Ahmad cannot run

Ahmad cannot run

1. Anatomy of the foot

   • Muscles
     • Thyroid Hormone
       • 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

2. Physical examination of ankle & foot

   • Look
     • Symmetry Valgus/varus feet, Pes planus/pes cavus, Hallux valgus, Toe clawing
   • Feel
     • Bony prominances, joints, ligaments, tendons, dorsalis pedis artery
   • Move
     • Special tests include: Inversion and eversion stress tests , Morton’s Metatarsalgia test

3. 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 muscle fiber 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
       • Becker
       • Emery-Dreifuss

4. Abnormal gait

   • Antalgic
     • Ataxic
       • Trendelennerg

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