BODY MECHANICS

Body mechanics
the efficient use of the body as a machine and as a means of locomotion concepts most helpful to the understanding of body mechanics:
body alignment, balance, coordinated body movement, and joint mobility

Body Alignment
the geometric arrangement of body parts in relation to each other; synonymous with good posture benefits of good body alignment:
optimal musculoskeletal balance and operation healthy physiologic functioning without undue strain on the joints, muscles, tendons, or ligaments in any position, e.g.:
standing sitting lying

application of correct body alignment when standing

the head is held erect the face is in the forward position, in the same direction as the feet the chest is held upward and forward the spinal column is upright, and the curves of the spine are within normal limits the abdominal muscles are held upward and the buttocks downward

application of correct body alignment when standing

the knees are extended - not bent or hyperextended in the knee-locked position the feet are at right angles to the lower legs the line of gravity goes through the center of the knees and in front of the ankle joint the base of support is on the soles of the feet, and weight is distributed through the soles and heels

application of correct body alignment when sitting

the head is held erect, and the neck and vertebral column are in straight alignment the body weight is distributed on the buttocks and thighs both feet are supported on the floor; with short patients, a footstool is used a 2.5 cm - 5 cm (1 - 2 in) space is maintained between the edge of the seat and popliteal space on the posterior surface of the knee the forearms are supported on the arm rests, in the lap, or on a table in front of the chair

balance
the state of equilibrium in which opposing forces counteract each other concepts most helpful to understanding balance:
base of support, center of gravity, and line of gravity

Balance
base of support
the foundation on which an object rests

center of gravity
the point at which all of the mass of an object is centered located in the center of the pelvis about midway between the umbilicus and symphysis pubis

line of gravity
an imaginary vertical line drawn through an object's center of gravity and base of support

Balance
good balance is accomplished by:
a wide base of support
to widen the base of support, spread the feet further apart

a low center of gravity

to lower the center of gravity, flex the hips and knees until a squatting position is achieved

a line of gravity through the center of gravity and base of support

Balance
conversely, poor balance is accomplished by:
a narrow base of support a high center of gravity a line of gravity which falls near the edge of or outside of the base of support or is constantly changing

coordinated body movement

the production of balanced, smooth, and purposeful movement
coordinated body movements are accomplished through the following:
use of major muscle groups rather than weaker ones, e.g.:
flexors, extensors, and abductors of the thighs flexors and extensors of the knees flexors and extensors of the upper and lower arms

coordinated body movement

use of the arm bones as levers and the elbows as fulcrums to facilitate lifting a weight against resistance (force of gravity) use of a pull sheet and smooth, dry, firm bed foundation to decrease the effect of friction which increases the amount of effort required to move an object working close to the object to be moved to decrease the effort involved

coordinated body movements

coordinated body movements are also accomplished through the integrative function of antagonistic, synergistic, and antigravity muscle groups
antagonistic muscle groups
muscle group that brings about movement at a joint by contraction of a prime mover and relaxation of its antagonist, e.g.:
to flex the arm, the prime mover (biceps brachii) contracts while its antagonist (triceps brachii) relaxes to extend the arm, the new prime mover (triceps brachii) contracts while its new antagonist (biceps brachii) relaxes

coordinated body movements

synergistic muscle groups
muscle group that brings about movement at a joint by strengthening the contraction of the prime mover, e.g.:

to flex the arm, the contraction of the prime mover (biceps brachii) is strengthened by contraction of its synergist (brachialis)

coordinated body movements

antigravity muscle groups
bring about and maintain an upright or sitting posture by contracting and/or relaxing to oppose the effect of gravity on the body e.g., extensors of the leg, gluteus maximus, quadriceps femoris, muscles of the back

postural reflexes
coordinated body movements are also accomplished through the integrative functioning of postural reflexes, e.g.:
labyrinthine sense
assists in producing coordinated body movement by alerting an individual to movement of the head in relation to gravity through stimulation of receptors in the semicircular canals in the inner ear

postural reflexes
visual or optic reflex
assists in producing coordinated body movement by alerting the brain of the spatial relationships within the environment (e.g., nearness of ceilings, walls, furniture, condition of floor) through stimulation of receptors in the visual special sense

postural reflexes
proprioceptive or kinesthetic sense
assists in producing coordinated body movements by alerting the brain of the location of a limb or body part in space through stimulation of proprioceptive receptors in muscles, tendons, and fascia

postural reflexes
extensor or stretch reflex
assists in producing coordinated body movement by alerting the brain of the need to stimulate extensor muscles to reestablish an erect posture through stimulation of receptors in antigravity muscle groups

postural reflexes
plantar reflex
assists in producing coordinated body movement by alerting the brain of the need to stimulate extensor muscles of the lower legs though the stimulation of receptors in the soles of the feet

joint mobility
the complete extent of movement of which a joint (area when bone surfaces come into close contact with another or articulate) is normally capable

types of joints
synarthroidal immovable joints examples:
skull sutures, epiphyseal plates, joint between first rib and manubrium of sternum

types of joints

amphiarthroidal
slightly movable joints examples:
vertebral joints, joint of the symphysis pubis

types of joints
diarthroidial
freely movable joints
consistent features of diarthroidial joints
ability to move freely a fibrous joint capsule a joint cavity a synovial membrane that lines the inner surface of the joint capsule lubricating synovial fluid secreted by the synovial membrane articular cartilage that covers the bony surfaces

types of diarthroidial joints ball-and-socket

ball-shaped head fits into concave socket of another bone examples:
hip joint between the femur and pelvis

types of diarthroidial joints

condyloid
oval-shaped condyle (protuberance at the end of a bone) fits into elliptical (oval, eggshaped) cavity of another bone
examples:
wrist joint between the radius and carpals

types of diarthroidial joints

gliding
articular surfaces; usually flat
examples:
finger joints between carpal bones

types of diarthroidial joints hinge

spool-like surface fits into concave surface of another bone
examples:
elbow joint between the humerus and ulna and radius

types of diarthroidial joints pivot

arch-shaped structure rotates about rounded, or peg-like, pivot
example:
joint between the atlas and axis

types of diarthroidial joints

saddle
saddle-shaped bone fits into a socket that is convex on one side and concave on the other
example: thumb joint between the trapezium and metacarpal

types of diarthroidal joint movements

flexion
decreasing the angle of the joint
e.g., bending the elbow

extension
increasing the angle of the joint
e.g., straightening the elbow

types of diarthroidal joint movements

hyperextension
further extension or straightening of the joint
e.g., bending the head backward

abduction
movement of the bone away from the midline of the body
e.g., moving the leg out to the side

types of diarthroidal joint movements

adduction
movement of bone toward the midline of the body
e.g., moving the leg back to the other leg

rotation
movement of the bone around its central axis
e.g., turning the head

types of diarthroidal joint movements

circumduction
movement of the distal part of the bone in a circle while the proximal end stays fixed
e.g., moving each leg up, to the side, and down in a circle

eversion
turning the sole of the foot outward by moving the ankle joint

 circumduction
movement of the distal part of the bone in a circle while the proximal end stays fixed
e.g., moving each leg up, to the side, and down in a circle

eversion
turning the sole of the foot outward by moving the ankle joint

 supination
moving the bones of the forearm so that the palm of the hand faces upward when held in front of the body

protraction
moving a part of the body forward in the same plane parallel to the ground
e.g., jutting chin out

 retraction
moving a part of the body backward in the same plane parallel to the ground
e.g., tucking chin in

principles of body mechanics

the wider the base of support, the greater the stability of the nurse the lower the center of gravity, the greater the stability of the nurse the equilibrium of an object is maintained as long as the line of gravity passes through its base of support the stronger the muscle group, the greater amount of work that can be safely done by it

 facing the direction of movement prevents abnormal twisting of the spine dividing balanced activity between arms and legs reduces the risk of back injury leverage, rolling, turning, or pivoting requires less work than lifting

when friction is reduced between the object to be moved and surface on which it is moved, less force is required to move it reducing the force of work reduces the risk of injury maintaining good body mechanics reduces fatigue of the muscle groups alternating periods of rest and activity helps to reduce fatigue

application of the principles of body mechanics

develop a habit of erect posture (correct alignment) use the longest and the strongest muscles of the arms and the legs to help provide the power needed in strenuous activities use the internal girdle and a long midriff to stabilize the pelvis and to protect the abdominal viscera when stooping, reaching, lifting, or pulling work as closely at possible to an object that is to be lifted or moved use the weight of the body as a force for pulling or pushing

 slide, roll, push, or pull an object rather than lift it to reduce the energy needed to lift the weight against gravity use the weight of the body to push an object by falling or rocking forward and to pull an object by falling or rocking backward spread the feet apart to provide a wider base of support when increased stability of the body is necessary flex the knees, put on the internal girdle, and come down close to an object that is to be lifted