1. Soft Tissue

2. Video of the day Achilles Tendon Rupture- Beckham
&feature=fvsr

3. Soft Tissue Basically, everything else in the body (excluding bones)
Muscles/Tendons
Ligaments
Nerves

4. Muscles (skeletal) Functions Movement Stabilization Heat production
Types
Skeletal (this is what we will focus on)
Smooth
Cardiac

5. Muscle Sarcomere Z disc Myosin (A band) Actin
Used to diiferentiate individual sarcomeres
Myosin (A band)
Thick filament (purple)
Actin
Thin filament (red)

6. How do muscles function?
Jq4w (2:59)

7. Sliding Filament Theory
Excitation Phase
Brain sends signal to muscle
Acetylcholine (neurotransmitter) is released at neuromuscular junction
Calcium (stored) is released from sarcoplasmic reticulum of muscle (floods myofibril)

8. Sliding Filament Theory cont.
Coupling Phase
Calcium bind troponin
Causes tropomyosin cover to shift, exposing binding sites on actin
Myosin “hands” can now grab onto actin

9. Sliding Filament Theory cont.
Contraction Phase
Myosin “hands” grab actin with phosphate and ADP attached= crossbridge (2 and 3)
ADP (previously ATP) is expended= powerstroke (cocked) (4)
(NOTE: myosin heads move and actin filaments moves)
ATP binds to myosin (and quickly broken down)= released from crossbridge (1)

10. Sliding Filament Theory cont
Relaxation
Calcium is absorbed back into sarcoplasmic reticulum
Tropomyosin covers actin binding sites

11. Types of Muscle Contractions
Isometric
Contracts but no change in sarcomere length (Z discs don’t move)
Examples: ???
Concentric
Contracts and sarcomere shortens (Z discs get closer)
Eccentric
Contracts and sarcomere lengthens (Z discs get farther from each other)
Stronger contraction

12. Question of the day
What are the four phases of the sliding filament theory and (briefly) what happens during each?
Excitation: brain signals to contract, calcium released
Coupling: calcium binds troponin, tropomyosin shifts and actin binding sites are exposed
Contraction: myosin binds actin (with ADP), powerstroke occurs (ADP released), myosin releases (ATP binds)
Relaxation: calcium returns to sarcoplasmic reticulum, tropomyosin covers actin binding sites

13. Video of the day
byrU&feature=related (knee injury: 0:57)

14. Ligaments and Tendons Tendon Ligament Attaches muscle to bone
Attaches bone to bone
Provide joint stability

15. Joint Stability and Role of Muscles and Ligaments
All joints have certain amount of stability (static)
Function of:
Bony anatomy
Ligaments
Muscles provide stability (dynamic) not afforded by ligaments/bones
Contract to help create stability

16. Example Bony stability (of shoulder)

17. Example Ligamentous stability (of shoulder)

18. Example Muscular stability (of shoulder)

19. Ligament Injury Sprain= an injury to a ligament from over-stretching
Grade
Tissue Injury
Signs and Sx
Grade 1
Over-stretching and separation (micro tears) of ligament fibers (minimal to no joint instability)
Mild to moderate pain, localized swelling, mild joint stiffness
Grade 2
Tearing and separation of ligament fibers (moderate joint instability)
Moderate to severe pain, swelling, discoloration, joint stiffness/looseness
Grade 3
Complete tearing of the ligament (severe joint instability sometimes resulting in subluxation or luxation/dislocation)
Severe pain (followed by little to no pain as nerve fibers disrupted), swelling, discoloration, joint looseness (MAY REQUIRE SURGICAL INTERVENTION)
Prentice

20. Muscle and Tendon Injury
Tendonitis= _________ of a tendon
Can be graded based on when it hurts
In general, 2 types
Torn
Not torn (microtrauma)
Contusion
Compression to muscle or tendon
Muscle/tendon goes into spasm
Muscle/function is diminished

21. Muscle Injury
Strain= an injury to a muscle from over- stretching or too much tension
Grade
Tissue Injury
Signs and Sx
Grade 1
Over-stretching and separation (micro tears) of muscle fibers
Mild to moderate pain, localized swelling, minimal to no strength loss compared to opposite side
Grade 2
Partial tearing and separation of muscle fibers
Moderate to severe pain, swelling, discoloration (bleeding), moderate strength loss compared to opposite side, palpable defect
Grade 3
Complete tearing of the muscle fibers
Severe pain, swelling, discoloration (bleeding), palpable defect (hole or “mushy”), little to no function as compared to opposite side, visual deformity (MAY REQUIRE SURGICAL INTERVENTION)
Prentice

22. Question for the class
What is the difference between a muscle strain and a “pulled” muscle?
ANSWER: NOTHING!!

23. For Comparison SPRAIN STRAIN Grade Tissue Injury Signs and Sx Grade 1
Over-stretching and separation (micro tears) of ligament fibers (minimal joint instability)
Mild to moderate pain, localized swelling, mild joint stiffness
Grade 2
Partial tearing and separation of ligament fibers (moderate joint instability)
Moderate to severe pain, swelling, discoloration, joint stiffness/dysfunction
Grade 3
Complete tearing of the ligament (severe joint instability sometimes resulting in subluxation or luxation/dislocation)
Severe pain (followed by little to no pain as nerve fibers disrupted), swelling, discoloration, joint looseness (MAY REQUIRE SURGICAL INTERVENTION)
STRAIN
Grade
Tissue Injury
Signs and Sx
Grade 1
Over-stretching and separation (micro tears) of muscle fibers
Mild to moderate pain, localized swelling, minimal strength loss compared to opposite side
Grade 2
Partial tearing and separation of muscle fibers
Moderate to severe pain, swelling, discoloration (bleeding), moderate strength loss compared to opposite side, palpable defect
Grade 3
Complete tearing of the muscle fibers
Severe pain, swelling, discoloration (bleeding), palpable defect (hole or “mushy”), little to no function as compared to opposite side, visual deformity (MAY REQUIRE SURGICAL INTERVENTION)

24. Nerve Injuries Contusion/Compression
Nerve Injuries
Contusion/Compression
Blow to nerve causing impairment (Sx can be transient or long lasting)
Example: “Funny Bone”
Stretching
Nerve gets over stretched (Sx can be transient or long lasting
Example: Neuropraxia (aka “Stinger”)
Tearing/Avulsion
Nerve gets severed or torn away from spinal cord
Example: Nerve root avulsion

25. Nerve Injuries Take much longer to heal
2mm-5mm per day
Like bone (but unlike muscle and ligament) heal with (own) nerve tissue
Muscle and ligaments heal with scar tissue
Usually present with tingling, burning, numbness/decreased sensation, and/or muscle weakness

26. Video
mASM (spiral fx of arm in baseball pitcher, :30)