Download The Muscular System

The Muscular
System
Chapter 4
Objectives
• Describe the functions and structures
of the muscular system including
muscle fibers, fascia, tendons and the
three types of muscle
• Recognize, define, spell and pronounce
the terms related to muscle movements
and explain how the muscles are named
• Recognize, define, pronounce, and spell
the terms related to the pathology and
the diagnostic and tx procedures of the
muscular system
Word Parts
•
•
•
•
•
•
•
Bi-cele
DysFasci/o
Fibr/o
-ia
-ic
• Kines/o
kinesi/o
• My/o
• -plegia
• -rrhexis
• Tax/o
• Ten/o,
tend/o,
tendin/o
• Ton/o
• Tri-
Fxns of the Muscular System
• mm hold the body erect and make
movement possible
• m movement generates nearly 85% of
the heat that keeps the body warm
• mm move food through the digestive
system
• m movement, such as walking, aids the
flow of blood through veins as it
returns to the heart
• m axn moves fluids through the ducts
and tubes associated c other body
systems
Structures of the Muscular
System
• Our bodies have more than
600 mm
• Our mm make up about 4045% of our body weight
• Skeletal m is made up of
fibers, covered c fascia, and
are attached to bones by
tendons
Structures of the Muscular
System
• Muscle Fibers
– Long, slender cells that make up mm
– Held together by connective tissue
and is enclosed in a fibrous sheath
• Fascia
– The sheet of fibrous connective tissue
that covers, supports and separates
mm or groups of mm
– Flexible but not elastic
• Myofascial – pertaining to m tissue and
fascia
Structures of the Muscular
System
• Tendons
– Narrow band of
non-elastic, dense,
fibrous
connective tissue
that attaches a m
to a bone
• Achilles Tendon
attaches the
gastrocnemius to
the heel bone
Types of Muscle Tissue
• 3 types:
Skeletal,
Smooth and
Myocardial
–Described
according to
description
and function
Types of Muscle Tissue
• Skeletal Muscles
– Attach to the bones of the skeleton
and make body motions possible
– Voluntary muscles
• We have conscious control over them
– Striated muscles
• Under a microscope there are light
and dark bands that create a striped
appearance
Types of Muscle Tissue
• Smooth Muscles
– located in the walls of internal organs
• Digestive tract, blood vessels, and ducts
– Fxn: move and control the flow of
fluids though these structures
– Involuntary muscles
• Under the control of the ANS
– Unstriated
– Visceral
• Found in Lg int organs
Types of Muscle Tissue
• Myocardial Muscle
–Myocardium or Cardiac Muscle
–Forms the muscular walls of the
heart
–Striated like skeletal muscle, but
involuntary like smooth muscle
–It’s contraction and relaxation
causes our heartbeat!
Review from
yesterday!!!!
Muscle Contraction and
Relaxation
• Muscle Innervation
– The stimulation of a muscle by an
impulse transmitted by a motor nerve
• Neuromuscular – pertaining to the
relationship between nerve and muscle
• Antagonist Muscle Pairs
– Antagonist – working in opposition to
each other
• Contraction – tightening of a m
• Relaxation – when a m returns to it
original form
Contrasting Muscle Motion
• Abduction and Adduction (ABD &
ADD)
– AB-Duction – mvmt of a limb AWAY FROM
the midline
– AD-Duction – mvmt of a limb TOWARD the
midline
• Flexion and Extension ( & /)
– Flexion – decreasing the angle between two
bones by bending a limb at the joint
– Extension – increasing the angle between
two bones or the straightening of a limb
• Hyperextension – extreme or overextension of a
limb/body part beyond normal limits
• Elevation and Depression
– Elevation – the act of raising or
lifting a body part
– Depression – the act of lowering a
body part
• Rotation and Circumduction
– Rotation – circular mvmt around an
axis such as the shoulder joint/neck
– Circumduction – the circular mvmt
of a limb at the far end (the
swinging motion @ the distal end of
the arm)
• Supination and Pronation
– Supination – the act of rotating the
arm or leg so that the palm/sole is
turned forward or upward
– Pronation – the act of rotating the
arm or leg so that the palm/sole is
turned downward or backward
• Dorsiflexion and Plantar Flexion
– Dorsiflexion - D √ - the mvmt that
bends the foot upward at the ankle
– Plantar Flexion – P √ – the mvmt that
bends the foot downward at the
ankle
• Muscles are named for their origin
and insertion
– The 2 points where the muscle attaches
– Origin
• The less moveable attachment where the
muscle BEGINS
• Located nearest the midline
– Insertion
• The more moveable attachment where the
muscle ENDS attaching to bone or tendon
O
I
O
I
O
I
• Muscles named for their
Action
–Named if they’re flexors or
extensors
–Flexor digiti minimi, extensor
carpi and flexor carpi muscles
• Muscles names for their location
– Named for the part of the body or
organ they’re near
– Pectoralis major – the thick fan-shaped
muscle on the front of the chest;
pectoral means chest
– Lateralis (lateral) and Medialis
(medial)
– External or Oblique, and Internal
• Muscles named for Fiber
Direction
– Oblique – slanted or at an angle
– Rectus – straight alignment with
the vertical axis of the body
– Sphincter – a ring like muscle that
tightly constricts the opening of a
passage
– Transverse – crosswise direction
• Muscles named for
Number of Divisions
–Biceps brachii – biceps;
formed from 2 divisions
–Triceps brachii – triceps;
formed from 3 divisions
• Muscles named for their Size
or Shape
–Gluteus Maximus – the larges
muscle of the buttock
–Deltoid Muscle – the shoulder
muscle; shaped like an inverted
triangle of the Greek letter
delta Δ
• Muscles named for Strange
Reasons
–The hamstring group… named
because that’s the muscles a by
which a slaughtered pig is
hanged by a butcher
• Biceps Femoris, Semitendonosis,
and Semimembranosis
Medical Specialties Related to
the Muscular System
• Exercise Physiologist
– works under a physician to develop,
implement and coordinate exercise programs
• Neurologist
– Specialized in muscular disorders where
there is loss of fxn
• Physiatrist
– Physician who specializes in physical
medicine and rehab
Medical Specialties Related to
the Muscular System
• Rheumatologist
– Physician who specializes in the dx and
tx of arthritis, and disorders like
osteoporosis, fibromyalgia and
tendonitis
• Sports Medicine Physician
– Specializes in the tx of sports-related
injuries of the bone, joints, and mm
Pathology of the Muscular
System
• Fibers, Fascia and Tendons
– Fasciitis – inflammation of the fascia
– Fibromyalgia Syndrome – chronic
condition characterized by fatigue,
diffuse or specific m, jt or bone p!
– Tenodynia – p! in the tendon
– Tendinitis – inflammation of a tendon
– Chronic Fatigue Syndrome
• Chronic, debilitating condition. Not like
fibromyalgia because it does not go away c
rest
Pathology of the Muscular
System
• Muscle Disorders
– Adhesions – a band of fibrous tissue
that holds structures together
abnormally
– Atrophy – weakness or wearing away
of body tissues and structures
– Myalgia – tenderness or p! in the m
– Myocele – the herniation of m
substance thought a tear in the fascia
surrounding it
Pathology of the Muscular
System
• Muscle Disorders
– Myolysis – degeneration of m tissue
– Myomalacia – abnormal softening of m
tissue
– Myorrhexis – rupture or tear of a m
– Polymyositis – m disease characterized
by simultaneous inflammation and
weakness of voluntary mm
– Sarcopenia – loss of m mass, strength,
and pxn that comes c age
Pathology of the Muscular
System
• Muscle Disorders
–Muscle Tone
• Known as tonus; the state of balanced
m tension
• Atonic – lacking normal m tone or
strength
• Dystonia – abnormal m tone that
causes the impairment of voluntary
m movement
Pathology of the Muscular
System
• Muscle Disorders
–Muscle Tone
• Hypertonia – excessive tone of the
skeletal mm
• Hypotonia – diminished tone of the
skeletal mm
• Myotonia – a meuromuscular
disorder characterized by the slow
relaxation of the mm after voluntary
contraction
How Muscles are Named
• Muscles are named for
–Origin and insertion
–Their Action
–Their location
–Fiber Direction
–Number of Divisions
–Their Size or Shape
–Strange Reasons
PATHOLOGY!!!!!!!
Pathology of the Muscular
System
• Fibers, Fascia and Tendons
– Fasciitis – inflammation of the fascia
– Fibromyalgia Syndrome – chronic
condition characterized by fatigue,
diffuse or specific m, jt or bone p!
– Tenodynia – p! in the tendon
– Tendinitis – inflammation of a tendon
– Chronic Fatigue Syndrome
• Chronic, debilitating condition. Not like
fibromyalgia because it does not go away c
rest
Pathology of the Muscular
System
• Muscle Disorders
– Adhesions – a band of fibrous tissue
that holds structures together
abnormally
– Atrophy – weakness or wearing away
of body tissues and structures
– Myalgia – tenderness or p! in the m
– Myocele – the herniation of m
substance thought a tear in the fascia
surrounding it
Pathology of the Muscular
System
• Muscle Disorders
– Myolysis – degeneration of m tissue
– Myomalacia – abnormal softening of m
tissue
– Myorrhexis – rupture or tear of a m
– Polymyositis – m disease characterized
by simultaneous inflammation and
weakness of voluntary mm
– Sarcopenia – loss of m mass, strength,
and pxn that comes c age
Pathology of the Muscular
System
• Muscle Disorders
–Muscle Tone
• Known as tonus; the state of balanced
m tension
• Atonic – lacking normal m tone or
strength
• Dystonia – abnormal m tone that
causes the impairment of voluntary
m movement
Pathology of the Muscular
System
• Muscle Disorders
–Muscle Tone
• Hypertonia – excessive tone of the
skeletal mm
• Hypotonia – diminished tone of the
skeletal mm
• Myotonia – a meuromuscular
disorder characterized by the slow
relaxation of the mm after voluntary
contraction
Muscle Disorders
• Voluntary Muscle Movement
– Ataxia
• The inability to coordinate m activity
during voluntary movement
– Dystaxia
• Partial ataxia
• A mild form of ataxia
– Contracture
• The permanent tightening of structures
occurring when normal connective tissue
is replaced w non-elastic fibrous tissues
Muscle
Disorders
• Voluntary Muscle Movement
– Intermittent Claudication
• P! in the leg mm during exercise; goes away
c rest
– Spasm
• Sudden, violent, involuntary contraction
of one or more mm
– Cramp
• Localized m cramp named for its cause
(heat cramp, writer’s cramp, etc)
– Spasmotic Torticollis
• Wryneck
• A spasmotic contracture of the neck
Muscle Disorders
• Muscle Function
– Bradykinesia
• Extreme slowness in movement
– Dyskinesia
• Distortion or impairment of voluntary
movement such as a tic or spasm
– Hyperkinesia
• Hyperactivity
• Abnormally increased m fxn or activity
– Hypokinesia
• Abnormally decreased m fxn or activity
Muscle Disorders
• Myoclonus
– The sudden, involuntary jerking of a m
or group of mm
– Nocturnal Myoclonus
• Thee jerking of limbs that can occur
normally as a person is falling asleep
– Singultus
• Hiccups
• Myoclonus of the diaphragm that causes
the characteristic hiccup sound c each
spasm
Muscular Disorders
• Myasthenia Gravis
–Chronic autoimmune
disease that affects the
neuromuscular junction
and produces serious
weakness of voluntary mm
Still Pathology…
Muscle Disorders
• Muscular Dystrophy
– A group of more than 30 genetic
diseases that cause progressive
weakness and degeneration of skeletal
muscle
– Duchenne Muscular Dystrophy – most
common; usually in boys 3-5 y/o; by 12
most can’t walk and need a respirator
– Becker Muscular Dystrophy – similar,
but less sever than Duchenne.
Repetitive Stress Disorders
• Caused by repeated motions
performed in the course of normal
work, ADLs, or sports
• Compartment Syndrome
– Compression of nerves and blood
vessels in a specific compartment
created by the fascia that separates
groups of mm
• Overuse Injuries
– Minor injuries that have not been given
sufficient time to heal
Repetitive Stress Disorders
• Overuse Tendonitis
–Inflammation of tendons caused by
excessive or unusual use of a joint
• Stress Fractures
–We studied these in Ch 3.
–Overuse; pounding, jumping,
crushing stress
Repetitive Stress Disorders
• Myofascial P! Syndrome
– Chronic p! disorder caused by the
development of trigger points
• Rotator Cuff Injuries
– Impingement Syndrome
• Occurs when inflamed tendons are caught in the
narrow spaces between the bone in the shoulder
– Rotator Cuff Tendonitis
• Inflammation of the tendons in the shoulder
– Ruptured Rotator Cuff
• Untreated tendonitis weakens tendons and they
can tear
Repetitive Stress Disorders
• Carpal Tunnel Syndrome
– Occurs when the tendons that pass
through the carpal tunnel are overused
and become inflamed and swollen
– Creates pressure on the median nerve
– Causes p!, burning and parasthesia in
the thumb, index and middle fingers
– Release
• Surgical fix where the tunnel is enlarged
Repetitive Stress Disorders
• Ganglion Cyst
– A harmless fluid filled swelling that
occurs most commonly on the outer
surface of the wrist
• Epicondylitis
– Inflammation of the tissues
surrounding the elbow
– Lateral
• Tennis Elbow
– Medial
• Golfer’s or Little Leaguer’s Elbow
Repetitive Stress Disorders
• Ankle and Feet Problems
–Heel Spurs
• A calcium deposit in the
plantar fascia near its
attachment to the calcaneus
–Plantar Fasciitis
• Inflammation of the plantar
fascia on the sole of the foot
Sports Injuries
• Sprain
– LIGAMENT injury
• Strain
– MUSCULAR injury
• Shin Splint
– Condition caused by the m pulling away from
the tibia (shin bone)
• Hamstring injury
– Any injury, strain or tear, to the mm of the
hamstring group
• Achilles Tendonitis
– Inflammation of the Achilles Tendon
Spinal Cord Injuries
• The spinal cord is the consistency of
toothpaste, basically, so protection is
extremely necessary
• The type or paralysis is determined by
the level of the vertebra closest to the
injury
– The higher up, the great the area of the body
that may be affected
• When the spinal cord is injured,
communication with the brain and the
area below the injury may be gone or
diminished
Spinal Cord Injuries
• Incomplete Injury
– The person will have some function
below the level or injury, even though
that function will not be normal
• Complete Injury
– There is complete loss of sensation and
m control below the level of the injury.
– Doesn’t mean to give up hope!
Spinal Cord Injuries
• Types of Paralysis
– Paralysis – the loss of sensation and
voluntary m movements in m through
disease or injury to its nerve supply
– Myoparesis – weakness or slight
muscular paralysis
– Hemiparesis – slight paralysis or
weakness affecting one side of the body
– Hemiplegia – total paralysis affecting
only one side of the body
• (L brain = R side of the body and vice versa)
Spinal Cord Injuries
• Paraplegia – paralysis of both
legs and the lower body
• Quadriplegia – paralysis of all
four extremities
• Cardioplegia –Cardiac Arrest;
paralysis of the heart m
–Caused by direct blow or trauma,
or medically induced
Diagnostic
Procedures of
the Muscular
System
• Deep Tendon Reflexes (DTR) - tested by
striking a reflex hammer on a tendon
• Range of Motion testing (ROM) –
procedure used to evaluate joint mobility
and muscle strength
• Electromyography – a test that measures
the electrical activity within m fibers in
response to nerve stimulation
• Electroneuromyography – nerve
conduction tests; testing and recording
neuromuscular activity by electric
stimulation of the nerve trunk that
carries fibers to and from the m
Treatment
Procedures
of the
Muscular System
• Medication
– Antispasmotic
• Anticholinergic; suppresses smooth m
contractions of the stomach, intestine or
bladder
– Skeletal m relaxant
• Administered to relax certain mm and to
relieve the stiffness, p! and discomfort
caused by strains, sprains, or other m
injuries
– Neuromuscular blocker
• A drug that causes temporary paralysis by
blocking the transmission of nerve stimuli
to the mm
• Ergonomics – the study of the human
factors that affect the design and
operation of tools and the work
environment
• Occupational and Physical Therapy
– OT – rehab for ADLs. Bathing, grooming,
eating, dressing, etc
– PT – tx to prevent disability or to restore fxn
through the use of exercise, heat, massage,
and other methods to improve circulation,
flexibility and m strength
• Myofascial Release – soft tissue manipulation to
ease p!
• Therapeutic Ultrasound – high-frequency sound
wave to produce deep heat to ease p!, decrease m
spasm and accelerate healing
• Still under OT and PT
– RICE – Rest, Ice, Compression and
Elevation; the recipe for injury
healing during the 1st few days postinjury
• Fascia
– Fasciotomy – surgical incision
through the fascia to relieve tension
or pressure
– Fascioplasty – the surgical repair of
fascia
• Tendons
– Tenodesis – surgical suturing of a tendon to
the bone
– Tenolysis – a release of a tendon from
adhesions
– Tenectomy – surgical resection/removal of a
portion of tendon
– Tenoplasty – surgical repair of tendons
– Tenorrhaphy – surgical suturing of divided
ends of a tendon
– Tenotomy – surgical division of a tendon for
relief of a deformity caused by the abnormal
shortening of a m
• Muscles
–Myectomy – surgical excision of
a portion of m
–Myoplasty – the surgical repair
of a m
–Myorrhaphy – the surgical
suturing of a m wound
–Myotomoy – a surgical incision
into a m