Chapter 34

Chapter 34 Activity Overview

• Copyright Notices: Addresses copyright information from Wolters Kluwer Health.

Role of the Skeletal System in Movement

• Support: Provides structural support for the body's soft tissues.

• Protection: Protects vital organs and systems.

• Muscle Attachment: Offers surfaces for muscles, tendons, and ligaments to attach.

• Mineral and Fat Storage: Acts as a reservoir for minerals (like calcium) and fat.

• Blood Cell Production: Engages in hematopoiesis, producing blood cells.

Types of Freely Movable Joints

• Ball and Socket: Allows rotational movement (e.g., shoulder, hip).

• Condyloid (Ellipsoidal): Allows movement but no rotation (e.g., wrist).

• Gliding: Allows limited movement in all directions (e.g., between carpals).

• Hinge: Allows movement in one plane (e.g., elbow, knee).

• Pivot: Allows rotational movement (e.g., neck).

• Saddle: Enables a wide range of motion (e.g., thumb).

Relationship of Skeletal Muscles to Bones

Key Concepts

• Muscle Origins and Insertions: Points of attachment for muscles to the skeleton.

• Fulcrum: The joint acts as the fulcrum in muscle contractions.

• Effort: Muscular contractions exert force that causes movement.

• Resistance: Refers to the weight of the object being lifted.

Classification of Bones by Shape

• Long Bones: Found in extremities (e.g., femur, humerus).

• Short Bones: Found in the wrist and ankle (e.g., carpals, tarsals).

• Flat Bones: Found in ribs and skull (e.g., sternum).

• Irregular Bones: Morphologically complex (e.g., vertebrae).

Exercise Questions

• Question 1: Classification of wrist bones?

  • Answer: B. Short bones.

  • Rationale: Short bones in the wrist allow for specialized movement; long bones are in extremities, flat bones are thin and form shape, and irregular bones are miscellaneous.

Joint Movements Overview

Common Movements

• Abduction: Movement away from the midline of the body.

• Adduction: Movement towards the midline of the body.

• Circumduction: Circular movement, proximal end stays fixed.

• Flexion/Extension: Bending and straightening of joints.

• Dorsiflexion/Plantar Flexion: Movement of the foot upwards and downwards.

• Hyperextension: Excessive extension beyond anatomical position.

Additional Movements

• Rotation: Twisting of a body part on its axis.

• Internal/External Rotation: Rotational motion towards or away from the center of the body.

• Supination/Pronation: Rotational movement of the forearm and foot.

• Inversion/Eversion: Movements affecting the ankle and foot.

Exam Questions

• Question 2: What movement occurs when a leg is moved in a circle?

  • Answer: C. Circumduction.

  • Rationale: Circumduction involves moving the distal limb in a circular motion while the proximal remains fixed, unlike abduction, flexion, or dorsiflexion.

Types of Muscles

• Skeletal Muscle: Voluntary, striated muscle attached to bones.

• Cardiac Muscle: Involuntary, striated muscle found in the heart.

• Smooth (Visceral) Muscle: Involuntary, non-striated muscle found in hollow organs.

Important Functions of Muscles

• Motion: Facilitates movements of the body.

• Posture Maintenance: Stabilizes body position.

• Support: Holds organs in place.

• Heat Production: Generates heat through contractions.

Effect of Nervous System on Muscle Contraction

• Neuron Role: Conducts impulses necessary for muscle activation.

• Afferent Pathway: Sends sensory information to the CNS.

• CNS Processing: Interprets incoming information and sends responses.

• Efferent Pathway: Directs responses to skeletal muscles via the somatic nervous system.

Postural Reflexes

• Labyrinthine Sense: Balance and orientation sense.

• Proprioceptive Sense: Awareness of body position and movement.

• Visual Reflexes: Contribution of sight to balance.

• Extensor Reflexes: Reflexes that involve straightening limbs.

Safe Patient Handling and Mobility (SPHM)

• Ergonomics: Designing tasks and equipment to fit the worker's capabilities.

• Injury Risks: Identifies factors contributing to handling injuries: uncoordinated lifts, awkward postures, manual handling, and repetitive tasks.

Factors Influencing Mobility

• Developmental Considerations: Age impacts mobility.

• Physical Health: Includes muscular and nervous system health.

• Mental Health: Psychological well-being affects mobility levels.

• Lifestyle Choices: Exercise habits and activity levels.

• Environmental Factors: Environmental barriers that affect physical capabilities.

Types of Exercises

• Isotonic: Muscle shortens with movement (e.g., weightlifting).

• Isometric: Muscle contracts without changing length (e.g., wall sit).

• Isokinetic: Muscle contracts with resistance throughout the movement.

Exam Questions on Exercise Types

• Question 3: Is jogging isometric?

  • Answer: B. False.

  • Rationale: Jogging is isotonic due to movement and muscle shortening.

Benefits of Exercise

Cardiovascular System

• Heart Efficiency: Enhances heart function.

• Heart Rate and Blood Pressure: Decreases both for improved health.

• Increased Blood Flow: Better circulation throughout the body.

• Venous Return: Improves the return of blood to the heart.

• Fibrinolysin: Increases circulation of this clot-busting substance.

Respiratory System

• Alveolar Ventilation: Increases lung capacity and efficiency.

• Work of Breathing: Reduces the effort needed for respiration.

• Diaphragmatic Excursion: Enhances diaphragm function.

Musculoskeletal System

• Muscle Efficiency: Boosts strength and flexibility.

• Coordination: Improves overall body coordination.

• Bone Health: Reduces risk of bone loss.

• Nerve Impulses: Improves efficiency of nerve signal transmission.

Metabolic Processes and GI System

• Triglyceride Breakdown: Enhances metabolism.

• Gastric Motility: Improves digestive efficiency.

• Body Heat: Generates heat through muscle activity.

• Appetite: Increases hunger and digestive function.

• Intestinal Tone: Improves digestion and waste elimination.

Risks Related to Exercise

• Cardiac Events: Could precipitate heart issues.

• Orthopedic Issues: May lead to discomfort and injuries.

• Health Problems: Risks of other health complications.

Effects of Immobility on the Body

• Impact on multiple systems including:

  • Cardiovascular: Risk of blood clots, weakened heart.

  • Respiratory: Reduced lung function.

  • Musculoskeletal: Weakness, atrophy, and joint issues.

  • Metabolic: Slower metabolism.

  • Gastrointestinal: Poor digestion.

  • Urinary: Risk of infections and kidney issues.

  • Skin: Pressure sores and decay.

  • Psychosocial: Mental health decline.

Health History for Mobility Assessment

• Activity Level: Daily movement patterns.

• Endurance: Ability to sustain physical activities.

• Exercise Goals: Personal fitness objectives.

• Mobility Issues: Identifies existing problems.

• Health Alterations: Impact of physical or mental health changes.

• External Mobility Factors: Environmental restraints.

Physical Assessment for Mobility

• Ease of Movement: Observations of ability to move.

• Gait and Posture: Evaluating walking style and alignment.

• Joint Function: Assessing movement and health of joints.

• Muscle Condition: Evaluating mass, tone, and strength.

• Endurance Testing: Measures stamina and ability to sustain activity.

Back Injury Risks in Healthcare Workers

• Uncoordinated Lifts: Risk factors during manual handling.

• Fatigue: Heightened risk after fatigue or injury.

• Repetitive Movements: Risks from frequent, similar actions.

• Postural Strain: Results from prolonged standing or awkward positions.

Proper Body Mechanics

• Movement: Emphasizes correct body mechanics in activities.

• Posture Prevention: Corrects postural issues.

• Coordination and Endurance: Enhances overall body mechanics.

Proper and Improper Lifting Techniques

• Proper Techniques: Correct posture, use of legs.

• Improper Practices: Common lifting mistakes that lead to injury.

Equipment and Assistive Devices

• Gait Belts: For safe patient transfers.

• Assistive Aids: Help with standing and moving.

• Friction-Reducing Devices: To ease patient movement.

• Lift Equipment: Various mechanical lifts for patient handling.

Patient Positioning Equipment

• Pillows and Mattresses: Used for comfort and support.

• Adjustable Beds: Facilitate positioning needs.

• Additional Equipment: Items enhancing safe and effective positioning.

Patient Positioning Techniques

• Fowler’s Position: Semi-sitting, common for various needs.

• Supine Position: Lying on the back.

• Side-Lying Position: Useful for comfort and safety.

• Sims’ Position: Variation of side-lying for medical procedures.

• Prone Position: Lying face down, used in specific medical scenarios.

Exam Questions on Patient Positioning

• Question 4: True or False: Oblique position reduces pressure on the trochanter.

  • Answer: A. True.

  • Rationale: Oblique position is preferred as it lowers pressure risks.

Patient Mobility Techniques

Methods of Movement and Transfer

• Turning in Bed: Correct techniques for repositioning patients.

• Moving in Bed: Techniques to adjust patient positions comfortably.

• Transfers: Moving patients from one surface to another.

• Range-of-Motion Exercises: Involves active and passive methods to promote mobility.

Physical Conditioning Exercises

• Quadriceps and Gluteal Drills: Strengthening techniques.

• Push-ups: Upper body strength exercise.

• Dangling: Preparation for standing or walking.

Mechanical Aids for Walking

• Walkers: For stability.

• Canes: Assistance for balance.

• Braces: Provides support to limbs.

• Crutches: Helps in transferring weight off injured limbs.