STUDY - Technical - New Dacian's Medicine
Muscle
atrophy (Classical / Allopathic Medicine)
Muscle atrophy
(muscle wasting) results from denervation or prolonged muscle
disuse. When deprived of regular exercise, muscle fibers lose
bulk and length, producing a visible loss of muscle size and
contour and apparent emaciation or deformity in the affected
area. Even slight atrophy usually causes some loss of motion
or power.
Atrophy usually
results from neuromuscular disease or injury. However, it may
also stem from certain metabolic and endocrine disorders and
prolonged immobility. Some muscle atrophy also occurs with
aging.
HISTORY:
Ask the patient when and where he first noticed the muscle wasting and how it has progressed.
Ask the patient about associated signs and symptoms, such as weakness, pain, loss of sensation, and recent weight loss.
Review the patient's medical history for a chronic illness or musculoskeletal or neurologic disorders, including trauma; and endocrine or metabolic disorders.
Obtain a drug history, including prescription and over-the-counter drugs (especially steroids), herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient when and where he first noticed the muscle wasting and how it has progressed.
Ask the patient about associated signs and symptoms, such as weakness, pain, loss of sensation, and recent weight loss.
Review the patient's medical history for a chronic illness or musculoskeletal or neurologic disorders, including trauma; and endocrine or metabolic disorders.
Obtain a drug history, including prescription and over-the-counter drugs (especially steroids), herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Measuring limb
circumference
To ensure accurate and consistent limb circumference measurements, use a consistent reference point each time and measure with the limb in full extension. The diagram here shows the correct reference points for arm and leg measurements.
PHYSICAL ASSESSMENT:
Determine the location and extent of atrophy. Visually evaluate small and large muscles. Check all major muscle groups for size, tonicity, and strength.
Measure the circumference of all limbs, comparing sides. (See Measuring limb circumference.)
Check for muscle contractures in all limbs by fully extending joints and noting pain or resistance.
Palpate peripheral pulses for quality and rate, assess sensory function in and around the atrophied area, and test deep tendon reflexes.
To ensure accurate and consistent limb circumference measurements, use a consistent reference point each time and measure with the limb in full extension. The diagram here shows the correct reference points for arm and leg measurements.
PHYSICAL ASSESSMENT:
Determine the location and extent of atrophy. Visually evaluate small and large muscles. Check all major muscle groups for size, tonicity, and strength.
Measure the circumference of all limbs, comparing sides. (See Measuring limb circumference.)
Check for muscle contractures in all limbs by fully extending joints and noting pain or resistance.
Palpate peripheral pulses for quality and rate, assess sensory function in and around the atrophied area, and test deep tendon reflexes.
SPECIAL
CONSIDERATIONS:
Prolonged steroid therapy interferes with muscle metabolism and leads to atrophy, most prominently in the limbs.
Prolonged steroid therapy interferes with muscle metabolism and leads to atrophy, most prominently in the limbs.
PEDIATRIC
POINTERS:
In young children, profound muscle weakness and atrophy can result from muscular dystrophy.
Muscle atrophy may result from cerebral palsy and poliomyelitis and from paralysis associated with meningocele and myelomeningocele.
In young children, profound muscle weakness and atrophy can result from muscular dystrophy.
Muscle atrophy may result from cerebral palsy and poliomyelitis and from paralysis associated with meningocele and myelomeningocele.
PATIENT
COUNSELING:
If the patient is immobile, encourage him to perform frequent active range-of-motion exercises. If he can't actively move a muscle, teach his family to provide active-assistive or passive exercises, and apply splints or braces to maintain muscle length.
If the patient is immobile, encourage him to perform frequent active range-of-motion exercises. If he can't actively move a muscle, teach his family to provide active-assistive or passive exercises, and apply splints or braces to maintain muscle length.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common symptoms,
Edition V, McGraw - Hill, 2002.