Mobility and Activity — Page-by-Page Comprehensive Notes
Page 1
- Topic: Mobility / Activity
- Source: Wolters Kluwer
- Emphasis: The slide appears to frame mobility and activity as key themes in the material.
Page 2
- Comparison: WITH SKELETON vs WITHOUT SKELETON
- Implication: Skeleton presence is essential for movement and structural support; lack of a skeleton would imply no movement framework.
Page 3
- Role of the Skeletal System in Movement
- Ca^{2+} (calcium ions) play a critical role in muscle contraction and bone metabolism.
- PO / PO_{4}^{3-} (phosphate) participate in mineral storage and energy metabolism.
- Protects internal organs.
- Stores and releases fat.
- Produces blood cells.
- Stores and releases minerals (e.g., Ca^{2+}, phosphate).
- Facilitates movement.
- Supports the body.
Page 4
- Types of Bones
- Long bone (e.g., humerus)
- Flat bone (e.g., sternum)
- Irregular bone (e.g., vertebra)
- Short bone (e.g., talus)
Page 5
- Important Functions of Muscles
- Motion
- Maintenance of posture
- Support
- Heat production
Page 6
- (Content not provided in transcript; no notes.)
Page 7
- Ligaments and Tendons (illustrated anatomy relative to the knee and thigh region)
- Quadriceps tendon
- Patella
- Lateral collateral ligament
- Patellar tendon
- Femur
- Posterior cruciate ligament
- Anterior cruciate ligament
- Medial collateral ligament
- Fibula
- Tibia
Page 8
- (Content not provided in transcript; no notes.)
Page 9
- Joints
- Fibrous joints: Connected by dense connective tissue (mainly collagen); fixed and immovable.
- Cartilaginous joints: Connected entirely by cartilage; provide cushioning between bones.
- Synovial joints: Bones joined by a fibrous joint capsule; filled with synovial fluid that lubricates joints during movement.
Page 10
- Front of head Fibrous Joints (examples and terms)
- Posterior fontanelle
- Anterior fontanelle
- Suture line
- Suture
- Dense fibrous connective tissue
Page 11
- Cartilaginous Joints
- A firm yet flexible connective tissue is found in areas such as the ears, nose, larynx, ribs, intervertebral discs, knees, and ankles.
Page 12
- Synovial Joints (components)
- Ligament
- Bone
- Periosteum
- Articulating bone
- Synovial (joint) cavity (contains)
- Articular capsule: Fibrous capsule
- Synovial membrane
- Synovial fluid
- Articular cartilage
- Articulating bone
- Ligament
Page 13
- Bone, Synovium, Synovial fluid, Ligament, Bone, Cartilage
- Key elements: Synovium and synovial fluid within a synovial joint; ligaments stabilize; cartilage reduces friction.
Page 14
- Cartilaginous and Synovial Joints (examples)
- Facet joints
- Joint capsule
- Joint cavity
- Body of vertebra
- Intervertebral disk
- Facet joint (repeated)
- Spinous process
Page 15
- Cartilaginous and Synovial Joints (spinal context)
- Spinal cord
- Disc: annulus fibrosus (outer ring) and nucleus pulposus (inner core)
- Normal disc vs. Herniated disc (nucleus pulposus protrudes, compressing nerve roots)
- Vertebral body
- Herniated disc illustration
Page 16
- NORMAL VERTEBRA, NERVE, DISC; SUBLUXATION (partial dislocation) noted
Page 17
- (Content not provided in transcript; no notes.)
Page 18
- Types of Movements
- Flexion: bend; reduces the angle between the bones
- Extension: straighten the limb
- Hyperextension: beyond normal extension
- Abduction: move away from the baseline
- Adduction: move toward the baseline
- Pronation: turning to face backward
- Supination: turning to face forward
- Circumduction: circular motion
- Rotation: side-to-side turning
- Inversion: turn inward
- Eversion: turn outward
- Dorsiflexion: toes drawn upward toward the body
- Plantarflexion: toes pointed downward, away from the body
Page 19
- Abduction and Adduction (definitions and examples)
- Abduction: moving a limb away from the midline
- Adduction: moving a limb toward the midline
Page 20
- Movement Terms (mixed list)
- Supination
- Flexion
- Extension
- Pronation
- Abduction
- Adduction
- Medial Rotation
- Lateral Rotation
- Dorsiflexion
- Plantar flexion
Page 21
- Hyperextension and Hip Movements
- Hyperextension
- Hip flexion
- Hip extension
- Hip hyperextension
Page 22
- Joint Movements #2
- Rotation (Internal rotation, External rotation)
- Supination
- Pronation
- Inversion
- Eversion
Page 23
- Diagram labels (A–E) illustrating Pronation, Supination, Eversion, Inversion, Dorsiflexion, Plantarflexion, Abduction, Adduction
- Note: Includes a copyright line from Mosby/Elsevier
Page 24
- (Content not provided in transcript; no notes.)
Page 25
- Contractures
- Contractures often result from inactivity, injury, or arthritis
- Definition: tightening/shortening of muscles, tendons, joints, or other tissues causing deformity
- Flexion contraction: a flexed joint that cannot be straightened actively or passively
- Chronic loss of joint motion due to structural changes in muscle, tendon, ligaments
- Common sites: hip, knee, elbow
- Symptoms: pain and loss of movement in the joint
Page 26
- Active Range of Motion (ROM) vs Passive ROM
- Active ROM: performed by the patient
- Passive ROM: performed by a physiotherapist
- Passive ROM cannot be used to help paralyzed patients; usually used to help paralyzed patients
Page 27
- ROM Exercises (examples to perform during care)
- Ankle pumps: Point toes toward the head and then away
- Foot circles: Rotate the feet in circles at the ankles
- Knee flexion: Flex and extend the legs at the knees
Page 28
- (Content not provided in transcript; no notes.)
Page 29
- Types of Exercises
- Isotonic: muscle shortening and active movement; ROM exercises, swimming, jogging, bicycling
- Isometric: muscle contraction without shortening; holding a constant position (e.g., yoga poses, planks)
- Isokinetic: muscle contraction with resistance; performed at a constant speed, progression possible (e.g., stationary bike)
Page 30
- Isotonic Exercises (header/summary)
Page 31
- Isometric Exercise (header/summary)
Page 32
- Isokinetic Exercises
- Resistance Chair (example device for controlled speed resistance)
Page 33
- (Content not provided in transcript; no notes.)
Page 34
- Benefits of Exercise to Cardiovascular System
- Increased efficiency of the heart
- Decreased heart rate and blood pressure
- Increased blood flow to all body parts
- Improved venous return
- Increased circulating fibrinolysin (enzyme that helps break up small clots)
Page 35
- Benefits of Exercise to the Respiratory System
- Improved alveolar ventilation
- Decreased work of breathing
- Improved diaphragmatic excursion
Page 36
- Benefits of Exercise to the Musculoskeletal System
- Increased muscle efficiency (strength) and flexibility
- Increased coordination
- Reduced bone loss
- Increased efficiency of nerve impulse transmission
Page 37
- Benefits of Exercise to Metabolic Processes and the GI System
- Increased triglyceride breakdown
- Increased gastric motility
- Increased production of body heat
- Increased appetite
- Increased intestinal tone, improving digestion and elimination
- Weight control
Page 38
- (Content not provided in transcript; no notes.)
Page 39
- Sleeping Positions
- Correct: lying on the side with a small head pillow and a pillow between the knees; spine straight; hips and legs aligned
- Incorrect: head propped on a large pillow; spine curved; legs crossed causing hip misalignment
Page 40
- (Content not provided in transcript; no notes.)
Page 41
- Hip Surgeries: Anatomy
- Acetabulum (socket)
- Femoral head (ball)
- Femur (thighbone)
Page 42
- Post-operative precautions for hip replacement
- Do not bend forward past 90 degrees
- Do not cross legs
- Do not turn toes inward or twist
- Do not turn knees inward or together
- The information is for general education; follow health care provider guidance for hip replacement care
- Reference: X17 106/2020 AAC Tow Hip Replacement
Page 43
- (Content not provided in transcript; no notes.)
Page 44
- Use an overhead trapeze to move in bed
Page 45
Page 46
- Sequential Compression Device (SCDs)
Page 47
- (Content not provided in transcript; no notes.)
Page 48
- DVTS - Deep Vein Thrombosis
Page 49
- Nursing Actions for suspected DVT
- Notify the provider immediately
- Ultrasound order
- Position the client in bed with the leg elevated
- Avoid any pressure at the site of inflammation
- Anticipate giving anticoagulants
- D-dimer test
Page 50
- Client Education: DVT risk reduction
- Avoid crossing legs
- Avoid long periods of sitting
- Avoid restrictive clothing on lower extremities
- Do not place pillows behind the knees
- Do not massage legs
- Avoid dependent positioning
Page 51
- (Content not provided in transcript; no notes.)
Page 52
- Osteoarthritis
- Most common type of arthritis and a degenerative joint disease
- Primarily affects middle-aged and older adults
- Cartilage breakdown leads to pain, stiffness, reduced joint function
- No cure; managed with lifestyle changes, medications, and sometimes surgery
Page 53
- Causes of Osteoarthritis
- Cartilage breakdown over time leading to bone-on-bone friction
- Genetics: family history increases risk
- Age: more common with increasing age
- Obesity: excess weight increases stress on weight-bearing joints
- Injuries: prior joint injuries accelerate cartilage breakdown
- Other factors: certain occupations, repetitive movements, some medical conditions
Page 54
- Symptoms of Osteoarthritis
- Joint pain (worse with movement, better with rest)
- Stiffness
- Swelling
- Tenderness
- Crepitus (grating sensation)
- Bone spurs
- Loss of flexibility
Page 55
- Imaging/Joint Changes in Osteoarthritis
- Articular cartilage loss
- Meniscal changes
- Narrowing of joint space
- Bone spurs
Page 56
- (Content not provided in transcript; no notes.)
Page 57
- Osteoporosis
- A condition that weakens bones, increasing fracture risk; often called a silent disease because symptoms may not appear until a fracture occurs (hip, spine, or wrist commonly affected)
Page 58
- Normal vs Osteoporotic bone visuals
Page 59
- Who is at risk for osteoporosis?
- About one in five women over age $50$ (
$1/5$) - About one in twenty men
- Family history of broken bones or osteoporosis
- Prior fracture after age $50$ ($50$ can be noted as age threshold)
- Surgical history (e.g., ovaries removed before natural menopause)
- Poor dietary calcium, vitamin D, or protein intake
- Smoking
- High alcohol use
- Hormonal factors (e.g., excessive thyroid hormone, low estrogen in women, low testosterone in men)
- Low body mass index or underweight
Page 60
- How to keep bones strong with age
- Nutrition: adequate calcium, vitamin D, and protein; sources include low-fat dairy, leafy greens, fish, fortified foods
- Activity: weight-bearing exercises (strength training, walking, hiking, jogging, stairs, tennis, dancing)
- Avoid smoking (increases bone weakness risk)
- Limit alcohol intake
Page 61
- (Content not provided in transcript; no notes.)
Page 62
- Factors Influencing Mobility
- Developmental considerations
- Physical health (muscular, skeletal, nervous system problems; other body system issues)
- Mental health
- Lifestyle
- Attitude and values
- Fatigue and stress
- External factors
Page 63
- Balance, Posture, Alignment; Spine curvature disorders
- Normal spine
- Lordosis (inward curve)
- Kyphosis (outward curve)
- Scoliosis (lateral curvature)
Page 64
- Posture quality visuals (descriptions)
- Poor posture: Forward head, flat back, rounded shoulders, weak abdominal muscles
- Good posture: Upright, balanced, aligned spine
Page 65
- (Content not provided in transcript; no notes.)
Page 67
- Equipment and Assistive Devices (illustrated, generic terms)
- Standard patter/t mover, side board, trapeze bar, adjustable equipment
- Examples in real settings include devices to aid mobility and positioning
Page 68
- Transferring a Client
- Assess client abilities and diagnosis
- Assess client ability to assist
- Use appropriate number of assists
- Assess area for clutter
- ExplainProcedure to client
- Administer pain medication if necessary (assessment)
- Support client’s body properly
- Avoid friction
- Use Safe Patient Handling and Mobility (SPHM) equipment as needed
- Definitions of assistance levels:
- Maximum assistance: client cannot bear weight or assist; use total mechanical lift/slings
- Moderate assistance: client can sit but lacks lower-extremity strength; use sit-to-stand lifts and devices
- Minimum assistance: client can rise from seated position and stand; use gait belt and assistive devices
- No assistance: client can stand and walk without help
- Always wear non-skid footwear and ensure a clear path
Page 69
- Ensuring Safe Patient Handling and Mobility
- Safe transfer/mobility practices include:
- Assess client abilities, diagnosis, and ability to assist
- Use appropriate number of assists
- Check area for clutter
- Explain actions to client
- Provide pain relief/assessment as needed
- Support the client’s body properly
- Avoid friction
- Use SPHM equipment when necessary
Page 70
- Equipment and Assistive Devices (examples)
- Gait belts
- Stand-assist and repositioning aids
- Lateral-assist devices
- Friction-reducing sheets
- Mechanical lateral-assist devices
- Transfer chairs
- Powered stand-assist and repositioning lifts
- Powered full-body lifts
Page 71
- Positioning Patients
- Pillows
- Mattresses
- Adjustable beds
- Bed side rails
- Trapeze bar
- Additional equipment as needed
Page 72
- Moving, Turning, or Transferring
- Turning a patient in bed
- Moving a patient up in bed
- Moving a patient from bed to stretcher
- Moving a patient from bed to chair
- Assisting with range-of-motion exercises (active and passive)
Page 73
- Anatomy focus areas for safe handling: hips, heels, head, elbows, shoulders, sacrum
Page 74
- (Content not provided in transcript; no notes.)
Page 75
- Implementation: Safety
- Emphasizes safety protocols in mobility and transfers
Page 76
- (Content not provided in transcript; no notes.)
Page 77
- (Content not provided in transcript; no notes.)
Page 78
- (Content not provided in transcript; no notes.)
Page 79
- (Content not provided in transcript; no notes.)
Page 80
- Mechanical Aids for Walking
- Walker
- Cane
- Braces
- Crutches
- (Other mobility aids possibly listed as equipment)
Page 81
- Implementation: Assistive Devices for Walking
- Step-by-step pivot/manoeuvre process:
- Step 1: Ask patient to cross arms over chest
- Step 2: Place one hand behind patient’s head and pull patient’s bottom toward you; assess dizziness
- Step 3: Put shoes on, place gait belt, ensure 4 fingers between belt and patient
- Step 4: Move wheelchair to bed side; patient holds your shoulders; grasp gait belt
- Provides a practical method for transferring from bed to wheelchair
Page 82
- Assistive Devices - Walker
- Procedures: Stand up, grasp walker, advance walker, bring affected leg forward, then advance the unaffected leg
Page 83
- Assistive Devices - Cane
- Steps: Stand on the unaffected side, position cane about 6 inches in front of the affected foot, move the affected leg to the level of the cane, then move the unaffected leg beyond the cane by ~6 inches; advance the cane again, repeat
Page 84
- Assistive Devices - Crutches (Ambulation and Gaits)
- Crutch setup and gait patterns: 4-point, 3-point, 2-point, swing gait
- Steps for crutch use and patient safety
- Includes steps for getting up from bed and positioned stance
Page 85
- Going Upstairs with Crutches
- Emphasizes using both crutches and the injured leg appropriately during ascent
Page 86
- Going Downstairs with Crutches
- Emphasizes controlled use of crutches and legs during descent
Page 87
- (Content not provided in transcript; no notes.)
Page 88
- Variables Leading to Back Injury in Health Care Workers (Ergonomics)
- Uncoordinated lifts
- Manual lifting/transferring without assistive devices
- Lifting while fatigued or after back injury recovery
- Repetitive movements (lifting, transferring, repositioning)
- Standing for long periods
- Transferring patients
- Repetitive tasks
- Handling uncooperative or confused patients
Page 89
- Proper Body Mechanics
- Use proper body movement in daily activities
- Prevent and correct posture-related problems
- Enhance coordination and endurance
Page 90
- Proper and Improper Way to Pick Up an Object
- Visual examples illustrating safe lifting techniques (not detailed in transcript)
Page 91
- Safe Body Mechanics (Key tips)
- Plan your lift
- Ask for help
- Widen your base of support
- Bend your knees
- Tighten your stomach muscles
- Lift with your leg muscles
- Keep your load close
- Keep your back straight