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PCM > Week 4 (Test 1) > Flashcards

Week 4 (Test 1) Flashcards

1
Q

Review of Systems

A
  • 14 body Systems
  • Sort of like “associated Systems” but question in this section are important for ruling out other important disease processes (other than chief complaint)
  • Billing is often based on the detail of the Documentation, so often times a “Full ROS” is dictated (or clicked on the EHR) so that a higher fee might be justified
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2
Q

Associated Systems vs ROS

A
  • Associated symptoms are symptoms that may be RELATED to the CHIEF COMPLAINT
  • ROS is about making sure the Clinician isn’t missing something ELSE that might do a Patient Harm
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3
Q

Transition statements

A
  • “I think i understand what brought you in here today, but now id like to ask you some questions about your medical problems in the past”
  • “We’ve talked a lot about your medical issues, but now I’d like to get to know you as a person”
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4
Q

Delivering Bad News

A
  • The Warning Shot
  • No Euphemisms
  • No Timelines
  • Non-anxious Presence
  • Use Silence Effectively
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5
Q

First thing First

A
  • Confirm the patient’s name and date of birth
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6
Q

Biomechanics Principles

A
  • The study of the structure and function of Biological Systems (living structures) by means of the methods of Mechanics (Statics, Dynamics, Mechanics of Materials)

To Understand Human Physical Performance:
1) How do we perform movement and apply force

2) How is human motion controlled and how can it be refined
3) How the internal and external forces act on the human body and the effect produced by these forces

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7
Q

Historical perspective

A

LEONARDO DA VINCI
- Recognized as the FIRST TRUE BIOCHEMIST

  • First to study anatomy in the CONTEXT of Mechanics
  • Analyzed muscle forces as acting ALONG LINES connecting Origins and Insertions and studied JOINT FUNCTION

GALILEO GALILEI
- Interested in the STRENGTH of BONES

  • Noted that Animals with Large Mass Bones INCREASE IN GIRTH
  • Theorized ADAPTED to LOADBEARING
  • Suggested that bones are HOLLOW for this AFFORDS MAXIMUM Strength with MINIMUM WEIGHT
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8
Q

Historical Perspective Cont

A

GIOVANI ALFONSO BORELLI
- Studied Walking, Running, Jumping and even the Piston action of the Heart within a Mechanical Framework

Determined:
- Position of the center of Gravity

  • Calculate and measured Inspired and Expired are Volumes
  • Showed that Inspiration is Muscle-Driven and Expiration is due to TISSUE ELASTICITY
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9
Q

Historical Perspective Cont.

A

ANDREW TAYLORS STILL
- Frontied Minister, Doctor, Farmer, and a MILLWRIGHT!!!!!!

  • Applied principles of Mechanics to Human Afflictions
  • Millwright have a history that spans 800 Years, as the profession is the predecessor of Mechanical Engineering
  • A person who maintains and cares for Mechanical Equipment
  • This includes such tasks as Leveling, Aligning and installing machinery on foundations or base plates and setting, leveling, and aligning
  • Their job requires a thorough knowledge of the LOADBEARING capabilities of the Equipment they use
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10
Q

Biomechanics Principles

A
  • Biomechanics describe the RELATIONSHIP BETWEEN STRUCTURE and FUNCTION
    • Basic Principle of OSTEOPATHY

STRUCTURE:
- Three dimensional and respond to Applied Forces, and to Motion, in each Dimension

FUNCTION:
- Different types of structures respond to forces applied to them differently

  • There is an Intricate, Interconnected Function relationship between Structures
    • Core Element of Kinesiology
  • Musculoskeletal system may be though of as a series of Simple Machines
  • Machines: used to Increase Mechanical Advantage
  • Consider Mechanical aspect of each musculoskeletal component in analysis with respect to that component’s Machine-like function
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11
Q

Machines function in Four Way

A

1) Balance Multiple Forces
2) Enhance Force in an attempt to Reduce Total Force needed to Overcome a Resistance
3) Enhance range of motion and speed of movement so that resistance may be moved Further or Faster than Applied Force
4) Alter resulting Direction of the Applied Force

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12
Q

3 Types of “machines” in producing Movement

A

1) LEVERLS (Most Common)
- Torque and Length

2) WHEEL-AXELS
- Function essentially as a form of a level

3) PULLEYS
- Single pulleys function to change effective direction of Force Application

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13
Q

Levers

A

1) First Class Levers
- Axis in between Force and Resistance

2) Second Class Levers
- Resistance in between Axis and Force

3) This Class Levers
- MOST COMMON
- Force in between Resistance and Axis

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14
Q

Joint Motion

A

Resultant of:
1) A Muscle Contraction

2) Drawing a DISTAL Segment MORE PROXIMAL
3) aThe DISTAL SEGMENT will ROTATE ABOUT the CENTER OF THE JOINT

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15
Q

Factors in Use of Anatomical Levers

A
  • Anatomical leverage system can be used to gain a Mechanical Advantage
  • Improve Simple or Complex Physical Movements
  • SOME USE HUMAN LEVERS PROPERLY
  • SOME DEVELOP HABITS and IMPROPERLY USE HUMAN LEVERS
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16
Q

Muscle Segments

A
  • ORIGINS and INSERTION of Muscle Segments lengthens vary markedly between individuals
  • The ability to produce different types of movement using the same MUSCLE Contraction Force will also DIFFER
17
Q

Range of Motion

A
  • Only a Partial Contraction, or Limited RANGE OF MOTION, of the muscles around a joints may be required to Accomplish the MOTION
  • The MUSCLE CONTRACTION effectively Mobilizes one segment of the Involved structures while Simultaneously Stabilizing Another!!!!
18
Q

Muscles

A
  • As the Matrix of the segment reaches EQUILIBRIUM, or Neutral Position, the LOAD necessary to maintain the LENGTH of the Segment will DECREASE
  • This property is known as RELAXATION
  • Relaxation (aka Flexibility) is IMPORTANT to Balance with Strength to Maintain an effective, FULL RANGE OF MOTION of the Joint!!!
19
Q

Body Segments

A
  • As Body Segments are moved through their RANGE OF MOTION Surfaces within the joint will move relative to Each other

The relative Motions of Joints Surfaces may include:

1) Gliding
2) Rolling
3) Spin
4) Compress
5) Distract

20
Q

Strength

A
  • AMOUNT of FORCE needed to CONTRACT a Muscle
  • Dependent on Degree of RESISTANCE (aka Load) Experienced
  • Produces a ROTATION (Torque)
  • The center of Rotation, Fulcrum of Axis, is created at the Point of Muscle Insertion
21
Q

The Moment

A

1) The FORCE being applied plus the MOMENT ARM
- Moment Arm: the DISTANCE FROM the CENTER of the joint to WHERE the Contracting muscle is ATTACHED
- Ex: Force x Distance

2) Used to Overcome the RESISTANCE on the Distal Limb
- This in turn exerts a Moment into the joint

22
Q

Movement

A
  • Most movement is a composites of more than one single Rotational Movement of Individual body segments around the Joint
  • The SUM OF the separate MOMENTS, together with the FORCE of the Contracting Muscle Directed into the Joint, becomes part of the JOINT REACTION FORCE
  • Which in turn applies a STRESS to the Joint during Movement
23
Q

Structures

A
  • Some Structures have a Decidedly more forgiving Composition
  • Some ABSORB the STRESS other REDISTRIBUTE the FORCE Applied
  • All have a Degree of ELASTICITY and ben to Varying Degrees
  • The amount of Force necessary to bend an Object is Commonly Known as the STIFFNESS of the Structures
24
Q

Viscosity

A
  • VISCOSITY of a tissue is largely related to its water content
    • Like a Sponge
  • RAPID STRETHC will be met with INCREASED RESISTANCE
    • The Faster you squeeze the less water you get out
  • SLOWER STRETCH will be met with LESS RESISTANCE
    • The Slower, longer the squeeze, the more Completel Expression of Fluid from within the Matrix
  • Slower Stretch is known as CREEP
25
Q

Stress

A
  • Force can act upon a structure from various orientations
    1) TENSIONS acts to stretch2) COMPRESSION
    3) SHEARING acts parallel to the Surface
    4) BENDING acts to fold about an Axis
    5) TORSION twists about an Axis
  • The SUM of all STRESSES on ab Object Contributes to the CUMULATIVE LOAD on a given Structure
  • TISSUE DEFORMATION can Result from MECHANICAL LOADING!!!!
26
Q

Applied Forces

A
  • Applied Forces are acting on Musculoskeletal Tissue during Physical Activity
  • Structures response depends upon a variety of Factors:
    1) Composition2) Shape3) How the FORCE is Applied:
    - INTERNAL
    - EXTERNAL
27
Q

Applied Forces Cont

A

EXTERNAL

  • Pressure applied to an Object at Rest
    • Manipulative Thrust
  • Moving object Require NO FORCE
    • Unless Other Forces (Friction) Resist Movement
  • Magnitude and combination of Vectors leads to a RESULTANT APPLIED FORCE

INTERNAL

  • Force generated to achieve Limb Movement
  • Ex: Muscle Contraction
28
Q

External Applied Forces

A
  • Produced from Outside the Body and Originate from GRAVITY, Inertia, or Direct Contact

GROUND REACTION FORCES
- The Force exerted by the round on a body in Contact with the Ground

  • All tissues, in varying Degrees, resist Changes in their Shape!!!
  • Tissue DEFORMATION may result from EXTERNAL FORCES, but can result from INTERNALLY generated FORCES!!!
29
Q

Internal Applied Forces

A
  • Muscular, Joint and Skeletal Actions of the Body during the Execution of a given task

VERTICAL LOAD:
- Summative weight transmitted through the Kinetic Chain to the Ground

FRICTION:
- FORCE that results from the resistance between surfaces of Two Objects from moving upon One Another!!!

30
Q

Mechanical Loading Basics

A
  • Significant MECHANICAL LOADS are generated and absorbed by the Tissues of the Body
  • INTERNAL or EXTERNAL forces may be causing these LOADS
  • Only muscles can ACTIVELY generate INTERNAL FORCE, but TENSION in Tendons, Connective Tissues, Ligaments, and Joints Capsuled may generate PASSIVE INTERNAL FORCES
31
Q

Excessive Cumulative Internal Forces Can:

A

1) Fracture Bones
2) Dislocate Joints
3) Disrupt Muscles and Connective Tissues
- To prevent Injury or damage from tissue DEFORMATION the body must Absorb and Dissipate Energy from both INTERNAL and EXTERNAL FORCEs

32
Q

The FORCE

A
  • The FORCE applied to the insertion or the muscle at the bone results in a COMPENSATORY CHANGE in the Shape, or DEFORMATION, of the Bone
  • The Magnitude of the FORCE Applied is known as the STRAIN Placed on that Bone
33
Q

Absorb Force

A
  • It is Advantageous to ABSORB FORCE over larger aspects of our body rather than smaller and to spread the Absorption rate over a Greater Period of Time
  • Stronger and Healthier Tissues are more likely to withstand Excessive Mechanical Loading and the resultant excessive tissue deformation
34
Q

Deformation

A
  • Can result in lost RESILIENCY of the Structure

- A recurrent or persistent LOAD is Necessary to maintain a Constant Deformation

PCM (6 decks)

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