PT Week 3 Study Guide PDF

3.1 Body mechanics a coordinated effort of the musculoskeletal and nervous system to maintain balance, posture and body alignment during lifting, moving, positioning and performing activities of daily living -it also refers to the way in which the clinicians body is positioned or aligned during task...

3.1 Body mechanics a coordinated effort of the musculoskeletal and nervous system to maintain balance, posture and body alignment during lifting, moving, positioning and performing activities of daily living -it also refers to the way in which the clinicians body is positioned or aligned during tasks. -healthcare workers have a higher incidence of injury than workers in construction, mining and manufacturing Value of Proper Body Mechanics 1. Conservation of energy 2. Stress and strain -body expends while lifting, pushing and pulling, proper body mechanics also help reduce stress and strain on muscles, joints, ligaments, and soft tissue structures of the body 3. promote effective and efficient movements 4. effective respiratory and cardiopulmonary function -result in a lowered risk of injury for the clinician Good posture, strength, and flexibility important factors in preventing back and neck problems Core stability essential for the maintenance of an upright posture, and especially for movements that require extra effort Chronic joint and muscle strains often caused by prolonged tension raised by muscles and joint because of poor posture Conditioning leads to strength index necessary to perform physical tasks without strain and is a predisposition injury. *sustained posture, even in good alignment, can cause fatigue* TESTING • to test posture, each patient stands lateral to a plumb line -the ideal alignment requires that the line rests as follows, slightly anterior to the lateral malleolus, slightly anterior to the midline through the knee, through the greater trochanter. Midway through the trunk to the bodies of the lumbar vertebrae, through the shoulder joint, & through the bodies of the cervical vertebrae and to the lobe of the ear *LOL SIS WHAT* Plumb line imaginary line that represents the alignment of body in an upward position -if the person is stand upright the center of gravity is located at about the navel -an objects center of gravity is located where the mass of an object is located -it is the heaviest area to move, or the most difficult to adjust to a new position -the base of support is every contact a person makes with the supporting surface 3.2 Therapist Lifting Mechanisms Minimal Lifting policies • mechanical lifting equipment or team approach should be used • about 25 lbs Types of Lifts 5 L’s of Lifting • Load: plan ahead & estimate load and clearing path • Lever: dist b/w COG and object, keep object close • Lordosis: proper posture • Legs: use larger muscles to protect • Lungs: exhale when lifting (avoid valsalva) Push vs Pull push better than pull bc can use legs Lifting stoop down/squat any object below hips BOS wide for more stability, move object close to you and pivot to turn • half kneel lift: rest object on knees if needed, eyes forward, use both legs • reaching: stand on footstool or ladder, keep object close befor lowering etc • carrying: close to body, in front of body at waist, bulkier can be on shoulders 3.3 Patient Positioning Patient positioning very important for safety and protection of patient’s skin - support and stability to the patient’s trunk and extremities is extremely important -prevents development of pressure injuries, which are commonly referred to as pressure sores -can decrease edema and increase function of a body area -helpful with comfort for decreased pain 2 hours -position that is most important for patient may not always be the most comfortable for them Pressure -can start to cause damage within hours if the patient’s skin isn’t relieved of the pressure through a position Patients in hospital -if patient gets a pressure sore while in the care of the hospital, the hospital can be penalized for a negative outcome Positioning Devices aid with protecting skin from injury including, pillows, blankets, heel protectors, splints, slings, braces, seat cushions and wedges Standard positioning for pt’s in short term health care setting supine, prone, side-lying, semi-Fowler, and sitting Supine Prone w UE in T-Position Using supports in UE Semi Fowler 3.3 Patient Positioning Positioning • support & stability to pt trunk & extremities • prevent development of pressure injury to skin • prevent joint contractures • to have easier access to area being treated • decrease edema • increased fu keep in mind w/ positioning skin injury • elderly • ppl who can’t change own position • decreased sensation • can’t communicate discomfort • pressure caused by weight of body structure on skin • shearing: pt stationary while underlying tissue shift/move • friction: when skin rubs over rough stationary surface position devices • pillows • blanket • heel protectors • splints, sling, & braces • seat cushion • wedges standard positions • supine • prone: extremities in “T” • side-lying • semi-fowler: head 30 degrees, pillows under popliteal space, used for grooming, improved sitting • 3.4 Draping reasons for draping • privacy/modesty/cultural safety • warmth • hygiene draping considerations • if pt need to change leave & knock • if pt needs help ask for permission first • know policy on doors • EXPLAIN TX PRIOR TO PT SESSION & obtain consent beginning • professional demeanor General procedures 1. Before • plan ahead • cover tx area • specific instructions • privacy Side-lying Position 3.5 Bed Mobility Bed Mobility body must have enough endurance and the muscles must be strong enough to stabilize body parts and move portions of the body against gravity -can challenge the cardiac and pulmonary systems, particularly in patients, who have been immobile for long periods -ultimate goal is for patients to have maximum functional independence to achieve their desired life goals for mobility Rolling going from supine to on your side, side to supine, ex: side to pro Scooting in bed referred to as scooting up and down the bed if you’re laying supine Supine to sitting patient goes from laying on their back to sitting upright at the edge of the bed Scooting Sideway when seated edge of bed unsupported setting -in which there is no backrest or anything behind the patient are having to use their body in order to maneuver themselves towards the head of the bed or foot of the bed 3.6 Systems Review Systems Review: brief/limited exam of an atomic & physiologic status of CV, Pulm, integ, MSK, neuro msk, GI, urinary system • beyond primary problem that brought client to PT • overview of whole person • guides PT in choosing appropriate test & measures or referral to another provider HELPS DETERMINE IF CLIENT APPROPRIATE FOR PT BC OF QUESTIONS THEY ASK Cardiovascular & Pulmonary vitals quick review: normal range for HR,BP,Temp, RR circulation visual inspection for cyanosis, edema • Integumentary system skin color • ex: bruising, rash nail • ex: cyanosis (bluish or gray/white) skin temp • ex: local vs generalized musculoskeletal system • symmetry in UE & LE gross ROM • symmetry in gross strength • height & weight neuromuscular screen • observation of general gross motor coordination during transfers, balance during transitions/ walking • observable tics or abnormal movement patterns