Clinical Patho 2
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Clinical Patho 2
Clinical pathology 2
What are the causes of immobility?
Injury, disease process, neurological, surgery, physician ordered, self-inflicted
What regulates/restricts movement?
What are the risks associated with bladder infection?
•Use of catheters
What are the 3 general phases of healing?
: Inflammatory response
: Repair response
What are the classifications of muscle strains, and what defines them?
Mild /first-degree - Tear of a few minor fibers, minor swelling, local tenderness
Moderate/2nd degree - Greater damage to the muscle & clear loss of strength
Severe/3rd degree - Tear extending across the whole muscle belly
What is tendinitis?
Inflammation of the tendon
Pain and loss of function
: rotator cuff, tennis elbow, patella tendon, IT Band, Shin Splints, Achilles, etc.
What is tendinosis?
Chronic alteration of the tendon accompanied by tissue degeneration, cell atrophy, and pain
What is paratenonitis?
Used to describe inflammatory disorder of tissues surrounding the tendon
How are ligament injuries classified? What are their characteristics?
•Grade I – stretching but no fiber damage
Normal ROM, little/no swelling, localized tenderness
Early return to training with protection/supervision
•Grade II – stretching and some tearing
Significant structural weakening, bruising, swelling
Tendency to recur, need protection/modified immobilization
•Grade III – complete ligament disruption
Loss of structural integrity, marked abnormal motion
Needs prolonged protection, surgery, permanent functional instability
Describe the 3 types of articular cartilage injury?
Type I Microscopic damage to chondrocytes and extracellular membrane (ECM)
: partial thickness
Microscopic disruption of articular cartilage
POOR prognosis because inflammatory response is not provoked
: full thickness - Disruption of articular cartilage with penetration into subchondral bone
What factors impact immobility?
Extent and duration of immobilization
Age of individual
What are the pathological influences on immobility?
Impaired muscle development
What are the musculoskeletal effects of immobility?
Decreased mechanical & structural properties of ligaments
Loss of muscular endurance
Decreased elastacity and extensibility
What are the cardiovascular effects of immobility?
thrombus vs. embolus
potentially decreased cardiac output
What are the respiratory effects of immobility?
decreased metabolic rate
decreased movement of the rib cage
decreased ability to expand chest wall and lung tissue
What are the GI effects of immobilization?
Decreased peristalsis and segmentation
decreased dietary intake
what are the urinary effects of immobilization?
urinary retention & stasis
Poor ability (supine) to completely empty bladder
increased protein dumping in urine
At risk for bladder infection (catheters, hygiene, body temp)
At risk for kidney stones
What are the metabolic effects of immobility?
decreased metabolic rate
increased body temp if infection is present
loss of electrolytes
-fever: through persperation
-w/o fever: lost in interstitial space
What are the psychological effects of immobility?
decreased sensory experience
altered sense of body image
loss of indepence
physiological assessment of immobility includes what?
: anthropometric measurements, wound healing,
: ventilatory status, breath sounds
: BP, pulse, peripheral circulation, signs of DVT
: ROM; muscle strength, tone, and mass (disuse atrophy)
: color, integrity, turgur
Elimination: bowel/bladder habits
What is included in the psychosocial assessment?
Reaction to immobility
Depression, loss of indepence
How are the hazards of immobility prevented?
~ Nutritional needs
: protein, calories, vitamins (B and C)
~ Promotion of chest and lung expansion
~ Removal of secretions
~ Maintenance of patent airway
~ Isometric exercise
~ Turning every 1 to 2 hours
: preventive aids
: footboards, trochanter rolls, hand rolls, and splints
~ Trapeze bar
~ Bed position
: Fowler’s, supine, prone, side-lying
How is health promotion implemented following immobility?
•Exercise (which results in)
1.Improves cardiac output
2.Decreasing resting heart rate
3.Increasing respiration rate and depth
4.Decreasing work of breathing
5.Increase basal metabolic rate
6.Increase use of glucose and fatty acids
7.Increase gastric motility
8.Improved muscle tone
9.Increased joint mobility
10.Reduce bone loss
12.Reports of decrease in illness
13.Reports of “feeling better”
What is included in restorative care after immobility?
Instrumental activities of daily living
Physical and occupational therapy
: canes, walkers, crutches, etc