Ahmad Cannot Run

Causes of Muscle Weakness
1. Infection
  1. poliovirus > poliomylitis Lyme disease
2. Neurological
  1. Demyelinating disorders: Guillain-Barré syndrome
3. Medications
  1. Statin> atorvastatin (Lipitor) Amiodarone (oral route)
4. Electrolyte
  1. Hyperkalemia
5. Genetics
6. Metabolic
  1. Glycogenoses: Acid maltase deficiency
Nutrients and Muscle Development
1. Calcium Iron Vitamin D Vitamin B12 Magnesium Zinc
Physical Examination
1. Muscle Strength Scale
2. Introduction & Consent HEPA Inspection SSSP Palpation: Skin Temperature Joints Tendons Ligaments
3. Move
  1. Dorsiflexion Plantar Flexion Inversion Eversion Flexion of great toe
4. Special Test
  1. Inversion and Eversion stress test Thompson’s test for tendoachillies rupture Tests for Morton’s metatarsalgia
5. pes cavus(high arch)
  1. fixed plantar flexion of the foot. A high arch is the opposite of a flat foot and is somewhat less common
Gait
1. Gait Cycle
2. abnormal gait
  1. Trendelenburg gait
  2. waddling (duck) gait.
  3. Anterior trunk bending
    1. inadequacy of the knee extensors.
  4. Posterior trunk bending
    1. inadequacy of hip extensors.
  5. Swing-out
    1. presence of weak hip flexors
  6. Steppage gait
    1. inadequate dorsiflexion control
  7. Vaulting
    1. Going up on the toes of the stance phase leg.
  8. Antalgic gait
    1. as short a time is possible is spent on the painful limb, and a correspondingly longer time is spent on the pain-free side.
Duchene Muscular Dystrophy
1. DMD Gene
  1. Xp21 2.2 megabases 79 exons 8 promoters
  2. mutation
2. dystrophin
  1. Dystrophin provides strength to muscle cells by linking the internal cytoskeleton to the surface membrane.
3. Genetic Difference Between DMD & BMD
4. complication
5. X-linked inherited
6. Investigations
  1. Serum Creatine Kinase
    1. A high CK generally indicates that there has been some recent muscle damage but will not indicate its location or cause.
  2. Electromyography
    1. EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.
  3. Thyroid Function Test
  4. Western Blot
    1. The separation of proteins by electrophoresis, then The binding of specific antibody to the protein of interest.
  5. Muscle Biopsy
    1. Cross section of muscle shows extensive replacement of muscle fibers by fat cells.
7. MANAGEMENT
  1. Physical and occupational therapy
  2. PHARAMACOLOGICAL
    1. Steroids Prednisone Deflazacort -Creatine monohydrate supplementation
  3. -Gene therapy:
  4. -Stem cell
8. Prognosis
  1. death occurs usually at about 18-20yrs of age.
Anatomy of the foot
1. foot and ankle bones
2. foot ligaments
3. arterial supply
4. nerve supply
5. layers of the sole
6. cutaneous nerve supply

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Ahmad Cannot Run

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	Creado por sarah hammoodi hace más de 7 años