Muscle Quick Facts • There are 650 skeletal muscles of various lengths, shapes, and strength. • A muscle cell has the ability to propagate an action potential along its cell membrane and has the internal machinery to give it the unique ability to contract. • Most muscles in the body can be classified as striated muscles • Although both skeletal and cardiac muscles are striated they do possess some characteristic functional differences. • Non-striated muscle consists of multi-unit and unitary (visceral) smooth muscle. • Most smooth muscles are part of the urinary bladder, uterus, spleen, gallbladder, and numerous other internal organs.
Muscle Names Skeletal muscles are often named after the following characteristics: • Number of origins. • Origin or insertion. • Location. • Shape. • Triangular • Trapezoid • Sawtoothed • Rhomboid’
(cont) Muscle Names • Direction of muscle fibers. • Rectus • Transverse • Oblique • Size. • Maximus • Minimus • Longus • Brevis • Action • Flexors • Extensors • Abductors • Adductore
Types of Muscle Fibers • White (fast) fibers – contract rapidly; fatigue quickly; energy production is mainly via anaerobic • Red (slow) fibers – contract slowly; fatigue slowly; energy production is mainly via aerobic • Intermediate fibers – have structural and functional qualities between those of white and of red fibers.
Muscle Attachment and Function • For coordinated movement to take place, the muscle must attach to either bone or cartilage or in the case of the muscles of face to skin. • The portion of a muscle attaching to bone is the tendon. • A muscle has two extremities, its origin and its insertion.
Contraction Excitation A muscle is triggered by the generation of an action potential in the muscle membrane. Contraction A response to excitation it involves the sliding of thin and thick myofilaments past one another making and breaking chemical bonds with each other. Tetanus When a volley of stimuli is applied to a muscle, each succeeding stimulus may arrive before the muscle can completely relax from the contraction caused by the preceding stimulus Energy Sources The immediate energy source for contraction is ATP
Musculoskeletal Pathologies Legg-Calve-Perthes disease: poor blood supply to the superior aspect of the femur. Causing it to deteriorates. Symptoms: • Hip and Knee pain, Limited AROM and PROM, Pain with gait and unequal leg length. Tests: • X-ray Hip, Test ROM of hip Treatment: • Surgery, Physical therapy, Brace, Bedrest Polymyalgia Rheumatica- hip or shoulder pain disorder in people greater than 50 years old. • Symptoms: • Shoulder pain, Hip pain, Fever, Anemia, Fatigue Treatment: • Pain management, Corticosteroids
Musculoskeletal Pathologies Rheumatoid Arthritis: inflammatory autoimmune disease that affects various tissues and joints. Symptoms: • Fever, Fatigue, Joint pain, swelling, ROM decreased, Hand/Feet deformities, Numbness, Skin color changes Tests: • Rheumatoid factor tests, Synovial fluid exam, X-rays of involved joints Treatment: • Physical therapy, Moist heat, Anti-inflammatory drugs Juvenile Rheumatoid Arthritis: inflammatory disease that occurs in children. Symptoms: • Painful joints, Eye inflammation, Fever,Rash, Temperature changes (joints)
Musculoskeletal Pathologies Paget’s disease: abnormal bone development that follows bone destruction. Symptoms: • Joint pain, Bow legged appearance,Hearing loss, Neck and back pain, Headaches, Sharp bone pain Tests: • X-rays- abnormal bone development., Bone scan Treatment: • NSAIDS and Surgery Osteoarthritis: chronic condition affecting the joint cartilage that may result in bone spurs being formed in the joints. Symptoms: • Joint pain, Morning stiffness, Limited AROM, Weight bearing increase symptoms Tests: • X-ray, Passive testing of joints
Musculoskeletal Pathologies Gout: uric acid development in the joints causing arthritis. Symptoms: • Joint edema, Fever, Lower extremity and/or upper extremity, joint pain Fibromyalgia: joint, muscle and soft tissue pain in numerous locations. Presence of tender points and soft tissue pain. • Symptoms: • Fatigue, Body aches, Poor exercise capacity, Muscle/Joint pain Duchenne muscular dystrophy: Genetically X-linked recessive type of muscular dystrophy that starts in the lower extremities. Symptoms: • Falls, Fatigue, Muscle weakness, Gait dysfunction, Scoliosis, Joint contractures
Musculoskeletal Pathologies Ankylosing spondylitis: Vertebrae of the spine fuse. Symptoms: • Limited AROM, Back and neck pain, Joint edema, Fever, Weight loss Compartment syndrome: impaired blood flow and nerve dysfunction caused by nerve and blood vessel compression. Symptoms: • Severe pain, Weakness, Skin color changes Osteosarcoma: bone tumor that is malignant and found in adolescents. Symptoms: • Bone pain, Fractures, Swelling
Special Test C-spine: • Quadrant Test C-spine • Vertebral Artery Test • Alar Ligmanet Test • Cranial-Atlas Lift • Chin Tuck/Reverse Chin tuck • Valsalva
Special Test T-Spine: • Slump Tension Test • Passive Neck Flexion • SIJ Compression/Distraction • Compression/Distraction
Special Test L-Spine: • Kernig’s Test • SLR • Femoral nerve Stretch • Hoover Test • SIJ Distraction/Compression
Special Test SI Testing: • Standing Flexion test • Long Sitting Test • Straight Leg Raise • Prone Knee Bend • Gillet’s Test • Leg Length Test
Special Test Hip: • Percussion Test • Thomas Test • Torque Test • Sign of the Buttock • Faber’s Test • Ober’s Test • Piriformis Test
Special Test Knee: • Meniscal- McMurray’s, Apley’s Compression, Bounce Home • Patella- Q angle, Perkin’s test, Apprehension Test, Plica Stutter, Grind Test • ITB- Ober’s Test, Noble’s Compression • Ligamentoous: Lachman’s, Recurvatum, A/P Drawer Test, Varus/Valgus Tests
Special Test Ankle: • Anterior Drawer • Talar Tilt • Tib/Fib Compression • Thompson’s • Percussion Test • Homan’s Sign • Forefoot Varus/Valgus • Tinnel’s
Special Test Shoulder: • Rotator Cuff Tear: Supraspinatus, Drop Arm Test • Impingement: Hawkin’s, Neer’s Test, Painful Arc • Biceps Tendinitis: Speed’s, Yeargeson’s, Ludington’s • Lax Capsule: Sulcus sign, Apprehension test
Special Test Elbow: • Tinnel’s sign • Pinch Grip Test • Varus/Valgus Test • Wartenberg’s Sign • Medial Epicondylitis Test • Lateral Epicondylitis Test • Elbow Flexion Test
Special Test Wrist/Hand: • Bunnel-Litter Test • Varus/Valgus Stress Test • Murphy’s sign • Hand Volume Test • Finkelstein Test • Tinnel’s sign • Allen’s Test
Works Cited • Morrison Media LLC. “NPTAE Secrets.” 2008. 1-171. Print. • Miles, Scott. Scorebuilders.“PTA Exam.” 2010. • Google Images