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MSS > Muscle Function: Analysis and Clinical Demonstration > Flashcards

Muscle Function: Analysis and Clinical Demonstration Flashcards

1
Q

What is manual muscle testing?

A
  • testing the structural unit
  • tests groups of muscles, not an isolated muscle
  • agonist, antagonists, synergists
  • check planes of movemnet and types of contraction
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2
Q

What are electromyography (EMG) and Nerve Conduction Studies

A

testing the functional unit

  • detailed evaluation of muscle and nerve function/ innervation
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3
Q

WHat is an agonist?

A

a primary mover

  • responible for the initiaon and execution of a specific action at a joint
  • often considered as a function muscle group
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4
Q

what are muscle antagonists?

What are synergists?

A

antagonists-oppose or reverse the action of the primary mover

synergist-assist the prime mover in its actions

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5
Q

How do agonists and antagonist work together to facilitate joint movement?

A

Reciprocal Inhibition

  • ensures smooth movement of a joint skeletal muscles function in pairs for maximal muscle efficiency speed and control and prevent injury
    • agonist: increases tone for full activation
    • antagonist: prepares to slow down/stop the intended function
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6
Q

Describe how reciprocoal inhibition works in a neurologically in tact person.

How about a neurologically compromised patient

A
  • Ia afferent enters spinal cord, synapses on the alpha motor neuron and causes the agonist to contract
  • at the saem time the other branch of the Ia afferent sunapses on the Ia inhibitory interneuron which synapse on the alpha motote neuron of the anatagonist, preventing the contraction of the antagonizing muscle group
  • Neurologically compromised
    • lack of reciprocal inhibition (lack of descending inhibition)
    • causes spascitity
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7
Q

What are the 3 planes of movement?

A
  1. Frontal/Coronal
    1. divide body into anterior and posterior
      1. abduction, adduction
  2. Sagittal
    1. divide body into right and left
      1. felxion/extension
  3. Transverse/horizontal
    1. divide body into top/bottom
      1. internal and external rotation
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8
Q

what are the agonist for shoulder abduction?

A

deltoid and surpaspinatus

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9
Q

antagonists for shoulder abduction? aka the adductors

A

latissimus dorsi

pectoralis major

teres major

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10
Q

what is a winged scapula

A
  • spinal accessory nerve for trapezius injury. increased winging with abduction
  • or if more prominent winging with flexion=long thoracic nerve/serratus anterior injury
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11
Q

How do you test for muscle integrity?

A

check plaes of movement

primary mover, antagonists, planes of movement

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12
Q

what are som eabnormalities that could be present when testing plnes of movement for dorsiflexion of ankle?

A

inversion or eversion could be prominent

different plane of movement coudl be utilized

they could be accomodating with other muscle groups!

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13
Q

Wat are the 3 types of contraction?

A
  • Isotonic
    • concentric
      • muscle shortens
    • eccentric
      • muscle elongates
  • Isometric
    • muscle length remains the same
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14
Q

wht type of contraction is capable of producing the greatest amount of force?

A

eccentric contractions

  • require less metabolic energy
  • with maximal contraction they can generate much higher tension levels when compared to concentric contractions
  • up to 50% higher!
  • important concept in rehab of tedinopathies
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15
Q

What kind of exercise should a 75 yo man who just had an MI avoid?

A

isometric! (planks) bc it can increase blood pressure

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16
Q

What kind of exercise would you want to do on a 20 yo with achilles tendinopathy?

A
  • eccentric! they generate the most force. this stimulates collagen growth factors which will repair the damaged achilles tendon!
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17
Q

What is the purpose of electromopathy?

A
  • certain disease processes such as nerve compression, hereditary or acquired diseases or myopathy will result in alteration of the normal recorded electrical signals and recruitment patterns
  • these diseases can be diagnosed with EMG and NErve conduction studies
    • EMG tests skeletal muscle fibers (type 1, slow twitch, muscle fibers)
    • nerve conduction tests motor, sensory, mixed nerves (standard studies are evaluating Ia large myelinated nerve fibers)
18
Q

WHat do EMGs test?

What do Nerve conduction studies test?

A
  • EMG: skeletal muscle . fibers (mostly type 1, slow twitch, muscle fiber)
  • nerve conduciton studies: motor, sensory, mixed nerves (standard studies are evaluating Ia large myelinated nerve fibers)
19
Q

what is the functional element of the neuromuscular system?

A

A motor unit! (LMN)

anterior horn cell (LMN)

axon

NMJ

Muscle fibers

20
Q

WHat is innervation ratio? what is it ssignificance?

A

the number of msucel fibers that belong to a ingle axon (innervated by a single axon)- important bc you dont need a ton of innervation for fine movemnts!

  • varies widely between muscles
  • low for fine motor: extraocular
  • high for gross motor: soleus to stand on your toes

**high innervation ratio=greater force generated by that motor unit**

21
Q

all muscle fibers innervated by one motor unit are ________

A

of the same muscl fiber type

22
Q

When an individual axon is depolarized an action potential propagates down the nerve. what happens with depolarization of all fibers in a motor unit?

A

an electrical potential called a motor unit action potential (MUAP)

analysis of the MUAP (size complexity firing frequency) and assesment of baseline electrical signal at rest served as the foundation for electromyography

23
Q

How do we record MUAPs of an individual muscle?

A

EMG- usuing a surface needle electrode

this infor can be used to monitor that muscle’s activity during a certain action and to asses the integrity of the muscle ans the nerves supplying it

24
Q

What id Henneman size principle?

A
  • the first motor unit is recruited at 5 Hz but to generate more force the firing rate and recruitment of more motor units must be increased
  • patterns of recruitment indicate neuropathic (reduced) vs. myopathic (early) conditions
25
Q

WHat do nerve conduction studies find?

A

they are a component of EMG and they assess the integrity of the peripheral nervous system

  • compoud motor action potential
  • sensroy nerve action potential
26
Q

What is an NCS of a compound mucle action potential looking for?

A

number of fibers actiavated

synchrony of firing fibers

fastest conducting motor fibers

27
Q

What is an NCS of a sensory nerve action potential assessing

A

amplitude

duration

onset latency

peak Intency

28
Q

what function are we measuring with an NCS

A

evaluation of peripheral nerve function

motor and sensory

ex: median nerve (motor=abductor pollicus brevis, sensory=index finger)

29
Q

WHat are you measuing durina a surface EMG

A

you want to see the activity of an agonist muscle vs an antagonist muscle. when flexing you want to see the agonist firing and antagonist relatively quiet. and vice versa

30
Q

What would you see on an EMG during isometric contraction?

A

flexors and extensors are both contraacting therefore they are both firing

31
Q

What is an upper motor neuron lesion? WHat do you see with an Upper motor lesion?

A

lesion of the upper motor neuron in the central nervous system (brain, spinal cord)

  • positive signs: hyperreflexia, spasticity
  • underactivity or negative signs: weakness
  • no atrophy
32
Q

What is spasticity?

A

a positive sign of the UMN syndrome

  • vleocity-dependent increase in tonic stretch reflex (muscl tone)
  • hyerexcitabilit of the strethc reflex
  • one component of the upper motor neuron syndorme
  • decreased reciprocal inhibition
    *
33
Q

What are the agonists of wrist flexion?

A

flexor carpi radialis

flexor carpi ulnaris

flexor digiti profundus

flexory digiti sublimis

34
Q

what are the antagonists of wrist flexion?

A

extensor carpi radialis longus and brevis

extensor ulnaris

extensor digitorum

35
Q

What are the agonists of hip flexion?

A

iliopsoas

rectus femoris

add long/brev

pectineus

gracilis

sartorius

tensor fasciae latae

36
Q

what are the antagonists of hip flexion

A

biceps femoris

semitendiosus

semimembranosis

gluteus maximus

gluteus magnus

37
Q

beside spasticity what is associated with UMN syndrome

A

hemiparetic gait and clonus

  • clonus is:
    • hyperactive stretch reflex
    • repetitive contract/relax
    • lack of reciprocal inhibition
38
Q

When doing an NCS to asses peripheral nerve function what do you neeed to make sure you get?

A

both motor and senosry! In the example of the median nerve you would get motor via the abductor pollicis brevis and sensory via index finger

39
Q

How does botulinum neurotoxin work?

A
  • intra-muscular injections can be used to reduce focal muscle overactivity
    • produces denervation by pre-synaptically blocking the release of Ach by cleaving SNAP-25 protein
40
Q

for most efficient function muscle should______

A

work together in functional muscle groups and in paris of agonist and antagonist

41
Q

electromyography is a useful tol for assesment of _____

A

peripheral nervous system

42
Q

upper motor neuron syndrome is more than just ______

A

motor and sensory loss

MSS (26 decks)

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