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Mobility Lecture

activity and fitness

Mobility a consideration of your health status. Your ability to engage in activity as well as free movement.
Mobility depends on 3 things... successful interaction b/w the skeleton, muscles and nervous systems.
skeletal systems consists of... bones, cartilage, ligaments and tendons.
purpose of skeletal system forms the framework of your body. Protects organs, produces blood cells and stores minerals, salts and fats.
Long bones femur
short bones phalanges
flat bones sternum
irregular bones vertebrae
osteoclast they break down old and damaged tissue of bones.
osteoblast bone-forming cells to repair your damaged bone.
articulations 2 bones that come together to form a joint.
synarthroses an immovable joint (cranial sutures)
amphiarthroses allow a limited amt of movement (vertebrae)
diarthroses freely movable
synovial fluid found in diarthroses joints. what allows the joints to move w/o friction.
ligaments connects bone to bone.
tendons attaches muscle to bone
3 different kinds of muscles skeletal, smooth,cardiac
skeletal muscles (striated) moves the skeleton, voluntary
smooth muscle involuntary, no control (digestive tract, bladder, blood vessels)
cardiac muscle muscle that spontaneously contract
Point of Origin Stationary bone
point of insertion movable bone
flexion bending, decreases the angle of a joint
Nervous system controls the movement of your muscular skeletal system.
autonomic nervous system innervates your involuntary muscles-no control (heart, blood vessels, glands)
somatic nervous system innervates your voluntary (elbows, knees, wrist, ankles)
body mechanics the way we move our body, promotes muscular skeletal functioning.
4 components of good body mechanics. body alignment, balance, coordination and joint mobility.
body alignment when aligned, balance is achieved with undo stress to your joints, muscles, ligaments and tendons.
Posture affects your... mood
balance state of equalibrium
how is balance maintained? line of gravity passes through center of gravity and center of gravity is close to base of support.
proprioception you are aware of your body part in relation to the rest of your body and space
Joint mobility allows us to sit, stand, bend and walk...to be active.
Active range of motion pt is moving his/her own joints
passive range of motion you are moving their joints
Prom is... to the point of slight resistance-never pain. only joint flexibility, no muscle strength.
Body Mechanic Guidelines principles of body mechanics, rules to allow you to move w/o causing injury to yourself.
In 2004, ANA launched... "Handle with Care"
"Handle with Care" focuses on... The use of assistive devices to decrease the risk of injury, no manual lifting and emphasizes on your stance.
An erect posture... when you have good body alignment.
In order to have good body alignment, you need... a wide base of support and feet apart.
Squating you do this when lifting heavy objects off the ground.
You know it's too heavy if you.. tap it with your foot and it doesn't move.
keep objects... close to your body
when carrying heavy objects... keep it close to your body, raise it waist level and use leg muscles. Push, pull or slide.
It is easier to... push than pull.
Exercising increases... muscle tone and strength.
Isometric muscle contraction without motion. Performed against an immovable surface (wall)
isotonic you have joint movement during muscle contraction...weight training and free weights, chin ups, sit ups.
isokinetic done with machines that control speed of contraction of your muscles within the range of motion.
aerobic the amount to oxygen taken in exceeds the amt required for the exercise. (jogging, cycling, brisk walking)
anaerobic the oxygen demand exceeds the amt of oxygen taken in. (sprinters, stairs)
Always do this before and after exercising. Stretch
stretching... Increase flexibility of that joint and decreases post exercise stiffness
Resistance training increases muscle strength and endurance.
aerobic conditioning effects... the fitness and body composition.
intensity how hard you're working
duration amt of time you're exercising.
frequency how often you exercise.
mode type of exercise you are doing.
benefits of exercise decreases cardiovascular disease, decreases hypertension and increases muscle tone.
You need to drink _____, and watch your ___________. water, environmental temperature
infants lift their head up and roll over
childhood crawling, pulling themselves up on tables or chairs, starting to walk
toddlers running and hopping
preschooler refining their walking ability, learning to skip.
middle age (6-12) posture improving, better locomotion.
adolescent (12-18) increasing mobility landmarks, become more agile.
young adult (21-23) functioning at peak efficiency.
middle age adult when you gradually decrease your muscle mass, strength and agility.
older adults there will be a change in your physiological system. Bone resorption (bone breakdown)
Reason for post menopausal bone break down no longer producing estrogen
Increase in obesity in young children ages 6-7 is causing... hypertension and type II diabetes.
Effects of exercise when you have a chronic illness not going to want to exercise b/c your body has no stamina.
____ plays a big part in mobility. lifestyle, sedetary...you lose endurance.
The more stress you have, the more ____ you are. fatigued
endorphins what is produced when exercising that makes you feel better and give you more energy.
External factors weather, pollution, neighborhood conditions, finances and support system.
4% Percentage of newborns, born with foot deformities.
scoliosis Lateral culvature of the spine. 65% are idiopathic.
idiopathic No known cause.
Sprain due to stretch injury. partial tear, rest. Complete tear, surgery.
Strain muscle injury, excessive stress to a muscle. From exercising beyond pain.
You need this to confirm fracture, strain and sprain x-ray
Disorders of central nervous system any disorder that affects the motor center of the brain or nerve transmition, affects mobility.
CVA stroke
myasthenia gravis effects the motor center of brain or nerve transmission or both.
parkinsons effects nerve transmission and coordination, have tremors, stiffness due to decreased dopamine in the basal ganglia.
dopamine neuerotransmittor
Diseases of other body systems affect mobility & affect activity tolerence. COPD, asthma, emphysema, pheumonia. SOB
circulatory disorders affect mobility related to decrease oxygen delivered to the tissues.
fatigue anemic, anorexic, depressed, cancer.
disuse atrophy muscles decrease in size from lack of use.
contractures muscle fibers can't shorten and lengthen. stroke or spinal cord injury...need proper alignment in bed.
stiffness/pain in joint connective tissue at joint becomes ankylosed. Bones demineralize, calcium is in blood and can land up in joints which grates causing pain.
bed rest can cause bone demineralization, bones are meant to bear weight.
Renal calculi kidney stones caused by increased calcium excretion from the bone from kidneys filtering calcium and too much being collected.
incentive spirometer take a deep breath and a little ball rises and you keep it up as far as it can go...increases lung compacity.
atelectasis a blockage of your bronchis with mucouse, causes low or entire lung to collapse.
hypostatic pheumonia pooled secretions, warm place for bacteria to grow...decrease gas exchange, can die.
During immobility you have... increased resting heart rate, shorter diastolic phase, decreased coronary blood flow. You try to move, but increases your HR, not enough O2 to heart.
angina heart pain from not enough O2 to heart.
Orthostatic hypertension a decrease in BP with a sudden position change.
venous vasodilation & stasis Decrease mobility, you have muscular/skeletal contraction. have muscle apathy which causes polling blood in veins, basal dilation and engorgement of legs that leads to incompetent valves.
Incompetence of valves allow dependent edema-blood pools starts to separated and goes to tissues and swells, can leak through skin.
thrombus formation blood clot due to status of blood.
virchow's triad 1)venous status 2)activation of clotting 3)damage to the vessels walls.
If thrombus breaks loose... embolism-traveling, on the move can land either @ heart, lungs or brain.
what exercise does for cardiovascular system increases cardiac output, increases HR, increases muscle strength. Do leg exercises every 1-2 hours, use TED hose so venous returns back to heart.
Effects of immobility on Metabolism increased serum lactic acid, decreased metabolic rate, decreased protein and glycogen synthesis. No protein, you can't heal. Increased fat stores. Negative nitrogen balance (more O2 excreted than taking in)
Effects of immobility on the integumentary system external pressure from lying in one position compresses your capillaries, obstructs circulation of your skin and decreases skin turgor.
Skin turgor decreased elasticity of the skin, causes a shift in fluid compartments.
lack of circulation causes... tissue ischmia because you have decreased O2 in blood, eventually have tissue death (necrosis)
necrosis tissue death
skin breakdown due to decreased circulation, decreased O2 and decreased nutrients to the skin.
decubitus ulcer pressure sore
To avoid pressure sores... turn pt every hour or more, keep skin clean and dry, no wrinkles and proper body alignment.
effects of immobility on the gastrointesinal system decreases peristalsis, prone to constipation.
peristalsis wave-like movement of the bowel.
paralytic ileus cessation of peristalsis. (brain freeze)
Effect of immobility on the genitourinary system supine inhibits complete drainage of urine from kidneys and bladder, can't go.
urinary stasis emptying isn't complete b/c your not going according to gravity. Bed pan-raise HOB.
urinary retention increases the bladder size and decreases muscle tone... you dribble.
urinary infection b/c of no movement of urine- dark, warm place for bacteria
how exercise helps with urinary... prevents urinary stasis and increases bloodflow to kidneys which gives you better excretion of waste products...H2O to flush your system out.
psychological effects of immobility decreases self-esteem and image. less active, more depressed, increased anxiety which leads to stress and poor desicion making.
mental status with exercising more mobile and active gives you more energy and less apathy.
Osteoporosis men also...brittle bones and decreased calcium-risk for fractures.
Osteoarthritis hips and knees; joint degeneration, form bony spurs (deformed knuckles)
nervous system disorders rare, but more severe. (M.S, CVA, SCI) muscles become weak, no tone, and spastic. can't control the muscles.
vertigo dizziness from inner ear infection, affects balance
How nutrition relates to activity increase or decrease effects your body alignment and body mechanics...more obese,more energy it takes to move around.
Important info on fluids... need to increase fluids, not only based on environmental temps, but on the intensity of your exercising.
physical assessment needs to focus on... mobility and exercise; muscular-skeletal system and the activity tolerance of pt.
well-rounded exercise program will include... flexiblility, aerobic conditioning and resistance training.
Functional assessment looking @ their ability to do ADL's...Head to toe.
Assessment data includes... VS,H, W, Body alignment, joint function and their gait.
Body alignment assessment front, back and side
sitting alignment scoleosis, lordosis and cyfosis
lordosis inward curve to lower part of spine.
cyfosis outward curve to spine (hunchback)
crepidis grating of the joints
activity tolerance assessment endurance level. check HR(rhythm), respiratory(rate/rhythm) BP(before, during, after) should return w/i 3 min.
stop exercises if... becomes pale, dizzy, weak, SOB, Pain ro diastolic pressure drops 10mm over what it was at rest.
Step test stairs-up 3, down 3-how long can they do that.
tendo- tendon
consto- rib
osteo- bone
artho- joint
congro- cartilage
myo- muscle
abduction moving toward the midline
adduction moving away from the midline
plantar flexion point toes and foot downward
supination turning upward
pronation turning downward
fowler's position semi-sitting. HOB is elevated 45-60 degrees
sim's position semi-prone (enemas)
prone on stomach (for back rub)
oblique position not on side or back. decreases pressure on spine and hip.
semi-fowler's position 30 degrees
high-fowler's 90 degrees...knee gatched.
orthopneic position sitting, leaning forward on bed stand with pillow. for COPD (can't breathe)
lateral on side. (check elbow, hip, knee and ankle)
supine (dorsal recumbent) on back (spiral anesthesia)
logrolling 2 or more people, turning as a unit (back surgery)
friction-reducing devices roller-board from one bed to another.(returning from back surgery)
pressure site any surface the pt is lying or sitting. Force of pressure can lead to skin breakdown.
friction skin dragged across a rough surface, like a bed sheet.
skin shear occurs underneath the skin. you can't see it, underneath skin. leads to skin ulcuration. (across x-ray table)
transfer board helps pt transfer from bed to wheel chair, need to be able to support self with upper body arm strength.
Assistive Active Range of Motion usually stroke victims, uses good leg to help w/ bad leg.
quadracepts knee down into bed (back of legs)
biceps pushing down on the bed to lift up to sitting position.
triceps arms down on bed and lifting butt off bed.
gluteal muscles pinching your buttocks together.
important for walker users have enough arm strength to use it.
axillary crutches under arm bar and hand grip
lofstrand crutch permanent. forearm cuff w/ hand grip.
canadian crutch permanent. upper grip, forearm grip and hand grip.
gait depends on... coordination of pt, ability to take steps, bear weight and balance.
Don't hunch on crutches because... goes underneath and pinches, can injure your brachial plexis and can cause permanent damage.
upstairs on crutches pressure on hand grips, good, bad, crutch.
downstairs on crutches crutch, good, bad
Created by: bdishman