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Active ROM
requires the client to move the joint through its full ROM
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Passive ROM
when the clint is unable to exercise each joint independently. Instead, you support the body andmove each joint through its ROM
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Asses muscle strenghs
along with movement by asking the pt to perform ROM while you apply resistance to the part being moved.
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Musculoskeletal system
- short, flat, and irregular bones contain red bone marrow and produce red blood cells. Long don't.
- Osteoclasts break down old or damaged tissue
- Osteoblasts: repair damaged bone and build new bone to keep the skeleton strong.
- Articualtion: joint of two bones
- ● Forms the framework of the body
- ● Protects the internal organs
- ● Produces red blood cells
- ● Serves as a storage site for calcium
- ● Works with the muscles to cause movement
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3 types of muscles and their movement
- Skeletol muscle: moves the skeleton
- Smooth muscle: in the digestive truct and other hollow structures, suchas the bladder and blood vessels, produces movement of food through the digesetive tract, urine ..blodd..
- Cardiac muscle: has the ability to contract spontaneously. Beating of the heart.
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Movements
- ● Abduction is moving away from midline
- ● Adduction is moving toward midline
- ● Flexion is bending, decreasing the joint angle
- ● Extension is straightening, increasing the joint angle
- ● Circumduction is moving in a circular fashion
- ● Internal rotation is turning toward midline
- ● Supination is turning upward
- ● Pronation is turning downward
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Joints
- Joints: healthy joints are smooth, non-tender, warm to touch and of similar color. Color changes of a joint may indicate inflammation or infection
- Should move freely and without pain or crepitus (clicking or grating)
- Effusion: is fluid accumulation, such as detected in knee joints.
- Joint function: is assessed by testing range of motion
- Synarthroses: are immovable joints
- amphiarthroses: allow for limited movement.
- Diarthroses, or synovial joints: freely movable
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Types of bones
- 206 bones
- long(femur and humerus), short(phalangs and metacarplas), flat (sternum and cranial bones), irregularly shaped (vertebrae and tarsal bones)
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Body alignment
Body alignment-posture, propper posture places the the spine in a neutral resting position, contributes to the normal functioning of the nervous system and improves feelings of well-being.
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Balance
- achives balance when it is in alingment.
- The closer the center of gravity is to the base of support when you are lifting objects the more balance you have and thefore sefer for the whole body.
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Coordination
- smooth movement requires coordination between the nervous system and the musculoskeletal system.
- preprioception: the awareness of posture, movement, and position sense - controlled by cerebellum.
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Assessment of musculasckelatal system
assess major bones, joints, and muscles by inspection, palpation, and determination of ROM.
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Joint mobility
- ROM - max movement possible at a joint.
- Full ROM: is part of being physically fit.
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Physical activity
- refers to bodily movemetn and energy expenditure involving contraction of the skeletal muscles above basal level.
- Baseline activity - refers to the light-intensity activities of daily living, such as standing, walking slowly, and lifting lightweight objects.
- Healht-enhancing physical activity: more than base line to produce health-enhancing benefits.
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Types of exercises
- ● Isometric exercises involve muscle contraction without motion. They are usually performed against an immovable surface or object. For example, when pressing the hand against the wall, the muscles of the arm contract but the wall does not move. Each position is held for 6 to 8 seconds with 5 to 10 repetitions. Isometric training is effective for developing total strength of a particular muscle or group of muscles. It is often used for rehabilitation because the exact area of muscle weakness can be isolated and strengthening can be administered at the proper joint angle. This kind of training requires no special equipment, and there is little chance of injury. Bedridden patients can use this form of exercise to maintain or regain muscle strength.
- ● Isotonic exercise involves movement of the joint during the muscle contraction. A classic example of an isotonic exercise is weight training with free weights. As the weight is moved throughout the range of motion, the muscle shortens and lengthens. Calisthenics, such as chin-ups, push-ups, and sit-ups, all of which use body weight as the resistance force, are also isotonic exercises.
- ● Isokinetic exercise utilizes machines that control the speed of contraction within the range of motion. Isokinetic exercise attempts to combine the best features of both isometrics and weight training by providing resistance at a constant preset speed while the muscle moves through the full range of motion. Specialized machines available at health clubs and physical therapy departments are used for this form of exercise.
- ● Aerobic exercise acquires energy from metabolic pathways that use oxygen—the amount of oxygen taken into the body meets or exceeds the amount of oxygen required to perform the activity. Aerobic exercise uses large muscle groups, can be maintained continuously, and is rhythmic in nature. It increases the heart and respiratory rate, thereby providing exercise for the cardiovascular system while simultaneously exercising the skeletal muscles
- ● Anaerobic exercise occurs when the amount of oxygen taken into the body does not meet the amount of oxygen required to perform the activity. Therefore, the muscles must obtain energy from metabolic pathways that do not use oxygen. Rapid, intense exercises, such as lifting heavy objects or sprinting, are examples of anaerobic exercise.
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Assessment of skeletal system: Inspection
- Posture: incudes the person's body build and alignment when standing and walking.. Assess curvature of the spine(lordosis, scholiosis, kyphosis) and the lengt, shape, and symetry of exremities. Inspect muscle mass for size and symmetry.
- Gait: abnormality in the stance phase of gaint is called an antalgic gait. (when part of one leg is painful, the patient shortens the stance phase on the affected side). An abnormality in the swing pahse is called lurch. (when the muscles in the buttocks and/or legs are too weak to allow the person to change weight from one foot to the other so shoulders are moved either side to side or front to back. )
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Major developmental consideration with elderly females regarding the musculoskeletal system
Incrased risk for osteoporosis
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