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Nursing Exam 1 Review Sheet Part 2

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Nursing Exam 1 Part 2 Review Sheet Normal functions of the musculoskeletal  Alignment and posture o Achieved when the joints and muscles are not experiencing extremes in extension or flexion or unusual stress  Balance o Maintaining balance is a complex function of counteracting gravity and coordinating reflexes to maintain posture.  Coordinated movement o The cerebellum, cerebral cortex, and basal ganglia are responsible for the control of motor functions  Subjective: Normal Pattern o Normal activity pattern; recent changes. exercises ; type of employment; leisure activities should be included o Activity level pattern and motivation to change should be noted o Rating scales may be useful for documenting level of independence for tasks requiring mobility Impact of immobility: physiologic  Muscle atrophy & weakness o Reduction in muscle size (atrophy) results from the alterations in metabolism that occur during immortality; the body breaks down muscle mass to obtain energy (catabolic meta)  Contractures & joint pain o In active, mobile person, movement promotes the formation of new connective tissue deposited around joints & muscles; tissue is loose & pliable  During immobility, stretching of muscles & movement of joints cease → results in deposition of denser, less pliable fibrotic tissue & renders joints more fixed & unable to move normally o Impaired blood flow to the muscle or joint hastens the formation of contractures  Flexion contractures are the most common in immobilized patients  Patients may assume positions of flexion naturally because these positions require less muscle stress & tension to maintain  Flexor muscles are usually stronger than their extensor counterparts  Foot drop → contracture in which the foot is fixed in plantar flexion o Increased cardiac workload → heart must work harder when the body is supine than when it is erect  Pooling of blood in legs usually does not occur in supine position  With less gravitational pull, blood can be redistributed from the legs to the trunk

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