3: The Body

Clinical Perspectives

• As mentioned previously, the following sections include information on clinical perspectives

Medical Technologies

• Magnetic resonance imaging (MRI) – soft tissue and hard tissue; tendons and muscles

  • Uses magnetic fields and radio waves – protons react to energy

  • Doesn’t use radiation, like X-rays and CT-scans

• X-rays and CT-scans – hard tissue

  • X-rays (radiographs) – areas with high levels of calcium block radiation; fastest and most accessible type of imaging

  • CT-scans (computed tomography) – combination of X-rays and computed technology; higher level of detail than X-rays (360-degree view of structures)

• Ultrasound (sonography) – use sound waves to produce images of internal organs

• PET scans (positron emission tomography) – injecting substance that detects diseased cells in tissues and organs

  • Useful for cancer, but increased risks with radiation (like X-rays and CT-scans)

Childhood Injuries

• Often result in osteoarthritis, especially if not treated

• Avulsion – tendon pulled off bone

• Greenstick fracture – bone breaks incompletely (bones are more flexible in children)

• Falls – #1 cause of injuries

  • Multiple injuries at same time

  • Colles fracture – catching oneself from fall

Muscles

• Voluntary – controlled movements 

• Involuntary – contracts without neural stimulation (you don’t have to think about it)

• Striated – nerve is attached to the muscle

• Nonstriated – no nerve attached

• Botulism/botox – bacteria that blocks nerve activity in muscles causing temporary reduction in muscle activity

  • Treatment for: muscle spasms, cosmetic reduction of wrinkles

• Tetanus/lockjaw – bacteria produces a toxin that causes the overstimulation of muscles

• The term tetanus technically refers to muscle contractions

• Cardiac muscle

  • Involuntary, striated, and produces cycles of contraction and relaxation so the heart isn’t overworked 

• Smooth muscle

  • Involuntary, nonstriated, and lines organs

  • Ex: stomach is lined with smooth muscle

• Skeletal muscle

  • Voluntary, striated muscle

  • Tendons are made up of skeletal muscle

  • Produces movement and maintains posture (prolonged states of contraction lead to fatigue)

Sports

• Overuse injuries

• Common injury sites

  • Ankle and knee – soccer

  • Hand and wrist – gymnastics

  • Elbow and shin – baseball and many other sports

  • Football – shoulder, cranium, brain

• 2 ligaments cross each other to form X in the knee – ACL and PCL

• ACL (anterior cruciate ligament) in front

  • Most ACL injuries are complete or near complete tears

  • If no surgery needed – heals in about 3-6 months

  • If surgery needed – heals in about 6 months - 1 year

• PCL (posterior cruciate ligament) in back

  • Stronger than ACL, injured less often

• Meniscus tear

  • Ligament between the femur and tibia

  • Heals in about 3 months

Chronic Traumatic Encephalopathy

• CTE is a subtype of dementia caused by repeated injuries to head

• Most commonly found in:

  • Football players

  • Rugby players

  • Boxers

  • Ice hockey players

  • Professional wrestlers

  • Stunt performers

  • Rodeo/bull riders

  • Domestic violence

• High school football players can undergo significant brain changes after just one season, even if they do not get a concussion

Arthritis

• Genetics, autoimmune disorders

  • Rheumatoid arthritis – small joints, more pain than stiffness

  • Ankylosing spondylitis – back, vertebrae harden and fuse together

• Osteoarthritis (OA)

  • Most common bone disease

  • Related to aging, repetitive stress, wear and tear on joints

  • Cartilage is worn away (bone rubs on bone)

• Bioarchaeological evidence of osteoarthritis

  • Porous appearance, bony growths

  • Eburnation – polish from bones rubbing together

• Some people with OA are asymptomatic while others without OA are symptomatic

  • With OA – possibly an earlier stage?

  • Without OA – possibly a problem with X-ray and MRI detection?

• Risk factors:

  • Heavy loads on body (manual labor occupation, etc.)

  • Injury

Lifestyle

• Varicose veins

  • Veins flow to the heart (deoxygenated)

  • Veins are more likely to be affected by lack of exercise than arteries (away from heart, oxygenated)

    • Rely on gravity, inertia, force of skeletal muscle contractions

  • Veins close to the surface can become varicose - blood pools because valve has weakened (often in lower limbs)

• Deep vein thrombosis (DVT)

  • Blood clots in deep veins 

  • Can be fatal

  • Not correlated with varicose veins

  • On long flights, important to get up now and then and drink plenty of water

• Carpal tunnel syndrome

  • Repetitive strain in wrist

  • Inflammation of muscle tendon causes pinched nerve

• High heel pain

  • Tendon is not being stretched (short)

  • When heels are taken off, the tendon stretches, which causes pain

Repetitive Stress

• Tendon disorders and tendonitis – inflammation of tendon caused by repeated rubbing against bone, ligaments, etc.

  • Ex: lateral epicondylitis (tennis elbow) – overuse of forearm muscles; not only from sports

• Nerve disorders – compression of nerves from repeated or sustained exposure to sharp edges, bones, ligaments, tendons, etc.

  • Ex: carpal tunnel

• Prevention:

  • Warm up and stretch before any prolonged, repetitive activities (this includes static positions, like sitting at a desk)

  • Take frequent breaks every 20-30 minutes

  • Don’t ignore pain

  • Use correct lifting techniques

  • Improve workstation ergonomics

• Most common muscular pain:

  • Lower back

  • Knees

  • Wrists and hands

  • Shoulders and neck

Desk Ergonomics

• Recommendations:

  • Don’t stick neck too far out

  • Keep elbows close to your side, slightly more than 90 degree bend

  • Keep wrists straight and off the table

  • Avoid reaching out for the mouse or keyboard

  • Keep keyboard at same height as elbows

  • Eyes should be level with top of screen

  • Get up and stretch frequently

  • Take frequent breaks from staring at a screen

Altitude

• High altitude sickness

  • Barometric pressure causes oxygen to be less concentrated

  • Difficulty breathing (hypoxia – oxygen starvation)

• Other concerns at high altitude

  • Increased ultraviolet radiation

  • Heat loss

  • Greater physical exertion in mountainous regions

  • Wind is stronger

  • Digestion and metabolism slows down

• Decompression sickness

  • High pressure underwater and high amounts of nitrogen diffuse into blood

  • Sudden decrease in pressure causes nitrogen to leave blood as a gas (causing bubbles)

Climbing Mt. Everest

• Artificial respiration systems are frequently used to climb Mt. Everest safely

  • Atmosphere is so thin at the summit that it can only support a human at rest

  • Some climbers seek to not use supplemental oxygen

  • Supplemental oxygen makes it possible for more inexperienced individuals to make the climb

  • Climbers are divided about the risks and benefits

 Biopower

• Biopower – political power that revolves around populations
• Bioarchaeology of care – individual life-history perspectives on health and wellness
• Occupational therapists and allied health organizations
  • Occupational justice – removing barriers to situations where people are denied opportunities that are meaningful to them
  • Occupational therapists – help people improve their ability to perform daily tasks (living environment, work environment, accommodations, physical and mental health needs)
• Portrayals of disability in the media?
  • An Exploration of the Principles for Media Representations of Disabled People by Colin Barnes