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Ch. 7 The Skeleton
Hoehn - Marieb Human Anatomy & Physiology, 12th edition
Hoehn, Haynes, Abbott12th EditionMarieb Human Anatomy & PhysiologyISBN: 9780138242732Not the one you use?Change textbook
All textbooksHoehn, Haynes, Abbott 12th EditionCh. 7 The SkeletonProblem 19
Chapter 7, Problem 19

Mrs. Shea came up with what she considered to be a clever idea to bypass the long lines at Disney World. She had her husband rent a wheelchair and he wheeled her around from one exhibit to another for the better part of three days. As they sat on the plane, waiting to take off for Chicago, she complained to him that she had two sore spots on her buttocks. Why? What do you suppose would happen (to her buttocks) if she was wheeled around for a few more days?

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Step 1: Understand the physiological concept involved — prolonged pressure on skin and underlying tissues can lead to reduced blood flow, causing ischemia and potentially leading to pressure ulcers (also known as bedsores or decubitus ulcers).
Step 2: Recognize that when Mrs. Shea was wheeled around for long periods without changing position, constant pressure was applied to specific areas of her buttocks, compressing blood vessels and reducing oxygen and nutrient delivery to those tissues.
Step 3: Consider that if this pressure continues for several more days without relief or repositioning, the affected skin and tissue may begin to break down, leading to the formation of pressure sores.
Step 4: Recall that pressure ulcers typically develop over bony prominences where soft tissue is compressed between bone and an external surface, such as the ischial tuberosities in the buttocks when sitting.
Step 5: Conclude that without proper pressure relief, skin care, and movement, Mrs. Shea’s sore spots could worsen, potentially resulting in painful ulcers that may require medical treatment.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Pressure Ulcers (Bedsores)

Pressure ulcers are injuries to the skin and underlying tissue caused by prolonged pressure on the skin. When a person remains seated or lying in one position for extended periods, blood flow is restricted, leading to tissue damage and sore spots, commonly on bony areas like the buttocks.
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Tissue Ischemia and Necrosis

Tissue ischemia occurs when blood supply to an area is reduced or cut off, depriving cells of oxygen and nutrients. Prolonged ischemia can cause cell death (necrosis), which manifests as painful sores or ulcers, especially in areas under constant pressure without relief.
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Importance of Movement and Pressure Relief

Regular movement and repositioning are essential to prevent pressure ulcers by restoring blood flow to compressed areas. Without frequent shifts in position, continuous pressure damages skin and tissues, worsening sores and potentially leading to serious infections or complications.
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Related Practice
Textbook Question

Mr. Wright had polio as a boy and was partially paralyzed in one lower limb for over a year. Although no longer paralyzed, he now has a severe lateral curvature of the lumbar spine. Explain what has happened and identify his condition.

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Textbook Question

List at least two specific anatomical characteristics each for typical cervical, thoracic, and lumbar vertebrae that would allow anyone to identify each type correctly.

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