Chapter 8
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| striated muscle tissue (voluntary muscles) | all the muscles that you can move consciously
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| smooth muscle tissue (involuntary muscles) | work on their own and include the muscles that pushes food and water through the gastrointestinal tract
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| cardiac muscle tissue | controls the heartbeat. It is involuntary and contracts and relaxes 72 times per min. in the average adult
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| tendons | elastic cordlike structures that connect muscles to bone
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| ligament | tough, white, fibrous cords that connect bone to bone
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| muscular system functions to provide the body with: | movement, posture, heat, protection
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| Why are muscles able to provide movement? | because they are attached to moveable parts of the body
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| Why is muscle tissue more resistant to infection than all other body tissues? | because muscle tissue have an abundant blood supply
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| paralysis | loss of voluntary movement
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| What causes paralysis? | damage to the brain or spinal cord makes it impossible to transmit the necessary signals that tell the muscles to act or react, so voluntary movement is lost
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| muscular dystrophy | group of muscle diseases that are progressively crippling due to weakness and atrophy of muscles
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| atrophy | occurs when muscle mass decreases in size (wasting of muscle).
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| What are some reasons that muscles are not used? | paralysis, limb in a cast or brace, pain, lack of motivation to move, etc. atrophy occurs when muscles are not being used
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| contracture | shortening of the muscle (permanent). Muscle becomes "fixed" or very resistant to stretching.
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| ankylosed | joints become very stiff, unmovable, and frozen
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| Why does contractures occur? | as a result of improper support and positioning of joints
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| edema | swelling of joints, tissue, or organs
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| What are some ways to prevent the disuse of the body? | range-of-motion exercises, ambulation (walking), positiong residents properly
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| range of motion | extent to which a joint can be moved before causing pain
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| passive range of motion | exercises done for the resident by the nursing assistant
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| active range of motion exercise | exercise done by the resident independently
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| range of motion exercise guidelines | exercise in an organized way, never exercise a swollen/redden joint, be gentle, support the limb at the joint, exercise each joint 3 times, be careful when exercising the head and neck
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| typse of movement | adduction, abduction, extension, hypertension, flexion, plantar flexion, dorsiflexion, rotation, pronation, supination, radial deviation, ulnar deviation
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| adduction | move an arm/leg toward the center of the body
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| abduction | move an arm/leg away from the center of the body
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| extension | straighten an arm or leg
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| hyperextension | beyond the normal extension
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| flexion | bend a joint (elbow, wrist, knee)
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| plantar flexion | extend the ankle (toward the sole of the foot)
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| dorsiflexion | to flex the ankle (away fromt he sole of the foot)
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| a) rotation b)internal rotation c)external rotation | a)move a joint in a circular motion around its axis b)turn in toward center c)turn out away from center
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| pronation | turn palms down
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| supination | turn palms up
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| radial deviation | toward the thumb side of the hand
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| ulnar deviation | away from the thumb side of the hand
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| When performing range of motion exercise, note and report | swollen joints, reddened skin, complaints of pain on movement, painful joints, weakness
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| present-time oriented people | (exist in cultures such as Hispanic and African American) may not see the value of range of motion exercises because they don't have problem in the present. They may choose to avoid the discomfort of the exercises.
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| The positive effects of ambulation | circulation is stimulated, muscles are strengthened, pressure on body parts is relieved, joints are extended and moved, weight is borned on the large bones, urinary and digestive systems work better, independence is increased, more positive self-image
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| What does the resident need to be ready to ambulate | strength and balance. Resident must be able to come front a sitting position to a standing position. Resident must have balance while standing. resident must be able to move forward one step at a time.
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| What should you do if the resident falls while ambulating? | Bring the resident close to your body and ease him to the floor, support the resident and call for help.
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| gait belt | a belt placed around a patient's waist. Nursing assistant stands behind the resident with one hand holding the belt
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| ambulation devices | braces, canes, crutches, and walkers
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| improper position leads to | skin breakdown, contractures, decreased circulation, pneumonia, discomfort, edema in limbs
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| alignment | put in a straight line
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| four basic positions | supine (face up), semisupine (tilt), semiprone, prone
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| trochanter roll | rolled towel or blanket use to prevent external rotation
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| rules for positioning | straigthen rather than flex the joints, avoid skin-to-skin contact, change position frequently, ask the resident if he is comfortable, make the resident comfortable
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| external rotation | legs roll outward, if this is prolonged, hip joint becomes "fixed" and ambulation is difficult
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| hand roll | placed in a resident's hand to prevent contractures. This resident is unable to move the hand and fingers due to paralysis
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| how to prevent foot drop | feet placed against a padded footboard or cradle
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| small roll | (towel, piece of foam, sheepskin) use to elevate the heels. The heels need to be protected from pressure
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| Should you ever place a pillow or blankets under the heels | NEVER
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| spasticity | tightening of the muscle with short jerking movements (if resident has this, you need to resposition him move often)
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| bridging | support areas above and below the pressure sore with foam or pillows
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