MUSCLE LESIONS Flashcards
Pure Motor LMN Lesion
🧠⚡ANM ⚡
Anterior HORN Cell
NMJ
Muscle
Characteristics of NMJ Lesion
🧠⚡CDeF OP ⚡
⭐ Chewing Difficulty: MASSETER Muscle weakness
⭐ DIURNAL VARIATION (Fluctuating Weakness)
⭐ FATIGABILITY
⭐ Opthalmoplegia
⭐ Ptosis
ANTERIOR HORN CELL CHARACTERISTIC FEATURE
🧠⚡WADA FoR AHC⚡
⭐ Wasting and Atrophy Prominent
⭐ Distal > Proximal
⭐ ASYMMETRICAL WEAKNESS (U/L)
⭐ FASICULATIONS ➕
⭐ Reflexes ⛔
MUSCLE DISORDER CHARACTERISTIC FEATURE
⭐ SYMMETRICAL
⭐ PAINLESS
⭐ PROXIMAL > DISTAL (LIMB GIRDLE PATTERN)
⭐ WEAKNESS PREDOMINANT
⭐ REFLEXES ➕
⭐ FASICULATIONS ⛔
Difficulty in GETTING UP from SQUATTING POSITION
(OR)
WASHING CLOTHES
(OR)
CLIMBING STAIRS
(OR)
LIFTING OBJECTS FROM SHELF
(OR)
COMBING HAIR
REPRESENTS?
PROXIMAL WEAKNESS
-Muscle disorders
DIFFICULTY IN
✨ USING SCREWS
✨ OPENING LOCK
✨ MIXING FOOD
✨ EATING CHAPPATI
✨ GRIPPING CHAPPALS
REPRESENT?
Distal WEAKNESS
Pain SENSITIVE Structures of MUSCLE
⭐ Perimysium
⭐ EPIMYSIUM
PAIN INSENSITIVE Covering of MUSCLE
⭐ ENDOMYSIUM
Majority of muscle pathologies affect only endomysium
ACQUIRED MUSCLE DISORDERS
⭐ Acute to Subacute
- Inflammatory Muscle Disorders (Polymyositis, Dermatomyositis, Inclusion Body Myositis)
- Drugs and TOXINS
- ENDOCRINE
- INFECTIONS
INHERITED Structural PROTEIN MUSCLE DISORDERS
Pathology?
Structural PROTEIN Involvement
⭐ MUSCLE NECROSIS ➕
⭐ MUSCLE REPLACED BY ADIPOSE and FIBROUS DISEASE
⭐ CHRONIC PROGRESSIVE DISEASE
INHERITED Structural PROTEIN MUSCLE DISORDERS
Example
🧠⚡ DEMBELE FC ⚡
🧠⚡ all Es stand for the same disease⚡
Duchenne (XLR)
Emery Dreifuss (XLR/AD)
Myotonic (AD)
Becker (XLR)
Emery Dreifuss
Limb girdle (AD/AR)
Emery Dreifuss
Fascio-scapulo-humeral (AD)
Oculopharyngeal Muscle Dystrophy (AD)
INHERITED Contractile PROTEIN MUSCLE DISORDERS
(OR)
CONGENITAL MYOPATHIES
🧠⚡NCCC ⚡
⭐ PRESENT at BIRTH
⭐ Non-progressive / Slowly progressive
Example
✨ NEMALINE myopathy
✨ Central Core myopathy
✨ Centronuclear myopathy
INHERITED Metabolic PROTEIN MUSCLE DISORDERS
Symptoms are seen after EXERCISE
EXERCISE INTOLERANCE
-Carbohydrate MYOPATHIES
-Lipid MYOPATHIES
-Mitochondrial MYOPATHIES
MYOPATHIES Classification
EPISODIC MUSCLE WEAKNESS
🧠⚡ECM ⚡
⭐ Channelopathies
⭐ Metabolic Myopathies
PERSISTENT WEAKNESS
LONG-STANDING WEAKNESS: Dystrophies
ACUTE WEAKNESS: INFLAMMATORY MUSCLE DISEASE
POSITIVE SYMPTOMS OF MUSCULAR WEAKNESS
🧠⚡ M³C² ⚡
⭐ Myalgia
⭐ Myotonia
⭐ Myoglobinuria
⭐ Cramps
⭐ Contractures
NEGATIVE SYMPTOMS OF MUSCULAR WEAKNESS
⭐ Weakness
⭐ Fatigue
⭐ Exercise Intolerance
⭐ Muscle atrophy
ASYMMETRICAL MUSCLE WEAKNESS
🧠⚡In fashion ⚡
⭐ INCLUSION BODY MYOSITIS
⭐ FASCIO-SCAPULO-HUMORAL DYSTROPHY
Proximal UL and Proximal LL Weakness is seen in
MOST MUSCULAR LESIONS
Proximal UL and Distal LL Weakness is seen in
🧠⚡3 words in Name ➡️ Some ab normal ⚡
Fascio-Scapulo-Humeral Dystrophy
Distal UL and Proximal LL Weakness is seen in
🧠⚡DUL PaL Phones by MI ⚡
⭐ Myotonic DYSTROPHY
⭐ Inclusion Body Myositis
Opthalmoplegia ➕ Ptosis ➕ Dysarthria
⭐ Occulo-Pharyngeal Muscle Dystrophy
⭐ NMJ disorders
Ptosis ➕ FACIAL MUSCLE Involvement
(Without Dysarthria: Pharyngeal involvement ⛔)
MYOTONIC DYSTROPHY
ABNORMAL FATIGUABILITY AFTER TRIVIAL EXERCISE
➕
CRAMPS and PAIN
➕
HIGH COLOURED URINE
⭐ Metabolic MYOPATHIES
⭐ RHABDOMYOLYSIS
MYALGIA
≈ MUSCLE PAIN
⭐ RHEUMATOLOGICAL cause
⭐ ORTHOPEDIC Cause
⭐ Pain is not CLASSICALLY SEEN with MYOPATHY, but seen in:
✨ CONSTANT: INFLAMMATORY MUSCLE DISORDERS
✨ EPISODIC: Metabolic MYOPATHIES
NON-NEUROLOGICAL CAUSES OF MYALGIA
⭐ POLYMYALGIA RHEUMATICA
⭐ FIBROMYALGIA
MYALGIA WITHOUT ELEVATED ENZYMES and NORMAL ESR
Fibromyalgia