Chapter 28: Immobility (IRAT/GRAT #1) Flashcards
body mechanics
the coordinated efforts of the musculoskeletal and nervous systems
body alignment
(posture) positioning of the joints, tendons, ligaments and muscles while standing, sitting or lying.
Benefits of correct body alignment
- reduces strain on musculoskeletal structures
- aids in maintaining adequate muscle tone
- promotes comfort
- contributes to balance and conservation of energy
impaired balance
a major threat to physical safety and contributes to a fear of falling and self-imposed restrictions on activity leading to decrease in muscle tone and an increase in risk for skin breakdown, pulmonary complications and social isolation.
shear
the force exerted against the skin while the skin remains stationary and the body structures move
(ex. sliding down the in the bed by gravity forces when HOB is increased. the tissues blood vessels are stretched and damaged resulting in decreased blood flow to deep tissues leading to pressure ulcers)
Posture and Movement
directly related to the skeleton and the shape of development of skeletal muscles
muscle tone
the normal state of muscle tension.
prolonged bed rest/immobility results in:
decreased activity level, activity tolerance and muscle tone
Primary motor cortex
the majority of motor fibers descend from the primary motor cortex (motor strip) and cross at the level of the medulla.
The fibers from the right motor cortex initiate
voluntary movement for the left side of the body
The fibers from the left motor cortex initiate
voluntary movement for the right side of the body
Afferent neurons
sensory
Efferent neurons
motor
What influences mobility?
- Posture
- Muscle Abnormalities
- Damage to CNS
- Trauma to musculoskeletal system
Posture abnormalities
- assess for body alignment and ROM
- postural abnormalities can cause pain, impaired alignment or mobility or both
Muscle abnormalities
dystrophies (degeneration of skeletal muscle fibers)
Any damage to any component of the CNS that regulates voluntary movement results in
impaired body alignment, balance and mobility
Direct trauma to the musculoskeletal system results in
bruises, contusions, sprains and fractures.
Factors influencing mobility-immobility: Bed rest
- muscular deconditioning associated with lack of physical activity is apparent in just a few days.
- disuse atrophy
An average health person on bed rest loses muscle strength from baseline at a rate of
3% per day
disuse atrophy
the tendency of cells and tissue to atrophy in size and function in response to prolonged inactivity from: bed rest, casting, and local nerve damage
Metabolic Changes: Changes in mobility alter
endocrine metabolism, calcium resorption and functioning of the GI system.
The endocrine system maintains and regulates vital functions such as:
response to stress and injury, growth and development (Ca resorption), reproduction, maintenance of the internal environment (Na+, K+, acid/base balance), energy production/use/storage.
