Medical Social Work
Rehabilitation Management, LLC

Abduction - Movement of the limb away from the mid-line of the body.

Activities of Daily Living (ADL) - Activities that include eating, dressing, grooming, shaving, bathing.

Acquired Brain Injury - ABI is a vast array of injuries that occur to the brain at any point after birth.

Adaptive Equipment - A wide selection of equipment and devices used to accomplish more ADL activities and
become more functionally independent.

Adduction - Movement of the limb toward the midline of the body

Advocate - An individual or organization chosen to serve on behalf of another individual.  

Ambulation - Walking with or without aids, such as braces and crutches.

Americans with Disabilities Act (ADA) - Its purpose is to eliminate discrimination on the basis of disability in the
full and equal enjoyment of the goods, services, facilities, privileges, advantages or accommodations of any place of public
accommodation by any person who owns, leases or operates a place of public accommodation
(Source: 42 U.S.C 12182.)

Anosognosia - Lack of awareness of deficits.

Aphasia - Difficulty understanding speech and/or difficulty expressing thoughts.  It is not a result of deafness or muscle
paralysis, and it does not necessarily affect intelligence.

Apraxia - Inability to conduct purposeful movement.

Arterial Line - An intravenous (IV) device inserted into an artery to determine blood pressure and draw blood.

Atelectasis - Loss of breathing function that is characterized by collapsed lung tissue. If lung secretions cannot be
cleared, this can lead to pneumonia.

Autonomic Dysreflexia - A potentially dangerous complication in SCI above the T-6 vertebra that involves high blood
pressure, sweating, chills, and headache.   Can be triggered by a variety of stimuli, including bladder distension, irritation to
the urinary tract, skin ulcers, fractures, abdominal emergencies, bowel impaction and uterine contractions.   Also known as

Autonomic Nervous System - The part of the nervous system that controls involuntary activities, such as the heart.

Biofeedback - A process that provides sight or sound information about body functions, such as blood pressure and
muscle tension, and enables patients to control these functions.

Blood Pressure - The force with which the heart pumps blood. Normal blood pressure is 120/80.

Bowel Program - A habit or pattern for emptying the bowel at a specific time.

Case Management - Case management is a collaborative approach to providing and coordinating health care services.
A case manager will work with you, your family, physicians and other health care providers to ensure you or your family
member receives all the necessary services to promote your health and oversee any illnesses or health conditions.

Catheter - A flexible tube for withdrawing from, or introducing fluids to the body, usually the bladder.

Central Nervous System (CNS) - The part of the nervous system that includes the brain and spinal cord.  

Cervical Spine - The seven bones or vertebrae of the spine in the region of the neck.

Closed Head Injury - When a person receives an impact to the head from an outside force, but the skull does not

Cognition - Conscious process of knowing or being aware of thoughts or perceptions, including understanding and
reasoning.  Mental processes include memory, attention, concentration, thinking, listening, judgment, decision-making and
awareness of the immediate environment including other people, places, and time.

Cognitive Impairment - Difficulty with perception, memory, attention and reasoning skills.

Coma - A state of unconsciousness from which the patient cannot be awakened or aroused, even by powerful stimulation.  
Glasgow Coma Scale of 8 or less.

Complete Injury - A total paralysis (loss of movement) and loss of sensation (feeling) below the level of injury

Community Skills - Abilities that enable someone to live and function safely in the community.

Competency - A legal term that reflects a mental ability to understand the nature and effect of one's acts.  Also known as

Computerized Axial Tomography (CT Scan) - A cross-sectional X-ray technique that produces high-
resolution, 3-D images that greatly enhance diagnosis.

Concussion - The common result of a blow to the head or sudden deceleration usually causing an altered mental state,
either temporary or prolonged. Physiologic and/or anatomic disruption of connections between some nerve cells in the brain
may occur.

Contracture - The stiffening of a body joint to the extent that the joint cannot be moved through normal range of motion.

Counseling - An intervention used by trained professionals to help clients in problems of living.

Coup-contra coup - When the back of the head is struck and the front of the brain is injured by the brain bouncing back
and forth.

Depression - A mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity.

Diffuse Axonal Injuries - Injuries caused by individual nerve cells stretching and breaking throughout the brain.

Disability - A physical or mental impairment that substantially limits one or more of the major life activities of an individual
(Source: 42 U.S.C. 12102)

Dorsal - The back, rear, or posterior part of the body.  For example, dorsiflexion of the toes means flexing the toes to the
back of the foot (the sole).

Duration - Length of time that a behavior continues.

DVT - Deep venous thrombosis, or blood clot, treated with blood-thinning medication.

Dysphagia - Difficulty swallowing.

Edema - A swelling, usually in the legs or feet, caused when the body tissues contain an excessive amount of fluid

Endotracheal Tube - A tube inserted into the mouth or nose that serves as an artificial airway. It passes through the
vocal cords, and therefore speech is not possible with this tube in place. It is this tube that connects a respirator to the patient.

Executive Functions - The ability to plan, initiate, direct and monitor one's activities.  Involves organizing, planning,
creating, evaluating and initiating projects and activities.

Extension - Movement which brings the body or limbs into a straight position.

Flexion - Movement which brings the body or limbs into a bent position.

Foley Catheter - A tube inserted into the bladder to drain the urine into a plastic bag either attached to the leg or the bed.

Frequency - Number of times that a skill or behavior is observed to occur.

Functional Electrical Stimulation (FES) -  Low-level, computer-controlled electric current to the muscles,
including paralyzed muscles, to enhance or produce function.

Guardian - Person who cares for the personal needs of the ward.

Guardianship - A legal arrangement under which one person, the guardian, has the legal right and duty to care for
another, the ward.

Halo Orthosis - A metal ring and supporting frame, placed around the head and attached to a body jacket or vest, to
immobilize the upper body and cervical spine.

Heterotopic Ossification (HO) - The formation of new bone deposits in the connective tissue that surrounds major

Household Management - Meal preparation, housekeeping, money management and other activities related to
managing where one lives.

IEP - Individualized Education Plan for a student found eligible for special education and/or related services that designates
the kinds and extent of services that the student needs.

Impaction - A blockage of the bowel with stool that results in severe constipation.

Incomplete Injury - Some movement and/or feeling remains below the level of injury; movement and feeling may
improve over time.

Incontinence - Lack of bladder and/or bowel control.

Indwelling Catheter - A flexible tube, retained in the bladder, and used for continuous urinary drainage to a leg bag or
other device.

Informed Consent - A patient's consent to health care based on a full disclosure of facts necessary to make an
intelligent decision.

In-School Transitions - Change in school, including moving from grade level to grade level, elementary to middle and
then high school, and finally graduation.

Intermittent Catheterization  - Using a catheter to empty the bladder on a regular schedule.

Intravenous Pyelogram (IVP) - An x-ray of the kidney to determine function

Intubation - Insert a tube through the nose or mouth into the windpipe to keep the airways open, prevent fluids from
entering the lungs, and remove fluids from the lung.

Laminectomy - An operation that is sometimes used to relieve pressure on the spinal cord.

Latency - Length of time it takes a person to initiate or complete a behavior.

Legal Rights - Powers or privileges that an individual has under the law.

Leisure Skills - Ability to use free time in ways that are not harmful.

Lesion - An injury or wound.

Lumbar Spine - The five bones or vertebrae of the spine in the region of the lower back, the strongest part of the spine.

Magnetic Resonance Imaging (MRI) - A technique used to display tissues that cannot be seen in x-rays or with
other techniques.

Memory Problems - Considered the most disabling consequence of brain injury, impaired memory affects a person's
ability to learn, retain and use new information and may significantly affect a person's ability to live independently.

Mobility - Ability to move about, either by walking or with the aid of an assistive device.

Neglect - Failure to provide for the basic needs of a dependent individual.

Neuroectomy - An operation in which the nerves to particular muscles are cut to eliminate severe spasticity.

Neurogenic Bladder - A bladder with any disturbance due to an injury of the nervous system.

Nurse - Registered nurses (RNs) work to promote good health and prevent illness. They educate patients and the public
about various medical conditions; treat patients and help in their rehabilitation; and provide advice and emotional support to
patients' families. RNs use considerable judgment in providing a wide variety of services.  They administer medications under
the supervision of doctors and keep records of symptoms and progress.

Occupational Therapist - provides a wide variety of services based on your needs including:
  • Increasing independence in dressing, grooming, hygiene, feeding, and homemaking skills.
  • Increasing the strength and function of your upper body and arms.
  • Improving your thinking, visual, and perception skills.
  • Evaluating and training in the safest method of bathroom transfers.

Orthosis - A device applied to the outside of the body to support, aid, and align the body and the limbs or to assist motion
by assisting, resisting, blocking, or unloading the body weight.

Osteoporosis - Loss of bone density, common in immobile bones after SCI.

Ostomy - An opening in the skin to allow for a suprapubic catheter (for the elimination of intestinal contents) or for the
passage of air (a tracheotomy).

Paraparesis - Weakness of the lower body and extremities below the cervical section of the spinal cord

Paraplegia - An impairment in motor and/or sensory function of the lower extremities.

Percussion - Forcefully tapping areas of the chest to dislodge and mobilize secretions.

Peripheral Nervous System - The part of the nervous system that includes the nerves that are outside the brain or
spinal cord.  If damaged, peripheral nerves have the ability to regenerate.

Person Centered Treatment Planning - Inclusion of the individual, whenever possible, in the development and
design of the treatment plan as well as discussion outcome criteria, goals, objectives and treatment methods.

Phrenic Nerve Stimulation - Electrical stimulation of the nerve that controls the diaphragm to facilitate breathing in
high level quadriplegics. Uses an implanted electrode and a receiver controlled by a wheelchair-mounted transmitter

Physiatrist - a physician specializing in physical medicine and rehabilitation. Physiatrists treat a wide range of problems
from sore shoulders to spinal cord injuries. They see patients in all age groups and treat problems that touch upon all the
major systems in the body. These specialists focus on restoring function to people.  The physiatrist is the Team Leader who
directs your care.

Physical Therapist - your physical therapist can help you meet goals in ambulation and independent movement, as
well as:
  • Increasing your upper and lower body strength.
  • Increasing your balance.
  • Obtaining maximum independence with a manual and/or motorized wheelchair.
  • Obtaining maximum independence with bathroom transfers.

Postural Drainage - Positioning the head lower than the chest so that gravity can be used to help clear the lungs of

Power of Attorney - A document in which a competent person appoints another to act for him in legal and financial

Pressure Sore - Also known as skin sore or decubitus ulcer. A breakdown in the skin due to pressure that results in
tissue death and sometimes infection

Prone - Lying horizontal with the face down, or, turning the hands so the palms face downward or backward.  Opposite of

Psychology - The Psychology Department provides services to you and members of your family who are learning to cope
with the effects of your disability. When illness or trauma causes changes in levels of function and lifestyles, support and
positive motivation are crucial to a successful adjustment by you and your family. You may meet with a member of the
psychology department several times a week, in individual or group sessions. Services provided by the psychology
department include:
  • Initial cognitive and emotional evaluation, as well as neuropsychological testing.
  • Individual and/or group psychotherapy to facilitate your involvement in the rehabilitation process, your adjustment to
    your injury or disability, and the alteration in your physical, cognitive, and emotional functioning.
  • Marital and family therapy that focuses on changes in family dynamics caused by illness, trauma, and/or disability, as
    well as sexual counseling.
  • Biofeedback and relaxation techniques

Quadriparesis - Weakness of all four limbs due to an injured or diseased spinal cord segment

Quadriplegia - Also known as tetraplegia, is a symptom in which a human experiences paralysis affecting all four limbs,
although not necessarily total paralysis or loss of function.

Radiculopathy - Pain and other symptoms like numbness, tingling, and weakness in your arms or legs that are caused
by a problem with your nerve roots.

Range of Motion (ROM) - The normal range of motion of any body joint.  Also refers to body exercises designed to
maintain this range and prevent contractures.

Receptive Communication - Ability to understand others through speech and language.

Recreational Therapist - Focus on leisure activities, hobbies, and crafts that integrate goals and functional tasks
begun in other therapies. An integral part of therapeutic recreation is the community re-entry program, which consists of
outings into the community, movies, shopping malls, etc. These outings provide an opportunity for you to apply techniques
learned during therapy sessions and reach your maximum level of independence in the "real world."

Reflex - An involuntary response to a stimulus involving nerves not under the control of the brain. In some types of paralysis,
reflexes become exaggerated and may cause spasms.

Regeneration - The re-growth or repair of nerve fiber tissue, which can permit the return of function.

Rehabilitation - A sequence of services designed to restore optimum physical, psychological, social and vocational
levels of function.

Rhizotomy - A procedure that cuts or interrupts spinal nerve roots to treat spasticity

Sacrum - The lowest part of the spine. The bones or vertebrae in this section of the spine end with the "tailbone" and join
the pelvis (hip).

Secondary Injury - Changes that occur in the body after the injury, such as swelling and loss of blood flow.

Self Help Skills - Bathing, dressing, eating, grooming and toileting.  Often referred to as ADLs.

Social Worker -   The Social Worker/Case Manager serves as an important member of the transdisciplinary team and
acts as a liaison  between the professional health care staff and all others concerned with the patient, including family, friends,
the insurance company or funding source, rehabilitation centers, and/or other facilities.  The Social Worker/Case Manager
performs a general background assessment or psychosocial history.  This assessment includes information about the
patient's pre-injury personality and lifestyle, emotional and financial resources, educational history, work and leisure interests,
special relationships, and previous problems.  A psychosocial history often reveals the patient's and family's understanding of
the current situation and this often allows the multidisciplinary team to bring long-term and short-term goals into better focus
for families.  A social worker is also someone the family can turn to for advice, support, and counseling regarding many
issues involved during the recovery process including economic concerns as well as disability issues.  

A social worker or case manager often acts as a team leader to coordinate the goals of the patient, family, multidisciplinary
treatment staff, and rehabilitation program.  As a coordinator of the therapists and an advocate for the patient, the rehabilitation
case manager oversees and helps develop the patient's ongoing treatment plan and discharge goals along with the rest of
the multidisciplinary team.  The rehabilitation case manager also serves as a liaison between the family, patient, treatment
facility and funding source or insurance company. (Source:  Understanding Brain Injury, An Educational Guide for Families and
Friends.  The Florida Institute for Neurologic Rehabilitation, Inc.

Spasm - Involuntary muscle contraction

Spasticity - overactive muscles that move or jerk involuntarily.

Speech Therapist - Speech-language pathologists assess, diagnose, treat, and help to prevent speech, language,
cognitive-communication, voice, swallowing, fluency, and other related disorders.  Speech-language pathologists work with
people who cannot produce speech sounds, or cannot produce them clearly; those with speech rhythm and fluency problems,
such as stuttering; people with voice disorders, such as inappropriate pitch or harsh voice; those with problems
understanding and producing language and those with cognitive communication impairments, such as attention, memory,
and problem solving disorders. They also work with people who have swallowing difficulties.

Sphincter - A small muscle that can open or block a passageway, such as the urethra or the rectum.

Spinal Cord Injury - Damage to the spinal cord that produces a loss of function or feeling.

Spinal Shock - The body's initial response to SCI, which lasts 3-4 weeks and causes immediate flaccid paralysis, in
which the muscles are soft or weak.

Suctioning - The removal of mucus and secretions from lungs used in individuals who lack the ability to cough.

Supine - Lying horizontally with the face up, or, turning the hands so the palms face upward or forward.  Opposite of Prone.

Suprapubic Cystostomy - A small opening made in the bladder to remove large stones or establish suprapubic
catheter urinary drainage.

Team Conference - Held a minimum of once every four to six weeks.  These conferences allow discussion of your
progress and revision of goals. Informal communication also occurs among members of your rehab team.

Tenodesis - A device to support the hand, wrist, and/or fingers and permit greater function of the disabled hand.

Therapeutic Recreation Specialist - Therapeutic recreation uses treatment, education, and recreation services to
help people with illnesses, disabilities, and other conditions develop and use their leisure in ways that enhance their health,
functional abilities, independence, and quality of life.

Thoracic Spine - The twelve bones or vertebrae of the spine in the area of the chest.

Tilt Table -  A motorized table used to gradually increase a patient's tolerance to a standing position.   

Tracheostomy, or Tracheotomy - Opening in the trachea, or windpipe, to insert a tube that protects the airway and
allows secretions to be removed from the lungs.

Transfer - A method of moving from one surface to another.

Traumatic Brain Injury - occurs as the result of a blow or jolt to the head or a penetrating head injury that disrupts the
function of the brain.

Urinary Tract Infection (UTI) - Bacterial invasion of the urinary tract, which includes the bladder, bladder neck, and

Ventilator - A mechanical device used to facilitate breathing in patients

Vertebrae - The bones that make up the spinal column.

Vital capacity - The amount of air in a full breath.

Vital Signs - Include blood pressure, pulse, respiration, and temperature.

Vocational Skills - Behaviors needed to get and keep a job.

Weaning - Gradually removing a ventilator as the patient's lung strength and vital capacity increase.
Medical Social Work Rehabilitation
Management, LLC.
2 Farmington Rd.
Livonia, MI 48152
Ph: 734-513-4100
Fax: 734-513-0900