Inc. energy uptake of muscles, Inc. muscle size as it does
protein synthesis THOUGH excessive amounts can cause
weakened muscles do to activation of proteolysis ‘ AND lack
of thyroid hormone causes the muscle to become sluggish
Bones
Nerves
Arteries
Physical examination of ankle & foot
Look
Symmetry
Valgus/varus
feet, Pes
planus/pes cavus,
Hallux valgus, Toe
clawing
Special tests
include:
Inversion and
eversion
stress tests ,
Morton’s
Metatarsalgia
test
Muscular Dystrophy
a group of inherited genetic conditions that
gradually cause the muscles to weaken,
leading to an increasing level of disability.
Types
Autosomal
recessevie
Limb girdle
Congenital
Autosomal
dominant
myotonic
Fascioscapulohumeral
Oculopharyngeal
Sex
linked
Duchenne Muscular Dystrophy
Causes
a genetic mutation that prevents
the body from producing
Dystrophin; connects the cytoskeleton of a
musclefiber to the surrounding extracellular
matrix through the cell membrane.
Pathology
Absence of dystophin leads to muscle damage leading to inflammation and finally leading to cell death
Risk factors
history of the condition in the family
Signs & Symptoms
Unable to walk by 18 months
Walking on toes
Falling down
Gower’s manoeuvre
Mode of inheritance
Investigations
Primary
Serum CK
Cardiac assessment
Secondary
Muscle biopsy
PCR for the dystrophin
gene mutation
Prognosis
Most Death due to respiratory failure or cardiomyopathy
no cure
Advancement in medical field
increased life expectancy by 10 years
Complications
Learning disability
Absence of dystrophin in the brain
challenges with important brain functions such as attention,
memory, learning, speech, and intellectual ability and more
susceptible to ADHD, OCD, Epilepsy, ASD.
Cardiomyopathy
Pseudohypertrophy of calf muscles
Contractures
More infections
Steroid treatment problems
Pulmonary problems
Severe
psychological
impact on
parents and
children