Muscles, Tendons, and Related Disorders

Word Analysis

  • Arthrocentesis: Centesis - Puncture of a joint.

  • Arthrodesis: Desis - To fuse together joints.

  • Arthrography: Graphy - Process of recording joint structures.

  • Arthroplasty: Plasty - Reshaping by surgery of a joint.

  • Arthroscopy: Scoly - Process of using an instrument to examine a joint visually.

Pharmacology

  • Bisphosphate: A class of drugs that slows the activity of osteoclasts, leading to increased bone mass.

    • Examples:

    • Fosamax

    • Actonel

  • Corticosteroid: Medications that reduce pain and inflammation associated with arthritis, which may include osteoporosis.

    • Example: Prednisone

Muscles & Tendons

Types of Muscles:

  1. Skeletal: Voluntary muscles responsible for movement, body heat, respiration, and communication.

    • Characteristics: Striated muscle, composed of muscle fibers, featuring striations, fascia, tendons, deep fascia.

Word Analysis: Functions and Definitions

  • Contract:

    • Con (together) + tract (to draw) - The action of muscles shortening.

  • Peristalsis:

    • Peri- (around) + stasis (standing) - Movement that causes contents to move through the digestive tract.

  • Voluntary:

    • Volunt (free will) + ary (pertaining to) - Refers to muscle action undertaken with conscious control.

  • Active:

    • Causing action or change.

  • Passive: Not active, refers to lack of voluntary movement.

  • Fascia: Sheet of fibrous connective tissue that encases muscles.

Structure of Skeletal Muscle:

  • Features of skeletal muscles:

    • Striations: Marked bands within the muscle fibers.

    • Muscle fibers: Cells that make up the muscle tissue.

    • Blood vessels: Supply nutrients and oxygen.

    • Nerve: Innervate the muscle fibers.

Muscle Terminology

  • Hypertrophy:

    • hyper (above, excessive) + trophy (nourishment) - Increase in muscle size due to exercise.

  • Atrophy:

    • a- (without) + trophy (nourishment) - Decrease in muscle size due to disuse.

  • Dystrophy:

    • dys (bad, difficult) + trophy (nourishment) - Genetic conditions leading to progressive muscle degeneration.

Muscles of the Upper Extremities

Shoulder (Pectoral) Girdle:

  • Function: Attaches the upper limb to the axial skeleton.

  • Components:

    • Muscles that originate on the scapula and insert into the humerus forming the rotator cuff.

    • Key Muscles: Supraspinatus, Teres Minor.

    • Helps hold the ball of the humerus in the scapula socket.

Muscles of the Upper Arm and Elbow Joint:

  • Anterior Muscles:

    • Biceps Brachii: Primary muscle for flexing the elbow.

    • Brachialis: Assist in elbow flexion.

    • Brachioradialis: Aids in flexion when forearm is in a neutral position.

  • Posterior Muscles:

    • Triceps Brachii: Primary extensor of the elbow.

Word Analysis of Muscles:

  • Ambulatory:

    • ambulat (to walk) + ory (pertaining to) - Relating to the capability of walking.

  • Deltoid:

    • delt (triangle shape) + oid (resembling) - Refers to the shoulder muscle shaped like a triangle.

  • Biceps:

    • bi (two) + ceps (heads) - Muscle with two points of origin.

  • Pectoral:

    • Pector (chest) + al (pertaining to) - Referring to chest muscles.

Muscles of the Hip and Thigh:

Thigh Muscles:

  • Gluteus Maximus: Largest muscle, supports hip joint and movement.

  • Quadriceps Femoris Muscle: Comprises four muscles, responsible for extending the knee.

  • Key Muscles Include:

    • Rectus Femoris

    • Vastus Lateralis

    • Vastus Medialis

    • Vastus Intermedius

  • Adductor Muscles: Inner thigh muscles that move towards the midline.

Muscles of the Lower Extremities:

  • Calf Muscles:

    • Gastrocnemius: Large muscle of the calf.

    • Soleus: Smaller muscle beneath the gastrocnemius.

  • Achilles Tendon: Formed by the gastrocnemius and soleus, attached to the heel bone (calcaneus).

Disorders & Injuries of Muscles & Tendons

  • Fibromyalgia:

    • Chronic pain affecting muscles and tendons, often accompanied by fatigue and depression.

  • Muscular Dystrophy:

    • Genetic condition leading to progressive muscle breakdown and weakness.

  • Muscle Strains: Stretch or tear of a muscle or tendon.

  • Sprains: Stretching or tearing of a ligament.

  • Rhabdomyolysis: Breakdown of muscle fibers leading to release of muscle contents into the bloodstream.

  • Bursitis: Inflammation of the sac surrounding a joint.

Common Disorders of the Wrist & Hand:

  • Ganglion Cyst: Fluid-filled cyst on wrist.

  • Stenosing Tenosynovitis (Trigger Finger): Swelling & inflammation causing difficulty bending fingers.

  • Carpal Tunnel Syndrome: Compression of the median nerve in the wrist.

Word Analysis & Definition:

  • Fibromyalgia: fibros (fiber) + my (muscle) + algia (pain) - Pain in fibrous tissue and muscles.

  • Tendinitis: Tendin (tendon) + itis (inflammation) - Inflammation of a tendon.

  • Rhabdomyolysis: Rhabdo (rod-shaped) + my/o (muscle) + lysis (destruction) - Muscle fiber destruction.

  • Tenosynovitis: Ten/o (tendon) + synov (synovial membrane) + itis (inflammation) - Inflammation of the tendon sheath.

  • Myopathy: Muscle disease affecting function.

Physical Medicine & Rehabilitation

Multidisciplinary Team:

  • Physiatrist: Medical specialists focused on rehabilitation.

  • Occupational Therapist: Focuses on using activities of daily living for recovery.

  • Physical Therapist: Enhances mobility and physical function.

  • Rehabilitation Psychologist: Manages emotional and psychological needs.

  • Social Worker: Supports psychosocial aspects of recovery.

  • Speech Therapist: Assists with communication and swallowing disorders.

  • Nutritionist: Provides dietary guidance.

Rehabilitation Medicine:

  • Restorative Rehabilitation: Aims to restore lost function.

  • Maintenance Rehabilitation: Aims to maintain current function.

  • 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, such as:

  • Managing finances

  • Using a phone

  • Cooking

  • Driving

  • Shopping

  • Housework

Assistive Devices:

  • Low-end Devices: Canes, walkers, shoe inserts.

  • High-end Devices: Computerized communication devices.

Amputations:

Causes:

  • Peripheral Vascular Disease (PVD) affecting the legs.

  • Wartime explosive devices causing limb loss.

Focus of Rehabilitation:

  • Promote healing of the stump.

  • Strengthen muscles above the amputation site.

  • Prevent contractures.

  • Provide emotional and psychological support to patients and families.

Diagnostic Procedures & Pharmacology

Diagnostic Procedures:

  • Blood Tests: Various analyses for muscle health.

  • Electromyography (EMG): Tests muscle electrical activity.

  • Nerve Conduction Studies: Measures electrical conduction along nerves.

  • MRI: Imaging to view structures.

  • Ultrasonography: Ultrasound imaging for muscle and tendon issues.

  • Muscle Biopsy: Sample taken for analysis.

  • Genetic Testing: Identifies genetic muscle disorders.

Abbreviations:

  • Bx: Biopsy

  • Ch: Creatine Hydroxylase

  • CRP: C-reactive protein

  • CT: Computed tomography

  • EMG: Electromyography

  • MRI: Magnetic resonance imaging

  • MSA: Myositis specific antibodies

Therapeutic Procedures:

  • Therapeutic Methods for muscle and tendon disorders:

    • RICE: Rest, Ice, Compression, Elevation

    • Physical Therapy

    • Medications: Muscle relaxants, anti-inflammatories.

  • Orthopedic Appliances: Devices to support physical rehabilitation.

Musculoskeletal Drugs:

  • NSAIDs: Non-steroidal anti-inflammatory drugs, e.g., Ibuprofen, Naproxen.

  • Acetaminophen (Tylenol): Pain relief and fever reduction.

  • Skeletal Muscle Relaxants: Reduces muscle tension and spasticity.

  • Anabolic Steroids: Synthetic testosterone leading to potential side effects (HTN, acne, kidney damage).

Word Analysis & Definitions (Advanced)

  • Analgesia: an- (without) + -alges- (pain sensation) + -ia (condition) - Condition of without pain.

  • Antipyretic: Anti- (against) + -pyret- (fever) + -ic (pertaining to) - Substance that reduces fever.

  • Metabolite: Metabol- (change) + -ite (associated) - Byproduct of metabolism.

  • Anabolic: Anabol- (raise up) + -ic (pertaining to) - Referring to metabolic processes that synthesize molecules.

The Eye and Accessories

Accessory Structures of the Eye:

  • Components: Eyelids, eyebrows, eyelashes, conjunctiva, lacrimal gland.

    • Functions: Clean and lubricate the eye, deliver nutrients, and prevent infection.

Stereopsis:

  • Refers to three-dimensional perception; relies on the accurate alignment of both eyes.

Structure of the Eyeball:

  • Layers from outermost to innermost:

    1. Iris: Regulates light entry.

    2. Pupil: Opening for light entrance.

    3. Lens: Focuses light onto retina.

    4. Retina: Converts light into neural signals.

Functions of the Eyeball:

  • Adjusts lighting, focuses images, and produces visual information.

Visual Pathway:

  • Refraction: The bending of light for focus.

  • Refraction Diagram: Involves the cornea and lens adjustments for focusing light onto the retina.

Word Analysis & Definitions:

  • Photoreceptor: Cells that receive light and convert it to electrical signals.

  • Choroid: Vascular layer of the eye, supplying blood to outer retina.

Disorders of the Eye

Disorders of the Accessory Glands:

  • Conjunctivitis: Inflammation of conjunctiva due to bacterial or viral infections.

  • Stye: Abscess from inflammation of sebaceous glands on eyelid.

  • Dry Eye Disease: Decreased tear production.

Disorders of the Eyeball:

  • Cataracts: Clouding of the lens, leading to vision impairment.

  • Glaucoma: Increased intraocular pressure due to the buildup of aqueous humor.

  • Retinal Detachment: Separation of the retina from the underlying tissue, presenting as shadow invasion.

The Ear and Hearing

Structure of the Ear:

  • Sections of the Ear:

    1. External Ear: Includes auricle, external auditory canal, and tympanic membrane.

    2. Middle Ear: Contains ossicles (malleus, incus, stapes) that amplify sound.

    3. Inner Ear: Comprises cochlea and vestibular structures for hearing and balance.

Disorders of the Ear:

  • Otitis Externa: Inflammation of the external auditory canal due to infection.

  • Otitis Media: Middle ear infection; can be acute or chronic.

  • Vertigo: Sensation of spinning caused by inner ear disturbances.

Hearing Disorders:

  • Conductive Hearing Loss: Caused by physical obstruction or damage in the ear pathway.

  • Sensorineural Hearing Loss: Damage to hair cells in the cochlea resulting from loud noises.

Diagnostic Procedures for the Ear:

  • Hearing Tests: Include whispered speech test, tuning fork tests (Weber and Rinne tests), and audiometry.

Therapeutic Procedures for the Ear:

  • Myringotomy: Surgical incision into the eardrum to relieve pressure.

  • Cochlear Implants: Devices used for severe hearing loss to restore sound perception.

Medications for the Ear:

  • Topical Antibiotics for infected conditions.

  • Antihistamines and Antianxiety Medications for balance disorders.

The Endocrine System

  • Includes the Hypothalamus, Pituitary, and Pineal Glands.