Muscle Pathologies

Question 0

Contracture

Answer 0

Shortening of connective tissue supporting structures over or around a joint.

Results in reduced ROM.

Question 1

Scar

Answer 1

Collagen based tissue that develops as a result of inflammation

Weaker than tissue it replaces.

Question 2

Adhesion

Answer 2

When reduced motion of a joint allows cross-links to form among collagen fibres, causing even more reduction in ROM.

Question 3

Scar tissue adhesion

Answer 3

Occurs with an injury or acute inflammatory process.

Adhesions/contractures occur in random pattern. ROM decreases.

Question 4

Fibrotic adhesion

Answer 4

Results from chronic inflammation and causes moderate to severe restrictions in ROM.

Difficult to eradicate.

Question 5

Irreversible contracture

Answer 5

Fibrotic tissue or bone replaces muscle and connective tissue.

ROM can only be recovered surgically.

Question 6

Proud Flesh

Answer 6

Abnormal raised, thick dermal granulation tissue that results from abnormal healing.

Question 7

Hypertrophic scarring

Answer 7

Overgrowth of dermal tissue that remains in the boundaries of the wound.

Collagen fibres randomly organized in a nodular or whirl pattern.

Associated with: deep partial or full thickness burns, skin grafts, sutures.

Sternum, upper back, shoulder/delt, buttock, dorsum of foot.

Question 8

Keloid scarring

Answer 8

Dermal scar tissue that grows beyond the boundaries of the original wound.

More collagen more randomly placed than hypertrophic scarring.

More common ear to waist, elbow to wrist, in darker skinned people.

Question 9

Muscular dystrophies

Answer 9

Largest and most common group of inherited progressive neuromuscular disorders.

Characterized by progressive weakness and degeneration of striated muscles.

Question 10

Duchenne’s MD

Answer 10

Most common

Sex linked. 1/3300 males

Lack of dystrophin (anchors thin filaments to cell membrane).

Muscle wasting begins in utero.
Affects all striated muscle.

Life expectancy: 20 years

Question 11

Backers MD

Answer 11

1/20000 males

Faulty or decreased dystrophy
Begins in late childhood
Life expectancy: 40-50s

Question 12

Myotonic dystrophy

Answer 12

AKA Steinert’s disease

Inability to relax muscles. Characterized by myotonia.

Autosomal dominant.

Onset 10-30 years. Initially affects muscles of eyelids, face, distal limbs.

Question 13

Facioscapulohumeral

Answer 13

AKA Landouzy-Dejerine Disease

Onset teens-twenties.

Autosomal dominant

Difficulty whistling, closing eyes, raising arms.

Normal life expectancy

Question 14

Limb Girdle Dystonia

Answer 14

Onset 3-20 years
Initially affects shoulders and hips; proximal limb distribution.
Moderate weakness
Slow progression.

Question 15

Congenital dystrophy

Answer 15

Muscular dystrophies symptomatic at birth, not otherwise specified.

Includes several rare forms.

General muscle weakness and joint deformities.

Question 16

Oculopharyngeal Dystrophy

Answer 16

Affects eyes and throat
Initial sign – eye drooping

Onset – middle age (40-69)
Slow progression

Question 17

Distal dystrophy

Answer 17

Involves hands, feet, forearms, lower legs.

Middle age onset
Slow progression.

Question 18

Emery Dreifuss dystrophy

Answer 18

Begins in muscles of the shoulders, upper arms, and shins.

Onset: early teens

Frequently involves heart.

Slow progression.

Question 19

Inflammatory myopathy es

Answer 19

Group of diseases that involve chronic muscle inflammation and weakness

Three main types:
Polymyositis
Dermatomyositis
Inclusion body myositis

Question 20

Inclusion body myositis

Answer 20

Idiopathic chronic myopathy
Chronic, progressive muscle inflammation.

May be asymetrical
Men > women

First symptoms: falling or tripping; may begin with weakness in the wrists and fingers. Difficulty swallowing.

Question 21

Polymyositis

Answer 21

Uncommon CT disease. Inflammatory myopathy. Idiopathic.

Symmetrical

More common in women 2:1
Blacks > whites
More common in 30-50 years.

Difficulty going up stairs, getting out of chairs, lifting above shoulders. Speech.
First sign: lifting head from pillow.

Question 22

Dermatomyositis

Answer 22

Uncommon. Distinctive skin rash

Can occur at any age. Most common 40-60 and 5-15. Women > men

Idiopathic

Slow development, possible periods of remission.

Dusty or violet rash. Face, eyelids, around nails, knuckles, elbows, knees, chest and back.

Dysphagia. Calcinosis cutis. Lung problems.

Question 23

Myasthenia Gravis

Answer 23

Motor end plate disorder. Autoimmune disorder associated with abnormal thymus

Antibodies block ACh receptors in NMjunctions.

Weakness, rapid fatigue of voluntary muscles.

Women under 40; men over 60.

Ptosis, diploplia, strabismus

Test with edrophomium – blocks ACherase, allowing ACh to bind and some muscle contraction

Tx: corticosteroids, AchE inhibitors, thymus surgery, plasmapheresis

Question 24

Necrotising fasciitis

Answer 24

Rare bacterial infection (strep pyrogenes)

Small reddish bump –> bronze/purple patch –> centre grows black and does.

1cm/hour

Question 25

Myofascial pain dysfunction

Answer 25

Regional pain disorder characterized by TrPs.

Related to dysfunctional end plates of skeletal muse fibres.

TrPs, pain, reduced ROM, weakness, pares thesis