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BSNC 1000 > Module 6 > Flashcards

Module 6 Flashcards

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1
Q

Scope of mobility

A

full mobility –> impaired mobility –> complete immobility

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2
Q

Systems affecting mobility

A 
Neurological
Musculoskeletal
Cardiovascular
Respiratory
Gastrointestinal
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3
Q

Physiological changes of aging

A

vertebral discs thin –> spinal column compression –
> kyphosis
bone density decreases –> frail, higher risk of fall injury
cartilage becomes rigid –> less protective
rigid ligaments –> reduce range of motion
decreased muscle mass
osteoblasts decrease mitotic activity
parathyroid hormone increases
calcitonin decreases

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4
Q

CV Consequences of immobility

A

reduced cardiac capacity –> reduced cardiac output
orthostatic hypotension
venous stasis –> deep vein thrombosis

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5
Q

Respiratory Consequences of immobility

A

reduced lung expansion –> reduced total lung capacity
atelactasis
pooling of respiratory secretions

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6
Q

Musculoskeletal consequences immobiilty

A 
reduction of muscle mass (atrophy)
contracture of joints and muscles --> stiffening
bone demineralization (weight-bearing exercise important)
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7
Q

Integumentary consequences of immobility

A

skin breakdown –> pressure ulcers over bony prominences

exacerbated by incontinence

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8
Q

GI consequences of immobility

A

reduced intestinal peristalsis

constipation

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9
Q

Urinary consequences of immobility

A 
renal calculi -
urinary stasis 
UTIs
urinary retention
impaired voiding
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10
Q

Determinants of mobility

A

nervous system
musculoskeletal system
adequate perfusion + gas exchange
adequate nutrition

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11
Q

Definition of mobility

A

state or quality of being mobile or movable

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12
Q

Definition of deconditioning

A

loss of physical fitness as a consequence of reduced activity

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13
Q

Function of cerebellum

A

coordination, balance, muscle tone, procioception

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14
Q

Motor cortex

A

located in the frontal lobe

generates nerve impulses –> motor neurons –> effectors (skeletal muscle)

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15
Q

Functional classification of joints

A 
synarthrosis = not movable
amphiarthrosis = slightly movable
diarthrosis = completely movable
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16
Q

Structural classification of joints

A 
fibrous = held together by connective tissue
cartilaginous = held together by cartilage 
synovial = in a fluid filled cavity
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17
Q

Joint

A

where bones join together

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18
Q

Determinants of skeletal muscle function

A

1) motor nerve impulses reaching muscle fibers
2) muscle fiber response to nerve stimulus
3) proprioception
4) mechanical load
5) joint mobility

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19
Q

Mechanical load

A

physical stress on muscles. increase muscle load = increased requisite strength

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20
Q

Procioception

A

sensation of position and movement

required for accuracy in motion

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21
Q

Definition of mobiliity

A

ability to independently and voluntarily move around in one’s environment / state of mobility

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22
Q

Peak Bone Mass

A

maximal amount of bone mass in the body at the end of skeletal maturation
bone growth peaks ~30

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23
Q

Secondary Osteoporosis Factors

A 
endocrine disorders
malabsorption disorders
malignancies
alcoholism
medications
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24
Q

Endocrine disorders

A 
hypothyroidism
hyperthyroidism 
hyperparathyroidism 
Cushing's syndrome
Diabetes mellitus 
Child development
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25
Factors impacting bone growth (adolesence --> early adulthood)
``` nutrition age vitamin d receptor physical activity hormonal status ```
26
Functions of bone remodelling
replace old, worn-out bone maintain bone health strengthen bone in areas of stress mineral homeostasis
27
Non-modifiable risk factors
age gender genetics (body frame size) ethnicity (asian, caucasian)
28
Modifiable risk factors
``` low peak bone mass dietary (calcium, vitamin d intake) sedentary lifestyle hormonal factors medication (glucocorticoids, anticonvulsants) alcohol smoking ```
29
Key Hormones
Parathyroid Hormone Calcitonin Vitamin D Estrogen
30
Parathyroid Hormone Function
produced by the parathyroid glands increase number and activity of osteoclasts --> promote bone resorption --> release calcium/phosphate into blood promote phosphate excretion by kidneys promote calcium retention by kidneys promote activation of vitamin D in kidneys --> promote calcium absorption in GI tract
31
Calcitonin Function
released by the thyroid glands inhibits activity and number of osteoclasts --> decrease bone resorption
32
Vitamin D Function
produced by the integumentary system/diet Vitamin D is converted into calcitriol in the kidneys calcitriol promotes the absorption of calcium in the GI tract
33
Estrogen Function
estrogen inhibits bone resorption estrogen decreases number and activity of osteoclasts increase osteoclast apoptosis
34
Sources of estrogen
estrogen = produced by the ovaries | post-menopause estrogen is provided through the conversion of androgens --> estrogen via aromatase
35
Glucocorticoid function
anti-inflammatory drug contribute to osteoporosis decrease number and activity of osteoblasts decreases osteoclast apoptosis inhibits OPG --> increased RANKL expression on osteoblasts --> increased osteoclast differentiation
36
Factors affecting peak bone mass
Genetics Hormones Nutrition Lifestyle
37
Risk Factors for Older Adults
``` Sarcopenia (reduced muscle mass) Chronic Pain Injury/Trauma Nutritional deficiencies Obesity Chronic Illness ```
38
Renal Calculi
mineral and salt deposits that form in the kidneys
39
Sarcopenia
Reduced skeletal muscle mass, strength and function
40
Consequences of immobility
``` dehydration bronchial pneumonia contractures deep vein thrombosis constipation pressure ulcers incontinence hypothermia Iatrogenic complications Disability Institutionalization Loss of independence Isolation & Depression ```
41
Disorders affecting mobility
``` ostoeporosis gait disorders parkinson's stroke arthritic conditions ```
42
Non-disorders affecting mobility
``` Paresthesia amputations neuromotor disturbances fractures (injury) joint problems illness (fatigue) ```
43
Paresthesia
burning or prickling sensation in the extremities
44
Iatrogenic
illness resulting from medication or treatment
45
Intrinsic Fall Factors
``` age gender (women at higher risk) gait balance/coordination poor vision cognition dizziness/vertigo orthostatic hypotension medication depression dementia incontinence --> rushing to the bathroom ```
46
Extrinsic Fall Factors
``` tripping hazards poor lighting lack of bathroom safety footwear improper use of mobility aids ```
47
Basic Activities of Daily Living Definition
basic self-care tasks that are performed daily. basic functional capacity
48
Instrumental Activities of Daily Living Definition
tasks that enable a person to live independently. more complex than basic ADL's and require adequate cognitive and physical function.
49
BADL examples
``` feeding continence transferring toileting dressing bathing ```
50
IADL examples
``` using the telephone shopping food preparation housekeeping doing laundry using transportation handling medications handling finances ```
51
Signs/Symptoms of Osteoporosis
``` height loss (>2cm - could indicate spine fracture) reduced range in motion fragility fractures ```
52
Anticonvulsants
causes changes in bone and calcium metabolism --> decreased bone mass may contribute to osteoporosis
53
Typical fracture sites for osteoporosis
Hips Wrists Shoulder
54
Fragility Fracture
spontaneous fracture that occurs from non-intense activity (sneezing, coughing, twisting, etc)
55
Paresthesia
burning/prickling sensation in the limbs
56
Normal height loss
1 cm every 10 years after age 60
57
Abnormal height loss
2-3 cm in a short timeframe | could indicate spinal fracture
58
Osteopenia
loss of bone density but not to the point of fragility | -1 to -2.5 on the bone density scale
59
Osteoporosis
condition in which excessive demineralization causes bones to become porous, weak, fragile caused by an imbalance between bone resorption and bone formation less than -2.5 on the bone density scale
60
What part of the bone does osteoporosis impact
Spongy bone Spongy bone is higher in surface area so tends to have more dramatic bone loss May be thinning of the compact bone as well
61
Osteoporosis Exercise Guidelines
strength exercise x2/week posture exercise - daily (5-10 min) balance exercise - daily weight-bearing aerobic physical activity - 150min/week
62
Physiological changes of aging
``` loss of muscle mass loss of bone density loss of articular cartilage rigidity of cartilage joint stiffening loss of elasticity of ligaments compression of IV discs --> kyphosis ```
63
Primary level of prevention
``` regular exercise diet/nutrition weight falls prevention programs environmental safety ```
64
Secondary level of prevention
women over 65 mobility screening osteoporosis screening fall risk assessments
65
Tertiary level of prevention
``` medial intervention surgery exercise therapy medication (anti-inflammatory, anagelsics, vitamin d/calcium supplements) diet exercise physiotherapy, occupational therapy weight loss ```
66
Treatment for immobile patient
``` change bed position every 2 hours head elevation bed exercises range of motion exercises ambulate patient as much as possible treat pain to encourage movement encourage deep breathing/coughing incentive spirometer ```
67
Diagnosis of Osteoporosis
bone density scan (2cm is abnormal)
68
Primary Osteoporosis
forms majority of cases | osteoporosis occurs without an identifiable cause
69
Recommended calcium intake
1000 mg/daily for men and women | 500 mg twice daily
70
Recommended calcium intake for post-menopausal women
1200 mg/daily | 600mg twice daily
71
Recommended Vitamin D Intake
600-800 units/daily

BSNC 1000 (10 decks)

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