Mobility Flashcards
axial skeleton
ribs, sternum, vertebral column, and skull
appendicular skeleton
pectoral girdles, upper limbs, pelvic girdle, and lower limbs
how many bones in the body
206
function of bones
- form body structure
- protect vital organs
- provide a point of attachement for muscles
- store minerals
- form blood cells
3 types of muscles
skeletal muscle
smooth muscle
cardiac muscle
skeletal muscle
voluntary
critical for physical mobility
640 muscles
smooth muscle
involuntary
forms the supporting tissue of blood vessels and hollow internal organs
cardiac muscle
involuntary
myocardium
joints
2 bones meet
hold skeleton together
provide mobility
ligaments
connect bones to other bones to form a joint
tendon
connect bones to muscles
carry contractile forces from muscle to bone to cause movement
cartilage
flexible connective tissue found throughout the body
- ribs to sternum
- structure for nose
epiphyseal plate
growth plate
-only pediatric
pediatric differences
- epiphyseal plate
- cartilage between epiphysis and diaphysis
- osteoblasts at growth plate produce new bone within the diaphysis to increase the length of the bone
- bones more porous, less dense = high risk of fracture
older adult differences
- low bone density (more bone resorped than made)
- bones are thinner, weaker
- spinal discs are thinner, loose fluid and thinner bones of the spine=spinal compression
- muscle fibers derease or atrophy (muscle strength, slower rxn time and impaired balance)
- tendons and joints are less elastic
Relationship between comfort and mobility/immobility
- acute and chronic pain
- end of life care
- fatique
- fibromyalgia
increased pain—>
less activity—>increased muscle atrophy and bone resorption
increased fatique—>
decreased muscle control—>decreased balance
end of life–>
decrease in mobility in general
Relationship between health/wellness/illness and mobility/immobility
increased physical activity–>increased muscle mass/strength and bone density
Relationship between stress and mobility/immobility
decreased mobility–>increased stress–>difficulty coping
Relationship between collaboration and mobility/immobility
interaction between multiple clinicans to regain full mobility
Relationship between safety and mobility/immobility
developmental considerations
- infants learning mobility—>increased risk of injury
- children in sports/activities—>increased risk of injury—>decreased mobility
- decreased mobility—>increased risk of falls and fractures in older adults esp.
back and spinal cord alternations
common causes: herniated discs and scoliosis
-overweight and poor physical fitness
Fractures
break in continuity of a bone
Factors that affect severity of the fracture
- nature of event
- strength of bone
Greatest risk factor for hip fracture
osteoporosis
Multiple Sclerosis (MS)
autoimmune disorder that destroys the myelin sheath around nerves, disrupting transmission of nerve impulses
-impairs the brain’s ability to communicate with the rest of the body resulting in a variety of symptoms including sensory and motor disturbances and alterations in bowel and bladder control
hard to diagnose due to alternating symptom episodes
Osteoarthritis
degeneration of cartilage and bone in a joint
- sometimes accompanied by bone spurs
- most commonly in knees, hips, hand and spine
Parkinson disease
central nervous system disorder caused by degeneration of neurons that produce the neurotransmitter dopamine
- more common in men than women
- progressive disease
Spinal cord injuries
- medical emergencies
- may result in permanent disability or paralysis
- location determines severity
General assessment of musculoskeletal system
- deformities
- tenderness
- pain
- measure extremities
- muscle mass and strength
Gait and Posture Assessment of musculoskeletal system
body posture and gait
spine curvature
Joint assessment of musculoskeletal system
inflammation
deformities
tenderness
warmth
pain
crepitus
crepitus
grating sound or sensation
bone to bone or bone to cartilage
ROM assessment of musculoskeletal system
RN to provide resistance by pushing in opposite direction
Uric acid test
blood test
increased uric acid levels may indicate gout, excessive exercise and a variety of non-musculoskeletal-related disorders
Phosphorus test
increased levels may indicate hypoparathyroidism
decreased levels may indicate hyperparathyroidism or lack of vit D
Calcium
increased blood calcium levels could indicate the presense of metastatic bone tumors, Paget disease, bone fractures, or hyperparathyroidism.
Decreased blood calcium levels could indicate hypoparathyroidism, osteomalacia, or vit D deficiency
Alkaline Phosphatase (ALP)
ALP is produced by bone and other organs
increased ALP may indicate bone disease, bone fracture, bone tumors, osteomalacia, Paget disease,
decreased ALP may indicate Wilson disease
Creatine Kinase (CK)
used to detect muscle damage, muscle inflammation, rhabdomyolysis, polymyositis, and muscular dystrophy.
CPK-MM is specific for skeletal muscle
Rheumatoid factor
elevated level may indicate RA, scleroderma, lupus, and adult still disease
growth hormone (GH)
high levels of GH may indicate acromegaly or gigantism.
low levels of growth hormone may result in dwarfism
parathyroid hormone/Calcitonin
PTH and Calcitonin have opposite actions in regulation of blood calcium levels
increased Cal. may indicate a thyroid tumor
increased PTH for osteoporosis that does not respond to therapy
Image testing
bone scan
bone density
CT scans
MRI scans
xrays
Electrical tests
EMG
NCV
Independant interventions for treatment and prevention of immobility
- Provide ROM
- Provide Education
- Promote comfort
- Prevent injury
Collaborative interventions for treatment and prevention of immobility
- PT
- Passive ROM
- Active ROM
- Actice Assistive ROM
- Exercise
- ambulation
- assistive devices (walkers, crutches)
- pharmacologic therapies
Passive ROM
performed by HCW
Active
performed by patient
Anti-inflammatory drugs
decreases inflamation
ibuprofen, aspirin, naproxen
Antispasmodics
relaxes skeletal muscles
baclofen, dantrolene
Bone growth stimulators
inhibits bone resorption
osteoporosis-alendronate, risendronate
Morse Fall Scale
predicts likelihood that a patient will fall
point system
performed once a day with change in patient status
provides info needed to tailor interventions to prevent falls
