Physical Medicine and Rehabilitation. The sections in this booklet introduce you to some of the basic terms of Physical Medicine and Rehabilitation. This guide mainly focuses on some of the essential terms in the Rehabilitation profession, specifically for Rehabilitation Assistants. Self-tests and answer keys have been included in this guide. The activities are meant to be completed after you have studied the corresponding unit. After you have read and understood the material you can try the tests yourself. If you score below 80% on the self tests, it is recommended that you go back and review those areas. What is “Physical Medicine and Rehabilitation”? Physical Medicine and Rehabilitation (PM&R), also known as physiatry, is a medical specialty that involves the process of restoring function for a person who has been disabled as a result of a disease, disorder, or injury. Physiatry provides integrated care with a variety of professionals aimed at recovery of the whole person - by addressing the individual's physical, emotional, medical, work (vocational), and social needs. A physician who specializes in physical medicine and rehabilitation is called a physiatrist (fizz-EYE-uh-trist). What is rehabilitation? Rehabilitate means to “make able”. Rehabilitation is the processes of helping a person achieve the highest level of function, independence, and quality of life possible. The focus of rehabilitation is not to reverse or undo the damage caused by disease or trauma, but to help restore the individual to best possible health, functioning, and well-being. The rehabilitation program Rehabilitation medicine is designed to meet each person's specific needs; therefore, each program is different. Some general treatment components for rehabilitation programs include the following: • • • • • treating the basic disease and preventing complications treating the disability and improving function providing adaptive tools and altering the environment Teaching the patient/family to adapt to lifestyle changes treating coexisting medical problems as needed 4 The Goal of Rehabilitation The purpose of rehabilitation is to help the patient reach the highest level of function by preventing complications, reducing disability, and improving independence. The success of rehabilitation depends on many things, including the following: • • • the nature and seriousness of the disease, disorder, or injury the overall health of the patient family support Areas covered in rehabilitation programs may include the following:1 Patient need: Self-care skills, including activities of daily living (ADLs) and Instrumental Activities of Daily Living (IADL) Physical care Mobility skills Communication skills Cognitive skills Socialization skills Pain management Psychological counselling Family support Education Example: ADL - Feeding, grooming, bathing, dressing and toileting. IADL – shopping, transportation and banking Nutritional needs, medication, and skin care Walking, transfers, and self-propelling a wheelchair Speech and language, writing, and alternative methods of communication Memory, concentration, judgment, problem solving, and organizational skills Interacting with others at home and within the community Medications and alternative methods of managing pain Identifying problems and solutions with thinking, behavioural, and emotional issues Assistance with adapting to lifestyle changes, financial concerns, and discharge planning Patient and family education and training about the condition, medical care, and adaptive techniques Rehabilitation is needed when a disease and/or injury causes loss of body function. Participation in the person's usual social roles is the goal of the rehabilitation process. Interdisciplinary Team A group of professional specialists with expertise in different areas that collaborate to develop and evaluate management alternatives. Attending Physician: The medical doctor who oversees all of a patient's hospital care, no matter how many specialists or therapists are involved in the person's care. 1 Retrieved on December 15’2008 from: http://medicalcenter.osu.edu/patientcare/healthcare_services/physical_rehabilitation/about/Pages/ind ex.aspx 5 Audiologist: The licensed/registered hearing professional who checks hearing loss, auditory (hearing) processing and function as well as working with hearing aids and cochlear implants. Case Managers/Social Workers: These licensed/registered professionals provide overall coordination for rehabilitative care. They will work with the patient, family/caregivers regarding plans for discharge and also serve as a liaison between the patient and their family/caregivers, insurance carrier, treatment team and community agencies. Dieticians: Registered Dieticians are licensed professionals who are focused on nutritional needs. They evaluate nutritional status; recommend appropriate diet based on personal assessments; and counsels patient/family on dietary changes. Occupational Therapists (OT): Occupational Therapists emphasize improvement of self-care skills (actives of daily living – ADL) such as bathing, dressing, and eating. They may focus on arms, hands or finger movements to increase independence with such daily tasks. They also address cognitive (thought) and perceptual (visual) deficits as they relate to daily life. Physiatrist: The physiatrist evaluates medical/functional status, manages medical care, orders therapies, and usually coordinates total rehabilitation/physical medicine efforts. Physical Therapists (PT): Licensed therapists provide training with walking, transfer techniques and wheelchair mobility. They address range of motion (ROM), strength, balance and coordination deficits. They may work with an orthotist or prosthetist to provide training to increase independence with orthotic and prosthetic devices to improve mobility. Recreational Therapists (RT): The Recreational Therapist assesses the patient’s interests and skills; incorporates leisure time activities into the rehab program; and assists in the patient’s community reintegration. 6 Rehabilitation Assistant: Rehabilitation Assistants provide rehabilitation care to clients and their families experiencing health needs under the supervision of a Speech Language Pathologist, Occupational Therapist and/or Physical Therapist. Rehabilitation Registered Nurses (RN): The rehabilitation nurse manages the nursing care team, serves as an educational resource to other (non-rehabilitation) nursing personnel, instructs patient/family in functional skills, and reinforces skills learned in therapy. Speech Language Pathologists (SLP): These licensed professionals focus on improving communication skills, cognitive (thinking) skills and treat problems with swallowing. They may include activities to improve word-finding in conversation, decision-making, reasoning skills and diagnosis and treatment of swallowing problems. Vocational Counsellor: The vocational counsellor evaluates vocational interests, training and skills; provides counselling concerning returning to work and serves as a liaison between the patient and prospective employers. 7 Interdisciplinary Team: Crossword2 Directions: Study the definitions of each job within the interdisciplinary team found on pages 5 & 6. Then find the answers to the clues below. (#1-9.) Across 3. Provide overall coordination for rehabilitative care. 7. Therapists emphasize improvement of self-care skills. 8. Focused on nutritional needs. Down 1. Speech Language _______. 2. Evaluates medical/functional status. 4. Therapist incorporates leisure time activities. 5. _______ counsellor. 6. Therapists provide training with walking, transfer techniques. 9. Instructs patient/family in functional skills. 2 Note: There may be other specialists included in the team, such as: respiratory therapist, child life specialist, horticultural therapist, music therapist, dance therapist, animal-assisted therapy specialist, chaplain, rehabilitation dentist, audiologist, and pharmacists. 8 Anatomy & Physiology As a Rehabilitation Assistant, it is important to understand anatomy & physiology. Body Systems: Matching Directions: In the space, write in the letter that matches the correct body system. A. Reproductive System B. Respiratory System C. Cardiovascular System D. Musculoskeletal System E. Nervous System F. Urinary System G. Digestive System H. Endocrine System I. J. Lymphatic System Skin 1. The __is the major controlling, regulatory, and communicating system in the body 2. The ___acts through chemical messengers called hormones that influence growth, development, and metabolic activities. 3. The ___ system consists of bones, cartilage, ligaments and tendons and muscle fibers. 4. The____ includes the heart and the blood vessels. The heart pumps blood, and the blood vessels channel and deliver it throughout the body. Arteries carry blood filled with nutrients away from the heart to all parts of the body. 5. The ____ works with the circulatory system to provide oxygen and to remove the waste products of metabolism. 6. The ____returns excess interstitial fluid to the blood, absorbs fats and fat-soluble vitamins from the digestive system and is a defense against invading microorganisms and disease. 7. The _____produces egg and sperm cells. 9 8. ____ processes food into molecules that can be absorbed and utilized by the cells of the body. 9. The principal function of the _____ is to maintain the volume and composition of body fluids within normal limits. 10. _______ is an organ, made up of multiple layers of epithelial tissues that guard underlying muscles and organs. 10 Physical Medicine & Rehabilitation Word List A-Z A Advocate: Someone who represents your best interest; works on your behalf. Often, people with disabilities become their own advocates. Accessory movement - Joint movements that cannot be performed willingly or in isolation by the patient. Achilles tendonitis – Swelling of the Achilles tendon. Activity limitation - Occurs when a person is not able to perform an activity in a normal way as a result of impairment, such as not being able to walk. Activities of daily living (ADLs) - Personal care activities necessary for everyday living, such as eating, bathing, grooming, dressing, and toileting; a term often used by healthcare professionals to assess the need and/or type of care a person may require. Acute: The early stages of an injury. Also may refer to level of rehabilitation care. The opposite of acute is chronic or long-term. Akinesia - No movement. Alternative Augmentive Communication (AAC) - The addition of a non-speech communication system to enhance and encourage. Example: word board, sign language. To watch a video called “The Power of Communication”. Angiogram: A diagnostic procedure done in the X-ray department to visualize blood vessels following introduction of a high-contrast dye injected into an artery. Anesthesia: Medication that blocks pain sensations. Some anesthesia causes a person to also fall asleep, while others may simply numb an area while the injured person is conscious. Aneurysm – A weakened, pouched area on the wall of an artery. 11 Aphasia – Problems with the thought process, understanding, expressing and formulation of language. Usually caused by a stroke. Arrhythmia - An abnormal heart rhythm. Arthralgia - Pain in a joint, usually because of arthritis or arthropathy. Arthritis - Inflammation of a joint usually accompanied by pain, swelling, possible change in structure. Arthroplasty - Joint replacement surgery. Example: total hip replacement, total knee replacement. Arthroscopy - A diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube (arthroscopy) which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen; used to evaluate any degenerative and/or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation. Articulation – the motor production involved in speech. Assistive device - A tool that helps a person with a disability to complete a task (such as a reacher, grabber, special eating utensil, or button-hooker). Assistive Technology: The utilization of technology, strategies, and methods in enabling individuals to master tasks at home, school, work, increase independence, and quality of life—use of computers, toys, controls, equipment, communications, modifications, etc. Usually done by OT, PT or SLP. Some centers for independent living provide assistance on assistive technologies. Avulsion - When a muscle is forcefully stretched beyond its freely-available range of motion, resulting in a breakage of fragment of bone. Audiologist – A professional who work with people having hearing, balance and related ear problems. Autism Spectrum Disorders – A range of disorders involving problems in the development of reciprocal social interaction, communication skills (verbal and non-verbal), restrictive imaginative play activity. B Bradykinesia: Slowness of movement. Bursa: A sac filled with fluid located between a bone and a tendon or muscle. 12 Bursitis - repeated small stresses and overuse that cause the bursa to swell and become inflamed. C Cardiac - Relating to the heart. Carpal tunnel syndrome - A repetitive strain injury in which the median nerve is squeezed as it passes through the carpal tunnel in the wrist, a narrow small space. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, many symptoms may result. Cartilage - A smooth material that covers bone ends of a joint to cushion the bone and allow the joint to move easily without pain. Cerebral Vascular Accident (Stroke) – Disruption of the blood supply to the brain. Cognition - Mental functions such as the ability to think, reason, and remember. Computed Tomography scan (Also called a CT or CAT scan.) - A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays. Congenital: Present at birth. Contracture: Inability to move a joint due to a permanent rigidity or contraction of a soft tissue (muscle, ligament, skin, fascia). Crepitus: Grinding noise or sensation within a joint. Cervical: The upper spine or neck area of the vertebral column. Cervical injuries include whiplash (damage to the soft tissues of the neck) and quadriplegia, also known as tetraplegia (damage to the spinal cord). Complete Lesion: An injury of the spinal cord with no motor or sensory function below the zone of cord destruction at the site of primary trauma. 13 Communication Disorder: A persistent difficulty in understanding and/or use of spoken or written language. Early detection, identification and treatment is essential. Word List A – C: Classifying Directions: Review the A-C wordlist. Write 3-5 examples under each category. Diseases/Conditions Anatomy Example: Communication Disorder Cartiledge WORDLIST CONTINUED D Deep Vein Thrombosis (DVT) - Blockage of the deep veins; particularly common in the lower leg. Dementia - A group of symptoms that characterize diseases and conditions; it is commonly defined as a decline in memory and brain functioning that is severe enough to interfere with the ability to perform routine activities. Disability - The inability to perform an activity in a normal way as a result of impairment, such as not being able to walk due to a weakness or paralysis in a leg. Disc herniation (Also called disc prolapse, disc bulge, slipped disc.) - A protruding or bulging of the padded areas, called discs, between the vertebrae in the spine. Discharge Planning - Preparation for life after rehab, including insurance and legal issues, home adaptation, and community support issues. 14 Dislocation - A dislocation occurs when extreme force is put on a ligament causing the two bone ends to separate. Dislocations can also affect a joint, the point where two or more bones come together. Example: The shoulder joint is created as a "ball-and-socket" joint. A dislocated shoulder joint causes the head of the bone (ball) to partially or completely come out of the socket. E Epilepsy (Also called seizure disorder.) - Brain disorder involving recurrent seizures. Ergonomics - The science of obtaining a correct match between the human body, workrelated tasks, and work tools. Extension - Movement that brings the body or limbs into straight position. F Fibromyalgia (Also called fibrositis.) - A chronic, widespread pain in muscles and soft tissues surrounding the joints throughout the body. Flaccidity - Decreased muscle tone that results in an inability to voluntarily move a joint/limb. Fracture - A break in a bone. Frozen shoulder (Also called adhesive capsulitis.) - A shoulder injury which has four stages: pain, pain and stiffness, stiffness, and resolution. Functional - The ability to carry out a purposeful activity. Functional Level - Motor level in patients with spinal disease or injury indicative of activity performance capability. G Gait - Pattern of walking or locomotion. Gait Training - Instruction in walking, with or without equipment. 15 Genu valgum - Commonly known as "knock knees." Genu varum - Commonly known as "bowed legs." Grades of movement - Standardized ways of documenting techniques of mobilization, relating it to the range of joint movement. H Hallo Traction - The process of immobilizing the upper body and cervical spine with a traction device following spinal injuries. The device consists of a metal ring around the head, held in place with pins into the skull. A supporting frame is attached to the ring and to a body jacket or vest to provide immobilization. Handicap - Barriers imposed by society, the environment, or attitudes that prevent a person with a disability from performing a role that is normal for that person. Hydrotherapy - Rehabilitation exercises performed in water. Hyper - Prefix meaning, above, beyond or excessive. Hyperextension - Active or passive force which takes the joint beyond extension and its normal range. Hypo - Prefix meaning, low, deficient, under. Hypomobility - A decrease in the normal range of joint movement. Hypoxia - Decreased level of oxygen in the blood or tissues. I Ice therapy - Cooling of soft tissues. Immobilization - Preventing movement to allow for natural healing to take place. Impairment - Loss of normal function of part of the body due to disease or injury, i.e., paralysis of the leg. Inflammation - A normal reaction to injury or disease, which usually results in swelling, pain, and stiffness. 16 Ischemia - Lack of oxygen to tissues. Interventions - Using some type of treatment or variable to see if it has any positive or negative effect upon a specifically identified condition. For example, one could do a comparison test to see if one type of wheelchair cushion is more helpful in preventing pressure sores from developing than another type of wheelchair cushion. Incontinence - Lack of bowel and/or bladder control. J Joint - Where the ends of two or more bones meet. Jumper's knee (Also called patellar tendonitis) - A condition characterized by swelling of the tendon in the knee area that causes local pain and tenderness. 17 Word List D – J: Crossword Directions: Study the terminology on pages 12 – 14, then find the answers to the clues below. Across 6. Straight position 7. A break 8. Not able to perform in a normal way 9. Decreased level of oxygen Down 1. Decreased muscle tone 2. Inflammation 3. Bones meet 4. Walking 5. Decline in memory 18 WORDLIST CONTINUED K Kyphosis - Exaggerated outward curvature of the spine. L Ligaments - A white, shiny, flexible band of stringy tissue that binds joints together and connects bone ends to form joints. Loose body - Name given to an object, located within a joint that has become detached. Lordosis - Inward curve of the spine. Lesion - An injury or wound, any disease or traumatic injury to the spinal cord. Lower Motor Neurons - Nerve cells that are located in the spinal cord and that provide the connection from the brain's upper motor neurons to the skeletal muscles which move joints and limbs. Lumbar - The area immediately below the thoracic spine; the lower back. M Magnetic Resonance Imaging (MRI) - A diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body. Massage - Mechanical form of therapy in which the soft tissues are made more flexible, promoting increased blood flow and healing. Medial Epicondylitis (Also known as golfer's elbow, baseball elbow, suitcase elbow, or forehand tennis elbow.) - Pain caused by damage to the tendons that bend the wrist toward the palm. Median Nerve - Large nerve, made up of segments from the cervical spine that is involved in nerve function of the upper limb; commonly compressed in the carpal tunnel of the wrist. Meninges - The thin layers of tissue that cover the brain. The three layers are the dura mater, the arachnoid, and the pia mater. 19 Menisci - Two crescent-shaped discs of connective tissue between the bones of the knees that act as shock absorbers to cushion the lower part of the leg from the weight of the rest of the body. Mobility - Movement. Multiple Sclerosis (MS) - A disease of the central nervous system that is an unpredictable condition that can be relatively benign, disabling, or devastating, leaving the patient unable to speak, walk, or write. Muscular Dystrophy - The name given to a group of diseases that are, genetically determined and cause gradual wasting of muscle with accompanying weakness and deformity. Musculoskeletal System - The complex system involving the body's muscles and skeleton, and including the joints, ligaments, tendons, and nerves. Myofascial Pain - An aching pain in muscles that tends to be associated with poor posture; patients can become sore in different parts of the body, such as the neck and arms, and often report they have difficulty sleeping or feeling restored from sleep. Myofascial Trigger Point - Areas of focal muscle tenderness and spasm. Medicare - The federal health care program that goes along with Social Security for those over 65 and for those receiving Social Security Disability after two years. Motor - Referring to motion/movement performed by the muscles. Myelin - A white, fatty insulating material produced in the peripheral nervous system necessary for rapid signal transmission along nerve fibers. Loss of myelin accompanies many central nervous system injuries. The process of remyelination is very important in spinal cord injury research. N Nerve Conduction Tests - Procedure to determine nerve impulse generation. To watch a video that explains nerve conduction tests. Neuralgia - Pain in distribution of nerve or nerves. Neuritis - Swelling of a nerve or nerves. Neurological - Relating to the nervous system. 20 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) - Medication that produces fever reducing, analgesic (pain relieving), and anti-inflammatory effects. Non-penetrating Injury - An injury to the spinal cord that comes when bones to the spine or vertebrae are damaged. This injury also is known as a closed injury, because the injuries are internal and not visible. O Orthosis - A brace or splint used to strengthen or stabilize part of the body, usually an arm or leg. Osteophyte - Small outgrowth of bone. Osteoporosis - A condition that develops when bone is no longer replaced as quickly as it is removed. Overuse Conditions (also known as repetitive strain injuries, RSI) - Injuries due to minor trauma involving soft-tissue injuries - injuries that affect the bone, muscles, ligaments, and/or tendons. Occupational Therapy - Treatment approach, which can include exercises, self-help skills, and adaptive equipment, designed to help people care for themselves. Orthotic - A device applied to the outer part of the body to support and align the body and limbs; or to influence motion by assisting, resisting, blocking, or unloading part of the body weight. P Pain - An subjective unpleasant sensory or emotional experience primarily associated with tissue damage, or described in terms of tissue damage, or both. Palpation - Examination by feeling part of the body. Palsy - Paralysis of a muscle or group of muscles. Phantom pain - Pain that occurs after an amputation, below the level of the amputated limb. Physiatrist - The physician who specializes in physical medicine and rehabilitation. Physiatry - Branch of medicine that deals with restoring function for a person who has been disabled as a result of a disease, disorder, or injury. 21 Prednisone - Corticosteroid medication; usually used for inflammation. Pubic Symphysis - Anterior joint of the pelvis. Paraplegia - Loss of function below the cervical spinal cord segments, wherein the upper body retains most function and sensation. Paraplegia results in paralysis of the lower limbs; however, the degree of loss depends on the level of spinal cord lesion. Peripheral Nervous System - Nerves outside the spinal cord and brain (not part of the central nervous system). If damaged, peripheral nerves have the ability to regenerate. Physical Therapy - Movements and exercises designed to improve mobility. Pressure Sore - Also known as decubitus ulcer. A potentially dangerous skin breakdown due to prolonged pressure on skin resulting in infection and tissue death. Pressure sores usually occur over bony areas and are subject to infection, which may move into the bone. Skin sores are preventable with twice daily checks for redness, weight shifts, and an appropriate seating system and cushion. Prosthetic - Replacement device for a body part, for example an artificial limb. Pulmonary - Pertaining to the lungs. Q Quadriceps - A large four-part muscle at the front of the thigh that facilitates knee extension. Quadriplegia - Loss of movement and sensation (feeling) in all four limbs. 22 Word List K – Q: Matching Directions: Match the correct word with the definition. Write in the Definition number next to the word. WORD a. Pulmonary ______ b. Motor ______ c. ______ 2. Mechanical form of therapy in which the soft tissues are made more pliable, promoting increased blood flow and healing. d. Paraplegia ______ 3. lungs e. Palsy ______ 4. A device applied to the exterior of the body to support and align the body and limbs f. ______ Physical Therapy Neurological Definition 1. Movements and exercises designed to improve mobility. 5. An injury to the spinal cord that comes when bones to the spine or vertebrae are damaged. This injury also is known as a closed injury, because the injuries are internal and not visible. g. Lesion ______ h. Massage ______ i. Overuse Conditions ______ 6. Referring to motion/movement performed by the muscles. j. Non-penetrating Injuring ______ 7. Paralysis of a muscle or group of muscles. k. Orthotic ______ 8. Pertaining to the nervous system. i. Occupational Therapy ______ 9. Loss of function below the cervical spinal cord segments, wherein the upper body retains most function and sensation. : 10. An injury or wound, any pathologic or traumatic injury to the spinal cord. 11. Injuries due to minor trauma involving soft-tissue injuries - injuries that affect the bone, muscles, ligaments, and/or tendons. 12. Treatment approach, which can include exercises, selfhelp skills, and adaptive equipment, designed to help people care for themselves. 23 WORDLIST CONTINUED R Rancho scales - Levels of a patient's response to external stimuli and the environment following a brain injury. Range of Motion - The extent that a joint will move from full extension to full flexion. Rheumatoid Arthritis - An inflammatory joint disease that involves the lining of the joint (synovium). The inflammation often affects the joints of the hands and the feet and tends to occur equally on both sides of the body. R.I.C.E. (Abbreviation) - Rest, Ice, Compression, and Elevation. Treatment for acute injuries. Rigidity - Increased resistance to the passive movement of a limb. Rotator cuff - Muscles and tendons that form a cuff over the shoulder joint. major function is to hold the head of the humerus into the socket formed by the scapula and produce rotation of the shoulder. Recreational Therapy - Exercises and activity usually guided by a medical professional towards promoting a patient's physical recovery or rehabilitation. Reflex - An involuntary response of a muscle to a stimulus involving nerves not under control of the brain. In some types of paralysis, reflexes cannot be inhibited by the brain and they become exaggerated, thereby causing spasms. Regeneration - In brain or spinal cord injury, regeneration is the regrowth of nerve fiber tissue by way of some as-yet-unknown biologic process. In the peripheral system, nerves do regenerate after damage, and reform functional connections. Regeneration researchers are confident central nerves can be induced to grow, with the proper environment. The challenge remains to restore functional connections to effectively restore function. Respiratory Treatment - Treatments, most often given in a medical facility, that help to keep the lungs breathing more freely. S Scapula - Shoulder blade. Sciatica (Also called lumbar radiculopathy.) - A pain that originates along the sciatic nerve in the lower back producing pain, motor and/or sensory deficits in the lower body. 24 Scoliosis - A lateral, or sideways, curvature and rotation of the back bones (vertebrae), giving the appearance that the person is leaning to one side. Seizure - Occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function. Shin Splints - Damage to one of two groups of muscles along the shin bone that cause pain and inflammation. Soft Tissues - The ligaments, tendons, and muscles in the Musculoskeletal system. Spasm - A condition in which a muscle or group of muscles involuntarily contract. Spasticity - Increased muscle tone that results in a tightening and shortening of a muscle. Spinal instability - Increased motion between vertebra, usually resulting from an injury; pain typically feels like tingling in the neck or arms. Spinal stenosis - Narrowing of the nerve openings either around the spinal cord or nerve roots that can cause symptoms similar to a pinched nerve; pain is described either as an aching or an electrical feeling down the arm. Spine - A column in the body consisting of 33 vertebrae. Sprain - A partial or complete tear of a ligament. Straight Leg Raise (SLR) - Technique for measuring sciatic nerve mobility and/or hamstring length. Strain - A partial or complete tear of a muscle or tendon. Stress Fracture - A bone injury caused by overuse. SCI Care System - An organized multi-disciplinary system of care including acute treatment, rehabilitation and lifetime follow-up services for spinal cord injured individuals. Sensory Level - Feelings from the body: hot, cold, pain, touch. Spinal Cord Injury - Impairment or loss of motor and sensory function in the cervical, thoracic, lumbar, or sacral neurologic segments secondary to damage of neural elements within the spinal canal. Spinal Shock - Similar to concussion in the brain, spinal shock causes the system to shut down. In spinal cord injury, shock causes immediate flaccid (lack of muscle tone) paralysis, which lasts about three or four weeks. 25 T Tendon - The tough cords of tissue that connect muscles to bones. Tendonitis - An inflammation in a tendon or the tendon covering. Thoracic Spine - The 12 vertebrae between the cervical and lumbar spines that provide attachments for the ribs. Transcutaneous Electrical Nerve Stimulation (TENS) - A method of local electrical stimulation to nerve endings under the skin to provide pain relief. Transient Ischemic Attack (TIA) - Temporary loss of blood supply to tissues in the brain; also called a "mini-stroke." Transverse Friction - Deep massage technique used for tendon and ligament conditions. Trauma Center - A medical facility that specializes in wounds or injuries caused by a sudden, physical blow. Traumatic Injury - An extreme or acute injury that results from a major accident, such as a fall or car crash. U Ultrasound - In physical therapy a therapeutic modality which uses high-frequency sound waves to mobilize and heal soft tissues. *Upper Motor Neurons - Brain nerve cells that initiate voluntary movements by sending an electrical impulse down their axons lying in the spinal cord to stimulate lower motor neurons. V Vertebrae - Bony structures that surround the spinal cord; also called the "back bone." Ventilator - Mechanical device to help facilitate a person with impaired diaphragm function to breathe. Vocational Rehabilitation - Services that guide those with a physical or mental impairment with vocational therapy (see above definition) for the purpose of integration or reintegration into the workforce consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, and informed choice. 26 W Weaning - Gradual removal of mechanical ventilation as patient's lung strength and vital capacity increases. X X-ray - A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. 27 Word List R-X: Crossword Directions: Study the terminology on pages 20 – 22, and then find the answers to the clues below. Across 3. Levels of a patient's response to external stimuli 6. Swelling in a tendon 7. Uses invisible electromagnetic energy 8. Bony structures that surround the spinal cord Down 1. High-frequency sound waves 2. Abbreviation for a "mini stroke" 3. Regrowth of nerve fibre tissue 4. Muscles involuntarily contract 5. Tear of a muscle or tendon 28 ANSWER KEY Interdisciplinary Team: Crossword. (Page 7) 1. pathologists 2. physiatrist 3. caseworkers 4. recreational 5. vocational 6. physical 7. occupational 8. dieticians 9. nurses Body Systems: Matching (Page 8) 1. e 2. h 3. d 4. c 5. b 6. j 7. a 8. g 9. f 10. i Word List A – C: Classifying (Page 13) Diseases/Conditions Anatomy Communication Disorder Contracture Congenital Cerebral vascular Accident (Stroke) Carpal tunnel syndrome Bursitis Bradykinesia Autism Spectrum Disorders Avulsion Arthritis Arthralgia Arrhythmia Aphasia Aneurysm Akinesia Achilles tendonitis Cervical Cartilage Cardiac Bursa Word List D – J: Crossword (Page 17) Down 1. Flaccidity 2. swelling 3. Joint 4. Gait 5. Dementia Across 6. Extension 7. Fracture 8. Disability 9. Hypoxia 29 Word List K- Q: Matching (Page 33) a. b. c. d. e. f. Pulmonary (3) Motor (6) Physical Therapy (1) Paraplegia Palsy (7) Neurological (8) g. h. i. j. k. l. Lesion (10) Massage (2) Overuse Conditions (11) Non-penetrating Injuring (5) Orthotic (4) Occupational Therapy Word List R – X: Crossword (Page 27) Across Down 3. Rancho Scales 6. Tendonitis 7. X-ray 8. Vertebrae 1. Ultrasound 2. TIA 3. Regeneration 4. Spasm 5. Strain 30 References Acronyms and Initialisms for Health Information Resources, Retrieved on February 6, 2009, from http://www.geocities.com/~mlshams/acronym/acr.htm Anatomy & Physiology, Retrieved on February 6, 2009, from http://training.seer.cancer.gov/module_anatomy/anatomy_physiology_home.html Canadian Centre for Occupational Health and Safety: Erognomics, Retrieved on February 21, 2009 from http://www.ccohs.ca/oshanswers/ergonomics/ Human Anatomy Online, Retrieved on February 6, 2009, from http://www.innerbody.com/index.html Garrison, Susan. (1995) Physical Medicine and Rehabilitation Basics: Handbook. Lippincott-Raven, New York. ISBN 0-397-51336-4 Medical Terminology, Retrieved on February 6, 2009, from http://ec.hku.hk/mt/ Musculoskeletal System, Retrieved on February 7, 2009, from http://www.youtube.com/watch?v=C2dTbJDQ3u0 Nerve Conduction Test for Carpal Tunnel, Retrieved on February 7, 2009, from http://www.youtube.com/watch?v=sA6d2HKzQec&feature=related The Ohio State University Medical Centre: About Rehabilitation, Retrieved on December 15’2008 from http://medicalcenter.osu.edu/patientcare/healthcare_services/physical_rehabilitation/ab out/Pages/index.aspx The Power of Communication, Retrieved on February 21, 2009, from http://video.google.ca/videosearch?q=Alternative+Augmentive+Communication+%28AA C%29+&hl=en&emb=0&aq=-1&oq=# Updated: January 2009 31