1. Muscular System
HS-EHS-6 Evaluate the anatomy, physiology, and basic pathophysiology of the muscular and skeletal systems, and perform technical skills related to the systems.
6.1 Analyze the basic structures and functions of the muscular system.
6.3 Explain the relationship between the muscular and skeletal systems, and identify their interdependence as they relate to body structure, movement and posture.
6.5 Research common diseases, disorders, and emerging disorders of the muscular and skeletal systems including pathophysiology, prevention, diagnosis and treatment that might be utilized.
6.9 Locate and identify the types of muscles in the muscular system and test them.
6.10 Perform range of motion (ROM) for joints such as the shoulder, wrist and ankle.
6.11 Differentiate between active and passive range of motion.

2. Essential Questions
What are the structures and functions of the muscular system?
How does the muscular and skeletal systems relates?
What is the difference between voluntary and involuntary muscle control?
What is the difference btwn. active and passive range of motion?

3. The Muscular System
The ability to move is an essential activity of the human body
½ our body weight comes from muscles
Consists of over 600 individual muscles.
3 purposes:
Body movement
Body shape
Body heat (maintain temp.)

4. The Muscular System
Body movements are determined by three types of muscles
Smooth (involuntary) – cannot be controlled by will.
Cardiac – control the contractions of the heart.
Skeletal (Voluntary) – can be controlled by will.

5. Function of Skeletal muscles
Attach to bones to provide voluntary movement
Tendons: strong, tough connective cords
Fascia: tough, sheet-like membrane
Produce heat and energy for the body
Help maintain posture
Protect internal organs
Called striated (striped) because they have striations of alternating light and dark band

6. Functions cont’d. Fleshy body parts are made of skeletal muscles
Provide movements to the limbs, but contract quickly, fatigue easily and lack the ability to maintain contraction for long periods
Blinking eyes, talking, breathing, eating, dancing and writing all produced by these muscles

7. Function of Smooth Muscle
Called smooth muscle because they are unmarked by striations, small spindle shaped
Unattached to bones, act slowly, do not tire easily and can remain contracted for a long time
Not under conscious control so they are also called involuntary muscles
Found in walls of internal organs (intestines, bladder, stomach, uterus, blood vessels)

8. Function of cardiac muscle
Found only in the heart
Involuntary muscle
Requires a continuous supply of oxygen to function
Cardiac muscle cells begin to die after 30 seconds of oxygen cut-off
Striated and branched

9. Special muscles Sphincter (dilator) muscles are openings between
the esophagus and stomach
The stomach and small intestines
Walls of the anus, urethra and mouth
Open and close to control passage of substances

10. Active vs. Passive ROM
Active ROM -people trying to increase or maintain flexibility on their own. (They require no assistance to perform simple movements, such as arm circles or flexing of fingers).
Passive ROM-someone physically moving a part of your body for you. (This requires no effort on the part of the patient, for instance, a therapist may grasp your arm gently and move it in a circular motion).
For active, you move the arm; for passive, someone else moves it.

11. Characteristics of Muscles
All muscles have 4 common characteristics
Excitability – ability to respond to a stimulus (ie: nerve impulse)
Contractibility – muscle fibers that are stimulated by nerves contract (become shorter) and causes movement
Extensibility – ability to be stretched
Elasticity – allows the muscle to return to its original shape after it has been stretched

12. Sources of heat/energy
When muscles work, they produce heat that our body needs to function properly
Major source of this energy is ATP – a compound found in muscle cells
ATP requires muscle cells to have oxygen, glucose and other materials circulated by the blood
When the muscle is stimulated, ATP is released, thus producing heat

13. Definitions Adduction: Abduction: Flexion: Extention: Rotation:
Moving a body part toward the midline
Abduction:
Moving a body part away from the midline
Flexion:
Decreasing the angle between two bones or bending body parts
Extention:
Increasing the angle between two bones or straightening the body part
Rotation:
Turning a body part around its own axis
Circumduction:
Moving in a circle at a joint

14. State of partial contraction is called:
Buildup of lactic acid caused by vigorous exercise where blood is unable to be transported:
MUSCLE FATIGUE
State of partial contraction is called:
MUSCLE TONE
Loss of muscle tone occurs when muscles are not used for a long period of time. Muscles atrophy (shrink in size and lose strength) and results in:
CONTRACTURES
Foot drop is the most common type of contracture seen, but fingers, knees and other joints can be affected

15. MUSCLES YOU NEED TO KNOW THE FUNCTIONS OF:
Biceps – flexes lower arm
Deltoid – abducts arm; injection site
Sternocleidomastoid – turns head
Gastrocnemius – flexes sole of feet
Latissimus dorsi – extends & adducts upper arm
Pectoralis major – adducts and flexes upper arm
intercostals – moves ribs for breathing

16. Trapezius – extends head, moves shoulder
Triceps – extends lower arm
Gluteus maximus – extends thigh; injection site
Sartorius – abducts thigh, flexes leg
Vastus lateralis – extends leg
Rectus abdominus – compresses the abdomen
Rectus femoris – flexes thigh & extends lower leg
Tibialis anterior – flexes and inverts foot

17. MUSCULAR DYSTROPHY
Group of inherited diseases that cause chronic, progressive muscle atrophy resulting in total disability and early death
No cure
Treatment used to slow progression of disease
FIBROMYALGIA
Chronic, widespread pain in specific muscle site; numbness and tingling in arms or legs; headaches
Cause unknown
Treat symptoms – pain relief; stress reduction and muscle relaxers

18. MYASTENIA GRAVIS
Chronic condition where nerve impulses are not transmitted correctly leading to progressive muscular weakness and paralysis; affects respiratory muscles and can be fatal
Cause unknown
Treatment is supportive
MUSCLE SPASMS/CRAMPS
Sudden, painful involuntary muscle contractions
Caused from overexertion, low electrolytes or poor circulation
Treat by applying gentle pressure and stretching of the affected muscle

19. STRAIN
Overstretching of a muscle or tendon frequently in legs, back or arms
Caused by sudden muscle exertion
Treated by resting, muscle relaxants, or pain medications, elevation of extremity and applying hot/cold compresses

20. RANGE OF MOTION

21. ????? WHY ?????
Done to maintain health of the musculoskeletal system (muscle/skeleton)
Each joint and muscle is moved through its full range for patients with limited ability to move
Administered by: PT, RN, Assistant, or other authorized personnel (with training)
Done to prevent problems caused by lack of movement

22. Problems from lack of movement
Contractures
Tightening and shortening of a muscle resulting in a permanent flexing of a joint
Muscle atrophy
Muscles become weak and joints become stiff
Circulatory impairment
Blood clots and pressure ulcers can develop
Mineral loss
Especially calcium from the bones making bones brittle and easily to be fractured
Other problems
Poor appetite; constipation; urinary infections; respiratory problems; and pneumonia

23. Types of ROM Active ROM Active assistive ROM Passive ROM Resistive ROM
Performed by patients who are able to move each joint without assistance
Active assistive ROM
Patient actively moves the joints but receives assistance to complete the entire range
Passive ROM
Another person moves each joint for a patient who is not able to exercise
Resistive ROM
Exercises are performed by a PT against resistance

24. Definitions Abduction – moving away from midline
Adduction – moving toward midline
Flexion – bending of body part
Extension – straightening of body part
Rotation – moving around its own axis
Circumduction – moving in a circle at a joint

25. Principles to follow Movement should be slow and smooth
Support provided to the parts above and below the joint being exercised
Never force a joint beyond its ROM or to the point of pain
STOP if a person complains of pain
Perform each movement 3-5 times
Encourage patient to assist as much as possible
Prevent patient exposure
Keep door closed and patient screened off
Use correct body mechanics

26. Body Mechanics

27. 4 main reasons… Muscles work best when used correctly
Correct use of muscles makes lifting, pulling and pushing easier
Prevents unnecessary fatigue and strain therefore, saves energy
Prevents injury to self

28. 8 rules of good body mechanics
Maintain broad base of support (8-10 in.)
Bend from hips and knees to get close to object
Use strongest muscles: shoulders, arms, hips, thighs
Use weight of body to help push/pull
Carry heavy objects close
Avoid twisting body; turn whole body when changing direction
Avoid bending for long periods
Get help if object is too heavy