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UM - MSK > Muscles > Flashcards

Muscles Flashcards

Histology, Injuries, Healing, and Assessment

1
Q

What is the histology of muscle tissue?

A

It is highly specialized tissue surrounded by basement membrane or external lamina w/contractile, extensibility, elasticity and excitability properties

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2
Q

What are the myofilaments of skeletal muscle

A

The sarcomere w/thin actin portions and thick myosin portions
- the sarcomeres cause the striations in the mm

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3
Q

What is true of skeletal mm

A

It is a large, elongated, and multinucleated fibers w/a cellular unit of myofiber and a basement membrane w/collagen, laminin, fibronectin and mm-specific proteoglycan

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4
Q

Which mm fiber types are influenced more by agining

A

Type II more than type I

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5
Q

What is the effect of aging on mm

A

There is a decrease in number of mm fibers that may occur secondary to decrease in demand on the body that can be reversed (partially) by exercise

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6
Q

What are the effects of immobilization at the musculotendinous junction

A

There is an adjustment in the number and length of sarcomeres that occurs w/in 12-24 hours after immobilization

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7
Q

where are the effects of immobilization seen first in a mm

A

at the musculotendinous junction

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8
Q

What are the effects of immobilization at the mm belly

A

There is an increase in connective tissue and decrease in tissue extensibility, increase in thickness of endo- and perimysium and the contractile elements are lost before the noncontractile elements

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9
Q

What are some common dysfunctions of mm

A
  • mm spasm
  • mm contracture/tightness
  • mm imbalances (upper cross syndrome, lower cross syndrome, layer syndrome)
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10
Q

What is the end feel of a mm spasm

A

The movement has a sudden stop often accompanied by pain

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11
Q

What is an early mm spasm?

A

It occurs early in the ROM and is associated w/inflammation, seen more in acute conditions

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12
Q

What is a late mm spasm

A

Occurs at or near the end of the ROM, caused by instability of the joint and irritability of the tissues

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13
Q

What is a mm spasm?

A

a protective response as the subconscious body tries to protect against further injury

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14
Q

What is spasticity

A

It is from an UMN lesion providing a resistance to stretch

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15
Q

What is a mm contracture

A

Adaptive shortening of the mm tendon unit and other soft tissues that cross the joint which results in significant loss of ROM, resistance to passive or active stretch of the joint

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16
Q

How is a mm contracture described

A

By the location and action of the shortened mm

- ex) hip flexion contracture means they can do flex but not extension

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17
Q

List the types of contractures

A
  1. myostatic
  2. pseudo-myostatic
  3. arthrogenic or periarticular contracture
  4. fibrotic contracture and irreversible contracture
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18
Q

What is a myostatic contracture?

A

The musculotendinous unit has shortened w/o a mm pathology w/dec # sarcomeres that can be resolved w/stretching

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19
Q

What is a pesudo-myostatic contracture

A

It is limited ROM due to mm hypertonicity associated w/UMN lesion where mm is in constant state of tension, but can be lengthened if the tone is dec

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20
Q

What is an arthrogenic/periarticular contracture

A

It is an intraarticular pathology that involves adhesions, synovial proliferations, effusion and changes in articular cartilage that restricts arthrokinematics

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21
Q

What is a fibrotic contracture and irreversible contracture

A

A fibrous change in connective tissue of mm and periarticular structure that is difficult to stretch out, and the longer it occurs, the greater the replacement is with fibrotic contracture, leading to a potential irreversible contracture

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22
Q

Which type of contracture can be treated w/serial casting

A

fibrotic contracture

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23
Q

What are the injuries of the musculotendinous junction and mm belly

A

stretching (chronic sprain)
laceration
atrophy

24
Q

What is a contusion

A

A mild, moderate, or severe capillary rupture causing bleeding and an inflammatory rxn in the mm taking at least 24 hours to stabilize

25
Q

What is a mm/tendon strain

A

can be acute or chronic, when mm or tendon lacks flexibility, strength or endurance to accommodate the demands placed on it

26
Q

What is a Grade 1: Mild or First Degree sprain

A
  • There is no disruption of the mm
  • painful AROM and PROM w/o loss of motion in nearby jts
  • localized swelling and tenderness
  • No loss of strength
  • possible mild mm spasm
27
Q

What is a Grade 2: Moderate or 2nd degree sprain

A
  • some degree of disruption of the mm
  • tenderness to palpation
  • very painful PROM and AROM w/dec. in ROM in nearby jts
  • DECREASED mm strength
  • possible discontinuity
  • moderate spasms
28
Q

What is a Grade 3: Severe or 3rd degree sprain

A
  • one or more components of mm are completely disrupted
  • no change in pain w/PROM & motion in nearby jts VERY restricted
  • extreme tenderness w/swelling
  • palpable defect w/possible compartment syndrome
  • less painful than grade 2
29
Q

T or F: mm can regenerate

A

True - if the torn ends are close enough together, the mm can regenerate

30
Q

What happens during the proliferation (repair) phase for mm healing

A

Fibronectin and fibrin cross link to form a matrix for fibroblasts that synthesize proteins and Type I collagen is produced (less flexible than other)

31
Q

What occurs during mm healing

A
  • injury occurs and mm degenerates w/fragmentation, causes necrosis of tissue, and then hematoma forms b/t ruptured myofibers
32
Q

What happens during the regeneration phase for mm healing

A

activation of satellite cells to divide, proliferate and differentiate into myotubes and myofibers that can fuse the ends of the wound

33
Q

T or F: Regeneration and repair occur at the same time

A

True - the amount of regeneration vs repair depends on the size of the injury

34
Q

Growth Hormones role in mm healing

A

It is under investigation that it might improve regeneration of the tissue

35
Q

What occurs during the maturation phase

A
  • repair: continue to strengthen around scar tissue

- regen: matrix matures and contracts and continues to strengthen

36
Q

which is stronger repaired mm or regenerated mm?

A

Regenerated mm because repaired mm is type I collagen which is weaker

37
Q

How does an incision in a mm heal

A

W/primary intention to minimize scarring and the wound is closed w/sutures, staples, or adhesive tape

38
Q

what is healing by primary intention

A

healing where the edges of the wound are brought closer so that there is minimal scarring

39
Q

What is healing by secondary intention

A

The wound granulates resulting in a broader scar and a slower healing process requiring daily wound care

40
Q

What are some reasons mm atrophy occurs

A
  • lack of innervation
  • disuse (NWB or immob for min 3 days)
  • aging
41
Q

List some diseases and disorders of mm

A

MF TP
Fibromyalgia
Myositis
Rhabdomyolysis

42
Q

What is myofascial pain syndrome (TPs)

A

Hyperirritable points w/in a taut band of skeletal mm located in tissue or associated fascia that evokes a characteristic referred pain pattern

43
Q

What is the sign of myofascial pain syndrome

A

A “jump sign” where it is painful on compression

44
Q

What is fibromyalgia and the etiology

A

Chronic widespread pain and tenderness to touch w/an unknown etiology (stress, genetic, sleep, DA abnormality)

45
Q

T or F: Fibromyalgia is centrally mediated

A

Maybe - recent lit suggests that areas of the brain are turned on when P applied to a periph area of the body, possibly decreasing their reactivity threshold

46
Q

What are the clinical manifestations of fibromyalgia

A
  • widespread, non-radicular pain
  • > 3 mo
  • fatigue
  • nonrestorative sleep
47
Q

TP and Fibromyalgia

A

At least half of the 18 sites must be positive for it to be fibromyalgia

48
Q

What is myositis

A

An infectious inflammatory disease of mm from viral, bacterial or parasitic agents

49
Q

What are the most common types of myositis

A

Polymositis (weak trunk) and dermatomyositis (weakness + rash)

50
Q

What are the clinical manifestations of myositis

A 
Malasie
pain
tenderness
lethargy
swelling
fever
creatine kinase levels in blood
51
Q

What is rhabdomyolysis

A

Rapid breakdown of skeletal mm tissue releasing myoglobin into the blood stream

52
Q

What are s/s of rhabdomyolysis

A

Change in urine color (Brown from breakdown)
mm pain and weakness
bruising

53
Q

What are some causes of rhabdomyolysis

A
  • physical (prolonged high fever, excessive phys exertion)
  • mechanical (crush injury, burns, compression)
  • chemical (meds, herbal supp, excessive alcohol use, drug abuse)
54
Q

What is an acute exertional rhabdomyolysis

A

Hx is intense exercise performed recently w/CO mm pain and weakness w/poor hydration, poor physical condition, and a hot humid environment

55
Q

What can happen if acute exertional rhabdo is severe enough

A
  • can damage kidneys
  • increase HR from K+
  • renal failure
  • death
56
Q

What is the treatment for acute exertional rhabdo

A
  • fluids and PT to recover mm function

UM - MSK (9 decks)

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