Ergonomics and musculoskeletal disorders Flashcards

1
Q

What are musculoskeletal disorders, how are they a major occupational health issue for dental hygienists?

A

An injury to the body caused by:
- Fast-paced or repetitive movements
- Forceful or awkward movements

  • overuse of small muscles and tight grips
  • Poor posture
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2
Q

What are the risk factors for musculoskeletal stress? 6

A
  • Fixed working positions (static postures)
  • Excessive use of small muscles
  • Tight grips
  • Repetitive movements
  • Positioning challenges
  • Confined working space/Equipment limitations
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3
Q

Explain the common musculoskeletal disorders in dental hygienists:

Thoracic Outlet Syndrome and its causes

A
  • Disorder of the fingers, hand, and/or wrist as a result of the compression of the brachial nerve plexus and vessels
  • Causes:

*Tilting the head forward

*Hunching the shoulders forward

*Continuously reaching overhead

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4
Q

Explain the common musculoskeletal disorders in dental hygienists:

Rotator Cuff Tendonitis and causes

A
  • Inflammation of the muscle tendons in the shoulder region
  • Causes:

*Holding the elbow above waist level

*Holding the upper arm away from the body

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5
Q

Explain the common musculoskeletal disorders in dental hygienists:

Pronator Syndrome and causes

A
  • Disorder of the wrist and hand as a result of the compression of the median nerve by the pronator muscle
  • Causes:

*Holding the lower arm away from the torso of the body

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6
Q

Explain the common musculoskeletal disorders in dental hygienists:

Extensor Wad Strain.

A
  • Disorder of the fingers as a result of injury to the extensor muscles
  • Causes:

*Extending the fingers independently of each other

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7
Q

Explain the common musculoskeletal disorders in dental hygienists:

Carpal Tunnel Syndrome

A
  • Disorder of the wrist and hand as a result of the compression of the median nerve in the wrist
  • Causes:

*Repeatedly bending the hand up, down, or from side to side at the wrist

*Pinch-gripping an instrument without resting the muscles

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8
Q

Explain the common musculoskeletal disorders in dental hygienists:

Ulnar Nerve Entrapment.

A
  • Disorder of the lower arm and wrist as a result of the compression of the ulnar nerve at the wrist
  • Causes:

*Repeatedly bending the hand up, down, or from side to side at the wrist

*Holding the little finger a full span away from the hand

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9
Q

Explain the common musculoskeletal disorders in dental hygienists:

Tenosynovitis.

A
  • Inflammation of the tendons on the side of the wrist and base of the thumb
  • Causes:

*Hand twisting

*Forceful gripping

*Bending the hand back or to the side

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10
Q

Explain the common musculoskeletal disorders in dental hygienists:

Tendonitis.

A
  • A painful inflammation of the tendons of the wrist
  • Causes:

*Repeatedly bending the hand up, down, or from side to side at the wrist

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11
Q

What is ergonomics?

A
  • Considerations for ideal posture, movement and positioning during dental hygiene procedures to avoid discomfort and injuries
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12
Q

By applying ergonomic principles and undertaking regular physical activity, you can
2

A

*Prevent musculoskeletal disorders
*Improve likelihood of career longevity

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13
Q

What should you always be thinking before going into a patients mouth

A

“Me, my patient, my light, my nondominant hand, my dominant hand”

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14
Q

What is neutral positioning?

A
  • Ideal positioning of the body in a balanced position.
  • Results in a decreased risk of musculoskeletal injury.
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15
Q

What is the neutral neck position?

A
  • Goal: head tilt of 0 to 15 degrees

AVOID:
*Head tipped too far forward
*Head tilted to one side

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16
Q

What is the neutral back position?

A
  • Goal: Leaning forward slightly from the waist or hips. between 0-20 degrees.
  • AVOID:
    Curved back
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17
Q

What is the neutral torso position?

A
  • Goal: Torso in line with long axis
  • AVOID: Leaning or twisting torso
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18
Q

What is the neutral shoulder position?

A
  • Goal: Shoulders even
  • AVOID: Shoulders hunched up toward ears
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19
Q

What is the neutral upper arm position?

A
  • Goal: elbows at waist level held slightly away from the body. between 0-20 degrees
  • AVOID: elbows held above waist level
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20
Q

What is the neutral forearm position?

A
  • Goal: forearm parallel to the floor; between 60-100 degrees
  • AVOID: angle between forearm and upper arm of less than 60 degrees
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21
Q

What is the neutral hand position?

A
  • Goal: little finger-side of palm slightly lower than the thumb-side of palm.
  • AVOID: palm parallel to floor
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22
Q

What are the 3 curves of a healthy back?

A
  1. Cervical (inward curve)
  2. Thoracic (slight outward
    curve)
  3. Lumbar (inward curve)
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23
Q

What is the neutral seated position?
4

A
  • Weight evenly distributed
  • Seat back about 1 inch higher than front of seat
  • Hips slightly higher than knees
  • Seat height positioned low enough so that you are able to rest the soles of your feet on the floor
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24
Q

What are the conditions for selecting a clinician stool?
2

A
  • Each clinician should adjust stool height and seat back to his or her own body proportions and height
  • Adjust seat tilt and lumbar height of backrest
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25
Q

What is the saddle stool positioning?
4

A
  • Halfway between sitting and standing
  • Tripod position
  • Feet flat on the floor
  • Thighs at a 135 degree angle
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26
Q

What are saddle stool benefits?
4

A
  • Easier to maintain neutral spine
  • Able to sit closer to the patient
  • Easier to move around
  • Easier to go from sitting to standing
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27
Q

What are the 4 neutral positions for the patient?

A
  1. Supine
  2. Upright
  3. Semi-upright
  4. Tredelenburg
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28
Q

What are the characteristics of supine patient position?
3

A
  • Brain is at same level as heart
  • Back of chair parallel to the floor
  • Position used for most treatment procedures
29
Q

What are the characteristics of the upright patient position?

A
  • Initial position for patient reception (health history assessment)
30
Q

Upright patient position

A

initial position for patient reception

31
Q

What are the characteristics of the semi-upright patient position?

A
  • Chair reclined a 45 degree angle
  • Patients with certain types of cardiovascular, respiratory, or vertigo problems may need this position
    > most patients CAN lean back. ask questions; how do you sleep at night?
32
Q

What are the characteristics of the Trendelenburg patient position?

A
  • Supine position then tipped down and back 10-15 degrees so the brain is lower than the heart
  • Basic position for some medical emergencies
33
Q

What is the head position for maxillary treatment?
3

A
  • Nose and chin are approximately level
  • Upper arch angled backward past vertical plane > upper arch perpendicular to the floor
  • “Chin-up position”
34
Q

What is the head position for mandibular treatment?
3

A
  • Chin lower than nose
  • Occlusal/incisal surface approximately parallel to floor
  • “Chin-down position”
35
Q

What is the neutral positioning of equipment?
4

A

Equipment should be designed/positioned to fit the user instead of forcing the user to fit the equipment.

Bracket tray and assistant arm within reach without full arm extension or leaning

Extend keyboard mount, move mouse

“You can’t use what you can’t reach

36
Q

What is the light equipment neutral positioning for maxillary treatment?

A
  • Dental light at a 45 degree angle to the floor
  • Light at arm’s length within comfortable reach
37
Q

What is the light equipment neutral positioning for mandibular treatment?

A
  • Dental light directly over the oral cavity perpendicular to the floor
  • Light at arm’s length within comfortable reach
38
Q

What is the neutral position in relation to the patient?

A
  • Lower the patient chair until the tip of the patient’s nose is below the clinician’s waist
39
Q

What is the neutral position in relation to the patient?

A
  • Lower the patient chair until the tip of the patient’s nose is below the clinician’s waist

*mouth below the elbow

40
Q

What are common positioning errors in neutral position in relation to the patient?

A
  • Patient too high
  • Clinician’s arms above waist level
  • Clinician’s arms held far away from torso
41
Q

How to obtain easy neutral positions in relation to the patient?

5

A
  1. Sit alongside the patient.
  2. Position your arm against your side.
  3. Position your arm crossed at your waist.
  4. Make sure that your shoulders are not raised up toward your ears!
  5. Lower the patient’s chair until the patient’s open mouth is below the point of your elbow.
42
Q

What are the patient head positions?

A
  • Ask patient to adjust his or her head to have access to treatment area
  • Maxillary arch: patient in chin-up position
  • Mandibular arch: patient in chin-down position
43
Q

What is coaxial illumination?
2

A
  • Spectacle-mounted or headband-mounted lights (dental headlights)
  • Light beam parallel to clinician’s line of vision
44
Q

What are the functions of magnification loupes?
5

A
  • Magnifies treatment area
  • Improves visual sharpness
  • Reduces strain to clinician’s back and shoulders
  • Decreases eyestrain
  • forces you to have good ergonomics; gets blurry if you are too close
45
Q

What is the difference between the field of vision with/without loupes?

A

Field of Vision Without Loupes:

*When learning the skills of positioning, mirror use, and finger rests, the clinician needs a normal field of vision
*Permits self-evaluation of skills

Field of Vision With Loupes:

*With loupes the clinician’s field of vision is limited to the oral cavity
*Too restricted for practicing skills of position, mirror, and finger rests

46
Q

Why do we use the clinician clock positioning?

A
  • During instrumentation the clinician moves around the patient to maintain a neutral body position.
  • Use the face of an analog clock as a guide to identify the clinician’s position in relation to the patient’s head.
47
Q

What are the clinician clock positions and the range?

A

Using an analog clock face as a guide:
*The patient’s head is at 12 o’clock.
*The patient’s feet are at 6 o’clock.
Range of clock positions: 8 to 4 o’clock

48
Q

Why is the clinician clock position recommended?

A
  • Reduces musculoskeletal stress because the clinician can maintain neutral positioning
  • Provides optimal vision of the tooth surfaces during instrumentation
49
Q

What is important of the patient head position?

A
  • The patient’s head position should facilitate neutral arm, wrist, and hand position for the clinician.
50
Q

Left handed clinician clock position (4:00)

A

To the front of the patient

51
Q

Left handed clinician clock position (3:00)

A

to the side of the patient

52
Q

Left handed clinician clock position (1-2:00)

A

Corner of the headrest

53
Q

Left handed clinician clock position (12:00)

A

behind the patient

54
Q

How do you divide the teeth for the positioning of anterior sextants?

A

Divide tooth at midline
- Halves of an anterior tooth:
-Surface TOWARD the clinician
-Surface AWAY FROM the clinician

55
Q

Left-handed Clinician;
Anterior Sextants;
Anterior Surfaces Toward

A

Clock position for clinician ranges from 3 to 4 o’clock

56
Q

Left-handed Clinician;
Anterior Sextants;
Anterior Surfaces Away

A

Clock position for clinician ranges from 11 to 1 o’clock

57
Q

How do you divide the teeth for the positioning of posterior sextants?

A

Divide the sextant into two aspects:
* Facial Aspect
* Lingual Aspect

58
Q

Left-handed Clinician;
Posterior Sextants.

A

The terms aspect toward and aspect away always refer to a posterior sextant when viewed from the 3:00 position

59
Q

left handed clinician:
posterior aspect towards

A
  • clock position in 3 oclock
  • patient turns head slightly to the right
60
Q

left handed:
posterior aspects away

A
  • clock position ranges from 2-1
  • patient turns head slightly to the left
61
Q

mandibular arch - anterior surfaces toward

A

clock position: 3-4
patient head position: chin down; neutral to turned right or left

62
Q

maxillary arch - anterior surfaces toward

A

clock position: 3-4
patient head position: chin up; neutral to turned right or left

63
Q

mandibular arch - anterior surfaces away

A

clock position: 11-1
patient head position: chin down; neutral to turned right or left

64
Q

maxillary arch - anterior surfaces away

A

clock position: 11-1
patient head position: chin up; neutral to turned right or left

65
Q

mandibular arch - posterior aspects toward

A

clock position: 3
patient head position: chin down; neutral

66
Q

maxillary arch - posterior aspects toward

A

clock position: 3
patient head position: chin up; neutral to turned slightly away

67
Q

mandibular arch - posterior aspects away

A

clock position: 1-2
patient head position: chin down; toward

68
Q

maxillary arch - posterior aspects away

A

clock position: 1-2
patient head position: chin up; toward