Clinical anatomy of joint & Muscles respectively.
Disc prolapse or Herniation of disc .
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| Disc prolapse |
Intervertebral disc forms secondary cartilaginous joint between the bodies of the vertebrae. If the nucleus pulposus part of the disc gets protruded backwards, it may press on the spinal nerve leaving out from the intervertebral foramina. The condition is known as herniation of the disc or disc prolapse. If disc prolapse occurs in lumbar or sacral nerves, there is radiating pain in the lower limb, then the condition is called sciatica .
Dislocation & Subluxation .
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| (a) Subluxation, (b) Dislocation |
The joints may get dislocated, i.e. the end of one of the bones gets out of its socket. In subluxation, the end of the bone partially leaves its socket .
Rheumatic fever .
Rheumatic fever causes fleeting pain in the joints, accompanied by streptococcal pharyngitis. It is mostly temporary pain in the joints. The toxins of the bacteria may affect the mitral valve of the heart or the kidneys.
Rheumatoid arthritis .
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| Changes in Rheumatoid arthritis |
Rheumatoid arthritis is an inflammatory systemic disease involving the synovial membranes of small joints of the hands. Due to chronic inflammatory process there is deformity of the fingers .
Osteoarthritis .
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| Osteoarthritis |
Osteoarthritis is a degenerative condition of the large weight- bearing joints. The articular cartilage wears out, degenerates and there is formation of peripheral osteophytes. The patients feels lots of pain due to rubbing of the bones together during movements of the joints .
Cervical Spondylitis .
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| Cervical Spondylitis |
The degenerative changes or spondylitis may occur in the cervical spine, leading to narrowed intervertebral foramen, causing pressure on the spinal nerve .
Injury to Medial meniscus .
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| Injury to medial meniscus |
There may be injury to various structures in the joints. At times the medial meniscus of the knee joint may get injured. In that case it needs to be removed .
Septic arthritis .
The metaphysis, the end of diaphysis or shaft is the actively growing end of the bone. In some joints, the capsule encloses the metaphysis as well. In such joints, infection from metaphysis would reach the joint cavity and cause septic arthritis .
Stiffness of joint due cold weather .
Stiffness of joints related to weather. The viscosity of synovial fluid increases with fall in temperature. This accounts for stiffness of the joints in cold weather. Mobility of joint in itself is an important factor in promoting lubrication. Thus the stiffness of joints experienced in the morning gradually passes off as the movements are resumed.
Neuropathic Joint .
• Neuropathic joint is the result of its complete denervation, so that all reflexes are eliminated and the joint is left unprotected and liable to mechanical damage. A neuropathic joint shows painless swelling, excessive mobility and bony destruction. It is commonly caused by leprosy, tabes dorsalis and syringomyelia.
Paralysis .
Loss of motor power (power of movement) is called paralysis. This is due to inability of the muscles to contract, caused either by damage to the motor neural pathways (upper or lower motor neuron), or by the inherent disease of muscles (myopathy). Damage to the upper motor neuron causes spastic paralysis with exaggerated tendon jerks. Damage to the lower motor neuron causes flaccid paralysis with loss of tendon jerks.
Muscular spasm .
These are quite painful. Localized muscle spasm is commonly caused by a ‘muscle pull’. In order to relieve its pain the muscle should be relaxed by appropriate treatment. Generalized muscle spasms occur in tetanus and epilepsy.
Disuse atrophy and hypertrophy .
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| Disuse atrophy and hypertrophy |
The muscles which are not used for long times become thin and weak. This is called disuse atrophy. Conversely, adequate or excessive use of particular muscles causes their better development, or even hypertrophy . Muscular ‘wasting’ (reduction in size) is a feature of lower motor neuron paralysis and generalized debility.
Regeneration of skeletal muscle .
Skeletal muscle is capable of limited regeneration. If large regions are damaged, regeneration does not occur and the missing muscle is replaced by connective tissue.
Hyperplasia .
Increase in number of smooth muscle fibres. Usually occurs in uterus during pregnancy.
Myasthenia gravis .
Myasthenia gravis is an autoimmune disease of muscle of unknown origin. Antibodies are produced that bind to acetylcholine receptor and block it. The nerve impulse transmission to muscle fibres is therefore blocked. This leads to extensive and progressive muscle weakness although the muscles are normal. Extraocular and eyelid muscles are affected first, followed by those of the neck and limbs. It affects more women that men and usually those between age of 20 and 40 years.
Polymyositis .
Polymyositis is a disease of muscle characterized by inflammation of the muscle fibres. It starts when white blood cells (immune cells of inflammation) spontaneously invade the muscle. Muscles close to trunk or torso are mostly affected by polymyositis that results in severe weakness. Polymyositis associated with skin rash is referred to as “dermamyositis”.
Fibrillation condition .
Fibrillation is the abnormal contraction of cardiac muscle. The cardiac chambers do not contract as a whole resulting in the disruption of pumping action. In atrial fibrillation, there is rapid and uncoordinated contraction of atria, ineffective pumping and abnormal contraction of the AV node. Ventricular fibrillation is characterized by very rapid and disorganized contraction of ventricle. This leads to disruption of ventricular function.
Angina Pectoris .
Angina pectoris is episode of chest pain due to temporary ischaemia of cardiac muscle. It is usually relieved by rest and nitrites.
Myocardial ischaemia .
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| Myocardial ischaemia |
Persistent ischaemia due to blockage of more than one arteries results in necrosis (death) of the cardiac muscle . Pain, not relieved by rest, gets referred to left arm, chest, and neighbouring areas.
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