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57 Cards in this Set

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Scientific Knowledge- Exercise and Activity
Physical activity for conditioning the body, improving health, maintaining fitness, or as a therapeutic measure.
Friction
a force that occurs in a direction to oppose movement. Reduce it as much as possible. The greater the surface area the greater the friction. Have client assist, use air assisted devices,& draw sheets to help reduce friction while moving or transferring the client.
Isotonic Exercise
cause muscle contraction and change in muscle length, enhance circulatory and respiratory functioning; increase muscle mass, tone and strength; and promote osteoblastic activity. Examples-walking, swimming, dance aerobics, jogging, bicycling, moving arms and legs with light resistance.
Isometric Exercise
involve tightening the muscles without moving body parts, and is ideal for clients who are unable to tolerate increased activity. Benefits-increased muscle mass, tone, and strength, increased circulation to involved body parts, and increase osteoblastic activity. Examples- quadriceps sets and gluteal muscle contractions.
Resistive isometric excercise
contraction of muscles while pushing against a stationary object or resisting th movement of an object. Promote muscle strength and provide sufficient stress against bone to promote osteoblastic activity. examples- push-ups, hip lifting and pushing against foot boards while in bed.
Body Alignment
Posture- the relationship of one body part to another body part along a horizontal or vertical line. Promotes lung expansion, and facilitates efficient systemic functioning (circulation, renal, GI) Have a good base of support
Balance (stability)
occurs when a relatively low center of gravity is balanced over a wide, stable base of support and a vertical line falls from the center of gravity through the base of support. Affected by the labyrinth in inner ear, vision, and stretch receptors in muscles and tendons. Controlled by the nervous system (cerebellum, and inner ear)
Coordinated body movement
is a result of weight, center of gravity, and balance.
Joint Mobility
Maintained and improved by Range of motion exercises either passive or active, Joints that are not moved periodically are at risk for contractures (permanent shortening of a muscle followed by shortening of associated ligaments and tendon) The degree of mobility varies with each individual.
Regulation of Movement-Skeletal System
bones provide support, protection, movement, mineral storage, and hematopoiesis (blood cell formation), bones provide framework for body, and contribute to shape, alignment, and positioning. Act as levers for muscle attachment.
Regulation of Movement-Joints
an articulation, the connection between bones. Fibrous joints-fit closely together and are fixed (syndesmosis between tibia and fibula). Cartilaginous joints- little movement but are elastic and used to unite seperate body surfaces(synchondrosis that attaches ribs to costal cartilage) Synovial joints- true joints that move freely and are most mobile, numerous and complex (hips, elbow)
Regulation of movement-Ligaments
white, shiny, flexible bands of fibrous tissue that bind joints and connect bones and cartilage. Are elastic and aid joint flexibility and support.
Regulation of movement- Tendons
white, glistening, fibrous bands of tissue that connect muscle to bone.
Regulation of movement- cartilage
non-vascular, supporting connective tissue with the flexibility of a firm, plastic material. permits it to sustain weight and serve as a shock absorber between articulating bones.
Regulation of movement- skeletal muscle
over 600 skeletal muscles in body, they facilitate movement and determine form, and contour of our bodies.
Regulation of movement- Muscles with movement
located near skeletal region, where a lever system causes movement. muscles that attach to bones of leverage provide necessary strength to move the object.
Regulation of Movement- Muscles with posture
maintain a low level of sustained contraction to counter act the force of gravity on the body.
Regulation of Movement- muscle groups
coordinated by the nervous system and are responsible for maintaining posture and initiating movement. Antagonistic muscles bring movement at the joint. Synergistic muscle contract to accomplish the same movement. Anti-gravity muscles are involved with joint stabilization
Regulation of movement-nervous system
regulates movement and posture. voluntary motor area controlled by the precentral gyrus (motor strip) in the cerebral cortex. neurotransmitters which transfer the electrical impulse from the nerve across the myoneural junction to stimulate the muscle causing movement.
Regulation of Movement-Proprioception
the awareness of the position of the body and its parts and is monitored by proprioceptors located on nerve endings. help to monitor muscle activity and body alignment/positioning.
osteomalacia
an uncommon metabolic disease characterized by inadequate and delayed mineralization, resulting in compact and spongy bone.
Osteogenesis imperfecta
an inherited disorder that affects bonees which become porous, shor, bowed, and deformed.
Scoliosis
a structural curvature of the spine associated with vertebral rotation.
Arthritis/inflammatory joint disease
inflammation or destruction of the synovial membrane and articular cartilage, and by systemic signs of inflammation.
Effects of exercise- Cardiovascular system
improved cardiac output, improved myocardial contraction, thereby strengthening cardiac muscle, decreased resting heart rate, improved venous return.
Effects of exercise- Pulmonary System
Increased respiratory rate and depth followed by a quicker return to resting rate, improved alveolar ventilation, decreased work of breathing, improved diaphragmatic excursion.
Effects of exercise- Metabolic system
increased basal metabolic rate, increased use of glucose and fatty acids, increased triglyceride breakdown, increased gastric motility, increased production of body heat.
Effects of exercise- Musculoskeletal system
improved muscle tone, increased joint mobility, improved muscle tolerance to physical exercise, possible increase in muscle mass, reduced bone loss
Effects of exercise- Activity tolerance
improved tolerance and decreased fatigue
effects of exercise- psychosocial factors
improved tolerance to stress, reports of "feeling better", reports of decrease in illness (colds, influenza)
Concentric Tension
increase muscle contraction causes muscle shortening resulting in movement, such as when a client uses an overhead trapeze to pull up in bed.
Eccentric tension
helps control the speed and direction of movement.
Leverage
an inducing or compelling force and occurs when specific bones and the associated joints act together as a lever.
Muscle tone/tonus
the normal state of balanced muscle tension. alternating contraction and relaxation without active movement of neighboring fibers of a specific muscle group.
muscular dystrophy
progressive, symmetrical weakness and wasting of skeletal muscle groups, with increasing disability and deformity.
pathological fracture
fractures caused by weakened bone tissue.
Damage to CNS and movement
damage to the cerebellum causes problems with balance and motor impairment is directly related to the amount of destruction of the motor strip.
Bed rest
an intervention that restricts clients to bed for therapeutic reasons and is the #1 reason for decreased demand for oxygen.
Impaired physical mobility
a limitation in independent, purposeful physical movement of the body or one or more extremities.
disuse atrophy
the tendency of cells and tissues to reduce in size and function in response to prolonged inactivity resulting from bed rest, trauma, casting, or local nerve damage.
Negative Nitrogen balance
the body excretes more nitrogen (the end product of amino acid breakdown) than it ingests in proteins. weight loss, decreased muscle mass, weakness result from tissue catabolism (breakdown).
Effects of immobility- Musculoskeletal system
bone loss-caused by resorption, osteoporosis; muscle wasting- atrophy, reduced muscle mass; contractures, and joint stiffness
Effects of immobility- Cardiovascular system
cardiac muscles weaken, orthostatic hypotension (an increase in heart rate of more than 15%, and drop of 15 mmHg in systolic blood pressure), venous stasis (blood pools in lower extremities as venous return decreases, decrease in cardiac output, and a decline in BP), thrombus formation (accumulation of platelets, fibrin, clotting factors, and cellular elements attached to internal wall of vein or artery) and dependent edema.
Effects of immobility- respiratory system
decreased resspiratory movement, pooling of respiratory secretions, atelectasis- collapse of alveoli; hypostatic pneumonia- inflammation of the lung from stasis or pooling of secretions
Effects of immobility- Metabolic System
Decreased metabolic rate, negative nitrogen balance (depleted protein necessary for muscle building and wound healing), anorexia, and negative calcium balance (depleted calcium necessary for bone building) Increased calcium in circulation if kidneys are not able to express calcium resulting in hypercalcemia.
Effects of immobility- Urinary system
kidney needs help of gravity to move urine to bladder, when immobilized the kidney is unable to move urine, so renal pelvis fills before urine enters ureters (urinary stasis), this increase risk of UTI and renal Calculi (from hypercalcemia, Urinary output declines on 5-6 days of immobility.
Effects of immobility- Gastrointestinal system
constipation, and excessive use of valsalva maneuver( this makes it more difficult for hear to beat, lungs to work, and could lead to hemorrhagic stroke)
Effects of immobility- integumentary system
reduced skin turgor, pressure ulcers and skin breakdown are real dangers (ischemia-decreased blood supply)
Effects of immobility- Psychosocial Effects
Decreased self esteem, exaggerated emotional reactions, anxiety, sleep patterns altered, hostility, giddiness, fear,and depression which can lead to withdrawal.
Interventions to prevent the hazards of immobility
monitor client for changes- vital signs, breath sounds, muscle size and strength, skin condition, serum labs, skin turgor, nutritional and fluid intake, urine and fecal output, and daily weight. Use Assertive techniques- active/passive ROM every 4 hours, as much self-care as possible, protective positioning every 2 hours, early ambulation, anti-embolism devices, leg elevation, get out of bed slowly, TCDB, active client participation.
Trouble areas for clients in supported Fowlers position
increased cervical flexion because the pillow is to thick and the head thrusts forward; extension of the needs, allowing the client to slide to the foot of the bed; pressure on the posterior aspects of the knees, decreasing circulation to the feet; external rotation of the hips; arms hanging unsupported at the clients sides; unsupported feet or pressure on heels; unprotected pressure points at the sacrum and heels; increased shearing force on the back and heels when head is elevated more than 60 degrees. To avoid complications: use a small pillow behind the head, use pillows to support arms/hands, position a pillow at the lower back, place a small pillow under thigh, and use pressure relief device for the heels.
postural abnormalities impact on mobility
congenital or acquired postural abnormalities affect the efficiency of the musculoskeletal system, as well as body alignment, balance, and appearance. They can cause pain, impair alignment/mobility or both.
Postural Abnormalities
Read table 47-1 page 1224
immobility and infants, toddlers, preschoolers
prolonged immobility delays gross motor skills, intellectual development or musculoskeletal development. (normal posture is awkward as head and trunk are carried forward)
Immobility- Adolescents
Delayed in gaining independence and in accomplishing skills. Social isolation can occur (growth is normally uneven, which making them a little more clumsy) Immobility can also alter growth patterns.
Immobility- Adults
physiological systems are at risk, changes in family and social structures occur.
Immobility- Older Adults
decreased physical activity, hormonal changes, and bone re-absorption.