Study Notes on Muscles and Tendons

Chapter 5: Muscles and Tendons

Overview

  • Learning changes everything.

  • This chapter focuses on the essentials of the languages of orthopedics and rehabilitation, emphasizing muscles and tendons.

Learning Outcomes

  • After studying this chapter, you will be able to:

    • Construct and Analyze Medical Terms: Use roots, combining forms, suffixes, and prefixes to construct and analyze medical terms related to muscles and tendons and rehabilitation medicine.

    • Spell and Pronounce Medical Terms: Spell and pronounce medical terms accurately to communicate effectively in healthcare settings.

    • Define Abbreviations: Define accepted abbreviations related to muscles and tendons and rehabilitation medicine.

    • Apply Knowledge: Apply knowledge of medical terms concerning muscles, tendons, their disorders, and rehabilitation to documentation, medical records, and reports.

    • Translate Medical Terms: Translate medical terms into everyday language to communicate clearly with patients and their families.

Muscles and Tendons

Types of Muscles

  1. Skeletal Muscle (Voluntary Muscle)

    • Functions:

      • Movement

      • Posture

      • Body heat production

      • Respiration

      • Communication

  2. Cardiac Muscle

  3. Smooth Muscle

Structure of Skeletal Muscle

  • Characteristics:

    • Striated muscle

    • Muscle fibers

    • Striations

    • Fascia (connective tissue surrounding muscle)

Word Analysis and Definitions

Terminology Differences

  • Hypertrophy

    • Definition: Excessive nourishment (hyper- = above, excessive; -trophy = nourishment)

  • Atrophy

    • Definition: Lack of nourishment (a- = without; -trophy = nourishment)

  • Dystrophy

    • Definition: Poor nourishment (dys- = bad; -trophy = nourishment)

Term Deconstruction

  1. Contract: Breaking down the components into elements.

  2. Peristalsis: Breaking down the components into elements.

  3. Voluntary: Breaking down the components into elements.

Latin Definitions

  • Active: Refers to using energy or action.

  • Fascia: Thin layer of connective tissue surrounding muscles.

  • Passive: Refers to inaction or lack of energy.

Disorders of Skeletal Muscle

  • Conditions related to muscle disorders:

    • Soreness

    • Cramps

    • Strains

    • Fibromyalgia: A disorder characterized by widespread musculoskeletal pain.

    • Muscular Dystrophy: A genetic disorder that weakens muscles.

    • Rhabdomyolysis: A serious syndrome resulting from the breakdown of skeletal muscle fibers.

    • Myasthenia Gravis: A chronic autoimmune neuromuscular disease.

    • Myopathy: Diseases affecting muscle tissue.

Deconstruction of Terms Related to Muscle Disorders

  1. Fibromyalgia: Breaking down the components into elements.

  2. Tendinitis: Breaking down the components into elements.

  3. Rhabdomyolysis: Breaking down the components into elements.

  4. Tenosynovitis: Breaking down the components into elements.

  5. Myopathy: Breaking down the components into elements.

Diagnostic Methods for Disorders of Muscles and Tendons

  • Techniques:

    • Blood tests

    • Electromyography (EMG)

    • MRI and CT scans

    • Muscle biopsy

    • Genetic testing

    • Myositis specific antibodies (MSA)

Therapeutic Methods for Disorders of Muscles and Tendons

  • Interventions:

    • RICE: Rest, Ice, Compression, Elevation

    • Physical therapy

    • Medications

    • Surgical interventions

    • Orthopedic appliances (supports/ braces)

Muscles and Tendons of the Shoulder Girdle, Trunk, and Upper Limb

Pectoral Girdle

  • Connects the upper limb to the axial skeleton.

  • Comprises four muscles originating from the scapula.

  • Forms a large tendon known as the rotator cuff, which:

    • Inserts into the humerus

    • Holds the head of the humerus in the scapula socket
      a

    • Can tear due to overuse.

Upper Arm and Elbow Joint

  • Muscles:

    • Anterior:

    • Deltoid

    • Pectoralis Major

    • Posterior:

    • Latissimus Dorsi

  • Function: Connects the upper arm to the shoulder girdle, spine, and ribs.

  • Movement of Elbow and Forearm:

    • Anteriorly:

    • Biceps Brachii

    • Brachialis

    • Brachioradialis

    • Posteriorly:

    • Triceps Brachii

Forearm Muscles

  • Functions:

    • Supination and pronation of the forearm

    • Flexion and extension of the wrist

    • Medial and lateral movements of the hand

Tendon Disorders

  • Common conditions include:

    • Tendinitis

    • Tennis Elbow

    • Tenosynovitis

    • Carpal Tunnel Syndrome

    • Ganglion Cysts

Additional Word Analysis

  • Deconstructing terms related to upper limb muscles:

    1. Ambulatory

    2. Biceps

    3. Brachialis

    4. Deltoid

    5. Ulnar

    6. Triceps Brachii

Pelvic Girdle, Thigh, Leg, and Foot

Muscles of the Hip and Thigh

  • Support the hip joint and facilitate thigh movement:

    • Gluteus Muscles:

    • Maximus

    • Medius

    • Minimus

    • Adductor Muscle of the inner thigh

Thigh Muscles

  1. Quadriceps Femoris Group:

    • Rectus Femoris

    • Vastus Lateralis

    • Vastus Medialis

    • Vastus Intermedius

    • Labeled collectively as the quadriceps tendon.

  2. Hamstring Group:

    • Biceps Femoris

    • Semimembranosus

    • Semitendinosus

Lower Leg, Ankle, and Foot Muscles

  • Calf Muscles:

    • Gastrocnemius (large muscle)

    • Soleus (smaller muscle)

    • These muscles' tendons form the Achilles Tendon (calcaneal tendon) that attaches to the heel bone (calcaneus).

Further Word Analysis

  • Deconstruct the following terms:

    1. Abduct

    2. Abduction

    3. Adduction

    4. Adductor

    5. Dorsum

    6. Dorsal

Physical Medicine and Rehabilitation (PM&R)

Multidisciplinary Team Approach

  • The PM&R team includes:

    • Physiatrists

    • Medical specialists

    • Occupational therapists

    • Physical therapists

    • Rehabilitation psychologists

    • Social workers

    • Speech therapists

    • Orthotists

    • Nutritionists

Rehabilitation Goals

  • Rehabilitation Medicine aims to focus on maintaining function to ensure independence and quality of life.

  • Restorative Rehabilitation: Aims to restore lost function.

  • Maintenance Rehabilitation: Aims to strengthen and maintain functions that are deteriorating, as well as preventing function loss and injury.

Measurement and Monitoring

  • Activities of Daily Living (ADLs):

    1. Eating

    2. Bathing

    3. Dressing

    4. Grooming

    5. Toileting

    6. Transferring

  • Instrumental Activities of Daily Living (IADLs): Relate to independent living, e.g., managing money, using the telephone, cooking, driving, shopping, and housework.

Assistive Devices

  • Definition: Equipment used to maintain or promote function in individuals with disabilities.

    • Low-End Devices: Cane, walker, shoe inserts.

    • High-End Devices: Computerized communication devices.

  • Adaptive Equipment: Includes items to assist with ADLs, e.g., eating devices, raised toilet seats, handrails in bathrooms and showers.

Further Word Analysis

  • Deconstruct terms related to assistance in rehabilitation:

    1. Assist

    2. Assistive

    3. Assistant

    4. Physiotherapy

    5. Physiotherapist

    6. Physiotherapeutic

Amputations

  • Causes:

    • Peripheral vascular disease (PVD) for legs.

    • Injuries from wartime explosive devices affecting arms and legs.

  • Focus Post-Amputation:

    • Promote healing of the stump

    • Strengthen muscles above the amputation site (and arm if applicable)

    • Prevent contractures

    • Ensure the stump shrinks to fit into the prosthetic socket

    • Provide emotional, psychological, and family support

Further Word Analysis on Amputation Terms

  • Deconstruct terms:

    1. Amputation

    2. Contracture

    3. Prosthesis

    4. Rehabilitation

Diagnostic and Therapeutic Procedures and Pharmacology for Muscle and Tendon Disorders

Diagnostic Procedures

  • Examples:

    • Blood tests
      d - Electromyography
      d - Nerve conduction studies

    • Magnetic resonance imaging (MRI)

    • Ultrasonography

    • Muscle biopsy

    • Genetic testing

    • Myositis specific antibodies detection

Therapeutic Methods

  • Interventions include:

    • RICE (Rest, Ice, Compression, Elevation)

    • Physical therapy and exercise

    • Medications

    • Surgical treatments

    • Use of orthopedic appliances

Word Analysis for Diagnostic Terms

  • Identify the prefix, suffix, and root word in the following terms, and state their definitions:

    1. Electromyography

    2. Inflammation

    3. Ultrasonography

Abbreviations in Medical Context

  • Common abbreviations include:

    • ESR

    • Bx

    • MSA

    • EMG

Musculoskeletal Drugs

  • Classes of drugs include:

    • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

    • Paracetamol

    • Skeletal Muscle Relaxants

    • Anabolic Steroids

Further Word Analysis

  • Deconstruct the following terms:

    1. Contracture

    2. Immunosuppressive

    3. Rhabdomyolysis

    4. Myopathy

    5. Tenosynovitis

Final Thoughts

  • Muscles’ Role: Muscles provide movement and maintain posture. The appendicular skeleton, including the bones of the upper and lower limbs, connects to the axial skeleton through joints and muscles.

  • Understanding muscle and joint structures and functions is crucial for assisting patients through rehabilitation and recovery processes following illness, surgery, or medical procedures.