Chapter 6 Muscular System Copyright 2013 Wolters Kluwer

Muscular System • ______ (how many) muscles in the human body • Functions –

Muscular System • Muscles are arranged in layers • All muscular movement is made

Word Parts Definition Example brachio arm, brachialis brachy- ______ brachycardia bucco- ______, ______ buccal

Word Parts Definition Example ______ fibromyalgia kin-, kine-, kino- ______ kinesthetics kinesi-, kinesio- ______

Word Parts Definition Example my-, myo- ______ myoma platy- flat, broad platysma pter-, ptero-

Word Parts Definition Example rhabd-, rhabdo- rod-shaped rhabdosarcoma sarco- ______, ______ sarcomere tendo-, teno-

Word Etymology brevis short bucca cheek femur thigh gloutos buttock Copyright © 2013 Wolters

Word Etymology pteron wing, feather pteryx wing rectur straight teres round, smooth vastus great

Medical Term Parts Used as Prefixes brachy- short bucco- cheek, mouth fascio- fascia pterygo-

Medical Term Parts Used as Suffixes - ______ nutrition, nourishment Copyright © 2013 Wolters

Muscular System Preview • Key characteristic of muscle is its ability to ______ when

Structures of the Muscular System • Muscle cells/muscle fibers • Muscle tissue • ______

Muscular System Structure Key Terms muscle cells muscle fibers/myofibrils muscle fibers muscle cells muscle

Muscular System Structure Key Terms sarcolemma ______ sarcoplasm ______ sarcomere ______ Copyright © 2013

Muscle Fiber Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Fiber • Individual muscle fiber has many parts – Sarcolemma = outer cell

Muscle Tissue • Three types of muscle tissue 1. ______ 2. ______ 3. ______

Skeletal Muscle Tissue • Attaches to skeletal system by ______ • Provides movement •

Skeletal Muscle Tissue Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Smooth Muscle Tissue • Nonstriated • Involuntary controlled • Appears nonstriped • ______ and

Smooth Muscle Tissue Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Cardiac Muscle Tissue • Found only in the ______ • Permits constant pumping action

Cardiac Muscle Tissue Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Tissue Key Terms skeletal muscle associated with the skeleton ______ muscle in viscera

Muscle Tissue Key Terms ______ fibrous bands or cords attaching muscle to bone or

Muscle Movement • Muscle movement is produced by pulling on bones – ______ =

Muscle Movement: Contraction • Occurs within the musculature • Requires – Motor neuron (nerve

Muscle Movement • Energy is required • Molecules that supply energy are – ATP

Muscle Movement: Muscle Fatigue • Occurs when a muscle loses its ability to contract

Muscle Movement: Muscle Relaxation • Involves – Calcium ions (Ca 2+) – ______(SR) =

Muscle Movement Key Terms origin muscle end that remains fixed during contraction insertion muscle

Muscle Movement Key Terms ______ chemical involved in nerve impulse transmission adenosine ______ cell’s

Muscle Tone • Resting tension • Sustained contraction of portions of skeletal muscle achieves

Muscle Tone Key Terms muscle tone muscle integrity achieved through active contraction of some

Basis for Naming Skeletal Muscles • Location • Fiber direction • ______ • Number

Naming Skeletal Muscles Key Terms abductors muscles that draw a body part ______ when

Naming Skeletal Muscles Key Terms extensors muscles that ______ or ______ a limb or

Pathology of Muscle System • Signs and symptoms – Muscle pain – Muscle weakness

Types of Muscle Diseases: Myopathy • Myopathy—disease of the muscles and muscle tissues that

Botulism • Serious form of food poisoning • Caused by eating contaminated food •

Botulism (cont’d) • Treatment – Guanidine hydrochloride – Pulmonary ventilation – Recovery is gradual—up

Fibromyalgia • Unknown origin • Characteristics – Myalgia, stiffness – Tenderness • Signs and

Fibromyalgia (cont’d) • Joint regions involved – Antecubital – Cervical – Sacroiliac – Patellar

Fibromyalgia (cont’d) • Treatment – Most common • Analgesics • Aspirin • NSAIDs –

Muscular Dystrophies (MDs) • Inherited disease/genetic disorder • Characteristics – Degeneration of muscle cells

Muscular Dystrophies (cont’d) • Diagnosis – Blood tests – Urine tests • Treatment –

Myasthenia Gravis • Autoimmune disease • Weakness of ______ muscles • Affects more women

Polymyositis (PM) • Autoimmune disease • Causes myositis, myomalacia , and atrophy • Affects

Polymyositis (cont’d) • Diagnosis – History – Physical examination • Treatment – Steroids to

Myopathies Key Terms ______ any disease of muscles ______ illness acquired through ingesting improperly

Myopathies Key Terms fibrosis increase in fibrous tissue fibrositis ______ muscular ______ hereditary diseases

Myopathies Key Terms ______ aminotransferase test blood enzyme test to detect tissue damage or

Myopathies Key Terms 3 -methoxy-4 -hydroxymandelic acid test urine test to detect possible muscular

Myopathies Key Terms ______ muscle inflammation electromyography procedure to obtain electromyogram muscle biopsy tissue

Muscular System Disorders: Trauma • Hernia • Rotator cuff injuries • Shin splints •

Hernia • Protrusion of an organ through an opening • Occurs when forceful muscle

Umbilical Hernia Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Rotator Cuff Injuries • Involves group of shoulder muscle: SITS – ______ – Results

Rotator Cuff Injuries (cont’d) • Diagnosis – Physical evaluation – CT scan – MRI

Shin Splints • Associated with tibial periosteum and related extensor muscles • Occurs from

Shin Splints (cont’d) • Treatment – Alternate heat and ice treatments – Analgesics –

Severed Tendon • Results from trauma or laceration • Elastic fibrous cord snaps •

Severed Tendon (cont’d) • Diagnosis – Patient history – Physical exam – Radiographic studies

Strain, Sprain, Tendonitis • Strain – Injury to the ______ – Results from overexertion

Strain, Sprain, Tendonitis (cont’d) • Signs and symptoms of strains and sprains – ______(swelling)

Strain, Sprain, Tendonitis (cont’d) • Diagnosis – Physical examination – Radiographic studies • Treatment

Muscular System Trauma Key Terms hernia protrusion as a result of pressure inguinal hernia

Muscular System Trauma Key Terms shin splints pain in anterior tibial region of lower

Muscular System Trauma Key Terms ______ injury from overexertion or trauma; involves stretching or

Muscular System Disorders: Tumors • Muscle tumors are rare • Two skeletal muscle tumors

Muscular System Tumors Key Terms rhabdomyosarcoma ______ tumor of skeletal muscle rhabdomyoma ______ tumor

Common Abbreviations: Muscular System ______ acetylcholine ACL anterior ______ ligament ADL ______ ATP ______

Common Abbreviations: Muscular System CP creatine phosphate CPK creatine phosphokinase DM ______ DMD ______

Common Abbreviations: Muscular System EMG electromyogram MCL medial ______ ligament MD ______ MG ______

Common Abbreviations: Muscular Systems NM junction ______ junction NSAIDs ______ OT ______ therapy PM

Common Abbreviations: Muscular System PT ______ therapy ROM ______ SR ______ WFL within ______

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Muscular System • ______ (how many) muscles in the human body • Functions – Moving the body’s framework – Maintaining posture – Producing ______ – Assisting ______ transport • Muscle mass makes up 40% of an average person’s body weight Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular System • Muscles are arranged in layers • All muscular movement is made possible through nerve impulses acting on tissue, causing ______ • Optimal function is achieved through muscles, tendons, ligaments, bones, and nerves working in concert Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Word Parts Definition Example brachio arm, brachialis brachy- ______ brachycardia bucco- ______, ______ buccal cardi-, cardio ______, ______ cardiopathy fascio- fascial Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Word Parts Definition Example ______ fibromyalgia kin-, kine-, kino- ______ kinesthetics kinesi-, kinesio- ______ muscul-, musculo- muscle fibr-, fibro Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins kinesiology muscular

Word Parts Definition Example my-, myo- ______ myoma platy- flat, broad platysma pter-, ptero- wing, feather pterion pterygo- ______ pterygoid Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Word Parts Definition Example rhabd-, rhabdo- rod-shaped rhabdosarcoma sarco- ______, ______ sarcomere tendo-, teno- ______ -troph, troph-, tropho-, -trophic ______, ______ atrophy tendinopathy Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular System Preview • Key characteristic of muscle is its ability to ______ when stimulated by nerves to produce movement – Nerve impulse travels to muscle tissue, exciting the muscle to contract – Accomplished through functioning of several muscle structures that shorten to produce contraction Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular System Structure Key Terms muscle cells muscle fibers/myofibrils muscle fibers muscle cells muscle tissue composed of contractile fibers Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Fiber • Individual muscle fiber has many parts – Sarcolemma = outer cell membrane – Sarcoplasm = cytosol within a muscle fiber – ______ = contractile fibers (thread-like) within muscle • Contain contractile proteins that enable muscle to contract • Sarcomeres = functional units of a myofiber that cause muscles to shorten Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Skeletal Muscle Tissue • Attaches to skeletal system by ______ • Provides movement • Also called ______ muscle • Voluntary control • Contracts and relaxes rapidly Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Smooth Muscle Tissue • Nonstriated • Involuntary controlled • Appears nonstriped • ______ and ______ are lined by smooth muscle • Contracts and relaxes slowly Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Cardiac Muscle Tissue • Found only in the ______ • Permits constant pumping action • Appears ______ • Involuntary • Cardiac muscle fibers contract as a rhythmic unit and are self-stimulated Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Tissue Key Terms skeletal muscle associated with the skeleton ______ muscle in viscera walls and blood vessels ______ progressive waves of contraction cardiac muscle heart muscle Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Tissue Key Terms ______ fibrous bands or cords attaching muscle to bone or muscle to other body parts ______ tendon sheets fascia ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Movement • Muscle movement is produced by pulling on bones – ______ = end of muscle that is attached to a immovable part – ______ = end of muscle that is attached to a movable part – When contraction occurs, one muscle typically produces movement in one direction, while another muscle produces movement in another direction. – ______ serve as levers – Joints serve as ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Movement: Contraction • Occurs within the musculature • Requires – Motor neuron (nerve cell that excites a muscle) – Muscle fiber • Threshold stimulus (level of stimulation) must be exceeded • Results from a sliding movement within the myofibrils • Byproduct is ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Movement • Energy is required • Molecules that supply energy are – ATP (______) • ATP supplies energy for muscle fiber contraction. – CP (______) • CP (present in muscle tissue and an energy-storing substance) synthesizes ATP as it decomposes • Active muscles depend on cellular ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Movement: Muscle Fatigue • Occurs when a muscle loses its ability to contract • Results from – Interruption of blood supply to the muscle – Lack of ______ – Accumulation of ______ acid as a result of anaerobic respiration Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Movement: Muscle Relaxation • Involves – Calcium ions (Ca 2+) – ______(SR) = storage and release site of Ca 2+ in a muscle fiber • After the Ca 2+ is released, the SR reabsorbs the calcium, thereby halting the contraction process Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Movement Key Terms origin muscle end that remains fixed during contraction insertion muscle end that moves during contraction ______ junctions myoneural junctions Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Movement Key Terms ______ chemical involved in nerve impulse transmission adenosine ______ cell’s energy source myoglobin muscle hemoglobin, myohemoglobin Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Tone • Resting tension • Sustained contraction of portions of skeletal muscle achieves muscle tone • Essential for posture and balance • Atrophy describes muscle tissue wasting as a result of – disease – ischemia – nutritional deficiencies • ______ is enlargement of muscle tissue (ex: muscle builders) Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscle Tone Key Terms muscle tone muscle integrity achieved through active contraction of some fibers ______ physiologic or pathologic muscle size reduction hypertrophy ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Basis for Naming Skeletal Muscles • Location • Fiber direction • ______ • Number of ______ • Origin • ______ • Action • Point of achievement Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Naming Skeletal Muscles Key Terms abductors muscles that draw a body part ______ when contracted adductors muscles that draw a body part ______ when contracted Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Naming Skeletal Muscles Key Terms extensors muscles that ______ or ______ a limb or part flexors muscles that ______ or ______ a limb or part Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Pathology of Muscle System • Signs and symptoms – Muscle pain – Muscle weakness • Muscle disorders usually result from – Trauma – Tumor – Immune disorder – Improper nerve conduction – Inheritance – Infection Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Types of Muscle Diseases: Myopathy • Myopathy—disease of the muscles and muscle tissues that is either inherited or acquired – Acquired • ______ – Inherited • ______(MDs) • ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Botulism • Serious form of food poisoning • Caused by eating contaminated food • Contains toxin: ______, the most potent poison known • Signs and symptoms – Double vision – Light sensitivity – Blurred speech – Nausea – Vomiting – Inability to walk—muscle weakness Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Fibromyalgia (cont’d) • Joint regions involved – Antecubital – Cervical – Sacroiliac – Patellar • Diagnosis – Patient history and physical exam Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Fibromyalgia (cont’d) • Treatment – Most common • Analgesics • Aspirin • NSAIDs – Proven successful • Chiropractic adjustments • Physical therapy • Medical massage Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular Dystrophies (MDs) • Inherited disease/genetic disorder • Characteristics – Degeneration of muscle cells causing progressive muscle weakness – Muscles replaced by fat and connective tissue • Types – ______ muscular dystrophy (DMD) is the most common type – ______ MD is an x-linked genetic disorder affecting only males Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Myasthenia Gravis • Autoimmune disease • Weakness of ______ muscles • Affects more women than men • Signs and symptoms – difficulty in chewing, swallowing, and talking • Diagnosis – history and physical examination • Treatment – cholinesterase inhibitors – corticosteroid therapy Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Polymyositis (PM) • Autoimmune disease • Causes myositis, myomalacia , and atrophy • Affects mainly women • Signs and symptoms – Inability to raise arms over the head – Difficulty in walking Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Polymyositis (cont’d) • Diagnosis – History – Physical examination • Treatment – Steroids to minimize inflammation – Immunosuppressants – Physical therapy – Medical massage Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Myopathies Key Terms ______ any disease of muscles ______ illness acquired through ingesting improperly cooked or canned food containing Clostridium botulinum fibromyalgia widespread muscle and joint pain of unknown origin myalgia ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Myopathies Key Terms fibrosis increase in fibrous tissue fibrositis ______ muscular ______ hereditary diseases marked by muscle cell degeneration alanine ______ test blood enzyme to detect tissue damage Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Myopathies Key Terms ______ aminotransferase test blood enzyme test to detect tissue damage or muscular dystrophy ______ phosphokinase test blood enzyme test to detect tissue damage ______ urine test to detect muscle damage Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Myopathies Key Terms 3 -methoxy-4 -hydroxymandelic acid test urine test to detect possible muscular dystrophy myasthenia gravis ______ polymyositis autoimmune disease characterized by muscle inflammation and atrophy Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Myopathies Key Terms ______ muscle inflammation electromyography procedure to obtain electromyogram muscle biopsy tissue sample taken for evaluation Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular System Disorders: Trauma • Hernia • Rotator cuff injuries • Shin splints • Severed tendon • Strains • Sprains • Tendonitis Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Hernia • Protrusion of an organ through an opening • Occurs when forceful muscle contractions increase abdominopelvic pressure considerably, forcing organ bulging • General forms 1. ______ 2. ______ Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Rotator Cuff Injuries • Involves group of shoulder muscle: SITS – ______ – Results from a consequence of acute trauma, degenerative changes or overuse • Immediate pain and inability to abduct the arm Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Shin Splints • Associated with tibial periosteum and related extensor muscles • Occurs from tremendous muscle stress caused by running • Diagnosis – Physical exam – Radiographic studies Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Severed Tendon • Results from trauma or laceration • Elastic fibrous cord snaps • Signs and symptoms – Pain – Inflammation – Immobility of affected area Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Strain, Sprain, Tendonitis • Strain – Injury to the ______ – Results from overexertion or trauma – Involves stretching or tearing ______ fibers • Sprain – Similar to strain but more serious – Occurs near a ______ – Caused by acute or accumulative trauma Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Strain, Sprain, Tendonitis (cont’d) • Signs and symptoms of strains and sprains – ______(swelling) – Fibromyositis (muscle and tendon inflammation) – Myalgia • Tendonitis may occur with sprain injuries • Slow healing–up to 6 weeks’ recovery Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Strain, Sprain, Tendonitis (cont’d) • Diagnosis – Physical examination – Radiographic studies • Treatment – Limb elevation – Rest – Analgesics – NSAIDs Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular System Trauma Key Terms shin splints pain in anterior tibial region of lower leg severed tendon lacerated tendon ______ surgical removal of a tendon Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular System Trauma Key Terms ______ injury from overexertion or trauma; involves stretching or tearing muscle fibers ______ injury near a joint involving ligament or tendon damage ______ muscle and tendon inflammation tendonitis tendon inflammation Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Muscular System Disorders: Tumors • Muscle tumors are rare • Two skeletal muscle tumors – ______—malignant tumor – ______—benign tumor – Rhabd- and rhabdo- mean striated, indicating location in the skeletal muscle tissue Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins