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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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