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LOCO2 > Muscle In Health And Disease > Flashcards

Muscle In Health And Disease Flashcards

1
Q

What happens when potassium is low in muscles

A

Muscle Cramps

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2
Q

Is skeletal under UMN or LMN control

A

LMN

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3
Q

Where are LMNs found

A

Ventral horn of spinal cord
Cranial nerve nuclei

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4
Q

Motor unit

A

motor neuron and all of the skeletal muscle fibers innervated by the neuron’s axon terminals

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5
Q

What happens to a muscle fibre when it loses innervation

A

Atrophies and becomes angulated

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6
Q

How are deinnervated muscle fibres reinnervated

A

Axons sprout from other motor neurones to innervate more fibres

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7
Q

Target fibre

A

Re innervated muscle fibre that looks like a target due to central nuclei

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8
Q

What determines whypich type of fibre a muscle fibre is

A

Primary motor neurone

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9
Q

Why can muscle fibres switch between fast and slow when they are deinnervated and reinnervated

A

Fibre type determined by mtooor neurone

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10
Q

Group atrophy

A

All fibres in a motor unit degenerate

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11
Q

Muscle structure in infantile hypotonia

A

Most fibres small and round with a few massively hypertrophic fibres

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12
Q

By what age are all symptoms of infantile hypotonia usually gone by

A

2 yrs

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13
Q

2 forms of infantile hypotonia

A

Large type 1 fibres + small type 2 fibres
Small type 1 fibres + normal/large type 2 fibres

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14
Q

Infantile hypotonia

A

abnormal limpness when an infant is born, affecting limbs, trunk, and head

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15
Q

Sarcopenia/cachexia

A

Age related gradual loss of muscle mass, strength and function

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16
Q

Are type 1 or type 2 muscle fibres more effected by sarcopenia

A

Type 2

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17
Q

Why does sarcopenia not cause decrease in body part size

A

Muscle replaced by fat

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18
Q

What causes muscle loss in sarcopenia

A

Pro inflammatory cytokines

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19
Q

General muscle disorder symptoms

A

Pain
Weakness
Twitching
Cramps
Muscle atrophy
Contractures
Drug exposure
Endocrine disorders

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20
Q

How can muscle disorders be diagnosed

A

Biopsy
EMG

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21
Q

Difference between polymyositis and dermatomyositis

A

Same condition but pt has skin rash in dermatomyositis

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22
Q

Polymyositis/dermatomyositis

A

Inflammatory myopathy causing chronic muscle inflammation, weakness, and pain (+ rash in dermatomyositis) from lymphocytes infiltrating CT around muscle fibres

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23
Q

What type of disease are inflammatory myopathies

A

Autoimmune

24
Q

Rash characteristics in dermatomyositis

A

Red/purple
spotty/streaky
Hyperpigmentation in photodistribution pattern
Heliotrope rash over eyelids
Periorbital oedema
Hyperkeratotic papules on hands

25
Q

Is myosotis symmetrical

A

Yes

26
Q

How does myosotis effect serum creatine kinase

A

Incr

27
Q

EMG in myositis

A

Irritable

28
Q

Biopsy in myositis

A

Variation in fibre size
Central nuclei
Necrosis and regeneration
Infiltration of inflam cells

29
Q

Hyperkeratotic papules

A

Epidermis thickens and keratinises
Dermatomyositis

30
Q

Subcutaneous calcifications

A

Calcification in muscle and skin caused by autoimmune CT disease

31
Q

First step of subcutaneous calcification

A

Mucin deposition

32
Q

Myositis treatment

A

High dose corticosteroids
Azathioprine
Methotrexate
Rituximab

33
Q

Most common muscle disease in elderly

A

Inclusion body myositis

34
Q

Inclusion body myositis signs and symptoms

A

slowly progressive weakness and wasting of muscles
Associated polyneuropathy
Loss of quadriceps reflex
Dysphagia

35
Q

Which muscle are most effected by inclusion body myositis

A

Finger and wrist flexors
Knee extensors

36
Q

Why does inclusion body myositis cause loss of quadriceps reflex

A

Quadriceps atrophy

37
Q

Inclusion body myositis biopsy

A

Empty vacuoles in muscle fibres
clumps of cellular material in fibres - beta amyloid, hyperphosphorylated TAU, apolipoprotein E

38
Q

How does inclusion body myositis cause muscle atrophy

A

Muscle can’t contract properly due to vacuoles and cellular material so rip selves apart

39
Q

Muscular dystrophies

A

Progressive genetically linked degenerative myopathies

40
Q

X linked muscular dystrophies

A

Duchenne MD
Becker MD
limb girdle MD
emery-Dreyfus MD

41
Q

Autosomal recessive muscular dystrophies

A

Limb girdle MD
emery dreifuss MD

42
Q

Autosomal dominant muscular dystrophies

A

Facioscapulohumeral MD
limb girdle MD
emery dreifuss MD
oculopharyngeal MD

43
Q

Most common MD

A

duchenne MD

44
Q

Duchenne MD progression

A

Proximal muscle weakness in first 2 yrs
Continuous slow decline
Unable to walk by 7-12yrs
Death in early 30s

45
Q

Difference between duchenne and Becker MDs

A

Duchenne has no dystrophin
Becker has some dystrophin

46
Q

What causes duchenne and Becker MD

A

No/ lack of dystrophin

47
Q

What is the gower manoeuvre and What condition is it associated with

A

child gets on hands-and-knees then walks hands up legs to stand
Duchenne MD

48
Q

Why is creatine kinase elevated in duchenne MD

A

Muscle fibres rip self apart and repair continuously

49
Q

Dystrophin

A

Protein between myofibres and sarcolemma that acts as a membrane stabilizer during muscle contraction to prevent contraction-induced damage

50
Q

Duchenne MD biopsy

A

Fibre size variability
Endomysial fibrosis
Degenerating muscle fibres undergoing myophagocytosis
Thickened Perimetrium
Increased fibrotic material and fat
Atrophy and fibre death

51
Q

What are dead muscle fibres replaced with in duchenne MD

A

Fibrotic material
Fat

52
Q

What drugs can induce myopathies

A

Corticosteroids
Statins
Alcohol
Hydroxychloroquine

53
Q

Fibromyalgia

A

chronic disorder characterized by widespread pain and other symptoms such as fatigue, muscle stiffness, and insomnia

54
Q

Which antibodies are associated with fibromyalgia

A

Anti polymer antibodies

55
Q

How many of 18 specific points need to be tender when pressure applied for fibromyalgia diagnosis

A

11

56
Q

Fibromyalgia treatment

A

Tricyclic antidepressants - Amitryptyline
SSRIs - fluoxetine
Exercise
Massage, therapy, yoga

LOCO2 (26 decks)

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