MUSCULOSKELETAL SYSTEM

. The musculoskeletal system is made up of the body's bones (the skeleton), muscles,
cartilage, tendons, ligaments, joints, and other connective tissue that supports and binds
tissues and organs together. Its primary functions include supporting the body, allowing
motion, and protecting vital organs.

Key terms

Term Meaning

Musculoskeletal The body system that provides support, stability, shape, and

system movement to the body

Joint The point at which two (or more) bones meet.

Cartilage Soft connective tissue found between joints

Ligaments Connective tissue that attaches bone to bone at a joint

Tendons Connective tissue that attaches muscle to bone

Voluntary muscle Muscle that can be consciously controlled

Muscle that is controlled by the autonomic nervous system (not

Involuntary muscle consciously controlled)

Muscle tissue that has a striped appearance due to its fiber

Striated muscle composition

The musculoskeletal system:-In the musculoskeletal system, the muscular and skeletal
systems work together to support and move the body.

The bones of the skeletal system serve to protect the body's organs, support the weight of the
body, and give the body shape. The muscles of the muscular system attach to these bones,
pulling on them to allow for movement of the body.
 The human skeleton

The human skeleton performs several major functions. It protects the internal organs,
supports and gives shape to the body and allows for movement. It also is the site of blood cell
production, which occurs in the marrow of some bones.

The skeleton

The human skeleton is divided into two parts: the axial skeleton and the appendicular
skeleton.

 The axial skeleton consists of:

 the skull, which protects the brain and supports facial structure
 the vertebral column (spine), which surrounds and protects the spinal cord and support the
head
 the thoracic (rib cage), which surrounds and protects the organs within the chest (including
heart and lungs)
 The appendicular skeleton consists of:

 the pectoral girdle (shoulders):

 upper and lower limbs (arms and legs)
 the pelvic girdle (hip bones)


 Joints, cartilage, ligaments, and tendons

 The musculoskeletal system also contains connective structures and tissues that
support the body and allow for its movement.
 Cartilage acts as a shock absorber to reduce friction.
 Ligaments help stabilize the joint, keeping it from moving outside of its intended
range of motion.
 Tendons connect the skeletal system to the muscular system by attaching muscle to
bone. When muscle contracts, the tendon acts on the bone, causing movement.

Muscle
  Human body has more than 600 muscles. Muscles perform many useful functions and
help us in doing everything in day-to-day life. Muscles are classified by different
methods, based on different factors:

Muscle contraction

When a muscle fiber receives a signal from the nervous system, myosin filaments are
stimulated, pulling actin filaments closer together. This shortens sarcomeres within a fiber,
causing it to contract.

DEFINITION OF PHYSIOLOGY OF MUSCULOSKELETAL

Musculoskeletal Physiology Is The Branch Of Physiology Which

Addresses The Processes Of Musculoskeletal System.[1]
In Subclassifying Musculoskeletal Physiology, Mesh Emphasizes The Division Between
"Phenomena" And "Processes". It Is Also Possible To Emphasize The Division Between
Processes Primarily Affecting Bone, And Those Primarily Affecting Muscle.

There Are Three General Types Of Movement :

 Gliding
 Angular movement
 Rotation
 Gliding :- Gliding movement also known as translation are the simplest joint
movements one flat,or nearly flat, bone surface glides or slips over on other without
appreciable angulation or rotation.
 Gliding movements occur at the intercarpal and intertarsal joints, and between the flat
articular process of the vertebrae as well as in combination with other movements.

ANGULAR MOVEMENTS: movement incease and decrease the angle between two bones.

 These movement may occur in any plane of the body and include :

 Flexion
 extension

 hyperextension
 Abduction
 Adduction
 Circumduction
FLEXION:-it is a bending movement, usually along the sagittal plane, that decrease
the angle of joint and brings the articulating bones closer together examples include
bending the head forward on the chest and bending the body trunk the knee from a
straight to an angled position as a less obvious example, the arm is flexed at the
shoulder when the arm is lifted in on anterior direction.

EXTENSION:- extension is the reverse of flexion and occurs at the some joints.it
involves movements along the sagittal plane that increase the angle between the
articulating bones, such as straightening a flexed neck, body trunk, elbow or knee
bending the head backward beyond its straight (upright position is called
hyperextention.

At the soulder, extension carries the arm to a point posterior to the soulder joint.

DORSIFLEXION AND PLANTER FLEXION OF THE FOOT:-

The up and down movement of the foot at the ankle joint are given more specific
names lifting the foot so that its superior surface approaches the shin is dorsiflexion
(corresponds to wrist extension) whereas depressing the foot (pointing the toes) is
plantar flexion (corresponds to wrist flexion )

ABDUCTION:- abduction (moving away)is movement of a limb away from the

midline or median plane of the body along the frontal plane.

Raising the arm or thigh laterally is an example of abduction.

When the term is used to indicate the movement of the fingers or toes , it means
spreading them apart.

In this case; midline is the longest digit:the third finger or second toe .

Notice however,that lateral bending of the trunk away from the body midline in the
frontal plane is called lateral flexion , not abduction.

ADDUCTION:- adduction (moving toward) is the opposite of the abduction so it is

the movement of a limb toward the body midline of the hand or foot.

CIRCUMDUCTION:- is moving a limb so that is describe a cone in space(

circum=around,,duco=to draw)

The distal end of limb moves in a circle, while the point of the cone (the shoulder or
hip joint) is more or less stationary .

A pitcher winding up to throw a ball is actually circumduction consists of flexion

abduction, extension, and adduction performed in succession it is the quickest way to
exercise the many muscles that move the hip and shoulder ball and socket joints.

ROTATION:- Rotation is the turning of a bone around its own long axis. It is the
only movement allowed between the first cervical vertebrae and is common at the hip
and shoulder joints.Rotation may be directed toward the midline or away from it.For
 i.e in medial rotation of the thigh the femur anterior surface moves toward the median
plane of the body; lateral rotation is opposite movement.

SPECIAL MOVEMENTS:- Certain movements do not fit into any of the above categories
and occurs at only a few joints.Some of these special movements are:-

The terms supination (turning backward) and pronation

(turning forward) refer to the movements of radius around the ulna.

Rotating the forearm laterally so that the palm rotating the forearm laterally so that the palm
faces anteriorly or superiorly is supinated and the radius and ulna are parallel. In pronation,
the forearm ratates medially and the palm faces posteriorly or inferiorly. Pronation moves the
distal end of the radius and ulna are parallel.in pronation, the forearm ratates medially and the
palm faces posteriorly or inferiorly. Pronation moves the distal end of the radius across the
ulna so that the two bones forms an X. this is the forearm position when we are standing in a
relaxed manner.pronation is a much weaker movement than supination.

Inversion And Eversion : are special movement of the foot in inversion the sole of the foot
turns medially in eversion the faces laterlly.
PROTRACTION AND RETRACTION:- Retraction/Protraction/Depression/Elevation.
Scapularretraction refers to moving the shoulder blades (scapula) towards the spine. The
opposite is protraction – moving the shoulder blades away from the spine. ... The opposite is
elevation, which is bringing the shoulder blades closer to the ears.

Elevation and depression:-

Elevation refers to movement in a superior direction. For example, shrugging is an example
of elevation of the scapula. Depression refers to movement in an inferior direction, the
opposite of elevation.

Opposition:-
refers to the movement that involves grasping of the thumb and fingers. ...
Reciprocal motion refers to alternating motions in opposing directions.

Muscle Physiology
Human body has more than 600 muscles. Muscles perform many useful functions and help us
in doing everything in day-to-day life. Muscles are classified by three different methods,

based on different factors:

1. Nuclei
2. Myofibril
3. Golgi apparatus
4. Mitochondria
5. Sarcoplasmic reticulum
6. Ribosomes
7. Glycogen droplet
8. Occasional lipid droplets
Myofibril, very fine contractile fibres, groups of which extend in parallel columns
along the length of striated muscle fibres. The myofibrils are made up of thick and
thin myofilaments, which help give the muscle its striped appearance. The thick
filaments are composed of myosin, and the thin filaments are predominantly actin,
along with two other muscle proteins, tropomyosin and troponin. Muscular
contraction is caused by the interaction between actin and myosin as they temporarily
 bind to each other and are released.

SARCOMERE:- Definition Sarcomere is defined as the structural and functional unit of a

skeletal muscle. It is also called the basic contractile unit of the muscle.

Extent:- Each sarcomere extends between two ‘Z’ lines.

Components:- Each myofibril consists of an alternate dark ‘A’ band and light ‘I’ band In
the middle of ‘A’ band, there is a light area called ‘H’ zone. In the middle of ‘H’ zone lies the
middle part of myosin filament. This is called ‘M’ line ‘M’ line is formed by myosin binding
proteins.

CONTRACTILE ELEMENTS (PROTEINS) OF MUSCLE:-

Myofibrils are built from three kinds of proteins:-

1.Contractile proteins:- generation of force

2.Regulatory protein:-contration process on and off.

3.Structural proteins:-

 structural framework (nebulin,titin,etc)

 Keep thick and thin filaments in proper alignment
  Provide myofibril elasticity and extensibility
 Linking myofibrils to sarcolemma and extracellular

Myosin:- thick filaments

Actin:-thin filaments

No.of sub units:-

2 heavy chain

4light chain .

Classification of Muscles:
1.DEPENDING UPON STRIATIONS:
Depending upon the presence or absence of cross striations, the muscles are divided into two
groups:
1.Striated muscle:
Striated muscle is the muscle which has a large number of cross-striations (transverse lines).
Skeletal muscle and cardiac muscle belong to this category.
2. Non-striated muscle.„ Muscle which does not have cross-striations is called non-
striated muscle. It is also called plain muscle or smooth muscle. It is found in the wall of the
visceral organs.
2.DEPENDING UPON CONTROL:
Depending upon control, the muscles are classified into two types:
1. Voluntary Muscle
Voluntary muscle is the muscle that is controlled by the will. Skeletal muscles are the
voluntary muscles. These muscles are innervated by somatic nerves.
2. Involuntary Muscle
Muscle that cannot be controlled by the will is called involuntary muscle. Cardiac muscle
and smooth muscle are involuntary muscles. These muscles are innervated by autonomic
nerves.
 DEPENDING UPON SITUATION:
 Depending upon situation, the muscles are classified into three types:
 1. Skeletal muscleSkeletal: muscle is situated in association with bones forming the
skeletal system. The skeletal muscles form 40% to 50% of body mass and are voluntary
and striated. These muscles are supplied by somatic nerves. Fibers of the skeletal muscles
 are arranged in parallel. In most of the skeletal muscles, muscle fibers are attached to
tendons on either end. Skeletal muscles are anchored to the bones by the tendons.
 2. Cardiac muscle: Cardiac muscle forms the musculature of the heart. These muscles
are striated and involuntary. Cardiac muscles are supplied by autonomic nerve fibers.
 3. Smooth muscle: Smooth muscle is situated in association with viscera. It is also
called visceral muscle. It is different from skeletal and cardiac muscles because of the
absence of crossstriations, hence the name smooth muscle. Smooth muscle is supplied by
autonomic nerve fibers. Smooth muscles form the main contractile units of wall of the
various visceral organs
Structure of a skeletal muscle
A skeletal muscle refers to multiple bundles (fascicles) of cells joined together called
muscle fibers. The fibers and muscles are surrounded by connective tissue layers
called fasciae
Muscle fibers are in turn composed of myofibrils. The myofibrils are composed
of actin and myosin filaments, repeated in units called sarcomeres, which are the basic
functional units of the muscle fiber. The sarcomere is responsible for the striated
appearance of skeletal muscle and forms the basic machinery necessary for muscle
contraction.

Skeletal muscle predominantly consists of muscle fibers and connective tissue. The latter
is distributed on three levels of scale in the muscle: the endomysium, which surrounds
each muscle fiber, the perimysium, which compartmentalizes muscle in fiber bundles, and
finally the epimysium, which is the external envelope of muscle. Within the fibers, the
myofibrils occupy nearly the entire intracellular volume. The contractile unit of the
muscle fiber is the sarcomere.
 The sarcomere, which is the smallest contractile unit of the muscle, is delimited by the Z
disks. It consists of at least thirty different proteins, of which the most abundant are
myosin and actin(Review Article)
Properties of Skeletal Muscle
EXCITABILITY
Excitability is defined as the reaction or response of a tissue to irritation or
stimulatiosn. It is a physicochemical change.
CONTRACTILITY:
Contractility is the response of the muscle to a stimulus. Contraction is defined as the
internal events of muscle with change in either length or tension of the muscle fibers.
TYPES OF CONTRACTION: Muscular contraction is classified into two types based
on change in the length of muscle fibers or tension of the muscle:

Isotonic Contraction:
Isotonic contraction is the type of muscular contraction in which the tension remains the
same and the length of the muscle fiber is altered (iso = same: tonic = tension). Example:
Simple flexion of arm, where shortening of muscle fibers occurs but the tension does not
change.
Isometric Contraction:
Isometric contraction is the type of muscular contraction in which the length of muscle fibers
remains the same and the tension is increased. Example: Pulling any heavy object when
muscles become stiff and strained with increased tension but the length does not change
INVOLUNTARY MUSCLE MOVEMENT:-A Spasm is a sudden involuntary contraction
of a muscle .muscle spasm occur suddenly, usually resolve quickly and are often painful.
When smooth and skeletal muscle go through multiple spasms, these are referred either as
seizure or convulsion.
Cramps:-muscle cramps are sudden, involuntary contractions or spasm in one or more of
the muscles.cramps can be caused by cold,overexertion or a low calcium level in the blood.
Tremor:-A tremor is an involuntary somewhat rhythmic muscle movement involving to
and fro movements(oscillations)of one or more body parts.
Fasciculation:-fasiculation is an involuntary brief twitch of a muscle visible under the
skin.it is recorded by electromyography.
Tetanus:-when a muscle receives repeated stimuli at a rapid rate.
SIMPLE MUSCLE CONTRACTION OR TWITCH OR CURVE : The
contractile property of the muscle is studied by using gastrocnemius-sciatic preparation from
frog. It is also called muscle-nerve preparation. When the stimulus with threshold strength is
applied, the muscle contracts and then relaxes. These activities are recorded graphically by
using suitable instruments. The contraction is recorded as upward deflection from the base
line. And, relaxation is recorded as downward deflection back to the base line
Simple contraction of the muscle is called simple muscle twitch and the graphical recording
of this is called simple muscle curve.
Important Points in Simple Muscle Curve:- Four points are to be observed in
simple muscle curve:
1. Point of stimulus (PS): The time when the stimulus is applied
. 2. Point of contraction (PC): The time when muscle begins to contract.
3. Point of maximum contraction (PMC): The point up to which the muscle contracts. It also
indicates the beginning of relaxation of the muscle.
4. Point of maximum relaxation (PMR): The point when muscle relaxes completely
Periods of Simple Muscle Curve:
All the four points mentioned above divide the entire simple muscle curve into three periods
:Latent period :Latent period is the time interval between the point of stimulus and point
of contraction. The muscle does not show any mechanical activity during this period

1. Isotonic simple muscle curve

2. PS = Point of stimulus
3. PC = Point of contraction
4. PMC = Point of maximum contraction
5. PMR = Point of maximum relaxation
6. LP = Latent period (0.01 sec)
7. CP = Contraction period (0.04 sec)
8. RP = Relaxation period (0.05 sec)
2. Contraction period: Contraction period is the interval between point of contraction
and point of maximum contraction. Muscle contracts during this period.
3. Relaxation period: Relaxation period is the interval between point of maximum
contraction and point of maximum relaxation. The muscle relaxes during this period.
Duration of different periods in a typical simple muscle curve:
 Latent period : 0.01 second
  Contraction period : 0.04 second
 Relaxation period : 0.05 second
 Total twitch period : 0.10 second
Contraction period is always shorter than relaxation period. It is because, the contraction is an
active process and relaxation is a passive process.

Causes of Latent Period:

 Latent period is the time taken by the impulse to travel along the nerve from place of
stimulation to muscle.
 It is the time taken for the onset of initial chemical changes in the muscle.
 It is due to the delay in the conduction of impulse at the neuromuscular junction.
 It is due to the resistance offered by viscosity of the muscle. 5. It is also due to the
inertia of the recording instrument
FACTORS AFFECTING FORCE OF CONTRACTION :- Force of contraction of the
skeletal muscle is affected by the following factors:
1. Strength of stimulus
2. Number of stimulus
3. Temperature
4. Load
Skeletal Muscle Contraction:-

Sliding Filament Theory of muscular contraction:- The sliding filament theory is

the explanation for how muscles contract to produce force.
the actin and myosin filaments within the sarcomeres of muscle fibres bind to create cross-
bridges and slide past one another, creating a contraction. The sliding filament theory
explains how these cross-bridges are formed and the subsequent contraction of muscle.

For a contraction to occur there must first be a stimulation of the muscle in the form of an
impulse (action potential) from a motor neuron (nerve that connects to muscle).
 Note that one motor neuron does not
stimulate the entire muscle but only a number of muscle fibres within a muscle.

The individual motor neuron plus the muscle fibres it stimulates, is called a motor unit. The
motor end plate (also known as the neuromuscular junction) is the junction of the motor
neurons axon and the muscle fibres it stimulates.

When an impulse reaches the muscle fibres of a motor unit, it stimulates a reaction in each
sarcomere between the actin and myosin filaments. This reaction results in the start of a
contraction and the sliding filament theory.

The reaction, created from the arrival of an impulse stimulates the 'heads' on the myosin
filament to reach forward, attach to the actin filament and pull actin towards the centre of the
sarcomere. This process occurs simultaneously in all sarcomeres, the end process of which is
the shortening of all sarcomeres.

Troponin is a complex of three proteins that are integral to muscle contraction. Troponin is
attached to the protein tropomyosin within the actin filaments, as seen in the image below.
When the muscle is relaxed tropomyosin blocks the attachment sites for the myosin cross
bridges (heads), thus preventing contraction.

When the muscle is stimulated to contract by the nerve impulse, calcium channels open in the
sarcoplasmic reticulum (which is effectively a storage house for calcium within the muscle)
and release calcium into the sarcoplasm (fluid within the muscle cell). Some of this calcium
attaches to troponin which causes a change in the muscle cell that moves tropomyosin out of
the way so the cross bridges can attach and produce muscle contraction
In summary the sliding filament theory of muscle contraction can be broken down into four
distinct stages, these are;

1. Muscle activation: The motor nerve stimulates an action potential (impulse) to pass
down a neuron to the neuromuscular junction. This stimulates the sarcoplasmic reticulum to
release calcium into the muscle cell.

2. Muscle contraction: Calcium floods into the muscle cell binding with troponin
allowing actin and myosin to bind. The actin and myosin cross bridges bind and contract
using ATP as energy (ATP is an energy compound that all cells use to fuel their activity –
this is discussed in greater detail in the energy system folder here at ptdirect).
3. Recharging: ATP is re-synthesised (re-manufactured) allowing actin and myosin to
maintain their strong binding state

4. Relaxation: Relaxation occurs when stimulation of the nerve stops. Calcium is then
pumped back into the sarcoplasmic reticulum breaking the link between actin and myosin.
Actin and myosin return to their unbound state causing the muscle to relax. Alternatively
relaxation (failure) will also occur when ATP is no longer available.

In order for a skeletal muscle contraction to occur;

1. There must be a neural stimulus

2. There must be calcium in the muscle cells
3. ATP must be available for energy

So, a few things can stop a contraction;

1. Energy system fatigue: There is no more ATP left in the muscle cell so it can’t keep
contracting.
2. Nervous system fatigue: The nervous system is not able to create impulses
sufficiently or quickly enough to maintain the stimulus and cause calcium to release.

3. Voluntary nervous system control: The nerve that tells the muscle to contract
stops sending that signal because the brain tells it to, so no more calcium ions will enter the
muscle cell and the contraction stops.

4. Sensory nervous system information: For example, a sensory neuron (nerves that
detect stimuli like pain or how heavy something is) provides feedback to the brain indicating
that a muscle is injured while you are trying to lift a heavy weight and consequently the
impulse to that muscle telling it to contract is stopped

RELAXATION OF A MUSCLE:-When a muscle relaxes, the following sequence

occure:-
1. Acetylcholine is broken down by acetylcholine sterase (AChE) which is released from the
plasma membrane of the muscle fiber. AChE is attached to collagen fibers in extracellular
matrix of the synaptic cleft. AChE break down Ach into acetate and choline. Without the
stimulation of an action potential, the calcium ions move away from the myofilaments and
are actively transported to the sarcoplasmic reticulum by Ca ATPase.
2 .without calcium,tropnin and tropomyosin once again block the active binding sites in the
actin myofilament, preventing myosin from forming cross bridges and binding with actin.
3.As the myosin and actin myofilaments return to their original positions in the sarcomere,
the I bands become broaderand Z lines move farther apart. The sarcomeres return to their
original (resting) length and the muscle fiber relaxes.

MUSCLE TONE: „
DEFINITION:- Muscle tone is defined as continuous and partial contraction of the muscles
with certain degree of vigor and tension.
MAINTENANCE OF MUSCLE TONE
In Skeletal Muscle:- Maintenance of tone in skeletal muscle is neurogenic. It is due to
continuous discharge of impulses from gamma motor neurons in anterior gray horn of spinal
cord. The gamma motor neurons in spinal cord are controlled by higher centers in brain.
In Cardiac Muscle:- In cardiac muscle, maintenance of tone is purely myogenic, i.e. the
muscles themselves control the tone. The tone is not under nervous control in cardiac muscle.
In Smooth Muscle:-
In smooth muscle, tone is myogenic. It depends upon calcium level and number of cross
bridges.

PHYSIOLOGY OF A SKELETAL MUSCLE FIBER:-

For a skeletal muscle fiber to contract, it must be stimulated by a nerve ending and must
propagate an electrical current, or action potential, along its sarcolemma.

The series of events linking the electrical signal to contraction is called excitation-contraction
coupling let consider these events in order.

THE NEUROMUSCULAR JUNCTION AND THE NERVE STIMULUS:-

skeletal muscle cells are stimulated by motor neurons of the somatic nervous system.
Although these motor neurons reside in the brain or spinal cord, their long threadlike
extensions called axons travel, bundled within nerves to the muscle cells they serve.

The axon of each motor neuron divides profusely as it enters the muscle and each axonal
ending forms a branching neuromuscular junction with a single muscle fiber.

As a rule each muscle fiber has only one neuromuscular junction located approximately
midway along the fiber length.

Although the axonal ending and the muscle fiber are exceedingly close they remain srparated
by a space the synaptic cleft.filled with a gel-like extracellular substance rich in glycol-
proteins.

Within the flattened moundlike axonal ending are synaptic vesicles, small membranous sacs
containing the neurotransmitter acetylcholine(ACH)

Three Steps to an Action Potential in a Sarcolemma:-

1) Depolarization
2) Propagation as local depolarization

3) Repolarization

BIBLIOGRAPHY

Kaur prabhjot. textbook of anatomy and physiology. lotus publication page no.179-182,195-
211.

K Sembulingam and prema sembulingam. essentials of medical physiology. jaypee brother

medical physiology. sixthed edition Page no.113-143

Marieb Elaine N. Human anatomy and physiology. sixth edition.