Physical Therapy History PDF

Polio Outbreak in 1916 Alversado & Lapada Inc. - In this period, young women began treating polio patients with residual...

Polio Outbreak in 1916 Alversado & Lapada Inc. - In this period, young women began treating polio patients with residual paralysis by using passive movements. History and Scope of Physical Therapy - PTs developed MMT for assessing the strength of the muscle and thereby History of PT implementing muscle re-education techniques for weaker muscles. 460 B.C. - In the US, the polio epidemic continued - Physicians like Hippocrates and later to ravage to such an extent that it had Galen are believed to be the first afflicted the future president of the US, practitioners of physical therapy, Franklin D. Roosevelt. advocating massage, manual therapy techniques, and hydrotherapy to teach First World war people - In 1917, the US entered the war and the need to rehabilitate soldiers was 1800-1900’s recognized by the army. - Earliest documented origins of actual - This led to the formation of a special unit physical therapy as a professional group of the army medical dept. They also date back to Per Henrick Ling, “Father of developed 15 reconstruction aide’, Swedish Gymnastics”. Founded the Royal training in 1917 to meet the demand of Central Institute of Gymnastics (RCIG) in medical workers who were specially 1813 for manipulation , and exercise. trained in rehabilitation. - In 1887, PTs were given official registration by Sweden’s National Board RECONSTRUCTION AIDE of Health and Welfare. - In 1894, four nurses in Great Britain formed the Chartered Society of Physiotherapy. - The school of physiotherapy at the University of Otago in New Zealand in 1913, and the United States’ 1914 Reed College in Portland, Oregon , which graduated “reconstruction aides’ - In 1851, the term Physiotherapy first appeared in its German form “Physiotherapie” in an article written by Dr. Lorenz Gleich, a military physician from Bavaria. Post World War 1 - With time the word “Physiotherapie” - In the 1920s, a partnership grew between changed to “Physiotherapy” and then to PTs and the medical and surgical “Physical Therapy”. community, which boosted public recognition and validation.  - In the 1930s the polio epidemic was still continuing and in the year 1937 the Post Korean (1950’s) and Vietnam War (50’s-70’s) National Foundation of Infantile Paralysis - The huge army population with was established, which gave major neuro-musculoskeletal problems was support to the growth of Physical managed by very few orthopedic Therapy as a profession. surgeons. - The performance record and the scope of Second World War (1939-1945) practice required in Korea and Vietnam - Physical Therapy continued to show its led to the identification of PT’s as a dominance by treating the individuals “Physician Extenders”, who were who sustained injuries during the war. credentialed to evaluate and treat - In the first half of 1940s with World War neuro-musculoskeletal patients without II at its peak, the world required the physician referral. attention of PTs for wounded soldiers who returned home with amputations, 1960’s - 1970’s burns, cold injuries, wounds, fractures, - The decade 1967-1976 saw the expansion nerve and spinal cord injuries. of the profession into the management of - Investigation on application of electrical orthopedics and cardiopulmonary stimulation gave a new direction to the disorders. With the advent of open heart Physical Therapy treatment. surgery, Physical Therapy began to be - They had realized it’s not just to retard practiced in preoperative and and prevent atrophy but to restore postoperative units. The care of muscle mass and strength. The “Galvanic individuals with severe joint restrictions Exercise” was given by the PTs on the altered with the increasing practice of atrophied hands of the patients who had joint replacements. an ulnar nerve lesion from surgery upon a wound. Modern Physical Therapy - In the 21st century, the profession has Post World War 2 continued to grow substantially. Patients - The need for PTs declined and the are able to refer themselves to a PT training of new PTs was suspended. The without being told to refer themselves by PTs already on active duty were included a health professional, in the newly established Women’s - New generation PTs consider movement Medical Specialist Corps (WMSC) in 1947. as an essential element of health and Male therapists were accepted into the well-being, which is dependent upon the corps in 1955 and the name of the corps integrated, coordinated function of the was changed to the Army Medical human body at a number of levels. Specialist Corps (AMSC). - PNF and Bobath Concept introduced in practice for the treatment of children What is PT? with CP and adults with neurologic conditions. - Physical Therapy also known as Physiotherapy, is one of the allied health  professions that, by using mechanical Outpatient Clinics or offices force and movements (bio-mechanics or Inpatient rehabilitation facilities kinesiology), manual therapy, exercise Skilled nursing, extended care, or therapy, and electrotherapy, remediates subacute facilities impairments and promotes mobility and Homes function. Education or research centers - Physical Therapy is used to improve a Schools patient’s quality of life through Hospices examination, diagnosis, prognosis, Industrial, workplace, or other physical intervention, and patient occupational environments education. Fitness center and sports training facilities Role of Physical Therapists - Physical Therapists are healthcare professionals who diagnose and treat ❖ World PT Day Sept 8 individuals of all ages, from newborns to ❖ PPTA (Philippine Physical the very oldest, who have medical Therapy Association) problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Proper Body Mechanics - PTs examine each individual and develop Body Mechanics a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. - Can be described as the use of one’s body - PTs work with individuals to prevent the to produce motion that is safe, energy loss of mobility before it occurs by conserving, anatomically and developing fitness and wellness-oriented physiologically efficient, and maintains programs for healthier and more active body balance and control. lifestyles. - Thus proper use of body mechanics will - PTs provide care for people in a variety of better protect from injury. Stress and settings including hospitals, private Strain to many anatomical structures and practices, outpatient clinics, home health body systems are reduced when proper agencies, schools, sports and fitness body mechanics and good posture are facilities, work settings, and nursing used so that work and patient activities homes. can be managed with greater safety. - Patients should be taught to breathe Who are Physical Therapists? normally when performing physical - PTs are highly-educated, licensed health activity and avoid the potential adverse care professionals who can help patients effects of the Valsalva reduce pain and improve or restore phenomenon/maneuver. mobility. - This phenomenon can occur when the patient holds his or her breath and air is Where do Physical Therapists Practice?  trapped in the thorax which increases - Before you attempt to lift, pull, reach for, intrathoracic pressure. or carry an object, the following two - Valsalva phenomenon/maneuver > actions are required to use proper body Decreased return of venous blood to mechanics: heart > decreased cardiac output > 1. Position yourself so your center of Increase peripheral blood pressure > gravity (COG) and the objects COG rupture of cerebral vessel or are as close as possible. cerebrovascular accident > DEATH 2. Increase your Base Of Support - This Phenomenon is most likely to occur (BOS). when the patient is performing heavy lifting, pushing, or pulling but can occur Center of Gravity (COG) anytime during active or resistive - An object’s COG is located where the exercise. mass of an object is located; it is the heaviest area to move or the most difficult to adjust to a new position. - The COG of a standing person is located Value of Proper Body Mechanics approximately at the level of the second It conserves energy sacral segment in the center of the pelvis. It reduces stress and strain on muscles, joints, ligaments, and soft tissue Base of Support (BOS) It promotes effective, efficient and safe - Stability is vital before attempting to lift, movements reach, push, pull, or carry any object. It promotes and maintains proper body - You can achieve stability by: control and balance 1. Tightening your core stabilizers. It promotes effective, efficient 2. Increase your BOS respiratory and cardiopulmonary 3. Lowering your COG function 4. Maintaining your Vertical Gravity Line (VGL) within your BOS 5. Positioning your feet according to Principles and Concepts of PBM the direction of movement you will use to perform the activity. - Gravity and friction are forces that add resistance to many activities associated Vertical Gravity Line (VGL) with lifting, reaching, pushing, pulling, - The VGL is an imaginary line that bisects and carrying an object. your body in the sagittal plane beginning - Therefore it is important to select and at your head continuing to your pelvis apply techniques that will, in some and through your COG. It indicates the situations, reduce the adverse effects of vertical positioning of your COG. The VG gravity or friction and, in other must be within your BOS (i.e., in between situations, enhance the positive effects of your feet) for balance and stability. these two forces to reduce expenditure of energy, avoid undue stress or pain on Principles of PBM body systems, and maintain control of Mentally and Physically plan the activity the body. before attempting it.  Position yourself close to the object to be or overuse of the same muscles, even moved so you can use short lever arms when light objects are involved. Maintain your VGL within your BOS to maintain stability and balance Common causes of Back Problems/Discomfort Position your COG cose to the object's Faulty posture COG to improve control of the object. Stressful living work habits, such as being Tighten your “core” muscles before unable to relax or staying in a posture for beginning the lift: use the major muscles a prolonged period of the extremities and trunk to perform Faulty, improper use of body mechanics movements or activities and maintain Repetitive, sustained microtrauma to your lumbar lordosis. structures of the back and trunk Roll, Push, pull, or slide an object rather Poor flexibility of muscles and ligaments than lift it. of the back and trunk Avoid simultaneous trunk flexion and A decline in general physical fitness rotation when lifting and reaching. Use of improper techniques to lift, push, Look straight ahead and do not twist your pull, reach, or carry body while lifting. Episodes of trauma that culminate in one Take your time and lift the item with a specific or final event (“the final straw”); smooth motion; avoid jerking stress, strain, or tearing of a muscle or movements. ligament; change in the shape of a disk Perform all activities within your physical that then impinges on nerve root; capability. irritation of vertebral joints. Do not lift an object immediately after a prolonged period of sitting, lying or - The lumbar spine should be maintained inactivity; gently stretch the back and in its normal or “neutral” position of lower extremities first. lordosis when lifting is performed. When performing a lift with two or more - This position tends to reduce stress on people, instruct everyone how and when the major structures of the lumbar area, they are to assist; use a mechanical lift or and when combined with the partial or other appropriate equipment if it is full flexion of the hips and knees, will available. reduce the tendency to bend forward at the waist during the lift. Rationale for Lumbar Lordosis Posture LIfting Principles and Techniques Lordosis reduces the mechanical stress to the lumbar ligaments and the - Injury resulting from lifting may be intervertebral disk. caused by the single act of lifting a heavy When the back is in the lordosis posture, object, by lifting improperly, or by compression forces on the intervertebral repetitive lifting. disk are directed anteriorly rather than - Most upper and lower back injuries are posteriorly, a direction that reduces the caused by cumulative episodes of potential for a posterolateral rupture of microtrauma caused by repetitive lifting the disk.  Lumbar Spine stability is increased as a - The lifter's trunk is maintained in a more result of the approximation of vertebral vertical than horizontal position, and the facets. lumbar spine remains in lordosis with an The function of the lumbopelvic force anterior pelvic tilt couple is maximized. The anterior and posterior lower trunk muscles are positioned to function more effectively. Lift Techniques Deep Squat LIft - A deep squat is performed to position the hips below the level of the knees. - The lifter's feet straddle the object, with Straight Leg Lift the upper extremities parallel to each - In a straight leg lift, the lifter's knees are other. only slightly flexed or may be fully - The lifter grasps the opposite sides, the extended. handles, or the underside of the object. - The lower extremities are either parallel - The lifter's trunk is maintained in a to each other or straddle the object, and vertical position, and the lumbar spine the upper extremities are either parallel remains in lordosis with an anterior to each other or grasp the opposite sides pelvic tilt (inclination) of the object. - The trunk may be positioned either vertically or horizontally, and the lumbar spine remains in lordosis Power Lift - In a power lift, only a half squat is performed so the hips remain above the level of the knees. One-Leg Stance Lift (“Golfer’s Lift”) - The lifter's feet are parallel to each other - The one-leg stance lift can be used for and remain behind the object, with the light objects that can be lifted easily with upper extremities parallel to each other. one upper extremity. - The lifter grasps the opposite sides, the - The lifter faces the object, with the body handles, or under the bottom of the weight shifted onto the forward lower object. extremity.  - To pick up the object, the weight-bearing anteroposterior on each side of the lower extremity is partially flexed at the object and the lower extremities in a hip and knee while the deep squat. non-weight-bearing lower extremity is - The person grasps the underside of the extended to counterbalance the forward object with the upper extremities parallel movement of the trunk. or anteroposterior to each other. - The lifter picks up the object in manner - The lift is begun by the flexor muscles of similar to the way a goffer removes a golf the upper extremities to partially lift the ball from the cup and returns to an object, and then the lower extremities upright position are used to raise the body with the object to an upright position as the hips and knees extend. - The object should be held close to the body, and the lumbar spine should maintain its normal lordosis throughout the lift Half-kneeling Lift - The half-kneeling lift is useful for persons of small stature, those with limited upper extremity strength, and for persons whose initial unilateral lower extremity strength and overall balance while rising to standing are exceptional. - Caution: Persons with a knee condition Stoop Lift that would be exacerbated by kneeling - When an object rests below the level of should avoid this lift, and rotating or the waist but can be reached without twisting the trunk to position the object squatting, the lifter can stoop to lift. on the thigh should be avoided. - The person partially flexes the hips and knees and maintains the lumbar spine in its normal lordosis. - The lifter grasps the object and uses the lower extremities to raise the body and the object. - To improve stability and balance, the feet are positioned at shoulder width and slightly anteroposterior to each other. - When the object can be lifted by one Traditional Lift upper extremity (e.g., a suitcase, - To perform a traditional lift, the lifter briefcase, tool carrier, pail, or a shopping faces the object with the feet bag with handles), the other upper  extremity can be used for support or balance. This lift requires less energy expenditure than a lift that uses a deep or full squat. Reaching Activities - Reaching for an object above your shoulder or head will be less strenuous if the object is lowered or if you raise your position by standing on a wide-based footstool or ladder. These actions approximate the COG of the object and your COG, allow the use of shortened extremity lever arms, and decrease strain to back structures. Carrying Activities - When carrying an object, hold it close to your body; the best positions are in Pushing, Pulling, Reaching, and Carrying front of your body at the level of your - Many of the same principles described waist or on your back. for lifting also apply to pushing and - If you carry an object in one hand (e.g., a pulling activities. suitcase or a briefcase), alternate - Use a crouched or semi-squat position to carrying it in one hand and then the push or pull. This position lowers your other; do not twist your back when COG nearer to the object's COG, which moving the object from one hand to the increases stability, reduces energy other; stoop to lift it from the floor. expenditure, and improves control of the - Balance the load whenever possible. object. Some bulky or heavy objects can be - The force of the push or pull should be carried on your shoulders, especially if applied parallel to the surface over which you must carry them for a substantial the object is to be moved and in the line distance. of the movement desired. - Avoid carrying or balancing a small child on one hip; use an infant carrier, or hold Pushing and Pulling activities the child close to your chest or on your - Flex your knees and face the object back with use of an approved child squarely. carrier. - Use your arms and legs to push or pull; - When a backpack is used, apply both push with your arms partially flexed. shoulder straps. - Push or pull in a straight line; your force should be parallel to the floor. - Be certain there are no objects in your path and doorways are wide enough for the object to pass through.  covered to maintain modesty and Positioning and Draping warmth. Positioning - Avoid unnecessary exposure of sensitive areas (breasts, genitalia) - Do not use patient's clothes as drape - Considered before, during and after - Assure the patient that his or her treatment modesty will be maintained - When patient is to be at rest for extended - Avoid folds and wrinkles in the linen periods beneath patient - Teach other caregivers and family - Linen used to protect the axilla, members techniques and importance of perineum, or gluteal cleft must be positioning discarded as soon as it is removed from - Patient comfort is a consideration, but PT the patient. must be aware that a position of comfort - Never reapply used linen could lead to complications. - Instruct patients how to initially drape - Change position every 2 hours to prevent the body. A gown should be provided if contractures, and relieve pressure on the removal of clothing is required (give skin, subcutaneous tissue, and the specific instructions) circulatory, neural, respiratory, and - Treatment table should be prepared with lymphatic systems, as well as other linen and pillows before the patient is structures positioned. - Greatest pressure is put on area of bony prominences - Caregiver should use caution for patients who have decreased sensation, immobile, Bony Prominences that can cause pressure confused, and is unable to communicate injuries discomfort - Trunk, head, and extremities should be Supine Position supported and stabilized in proper - Occipital protuberance, alignment. - Spine of scapula, inferior angle of scapula - Distal part of the extremity should be - Vertebral spinous process higher than the heart - posterior iliac crest - The patient should be positioned to - Sacrum enable the caregiver to administer - Medial epicondyle of humerus, treatment effectively, efficiently, and - Olecranon process safely. Therefore caregivers should - Posterior calcaneus determine how the patient's position may - Greater trochanter affect his or her body mechanics and the - head of fibula application of the treatment program - lateral malleolus before initiating treatment. Principles and Concepts - Use clean and unused linen and only expose areas or body parts to be treated. with the remainder of the patient's body  Sitting Position Prone Position - Ischial tuberosities - Forehead, Lateral ear, Tip of acromion - Scapular and vertebral spinous processes process, Sternum, (if leaning against back of chair); sacrum - Anterosuperior iliac spine if the patient is slouched - Anterior head of humerus - Medial epicondyle of humerus, Olecranon - Clavicle process (if resting on a hard surface) - Patella, - Greater trochanter, Popliteal fossa, - Ridge of tibia Posterior calcaneus if resting against a - Dorsum of foot hard surface Side-lying Position (Lowermost Extremity) - Lateral ear, Lateral ribs, Lateral acromion process - Lateral head of humerus, Medial or ❖ For chair bound patients, cushions can lateral epicondyle of humerus be used for adequate support and - Greater trochanter of femur, Medial and comfort. lateral condyles of femur ❖ Patients who can position themselves - Malleolus of fibula and tibia Fifth should be instructed to do so at 10 to 15 metatarsal minute intervals. ❖ Patients with good upper body strength should be taught wheel-chair Side-lying Position (Uppermost Extremity) push-ups, leaning side to side is - Medial epicondyle of humerus (if resting another option if patient is unable to on a hard surface) perform push-ups - Medial condyle of femur - Malleolus of tibia  4. If the patient is wearing street clothes, Importance of Proper Positioning indicate the specific articles of clothing - It prevents soft-tissue injury, pressure, to be removed or request permission to and joint contracture. remove them if assistance is necessary. - It provides patient comfort. 5. Provide temporary clothing or linen to - It provides support and stability for the protect modesty and provide warmth. trunk and extremities. 6. Ensure that sufficient linens, pillows, and - It provides access and exposure to areas equipment needed for the treatment are to be treated. available in the cubicle or treatment area. - It promotes efficient function of patient's 7. Provide safe and secure storage for the body systems. patient's personal items - It relieves excessive, prolonged pressure 8. Specifically describe how you want the on soft tissue, bony prominences, and patient to apply linen items, a gown, a circulatory and neurologic structures. robe, or exercise clothing to cover (drape) the body; provide privacy while the patient is disrobing and dressing. Draping 9. Instruct the patient to inform you when he or she is positioned and draped, or Importance of Draping confirm that the patient is clothed or - It provides modesty for the patient. draped before you enter the cubicle. - It helps the patient maintain an 10. At the end of treatment, take the appropriate body temperature. following steps: - It provides access and exposure to areas Instruct the patient to remove to be treated while protecting other draping items and temporary areas. clothing and put on his or her own - It protects the patient's skin or clothing clothing; provide assistance if from being soiled or damaged. required or provide privacy while the patient is dressing. Provide linen so the patient can Summary of General Guidelines remove perspiration, massage lotion, electrotherapy gels, water, or other substances. 1. Introduce yourself by providing your Return personal items to the name and title. Confirm patient's identity patient. and current, relevant information Dispose of used linen in the (diagnosis, complaints, previous proper container. treatment, patient's physician). Prepare the cubicle or treatment 2. Inform the patient of the planned area for future use or assign the treatment, apply the principles of task to another person. informed consent, and obtain consent for treatment 3. Specifically describe how the patient is to be positioned and provide assistance if required.  upper or middle chest or positioned lengthwise from the pelvis to the thorax Body Positioning to maintain lordosis.) - A rolled towel should be placed under Positioning in the Supine Position each anterior shoulder area to adduct the - Small pillow or cervical roll under scapula, reduce the stress to the patient's head interscapular muscles, and protect the - Small pillows, rolled towels or small head of the humerus. bolster can be placed in the popliteal - Pillow, towel roll, or small bolster under spaces. (to relieve excessive lumbar the patient's ankle (relieve stress on the lordosis) hamstrings, feet, and allow the pelvis and - Small pillow under the patient's ankle to lower back to relax) relieve pressure on the calcaneus (knee hyperextension should be avoided) - The patient's upper extremities may be elevated on pillows or positioned in whatever way the patient desires for comfort (such as by the patient's side, in a reverse T position, or folded on the chest). Positioning in the Side-Lying Position - Position the patient in the center of the bed, mat, or table with head, trunk, and pelvis aligned. Both of the patient's LE's (Lower Extremities) should be flexed at the hip and knee. The uppermost LE is supported on 1 or 2 pillows and positioned slightly forward. Positioning in the Prone Position - Small towel roll placed proximal to the - Small pillow or towel roll under the lowermost lateral malleolus. patient's head or position the head left or - 1 or 2 pillows to support the patient's right head. - Some patients in the prone position may - Folded pillow placed at the patient's chest be more comfortable if they rest their to support the uppermost extremity and forehead on a folded towel or a special prevent the patient from rolling forward headrest. - To protect the lowermost greater - A treatment table that has a cutout trochanter, a rolled towel or pillow may portion for the face and supports the be placed proximal to the trochanter, and head provides the most comfortable if necessary, a pillow may be used under positioning. (maintains neck in neutral or the thigh below the greater trochanter. slightly flexed position) - Pillow under the patient's lower abdomen (reduce lumbar lordosis) - (For some patients, maintenance of the normal lumbar lordosis may be desired, and a pillow may be placed under the Positioning in the Sitting Position Prone - The patient should be seated in a chair - Ankle plantar flexors with adequate support and stability for - Shoulder extensors, adductors, and the trunk, which can be provided by internal/external rotators pillows, belts, straps, or the back of the - Neck rotators, left or right chair, or by leaning forward onto a treatment table. Lying on the Side - The patient's lower extremities should be - Hip and knee flexors supported with the feet on a footstool, on - Hip adductors and internal rotators the footrests of a wheelchair, or on the - Shoulder adductors and internal rotators floor. The distal, posterior thigh tissue and deeper structures should be free of Sitting excessive pressure from the edge of the - Hip and knee flexors chair or the wheelchair seat. - Hip adductors and internal rotators - Shoulder adductors, extensors, and internal rotators Common Soft-tissue Contracture sites Related to Prolonged Positioning Supine - Hip and knee flexors - Ankle plantar flexors - Shoulder extensors, adductors, and internal rotators - Hip external rotators  Respiration: 20-30 breaths per minute Blood pressure: Systolic 78-114 mm Hg, PT- TOPIC 4 VITAL SIGNS: Diastolic 46-78 mm Hg 10 Years Old: Vital Signs Temperature: 97.5-98.6°F (36.3-37°C) Indicators of the body’s physiological Pulse: 70-110 beats per minute status & response to physical activity, Respiration: 16-22 breaths per minute environmental conditions and emotional stressors. Blood pressure: Systolic 90-132 mm Hg, Indicators of general health or Diastolic 56-86 mm Hg physiologic status 16 Years Old: Temperature: 97.6-98.8°F (36.4-37.1°C) Vital signs: Pulse: 55-100 beats per minute BODY TEMPERATURE (°C, °F) Respiration: 15-20 breaths per minute HEART RATE (BPM) Blood pressure: Systolic 104-108 mm BLOOD PRESSURE (mm Hg) Hg, Diastolic 60-92 mm Hg RESPIRATION RATE (cycles per minute) Adult: PAIN Temperature: 96.8-99.5°F (36-37.5°C) Pulse: 60-100 beats per minute Normal Vital Signs by Age Respiration: 12-20 breaths per minute Newborn: Blood pressure: Systolic less than 120 mm Hg, Diastolic less than 80 mm Hg Temperature: 98.6-99.8°F (37-37.7°C) Older Adult: Pulse: 120-160 beats per minute Temperature: 96.5-97.5°F (35.9-36.3°C) Respiration: 30-80 breaths per minute Pulse: 60-100 beats per minute Blood pressure: Systolic 50-52 mm Hg, Diastolic 25-30 mm Hg, Mean 35-40 mm Respiration: 15-25 breaths per minute Hg Blood pressure: Systolic less than 120 mm Hg, Diastolic less than 80 mm Hg BODY TEMPERATURE 3 Years Old: Represents the balance between the heat produced & the amount lost Temperature: 98.5-99.5°F (36.9-37.5°C) Pulse: 80-125 beats per minute  Primary Effector Systems: o Vascular: Blood vessels help regulate heat loss through vasodilation (widening-mainit) or THERMOREGULATORY SYSTEM vasoconstriction (narrowing-malamig). Monitors & acts to maintain temperatures that are optimal and vital o Metabolic: The body's for organ function. metabolism can be adjusted to produce more or less heat. o Skeletal Muscle (Shivering): THERMOREGULATORY SYSTEM: Involuntary muscle contractions THERMORECEPTORS can generate heat. THE REGULATING CENTER o Sweating: Evaporation of sweat from the skin can cool the body. THE EFFECTOR ORGANS (Note: this is just additional information just remember the name of these 4) THERMORECEPTORS Provides input to the hypothalamus CUTIS ANSERINA OR PILOERECTION: The regulating center is dependent on the information from the Response to Cooling: When the thermoreceptors to achieve constant hypothalamus detects a decrease in temperature body temperature, it triggers a response (Pag umabot na yung info kay known as cutis anserina or piloerection. hypothalamus I -cocompare niya yun Gooseflesh: This mechanism is sa “set point“ standard) commonly described as "gooseflesh" due to the appearance of raised bumps on the skin. REGULATING CENTER Hair Erection: The term "piloerection" literally means "hairs standing on end." Located in the hypothalamus Controls the process of heat loss & Function: While less significant in production humans, this mechanism functions to Influences the effector organs trap a layer of insulating air near the skin, helping to reduce heat loss. This is particularly important in lower mammals Effector Organs and Temperature with thicker hair coverings. Regulation: Response to Temperature Changes: POSTERIOR THALAMUS Effector organs play a crucial role in responding to both increases and Where the primary motor center for decreases in body temperature. shivering is located  RADIATION Remittent: Body temperature remains Transfer of heat through above normal but fluctuates more than electromagnetic waves from one object 3.6°F (2°C) within a 24-hour period. to another. Relapsing (or Recurrent): Periods of fever alternate with periods of normal temperatures, each lasting at least one CONDUCTION day. Constant: Body temperature remains Transfer of heat through a liquid, solid, consistently elevated above normal, or gas although it may fluctuate slightly. FACTORS AFFECTING BODY CONVECTION TEMPERATURE Transfer of heat through movement of Time of Day: air or liquid Morning: Generally lower Afternoon: Generally higher PYREXIA Age: Elevation of normal body temperature Older Adults: Tend to have lower body commonly called a fever (HIGHER temperatures THAN 38 DEGREES CELSIUS) Environment: Hot: Increases body temperature HYPERPYREXIA & HYPERTHERMIA Cold: Increases body temperature (as Unusual high fever basta lagpas the body tries to conserve heat) (41.1°C) Infection: Illness: Often associated with increased PYROGENS body temperature Fever-producing substances Physical Activity: Secreted by toxic bacteria Increased Activity: Raises body temperature Conditioning: Body temperature PHASES OF FEVER: plateaus with regular physical activity Emotional Status: PRODROMAL PHASE – Before fever Stress/Anger: Can elevate body ONSET – May fever kana temperature Site of Measurement: COURSE – Peak of fever Rectal: Generally higher than oral TERMINATION – Okay na temperature Oral: Generally lower than rectal temperature Menstrual Cycle: Ovulation and Pregnancy: Body temperature may be slightly higher TYPES OF FEVER Oral Cavity Temperature: Hot Beverages/Smoking: Can affect Intermittent: Body temperature fluctuates between fever and normal oral temperature accuracy for 14-30 temperatures at regular intervals. minutes  dioxide between the lungs and the environment. Internal respiration: This involves the exchange of oxygen and carbon dioxide between the circulating blood and body tissues. PULSE Indirect measure of the contraction of the left ventricle of the heart Movement of blood in an artery 3 PARAMETERS OF PULSE RATE – Number of pulsations (Bradycardia slow HR, Tachycardia Fast HR, PALPITATION Rapid & irregular HR) RHYTHM – Pattern of pulsations (Arrhythmia/dysrhythmia irregular rhythm) QUALITY – Amount of force NUMERICAL SCALE TO GRADE PULSE INSPIRATION (INHALATION) ABSENT - Wala Inspiration is the process of taking air into THREADY – barely perceptible the lungs. It's initiated by the contraction of two key muscle groups: WEAK – difficult to palpate 1. Diaphragm: This dome-shaped muscle NORMAL - normal is located below the lungs. When it BOUNDING – malakas contracts, it flattens downward, creating more space in the chest cavity. 2. Intercostal Muscles: These muscles RESPIRATION are found between the ribs. When they The primary function of respiration is to contract, they lift the ribs upward and supply the body with oxygen for metabolic outward, further expanding the chest activity and to remove carbon dioxide. cavity. There are two main types of respiration: This expansion of the chest cavity creates a lower pressure within the lungs compared to External respiration: This involves the exchange of oxygen and carbon the outside air. This pressure difference causes CHEMORECEPTORS: air to flow into the lungs, filling them up. Central Chemoreceptors: A normal inspiration typically lasts between o Located in the respiratory 1 and 1.5 seconds. center. o Sensitive to changes in carbon dioxide (CO2) and hydrogen ion (H+) levels in the arterial blood. o Increased CO2 or H+ levels EXPIRATION (EXHALATION) stimulate breathing. Expiration is the process of breathing out, Peripheral Chemoreceptors: or expelling air from the lungs. Unlike inspiration, which is an active process, relaxed o Located at the bifurcation of expiration is largely passive. This means it the carotid arteries (carotid doesn't require a lot of muscular effort. bodies) and in the arch of the aorta (aortic bodies). Here's how it works: o Sensitive to changes in oxygen 1. Muscle Relaxation: Once the partial pressure (PaO2) in the respiratory muscles (like the diaphragm arterial blood. and intercostal muscles) that were involved in inspiration relax, the chest o Decreased PaO2 stimulates cavity starts to shrink. breathing. 2. Lung Recoil: The lungs themselves These chemoreceptors, along with other have elastic properties, meaning they factors like lung stretch receptors and voluntary naturally want to return to their original control, work together to regulate respiration, size after being stretched during ensuring that the body receives adequate inspiration. oxygen and eliminates carbon dioxide effectively. 3. Air Expulsion: As the chest cavity gets smaller, the pressure inside the lungs increases, forcing air out of the body. HERING-BREUER REFLEX A normal expiration typically lasts between Respiration also is influenced by a 2 and 3 seconds. protective stretch mechanism called the Hering-Breuer reflex. Pulmonary stretch receptors throughout the walls of the REGULATORY MECHANISMS OF lungs detect the amount of stretch RESPIRATION imposed by entering air. Respiratory Center: When overstretched, these receptors send impulses to the respiratory center Located bilaterally in the pons and to inhibit further inspiration and increase medulla oblongata (parts of the the duration of expiration brainstem). Controls the rate and depth of breathing.  o Aortic sinuses: Monitor BP throughout the body BLOOD PRESSURE It has 3 primary elements: Key Points of Respiration Assessment Cardiac output Peripheral resistance Rate: Viscocity Number of breaths per minute BLOOD PRESSURE REGULATION Rhythm: Vasomotor center Regularity of the breathing pattern assists in providing the stable arterial pressure required to maintain blood flow to body tissue and organs. Depth: occurs because of its close connection to the cardiac controlling center in the Amount of air exchanged with each medulla (because changes in cardiac breath output will influence BP). In addition, the vasomotor and cardiac controlling centers require input from afferent Character: receptors BARORECEPTORS Deviations from normal, resting, or Stimulus: Stretch of vessel walls quiet respiration High concentrations: In the internal carotid artery (ICA) Function: Monitor blood pressure (BP) Breathing Patterns: o Carotid sinuses: Monitor BP to the brain  A person may be an upper chest Rectal, temporal lobe, or ear canal (thoracic) or abdominal breather. For Unconscious Patients: During respiratory distress, a person may exhibit both breathing patterns. Rectal or ear canal Least Desirable: Axillary and inguinal Key Points of Body Temperature Yun lang guys goodluck sa prelims! Assessment Sites for Temperature Measurement: Oral cavity Rectum Axilla (armpit) Ear canal Forehead or temporal lobe Inguinal fold (rarely used) Most Common and Convenient: Oral Most Accurate: Rectal For Infants and Young Children: