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ID:62065881
大小:1.27 MB
页数:87页
时间:2021-04-14
《最新Approach to the patient with Myopathy:方法对患者的肌病教学讲义ppt课件.ppt》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、ApproachtothepatientwithMyopathy:方法对患者的肌病OutlineBasicsClinicalmanifestationsDiagnosticapproachIndividualmyopathiesApproachtothepatientSkeletalmuscleComposedofmusclefibersthatcontractwhenstimulatedbyamotorneuronSkeletalmuscle:coveredbyconnectivetissuesheath(epimysium):compo
2、sedofmanycolumns(fascicles)Fascicles:surroundedbyperimysium:composedofmanymusclefibersMusclefibers:coveredbycellmembrane(sarcolemma)andsurroundedbyendomysium.:anatomicandphysiologicunit.Twotypes:1.Type-I/slowtwitch/redfibers:richerinoxidativebutpooreringlycolyticenzymes.2.
3、Type-II/fasttwitch/whitefibers:richeringlycolyticbutpoorerinoxidativeenzymes.:composedofnuclei,cytoplasm(sarcoplasm),myofibrils,ribosomes,mitochondria,storedfat,manyenzymes,glycogen,myoglobin.Cont,dMusclecontraction:slidingofthinfilamentsoverandb/nthickfilamentsbytheaction
4、ofnumerouscrossbridgesthatextendoutfromthemyosinetowardtheactin.:musclefiberstimulationbymotorneuron→ca+2movesfromitsstoresiteinthesarcoplasmicreticulumtothesarcoplasm→attachestotroponine→conformationalchangethatmovesthetroponincomplexanditsattachedtropomyosineoutoftheways
5、othatcrossbridgescanattachtoactin→slidingoffilamentsandthusmuscletensionandshortening.▪Energysource:fattyacids,glycogenandbloodglucose,aminoacids:skeletalmusclesgenerateATPthroughanaerobicandaerobicrespirationsandphosphategroupsdonatedbycreatinephosphate.ATP:servesastheimm
6、ediatesourceofenergyfor1.movementofcrossbridgesformusclecontraction2.pumpingofca+2intothesarcoplasmicreticulumformusclerelaxation.Cont,dMitochondria:playskeyroleinenergyproductionAnaerobicrespiration:majorsourceofenergyduringexerciseGlucose→Lacticacid+ATPAerobicrespiration
7、:lipids–importantsourcesofenergyduringrest&duringprolongedsubmaximalexerciseVLDLTriglycerides→fattyacids→activatedfattyacids/acyl-coA/↓CPT-Ilinkedwithcarnitine↓mitochondria↓CPT-IIATP←Betaoxidation←acyl-coA+carnitineMyopathyDefn.:disorderswithstructuralchangesorfunctionalim
8、pairmentofamuscle;unrelatedtoanydisorderofinnervationorNMJ.Classification:1.Acquired2.Her
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