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.

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?

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.)

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.

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

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

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)

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

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

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.

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

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

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

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

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

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

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

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

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

RANGE OF MOTION

????? 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

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

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

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

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

Body Mechanics

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

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