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Flexion
decreasing the angle of the joint
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Extension
increasing the angle of a joint
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Hyperextension
further extension or straightening of a joint
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Abduction
movement of the bone away from the midline of the body
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Adduction
movement of the bone toward the midline of the body
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Rotation
movement of the bone around its central axis
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Circumduction
movement of the distal part of the bone in a circle while the proximal end remains fixed
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Eversion
turning the sole of the foot outward by moving the ankle joint
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Inversion
turning the sole of the foot inward by moving the ankle joint
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pronation
moving the bones of the forearm so that the palm of the hand faces downward when held in front of the body
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supination
moving the bones of the forearm so that the palm of the hand faces upward when held in front of the body
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the extensor muscles or antigravity muscles
carry the major load as they keep the body upright
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proprioception
is the term used to describe awareness of posture, movement and changes in equilibrium and the knowledge of position, weight and resistance of objects in relation to the body
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A person maintains balance as long as the line of gravity
(an imaginary vertical line drawn through the center of gravity) passes through the center of gravity (the point which all of bodys mass is centered) and the base of support (the foundation on which the body rest).
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Intensity
of exercise can be measured by target heart rate ,talk test or borg scale of perceived exertion.
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Types of exercise
aerobic-
3 times a week, total of 30 minutes a day, measured by the heart rate, talk test and borg test. Moderate intensity
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Type of exercise:
anaerobic
The flexor muscles are stronger than the extensor muscles so when a person is inactive, the joints are pulled into a flexed (bent) position. The muscle could become permanently shortened and the joint fixed in a flexed position (contracture).
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coordinated movement
balanced, smooth, purposeful movement
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Three components to coordinated movement ..
Cerebral cortex, cerebellum, basal ganglia
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One component of coordinated movement is:
cerebral cortex
sends out a signal and tells us to pick the cup up. It initiates voluntary motor activity
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One component of coordinated movement is cerebellum
translations instructions, tells which muscle what to do. With a cerebellum injury, the client movements would become clumsy, unsure, and uncoordinated
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One component of coordinated movement is:
basal ganglia
maintains posture
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Benefits of exercise: Musculoskeletal
decreases muscle atropy, bone density and strength is maintained through weight bearing. The stress between weight bearing and high impact movement maintains a balance between osteoblasts ( bone building cells) and osteoclats ( bone reabsorption and breakdown cells).
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Disuse osteoporosis
without the stress of weight bearing activity, the bones demineralize. They are depleted of calcium, which gives the bones strength and density.
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Disuse atrophy
unused muscles atrophy ( decrease in size), losing most of their strength and normal functions.
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Contractures
irreversible except by surgery, a shortening of the muscle and fixing of the joint. Ex. Foot drop.
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Stiffness and pain in the joint
without movement the collagen tissues at the joint becomes permanently immobile (ankylosed)
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Cardiovascular system - Diminished cardiac reserve
- decreased mobility creates a imbalance in the autonomic nervous system;
- immobilized person may experience tachycardia with even minimal exertion, edema thrombus formation. Venous vasodilation, and statis
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Respiratory
decreased respiratory movement, pooling of respiratory secretions,atelectasis( blocking of a bronchiole), hypostatic pneumonia,
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Metabolic system
decreased metabolic rate, negative nitrogen balance(anabolism and catabolism), anorexia (loss of appetite) ,negative calcium balance,
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Urinary system- urinary statis
stopping or slowing down of flow
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urinary retention
accumulation, urinary incontinence or infection.
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Most common organism for UTIs is
Escherichia coli
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Psychoneurologic system
Gastrointestinal system and Integumentary system, reduced skin tugor, skin breakdown
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Four levels of diagnosing activity:
- level 1 - walk regular pace, ground level, shortness of breath above normal after climbing a flight of stairs
- Level 2 - walk one city block, one level ground, indefinitely, climb one flight of stairs slowing without stopping.
- Level 3 – walk no more than 50 feet on level ground without stopping, unable to climb one flight of stairs without stopping
- Level 4 - dyspnea - a fatigue at rest
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Peristatsis
natural bowel movement
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Risk for activity intolerance:
impaired physical mobility, impaired bed mobility, impaired walking, impaired wheelchair mobility, impaired transferred alerts
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Preventing back injuries, pg 1131—
lift no more weight than 51 pds,firm mattress, soft pillow, knees slightly higher than hips when sitting; to lift, stand with feet apart , wide base, let legs bear most of the burden.
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Orthopeneic
positionsitting up in bed or on the side of the bed, table across lab, ciliates respiration
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Fowlers position
head raised 30 to 90 degrees, pillow at head, lumbar, knees may or may not be flexed, feet in plantar position. Position for people who have difficulty breathing
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Dorsal recumbent position
black lying. Or supine position. head and shoulders slightly elevated. Used to facilitate healing
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Prone position
client lies on abdomen, head turned to one side, pillow under abdomen and head. Promotes drainage from the mouth and is esp useful for unconscious clients.Should only be used when the clients back is aligned correctly.
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Lateral position
side lying, pillow under head, between knees, and in front of chest. Promotes good back alignment, reduces Lordosis, good for resting and sleeping clients
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Sims position
posture halfway between prone and lateral, one arm by pillow and one arm behind and down.towel role for feet. Helps with drainage,
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Capillary Blood glucose, Ch 34, pg 805-807
Normal blood sugar is 60-120. For elders who have poor circulation- warm their hands with a warm washcloth for a few minutes.
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Active ROM exercises
isotonic exercises in which the client moves each joint in the body through its complete range, maximally stretching all muscle groups within each plane over the joint
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Activity tolerance
the type and amount of exercise or daily activities an individual is able to perform
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Activity-exercise pattern
refers to a person's pattern of exercise, activity, leisure, and recreation
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Aerobic exercise
any activity during which the body takes in more or an equal amount of oxygen than it expends
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Ambulation
the act of walking
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Anabolism
a process in which simple substances are converted by the body cells into more complex substances (e.g., building tissue, positive nitrogen balance)
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Anaerobic exercise
involves activity in which the muscles cannot draw out enough oxygen from the blood stream; used in endurance training
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Ankylosed
permanently immobile joints
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Anorexia
lack of appetite
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Atrophy
wasting away; decrease in size of organ or tissue (e.g., muscle)
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Base of support
the area on which an object rests
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Bed rest
strict confinement to bed (complete bed rest), or the client may be allowed to use a bedside commode or have bathroom privileges
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Catabolism
a process in which complex substances are broken down into simpler substances (e.g., breakdown of tissue)
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Center of gravity
the point at which the mass (weight) of the body is centered
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Contracture
permanent shortening of a muscle and subsequent shortening of tendons and ligaments
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Crepitation
- (1) a dry, crackling sound like that of crumpled cellophane, produced by air in the subcutaneous tissue or by air moving through fluid in the alveoli of the lungs;
- (2) a crackling, grating sound produced by bone rubbing against bone
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Dorsal position
back-lying position without a pillow
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Dorsal recumbent position
a back-lying position with the head and shoulders slightly elevated
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Embolus
a blood clot (or a substance such as air) that has moved from its place of origin and is causing obstruction to circulation elsewhere (plural: emboli)
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Exercise
a type of physical activity; a planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness
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Fowler's position
a bed sitting position with the head of the bed raised to 45 degrees
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Gait
the way a person walks
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High Fowler's position
a bed-sitting position in which the head of the bed is elevated 90 degrees
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Hypertrophy
enlargement of a muscle or organ
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Isokinetic (resistive) exercise
muscle contraction or tension against resistance. Ex weight lifting and body building
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Isometric (static or setting) exercise
tensing of a muscle against an immovable outer resistance, which does not change muscle length or produce joint motion Ex. Kegal, quad sets.
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Isotonic (dynamic) exercise
exercise in which muscle tension is constant and the muscle shortens to produce muscle contraction and active movement. Ex running, walking,
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Lateral position
a side-lying position
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Line of gravity
an imaginary vertical line running through the center of gravity
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Logrolling
a technique used to turn a client whose body must at all times be kept in straight alignment (like a log)
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Lordosis
an exaggerated concavity in the lumbar region of the vertebral column
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Low Fowler's position
a bed-sitting position in which the head of the bed is elevated between 15 and 45 degrees, with or without knee flexion
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Mobility
ability to move about freely, easily, and purposefully in the environment
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Orthopneic position
a sitting position to relieve respiratory difficulty in which the client leans over and is supported by an overbed table across the lap
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Pace
number of steps taken per minute or the distance taken in one step when walking
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Passive ROM exercises
another person moves each of the client's joints through its complete range of movement, maximally stretching all muscle groups within each plane over each joint
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Physical activity
bodily movement produced by skeletal muscles that requires energy expenditure and produces progressive health benefits
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Prone position
face-lying position, with or without a small pillow
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Range of motion (ROM)
the degree of movement possible for each joint
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Sims' position
side-lying position with lowermost arm behind the body and uppermost leg flexed
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Spastic
describing the sudden, prolonged involuntary muscle contractions of clients with damage to the central nervous system
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Thrombus
a solid mass of blood constituents in the circulatory system; a clot (plural: thrombi)
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Tripod (triangle) position
the proper standing position with crutches; crutches are placed about 15 cm (6 in) in front of the feet and out laterally about 15 cm (6 in), creating a wide base of support
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Urinary incontinence
a temporary or permanent inability of the external sphincter muscles to control the flow of urine from the bladder
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Urinary reflux
backward flow of urine
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Urinary retention
the accumulation of urine in the bladder and inability of the bladder to empty itself
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Urinary stasis
stagnation of urinary flow
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Valsalva maneuver
forceful exhalation against a closed glottis, which increases intrathoracic pressure and thus interferes with venous blood return to the heart
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Vital capacity
the maximum amount of air that can be exhaled after a maximum inhalation
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