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)