Medical Terminology Slides: Musculatory System 2m441q

Chapter 20: The Muscular System

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Learning Objectives • Compare the location and function of smooth, cardiac, and skeletal muscle. • Describe the typical structure of a skeletal muscle.

• Briefly describe the mechanism of muscle contraction. • Explain how muscles work together to produce movement. • Describe the main types of movements produced by muscles.


Learning Objectives (cont’d) • List some of the criteria for naming muscles and give examples of each. • Identify and use the roots pertaining to the muscular system. • Describe at least seven disorders that affect muscles. • Interpret abbreviations pertaining to muscles.


Pretest 1. The neuromuscular junction is between a muscle and a: (a) gland (b) neuron

(c) bone (d) gonad


Pretest 1. The neuromuscular junction is between a muscle and a : (a) gland (b) neuron

(c) bone (d) gonad


Pretest 2. In the muscular system, the opposite of the origin is the: (a) counterorigin

(b) agonist (c) diaphragm (d) insertion


Pretest 2. In the muscular system, the opposite of the origin is the: (a) counterorigin

(b) agonist (c) diaphragm (d) insertion


Pretest 3. The quadriceps femoris muscle forms the anterior part of the: (a) neck

(b) back (c) thigh (d) abdomen


Pretest 3. The quadriceps femoris muscle forms the anterior part of the: (a) neck

(b) back (c) thigh (d) abdomen


Pretest 4. The opposite of flexion is: (a) rotation (b) antiflexion (c) relaxation (d) extension


Pretest 4. The opposite of flexion is: (a) rotation (b) antiflexion (c) relaxation (d) extension


Pretest 5. The opposite of abduction is: (a) adduction (b) circumduction (c) periduction (d) pronation


Pretest 5. The opposite of abduction is: (a) adduction (b) circumduction (c) periduction (d) pronation


Pretest 6. The band of connective tissue that attaches a muscle to a bone is a: (a) cartilage

(b) bursa (c) tendon (d) diaphysis


Pretest 6. The band of connective tissue that attaches a muscle to a bone is a: (a) cartilage

(b) bursa (c) tendon (d) diaphysis


Pretest 7. Polymyositis is inflammation of many: (a) sense organs (b) muscles (c) glands (d) bones


Pretest 7. Polymyositis is inflammation of many: (a) sense organs (b) muscles (c) glands (d) bones


Pretest 8. The word kinesis means: (a) movement (b) bending (c) stretching (d) pain


Pretest 8. The word kinesis means: (a) movement (b) bending (c) stretching (d) pain


Roots Pertaining to Muscles

Root

Meaning

Example

Definition of Example

my/o

muscle

myositis*

inflammation of muscle

muscul/o

muscle

musculature

muscle arrangement in a part or the whole body

in/o

fiber

inotropic

acting on (muscle) fibers

fasci/o

fascia

fasciodesis

binding (suture) of a fascia to a tendon or other fascia

* Note addition of s to this root before the suffix –itis.


Roots Pertaining to Muscles (cont’d)

Root

Meaning

Example

Definition of Example

ten/o, tendin/o tendon

tenostosis

ossification of a tendon

ton/o

tone

cardiotonic

having a strengthening action on the heart

erg/o

work

ergonomics

study of the efficient use of energy during work

kin/o-, kine, kinesi/o, kinet/o

movement

kinesis

movement (adjective: kinetic)


Types of Muscles • Smooth – Walls of hollow organs and ducts – Operates involuntarily

– Responsible for peristalsis • Cardiac – Myocardium of heart wall – Functions involuntarily – Responsible for pumping of heart Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Types of Muscles (cont’d) • Skeletal – Attaches to bones – Responsible for voluntary movement – Maintains posture – Generates large portion of body heat


Muscle Structure • Fibers held together in fascicles • Fascia covers muscle • Tendons attach muscles to bones



Muscle Action • Skeletal muscles stimulated by motor neurons of nervous system • Acetylcholine released

– Prompts contraction • Requires actin and myosin to interact • ATP and calcium needed for this response • Partial contraction = tonus


Muscle Action (cont’d) • Muscles work in pairs at ts to produce movement – Agonist = contraction – Antagonist = relaxation • Point of origin = muscle attachment point to stable part of skeleton • Point of insertion = muscle attachment point to moving part of skeleton


Neuromuscular Junction



Origins and Insertions



Naming of Muscles • Named by: – Location – Direction of fibers – Size – Shape – Number of attachment heads • Indicated by suffix -ceps

– Its action • Indicated by suffix -or Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Superficial Muscles, Anterior



Superficial Muscles, Posterior



Key Normal Structure and Function Term

Meaning

acetylcholine (ACh)

A neurotransmitter that stimulates contraction of skeletal muscles

actin

One of the two contractile proteins in muscle cells; the other is myosin

agonist

The muscle that carries out a given movement; prime mover

antagonist

The muscle that opposes an agonist (prime mover); it must relax when the agonist contracts

cardiac muscle

Involuntary muscle that makes up the wall of the heart

fascia

The fibrous sheath of connective tissue that covers a muscle; called deep fascia to differentiate it from the superficial fascia that underlies the skin (root: fasci/o); plural: fasciae

fascicle

A small bundle, as of muscle or nerve fibers

insertion

In a given movement, the point where a muscle is attached to a moving part of the skeleton

muscle

An organ that produces movement by contracting; also the tissue that composes such organs (root: my/o, muscul/o) Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Key Normal Structure and Function (cont’d) Term

Meaning

myosin

One of the two contractile proteins in muscle cells; the other is actin

neuromuscular junction (NMJ)

The point of , or synapse, between a branch of a motor neuron and a muscle cell

origin

In a given movement, the point where a muscle is attached to a stable part of the skeleton

skeletal muscle

Voluntary muscle that moves the skeleton and maintains posture

smooth muscle

Involuntary muscle that makes up the wall of the hollow organs, vessels, and ducts; visceral muscle

synergist

A muscle that assists an agonist to produce a given movement

tendon

A fibrous band of connective tissue that attaches a muscle to a bone (root: ten/o, tendin/o)

tonus

A state of steady, partial contraction of muscle that maintains firmness; muscle tone (root: ton/o) Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Clinical Aspects of the Muscular System • Myopathy is a disorder of the muscles • Techniques for diagnosing: – Study of muscle in action – Electromyography (EMG) – Serum assay of enzymes released in damaged muscles • Creatine kinase


Muscular Dystrophy • Group of hereditary diseases – Most common is Duchenne muscular dystrophy

• Progressive, noninflammatory degeneration of muscles • Muscle tissue weakens and wastes away – Gradually replaced with connective tissue and fat

• May co-exist with: – Cardiomyopathy (disease of cardiac muscle) – Mental impairment Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Polymyositis • Inflammation of skeletal muscle leading to weakness – Dysphagia – Cardiac problems • Cause unknown – May be related to viral infection or autoimmunity • Often associated with other systemic diseases – Rheumatoid arthritis – Lupus erythematosus


Polymyositis (cont’d) • If skin is involved it is known as dermatomyositis • Symptoms – Erythema – Dermatitis – Lilac-colored rash • Diagnosis – Enzyme studies – EMG – Muscle biopsy


Fibromyalgia Syndrome Often associated with: • Widespread muscle aches

• Tenderness • Stiffness • Fatigue

• Sleep disorders • Difficult to diagnose • Treatment –

Exercise program

–

Pain relievers, muscle relaxants, antidepressants Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chronic Fatigue Syndrome • Persistent fatigue of no known cause • Associated with:

–

Impaired memory

–

Sore throat

–

Painful lymph nodes

–

Muscle and t pain

–

Headaches

–

Sleep problems

–

Immune disorders

• Often occurs after viral infection • No consistent successful treatments Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Myasthenia Gravis • Acquired autoimmune disease – Antibodies interfere with muscle stimulation at neuromuscular junction

– Progressive loss of muscle power • Especially in: • External eye muscles • Other facial muscles


Amyotrophic Lateral Sclerosis • Lou Gehrig disease • Progressive degeneration of motor neurons, leads to muscular atrophy

• Signs: – Weakness – Cramping – Muscle twitching • Eventually leads to death Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Stress Injuries • Include: –

Accidental injuries

–

Damage caused by overexertion or repetitive motion (RSI)

• Damage to soft tissue: –

Muscle strain

–

Inflammation

–

Tearing of ligaments and tendons

–

Bursitis


Stress Injuries (cont’d) • Tendonitis is an inflammation of tendon, tendon sheath, and synovial membrane at t • Signs: pain, fatigue, weakness, stiffness, numbness, range of motion (ROM) • Treatment: rest, elevation, ice packs, bracing, medications – If more severe: steroid injections, ultrasound for deep heat, strength exercises, surgery, PT


Common Upper Extremity Conditions

• Rotator cuff • Epicondylitis • Carpal tunnel syndrome • Trigger finger


Carpal Tunnel Syndrome



Common Lower Extremity Conditions

• Hamstring strain • Shin splint • Achilles tendonitis


Key Disorders Term

Meaning

amyotrophic lateral sclerosis (ALS)

A disease caused by degeneration of motor neurons resulting in muscular weakness and atrophy; Lou Gehrig disease

chronic fatigue syndrome (CFS)

A disease of unknown cause that involves persistent fatigue, along with muscle and t pain and other symptoms; may be virally induced

dermatomyositis

A disease of unknown origin involving inflammation of muscles as well as dermatitis and skin rashes

fibromyalgia syndrome (FMS)

A disorder associated with widespread muscular aches and stiffness and having no known cause

muscular dystrophy

A group of hereditary muscular disorders marked by progressive weakness and atrophy of muscles

myasthenia gravis (MG)

A disease characterized by progressive muscular weakness; an autoimmune disease affecting the neuromuscular junction


Key Disorders (cont’d) Term

Meaning

polymyositis

A disease of unknown cause involving muscle inflammation and weakness

repetitive strain injury

Tissue damage caused by repeated motion, usually overuse of the arm or hand in occupational activities such as writing, typing, painting, or using hand tools; also called repetitive motion injury, cumulative trauma injury, overuse syndrome

sprain

Injury to a ligament caused by abnormal or excessive force at a t, but without bone dislocation or fracture

strain

Trauma to a muscle because of overuse or excessive stretch; if severe, may involve tearing of muscle, bleeding, or separation of muscle from its tendon or separation of a tendon from bone

tendinitis

Inflammation of a tendon, usually caused by injury or overuse; the shoulder, elbow, and hip are common sites; also spelled tendonitis

tenosynovitis

Inflammation of a tendon sheath Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Key Diagnosis

Term

Meaning

creatine kinase (CK)

An enzyme found in muscle tissue; the serum level of CK increases in cases of muscle damage; creatine phosphokinase (K)

electromyography (EMG)

Study of the electrical activity of muscles during contraction


Supplementary Normal Structure and Function Term

Meaning

aponeurosis

A flat, white, sheetlike tendon that connects a muscle with the part that it moves

creatine

A substance in muscle cells that stores energy for contraction

glycogen

A complex sugar that is stored for energy in muscles and in the liver

isometric

Pertaining to a muscle action in which the muscle tenses but does not shorten (literally: same measurement)

isotonic

Pertaining to a muscle action in which the muscle shortens to accomplish movement (literally: same tone)

kinesthesia

Awareness of movement; perception of the weight, direction, and degree of movement (-esthesia means “sensation”)


Supplementary Normal Structure and Function (cont’d) Term

Meaning

lactic acid

An acid produced in muscle cells that accumulates in muscle cells functioning without enough oxygen (anaerobically), as in times of great physical exertion

motor unit

A single motor neuron and all of the muscle cells that its branches stimulate

myoglobin

A pigment similar to hemoglobin that stores oxygen in muscle cells


Supplementary Symptoms and Conditions Term

Meaning

asterixis

Rapid, jerky movements, especially in the hands, caused by intermittent loss of muscle tone

asthenia

Weakness (prefix a- meaning “without” with root sthen/o meaning “strength”)

ataxia

Lack of muscle coordination (from root tax/o meaning “order, arrangement”); adjective: ataxic

athetosis

A condition marked by slow, irregular, twisting movements, especially in the hands and fingers; adjective: athetotic

atrophy

A wasting away; a decrease in the size of a tissue or organ, such as the wasting of muscle from disuse

avulsion

Forcible tearing away of a part

clonus

Alternating spasmodic contraction and relaxation in a muscle; adjective: clonic

contracture

Permanent contraction of a muscle Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Supplementary Symptoms and Conditions (cont’d) Term

Meaning

fasciculation

Involuntary small contractions or twitching of muscle fiber groups (fasciculi)

fibromyositis

A nonspecific term for pain, tenderness, and stiffness in muscles and ts

fibrositis

Inflammation of fibrous connective tissue, especially the muscle fasciae; marked by pain and stiffness

restless legs syndrome (RLS)

Uneasiness, twitching, or restlessness in the legs that occurs after going to bed and often leading to insomnia; may be caused by poor circulation or drug side effects

rhabdomyolysis

An acute disease involving diffuse destruction of skeletal muscle cells (root rhabd/o means “rod,” referring to the long, rodlike muscle cells)

rhabdomyoma

A benign tumor of skeletal muscle

rhabdomyosarcoma

A highly malignant tumor of skeletal muscle Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Supplementary Symptoms and Conditions (cont’d) Term

Meaning

rheumatism

A general term for inflammation, soreness, and stiffness of muscles associated with pain in ts (adjective: rheumatic, rheumatoid)

spasm

A sudden, involuntary muscle contraction; may be clonic (contraction alternating with relaxation) or tonic (sustained); a strong and painful spasm may be called a cramp (adjectives, spastic, spasmodic)

spasticity

Increased tone or contractions of muscles causing stiff and awkward movements

tetanus

An acute infectious disease caused by the anaerobic bacillus Clostridium tetani. It is marked by persistent painful spasms of voluntary muscles; lockjaw

tetany

A condition marked by spasms, cramps, and muscle twitching caused by a metabolic imbalance, such as low blood calcium caused by underactivity of the parathyroid glands

torticollis

Spasmodic contraction of the neck muscles causing stiffness and twisting of the neck; wryneck Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Supplementary Diagnosis and Treatment Term

Meaning

Chvostek sign

Spasm of facial muscles after a tap over the facial nerve; evidence of tetany

occupational therapy

Health profession concerned with increasing function and preventing disability through work and play activities. The goal of occupational therapy is to increase the patient's independence and quality of daily life

physical therapy

Health profession concerned with physical rehabilitation and prevention of disability. Exercise, massage, and other therapeutic methods are used to restore proper movement

rheumatology

The study and treatment of rheumatic diseases

Trousseau sign

Spasmodic contractions caused by pressing the nerve supplying a muscle; seen in tetany


Supplementary Drugs Term

Meaning

antiinflammatory agent

Drug that reduces inflammation; includes steroids, such as cortisone, and nonsteroidal antiinflammatory drugs

COX-2 inhibitor

Nonsteroidal antiinflammatory drug that does not cause the stomach problems associated with other NSAIDs. Inhibits the cyclooxygenase (COX)-2 enzyme without affecting the COX-1 enzyme, a lack of which can cause stomach ulcers. Some of these drugs have been withdrawn from the market because of cardiac risk. Example is celecoxib (Celebrex)

muscle relaxant

A drug that reduces muscle tension; different forms may be used to relax muscles during surgery, to control spasticity, or to relieve musculoskeletal pain

nonsteroidal antiinflammatory drug (NSAID)

Drug that reduces inflammation but is not a steroid; examples include aspirin, ibuprofen, naproxen, and other inhibitors of prostaglandins, naturally produced substances that promote inflammation


Abbreviations Ach

Acetylcholine

ALS

Amyotrophic lateral sclerosis

CFS

Chronic fatigue syndrome

C(P)K

Creatine (phospho)kinase

CTS

Carpal tunnel syndrome

EMG

Electromyography, electromyogram

FMS

Fibromyalgia syndrome

MG

Myasthenia gravis

MMT

Manual muscle test(ing)


Abbreviations (cont’d) NMJ

Neuromuscular junction

OT

Occupational therapy/therapist

PT

Physical therapy/therapist

RICE

Rest, ice, compression, elevation

RLS

Restless legs syndrome

ROM

Range of motion

RSI

Repetitive strain injury

RTC

Rotator cuff

SITS

Supraspinatus, infraspinatus, teres minor, subscapularis (muscles)


Post Test Underline the term that best fits the definition: 1. Movement away from the midline of the body: (abduction, adduction)

2. Fibrous band of connective tissue that connects muscle to bone: (tendon, fascia) 3. Muscle that carries out a given movement: (antagonist, agonist)


Post Test Underline the term that best fits the definition: 1. Movement away from the midline of the body: (abduction, adduction)

2. Fibrous band of connective tissue that connects muscle to bone: (tendon, fascia) 3. Muscle that carries out a given movement or a prime mover: (antagonist, agonist)


Post Test Fill in the blank with the best term. 4. ____________ is an acquired autoimmune disease in which antibodies interfere with muscle stimulation at the NMJ. 5. Injury to a ligament caused by abnormal or excessive force at a t, but without bone dislocation or fracture is known as a(n) ____________.


Post Test Fill in the blank with the best term. 4. Myasthenia gravis is an acquired autoimmune disease in which antibodies interfere with muscle stimulation at the NMJ. 5. Injury to a ligament caused by abnormal or excessive force at a t, but without bone dislocation or fracture is known as a(n) sprain.


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