1. The Muscular System
Chapter 4

2. Objectives
Describe the functions and structures of the muscular system including muscle fibers, fascia, tendons and the three types of muscle
Recognize, define, spell and pronounce the terms related to muscle movements and explain how the muscles are named
Recognize, define, pronounce, and spell the terms related to the pathology and the diagnostic and tx procedures of the muscular system

3. Word Parts Bi- Kines/o kinesi/o Ten/o, tend/o, tendin/o -cele My/o
Dys-
Ton/o
-plegia
Fasci/o
Tri-
-rrhexis
Fibr/o
Tax/o
-ia
-ic

4. Fxns of the Muscular System
mm hold the body erect and make movement possible
m movement generates nearly 85% of the heat that keeps the body warm
mm move food through the digestive system
m movement, such as walking, aids the flow of blood through veins as it returns to the heart
m axn moves fluids through the ducts and tubes associated c other body systems

5. Structures of the Muscular System
Our bodies have more than 600 mm
Our mm make up about 40-45% of our body weight
Skeletal m is made up of fibers, covered c fascia, and are attached to bones by tendons

6. Structures of the Muscular System
Muscle Fibers
Long, slender cells that make up mm
Held together by connective tissue and is enclosed in a fibrous sheath
Fascia
The sheet of fibrous connective tissue that covers, supports and separates mm or groups of mm
Flexible but not elastic
Myofascial – pertaining to m tissue and fascia

8. Structures of the Muscular System
Tendons
Narrow band of non-elastic, dense, fibrous connective tissue that attaches a m to a bone
Achilles Tendon attaches the gastrocnemius to the heel bone

9. 3 types: Skeletal, Smooth and Myocardial
Types of Muscle Tissue
3 types: Skeletal, Smooth and Myocardial
Described according to description and function

10. Types of Muscle Tissue Skeletal Muscles
Attach to the bones of the skeleton and make body motions possible
Voluntary muscles
We have conscious control over them
Striated muscles
Under a microscope there are light and dark bands that create a striped appearance

12. Types of Muscle Tissue Smooth Muscles
located in the walls of internal organs
Digestive tract, blood vessels, and ducts
Fxn: move and control the flow of fluids though these structures
Involuntary muscles
Under the control of the ANS
Unstriated
Visceral
Found in Lg int organs

14. Types of Muscle Tissue Myocardial Muscle Myocardium or Cardiac Muscle
Forms the muscular walls of the heart
Striated like skeletal muscle, but involuntary like smooth muscle
It’s contraction and relaxation causes our heartbeat!

16. Review from yesterday!!!!

17. Muscle Contraction and Relaxation
Muscle Innervation
The stimulation of a muscle by an impulse transmitted by a motor nerve
Neuromuscular – pertaining to the relationship between nerve and muscle
Antagonist Muscle Pairs
Antagonist – working in opposition to each other
Contraction – tightening of a m
Relaxation – when a m returns to it original form

18. Contrasting Muscle Motion
Abduction and Adduction (ABD & ADD)
AB-Duction – mvmt of a limb AWAY FROM the midline
AD-Duction – mvmt of a limb TOWARD the midline
Flexion and Extension ( & /)
Flexion – decreasing the angle between two bones by bending a limb at the joint
Extension – increasing the angle between two bones or the straightening of a limb
Hyperextension – extreme or overextension of a limb/body part beyond normal limits
√ is \|/ /_ btwn 2 bones by bending jt

19. Elevation and Depression
Elevation – the act of raising or lifting a body part
Depression – the act of lowering a body part
Rotation and Circumduction
Rotation – circular mvmt around an axis such as the shoulder joint/neck
Circumduction – the circular mvmt of a limb at the far end (the swinging the distal end of the arm)

20. Supination and Pronation
Supination – the act of rotating the arm or leg so that the palm/sole is turned forward or upward
Pronation – the act of rotating the arm or leg so that the palm/sole is turned downward or backward
Dorsiflexion and Plantar Flexion
Dorsiflexion - D √ - the mvmt that bends the foot upward at the ankle
Plantar Flexion – P √ – the mvmt that bends the foot downward at the ankle

21. How Muscles are Named 1
Muscles are named for their origin and insertion
The 2 points where the muscle attaches
Origin
The less moveable attachment where the muscle BEGINS
Located nearest the midline
Insertion
The more moveable attachment where the muscle ENDS attaching to bone or tendon

22. O I O I O I

23. 2 How Muscles are Named Muscles named for their Action
Named if they’re flexors or extensors
Flexor digiti minimi, extensor carpi and flexor carpi muscles

25. 3 How Muscles are Named Muscles names for their location
Named for the part of the body or organ they’re near
Pectoralis major – the thick fan-shaped muscle on the front of the chest; pectoral means chest
Lateralis (lateral) and Medialis (medial)
External or Oblique, and Internal 3

27. 4 How Muscles are Named Muscles named for Fiber Direction
Oblique – slanted or at an angle
Rectus – straight alignment with the vertical axis of the body
Sphincter – a ring like muscle that tightly constricts the opening of a passage
Transverse – crosswise direction

29. 5 How Muscles are Named Muscles named for Number of Divisions
Biceps brachii – biceps; formed from 2 divisions
Triceps brachii – triceps; formed from 3 divisions

31. 6 How Muscles are Named Muscles named for their Size or Shape
Gluteus Maximus – the larges muscle of the buttock
Deltoid Muscle – the shoulder muscle; shaped like an inverted triangle of the Greek letter delta Δ 6

33. 7 How Muscles are Named Muscles named for Strange Reasons
The hamstring group… named because that’s the muscles a by which a slaughtered pig is hanged by a butcher
Biceps Femoris, Semitendonosis, and Semimembranosis 7

35. Medical Specialties Related to the Muscular System
Exercise Physiologist
works under a physician to develop, implement and coordinate exercise programs
Neurologist
Specialized in muscular disorders where there is loss of fxn
Physiatrist
Physician who specializes in physical medicine and rehab

36. Medical Specialties Related to the Muscular System
Rheumatologist
Physician who specializes in the dx and tx of arthritis, and disorders like osteoporosis, fibromyalgia and tendonitis
Sports Medicine Physician
Specializes in the tx of sports-related injuries of the bone, joints, and mm

37. Pathology of the Muscular System
Fibers, Fascia and Tendons
Fasciitis – inflammation of the fascia
Fibromyalgia Syndrome – chronic condition characterized by fatigue, diffuse or specific m, jt or bone p!
Tenodynia – p! in the tendon
Tendinitis – inflammation of a tendon
Chronic Fatigue Syndrome
Chronic, debilitating condition. Not like fibromyalgia because it does not go away c rest

38. Pathology of the Muscular System
Muscle Disorders
Adhesions – a band of fibrous tissue that holds structures together abnormally
Atrophy – weakness or wearing away of body tissues and structures
Myalgia – tenderness or p! in the m
Myocele – the herniation of m substance thought a tear in the fascia surrounding it

39. Pathology of the Muscular System
Muscle Disorders
Myolysis – degeneration of m tissue
Myomalacia – abnormal softening of m tissue
Myorrhexis – rupture or tear of a m
Polymyositis – m disease characterized by simultaneous inflammation and weakness of voluntary mm
Sarcopenia – loss of m mass, strength, and pxn that comes c age

40. Pathology of the Muscular System
Muscle Disorders
Muscle Tone
Known as tonus; the state of balanced m tension
Atonic – lacking normal m tone or strength
Dystonia – abnormal m tone that causes the impairment of voluntary m movement

41. Pathology of the Muscular System
Muscle Disorders
Muscle Tone
Hypertonia – excessive tone of the skeletal mm
Hypotonia – diminished tone of the skeletal mm
Myotonia – a meuromuscular disorder characterized by the slow relaxation of the mm after voluntary contraction

42. How Muscles are Named Muscles are named for Origin and insertion
Their Action
Their location
Fiber Direction
Number of Divisions
Their Size or Shape
Strange Reasons

43. PATHOLOGY!!!!!!!

44. Pathology of the Muscular System
Fibers, Fascia and Tendons
Fasciitis – inflammation of the fascia
Fibromyalgia Syndrome – chronic condition characterized by fatigue, diffuse or specific m, jt or bone p!
Tenodynia – p! in the tendon
Tendinitis – inflammation of a tendon
Chronic Fatigue Syndrome
Chronic, debilitating condition. Not like fibromyalgia because it does not go away c rest

45. Pathology of the Muscular System
Muscle Disorders
Adhesions – a band of fibrous tissue that holds structures together abnormally
Atrophy – weakness or wearing away of body tissues and structures
Myalgia – tenderness or p! in the m
Myocele – the herniation of m substance thought a tear in the fascia surrounding it

46. Pathology of the Muscular System
Muscle Disorders
Myolysis – degeneration of m tissue
Myomalacia – abnormal softening of m tissue
Myorrhexis – rupture or tear of a m
Polymyositis – m disease characterized by simultaneous inflammation and weakness of voluntary mm
Sarcopenia – loss of m mass, strength, and pxn that comes c age

47. Pathology of the Muscular System
Muscle Disorders
Muscle Tone
Known as tonus; the state of balanced m tension
Atonic – lacking normal m tone or strength
Dystonia – abnormal m tone that causes the impairment of voluntary m movement

48. Pathology of the Muscular System
Muscle Disorders
Muscle Tone
Hypertonia – excessive tone of the skeletal mm
Hypotonia – diminished tone of the skeletal mm
Myotonia – a meuromuscular disorder characterized by the slow relaxation of the mm after voluntary contraction

49. Muscle Disorders Voluntary Muscle Movement Ataxia Dystaxia Contracture
The inability to coordinate m activity during voluntary movement
Dystaxia
Partial ataxia
A mild form of ataxia
Contracture
The permanent tightening of structures occurring when normal connective tissue is replaced w non-elastic fibrous tissues

50. Muscle Disorders Voluntary Muscle Movement Intermittent Claudication
P! in the leg mm during exercise; goes away c rest
Spasm
Sudden, violent, involuntary contraction of one or more mm
Cramp
Localized m cramp named for its cause (heat cramp, writer’s cramp, etc)
Spasmotic Torticollis
Wryneck
A spasmotic contracture of the neck

51. Muscle Disorders Muscle Function Bradykinesia Dyskinesia Hyperkinesia
Extreme slowness in movement
Dyskinesia
Distortion or impairment of voluntary movement such as a tic or spasm
Hyperkinesia
Hyperactivity
Abnormally increased m fxn or activity
Hypokinesia
Abnormally decreased m fxn or activity

52. Muscle Disorders Myoclonus
The sudden, involuntary jerking of a m or group of mm
Nocturnal Myoclonus
Thee jerking of limbs that can occur normally as a person is falling asleep
Singultus
Hiccups
Myoclonus of the diaphragm that causes the characteristic hiccup sound c each spasm

53. Muscular Disorders Myasthenia Gravis
Chronic autoimmune disease that affects the neuromuscular junction and produces serious weakness of voluntary mm

54. Still Pathology…

55. Muscle Disorders Muscular Dystrophy
A group of more than 30 genetic diseases that cause progressive weakness and degeneration of skeletal muscle
Duchenne Muscular Dystrophy – most common; usually in boys 3-5 y/o; by 12 most can’t walk and need a respirator
Becker Muscular Dystrophy – similar, but less sever than Duchenne.

56. Repetitive Stress Disorders
Caused by repeated motions performed in the course of normal work, ADLs, or sports
Compartment Syndrome
Compression of nerves and blood vessels in a specific compartment created by the fascia that separates groups of mm
Overuse Injuries
Minor injuries that have not been given sufficient time to heal

58. Repetitive Stress Disorders
Overuse Tendonitis
Inflammation of tendons caused by excessive or unusual use of a joint
Stress Fractures
We studied these in Ch 3.
Overuse; pounding, jumping, crushing stress

60. Repetitive Stress Disorders
Myofascial P! Syndrome
Chronic p! disorder caused by the development of trigger points
Rotator Cuff Injuries
Impingement Syndrome
Occurs when inflamed tendons are caught in the narrow spaces between the bone in the shoulder
Rotator Cuff Tendonitis
Inflammation of the tendons in the shoulder
Ruptured Rotator Cuff
Untreated tendonitis weakens tendons and they can tear

62. Repetitive Stress Disorders
Carpal Tunnel Syndrome
Occurs when the tendons that pass through the carpal tunnel are overused and become inflamed and swollen
Creates pressure on the median nerve
Causes p!, burning and parasthesia in the thumb, index and middle fingers
Release
Surgical fix where the tunnel is enlarged

64. Repetitive Stress Disorders
Ganglion Cyst
A harmless fluid filled swelling that occurs most commonly on the outer surface of the wrist
Epicondylitis
Inflammation of the tissues surrounding the elbow
Lateral
Tennis Elbow
Medial
Golfer’s or Little Leaguer’s Elbow

66. Repetitive Stress Disorders
Ankle and Feet Problems
Heel Spurs
A calcium deposit in the plantar fascia near its attachment to the calcaneus
Plantar Fasciitis
Inflammation of the plantar fascia on the sole of the foot

68. Sports Injuries Sprain Strain Shin Splint Hamstring injury
LIGAMENT injury
Strain
MUSCULAR injury
Shin Splint
Condition caused by the m pulling away from the tibia (shin bone)
Hamstring injury
Any injury, strain or tear, to the mm of the hamstring group
Achilles Tendonitis
Inflammation of the Achilles Tendon

69. Spinal Cord Injuries
The spinal cord is the consistency of toothpaste, basically, so protection is extremely necessary
The type or paralysis is determined by the level of the vertebra closest to the injury
The higher up, the great the area of the body that may be affected
When the spinal cord is injured, communication with the brain and the area below the injury may be gone or diminished

70. Spinal Cord Injuries Incomplete Injury Complete Injury
The person will have some function below the level or injury, even though that function will not be normal
Complete Injury
There is complete loss of sensation and m control below the level of the injury.
Doesn’t mean to give up hope!

73. Spinal Cord Injuries Types of Paralysis
Paralysis – the loss of sensation and voluntary m movements in m through disease or injury to its nerve supply
Myoparesis – weakness or slight muscular paralysis
Hemiparesis – slight paralysis or weakness affecting one side of the body
Hemiplegia – total paralysis affecting only one side of the body
(L brain = R side of the body and vice versa)

74. Spinal Cord Injuries
Paraplegia – paralysis of both legs and the lower body
Quadriplegia – paralysis of all four extremities
Cardioplegia –Cardiac Arrest; paralysis of the heart m
Caused by direct blow or trauma, or medically induced

75. Diagnostic Procedures of the Muscular System

76. Deep Tendon Reflexes (DTR) - tested by striking a reflex hammer on a tendon
Range of Motion testing (ROM) – procedure used to evaluate joint mobility and muscle strength
Electromyography – a test that measures the electrical activity within m fibers in response to nerve stimulation
Electroneuromyography – nerve conduction tests; testing and recording neuromuscular activity by electric stimulation of the nerve trunk that carries fibers to and from the m

77. Treatment Procedures of the Muscular System

78. Medication Antispasmotic Skeletal m relaxant Neuromuscular blocker
Anticholinergic; suppresses smooth m contractions of the stomach, intestine or bladder
Skeletal m relaxant
Administered to relax certain mm and to relieve the stiffness, p! and discomfort caused by strains, sprains, or other m injuries
Neuromuscular blocker
A drug that causes temporary paralysis by blocking the transmission of nerve stimuli to the mm

79. Occupational and Physical Therapy
Ergonomics – the study of the human factors that affect the design and operation of tools and the work environment
Occupational and Physical Therapy
OT – rehab for ADLs. Bathing, grooming, eating, dressing, etc
PT – tx to prevent disability or to restore fxn through the use of exercise, heat, massage, and other methods to improve circulation, flexibility and m strength
Myofascial Release – soft tissue manipulation to ease p!
Therapeutic Ultrasound – high-frequency sound wave to produce deep heat to ease p!, decrease m spasm and accelerate healing

80. Still under OT and PT Fascia
RICE – Rest, Ice, Compression and Elevation; the recipe for injury healing during the 1st few days post-injury
Fascia
Fasciotomy – surgical incision through the fascia to relieve tension or pressure
Fascioplasty – the surgical repair of fascia

81. Tendons Tenodesis – surgical suturing of a tendon to the bone
Tenolysis – a release of a tendon from adhesions
Tenectomy – surgical resection/removal of a portion of tendon
Tenoplasty – surgical repair of tendons
Tenorrhaphy – surgical suturing of divided ends of a tendon
Tenotomy – surgical division of a tendon for relief of a deformity caused by the abnormal shortening of a m

82. Muscles Myectomy – surgical excision of a portion of m
Myoplasty – the surgical repair of a m
Myorrhaphy – the surgical suturing of a m wound
Myotomoy – a surgical incision into a m