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