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Mobility Lecture
activity and fitness
| Question | Answer |
|---|---|
| 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
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