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Is there a history of drug ingestion? Many drugs produce muscular cramps. The most notable are the diuretics.
Are there absent or diminished peripheral pulses? Absent or diminished peripheral pulses suggest the cramps are due to ischemia ... DIAGNOSTIC WORKUP
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Is it focal or diffuse? Focal muscular atrophy would suggest poliomyelitis, early spinal muscular atrophy, peripheral vascular disease, and sympathetic dystrophy. However, occasionally it is an indication of an early spinal cord tumor, herniated ... DIAGNOSTIC WORKUP
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Distal weakness is most likely secondary to neuropathy, and is often associated with loss of deep tendon reflexes (DTRs) either with or without sensory abnormalities. In contrast, increased DTRs or extensor plantor responses raise the concern for “central” causes... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Proximal weakness is usually due to dysfunction of the lower motor unit; that is, anterior horn cells in the spinal cord, neuromuscular junction (NMJ), or the muscle itself. The neurologic examination, EMG, and nerve conduction studies, and finally the muscle... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... To develop a list of possible causes of muscular cramps think of anatomy and physiology. Anatomically a muscle bundle is supplied by arteries, veins and nerves. Considering the arteries will prompt
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... This symptom is developed using both anatomy and physiology. Atrophy of any muscle may develop in seven ways:
Lack of use of the muscle
Malnutrition or increased body metabolism
Primary muscle disease
Myoneural junction disease
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... Flaccid muscles are profoundly weak and soft, with decreased resistance to movement, increased mobility, and a greater than normal range of motion (ROM). The result of disrupted muscle innervation, flaccidity can be localized to a limb or muscle group... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral nerves, or myoneural junctions and... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Muscle spasms are strong, painful contractions. They can occur in virtually any muscle, but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during pregnancy. However, they may also develop in electrolyte... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient’s fear or nervousness upon palpation; involuntary... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Spasticity is a state of excessive muscle tone manifested by increased resistance to stretching and heightened reflexes. It’s commonly detected by evaluating a muscle’s response to passive movement; a spastic muscle offers more... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... When breathing requires extra effort, the accessory muscles — the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostals, and abdominal muscles — stabilize the thorax during respiration. Some accessory muscle use normally... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Muscle atrophy 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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Acute or Subacute*
Electrolyte abnormality
Hyperkalemia
Hypokalemia
Hypercalcemia
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... Muscular dystrophy is actually a group of congenital disorders characterized by progressive symmetrical wasting of skeletal muscles without neural or sensory defects. Paradoxically, these wasted muscles tend to enlarge because of connective tissue and fat deposits,... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Flaccid muscles are profoundly weak and soft, with decreased resistance to movement, increased mobility, and greater than normal range of motion. The result of disrupted muscle innervation, flaccidity can be localized to a limb or muscle group or... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral nerves, or myoneural junctions and within the muscle... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Muscle spasms are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during pregnancy. However, they may... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient’s fear or nervousness upon palpation;... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... Spasticity is a state of excessive muscle tone manifested by increased resistance to stretching and heightened reflexes. It’s commonly detected by evaluating a muscle’s response to passive movement; a spastic muscle offers more resistance when the passive movement is... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... When breathing requires extra effort, the accessory muscles—the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostals, and abdominal muscles—stabilize the thorax during respiration. Some accessory muscle use normally takes place during such... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Muscle atrophy results from denervation or prolonged muscle disuse. When deprived of regular exercise, muscle fibers lose both bulk and length, producing a visible loss of muscle size and contour and apparent emaciation or deformity in the... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Differential Overview
❑ Ordinary muscle cramp
❑ Overuse
❑ Dehydration
❑ Drugs/toxins
❑ Hypokalemia ... Diagnostic Approach ... Clinical Findings
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... Muscle spasms are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during pregnancy. However, they may also develop... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral nerves, or myoneural junctions and within... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... When breathing requires extra effort, the accessory muscles — the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostal, and abdominal muscles — stabilize the thorax during respiration. Some accessory... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Muscle spasms, or muscle cramps, are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during pregnancy.... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Spasticity is a state of excessive muscle tone manifested by increased resistance to stretching and heightened reflexes. Also known as muscle hypertonicity, it’s commonly detected by evaluating a muscle’s response to passive movement; a spastic... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Flaccid muscles are profoundly weak and soft, with decreased resistance to movement, increased mobility, and a greater than normal range of motion (ROM). The result of disrupted muscle innervation, flaccidity can be localized to a limb or muscle group or generalized over the entire body... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral nerves, or myoneural junctions... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Muscle spasms are strong, painful contractions of the muscles. They can occur in virtually any muscle, but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during pregnancy. However, they may also occur with... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient's fear or nervousness upon palpation; involuntary rigidity... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Spasticity is a state of excessive muscle tone manifested by increased resistance to stretching and heightened reflexes. It's commonly detected by evaluating a muscle's response to passive movement; a spastic muscle offers more resistance when... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... When breathing requires extra effort, the accessory muscles—the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostals, and abdominal muscles—stabilize the thorax during respiration. Some accessory muscle use normally... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Muscle atrophy 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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
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This symptom is developed using both anatomy and
physiology. Atrophy of any muscle may develop in seven ways.
Lack of use of the muscle
... Pictures
... READ EXCERPTS »
...
To develop a list of possible causes of muscular cramps, think of
anatomy and physiology. Anatomically a muscle bundle is
supplied by arteries, veins, and nerves. Considering the arteries will
prompt the recall of arteriosclerosis, emboli,... Pictures
... READ EXCERPTS »
In this segment, Dr. Allan Gibofsky answers your questions about arthritis. Can cracking your knuckles cause arthritis?