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Deltoid Muscle: Thick triangular muscle in the Shoulder whose function is to abduct, flex, and extend the arm. It is a common site of Intramuscular injections.
 Science Education: Essentials of Nursing Skills

Preparing and Administering Intramuscular Injections

JoVE Science Education

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

Intramuscular (IM) injections deposit medications deep into the muscle tissue. Since muscle fibers are well perfused, this route of administration provides quick uptake of the medication and allows for the administration of relatively large volumes. Skeletal muscles have fewer pain-sensing nerves than subcutaneous tissue, which allows for the less painful administration of irritating drugs (e.g., chlorpromazine, an anti-psychotic). IM injections are recommended for patients unable to take oral medications and for uncooperative patients. Some examples of medications that are commonly delivered by IM injections include antibiotics, hormones, and vaccinations. As in any other route of administration, the nurse must consider if the medication is appropriate, given the patient's medical conditions, allergies, and current clinical status. In addition, specifically for IM injections, it is important to assess the patient's muscle mass to determine the appropriate needle size. Also, if the patient has already received this injection, it is necessary to verify the injection site that was previously used and to ensure that the previous dose did not result in any adverse

 Science Education: Essentials of Physical Examinations III

Neck Exam

JoVE Science Education

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

Examination of the neck can be a challenge because of the many bones, joints, and ligaments that make up the underlying cervical spine. The cervical spine is composed of seven vertebrae stacked in gentle C-shaped curve. The anterior part of each vertebra is made up of the thick bony body, which is linked to the body above and below by intervertebral discs. These discs help provide stability and shock absorption to the cervical spine. The posterior elements of the vertebra, which include the laminae, transverse, and spinous processes and the facet joints, form a protective canal for the cervical spinal cord and its nerve roots. The cervical spine supports the head and protects the neural elements as they come from the brain and from the spinal cord. Therefore, injuries or disorders affecting the neck can also affect the underlying spinal cord and have potentially catastrophic consequences. The significant motion that occurs in the neck places the cervical spine at increased risk for injury and degenerative changes. The cervical spine is also a common source of radicular pain in the shoulder. For this reason, the neck should be evaluated as a routine part of every shoulder exam.

 Science Education: Essentials of Physical Examinations III

Motor Exam I

JoVE Science Education

Source:Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA

Abnormalities in the motor function are associated with a wide range of diseases, from movement disorders and myopathies to strokes. The motor assessment starts with observation of the patient. When the patient enters the examination area, the clinician observes the patient's ability to walk unassisted and the speed and coordination while moving. Taking the patient's history provides an additional opportunity to observe for evidence of tremors or other abnormal movements, such as chorea or tardive dyskinesia. Such simple but important observations can yield valuable clues to the diagnosis and help to focus the rest of the examination. The motor assessment continues in a systematic fashion, including inspection for muscle atrophy and abnormal movements, assessment of muscle tone, muscle strength testing, and finally the examination of the muscle reflexes and coordination. The careful systematic testing of the motor system and the integration of all the findings provide insight to the level at which the motor pathway is affected, and also help the clinician to formulate the differential diagnosis and determine the course of the subsequent evaluation and treatment.

 Science Education: Essentials of Physical Examinations III

Ankle Exam

JoVE Science Education

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The ankle and foot provide the foundation for the body and the stability needed for upright posture and ambulation. Because of its weight-bearing function, the ankle joint is a common site of injury among athletes and in the general population. Ankle injuries occur as a result of both acute trauma and repetitive overuse (such as running). The ankle is a fairly simple joint, consisting of the articulation between the distal tibia and talus of the foot, along with the fibula on the lateral side. The ankle is supported by numerous ligaments, most notably the deltoid ligament on the medial side, and laterally by three lateral ligaments: the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). Physical examination of the ankle and the patient history (including the mechanism of the injury and the location of pain) provide diagnostic information that helps the physician to pinpoint specific structures involved in an injury, and are essential for determining the severity of the injury and the subsequent diagnostic steps. When examining the ankle, it is important to closely compare the injured ankle to the uninvolved side. Essential components of the ankle exam i

 JoVE Medicine

Human Vastus Lateralis Skeletal Muscle Biopsy Using the Weil-Blakesley Conchotome

1Academic Geriatric Medicine, University of Southampton, University Hospital Southampton, 2National Institute for Health Research Southampton Biomedical Research Center, University of Southampton and University Hospital Southampton NHS Foundation Trust, 3MRC Lifecourse Epidemiology Unit, University of Southampton, 4National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, 5National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, 6Newcastle University Institute of Ageing and Institute of Health and Society, Newcastle University


JoVE 53075

 Science Education: Essentials of Emergency Medicine and Critical Care

Intra-articular Shoulder Injection for Reduction Following Shoulder Dislocation

JoVE Science Education

Source: Rachel Liu, BAO, MBBCh, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA

The anterior shoulder dislocation is one of the most common joint dislocations seen in emergency settings. In anterior shoulder dislocation, the humeral head is displaced out of the glenohumeral joint in front of the scapular glenoid, resulting in a loss of the articulation between the arm and the rest of the shoulder. This can be caused by a fall onto an abducted, extended, and externally rotated arm, such as in a bicycle or running accident. Sometimes anterior shoulder dislocation can be due to a minor trauma or even result from rolling over in bed with an externally rotated and stretched overhead arm. Anterior shoulder dislocation is a painful injury. Patients cannot actively abduct, adduct or internally rotate the shoulder. Reduction of the shoulder is the best form of analgesia and, of course, is necessary to restore arm function. While it is current practice for patients to undergo procedural sedation during the shoulder reduction procedure, the sedatives have serious side effects (cardiac and respiratory depression), and require long stays in the emergency department (ED), dedicated nursing staff, multiple radiographs, and consulting services. Intra-art

 JoVE Medicine

Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

1Outcomes After Critical Illness and Surgery (OACIS) Group, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 2Critical Care Physical Medicine and Rehabilitation Program, Johns Hopkins Hospital, 3Department of Physical Medicine and Rehabilitation, Johns Hopkins University, 4Department of Rehabilitation Services, University of Maryland Medical System


JoVE 2632

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 JoVE Biology

Tissue Triage and Freezing for Models of Skeletal Muscle Disease

1Division of Pediatric Pathology, Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, 2Department of Physiology and Cell Biology, The Ohio State University, 3Department of Human Nutrition, Foods and Exercise, Virginia Tech, 4Division of Biomedical Informatics, Department of Biostatistics, Department of Computer Science, University of Kentucky, 5Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, 6Cure Congenital Muscular Dystrophy, 7Joshua Frase Foundation, 8Department of Rehabilitation Medicine, University of Washington, 9Department of Physiology, University of Arizona


JoVE 51586

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 JoVE Medicine

Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease

1Institute of Imaging Science, Vanderbilt University, 2Department of Radiology and Radiological Sciences, Vanderbilt University, 3Department of Biomedical Engineering, Vanderbilt University, 4Department of Molecular Physiology and Biophysics, Vanderbilt University, 5Department of Physical Medicine and Rehabilitation, Vanderbilt University, 6Department of Physics and Astronomy, Vanderbilt University


JoVE 52352

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 JoVE In-Press

3D Ultrasound Imaging: Fast and Cost-Effective Morphometry of Musculoskeletal Tissue

1Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 2Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, Amsterdam Movement Sciences

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JoVE 55943

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 JoVE Neuroscience

The Neuromuscular Junction: Measuring Synapse Size, Fragmentation and Changes in Synaptic Protein Density Using Confocal Fluorescence Microscopy

1Physiology and Bosch Institute, University of Sydney, 2Motor Neuron Disease Research Group, Australian School of Advanced Medicine, Macquarie University, 3Advanced Microscopy Facility, Bosch Institute, University of Sydney


JoVE 52220

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 JoVE Bioengineering

Measurement of Maximum Isometric Force Generated by Permeabilized Skeletal Muscle Fibers

1Department of Orthopaedic Surgery, University of Michigan Medical School, 2Department of Molecular & Integrative Physiology, University of Michigan Medical School, 3Department of Biomedical Engineering, University of Michigan Medical School, 4Department of Surgery, Section of Plastic Surgery, University of Michigan Medical School


JoVE 52695

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 JoVE Biology

In Situ Immunofluorescent Staining of Autophagy in Muscle Stem Cells

1Department of Medicine, Institute of Translational Pharmacology, Italian National Research Council, 2Epigenetics and Regenerative Medicine, IRCCS Fondazione Santa Lucia, 3Biological and Environmental Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), 4Department of Life Sciences, University of Modena and Reggio Emilia


JoVE 55908

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 JoVE Developmental Biology

Isolation and Characterization of Satellite Cells from Rat Head Branchiomeric Muscles

1Department of Orthodontics and Craniofacial Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, 2Department of Biological Structure, University of Washington School of Medicine, 3Department of Biochemistry, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center


JoVE 52802

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 JoVE Medicine

Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle

1Davis Heart and Lung Research Institute, The Ohio State University, 2Laboratory of Clinical Investigation, National Institute on Aging, 3Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, 4Department of Human Sciences, Human Nutrition, The Ohio State University, 5Division of Endocrinology and Diabetes, Department of Pediatrics, University of Pennsylvania


JoVE 54977

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 JoVE Medicine

Combined Intravital Microscopy and Contrast-enhanced Ultrasonography of the Mouse Hindlimb to Study Insulin-induced Vasodilation and Muscle Perfusion

1Laboratory for Physiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, 2Department of Internal Medicine, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center


JoVE 54912

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 JoVE Biology

Glucose Uptake Measurement and Response to Insulin Stimulation in In Vitro Cultured Human Primary Myotubes

1CarMeN Laboratory, INSERM U1060, INRA 1397, University of Lyon, 2Department of digestive and bariatric surgery, Obesity Integrated Center, University Hospital of Edouard Herriot, Hospices Civils de Lyon, Lyon 1 University, 3Division of Endocrinology, Diabetes, Hypertension and Nutrition, Department of Clinical Medicine, Faculty of Medicine, University of Geneva


JoVE 55743

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 JoVE Biology

A Rapid Automated Protocol for Muscle Fiber Population Analysis in Rat Muscle Cross Sections Using Myosin Heavy Chain Immunohistochemistry

1CD Laboratory for the Restoration of Extremity Function, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, 2Core Facility Imaging, Core Facilities, Medical University Vienna, 3Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery, University of Heidelberg


JoVE 55441

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