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  1. 1. THE UNIVERSITY OF ALABAMA AT BIRMINGHAM SCHOOL OF HEALTH RELATED PROFESSIONS DIVISION OF OCCUPATIONAL THERAPY COURSE NUMBER AND TITLE: OT 609 Barriers to Occupational Performance LEVEL: First Year SEMESTER & YEAR OFFERED: Fall, 2001 CREDIT HOURS: 3 CLOCK HOURS: LECTURE: 30 LAB: 30 EXAM: 0 COURSE INSTRUCTOR(S): Retta P. Johnson, MA, OTR/L, CHT Mary Warren, MS, OTR/L INSTRUCTOR(S) OFFICE NUMBER(S): Retta (BB145C) E-MAIL ADDRESS(ES): (rpjohnso@uab.edu) (warrenm@uab.edu) PHONE NUMBER(S): Retta 4-3568 Mary 4-1800 COURSE DESCRIPTION AND PREREQUISITES: Evaluation of specific body systems and exposure to disease processes, injuries, and inherited or developmental abnormalities within these systems. PURPOSE OR JUSTIFICATION: Occupational Therapists work in a variety of settings with a diverse patient population. This course is designed to evaluate specific body systems and to be exposed to disease processes, injury, and inherited or developmental abnormalities within these systems. This course is a functional survey of the disease process, physical and developmental diagnoses and general OT intervention. It will provide a foundation upon which the physical dysfunction and developmental dysfunction coursework will expand into specific OT evaluation, critical treatment design, treatment techniques, and patient education development. The participant should be able to explain the relationship of OT intervention within these medical diagnoses. COURSE OBJECTIVES: The participant will use material presented in lectures by instructors and guest lectures in order to meet the following objectives. 1. Recognize the importance of health promotion and disease prevention as it relates to patient care in OT. 2. Establish a level of understanding in the biopsychosocial effects associated with disease, illness, and injury, including the concept that certain variations in patient populations and lifestyles affect the incidence of pathological conditions.
  2. 2. COURSE OBJECTIVES (Continued) 3. Explain the effects of stress, coping, depression, adaptation on health and the disease process. 4. Develop a knowledge of the effects of environmental and occupational exposure on health and the disease process. 5. Recognize the importance of obtaining diagnostic information and precautions related to medical conditions. 6. Explain the wound healing properties of all tissues, including the stages of wound healing. 7. Display knowledge of the basic functions of the human body system. 8. Recognize specific medical conditions and their pathological processes; recognize the effects of aging, environmental genetics, stress, and infectious disease on the human organ system. 9. Distinguish the environmental factors and personal choices that affect health. 10. Review the soft tissues’ response to injury and immobilization. 11. Review the specific pathology, trauma, and disease processes of the human organ systems, display knowledge in identification of the medical conditions of the systems. 12. Explain the effect of a medical condition on occupational performance. STUDENT RESPONSIBILITIES AND ATTENDANCE: 1. Satisfactory completion of written examinations. 2. Satisfactory completion of paper on a specific diagnosis covered in coursework. 3. Class participation and presentation of paper. 4. Attendance is required for this course. Each absence that is not validated by a physician’s excuse or properly documented and approved by coursemaster will result in a 5% deduction of final grade. INSTRUCTIONAL METHODS: Lecture, guest lecturers, videotape, presentations REQUIRED TEXTBOOKS: Goodman C., Boissonnault W. Pathology: Implications for the Physical Therapist. WB Saunders Company; 1998 RECOMMENDED TEXTBOOKS: None 2
  3. 3. GRADING CRITERIA: A = 90 – 100 points B = 80 – 89 points C = 70 – 79 points F = 69 and below METHOD OF STUDENT EVALUATION: Midterm 40% Final Exam 40% Paper 20% TOPIC OUTLINE: I. Introduction 1. Discuss course requirements, written assignments, testing, and grading criteria. 2. Discuss medical terminology and medical abbreviations and their uses. 3. Health promotion and disease prevention. 4. Biopsychosocial effects associated with pathology 5. Stress, depression, coping, adaptation and the effects on health and the disease process. 6. Discuss the importance of obtaining diagnostic information on medical conditions in order to provide OT intervention. 7. Environmental and occupational exposure on health and the disease process. II. Immune System 1. The immune response and factors affecting immunity. 2. Immunodeficiency diseases 3. Hypersensitivity disorders 4. Autoimmune diseases 5. Infection control in immunodeficiency disorders III. Skin and Tissue Injury: Steps involved in wound healing 1. Introduction to skin anatomy 2. Discuss the wound healing principles of inflammation, repair/remodeling, and scar maturation 3. Introduction to specific diagnoses related to skin: burns, wounds, decubitus ulcers, infections, and neoplastic skin diseases 4. Specific terminology related to wound healing and disease processes of the skin 5. Skin infections 6. Skin cancers 7. Thermal injuries 8. Skin and the aging process 3
  4. 4. TOPIC OUTLINE (Continued) IV. Multiple System/Imbalances 1. Systemic effects of pathology 2. Adverse drug reactions 3. Fluid and electrolyte imbalances 4. Acid-base imbalances 5. Signs of systemic disorders V. Infectious Diseases 1. Signs and symptoms of infectious diseases 2. The effects of aging on infectious diseases 3. Types of organisms and specific infectious diseases 4. Infections with prostheses and implants 5. Uncommon infectious diseases VI. Oncology 1. Tumor definitions 2. Neoplasm classifications 3. Staging and grading of tumors 4. Cancer incidences 5. Factors related to tumor formation: environmental, occupational, and genetic and other risk factors and personal behaviors 6. Oncogenesis and pathogenesis 7. Clinical symptoms of cancer: local and systemic 8. Manifestations of metastasis 9. Treatment of cancer 10. Side effects of cancer therapy VII. Cardiovascular System 1. Anatomy structure and function of the heart and peripheral vascular system 2. Circulation of the heart 3. Signs and symptoms of cardiovascular disease 4. Integration of cardiac and pulmonary function 5. Environmental factors related to cardiac disease 6. Infectious disease and nutritional factors related to cardiac dysfunctions 7. Risk factors related to cardiac disease 8. Specific cardiac disorders: CAD, CHF, MI, PVCs, Congenital diseases, valve defects, aortic aneurysms, ventricular fibrillations, aortic stenosis, RHD, bacterial endocarditis, right vs. left heart failure 9. Diseases of the peripheral system: PVD, arteriosclerosis, thrombosis and embolism, HTN, aneurysm, hemorrhage, phlebitis, varicosities VIII. The Hematological System 1. Composition of blood and specific cell function 2. Signs and symptoms of hemodynamic disorders 4
  5. 5. TOPIC OUTLINE (Continued) 3. Disorders of the erythrocytes 4. Disorders of the leukocytes 5. Neoplastic diseases of the blood and lymphatic system 6. Disorders of hemostasis IX. Pulmonary System 1. Anatomy, structure, and function of the pulmonary system 2. Mechanics of respiration 3. Environmental, occupational, and personal risks that affect pulmonary health 4. Infections and inflammatory diseases 5. Obstructive diseases 6. Pleural space disorders 7. Obstruction of the airway 8. Developmental pulmonary dysfunction X. The Endocrine and Metabolic Systems 1. Review of anatomy, structure, and function 2. Specific hormone actions excreted by endocrine glands 3. Specific endocrine disorders and their treatment 4. The pancreas: an endocrine and exocrine gland 5. Diabetes and clinical manifestations 6. Comparison of hypoglycemia and hyperglycemia 7. Nutrition, vitamin and mineral requirements, daily nutritional requirement. 8. Describe disorders related to nutrition, including obesity and eating disorders. XI. The Kidney, Urinary System and the Male/Female Genital/Reproductive Systems 1. Anatomy, structure, and functions of the kidney, including the functional unit (nephron) and bladder. 2. Disease processes of the urinary tract, hypertension related to kidney/endocrine excretion. 3. Review specific disorders of the male and female reproductive system. 4. Discuss sexually transmitted diseases. XII. The Musculoskeletal System 1. Review the structure and function of muscle, bone, and joint systems and the role that soft tissues play in their function. 2. Demonstrate the human body’s biological response to trauma and immobilization in the musculoskeletal system. 3. Explain metabolic disorders of the musculoskeletal system. 4. Describe specific metabolic bone disorders and their clinical manifestations. 5. Differentiate the causes of specific metabolic bone conditions. 5
  6. 6. TOPIC OUTLINE (Continued) 6. Discuss infectious disease processes of the human musculoskeletal system. 7. Introduce specific neoplastic conditions found in the humans musculoskeletal system. 8. Present specific joint disorders and differentiate between the manifestations of these processes. 9. Describe soft tissue and connective tissue disease processes and their signs and symptoms. 10. Review the basic muscle units, from myoneural junction and motor endplates to entire muscle bellies. 11. Discuss disorders and conditions in the muscle system of the human body, including, muscle injury and tendon involvement. 12. Describe specific diseases related to muscle irritation and failure and contraction failure. XIII. The Human Nervous System 1. Review the structure and function of the central nervous system, autonomic nervous system, and peripheral nervous system. Discuss pathology and disease processes of the specific nervous systems, including demylenization, traumatic injuries, developmental errors, seizure disorders, vascular diseases, Guillan-Barré, and peripheral nerve compression. 2. Review the autonomic nervous system and pathological processes that cause diseases. 3. Review the spinal cord and peripheral nervous system, including specific pathology and disease processes, including developmental errors, compression syndromes, and traumatic injuries. 4. Review infectious conditions in the human nervous system. 5. Describe specific primary and metastatic neoplastic conditions in the central and peripheral nervous system and the specific cell involvement. 6. Differentiate degenerative neurological syndromes and their manifestations as well as location of lesion. 7. Review specific peripheral nerve disorders and nerve injuries. 8. Discuss the presentation of brachial plexus injuries. XIV. Genetic and Developmental Disorders 1. The mechanism of transmission of heredity or familial diseases will be explained. 2. Inheritance of diseases from a single autosomal dominant gene, autosomal recessive gene, homozygous, chromosomal abnormalities, or sex-linked diseases are discussed. 3. Review genetic testing for determination of pre-disposition or fetal testing. 4. Explain acquired birth-related disorders of the human body and their effect on mental retardation and learning disabilities. 6
  7. 7. TOPIC OUTLINE (Continued) 5. Review other developmental conditions that are categorized into a psychosocial diagnostic group and differentiate by manifestation of the symptoms. 6. Discuss birth related nervous system disorders, including, cerebral palsy, obstetrical nerve palsy, hydrocephaly, anoxia and its effect on mental retardation and learning disabilities. 7. Discuss genetic and developmental disorders of the musculoskeletal system. WEEK#/TOPIC ASSIGNED/READING LEARNING OBJECTIVES OR ACTIVITY: Week Topic Assignment Objectives 1 1. Introduction to course, require- Readings: Topic Outline ments, assignments. Ch. 1, pp. 7-8 I,II Thurs 2. Health Promotion/Disease Pre- Ch. 2, pp. 9-26 Aug vention. Ch. 3, pp. 44-54 23 3. Biopsychosocial effects of Ch. 5, pp. 91-121 disease. 4. Diagnostic Testing 5. The Immune System and its disorders. 2 1. The hematological system Ch.11, pp. 354-395 Topic Outline 2. Composition of Blood VIII and IX Tues 3. Specific disorders of the Aug RBCs, WBCs, platelets 28 4. Neoplastic conditions of the blood and lymphatic system 5. Anatomy, function, and Ch. 12, pp. 399-452 mechanics of respiration 6. Risks affecting pulmonary health Thurs 1. Cardiovascular system, begin- Ch. 10, pp. 263-347 Topic Outline VII Aug ning Lecture—Anatomy, 30 function, circulation Cardiac and pulmonary integration 2. Specific disorders of the car- diovascular system 7
  8. 8. 3 1. Continuation—pulmonary Readings: Topic Outline disorders Ch. 4, pp. 74-86 IV,V,VI Tues 2. Multiple System Imbalances Ch. 6, pp. 124-149 Sept 4 3. Infectious diseases Thurs 1. Continuation, Cardiovascular Sept 6 System 4 1. Oncology Readings: Topic Outline VII Ch. 7, pp. 152-170 Tues Sept 11 Thurs 1. The endocrine system—func- Ch. 9, pp. 216-260 Topic Outline X Sept tion and disorders 13 5 1. Skin anatomy and function Readings: Topic Outline 2. Skin and tissue injury: Steps Ch. 8, pp.173-176, III Tues involved 185-193, 202-211 Sept 3. Skin infections 18 4. Skin cancer Thurs 1. Continuation, endocrine Topic Outline X Sept system disorders 20 6 1. The aging process Topic Outline 2. Burn Management III Tues 3. Decubitus Ulcers Sept 25 Thurs 1. Nervous system structure and Ch. 24-26, pp. Topic Outline XIII Sept Pathology: structure and 681-721 27 function of the CNS, ANS, and PNS 2. Pathology of specific nervous System structures 3. Infections of the CNS 4. CNS Neoplasms
  9. 9. 7 1. Spinal cord injury Readings: Topic Outline 2. PNS Disorders Ch. 30, pp. 775-784 XIII Tues Ch. 34, pp. 811-836 Oct 2 Thurs 1. Continuation, Nervous System Oct 4 Structure and Pathology 8 MIDTERM Tues Oct 9 Thurs 1. Degenerative neurological Ch. 27-29, Oct Disease pp. 723-773 11 1. Stroke 2. TBI 9 1. The Musculoskeletal System Ch. 18, pp. 571-575 Topic Outline 2. Structure and function of Ch. 20, pp. 617-622 XI Tues muscles, bones, and joint Ch. 21, pp. 626-634 Oct systems Ch. 22, pp. 639-655 16 3. Response of the musculoskeletal system to trauma and immobilization 4. Metabolic disorders: causes and clinical manifestations 5. Neoplastic conditions of the musculoskeletal system Thurs 1. Continuation, Degenerative Oct Neurological conditions, CVA, 18 TBI 10 1. Continuation, the Topic Outline musculoskeletal system XII Tues Oct 23 Thurs 1. Continuation, CNS disorders— Ch. 33, pp. 799-810 Oct CVA, TBI, vestibular disorders 25
  10. 10. 11 1. Joint disorders: OA and RA Topic #1 & 2 Topic Outline 2. Soft tissue and connective Ch. 23, pp. 660-676 XII Tues tissue disease processes Oct 3. Muscle unit function 30 4. Disorders and condition of the muscle system Thurs 1. Genetic and Developmental Ch. 19, pp. 577-614 Nov 1 Disorders: 2. Mechanism of transmission of heredity or familial diseases 3. Inheritance of diseases from dominant, recessive, x-linked, and chromosomal abnormalities 4. Acquired birth-related Disorders and their effect on mental capacity 12 1. Muscle Joint Function Ch. 34, pp. 833-834 Topic Outline 2. Disorders and conditions of the XII Tues muscle system Nov 6 Thurs 1. Genetic and developmental Topic Outline Nov 8 disorders of the XIII musculoskeletal system 13 1. The Kidney, urinary system Ch. 15-17 Topic Outline and genital/reproductive pp. 532-568 XI Tues systems Nov 2. Anatomy, structure, and func- 13 tions of the kidney and urinary system 3. Disease process of the kidney and urinary system 4. Specific disorders of the male and female reproductive system 5. Discuss STDs 1. Continuation, genetic and Thurs developmental disorders Nov 15
  11. 11. 14 1. Continuation, the kidney and Topic Outline urinary system XI Tues 2. Specific disorders of the male Nov and female reproductive 20 system Thurs THANKSGIVING BREAK Nov 22 15 1. The hepatic system and its Ch. 2, pp. 14-22 Topic Outline X disorders Ch. 14, pp. 496-525 Tues 2. Disorders related to diet, Nov nutrition, and lifestyle 27 Thurs 1. Learning disabilities and Topic Outline XIV Nov mental retardation 29 2. Psychosocial diagnostic developmental conditions 3. Birth-related nervous system disorders 16 FINAL EXAMINATION TUESDAY—DECEMBER 3rd