Musculoskeletal System

19.1 Overview of the Human Skeleton

  • The skeleton provides attachment sites for the muscles.

    • Muscle contraction facilitates movement of bones.

    • Enables activities such as walking, playing sports, and holding objects.

  • The musculoskeletal system encompasses both bones and muscles.

Organization of Tissues in the Skeleton

  • Bones are classified based on their shape:

    • Long

    • Short

    • Flat

    • Irregular

    • Round

  • Structural organization of bone tissues:

    • Enclosed by the periosteum, a tough, fibrous connective tissue.

    • The periosteum is continuous with ligaments and contains blood vessels that supply the bone.

  • Main structural components of long bones:

    • Epiphysis: The expanded end of a long bone.

    • Diaphysis: The shaft between the epiphyses.

    • Joints between bones are covered by cartilage.

Anatomy of a Long Bone

  • Primary connective tissues of the skeleton include:

    • Bone

    • Cartilage

    • Dense fibrous connective tissue

  • Characteristics of bone

    • Composed of cells separated by a matrix with fibers.

    • Strength is due to collagen fibers and mineral salts like calcium phosphate.

Bone Structure and Types
  1. Compact Bone:

    • Highly organized structure comprising osteons (tubular units).

    • Osteocytes (bone cells) reside in lacunae, arranged in concentric circles around a central canal.

    • Central canals include blood vessels, lymphatic vessels, and nerves.

    • Canaliculi form connections between lacunae and the central canal.

  2. Spongy Bone:

    • Appears unorganized; osteocytes are found in trabeculae (thin plates with unequal spaces).

    • Plates align along lines of stress, providing strength.

    • Spaces within spongy bone are filled with red bone marrow.

      • Red marrow produces blood cells.

      • Infants have red marrow in all bones; in adults, it is restricted to certain bones.

Anatomy and Structure of Long Bones
  • The Epiphysis of a long bone predominantly comprises spongy bone.

  • The Diaphysis contains:

    • Compact bone as a protective border.

    • Medullary cavity housing yellow bone marrow, which contains a substantial amount of fat.

  • Metaphysis:

    • This small region separates the diaphysis from the epiphysis and contains the epiphyseal plate (growth plate), which consists of cartilage.

Cartilage

  • Definition: A flexible connective tissue that is not as strong as bone.

  • Characteristic features:

    • Gel-like matrix comprised of collagen and elastic fibers.

    • Cells resided within lacunae arranged irregularly.

    • Lacks blood vessels.

Types of Cartilage

  1. Hyaline Cartilage:

    • Firm yet flexible; found at the ends of long bones, nose, ends of ribs, larynx, and trachea.

  2. Fibrocartilage:

    • Composed of thicker collagen fibers; strong and can withstand pressure and tension.

    • Commonly found in intervertebral discs and knees.

  3. Elastic Cartilage:

    • Characterized by extensive elastin fibers, making it highly flexible.

    • Present in structures such as the ear flaps and epiglottis.

Dense Fibrous Connective Tissue

  • Composed of densely packed fibroblasts set apart by bundles of collagen fibers.

  • Key functions include:

    • Forming the flared sides of the nose.

    • -

Ligaments and Tendons
  • Ligaments connect bone to bone.

  • Tendons connect muscle to bone.

Bone Growth and Remodeling

  • Bones initially appear as hyaline cartilage (with skull bones being the notable exception).

  • Endochondral ossification:

    • Replacement of cartilage with bone through a gradual process.

    • Starts with a hyaline cartilage template; cartilage is substituted by bone over time.

    • The process involves:

    • Breakdown of cartilage in the center of a long bone, allowing periosteum to develop.

Stages of Bone Development and Growth

  1. Primary Ossification Center:

    • Osteoblasts invade and produce spongy bone.

    • Other osteoblasts lay compact bone beneath the periosteum.

    • Osteoclasts deconstruct spongy bone to create the medullary cavity.

  2. Secondary Ossification Centers:

    • Appear at the ends of developing bones where spongy bone forms and remains intact.

    • The growth plate persists between primary and secondary ossification centers, allowing for continued lengthening until ossification occurs, halting growth.

Remodeling of Bones

  • Adult bones undergo continuous breakdown and rebuilding.

  • Osteoclasts break down the bone matrix releasing calcium into the bloodstream.

  • Osteoblasts absorb calcium and deposit it within the new bone matrix.

  • Certain osteoblasts become trapped in the matrix, evolving into osteocytes.

  • Remodeling can alter bone thickness, influenced by hormones and physical activity.

Healing Fractured Bone

  1. Reactive Phase: An inflammatory response occurs immediately after injury.

  2. Reparative Phase: Involves the formation of a bone callus, a temporary connective tissue bridge that eventually gets replaced.

  3. Remodeling Phase: Osteoclasts and osteoblasts gradually replace temporary bone with compact bone.

Functions of the Skeleton

  • Support body structures, especially pelvis and leg bones.

  • Protect soft body parts (e.g., skull protects the brain; rib cage guards the heart and lungs).

  • Produce blood cells.

  • Store minerals and fat.

  • Facilitate muscle movement.

Classification of the Bones

  • Total of approximately 206 bones categorized into two divisions:

    • Axial Skeleton: Comprises the midline bones of the body.

    • Appendicular Skeleton: Encompasses the bones of limbs and their girdles.

  • Classification by shape includes:

    • Long Bones: Longer than they are wide (e.g., limbs, phalanges).

    • Short Bones: Cube-shaped bones (e.g., carpals, tarsals).

    • Flat Bones: Plate-like structures (e.g., skull, scapula).

    • Irregular Bones: Bones with irregular shapes (e.g., vertebrae, facial bones).

    • Round Bones: Spherical in shape (e.g., patella).

The Axial Skeleton

  • Comprises the skull, hyoid bone, vertebral column, rib cage, and ossicles.

  • The Skull:

    • Includes the cranium (braincase) and facial bones.

    • The cranium protects the brain and consists of eight tightly fitted bones, not completely ossified in infants.

    • Fontanels: Gaps in an infant's skull that close by 24 months through intramembranous ossification.

    • Sinuses: Air cavities lined with mucous membranes to reduce skull weight and provide resonance to the voice.

The Cranium

  • Bones named according to their corresponding brain lobes:

    • Frontal Bone: Forehead region.

    • Parietal Bones: Top and sides of the braincase.

    • Temporal Bones: Situated below parietals, containing external auditory canal and styloid process.

    • Occipital Bone: Base of the skull; contains the foramen magnum, allowing the spinal cord’s passage.

    • Sphenoid Bone: Forms the cranial floor, contributing to the orbits.

    • Ethmoid Bone: Forms part of the orbits and nasal septum.

Facial Bones

  • Mandible: The lower jaw; the only movable skull bone.

  • Maxillae: Upper jaw and anterior hard palate.

  • Palatine Bones: Posterior segment of hard palate; form floor of the nose.

  • Zygomatic Bones: Cheekbones.

  • Nasal Bones: Bridge of the nose.

  • Lacrimal Bones: Contain nasolacrimal canals.

The Hyoid Bone

  • The hyoid is unique in being the only bone that does not articulate with another bone.

    • It attaches to the larynx through membranes and to temporal bones via muscles and ligaments.

    • Serves to anchor the tongue and attach swallowing-associated muscles.

The Vertebral Column

  • Comprises thirty-three vertebrae and possesses four normal curvatures:

    • Abnormal curvatures include:

    • Scoliosis: Abnormal lateral curvature.

    • Kyphosis: Hunchback appearance.

    • Lordosis: Swayback posture.

  • The spinal cord traverses through the vertebral canal; spinal nerves exit via intervertebral foramina.

    • Spinous and transverse processes serve as muscle attachment sites.

Types of Vertebrae

  • Seven Cervical Vertebrae: Form the neck region (first two specialized as Atlas and Axis).

    • Atlas: Facilitates the "yes" motion.

    • Axis: Facilitates the "no" motion.

  • Twelve Thoracic Vertebrae: Feature long, thin spinous processes; articular facets for rib attachments.

  • Five Lumbar Vertebrae: Characterized by large bodies and thick processes.

  • Five Sacral Vertebrae: Fused to form the sacrum.

  • Coccyx: Comprised of four fused vertebrae, also referred to as the tailbone.

Vertebral Counting in Other Species

  • Cats and Dogs:

    • C7, T13, L7, S3, Cd20-ish.

  • Horses:

    • C7, T18, L6, S5, Cd20-ish.

  • Cows:

    • C7, T13, L6, S5, Cd20-ish.

  • Birds (e.g., Chickens):

    • C14, T7, LS14, Cd6; variations exists among different species.

Intervertebral Discs

  • Located between vertebrae, acting as padding to absorb shock and prevent grinding.

  • Composed of fibrocartilage.

  • Risks include rupture and herniation, which can exert pressure on spinal cord.

The Rib Cage

  • Also known as the thoracic cage; a component of the axial skeleton.

    • Composed of thoracic vertebrae, ribs, associated cartilages, and sternum.

  • Protective and flexible in functioning.

    • Safeguards the heart and lungs while allowing expansion during breathing.

The Ribs

  • Twelve Pairs of Ribs: Flattened bones that curve outward, then forward and downward.

    • “True Ribs”: Seven pairs connect directly with the sternum via costal cartilage.

    • “False Ribs”: Three pairs that joint to sternum through shared cartilage.

    • “Floating Ribs”: Last two pairs, not connected to the sternum.

  • General pattern for mammals dictates that the number of ribs generally matches that of thoracic vertebrae.

The Sternum

  • Also called the breastbone, in conjunction with the ribs, it safeguards the heart and lungs.

    • Formed from three bones fused during fetal development.

    • Manubrium: Articulates with clavicle and first rib pair.

    • Body: Junction point with the manubrium, serves as a landmark for rib counting.

    • Xiphoid Process: Provides attachment for the diaphragm.

The Appendicular Skeleton

  • Comprises the bones within the pectoral and pelvic girdles along with associated limbs.

    • Pectoral girdles and upper limbs are built for flexibility.

    • Pelvic girdle and lower limbs are structured for strength.

The Pectoral Girdles and Upper Limbs

Pectoral Girdle (shoulder girdle)
  • Clavicle: Spans across the top of the thorax, connecting with the sternum and acromion process of scapula.

    • Mammals may have a rudimentary, free-floating, or absent clavicle.

    • Species with adapted forelimbs exhibit variations in clavicle development, like the fused clavicle (wishbone) seen in birds which aids flight.

Scapula
  • Glenoid Cavity: Articulates with the humerus.

  • Rotator Cuff: Formed by encircling tendons around the shoulder joint.

  • Coracoid Process: Provides an attachment point for arm and chest muscles.

Upper Limb Structure
  • Humerus: The bone of the upper arm.

  • Radius and Ulna: Forearm bones.

  • Hand Composition:

    • Carpal Bones: Eight wrist bones.

    • Metacarpals: Five palm bones.

    • Phalanges: Bone structures in the fingers (digits).

The Pelvic Girdle and Lower Limbs

Pelvic Girdle
  • Composed of two coxal bones (hip bones), each formed from the fusion of three bones:

    • Ilium: The most significant among the three.

    • Ischium: Contains the ischial spine on its posterior side.

    • Pubis: Joins with the opposite pubis at the pubic symphysis.

  • The pelvis includes the pelvic girdle, sacrum, and coccyx, serving critical roles in protecting internal organs, supporting body weight, and functioning as attachment points for lower limbs.

Lower Limb Structure
  • Femur: The largest bone, whose head articulates with the acetabulum (the hip socket where the coxal bones converge).

  • Tibia: The primary weight-bearing bone of the lower leg.

  • Patella: Known as the kneecap.

  • Fibula: Slender bone along the lateral side of the tibia.

  • Tarsals: The ankle bones including talus and calcaneus (heel bone), which support body weight.

  • Metatarsals: Form the instep of the foot.

  • Phalanges: Compose the bones of the toes (digits).

Joints

  • Joints connect bones and are categorized as follows:

    • Fibrous Joints: Immovable, such as sutures between cranial bones.

    • Cartilaginous Joints: Slightly movable, connected by cartilage (e.g. ribs/sternum and intervertebral discs).

    • Synovial Joints: Freely movable and characterized by synovial fluid production.

Synovial Joints
  • Features include:

    • Ends of bones capped by articular cartilage.

    • Bones separated by a cavity.

    • Ligaments stabilize the joint and form a joint capsule.

    • Synovial membrane lines the capsule, producing lubricating synovial fluid.

Major Synovial Joints
  • Examples include the shoulder, elbow, hip, and knee; specific characteristics of the knee include:

    • Presence of menisci made of fibrocartilage, offering added stability and functioning as shock absorbers.

    • 13 fluid-filled sacs (bursae) reduce friction between tendons and ligaments, which can lead to bursitis if inflamed.

Types of Synovial Joints

  • Hinge Joint: Permits movement in one direction only (e.g., knee).

  • Pivot Joint: Allows rotational movement (e.g., between radius and ulna).

  • Ball-and-Socket Joint: Permits movement in all planes (e.g., hip joint).

19.3 Human Skeletal Muscle

  • Three types of muscle tissue:

    • Smooth Muscle

    • Cardiac Muscle

    • Skeletal Muscle: Dominates muscle tissue composition, characterized as voluntary due to its contractions being consciously stimulated and controlled by the nervous system.

Skeletal Muscles Work in Pairs

  • Skeletal muscles are covered by connective tissue layers termed fascia.

    • Fascia extends beyond the muscle to form a tendon, connecting muscle to bone.

  • Upon muscle contraction, one bone remains stationary (origin), and the counterpart moves (insertion).

Antagonistic Muscles
  • Antagonistic muscle pairs function in opposite movement directions:

    • Flexion: Brings bones closer at a joint.

    • Extension: Moves bones further apart at a joint.

    • Abduction: Moves limbs away from the midline of the body.

    • Adduction: Brings limbs towards the midline.

    • Rotation: Moves parts around an axis (twist).

Naming of Skeletal Muscles

  • Characteristic bases for naming skeletal muscles include:

    1. Size: Words like maximus indicate "largest"; for example, the gluteus maximus is the largest muscle in the buttocks.

    2. Shape: Shapes reference (e.g., trapezius for trapezoid shape; deltoid is triangle-shaped).

    3. Location: Includes names like frontalis (overlying frontal bone).

    4. Direction of Muscle Fibers: Includes terms like rectus (straight) as in rectus abdominis.

    5. Number of Attachments: Bi- in biceps brachii indicates two attachments.

    6. Action: For instance, extensor digitorum indicates extension of fingers.

Major Skeletal Muscles

  • Approximately 650 skeletal muscles exist in the human body.

    • Head Muscles: Involved in facial expression and chewing.

    • Neck Muscles: Facilitate head movement.

    • Trunk and Upper Limb Muscles: Responsible for arm, forearm, and finger movement.

    • Buttocks and Lower Limb Muscles: Manage movement in thigh, leg, and toes.

Major Human Muscles: Anterior and Posterior Views

  • Includes tables and figures illustrating the major muscle groups and their respective actions for both anterior and posterior views.

Mechanism of Muscle Fiber Contraction

  • Skeletal muscle tissues exhibit a striated appearance due to alternating light and dark bands reflecting the arrangement of myofilaments.

Structure of a Muscle Fiber

  1. Muscle Fiber:

    • Contains typical cellular components assigned special terms:

      • Sarcolemma: The muscle cell's plasma membrane.

      • Sarcoplasmic Reticulum: Functions as the muscle fiber's endoplasmic reticulum.

      • Sarcoplasm: The muscle fiber's cytoplasm.

    • Notable structures include T (Transverse) tubules that extend into the cell and contact sarcoplasmic reticulum portions.

  2. Sarcoplasmic Reticulum:

    • Expanded sections store calcium, essential for muscle contraction, enclosing multiple myofibrils.

    • Mitochondria are situated in the sarcoplasm between myofibrils, alongside glycogen (energy source) and myoglobin (oxygen-binding pigment).

Components of a Muscle Fiber
  • Table 19.3 Components of a Muscle Fiber:

    • Interaction of structures like sarcolemma, sarcoplasm, glycogen, myoglobin, T tubule, sarcoplasmic reticulum, myofibril, and myofilament is necessary for muscle contraction and function.

Myofibrils and Sarcomeres

  • Myofibrils: Cylindrical structures that extend the length of muscle fibers; their striated appearance is due to the arrangement of myofilaments.

  • The Sarcomere units stretch from Z-line to Z-line and house two types of protein myofilaments:

    • Thin Filaments: Comprised of actin.

    • Thick Filaments: Composed of myosin.

Sarcomere Structure

  • I Band: Light band containing only actin filaments, attached to Z line.

  • A Band: Band that features overlapping actin and myosin filaments.

  • H Band: Contains only myosin filaments.

Myofilaments

  1. Thick Filaments: Comprised of numerous myosin molecules.

    • Each molecule has a club-like shape with heads on both ends, except at the center of the sarcomere.

  2. Thin Filaments: Composed mainly of two intertwined strands of actin, with tropomyosin and troponin as associated proteins.

Sliding Filament Model of Contraction

  • Muscle stimulation triggers impulses traveling down T tubules, releasing calcium from the sarcoplasmic reticulum.

  • Calcium’s role activates muscle fiber contraction, facilitating the sliding of actin past myosin filaments, leading to sarcomere shortening.

    • I Band shortens, H Band may diminish altogether; the sarcomere itself contracts as filaments come near.

    • Myosin filaments perform work by breaking down ATP and forming cross-bridges.

Skeletal Muscle Contraction Mechanisms

  • Neuromuscular Junction: Site where a motor neuron synapses with a muscle fiber. Axons contain synaptic vesicles filled with acetylcholine (ACh).

  • Upon a stimulus reaching the axon terminal, ACh releases into the synaptic cleft, diffuses across, and binds to receptors on the sarcolemma.

    • Generates impulses that excite T tubules and prompt calcium release from the sarcoplasmic reticulum, initiating contraction processes.

Molecular Mechanism of Contraction

  • Tropomyosin winds around actin filaments, blocking myosin-binding sites.

    • When calcium binds to troponin, tropomyosin shifts to expose these binding sites.

  • Myosin heads attach to these sites leading to:

    • ADP and inorganic phosphate release as a power stroke pulls actin fibers toward the center of the sarcomere.

    • New ATP binding detaches myosin heads and permits the cycle to begin anew.

Role of Calcium and ATP in Muscle Contraction

  • Muscle contraction relies heavily on calcium and ATP.

Energy for Muscle Contraction

  • ATP production occurs via several pathways:

    1. Creatine Phosphate Breakdown: Quick source of ATP for intense activity, lasting approximately 8 seconds.

    2. Cellular Respiration (Aerobic): Utilizes glucose and fatty acids in the presence of oxygen, providing sustained energy.

    3. Fermentation (Anaerobic): Provides ATP when oxygen delivery fails, generating lactic acid and contributing to fatigue if prolonged.

Oxygen Debt

  • Oxygen debt occurs post-anaerobic activity where creatine phosphate or fermentation fulfill energy demands.

  • Repaying this debt entails:

    • Replenishing creatine phosphate reserves.

    • Eliminating lactate either through mitochondrial processing or conversion back to glycogen by the liver.

Whole Muscle Contraction: In the Laboratory

  • Isolated muscle fibers exhibit all-or-none law responses to stimuli, completely contracting.

  • Whole muscle contractions are recorded on a myogram, detailing varied contraction levels influenced by stimulation intensity.

    • Muscle Twitch Stages:

    1. Latent Period: Time between stimulus and contraction onset.

    2. Contraction Period: Active shortening of muscles.

    3. Relaxation Period: Muscle returns to resting length.

Whole Muscle Adjustments

  • Whole muscle contractions can vary in strength based on stimulation; stronger stimuli activate more fibers.

  • The sustained contraction (tetanus) results from summation, where twitches fuse into a continuous contraction until fatigue arises.

Physiology of Skeletal Muscle Contraction

  • The myogram reflects stages of simple muscle twitch and demonstrates summation and tetanus phenomena when stimulated at higher intensities.

Athletics and Muscle Contraction

  • Disuse leads to muscle atrophy; muscle gains from forceful activity appear through hypertrophy, which involves a minimum of 75% maximum tension during contractions.

Types of Muscle Fibers

  1. Slow-Twitch Fibers:

    • Aerobic, enduring, more mitochondria, colored dark by myoglobin.

    • Exhibit a steadier contractile force; suit activities like long-distance running.

  2. Fast-Twitch Fibers:

    • Anaerobic, less durable, lighter due to fewer mitochondria.

    • Generate maximum strength in short bursts; suited for spikes in activity like sprinting or weightlifting.

Disorders of the Musculoskeletal System

Disorders of the Skeleton and Joints

  • Fractured Bones: Classification into complete vs. incomplete, simple vs. compound, impacted vs. spiral, and stress fractures.

  • Osteoporosis: Characterized by reduced bone mass, increased fracture risk, typically affecting women.

  • Arthritis: Includes osteoarthritis (degenerative) and rheumatoid arthritis (autoimmune).

Disorders of Muscles

  1. Muscular Dystrophy (MD): A group of genetic disorders affecting muscles, most notably Duchenne MD, linked to dystrophin gene mutations.

  2. Hyperkalemic Periodic Paralysis (HYPP): Genetic disorder in which abnormal sodium channels affect muscle contractions, notably in horses descended from the stallion "Impressive."