Chapter 33: Activity

Week 5 Class Overview

Focus on Chapter 33: Activity
Discussion includes aspects of the skeletal and muscular systems in relation to movement.

Definition: The skeletal system is comprised of the framework of bones, joints, and cartilage, providing support and protection for vital organs and enabling movement.
Functions:
- Support: Provides structure for soft tissues in the body.
- Protection: Safeguards critical organs (e.g., rib cage protects the heart and lungs; skull protects the brain).
- Attachment: Tissues such as muscles, tendons, and ligaments attach to the surface of bones, facilitating movement.
- Storage: Stores minerals (like calcium) and fat.
- Blood Cell Production: Known as hematopoiesis (correct term from "metopoiesis") which occurs within the bone marrow.

Bones classified by shape:
- Long Bones: Example – arms and legs; contributes to height and movement.
- Short Bones: Example – wrists and ankles; allows for flexibility and movement in these joints.
- Flat Bones: Example – ribs and skull; flat design aids in protection and muscle attachment.
- Irregular Bones: Found in the vertebrae (spinal column) and mandible (jaw).

Types and functions of muscles:
- Skeletal Muscle: Attached to bones via tendons, facilitates voluntary movement.
- Cardiac Muscle: Forms the heart wall and controls the heartbeat involuntarily.
- Smooth (Visceral) Muscle: Found in walls of hollow organs, controls involuntary movements (e.g., stomach and intestines).

Functioning skeletal and muscular systems require a functional nervous system.
Nerve Impulses: Trigger muscle contractions, illustrating the relationship between the nervous system and movement.
Afferent vs Efferent Neurons:
- Afferent: Carries sensory information to the CNS.
- Efferent: Carries motor commands from the CNS to muscles.
Example of paralysis due to spinal cord injuries, illustrating the importance of this connection.

Discussed postural reflexes on page 1135:
- Labyrinthine Sense: Helps in balance and spatial orientation.
- Proprioceptors (Kinesthetic Senses): Detect body position and movement.
- Visual Reflexes: Processes visual information to orient body.
- Extensor (Stretch) Reflexes: Reflexes that maintain posture and prevent falls.

Developmental Considerations:
- Mobility changes from infancy (unsteady, crawling) to elderly (reduced physical capabilities).
Physical Health Conditions: Including muscular and skeletal issues, neurological diseases (e.g., MS, Lou Gehrig's disease) affecting mobility.
Mental Health: Depression or psychological conditions may impact the willingness to mobilize despite physical capability.
Lifestyle: Activity levels (sedentary vs active) affect mobility potential.
Attitude and Values: Patient motivation plays a crucial role in recovery and mobility initiatives.
Fatigue and Stress: These can inhibit physical activity and mobility.
External Factors: Injuries or environmental factors affecting physical activity capacity.

Isotonic: Muscle shortening during active movement (e.g., swimming, jogging).
Isometric: Muscle contraction without shortening (e.g., holding a yoga pose).
Isokinetic: Muscle contraction with resistance (e.g., weight lifting).

Increased Efficiency: Improved heart function leading to lower resting heart rate.
Increased Blood Flow: Enhanced circulation throughout the body, especially to lower extremities.
Venous Return: Muscle contractions assist in returning blood to the heart, preventing pooling.
Fibrinolysin Circulation: Reduced risk of blood clots through increased levels of the enzyme that breaks down clots.

Improved Alveolar Ventilation: Enhances gas exchange capacity in the lungs.
Decreased Work of Breathing: Better respiratory efficiency as fitness increases.
Improved Diaphragmatic Excursion: Helps maintain lung capacity and function in older adults.

Increased Muscle Strength and Flexibility: Regular exercise leads to enhanced muscle performance.
Reduced Bone Loss: Weight-bearing activities help maintain bone density.
Improved Coordination: Trains the body to maintain balance, beneficial for older adults.

Refer to Table 33-5, page 1147 for assessment techniques:
- Ambulation: Observe patient walking, evaluating posture, gait, and spinal alignment.
- Joint Function: Assess range of motion and presence of any pain or issues at joints.
- Muscle Assessment: Evaluate muscle mass, tone, strength, and endurance.

Common Causes: Uncoordinated lifts, manual handling without assistive devices, lifting while fatigued, repetitive movements (transferring patients).
Proper Body Mechanics:
- Maintain good posture during lifts.
- Utilize assistive devices for patient transfers.
- Seek assistance when maneuvering heavy patients.

Gait Belts: Provide support during ambulation, preventing falls.
Transfer Devices: Include slide boards, mechanical lifts (Hoyer lifts), and assistive chairs.
Mobility Aids: Walkers, canes, and crutches facilitate movement for patients with limited mobility.

Demonstrates how to position patients to prevent complications (refer to Tables 33-6):
- Supine: Used in patients at risk of aspiration or respiratory distress.
- Lateral: On their side to prevent aspiration if vomiting occurs.
- Prone: Face down position, though not commonly used.

Importance of understanding the relationship between the skeletal and muscular systems with movement, joint mechanics, and the role of exercise in promoting health. Careful physical assessments and proper techniques for patient interaction are crucial to preventing injuries in healthcare settings.