BODY ALIGNMENT
relationship of one body part to another
BODY BALANCE
achieved by low center of gravity
enhanced by posture
COORDINATED BODY MOVEMENT
weight
center of gravity
balance
FRICTION
force that occurs in a direction to oppose movement
CONCENTRIC TENSION
increased muscle contraction that causes muscle shortening
i.e. when a patient uses an overhead trapeze to pull up in bed
ECCENTRIC TENSION
helps control the speed and direction of movement
i.e. when a patient uses an overhead trapeze to slowly lower themselves to the bed
ISOTONIC CONTRACTION
muscle contractions that lengthen or shorten the muscle
also called "dynamic" muscle contractions
ISOTONIC EXERCISES
walking, swimming, dance, jogging, bicycling
enhance circulatory and respiratory functioning
increase muscle mass, tone, and strength
promote osteoblastic activity
ISOMETRIC CONTRACTION
static contraction
causes an increase in muscle tension
no shortening/lengthening of the muscle
ISOMETRIC EXERCISES
tightening/tensing of muscles without moving body parts
contraction occurs when pushing against stationary object
resisting the movement of an object
i.e. pushing against a footboard
ANTAGONISTIC MUSCLES
cause movement at a joint
one active mover muscle contracts while its antagonist relaxes
SYNERGISTIC MUSCLES
contract to accomplish the same movement
two active mover muscles contract while the antagonistic muscle relaxes
ANTIGRAVITY MUSCLES
stabilize joints
muscles continuously oppose the effect of gravity on the body
permit a person to maintain an upright or sitting posture
PROPRIOCEPTION
awareness of the position of the body and its parts
BALANCE
controlled by the nervous system
cerebellum and the inner ear
BALANCE - CEREBELLUM
coordinates all voluntary movement
BALANCE - INNER EAR
three semi-circular canals filled with fluid help maintain balance
when the head is suddenly rotated in one direction, the fluid remains stationary for a moment, but the canal turns with the head
This allows a person to change position suddenly without lo
PATHOLOGICAL INFLUENCES ON BODY ALIGNMENT, MOBILITY AND ACTIVITY
congenital defects
disorders of bones, joints, muscles
central nervous system damage
musculoskeletal trauma
STANDING - ASSESSMENT
head is erect, midline
body is symmetrical
spine is straight with normal curvature
abdomen is tucked
knees slightly flexed
feet pointed forward and slightly apart
arms at the sides
SITTING - ASSESSMENT
head is erect, midline
neck and vertebral column are in straight alignment
body weight is evenly distributed on buttocks and thighs
thighs are parallel and in a horizontal plane
feet supported on the floor
forearms supported on the armrest, in the lap, or
RECUMBENT POSITION - ASSESSMENT
vertebrae in straight alignment without any observable curves
MOBILITY - ASSESSMENT
gait
exercise
activity tolerance
NURSING DX
activity intolerance
ineffective coping
impaired gas exchange
risk for injury
impaired bed mobility
impaired physical mobility
acute/chronic pain
PRINCIPLES OF SAFE PATIENT TRANSFER & POSITIONING
- WHEN PATIENT CANNOT ASSIST
use mechanical lifts and lift teams
PRINCIPLES OF SAFE PATIENT TRANSFER AND POSITIONING
- WHEN PATIENT CAN ASSIST
the wider the base of support, the greater the stability of the nurse
the lower the center of gravity, the greater the stability of the nurse
the equilibrium of an object is maintained as long as the line of gravity passes through its base of support
Faci
ASSISTIVE DEVICES FOR WALKING
walkers
canes
crutches
WALKER
patient holds the handgrips on the upper bars
takes a step
moves walker forward
takes another step
CANE
keep cane on strong side of the body
place cane forward 6-10 inches
weak leg moves forward
strong leg moves forward just past the cane
CRUTCHES
wooden or metal
double adjustable or forearm crutch
must be measured to fit appropriately
MEASUREMENT OF CRUTCHES
length of the crutch should be 2-3 finger widths (2 inches) from the axilla
tips should be approximately 2 inches laterally and 4-6 inches anterior to the front of patient's shoes
elbow flexion should be 20-25 degrees
GONIOMETER
device to measures elbow flexion
AXILLARY CRUTCHES
has a padded, curved surface that fits under the axilla
hand grips in the form of a cross bar are held at the level of the palms to support the body
FOREARM CRUTCHES
has a handgrip and a metal band that fits around the patient's forearm
the metal band and the handgrip are adjusted to fit the patient's height
CRUTCH GAIT
alternately bearing weight on one or both legs and on the crutches
BASIC CRUTCH STANCE
tripod position
crutches are placed 6 inches in front of and 6 inches to the side of each foot
position improves the patient's balance by providing a wider base of support
axilla should not bear any weight
FOUR-POINT ALTERNATING GAIT
gives stability to the patient but requires weight bearing on both legs
Each leg is moved alternately with each opposing crutch so three points of support are on the floor at all times
THREE-POINT ALTERNATING GAIT
requires the patient to bear all of the weight on one foot
affected leg does not touch the ground
TWO-POINT GAIT
requires at least partial weight bearing on each foot
patient moves a crutch at the same time as the opposing leg so the crutch movements are similar to arm motion during normal walking
SWING-THROUGH GAIT
With weight placed on the supported legs, the patient places the crutches one stride in front and then swings to or through them while they support his or her weight
CRUTCHES - WALKING UP STAIRS
weight is placed on the crutch
weight is transferred from crutches to unaffected leg on stairs
crutches are aligned with unaffected leg on stairs
CRUTCHES - WALKING DOWN STAIRS
body weight is on unaffected leg
body weight is transferred to the crutches
unaffected leg is aligned on stairs with crutches
SITTING IN A CHAIR WITH CRUTCHES
both crutches are held in one hand
patient transfers weight to crutches and unaffected leg
patient grasps arm of chair with free hand and begins to lower into chair
patient completely lowers into chair
SCOLIOSIS
structural curvature of the spine associated with vertebral rotation
OSTEOGENESIS IMPERFECTA
inherited disorder that affects bone tissue
bones are porous, short, bowed, and deformed
presents with curvature of the spine and short stature
JOINT DEGENERATION
can occur with inflammatory and non-inflammatory disease
marked by changes in articular cartilage combined with overgrowth of bone at the articular ends
affect weight bearing joints