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BSNC 1000 > Module 6 > Flashcards

Module 6 Flashcards

1
Q

Scope of mobility

A

full mobility –> impaired mobility –> complete immobility

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2
Q

Systems affecting mobility

A 
Neurological
Musculoskeletal
Cardiovascular
Respiratory
Gastrointestinal
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3
Q

Physiological changes of aging

A

vertebral discs thin –> spinal column compression –
> kyphosis
bone density decreases –> frail, higher risk of fall injury
cartilage becomes rigid –> less protective
rigid ligaments –> reduce range of motion
decreased muscle mass
osteoblasts decrease mitotic activity
parathyroid hormone increases
calcitonin decreases

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4
Q

CV Consequences of immobility

A

reduced cardiac capacity –> reduced cardiac output
orthostatic hypotension
venous stasis –> deep vein thrombosis

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5
Q

Respiratory Consequences of immobility

A

reduced lung expansion –> reduced total lung capacity
atelactasis
pooling of respiratory secretions

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6
Q

Musculoskeletal consequences immobiilty

A 
reduction of muscle mass (atrophy)
contracture of joints and muscles --> stiffening
bone demineralization (weight-bearing exercise important)
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7
Q

Integumentary consequences of immobility

A

skin breakdown –> pressure ulcers over bony prominences

exacerbated by incontinence

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8
Q

GI consequences of immobility

A

reduced intestinal peristalsis

constipation

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9
Q

Urinary consequences of immobility

A 
renal calculi -
urinary stasis 
UTIs
urinary retention
impaired voiding
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10
Q

Determinants of mobility

A

nervous system
musculoskeletal system
adequate perfusion + gas exchange
adequate nutrition

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11
Q

Definition of mobility

A

state or quality of being mobile or movable

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12
Q

Definition of deconditioning

A

loss of physical fitness as a consequence of reduced activity

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13
Q

Function of cerebellum

A

coordination, balance, muscle tone, procioception

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14
Q

Motor cortex

A

located in the frontal lobe

generates nerve impulses –> motor neurons –> effectors (skeletal muscle)

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15
Q

Functional classification of joints

A 
synarthrosis = not movable
amphiarthrosis = slightly movable
diarthrosis = completely movable
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16
Q

Structural classification of joints

A 
fibrous = held together by connective tissue
cartilaginous = held together by cartilage 
synovial = in a fluid filled cavity
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17
Q

Joint

A

where bones join together

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18
Q

Determinants of skeletal muscle function

A

1) motor nerve impulses reaching muscle fibers
2) muscle fiber response to nerve stimulus
3) proprioception
4) mechanical load
5) joint mobility

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19
Q

Mechanical load

A

physical stress on muscles. increase muscle load = increased requisite strength

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20
Q

Procioception

A

sensation of position and movement

required for accuracy in motion

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21
Q

Definition of mobiliity

A

ability to independently and voluntarily move around in one’s environment / state of mobility

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22
Q

Peak Bone Mass

A

maximal amount of bone mass in the body at the end of skeletal maturation
bone growth peaks ~30

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23
Q

Secondary Osteoporosis Factors

A 
endocrine disorders
malabsorption disorders
malignancies
alcoholism
medications
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24
Q

Endocrine disorders

A 
hypothyroidism
hyperthyroidism 
hyperparathyroidism 
Cushing's syndrome
Diabetes mellitus 
Child development
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25
Q

Factors impacting bone growth (adolesence –> early adulthood)

A 
nutrition
age
vitamin d receptor 
physical activity 
hormonal status
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26
Q

Functions of bone remodelling

A

replace old, worn-out bone
maintain bone health
strengthen bone in areas of stress
mineral homeostasis

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27
Q

Non-modifiable risk factors

A

age
gender
genetics (body frame size)
ethnicity (asian, caucasian)

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28
Q

Modifiable risk factors

A 
low peak bone mass 
dietary (calcium, vitamin d intake)
sedentary lifestyle
hormonal factors 
medication (glucocorticoids, anticonvulsants)
alcohol 
smoking
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29
Q

Key Hormones

A

Parathyroid Hormone
Calcitonin
Vitamin D
Estrogen

30
Q

Parathyroid Hormone Function

A

produced by the parathyroid glands

increase number and activity of osteoclasts –> promote bone resorption –> release calcium/phosphate into blood
promote phosphate excretion by kidneys
promote calcium retention by kidneys
promote activation of vitamin D in kidneys –> promote calcium absorption in GI tract

31
Q

Calcitonin Function

A

released by the thyroid glands

inhibits activity and number of osteoclasts –> decrease bone resorption

32
Q

Vitamin D Function

A

produced by the integumentary system/diet

Vitamin D is converted into calcitriol in the kidneys
calcitriol promotes the absorption of calcium in the GI tract

33
Q

Estrogen Function

A

estrogen inhibits bone resorption
estrogen decreases number and activity of osteoclasts
increase osteoclast apoptosis

34
Q

Sources of estrogen

A

estrogen = produced by the ovaries

post-menopause estrogen is provided through the conversion of androgens –> estrogen via aromatase

35
Q

Glucocorticoid function

A

anti-inflammatory drug

contribute to osteoporosis
decrease number and activity of osteoblasts
decreases osteoclast apoptosis
inhibits OPG –> increased RANKL expression on osteoblasts –> increased osteoclast differentiation

36
Q

Factors affecting peak bone mass

A

Genetics
Hormones
Nutrition
Lifestyle

37
Q

Risk Factors for Older Adults

A 
Sarcopenia (reduced muscle mass)
Chronic Pain
Injury/Trauma
Nutritional deficiencies
Obesity
Chronic Illness
38
Q

Renal Calculi

A

mineral and salt deposits that form in the kidneys

39
Q

Sarcopenia

A

Reduced skeletal muscle mass, strength and function

40
Q

Consequences of immobility

A 
dehydration
bronchial pneumonia
contractures
deep vein thrombosis
constipation
pressure ulcers
incontinence
hypothermia 
Iatrogenic complications
Disability
Institutionalization
Loss of independence
Isolation & Depression
41
Q

Disorders affecting mobility

A 
ostoeporosis
gait disorders
parkinson's
stroke
arthritic conditions
42
Q

Non-disorders affecting mobility

A 
Paresthesia 
amputations
neuromotor disturbances
fractures (injury)
joint problems
illness (fatigue)
43
Q

Paresthesia

A

burning or prickling sensation in the extremities

44
Q

Iatrogenic

A

illness resulting from medication or treatment

45
Q

Intrinsic Fall Factors

A 
age 
gender (women at higher risk)
gait
balance/coordination 
poor vision
cognition
dizziness/vertigo
orthostatic hypotension 
medication
depression 
dementia
incontinence --> rushing to the bathroom
46
Q

Extrinsic Fall Factors

A 
tripping hazards
poor lighting
lack of bathroom safety
footwear
improper use of mobility aids
47
Q

Basic Activities of Daily Living Definition

A

basic self-care tasks that are performed daily.

basic functional capacity

48
Q

Instrumental Activities of Daily Living Definition

A

tasks that enable a person to live independently. more complex than basic ADL’s and require adequate cognitive and physical function.

49
Q

BADL examples

A 
feeding
continence
transferring
toileting
dressing
bathing
50
Q

IADL examples

A 
using the telephone
shopping
food preparation
housekeeping
doing laundry
using transportation 
handling medications
handling finances
51
Q

Signs/Symptoms of Osteoporosis

A 
height loss (>2cm - could indicate spine fracture)
reduced range in motion
fragility fractures
52
Q

Anticonvulsants

A

causes changes in bone and calcium metabolism –> decreased bone mass
may contribute to osteoporosis

53
Q

Typical fracture sites for osteoporosis

A

Hips
Wrists
Shoulder

54
Q

Fragility Fracture

A

spontaneous fracture that occurs from non-intense activity (sneezing, coughing, twisting, etc)

55
Q

Paresthesia

A

burning/prickling sensation in the limbs

56
Q

Normal height loss

A

1 cm every 10 years after age 60

57
Q

Abnormal height loss

A

2-3 cm in a short timeframe

could indicate spinal fracture

58
Q

Osteopenia

A

loss of bone density but not to the point of fragility

-1 to -2.5 on the bone density scale

59
Q

Osteoporosis

A

condition in which excessive demineralization causes bones to become porous, weak, fragile
caused by an imbalance between bone resorption and bone formation

less than -2.5 on the bone density scale

60
Q

What part of the bone does osteoporosis impact

A

Spongy bone
Spongy bone is higher in surface area so tends to have more dramatic bone loss

May be thinning of the compact bone as well

61
Q

Osteoporosis Exercise Guidelines

A

strength exercise x2/week
posture exercise - daily (5-10 min)
balance exercise - daily
weight-bearing aerobic physical activity - 150min/week

62
Q

Physiological changes of aging

A 
loss of muscle mass 
loss of bone density
loss of articular cartilage
rigidity of cartilage 
joint stiffening
loss of elasticity of ligaments 
compression of IV discs --> kyphosis
63
Q

Primary level of prevention

A 
regular exercise
diet/nutrition
weight
falls prevention programs 
environmental safety
64
Q

Secondary level of prevention

A

women over 65

mobility screening
osteoporosis screening
fall risk assessments

65
Q

Tertiary level of prevention

A 
medial intervention
surgery
exercise therapy
medication (anti-inflammatory, anagelsics, vitamin d/calcium supplements)
diet
exercise
physiotherapy, occupational therapy 
weight loss
66
Q

Treatment for immobile patient

A 
change bed position every 2 hours
head elevation
bed exercises
range of motion exercises
ambulate patient as much as possible
treat pain to encourage movement 
encourage deep breathing/coughing
incentive spirometer
67
Q

Diagnosis of Osteoporosis

A

bone density scan (2cm is abnormal)

68
Q

Primary Osteoporosis

A

forms majority of cases

osteoporosis occurs without an identifiable cause

69
Q

Recommended calcium intake

A

1000 mg/daily for men and women

500 mg twice daily

70
Q

Recommended calcium intake for post-menopausal women

A

1200 mg/daily

600mg twice daily

71
Q

Recommended Vitamin D Intake

A

600-800 units/daily

BSNC 1000 (10 decks)

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