PTA 101: Biomechanics and Vitals

T or F: a patient who uses oxygen therapy is allowed to smoke

False: oxygen supports combustion

T or F: if a pt has a fever greater than 100, treatment can continue with no issues

False: treatment is contraindicated

T or F: treatment can continue with either brady or tachycardia

False: treatment is contraindicated

Golfers lift

Light object on floor, one leg to balance, lean over on extended leg

Why does the disc tend to herniate posterior lateral?

the anterior ligament and annular wall is thicker than the posterior

Center of Gravity (COG)

the point at which the mass of a body or object is centered

Friction

the resistance that one surface or object encounters when moving over another.

What is the most common lever system in the body?

third class

What is the purpose of pursed lip breathing?

to help those with respiratory diseases to improve their breathing

Gravity

attraction between earth and an object, always directed downward

When is the best time to monitor vital signs?

before, during, and after

Base of Support (BOS)

part of the body that is in contact with the supporting surface

Name the four "Quality/Volume" parameters

0 Absent 1+ Thready: barely palpable 2+ Weak: poor force 3+ Normal 4+ Bounding: strong force

Describe posterior pelvic tilt

1. ASIS is higher than PSIS 2. decrease in lumbar lordosis 3. lumbar spine flexes

Describe anterior pelvic tilt

1. ASIS is lower than PSIS 2. increase in lumbar lordosis 3. lumbar spine extends

Name the factors that affect respiration

1. Age: young and old have higher respiration rates 2. Exercise 3. Emotional status 4. Air quality 5. Altitude 6. Lung disease

Describe the process of extension on the IVD

1. nucleus moves anterior 2. anterior wall of annulus becomes taught

Describe the process of flexion on the IVD

1. nucleus moves posterior 2. posterior wall of annulus becomes taught (tight) 3. prolonged sitting/slouching puts pressure on posterior wall

What are the functions of the vertebra?

1. protect spinal cord 2. provide motion 3. promote stability

Stop treatment/consult PT if:

1. pulse slowly increases or does not increase during active exercise 2. pulse rate continues to increase/decrease after exercise plateau is reached 3. pulse rate declines before exercise declines 4. rhythm of pulse becomes irregular

Documentation for respiration (RDRS)

1. rate: # of breaths 2. depth: how deep or shallow 3. rhythm: regular or chyne-stokes (gasps) 4. sound: normal, wheezing (whistling), rales/crackling (secretions), stridor (high pitch)

Ways to maintain a healthy back when lifting

1. remain close to object/person 2. widen BOS 3. lower COG (flex with knees, not back) 4. maintain lumbar lordosis during lifting

What is the purpose of the IVD?

1. shock absorber 2. provide stability 3. provide motion 4. transmit motion

Name the 6 most common abnormal respiratory conditions

1. syncope (fainting) 2. lightheadedness 3. confusion 4. skin color changes 5. sweating 6. digital clubbing (drop in O2 in blood)

What percentage weight does standing place on the spine?

100%

Normal HR for an infant?

100-130 bpm

Sitting with good posture places what percentage weight on the spine?

140%

What percentage is standing bent forward?

150%

What percentage is sitting with poor posture?

185%

What is the normal HR for an adult?

60-100 bpm

What pressure does the supine position put on the spine?

25%

What digits do you use to measure pulse rate?

2nd and 3rd

What is the procedure for counting heart beats?

30 minutes x 2 or 1 full minute if pulse irregular

Sidelying places what percentage weight on the spine?

75%

Normal HR for a child (1-7 yrs old)?

80-120 bpm

What are some other situations where you would check vitals?

A change in medical status Abnormal

Lever

A rigid bar that is free to move around a fixed point (bone)

Factors affecting normal HR

Age Gender (males slightly higher) Emotional stress Environmental temp (increases in higher temperatures) Infection (increases) Physical activity (athletes normally have lower resting HR)

Locations of palpable pulses

Carotid, brachial, radial, femoral, popliteal (back of knee), dorsal pedal

Temperature is measured in what?

Degrees

What happens during exhalation?

Diaphragm moves up (relaxes), rib cage lowers, abdomen falls

Describe a first class lever system and what it's designed for

Fulcrum lies between the effort and the resistance e.g. elbow joint, head on axis Designed for: balance

What are some abnormal temperature values?

Hypothermia: 94 degrees Pyrexia: 100 degrees Hyperpyrexia: 106 degrees

What is a force couple?

It occurs when two or more forces act in different directions resulting in a turning effect.

What is temperature?

Measure of heat withing the body

Locations for temperature measurement

Oral: 96.8-99.3 Rectal: 97.8-100.3 Axilla: 1 degree or less Ear Temporal

Normal adult temperature values?

Oral: 96.8-99.3 degrees

Factors that cause changes in vital signs

Physical activity Environment Age Emotional state Physiological state

What is body mechanics?

Positioning the body in ways that prevent injury

Items to document for pulse

Rate Rhythm Quality/Volume

What is pulse?

Rate at which heart is beating, movement of blood through the body

What is tachycardia? Bradycardia?

Tachycardia: rapid heart rate (>24rpm) Bradycardia: slow heart rate (<10rpm)

Types of vitals that we measure:

Temperature Pulse Respiration Blood pressure O2 Saturation

What is respiration?

The process of inhalation and expiration of air between lungs and environment

T or F: if a patient has a slight temperature of less than 100 degrees, pt can be monitored closely with frequent rest breaks

True

T or F: push rather than pull when possible

True

T or F: torque can be increased or decreased by changing the length of the moment arm of the force

True

What is a parallel force and give an example

a force that occurs in the same plan and in same/opposite direction shearing force

Give an example of a compression force

a muscle contraction or weight bearing activities

Equilibrium

a state in which opposing forces or influences are balanced.

What is apnea?

absence of breathing

What are the normal ranges for respiration for an adult, child, and infant?

adult: 12-20 child: 20-30 infant: 30-50rpm

Name the parts of the intervertebral disc (IVD)

annulus fibrosus (outer part) nucleus pulposus (inner layer)

Name the different vertebrae and how many of each?

cervical-7 thoracic-12 lumbar-5 sacral-5 coccyx-5

What are the normal curvatures of the spine?

cervical: lordotic thoracic: kyphotic lumbar: lordotic sacral: kyphotic

What is the procedure for measuring respiration?

count breaths for 30 seconds x 2 or if abnormal for full minute

A smooth or hard surface _________ friction

decreases

What is diaphragmatic breathing?

deep breathing that expands the belly rather than just the chest

What happens during inhalation?

diaphragm contracts (moves down) and rib cage expands, abdomen rises

What is dyspnea?

difficulty breathing

What is orthopnea?

difficulty breathing while lying down

Factors affecting normal temperature

exercise, time of day (increases 4-8), smoking, emotional status, environmental temperature, hydration levels, ingestion, age, infection

What is tachycardia?

fast heart rate (>100 bpm)

What is pyrexia?

fever

What is linear/translatory force and what types are there?

force causing movements in a straight line Types: compression and distraction

What is a rotary or torque force?

force that produces a rotation around an axis

Resistance

force to overcome the motion that is taking place (weight of bodypart)

Distraction forces

forces that push away or separate

Compression forces

forces that push toward each other

Describe a second class lever system and what it's designed for

fulcrum is on one end, axis on the other, resistance is in the middle e.g. ankle PF on toes, wheelbarrow Designed for: power or force

Describe a third class lever system and what it's designed for

fulcrum is on one end, force is in the middle, and resistance is on the other side (wrist, biceps) Designed for: ROM, distance and speed

Describe the deep squat

hips are below knee, UE parallel to each other and elbows straight

Describe the power lift

hips remain above knee level

What is hyperventilation?

increased rate and depth of breathing

A rough or soft surface __________ friction

increases

Shearing force

joint surfaces that move parallel to each other (gliding)

Name the 5 L's of lifting

load, lever, lordosis, legs, lungs

Describe the traditional lift

low COG and wide BOS, person grasps object with elbows bent

What is a disc protrusion?

nucleus bulges against an intact annulus

What is an extruded disc?

nucleus extends through annulus but remains contained by posterior longitudinal ligament

What is a sequestrated disc?

nucleus runs free within canal

What is heart rate (HR)?

number of heart beats per minute

What is bradycardia?

slow heart rate (less than 60 bpm)

Force

what causes the joint to move (muscles)

When can muscles produce the most rotary force and mechanical advantage to produce motion?

when muscle fibers are at 90* or midrange

Give an example of a distraction force

when traction is applied to a joint

Axis

where movement happens (joint)