Ch 4: The Muscular System

What is another name for an antispasmodic medication?

Anticholinergic

What is the primary function of an anticholinergic/antispasmodic drug?

To suppress smooth muscle contractions of the stomach, intestine, or bladder.

What specific antispasmodic is often administered preoperatively to relax smooth muscles during surgery?

Atropine

What is cortisone?

A corticosteroid drug injected to relieve pain and inflammation of a specific joint.

For what medical purpose (and what illegal purpose) are anabolic steroids used?

Medical: To replace muscle loss caused by disease. Illegal: Used by athletes and bodybuilders to build muscle mass.

How do muscle relaxants work and what are their potential negative interactions?

They act on the central nervous system to relieve stiffness, pain, and discomfort from injuries; they may interact negatively with alcohol and some antidepressants.

What is the role of neuromuscular blocking drugs during surgery?

They cause temporary paralysis by blocking the transmission of nerve stimuli to the muscles, acting as an adjunct to anesthesia to relax skeletal muscles.

What does the term "adjunct" mean in the context of anesthesia and neuromuscular blocking drugs?

In addition to.

What is Platelet rich plasma therapy (PRP)?

A treatment where a patient's own blood is separated to create a concentrated plasma that is injected into a joint to promote healing and pain relief.

What is viscosupplementation and what is its common nickname?

Direct injections of hyaluronic acid to the knee to increase viscous fluid for arthritis relief; often called "chicken shots."

Define the study of ergonomics.

The study of human factors that affect the design and operation of tools and workspaces with the goal of reducing injury, strain, and stress.

Which specialized soft tissue manipulation technique is used for conditions like fibromyalgia, TMJ disorders, and carpal tunnel syndrome?

Myofascial release

What is the goal of Occupational therapy (OT)?

To promote recovery and rehabilitation to assist patients in activities of daily living (ADL).

What are examples of activities of daily living (ADLs)?

Grooming, eating, and dressing.

What is Physical therapy (PT)?

Treatment to prevent disability or restore function through the use of exercise, heat, massage, or other techniques.

How does therapeutic ultrasound treat muscle injuries?

It uses high frequency sound waves to generate heat deep within muscle tissue, which eases pain, reduces spasms, and increases blood flow.

What does the acronym TENS stand for and how does it function?

Transcutaneous electrical nerve stimulation; it delivers small electrical impulses to nerve endings through the skin for pain control.

What is the literal meaning of individual word parts in "transcutaneous"?

Trans means across, cutane means skin, and ous means pertaining to.

What does the acronym RICE stand for in the context of first aid?

Rest, Ice, Compression, and Elevation.

When should heat and stretching be used for a soft tissue injury according to the RICE protocol?

After the first few days, once pain and swelling have decreased, to help bring blood to the area and speed healing.

What is a fasciotomy and why is it used to treat compartment syndrome?

A surgical incision through the fascia to relieve tension or pressure; without it, pressure can cause a loss of circulation that damages tissue.

Define tenodesis.

The surgical suturing of the end of a tendon to a bone.

What is tenolysis?

The release of a tendon from adhesions.

What is a tenotomy and what are examples of its use?

The surgical cutting of a tendon to provide release or allow lengthening; used for correcting clubfoot or strabismus.

What is the difference between myorrhaphy and myotomy?

Myorrhaphy is the surgical suturing of a muscle, while myotomy is a surgical incision into a muscle.

What tool is used to test Deep tendon reflexes (DTRs) by striking a tendon?

A reflex hammer

How are reflexes defined in the context of diagnostic procedures?

Involuntary responses to a stimulus

What is the purpose of the knee jerk test?

To determine whether there is homeostasis between the spinal cord and the peripheral nervous system

What should happen to a muscle immediately after its tendon is tapped during a diagnostic exam?

The muscle should immediately contract

What can a lack of response or an abnormal response to a reflex test indicate?

A disruption of the nerve supply to the involved muscles

Besides nerve supply disruption, what are two other reasons reflexes might be lost?

A deep coma or because of medications such as heavy sedation

What is the purpose of the diagnostic procedure known as Range of motion (ROM)?

To evaluate joint mobility and muscle strength

What specific tool is used to measure range of motion movements in a joint such as the elbow or knee?

A goniometer

What are three goals of Range of motion (ROM) exercises?

To increase strength, flexibility, and mobility

What does Electromyography (EMG) measure?

The electrical activity within muscle fibers in response to nerve stimulation

Based on the transcript's breakdown of the word Electromyography, what do the parts "electro", "myo", and "-graphy" mean?

Electro means electricity, myo means muscle, and graphy means the process of producing a picture or record

What is the name of the record produced by Electromyography?

An electromyogram

Under what clinical circumstances is Electromyography most frequently used?

When people have symptoms of weakness and examination shows impaired muscle strength

What does a muscle biopsy procedure involve?

The removal of a plug of tissue for examination

What specific instrument is commonly used to obtain a specimen for a muscle biopsy?

A biopsy needle

What is a soft tissue injury?

Damage to the skin, muscles, ligaments, and tendons as opposed to the bones or internal organs.

How is a sprain defined?

An injury to a joint, such as an ankle or wrist, which usually occurs when a ligament is wrenched or torn.

What is a strain?

An injury to the body of a muscle or the attachment of a tendon, usually involving a stretched or torn muscle or tendon attachment.

What causes a shin splint?

A painful condition caused by the tibialis anterior muscle tearing away from the tibia (shin bone) due to repetitive stress, such as running on uneven or hard surfaces.

What is a hamstring injury and its primary symptom?

A strain or tear on any of the three hamstring muscles that straighten the hip and bend the knee, characterized by sudden and severe pain in the back of the thigh.

What is Achilles tendinitis?

A painful inflammation of the Achilles tendon caused by excessive stress being placed on that tendon.

What is Iliotibial band syndrome (ITBS)?

An overuse injury causing pain above the knee joint; caused by the iliotibial band rubbing against bone

How is the extent of paralysis determined in a spinal cord injury (SCI)?

It is determined by the level of the vertebra closest to the injury; the higher the injury on the spinal cord, the greater the area of the body affected.

What is the difference between an incomplete and a complete spinal cord injury?

An incomplete injury means there is some function below the level of injury, whereas a complete injury means a complete loss of sensation and muscle control below the level of injury.

What is myoparesis?

A weakness or slight muscular paralysis; "myo" means muscle and "paresis" means partial or incomplete paralysis.

What is hemiparesis?

A weakness or slight paralysis affecting one side of the body, often caused by a stroke where damage to one side of the brain affects the opposite side of the body.

What is hemiplegia?

Total paralysis affecting only one side of the body; "hemi" means half and "plegia" means paralysis.

What is paraplegia?

Also known as partial paralysis, it is the paralysis of both legs and the lower part of the body.

What is quadriplegia (also known as tetraplegia)?

Paralysis of all four extremities; "quadri" means four and "plegia" means paralysis.

What are repetitive stress disorders (RSD), also known as repetitive motion disorders?

A variety of muscular conditions resulting from repeated motions performed in the course of normal work, daily activities, or recreation such as sports.

According to the transcript, what parts of the body are involved in symptoms caused by frequently repeated motions?

Muscles, tendons, nerves, and joints.

What is compartment syndrome?

A condition involving the compression of nerves and blood vessels due to swelling within an enclosed space created by the fascia that separates muscle groups.

What can cause compartment syndrome?

Trauma, tight bandages or casts, or repetitive activities such as running.

How are overuse injuries defined?

Minor tissue injuries that have not been given time to heal.

What is overuse tendonitis?

An inflammation of tendons caused by excessive or unusual use of a joint.

What is trigger finger?

The painful and progressive restriction of movement caused by an inflammation of a tendon synovial sheath.

What characterizes myofascial pain syndrome?

The development of trigger points producing local and referred muscle pain, caused by a muscle being contracted repetitively.

What are trigger points?

Tender areas that most commonly develop where the fascia comes into contact with a muscle.

What is the definition of referred pain?

Pain that originates in one area of the body but is felt in another.

What is the general term for irritation or degeneration of a tendon in any joint?

Tendinopathy.

What is impingement syndrome (also known as rotator cuff tendonitis)?

A condition occurring when inflamed and swollen tendons are caught in the narrow space between the bones within the shoulder joint.

What is the difference between a partial and complete rotator cuff tear?

In a partial tear, the tendon is frayed or damaged; in a complete tear, the tendon has detached from the head of the humerus.

What occurs during carpal tunnel syndrome

Symptoms occur when the tendons that pass through the carpal tunnel into the hand are chronically overused and become inflamed and swollen.

What structures pass through the carpal tunnel?

The median nerve and the tendons that bend the fingers.

What is a carpal tunnel release?

The surgical enlargement of the carpal tunnel or cutting of the ligament to reduce the pressure on the median nerve.

What are the characteristics of a ganglion cyst?

A benign fluid filled lump that usually occurs on the outer surface of the wrist or hand, most common in women between ages 20 and 40.

What is Epichondylitis?

Inflammation of the tissue surrounding the elbow.

What are the differences between lateral and medial epicondylitis?

Lateral epicondylitis (tennis elbow) is characterized by pain on the outer side of the forearm; medial epicondylitis (golfer's elbow) is characterized by pain on the palm side.

What is a heel spur?

A calcium deposit in the plantar fascia near attachment to the calcaneus.

What is plantar fasciitis, also known as plantar fasciopathy?

An inflammation of the plantar fascia on the sole of the foot that causes foot or heel pain when walking or running.

What is Morton's neuroma?

A condition in which pain on the ball of the foot is caused by a swollen inflamed nerve, usually between the third and fourth toes.

What is posterior tibial tendon dysfunction?

A condition also known as fallen arches that occurs when the tendon supporting the foot arch weakens.

How is Ataxia defined based on its word parts?

‘A’ means without, ‘tax’ means coordination, and ‘-ia’ means condition; it describes a lack of muscle coordination during voluntary movement.

Abnormal activity in which part of the brain most frequently causes ataxia?

The cerebellum.

What is a contracture?

The permanent tightening of fascia, muscles, tendons, ligaments, or skin that occurs when normally elastic connective tissues are replaced with non elastic fibrous tissues.

What are the most common causes of contractures?

Scarring or the lack of use due to a mobilization or inactivity.

What is Intermittent claudication (IC)?

Pain in the leg muscles that occurs during exercise and is relieved by rest, associated with poor circulation and peripheral vascular disease.

What is the meaning of the word parts in intermittent claudication?

Intermittent means coming and going at intervals and claudication means limping.

What is a spasm?

Any sudden involuntary contraction of one or more muscles.

What is a tic?

A repeated spasm often involving the eyelids or face that is difficult or impossible to control.

Define Myoclonus and its word parts.

‘Myo’ means muscle, ‘clon’ means violent action, and ‘-us’ is a singular noun ending; it is the quick involuntary jerking of a muscle or group of muscles.

What are some scenarios where myoclonus may occur?

Normally as a person is falling asleep, or as spasms resulting from a neurological disorder such as epilepsy, a metabolic condition, or a response to medication.

What is clonus and what conditions is it associated with?

A repetitive contraction of the muscles of the knees or ankles associated with cerebral palsy, stroke, and multiple sclerosis.

What is the medical term for hiccups and what causes the sound?

Singultus; it is myoclonus of the diaphragm that causes the characteristic hiccup sound with each spasm.

What is a charlie horse?

A slang term for a cramp, usually in the leg, that came into use in the 1880s among baseball players.

Define Torticollis.

Also known as wryneck, it is a stiff neck due to spasmodic contraction of the neck muscles that pull the head toward the affected side.

What is Bradykinesia and what disease is it associated with?

Extreme slowness in movement (Brady means slow, kines means movement, and ea means condition); it is a symptom of Parkinson's disease.

How is Dyskinesia defined?

The distortion or impairment of voluntary movement resulting in fragmented or jerky motions (Dys- means bad, kines- means movement, and ia- means condition).

What is Hyperkinesia?

Also known as hyperactivity, it is abnormally increased muscle function or activity (Hyper means excessive).

What is Myasthenia gravis?

A chronic autoimmune disease that affects the neuromuscular junction, producing weakness and rapid fatigue of voluntary muscles, especially in the eye, face, and throat.

What is the etymology of the term Myasthenia gravis?

‘My’ means muscle, ‘-asthenia’ means weakness or lack of strength, and ‘gravis’ comes from a Latin word meaning grave or serious.

What characterizes muscular dystrophy (MD)?

A group of more than 30 genetic diseases characterized by progressive weakness and degeneration of skeletal muscles without affecting the nervous system.

What is Duchenne muscular dystrophy (DMD)?

The most common form of MD in children, primarily affecting boys with onset between ages 3 and 5, often resulting in the inability to walk by age 12.

How does Becker muscular dystrophy (BMD) compare to Duchenne muscular dystrophy?

BMD is very similar to but less severe than Duchenne muscular dystrophy.