Medical Terminology - The Muscular System PDF

Medical Terminology The Muscular System 1 2  STRUCTURES OF THE MUSCULAR SYSTEM The muscular and skeletal systems are sometimes referred to jointly as the musculoskeletal system. Muscle fibers; the long, slender cells that make up mu...

Medical Terminology The Muscular System 1 2  STRUCTURES OF THE MUSCULAR SYSTEM The muscular and skeletal systems are sometimes referred to jointly as the musculoskeletal system. Muscle fibers; the long, slender cells that make up muscles. 3 4  Fascia (FASH-ee-ah); a band of connective tissue that envelops, separates, or binds together muscles or groups of muscles (plural, fasciae or fascias). Myofascial (my-oh-FASH-ee-ahl); pertaining to muscle tissue and fascia 5  Tendon; a narrow band of nonelastic, dense, fibrous connective tissue that attaches a muscle to a bone. Ligaments; bands of fibrous tissue that form joints by connecting one bone to another bone Achilles tendon attaches the gastrocnemius muscle (the major muscle of the calf of the leg) to the heel bone. 6  Aponeurosis; a sheet-like fibrous connective tissue ○ Resembles a flattened tendon ○ Serves as a fascia to bind muscles together or as a means of connecting muscle to bone (plural, aponeuroses). ○ As an example, the abdominal aponeurosis 7  TYPES OF MUSCLE TISSUE The three types of muscle tissue are ○ Skeletal muscle ○ Smooth muscle ○ Myocardial muscle 8  TYPES OF MUSCLE TISSUE Skeletal muscle: Attached to the bones of the skeleton and make body motions possible Also known as voluntary muscles because we have conscious (voluntary) control over these muscles. Also known as striated muscles because under a microscope, the dark and light bands in the muscle fibers create a striped appearance. ○ Striated means striped. 9  TYPES OF MUSCLE TISSUE Smooth muscle: Located in the walls of internal organs such as the digestive tract, blood vessels, and ducts leading from glands To move and control the flow of fluids through these structures. Aka, involuntary muscles because they are under the control of the autonomic nervous system Aka, unstriated muscles; No the dark and light bands Aka, visceral muscles. Visceral means relating to the internal organs. 10  TYPES OF MUSCLE TISSUE Myocardial muscle: also known as myocardium or cardiac muscle, form the muscular walls of the heart (my/o means muscle, cardi means heart, and -al means pertaining to) Like striated skeletal muscle in appearance, but is similar to smooth muscle in that its action is involuntary. It is the constant contraction and relaxation of the myocardial muscle that causes the heartbeat. 11  MUSCLE CONTRACTION AND RELAXATION Muscle innervation (in-err-VAY- shun); the stimulation of a muscle by an impulse transmitted by a motor nerve. When the stimulation stops, the muscle relaxes. If the nerve impulse is disrupted due to an injury or disease, the muscle is unable to function properly. Neuromuscular (new-roh-MUS- kyou-lar); pertaining to the relationship between a nerve and muscle 12  Antagonistic Muscle Pairs All muscles are arranged in antagonistic pairs. ○ Antagonistic; working in opposition to each other. Contrasting motions make contraction and relaxation possible. Contraction; the tightening of a muscle, it becomes shorter and thicker, causing the belly (center) of the muscle to enlarge. Relaxation; occurs when a muscle returns to its original form. The triceps and biceps work as a pair to make movement of the arm possible. 13  CONTRASTING MUSCLE MOTION Abduction (ab-DUCK-shun); the movement of a limb (arm or leg) away from the midline of the body An abductor is a muscle that moves a body part away from the midline. Adduction (ah-DUCK-shun); the movement of a limb (arm or leg) toward the midline of the body An adductor is a muscle that moves a body part toward the midline. 14  Flexion (FLECK-shun); decreasing the angle between two bones by bending a limb at a joint A flexor muscle bends a limb at a joint. Extension; increasing the angle between two bones or the straightening out of a limb An extensor muscle straightens a limb at a joint Hyperextension is the extreme or overextension of a limb or body part beyond its normal limit. 15  Elevation; the act of raising or lifting a body part. ○ For example, the elevation of the levator anguli oris muscles of the face raises the corners of the mouth into a smile. A levator is a muscle that raises a body part. Depression;the act of lowering a body part. ○ The depressor anguli oris lowers the corner of the mouth into a frown. A depressor muscle lowers a body part. 16  Rotation; a circular movement around an axis such as the shoulder joint. Circumduction (ser-kum-DUCK- shun); the circular movement at the far end of a limb. An example of circumduction is the swinging motion of the far end of the arm. A rotator muscle turns a body part on its axis. The head of the humerus (HYUM- er-us) rotates within the shoulder joint. The rotator cuff is the group of muscles and their tendons that hold the head of the humerus securely in place as it rotates within the shoulder joint. 17  Supination (soo-pih-NAY- shun); the act of rotating the arm or the leg so that the palm of the hand or sole of the foot is turned forward or upward. ○ Carrying a bowl of soup. Pronation (proh-NAY-shun); the act of rotating the arm or leg so that the palm of the hand or sole of the foot is turned downward or backward. 18  Dorsiflexion (dor-sih-FLECK-shun); the movement that bends the foot upward at the ankle. ○ Pointing the toes and foot upward decreases the angle between the top of the foot and the front of the leg. Plantar flexion (PLAN-tar FLECK- shun); the movement that bends the foot downward at the ankle. Plantar means pertaining to the sole of the foot. 19 HOW MUSCLES ARE NAMED Named for Their Origin and Insertion Named for Their Action Named for Their Location Named for Fiber Direction Named for Number of Divisions Named for Their Size or Shape Named for Strange Reasons 20  Muscles Named for Their Origin and Insertion Two points of attachment; the origin and insertion ○ The origin is where the muscle begins ○ The insertion is where the muscle ends by attaching to a bone or tendon. The sternocleidomastoid muscle, for example, helps bend the neck and rotate the head ○ Stern/o meaning breastbone and cleid/o meaning collar bone. ○ The mastoid muscle inserts at one point of insertion into the mastoid process. 21  Muscles Named for Fiber Direction Some muscles are named for the direction in which their fibers run. Oblique (oh-BLEEK); slanted or at an angle. ○ As an example, the external oblique and internal oblique muscles have a slanted alignment. 22  Muscles Named for Fiber Direction Rectus (RECK-tus); straight alignment with the vertical axis of the body. ○ As an example, the rectus abdominis and rectus femorus have straight alignment. 23  Muscles Named for Fiber Direction A sphincter (SFINK-ter) is a ring-like muscle that tightly constricts the opening of a passageway. ○ A sphincter is named for the passage involved. As an example, the anal sphincter closes the anus. Transverse (trans-VERSE) means in a crosswise direction. An example is the transverse abdominis muscle in the abdomen, which has a crosswise alignment. 24  Muscles Named for Number of Divisions Muscles may be named according to the number of divisions forming them. The biceps brachii (BYE-seps BRAY-kee-eye), also known as the biceps, is formed from two divisions (bi- means two, and -ceps means head). The triceps brachii (TRY-seps BRAY-kee-eye), also known as the triceps, is formed from three divisions (tri- means three, and -ceps means head). These muscles flex and extend the upper arm. 25  Muscles Named for Their Size or Shape Some muscles are named because they are broad or narrow, or large or small. The gluteus maximus (GLOO- tee-us MAX-ih-mus) is the largest muscle of the buttock, ○ Maximus means great or large. The deltoid muscle (DEL-toyd) is shaped like an inverted triangle, which is the Greek letter delta. 26  The hamstring group, located at the back of the upper leg, consists of three separate muscles: ○ Biceps femoris, ○ Semitendinosus ○ Semimembranosus muscles. The primary functions of the hamstrings are knee flexion and hip extension so named, because these are the muscles by which a butcher hangs a slaughtered pig. 27  SELECT MUSCLES AND THEIR FUNCTIONS Muscles of the Head ○ The frontalis (fron-TAY-lis), or occipitofrontalis, muscle is in the forehead. It raises and lowers the eyebrows. ○ The temporalis (tem-poh-RAY-lis) muscle moves the lower jaw up and back to close the mouth. ○ The masseter (mah-SEE-ter) muscle, which is one of the strongest in the body, moves the lower jaw up to close the mouth when chewing. 28  Muscles of the Trunk ○ The pectoralis major makes up the bulk of the chest muscles. 29 ○ The external oblique and internal oblique muscles are found in the abdomen. The external oblique muscles flex and rotate the vertebral column. They also flex the torso and compress the abdomen. The internal oblique muscles flex the spine, support the abdominal contents, help breathe, and rotate the spine. 30 ○ The rectus abdominis (ab-DOM-ih-nus) helps flex the trunk, assists in breathing, and supports the spine. ○ The transverse abdominis is located on the side of the abdomen. This core muscle is engaged when a person laughs or coughs. 31  Muscles of the Shoulders and Arms ○ The deltoid forms the muscular cap of the shoulder ○ The trapezius (trah-PEE-zee-us) muscle moves the head and shoulder blade. ○ The biceps brachii, located in the anterior upper arm, flexes the elbow. ○ The triceps brachii, located in the posterior upper arm, extends the elbow. 32  Muscles of the Legs ○ The rectus femoris (FEM-or-iss) extends the leg at the knee. ○ The quadriceps femoris is made up of four muscles, including the vastus lateralis and vastus medialis, which flex and extend the leg at the knee. ○ The hamstring group is involved in knee flexion and hip extension. ○ The gastrocnemius (gas-trok-NEE-mee-uhs) is the calf muscle that flexes the knee and bends the foot downward. 33  MEDICAL SPECIALTIES RELATED TO THE MUSCULAR SYSTEM An exercise physiologist (fiz-ee-OL-oh-jist) is a specialist who works under the supervision of a physician to develop, implement, and coordinate exercise programs, and administer medical tests to promote physical fitness. A neurologist (new-ROL-oh-jist) is a physician who specializes in treating the causes of paralysis and similar muscular disorders in which there is a loss of function. A physiatrist (fiz-ee-AT-rist) is a physician who specializes in physical medicine and rehabilitation with the focus on restoring function. Rehabilitation is restoration, following disease, illness, or injury, of the ability to function in a normal or near-normal manner. A sports medicine physician specializes in treating sports-related injuries of the bones, joints, and muscles. 34 PATHOLOGY OF THE MUSCULAR SYSTEM 35  Fibers, Fascia, and Tendons Fasciitis (fas-ee-EYE-tis), which is also spelled fascitis, is inflammation of a fascia Fibromyalgia syndrome (figh-broh-my-AL-jee-ah) is a debilitating chronic condition characterized by fatigue; diffuse or specific muscle, joint, or bone pain; and a wide range of other symptoms ○ Debilitating means a condition causing weakness. Tenosynovitis (ten-oh-sin-oh-VYE-tis) is an inflammation of the sheath surrounding a tendon. Tendinitis (ten-dih-NIGH-tis), sometimes spelled tendonitis, is an inflammation of the tendons caused by excessive or unusual use of the joint. 36  Muscle Disorders An adhesion (ad-HEE-zhun) is a band of fibrous tissue that holds structures together abnormally. ○ Adhesions can form in muscles or in internal organs, as the result of an injury or surgery. ○ The term frozen shoulder refers to adhesions forming in the capsule of connective tissue in the shoulder, tightening around the shoulder joint. Atrophy (AT-roh-fee) means weakness or wearing away of body tissues and structures. Atrophy of a muscle or muscles can be caused by pathology or by disuse of the muscle over a long period of time. Myalgia (my-AL-jee-ah) is tenderness or pain in the muscles (my means muscle, and -algia means pain). A myocele (MY-oh-seel) is the herniation (protrusion) of muscle substance through a tear in the fascia surrounding it (my/o means muscle, and -cele means a hernia). 37  A hernia (HER-nee-ah) is the protrusion of a part of a structure through the tissues normally containing it. Myolysis (my-OL-ih-sis) is the degeneration of muscle tissue (my/o means muscle, and -lysis means destruction or breaking down in disease). Myorrhexis (my-oh-RECK-sis) is the rupture or tearing of a muscle (my/o means muscle, and -rrhexis means rupture). Polymyositis (pol-ee-my-oh-SIGH-tis) is a muscle disease characterized by the simultaneous inflammation and weakening of voluntary muscles in many parts of the body (poly- means many, myos means muscle, and -itis means inflammation). Sarcopenia (sar-koh-PEE-nee-ah) is the loss of muscle mass, strength, and function that come with aging (sarc/o means flesh, and -penia means deficiency). 38  Muscle Tone Muscle tone is the state of balanced muscle tension (contraction and relaxation) that makes normal posture, coordination, and movement possible. Atonic (ah-TON-ick) means lacking normal muscle tone or strength (a- means without, ton means tone, and -ic means pertaining to). Dystonia (dis-TOH-nee-ah) is a condition of abnormal muscle tone that causes the impairment of voluntary muscle movement (dys- means bad, ton means tone, and -ia means condition). Hypotonia (high-poh-TOH-nee-ah) is a condition in which there is diminished tone of the skeletal muscles (hypo- means deficient, ton means tone, and -ia means condition). 39  Muscle Movement Ataxia (ah-TACK-see-ah) is the lack of muscle coordination during voluntary movement (a- means without, tax means coordination, and -ia means condition). ○ These movements, which are often shaky and unsteady, are most frequently caused by abnormal activity in the cerebellum A contracture (kon-TRACK-chur) is the permanent tightening of fascia, muscles, tendons, ligaments, or skin that occurs when normally elastic connective tissues are replaced with nonelastic fibrous tissues. The most common causes of contractures are scarring or the lack of use due to immobilization or inactivity. Intermittent claudication (klaw-dih-KAY-shun) is pain in the leg muscles that occurs during exercise and is relieved by rest. ○ Intermittent means coming and going at intervals, and claudication means limping. A cramp is a painful localized muscle spasm often named for its cause, such as menstrual cramps or writer’s cramp. Spasmodic torticollis (spaz-MOD-ick tor-tih-KOL-is), also known as wryneck, is a stiff neck due to spasmodic contraction of the neck muscles that pull the head toward the affected side. ○ Spasmodic means relating to a spasm, and torticollis means a contraction, or shortening, of the muscles of the neck. 40  Muscle Function Bradykinesia (brad-ee-kih-NEE-zee-ah) is extreme slowness in movement (brady- means slow, kines means movement, and -ia means condition). Dyskinesia (dis-kih-NEE-zee-ah) is the distortion or impairment of voluntary movement such as a tic or spasm (dys- means bad, kines means movement, and -ia means condition). ○ A tic is a spasmodic muscular contraction that often involves parts of the face. ○ Although these movements appear purposeful, they are not under voluntary control. Hyperkinesia (high-per-kye-NEE-zee-ah), also known as hyperactivity, is abnormally increased muscle function or activity (hyper- means excessive, kines means movement, and -ia means condition). 41  Myoclonus (my-oh-KLOH-nus) is the sudden, involuntary jerking of a muscle or group of muscles (my/o means muscle, clon mean violent action, and -us is a singular noun ending). Nocturnal myoclonus (nock-TER-nal my-oh-KLOH-nus) is jerking of the limbs that can occur normally as a person is falling asleep. Nocturnal means pertaining to night. Singultus (sing-GUL-tus), also known as hiccups, is myoclonus of the diaphragm that causes the characteristic hiccup sound with each spasm. 42  Myasthenia Gravis (my-as-THEE-nee-ah GRAH-vis); a chronic autoimmune disease of the neuromuscular junction ○ Serious weakness of voluntary muscles (eye movement, facial expression, chewing, talking, and swallowing) ○ Myasthenia; muscle weakness (my means muscle, and -asthenia means weakness or lack of strength). Gravis comes from the Latin word meaning grave or serious. Muscular Dystrophy; a group of more than 30 genetic diseases ○ Progressive weakness and degeneration of the skeletal muscles ○ Without affecting the nervous system. ○ Duchenne muscular dystrophy (DMD): the most common form of muscular dystrophy in children. ○ Becker muscular dystrophy (BMD): similar to, but less severe than, Duchenne muscular dystrophy. 43  Repetitive Stress Disorders; repetitive motion disorders ○ Repeated motions performed in the course of normal work, daily activities, or recreation such as sports. Involve muscles, tendons, nerves, and joints. ○ Compartment syndrome: the compression of nerves and blood vessels due to swelling within the enclosed space created by the fascia that separates groups of muscles. Caused by trauma, tight bandages or casts, or by repetitive activities such as running. ○ Overuse injuries: minor tissue injuries that have not been given time to heal. Spending hours at the computer keyboard or by lengthy sports training sessions. ○ Overuse tendinitis (ten-dih-NIGH-tis): aka overuse tendinosis An inflammation of tendons caused by excessive or unusual use of a joint ○ Stress fractures are also overuse injuries 44  Myofascial Pain Syndrome; a chronic pain disorder that affects muscles and fascia throughout the body. ○ Caused by the development of trigger points (where the fascia comes into contact with a muscle) ○ Produces local and referred muscle pain (felt in another area). Rotator Cuff Injuries; ○ Impingement syndrome (im-PINJ- ment); inflamed and swollen tendons are caught in the narrow space between the bones within the shoulder joint. Discomfort when raising arm above head. ○ Rotator cuff tendinitis (ten-dih-NIGH- tis); an inflammation of the tendons of the rotator cuff (Tennis shoulder or pitcher’s shoulder. ○ A ruptured rotator cuff; when rotator cuff tendinitis is left untreated or if the overuse continues, the irritated tendon weakens and tears 45  Carpal tunnel syndrome symptoms occur when the tendons that pass through the carpal tunnel are chronically overused and become inflamed and swollen. ○ The carpal tunnel is a narrow, bony passage in the wrist. ○ The median nerve and the tendons pass through ○ Carpal means pertaining to the wrist. ○ This swelling of carpal tunnel syndrome creates pressure on the median nerve as it passes through the tunnel. 46  A ganglion cyst (GANG-glee-on SIST) is a harmless fluid-filled swelling that occurs most commonly on the outer surface of the wrist. Epicondylitis (ep-ih-kon-dih-LYE-tis) is inflammation of the tissues surrounding the elbow (epi- means on, condyl means condyle, and -itis means inflammation). ○ Condyle refers to the round prominence at the end of a bone. ○ Lateral epicondylitis; tennis elbow ○ Medial epicondylitis; golfer’s elbow A heel spur is a calcium deposit in the plantar fascia near its attachment to the calcaneus (heel) bone that can be one of the causes of plantar fasciitis. Plantar fasciitis (PLAN-tar fas-ee-EYE-tis) is an inflammation of the plantar fascia on the sole of the foot. This condition causes foot or heel pain when walking or running 47  A heel spur is a calcium deposit in the plantar fascia near its attachment to the calcaneus (heel) bone that can be one of the causes of plantar fasciitis. Plantar fasciitis (PLAN-tar fas-ee-EYE-tis) is an inflammation of the plantar fascia on the sole of the foot. This condition causes foot or heel pain when walking or running 48 Sports Injuries A sprain is an injury to a joint, such as an ankle, knee, or wrist, which usually occurs when a ligament is wrenched or torn. A strain is an injury to the body of the muscle or to the attachment of a tendon. ○ Strains usually are associated with overuse injuries that involve a stretched or torn muscle or tendon attachment. A shin splint is a painful condition caused by the tibialis anterior muscle tearing away from the tibia (shin bone). A hamstring injury can be a strain or tear on any of the three hamstring muscles that straighten the hip and bend the knee. ○ Sudden and severe pain in the back of the thigh. Achilles tendinitis (ten-dih-NIGH-tis) is a painful inflammation of the Achilles tendon caused by excessive stress being placed on that tendon. Iliotibial band syndrome (ITBS) (ill-ee-oh-TIB-ee- al) is an overuse injury. ○ Band rubbing against bone, often in the area of the knee. 49 Spinal Cord Injuries (SCI) The type of paralysis is determined by the level of the vertebra May be an incomplete injury or a complete injury Paralysis (pah-RAL-ih-sis) is the loss of sensation and voluntary muscle movements in a muscle through disease or injury to its nerve supply. Myoparesis (my-oh-PAR-eh-sis) is a weakness or slight muscular paralysis (my/o means muscle, and -paresis means partial or incomplete paralysis). Hemiparesis (hem-ee-pah-REE-sis) is slight paralysis or weakness affecting one side of the body (hemi- means half, and -paresis means partial or incomplete paralysis). Hemiplegia (hem-ee-PLEE-jee-ah) is total paralysis affecting only one side of the body (hemi- means half, and -plegia means paralysis). ○ Usually associated with a stroke or brain damage. ○ Damage to one side of the brain causes paralysis on the opposite side of the body. ○ An individual affected with hemiplegia is known as a hemiplegic. Paraplegia (par-ah-PLEE-jee-ah) is the paralysis of both legs and the lower part of the body. ○ An individual affected with paraplegia is known as a paraplegic. Quadriplegia (kwad-rih-PLEE-jee-ah) is paralysis of all four extremities (quadr/i means four, and -plegia means paralysis). An individual affected with quadriplegia is known as a quadriplegic. Cardioplegia (kar-dee-oh-PLEE-jee-ah) is paralysis of heart muscle (induced 50 intentionally to perform surgery)  DIAGNOSTIC PROCEDURES OF THE MUSCULAR SYSTEM Deep tendon reflexes (DTR) are tested with a reflex hammer that is used to strike a tendon ○ A reflex is an involuntary response to a stimulus. ○ No response or an abnormal response can indicate a disruption of the nerve supply to the involved muscles. Range-of-motion testing (ROM) is a diagnostic procedure to evaluate joint mobility and muscle strength Electromyography (EMG) (ee-leck-troh-my- OG-rah-fee) is a diagnostic test that measures the electrical activity within muscle fibers in response to nerve stimulation (electr/o means electricity, my/o means muscle, and -graphy means the process of producing a picture or record). ○ The resulting record is called an electromyogram. A muscle biopsy involves removal of a plug of tissue for examination. 51  TREATMENT PROCEDURES OF THE MUSCULAR SYSTEM I An antispasmodic,aka an anticholinergic, is administered to suppress smooth muscle contractions of the stomach, intestine, or bladder. A skeletal muscle relaxant is administered to relax certain muscles and to relieve the stiffness, pain, and discomfort caused by strains, sprains, or other muscle injuries. A neuromuscular blocker, aka a neuromuscular blocking agent, is a drug that causes temporary paralysis by blocking the transmission of nerve stimuli to the muscles. Ergonomics (er-goh-NOM-icks) is the study of the human factors that affect the design and operation of tools and the work environment. ○ The design of equipment and workspaces, with the goal of reducing injuries, strain, and stress. Myofascial release (my-oh-FASH-ee-ahl) is a specialized soft-tissue manipulation technique used to ease the pain of conditions such as fibromyalgia syndrome, myofascial pain syndrome, movement restrictions, temporomandibular joint disorders (TMJ), and carpal tunnel syndrome. Occupational therapy (OT) consists of activities to promote recovery and rehabilitation to assist patients in performing the activities of daily living (ADL), which include grooming, eating, and dressing. Physical therapy (PT) is treatment to prevent disability or restore function through the use of exercise, heat, massage, or other techniques. Therapeutic ultrasound uses high-frequency sound waves to treat muscle injuries by generating heat deep within muscle tissue. Transcutaneous electrical nerve stimulation (TENS) uses a device that delivers electrical impulses through the skin, which cause changes in muscles. 52  TREATMENT PROCEDURES OF THE MUSCULAR SYSTEM II Rice; The most common first aid treatment of muscular injuries is known by the acronym RICE (Rest, Ice, Compression, and Elevation) A fasciotomy (fash-ee-OT-oh-mee) is a surgical incision through the fascia to relieve tension or pressure (fasci means fascia, and -otomy means a surgical inci-sion). ○ Commonly used to treat compartment syndrome Fascioplasty (FASH-ee-oh-plas-tee) is the surgical repair of a fascia (fasci/o means fascia, and -plasty means surgical repair). Tenodesis (ten-ODD-eh-sis) is the surgical suturing of the end of a tendon to a bone (ten/o means tendon, and -desis means to bind or tie together). Tenolysis (ten-OL-ih-sis), aka tendolysis, is the release of a tendon from adhesions (ten/o means tendon, and -lysis means to set free). Tenorrhaphy (ten-OR-ah-fee) is the surgical suturing together of the divided ends of a tendon (ten/o means tendon, and -rrhaphy means surgical suturing). Myorrhaphy (my-OR-ah-fee) is the surgical suturing a muscle (my/o means muscle, and -rrhaphy means surgical suturing). A myotomy (my-OT-oh-mee) is a surgical incision into a muscle (my 53 means muscle, and -otomy means surgical incision). 54 55 56 57 58 59 LEARNING EXERCISES 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84