Mobility Flashcards
How many bones are there in the skeleton?
206
What is the axial skeleton?
The axial skeleton contains the ribs, sternum, vertebral column, and skull.
What is the appendicular skeleton?
The appendicular skeleton contains the pectoral girdles, upper limbs, pelvic girdle, and lower limbs.
What are the three types of muscle?
The three types of muscle are skeletal muscle, smooth muscle, and cardiac muscle.
Why are skeletal muscles important? How many are there?
Skeletal muscle is critical for physical mobility. Skeletal muscles attach to bones via tendons; thus, muscle contraction causes movement of the skeletal bones. The human body contains more than 640 skeletal muscles that are under voluntary control by the nervous system.
What do ligaments do?
Ligaments connect bones to other bones to form a joint. They strengthen and stabilize the joint and may limit the mobility of some joints.
What connects bones to other bones?
Ligaments connect bones to other bones to form a joint. They strengthen and stabilize the joint and may limit the mobility of some joints.
What do tendons do?
Tendons connect bones to muscles and carry the contractile forces from the muscle to the bone to cause movement.
What connects bones to muscles?
Tendons
What type of flexible connective tissue is found throughout the body?
Cartilage is a type of flexible connective tissue found throughout the body. For example, cartilage connects the ribs to the sternum, covers the epiphyses of long bones to cushion the joint, and provides structure for the nose. Cartilage is less flexible than muscle, but not as rigid as bones. Of these three types of connective tissue, cartilage is the only one that does not contain blood vessels.
What type of connective tissue does not contain blood vessals?
The cartilage
What type of tissue connects the ribs and the sternum?
the cartilage
What type of tissue covers the epiphysis of the long bones to provide cusioning?
The cartilage
What type of tissue gives structure to the nose?
Cartilage
What are four properties of muscles (the three e’s and a c)
Excitability, extendibility, contractibility, and elasticity
Excitability, extendibility, contractibility and elasticity are properties of what?
muscle
What are the dangers of immobility for a patient? What medical conditions can it cause?
Along with exacerbating existing musculoskeletal impairment, immobility can lead to a host of other problems, including atelectasis (collapse of one or more sections of the lungs) and pneumonia; decreased gastrointestinal motility and paralytic ileus; and impaired tissue perfusion, which can predispose the patient to developing pressure injuries.
What conditions may limit mobility?
Conditions that may limit mobility include pain, fatigue, respiratory disorders, cardiovascular disease, nervous system disorders, and musculoskeletal diseases or injuries.
What are some conditions that will be exacerbated or caused by immobility?
Immobility may cause or affect problems with constipation, decubitus ulcers, metabolic disorders, depression, coping, or spirituality.
Why might a nurse take special care in making sure that the home of a patient with mild to moderate severe Alzeheimer’s is free from rugs and objects that might lead to falls?
For example, Suttanon and colleagues (2012) identified balance and mobility impairments in patients with mild to moderately severe Alzheimer disease (AD).
Why is it important to take folic acid during pregnancy?
Taking folic acid during pregnancy is known to reduce the risk of spina bifida (myelomeningocele), which can cause partial or complete loss of sensation and paralysis of the legs.
The lack of folic acid in pregnancy is associated with what disease?
spina bifida (myelomeningocele)
What genetic disorders impact mobility?
- muscular distrophy (MD): progressive weakness and degeneration of skeletal muscles 2. Marfan syndrome: a disorder of the connective tissues that affects the lungs, heart, blood vessals, eyes and skeleton. Causes long limbs and is associated with pain, numbness and weakness. 3. Amotrophic lateral sclerosis (ALS) a neurologic disorder that affects the neurons responsible for voluntary muscle movements. Symptoms include weaknesss, paralysis in limbs, slurred speech, trouble swallowing, muscle cramps and difficulty breathing. 4. Ellis-van Creveld Syndrome: a rare disorder that affects bone growth. It may cause a cleft lip or palate, polydactyly, tooth abnormalities or shortened arms/legs. Other disorders that may have a genetic component: rheumatoid arthritis, gout, developmental dysplasia of the hip, ankylosing spondylits, lupus
What is Muscular Distrophy?
A genetic condition: muscular distrophy (MD): progressive weakness and degeneration of skeletal muscles
What is Marfan syndrome?
Marfan syndrome is a genetic condition: Marfan syndrome: a disorder of the connective tissues that affects the lungs, heart, blood vessels, eyes and skeleton. Associated with long limbs relative to the body and is associated with pain, numbness and weakness. https://www.youtube.com/watch?v=6n6Tx_bdzk8
What is Ellis-van Creveld Syndrome?
Ellis-van Creveld Syndrome: a rare disorder that affects bone growth. It may cause a cleft lip or palate, polydactyly, tooth abnormalities or shortened arms/legs.
What is spina bifida?
A birth defect in which a developing baby’s spinal cord fails to develop properly.
https://www.youtube.com/watch?v=jlDZA2PNW2o
What is involved in the observation portion of a mobility assessment?
Observe patients as they ambulate across the room or to the examination room. Observe for balance, uneven gait, difficulty bearing weight, and use of assistive devices or furniture for balance or support. Observe for signs of pain, such as facial grimacing or guarding, or moaning or wincing with movement, bending, or weight bearing. Note any findings. Observation in the clinic or inpatient setting may be similar to that for the home setting.
What are questions one might ask regarding history when assessing for mobility?
History
Have you ever experienced a bone or muscle injury or problem? If so, describe it.
Have you ever taken medications to treat a bone or muscle injury or problem? If so, what were they?
Have you ever received treatments for a bone or muscle injury or problem, such as surgery, physical therapy, or alternative treatments? If so, describe them.
Has anyone in your family been diagnosed with a musculoskeletal or nervous disorder?
What are questions one might ask regarding current status when assessing mobility?
Current Problem
Describe the pain you are experiencing (onset, intensity, location, etiology, duration). What relieves the pain or makes it worse?
Do you have any symptoms accompanying your pain, such as swelling, muscle spasms, cognitive deficits, balance problems, numbness, stiffness, or muscle weakness?
Do your symptoms limit your ADLs, such as walking, bathing, cooking, or participating in social activities?
Are you currently taking any medications or other treatments to help decrease your symptoms?
Do you need to use assistive devices for ambulation or ADLs?
Does your condition affect your ability to sleep at night?
Has your condition ever caused you to fall?
Describe how this condition affects your relationships, your ability to work, or how you feel about yourself.
Does your condition contribute to feelings of stress? How do you cope with that stress?
If the patient is injured, ask the following questions:
Describe how the injury occurred.
How does it feel when you try to bend the joint (knee, ankle, shoulder) or use the affected area (hand/wrist, foot)?
How does it feel when you try to bear weight on the affected area (leg, foot)?
What lifestyle questions should a nurse ask when assessing mobility?
Lifestyle
Describe your typical dietary intake in a 24-hour period, especially your calcium intake.
Do you take vitamins or other supplements? If so, what type and how often?
Describe your physical activity in a 24-hour period.
Do you participate in a regular exercise program?
Does your job require you to do any physical labor, including lifting, bending, or twisting?
Do you smoke, drink, or use drugs? Do you feel this is contributing to your condition?
Are there any responsibilities that you may require assistance with at home, such as grocery shopping, pet care, laundry, and so forth?
Are there any barriers that you can think of that may make it difficult for you to return to your home? (For example, if the patient is non-weight-bearing, are there stairs in the home or leading into the home?)
How would you describe yourself in regard to religiosity or spirituality?
If the patient reports being religious, consider assessing for any religious beliefs behind or practices related to the injury.
Consider exploring how the patient may find comfort in spirituality.
Why is it important for nurses to address comfort for patients with mobility issues?
↑ Pain → ↓ activity tolerance → ↑ muscle atrophy and bone resorption.
↑ Fatigue (especially muscle fatigue) → ↓ muscle control and ↓ balance.
Patients at end of life often have ↓ mobility in general.
When addressing health, wellness illness and injury, the nurse is concerned with what impacts lack of movement can have?
↑ Physical activity → ↑ muscle mass/strength and bone density.
↓ Mobility → ↑ actual or perceived barrier.
Why would a nurse be concerned with the mood and affect when assessing mobility?
↓ Sense of self-worth or perception of life → ↑ risk of depression.
↓ Immobility → ↓ mood or affect → ↑ risk of self-harm or suicide.
What can a nurse do to address concerns with mood and affect?
Assess mood and affect.
Discuss signs and symptoms with healthcare providers as appropriate.
Make appropriate referrals.
Stay with patients; institute safety/suicide precautions.
What can a nurse do to address stress and coping with people with mobility issues?
Teach patients coping methods to counteract the stress of decreased mobility.
Encourage patients to adhere to the treatment plan to increase mobility.
Teach patients methods to reduce stress.
Why is it important to assess stress and coping when assessing mobility issues?
↓ Mobility → ↑ stress → difficulty coping.
What are 5 Ps of Neurovascular Assessment?
pain, pulses, pallor, paresthesia and paralysis(paresis)
What do you ask when assessing for paresthesia?
One asks about numbness, sensation, pins and needles.
What is paresthesia?
Definition. Paresthesia refers to a burning or prickling sensation that is usually felt in the hands, arms, legs, or feet, but can also occur in other parts of the body. The sensation, which happens without warning, is usually painless and described as tingling or numbness, skin crawling, or itching.
What does one call a burning or prickling sensation in the arms, legs and feet (or other parts of body)? It is described as tingling, numbness, skin crawling or itching?
Paresthesia
Why is coolness at an injury site along with a pallor of coolness worrying?
It may be a manifestation of decreased arterial supply to the area.
What is a nurse assessing when assessing pallor?
Observe skin color in the injured or affected extremity and in the skin in general. General pallor may indicate severe loss of blood, whereas pallor and coolness of the injured extremity indicates decreased arterial supply. In contrast, warmth and cyanosis may indicate venous stasis.
What might paresthesia indicate?
The presence of paresthesia (changes in sensation, such as burning, tingling, or numbness) indicates neural damage or involvement.
What does a nurse assess when examining for paresis and paralysis?
For the patient with a fracture, assess the patient’s ability to move body parts distal to the fracture, such as fingers and toes. Inability to move indicates paralysis, whereas muscle weakness indicates paresis. Paralysis or paresis may indicate nerve or tendon damage.
