Module 6 CHAPTER 33A Flashcards

1
Q

Role of Skeletal System in Movement

A

Supports the soft tissues of the body
Protects crucial components of the body
Furnishes surfaces for the attachment of muscles, tendons, and ligaments
Provides storage areas for minerals and fat
Produces blood cells

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2
Q

Bones Classified by Shape

A

Long bones: upper and lower extremities
Short bones: wrist and ankle
Flat bones: ribs and skull bones
Irregular bones: spinal column and jaw

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3
Q

Types of Joints

A

Fibrous (immovable/synarthrosis)
Sutures between bones of skull
Cartilaginous (slightly movable/amphiarthrosis)
Pubic symphysis; joints between bodies of vertebrae
Synovial (Freely movable/diarthrosis)
Gliding, hinge, pivot, condyloid, saddle, ball-and-socket joints

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4
Q

Joint Movements #1

A
Abduction
Adduction
Circumduction  
Flexion
Extension
Hyperextension
Dorsiflexion
Plantar flexion
Rotation
Internal rotation
External rotation
Supination
Pronation
Inversion
Eversion
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5
Q

Three Types of Muscles

A

Skeletal (Conscious movement)
Cardiac
Smooth or visceral (Controlled by unconscious part of brain)

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6
Q

Important Functions of Muscles

A

Motion
Maintenance of posture
Support
Heat production

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7
Q

Effect of Nervous System

on Muscle Contraction

A

The skeletal and muscular systems cannot produce purposeful movement without a functioning nervous system. Nerve impulses stimulate muscles to contract.
Neurons conduct impulses from one part of the body to another.
The afferent nervous system conveys information to the CNS.
Information is processed by the CNS leading to a response.
The efferent neurons convey the response from the CNS to skeletal muscles by way of the somatic nervous system

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8
Q

Postural Reflexes

A
Postural reflexes are the group of reflexes (automatic movements) that maintain body position and equilibrium, whether at rest or during movement.
Labyrinthine sense
Proprioceptor or kinesthetic sense
Visual or optic reflexes
Extensor or stretch reflexes
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9
Q

Factors Affecting Mobility and Alignment

A
Developmental level/considerations Table 33-3
Physical health
Muscular, Skeletal, or Nervous System Problems
Problems Involving Other Body Systems 
Mental health
Lifestyle
Attitude and values
Fatigue and stress
External factors
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10
Q

Problems Affecting Joint Mobility

A

Inflammation, degeneration, and trauma can all interfere with joint mobility.
The term arthritis describes more than 100 different diseases that affect areas in or around joints.
Arthritis is characterized by inflammation, pain, damage to joint cartilage, and/or stiffness
The most common type is osteoarthritis, also termed degenerative joint disease.

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11
Q

Osteoarthritis

A

Osteoarthritis is a noninflammatory, progressive disorder of movable joints, particularly weight-bearing joints, characterized by the deterioration of articular cartilage and pain with motion.
Once the articular cartilage is damaged, bony deposits (bone spurs) may form in the joints, causing more pain with movement of the joint.

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12
Q

Types of Exercises

A

Isotonic: muscle shortening and active movement
-ADL’s, swimming
Isometric: muscle contraction without shortening
Yoga,
Isokinetic: muscle contraction with resistance
-weight training

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13
Q

Benefits of Exercise to Cardiovascular System Table 33-4

A
Increased efficiency of the heart
Decreased heart rate and blood pressure
Increased blood flow to all body parts
Improved venous return
Increased circulating fibrinolysin (substance that breaks up small clots)
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14
Q

Benefits of Exercise to Respiratory System Table 33-4

A

Improved alveolar ventilation
Decreased work of breathing
Improved diaphragmatic excursion

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15
Q

Benefits of Exercise to Musculoskeletal System Table 33-4

A

Increased muscle efficiency (strength) and flexibility
Increased coordination
Reduced bone loss
Increased efficiency of nerve impulse transmission

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16
Q

Risk Related to Exercise

A

Cardiac Event
a man older than 45 or a woman older than age 55
family history of heart disease before age 55 in men and 65 in women
currently smoke or quit smoking in the past 6 months
have not exercised for at least 30 minutes, 3 days a week for 3 months or more
overweight or obese
high blood pressure or high cholesterol
impaired glucose tolerance
Orthopedic Discomfort and Disability
Orthopedic problems caused by irritation of bones, tendons, ligaments, and sometimes muscles are the most common injuries associated with exercise. This irritation may result from added weight-bearing stress or from collision with the ground, an object, or another person.

17
Q

Physical Assessment for Mobility

A
General ease of movement and gait
Alignment
Joint structure and function
Muscle mass, tone, and strength
Endurance
18
Q

Variables Leading to Back Injury in Health Care Workers

A

Uncoordinated lifts
Manual lifting and transferring of patients without assistive devices
Lifting when fatigued or after recent back injury recovery
Repetitive movements such as lifting, transferring, and repositioning patients
Standing for long periods of time
Transferring patients
Repetitive tasks
Transferring/repositioning uncooperative or confused patients

19
Q

Proper Body Mechanics

A

Use of proper body movement in daily activities
The prevention and correction of problems associated with posture
The enhancement of coordination and endurance

20
Q

Equipment and Assistive Devices

A
Gait belts
Stand-assist and repositioning aids
Lateral-assist devices
Friction-reducing sheets
Mechanical lateral-assist devices
Transfer chairs
Powered stand-assist and repositioning lifts
Powered full-body lifts
21
Q

Positioning Patients

A
Pillows
Mattresses
Adjustable beds
Bed side rails
Trapeze bar
Additional equipment
22
Q

Mechanical Aids for Walking

A

Walker
Cane
Braces
Crutches

23
Q

Nursing Care Plan for Quan Hong Nguyen 33-1 > PAGE 117

A

Review Care plan on page 1174-1177

24
Q

Proprioceptor or kinesthetic sense

A
Proprioception is the awareness of joint
position (the brain is informed of the location
of the limb), whereas kinesthesia is the
cognizance (awareness)
of joint movement.
25
Q

Visual or optic reflexes

A

• Contributes to posture by alerting the person to spatial relationships
with the environment (nearness of ceiling, walls, furniture, condition
of floor).

26
Q

Extensor or stretch reflexes

A

• When extensor muscles are stretched beyond a certain point (when a
knee buckles), their stimulation causes a reflex contraction that aids a
person to reestablish erect posture (straighten the knee).

27
Q

Nursing and Physical Assessment

A

• Nursing assessment related to activity includes asking patients about their daily activity
level (Ex. Sedentary lifestyle), endurance, exercise and fitness goals, mobility problems,
physical or mental health alterations that affect mobility, and external factors affecting
mobility.
*Knowing the patients baseline helps you educate them on the importance of checking
their pulse.
*The heart rate is a good indicator of exercise intensity: The higher the intensity, the faster
your heart beats.

Physical assessment of mobility status includes an assessment of general ease of movement and gait; alignment, joint structure, and function; muscle mass, tone,and strength; and endurance. The patient’s ability to stand, walk, sit up, and
grasp are important because these enable the patient to wash, dress, and feed
himself or herself and perform other basic ADLs.
• Example: If a client uses a cane, make sure they are using it correctly.
Which is, holding it on the stronger side.

28
Q

Components of the physical

assessment

A
• General ease of movement and gait
• Alignment
• Joint structure and function
• Muscle mass, tone, and strength
• Endurance
Physical assessment of an
ambulatory patient begins the
moment the patient walks into a
room.
• Patient’s medical diagnosis
• Patient capabilities
• Whether patient movement is
allowed
• Patient’s ability to assist with
planned movement
• Patient’s ability to understand
instructions
• Patient’s ability to cooperate with
directions
29
Q

Assessment of Involuntary

movements:

A
  • Tremors
  • Tics
  • Chorea
  • Athetosis
  • Dystonia
  • Fasciculations or muscle twitch
  • Myoclonus
  • Oral-facial Dyskinesias
30
Q

Factors to Assess (questions and approaches /interview)

Pg 1146

A
  • Daily activity level
  • Endurance
  • Exercise and fitness goals
  • Mobility Problems
  • Physical and Mental Health alterations
  • External Factors Affecting mobility (environmental or financial)
31
Q

Diagnosis

Problems of mobility

A
  • Activity intolerance
  • Impaired transfer mobility
  • Risk for injury
  • Risk for constipation
  • Toileting self-care deficit
  • Risk for ineffective peripheral tissue perfusion
32
Q

Planning

Patients with no mobility problems,

A
outcomes are directed towards promotion
of physical fitness.
Patients at risk for mobility problems, objective includes:
• Demonstrate correct body alignment
• Demonstrate full range of joint motion
• Demonstrate adequate muscle mass, tone, and strength to perform functional
ADLs
• One nurse vs two nurse assistance
• Need for assistive device

Patients that are immobile, objectives include:
• Be free from alterations in skin integrity
• Show signs of adequate venous return
• Be free of contractures

33
Q

Implementation/Intervention

Equipment and assistive devices

A

• Gait belts
• Stand-assist and repositioning aids
• Lateral-assist devices (side to side transfer)
• Friction-reducing sheets (prevents skin shearing)
• Mechanical lateral-assist devices
• Transfer chairs
• Powered stand-assist and repositioning lifts
• Powered full-body lifts
Mechanical aids for walking (walker, cane, braces, crutches)
• Positioning patients using (pillows, mattresses, adjustable beds, side
rails, trapeze bar)
• Protective Positioning

34
Q

Rationales for encouraging your patient to use a

assistive aid

A
  • Encourages patient independence
  • Reduces physical strain for staff
  • Decreases risk for patient injury
35
Q

Interventions that can affect patient

positioning

A

• Tubes: Must be protected to prevent dislodging; they impact direction
the patient can turn
• IV lines: Must be protected to prevent dislodging, if attached to an IV
pump, they will significantly impact positioning direction
• Incisions: May need to be splinted before changing position; avoid
incisional strain while positioning
• Medical equipment: If equipment must remain attached to the
patient, it will directly impact patient mobility—limit how the patient
can move

36
Q

Activity Variations Based on Developmental
Level:
Adult Assessment Priorities

A

• Assess balance between activity and rest in person’s lifestyle.
• Note any lifestyle factors or illnesses that interfere with mobility or
ability to carry out activities of daily living.
Nursing Intervention
• Fitness counseling
• clarify misconceptions about exercise
• design and monitor safe exercise programs
• those with mobility alterations may require special care
Older Adult Assessment Priorities
• Assess general ease of movement and gait.
• Assess alignment.
• Check joints and their function.
• Assess muscle mass, tone, and strength
Nursing Intervention
Teach and Council about:
• importance of regular exercise
• need for high protein, calcium, and vitamin D enriched diet
• pacing activities
• using assistive devices safely when needed
• safety proof home to reduce falls

37
Q

Safe patient handling and transfers

A

• Many devices and equipment are available to aid in transferring,
repositioning, and lifting patients. It is important to use the right
equipment and appropriate device based on patient assessment and
desired movement.