T4: Exercise and Mobility Flashcards
lightweight, easily moveable devices approximately waist high, made of wood or metal
canes
Patient keeps crane on their _____ side
strong side
wooden or metal staff
crutches
crutch pads should be _____ under axilla with the elbow slightly flexed
2-3 fingers
safest gait
three-point
alternately bearing weight on one or both legs and on the crutches
crutch gait
extremely light, moveable devices, approximately waist high and made of mental tubing
walker
maximum amount of movement available at a joint in one of the three planes of the body
range of motion (ROM)
passes through the body from front to back, dividing it into a left and right side
sagital plane
passes through the body from side to side and divides it into front and back
frontal plane
horizontal line that divides the body into upper and lower portions
transvers plane
movements of sagittal pane (5)
- extension and flexion
- dorsiflexion and plantar flexion
- extension
movements of frontal plane (4)
- abduction and adduction
- eversion and inversion
movements of transverse plane (4)
- pronation and supination
- internal and external rotation
type of joint: neck
pivotal
type of joint: shoulder
ball and socket
type of joint: elbow
hinge
type of joint: forearm
pivotal
type of joint: wrist
condyloid
type of joint: fingers
condyloid hinge
type of joint: thumb
saddle
type of joint: hip
ball and socket
type of joint: knee
hinge
type of joint: ankle
hinge
type of joint: foot
gliding
type of joint: toes
condyloid
you move a part of your body by using your muscles
active range of motion
you move a part of your body by using your muscles with slight support
active assisted ROM
part of your body can move when someone or something is creating the movement
passive ROM
steps of applying antiembolic elastic stockings (4)
f- Turn elastic stocking inside out
- Place patients toes into foot of elastic stocking up the heel
- Slide remaining portion of stocking over patient’s foot, making sure that toes are covered
- Slide stocking up over patient’s calf until sock is completely extended
Most important thing whoever is putting on antiembolic elastic stockings needs to do
make sure there are no wrinkles, needs to be pulled tight and completely smooth
instructions for patients who are wearing anti embolic elastic stockings (4)
- do not roll stockings down
- avoid wrinkles
- avoid crossing legs
- elevate legs while sitting
use mechanical lifts and lift teams when:
patient is unable to help
principles of safe transferring (7)
- wide base
- lower center of gravity
- maintain equilibrium through base of support
- face direction of movement
- divide balanced activity between arms and legs
- use leverage
- reduce friction as much as possible
coordinated efforts of the musculoskeletal and nervous system
body mechanics
reduces strain on musculoskeletal structures, aids in maintaining adequate muscle tone, promotes comfort, and contributes to balance and conservation of energy
body alignment
force that occurs in a direction to oppose movement
friction
the greater the __________, the greater the friction
surface area of the object that is being moved
force exerted against the skin while the skin remains stationary and the bony structures move
shear
fit closely together and are fixed permitting little if any movement
fibrous joint
have little movement, but are elastic and use cartilage to unite separate bony surfaces
cartilaginous joints
freely moveable and the most mobile, numerous, and anatomically complex body joint
synovial joints
body has a negative feedback response when it detects the increased stretch caused by a load
stretch reflex
mobilizing, causing the body to move
isotonic contractions
isotonic contractions include _______ & ________ tension
concentric tension and eccentric tension
increased muscle contraction causes muscle shortening, resulting in movement
concentric tension
causes muscle lengthening to control the speed and direction of movement
eccentric tension
stabilizing, causing the body to hold a stable position
isometric contraction
muscle that directly performs a specific movement
prime mover
muscle that, directly when contracting, opposes prime mover or agonist; relaxes while prime mover contracts
antagonist
muscle that contracts at same time as prime mover; Facilitates prime mover actions to produce more effective movement
synergists
muscles that stabilize joints, act as type of synergist; serves to maintain posture and balance
fixator
muscle sense that makes us aware of the position of the body and its parts, including body movement, orientation in space, and muscle stretch
proprioception
prevents external rotation of the hip s when a patient is in a supine position
trochanter roll
how to create trochanter roll
- Fold cotton bath blanket lengthwise to a width that extends from the greater trochanter of the femur to the lower border of the popliteal space
- Place under the buttocks and roll it counterclockwise until the thigh is in neutral position or inward rotation
triangular device that hangs down from a securely fastened overhead bar that is attached to the bedframe; allows a patient to pull with the upper extremities to raise the trunk off of the bed
trapeze bar
head of the bed is elevated to 45-60 degrees and the patient’s knees are slightly elevated without pressure to restrict circulation in the lower legs
supported fowler position
position of rest on their back
supine position
position when patient lies face or chest down
prone position
patient rest so the side with the major portion of body weight on the dependent hip and shoulder
side-lying position
patient lies on a side with the same hip and lower extremity straight and the opposite hip and knee bent
lateral recumbent position
recommended for patients at risk for pressure injuries
30 degree lateral position
exaggeration of anterior convex curve of lumbar spine
lordosis
lordosis cause
congenital condition or temporary condition (pregnancy)
increased convexity in curvature of thoracic spine
kyphosis
kyphosis cause
congenital condition; rickets, osteoporosis; tuberculosis of spine
lateral S- or C- shaped spinal column with vertebral rotation, unequal heights of hips and shoulders
scoliosis
cause of scoliosis
sometimes a consequence of numerous congenital idiopathic, and neuromuscular disorders
upper extremities flexed at the elbows and held close to the body; lower extremities externally rotated and extended
Decorticate posture (hemiplegic posture)
increased tone in extensor muscles and trunk muscles, with active tonic neck reflexes
Decerebrate posture
maintenance of an abnormal posture through muscular contractions may last several seconds to weeks; long term, can cause permanent, fixed contractures
dystonia
stooped, hyperflexed posture with a narrow-based, short-stepped gait; due to loss of natural postural reflexes
basal ganglion posture
decreased muscle tone with little or no resistance during passive muscle movement
hypotonia
loss of muscle tone and joint stiffness
muscle atrophy
hypotonia ic common with:
cerebellar damage
Prolonged bed rest is associated with sensorimotor dysfunction that commonly manifests as:
postural instability and a dysregulated sense of balance
Damage to cerebellum causes problems with _____ and motor impairment is directly related to the amount of destruction of the __________
- balance
- motor strip
direct trauma to the musculoskeletal system includes: (5)
Bruises, contusions, tears, sprains, and fractures
is one of the most common causes of chronic disability in adults due to pain and altered joint function
osteoarthritis
Arthritis is expected to increase _____ by year 2040
44%
osteoarthritis typically effects
knees and hips
chronic, systemic, inflammatory autoimmune disease
rheumatoid arthritis
pathological reduction in the normal size of muscle fibers after prolonged inactivity resulting from bed rest, trauma, casting or a body part, or local nerve damage
disuse atrophy
metabolic changes due to immobility (4)
- Endocrine metabolism
- calcium resorption
- functioning of the gastrointestinal system
- negative nitrogen balance
the body excreting more nitrogen that it ingests in proteins
negative nitrogen balance
respiratory changes due to immobility (2)
atelectasis and hypostatic pneumonia
collapse of alveoli
atelectasis
inflammation of the lung from stasis or pooling of secretions
hypostatic pneumonia
cardiovascular changes due to immobility (2)
- orthostatic hypotension
- thrombus
drop in systolic pressure by at least 20mmHg or a drop in diastolic pressure by at least 10mmHg within 3 minutes of rising to an upright position
orthostatic hypertension
symptoms of orthostatic hypertension (6)
Dizziness, light-headedness, nauseas, tachycardia, pallor, or fainting when changing from the supine to standing position
accumulation of platelets, fibrin, clotting factors, and the cellular elements of the blood attached to the interior wall of a vein or artery, which sometimes occludes the lumen of the vessel
thrombus
3 factors that contribute to thrombus is known as
virchow triad
virchow triad includes:
- damage to the vessel wall
- alterations of blood flow
- alterations in blood constituents
bone tissue is less dense or atrophied
disuse osteoporosis
abnormal and possibly permanent condition characterized by fixation of a joint
joint contracture
common type of joint contracture
foot drop
foot is permanently fixed in plantar flexion
foot drop
musculoskeletal changes due to immobility (2)
- disuse osteoporosis
- joint contracture
urinary elimination changes due to immobility (2)
- urinary stasis
- renal calculi
renal pelvis fills before urine enters the ureters
urinary stasis
calcium stones that lodge in the renal pelvis or pass through the ureters
renal calculi
integumentary change due to immobility
pressure injury
localized damage to the skin and underlying soft tissue, usually over a bony prominence or related to a medical device or other device
pressure injury
physiological effects of immobility
- social isolation
- loneliness
- depression
major musculoskeletal changes expected during assessment of a patient who is immobilized (3)
- decreased muscle strength
- loss of muscle tone and mass
- contractures