Skeletal, Muscles, Tendons, Physical Medicine & Rehab Presentation PDF

Skeletal, Muscles, Tendons, Physical Medicine & Rehab By Team 10 Kiet Quan Duong, Hannah Pulido, Irene Lee, Roland Foto, Natalia Ayala  Outline 1. Introduction 2. Functions of the Skeletal System 3...

Skeletal, Muscles, Tendons, Physical Medicine & Rehab By Team 10 Kiet Quan Duong, Hannah Pulido, Irene Lee, Roland Foto, Natalia Ayala  Outline 1. Introduction 2. Functions of the Skeletal System 3. The Axial and Appendicular Skeleton 4. Muscles and Tendons 5. Muscles and Tendons of the Upper and Lower Extremities 6. Disorder and Injuries of Muscles and Tendons 7. Procedures and Pharmacology 8. Physical Medicine and Rehab 9. Interactive Component:  Introduction What does t Functions of the Skeletal System The Axial and Appendicular Skeleton Muscles and Tendons Types of Muscles & Their Functions Cardiac Muscles Skeletal Muscles Smooth Muscles APPENDICULAR SKELETON  SHOULDER GIRDLE AND UPPER ARM The pectoral girdle-connects to Forearm, Wrist and Hand the axial skeleton to the upper The hand and wrist are a complex structure limbs and helps with movements. comprised of 27 bones Bones of the pectoral girdle: ○ Scapulae Muscles of the forearm allow for supination ○ Clavicle and pronation, and flex and extend the wrist Shoulder joint-connects the joint and hand and move the hand medially pectoral girdle to the upper limb and laterally Humerus- bone of the upper arm Metacarpals- Five long bones that ○ Two articulations: form the palm of the hand. Hinge joint Phalanges- finger bones Gliding joint  BONES OF THE LOWER BODY Pelvic Girdle- two hip bones that Bones and Joints of the Hip and Tight articulate anteriorly with each other with the symphysis pubis and posteriorly The hip joint is a ball-and socket with the sacrum to form the pelvis and synovial joint that is joined between between the hip bones you have the the head of the femur and the sacroiliac joints(SI). acetabulum. The hip joint is held in place by a The pelvic girdle has four functions thick joint capsule The hip bones are composed of three Labrum- cartilage that forms a rim bones each: around the socket of the joint 1. Ilium 2. Ischium 3. Pubis Bones and Joints of the Knee and Tight Bones and Joints of the Lower leg, Ankle, and Foot The knee is hinged joint and is composed of four bones: There are two bones in the lower leg which are the larger and medial tibia and the thinner 1. The lower end of the femur and lateral fibula 2. Flat upper end of the tibia 3. The patella The ankle has two joints: 4. The fibula 1. One between the lateral malleolus of the There are two crescent shaped cartilage pads fibula and the talus that are within the knee joint that are on top of 2. One between the medial malleolus of the the tibia that articulate with the femoral tibia and the talus condolytes. Ankle and Foot The medial and lateral menisci There are 26 bones and 33 joints in the foot. Calcaneus Tarsal bones Talus Metatarsal bones MUSCLES AND TENDONS OF THE UPPER AND LOWER EXTREMITIES  UPPER EXTREMITIES Shoulder girdle: - is a muscle that connects the arm to your upper body giving it movement. Four muscles originate from your scapula, wrap around the shoulder joint and fuse together and this fusion forms into one large tendon known as the rotator cuff which provides stability of the shoulder joint. Rotator cuff muscles: · Subscapularis-below the scapula · Supraspinatus-above the spine · Infraspinatus-beneath the spine · Teres minor- muscles that are part of the rotator cuff Upper Arm and Elbow Joint Forearm, Wrist and Hand Muscles that connect the humerus to the shoulder girdle, vertebral column and ribs. This enables your arm to move Muscles of the forearm supinate and pronate the freely at the shoulder joint. forearm; flex and extend the wrist joint and hand and move the hand medially and laterally. Major Anterior Muscles: · Deltoid Tendons pass over the wrist, and they are enveloped by synovial membrane and are held · Pectoralis major on in place by the wrist by a transverse thick · Latissimus dorsi fibrous band called a retinaculum. Muscles that move at the elbow joint and forearm are On the palm of the hand there are some connected to humerus or pectoral girdle which is inserted prominent pads of muscles called: into the bones of the forearm. · Thenar eminence On the front of the arm there are three muscles groups: · Hypothenar eminence · Biceps brachii · Brachialis The back of your hand is called the dorsum. · Brachioradialis  Muscles of the Pelvic Girdle and Lower Limb These are powerful muscles that give support to the hip The back of tight contains: joint and give movement to tight. They connect to the pelvic girdle and insertions into the femur. · Three hamstring muscles: biceps femoris, semimembranosus and semitendinosus Three gluteus muscles that are prominent: · The hollow of the back of the knee is called the · Maximus popliteal fossa. · Medius Muscles of the Lower leg · Minimus These muscles move the ankle, foot, and toes. And the adductor muscles that are part of the inner thigh ·Those in front of them are compartmentalized between the tibia and the fibula. They help dorsiflex Thigh Muscles and those on the lateral side evert the foot. These muscles move the knee joint and the lower leg. ·Those on the back of the leg plantar flex the foot, toes and invert the foot. The front of the thigh contains: o Gastrocnemius muscle · Quadriceps femoris muscle o Calcaneal Tendon (Achilles) · Quadriceps tendon Disorders and injuries of Muscle and Tendons → Muscle disease and disorders are Polymyalgia Rheumatica: A chronic characterized by pain and weakness. inflammatory disease of muscles that causes pain and stiffness on both sides of Fibromyalgia: A chronic condition that body → Pain in neck, shoulders, upper causes widespread pain throughout the arms, buttocks and thighs. body affecting muscles and tendons. (Most people who developed this disorder Fatigue are older than 65) → Women of caucasian. Depression Insomnia Appetite loss Lower abnormal pain and cramps Weight loss Difficult moving around (PT, stress reduction, pain Depression management) Myasthenia gravis: A chronic Muscular dystrophy: A hereditary autoimmune disease in which antibodies disorders that causes progressive block the passage of neurotransmitter weakness and loss of muscle mass. from motor nerves to muscles resulting in Trouble swallowing weakness of the skeletal muscles. Breathing & heart problems Facial muscle (eye and eyelid (Most people eventually need movement, chewing, and talking) wheelchair) Difficulty swallowing Heart problems Treatment → Lifestyle change, Gait Anticholinesterase medication, Duchenne muscular dystrophy Plasma exchange (DMD): A condition with symmetrical weakness and wasting of pelvic, shoulder, and proximal limb muscles. Commonly occurring among boys who have difficulty walking around the age of 3.  Injuries of Skeletal Muscle Muscle strains: When a muscle or Muscle soreness: Resulting from tendon is overstretched or torn. vigorous exercise if your muscles are not (Stretching or tearing of a ligament) used to it. Not warming up properly Buildup of lactic acid in muscle fibers Overusing muscle resulting in inflammation in the Repetitive injuries connective tissue. →24-72 hours (Part of muscle building Muscle cramps: Sudden painful process) contractions of a muscle or group of → Stretching, more movement and muscle. mobility (blood flowing), RICE Dehydration Electrolyte imbalance Muscle fatigue Not stretching enough Worst of muscle Cramps Rhabdomyolysis: The breakdown of muscle fibers. Achilles tendinitis: A small stretch This release a protein pigment called myoglobin into the bloodstreams. Myoglobin breaks down into toxic injury that causes the tendon to be compounds that can caused kidney failure. swollen and painful. Muscle trauma Pain → Inflammation in Achilles tendon Severed exertion (marathon running) (heel) which results in difficult walking or running. Alcoholism; cocaine, heroin, amphetamines Swelling and warmth along the heel Tenosynovitis: is inflammation of that sheath that Stiffness (REST, PT) surrounds the tendon. Characterized by tenderness in the tendon, difficult in movement of a join and aching. Repetitive use of wrist and hands/fingers (computers users) Treatment: Rest, immobilization, even surgery Nonsteroidal anti-inflammatory drugs (NSAIDS) Common disorders of shoulders and elbows Rotator cuff tears: are caused by wear Lateral epicondylitis: is caused by and tear of muscle/tendons from overuse overuse of elbow joint or poor techniques in work conditions. (A injury to the in playing tennis or golf. shoulder girdle) epicondyles Tendinitis: of the the shoulder joint is Ligament strains/bone fractures: caused when the rotator cuff and biceps Heavy fall or a blow to an elbow tendon becomes inflamed from overuse Bursitis: Inflammation of the lubricating sacs of the rotator cuff and Bursitis: can be produced by overused.  Common Disorders of the Wrist and Hand Carpal tunnel syndrome (CTS): Ganglion cysts: Fluid-filled cysts that Develops on the wrist and results from arise when synovial tendon sheaths that inflammation and swelling of overused run over the back of the wrist are irritated tendon sheath. or inflamed. → pain, numbness, and weakness in Stenosing tenosynovitis: Painful hands/fingers. inflammation of the the synovial sheaths on the back of the wrist. → Difficulty holding things paired with a shock like feeling.  Procedures and Pharmacology for the Skeletal System Diagnostic Procedures and Therapeutic Procedures for Disorders of the Muscles & Tendons Diagnostic Procedures Therapeutic Procedures 2 types of blood tests: Creatinine Therapeutic Exercise: A range of motion (ROM) exercise designed by a Kinase (CK) and Erythrocyte physical therapist to ease pain. Sedimentation rate. Dry Needling : A manual therapy Electromyography ( EMG) performed by a certified in the Nerve Conduction Studies procedure physical Therapist and Magnetic Resonance Imaging (MRI) consists of inserting thin needles in the and Computerized Tomography skin targeting the muscles. It is not the scan (CT) same as Acupuncture and is evidence Ultrasonography based medicine. Muscle Biopsy (Bx) Cupping: A manual therapy used to Genetic Testing treat painful musculoskeletal issues like muscle tension. It can cause bruising. Myositis Specific Antigen (MSA) Therapeutic Procedures (Cont.) Physical Therapy Modalities: refers to the electrical, thermal or mechanical energy use for treatment. Electrical Stimulation: Interferential current therapy (IFC), a type of e-stim , uses electrical stimulation with frequent sweep patterns. Thermal modalities : use heat Soft tissue Mobilization (STM) and or cold on targeted tissues and Myofascial Release (MFR): Both manual physical agent modalities (PAM) therapies performed using manual like electrotherapy. pressure. Ultrasound: Also called Instrument Assisted : ASTYM ( a-stim) Sonography. It uses soundwaves therapy uses plastic tools like evaluator, to cavitate cells in target areas the localizer and the isolator. Grayson and it not felt by the patient. Technique requires continuing education Musculoskeletal Drugs Nonsteroidal anti-inflammatory drugs ( NSAIDS) include : 1. Acetylsalicylic Acid ( Aspirin) OTC prevention of heart attacks. 2. Ibuprofen ( Advil, Motrin) OTC: Inhibits both COX enzymes. Caldolor an injectable form. 3. Naproxen (Aleve) OTC 4. Indomethacin: high potency and serious side effects. 5. Paracetamol (acetaminophen) OTC and not a NSAIDs, 6. Skeletal Muscle Relaxants. eg Lioresal for muscle spasms and carisoprodol for multiple sclerosis. 7. Anabolic Steroids. Mimics testosterone Physical Medicine and Rehab Physiatry Physiatry: medicine dedicated to prevention Types of Treatment and treatment of all types of disabilities - Therapeutic exercise - Prosthetics/orthotics - Pain medications - EMG (electromyography) - NCS (nerve conduction studies) - Soft tissue injections - Join injections - Spine injections - Musculoskeletal ultrasound - Interventional spinal therapeutics - Spasticity Management Rehabilitation Rehabilitation medicine: focuses on Activities of daily living (ADLs): function. Being able to function is routine activities of personal care. Six essential to an individual’s independence basic ADL: eating, bathing, dressing, grooming, toileting, and transferring. and ability to have a good quality of life. Assistive devices such as reachers, Restorative rehabilitation: restores a grabbers, easy-pull sock aids, long shoe function that has been lost. (e.g. hip horns, etc are designed to make ADLs easier to perform. fracture, hip replacement, stroke) usually short term (but intense) Instrumental activities of daily living (IADLs): related to independent living. Maintenance rehabilitation: Managing monet, using a telephone, strengthens and maintains a function that cooking, driving, shopping for groceries, is gradually being lost. Less intense than housework. restorative. Long term.