NURS 330: Mobility (Treas)

Motor Nervous System

  • The nervous system plays a critical role in controlling the movement of the musculoskeletal system.

  • Motor nerves are classified into:

    • Autonomic Nervous System: Responsible for controlling involuntary muscles, such as:

    • Heart

    • Blood vessels

    • Glands

    • Somatic Nervous System: Controls voluntary skeletal muscles.

Motor Commands and Muscle Contraction

  • Conscious motor commands originate in the motor area of the cerebral cortex.

  • Upper motor efferent nerves communicate with:

    • Lower motor neurons that transmit impulses to muscles.

  • When muscles receive sufficient stimuli:

    • For example, the biceps contract while the triceps relax to enable bending of the elbow.

  • Reflex mechanisms also play a role in movement, with examples being:

    • Knee-jerk reflex

    • Corneal reflex

  • Reflex responses stimulate afferent nerves, which relay information to:

    • Cerebral cortex

    • Cerebellum

  • This feedback controls and coordinates muscular activities.

Body Mechanics

Definition

  • Body mechanics refers to the way we move our bodies, encompassing:

    • Body alignment

    • Balance

    • Coordination

    • Joint mobility

Importance in Patient Handling

  • Body mechanics are crucial for teaching patients and ensuring safe handling.

  • Guidelines and proper techniques are necessary for good body mechanics.

Body Alignment

  • Alignment (posture) ensures the spine is in a neutral position, maintaining natural curves.

  • Proper posture prevents:

    • Stress and fatigue during movement

    • Ensures efficient functioning of bones, muscles, joints, and ligaments.

  • Good posture is associated with:

    • Normal nervous system functioning

    • Enhanced well-being

  • Common causes of poor posture include:

    • Accidents or injuries

    • Poor sitting, standing, or sleeping habits

    • Excessive weight

    • Foot problems and improper footwear

    • Negative self-image and occupational stress

    • Visual difficulties and weak muscles

    • Skeletal misalignment or deformities (e.g., scoliosis).

Balance

  • Balance is achieved when body alignment is optimal:

    • Line of Gravity: An imaginary vertical line from the head through the center of gravity.

    • Center of Gravity: In humans, located below the umbilicus, at the top of the pelvis.

    • Base of Support: Provided by the feet, which stabilize the body.

  • To prevent injury while lifting:

    • Keep the center of gravity close to the base of support.

    • Maintain proper posture and stance:

    • Head erect

    • Buttocks pulled in

    • Tight abdominal muscles

    • Elevated chest

    • Shoulders back

    • Feet wide apart.

Coordination

  • Smooth movements depend on coordination between the:

    • Nervous system

    • Musculoskeletal system

  • Key components include:

    • Cerebral Cortex: Initiates voluntary movements.

    • Cerebellum: Coordinates movements and manages proprioception (awareness of posture and movement).

    • Basal Ganglia: Deep in the cerebrum, assists with movement coordination.

Joint Mobility

  • Mobility refers to the ability to move within the environment:

    • Range of Motion (ROM): Maximum movement possible at a joint.

    • Active Range of Motion (AROM): Done by the individual without assistance.

    • Passive Range of Motion (PROM): Involves assistance to move the joints through their ROM.

Guidelines for Body Mechanics

  • Body mechanics principles minimize injury risk during patient care:

    • Patient-related factors (weight distribution, behavior) complicate applications of body mechanics alone.

    • For more detailed guidelines and patient assessment tools, refer to applicable clinical tables.

KnowledgeCheck 29-1

  • Three purposes of the skeletal system: Support, movement facilitation, and protection of organs.

  • Types of muscle: Skeletal, cardiac, and smooth muscles.

  • Muscle and nerve interaction: Nerves stimulate muscles to contract via motor neurons.

Guidelines for Maintaining Good Body Mechanics

  • Avoid prolonged standing; alternate foot elevation for comfort.

  • Keep core muscles engaged for back support.

  • Ergonomic seating is crucial for desk work.

  • Proper footwear is important to avoid strain.

Coordination and Joint Mobility

  • Proper coordination and ROM are essential:

    • Enable body functions, movement, and daily activities.

Think Like a Nurse 29-1

  • When assisting Ms. Jillian with chest pain:

    • Incorporate body mechanics to protect both patient and caregiver and gather necessary patient history.