Bone Types: Long bones- longer than they are wide, shaft & 2 ends (bones of arms &

legs, except wrist, ankle & patella), Short Bones-roughly cube-shaped (ankle &
wrist bones) Sesamoid bones-short bones within tendons (patella), Flat bones are thin, flat & often curved (sternum, scapulae, ribs & most skull bones), Irregular
bones-odd shapes and don't fit into other classes (hip bones & vertebrae)Cellular Structure of a Long Bone: 1. Compact bone - The hard outer layer of bones is
composed of compact bone tissue, so-called due to its minimal gaps and spaces. This tissue gives bones their smooth, white, and solid appearance, and accounts for
80% of the total bone mass of an adult skeleton. Compact bone may also be referred to as dense bone or cortical bone. 2. Spongy bone - Filling the interior of the
organ is the spongy bone tissue which is composed of a network of rod- and plate-like elements that make the overall organ lighter and allowing room for blood vessels
and marrow. Spongy bone accounts for the remaining 20% of total bone mass, but has nearly ten times the surface area of compact bone.Spongy bone is key in the
process of hematopoiesis, where blood vessels are formed Structure of Long Bone: 1. Diaphysis - main part of the long bone, Tubular shaft that forms the axis of long
bones Composed of compact bone that surrounds the medullary cavity Yellow bone marrow (fat) is contained in the medullary cavity 2. Epiphyses - expanded ends of
long bones , exterior is compact bone, and the interior is spongy bone , joint surface is covered with articular (hyaline) cartilage, epiphyseal line separates the diaphysis
from the epiphysis Bone Membranes of Long Bone: 1. Periosteum – double-layered protective membrane, Outer fibrous layer is dense regular CT, Inner osteogenic
layer is composed of osteoblasts and osteoclasts, Richly supplied with nerve fibers, blood, and lymphatic vessels (enter the bone via nutrient foramina), Secured to
underlying bone by Sharpey’s fibers, isolates bone from surrounding tissue.2. Endosteum –delicate membrane covering internal surfaces of bone Structure of Short,
Irregular, and Flat Bones: Thin plates of periosteum-covered compact bone on the outside with endosteum-covered spongy bone (diploë) on the inside, Have no
diaphysis or epiphysis, Contain bone marrow between the trabeculae, Microscopic Structure of Compact Bone: 1. Haversian system, or osteon – the structural unit of
compact bone 2. Lamellae – weight-bearing, column-like matrix tubes composed mainly of collagen 3. Haversian, or central canal – central channel containing blood
vessels and nerves 4. Volkmann’s canals – channels lying at right angles to the central canal, connecting blood and nerve supply of the periosteum to that of the
Haversian canal 5. Osteocytes – mature bone cells 6. Lacunae – small cavities in bone that contain osteocytes 7. Canaliculi – hair like canals that connect lacunae to
each other and the central canal
Cartilage: mostly water, no blood vessels or nerves, tough & resilient, new cartilage forms from chondroblasts, heal poorly Growth: 1. Appositional-cells in the perichondrium
secrete matrix against the external face of existing cartilage 2. Interstitial- lacunae-bound chondrocytes inside the cartilage divide and secrete new matrix, expanding the
cartilage from within,Hyaline Cartilages: fine collagen fiber matrix- most abundant type- found in articular (movable joint)cartilages, costal cartilages (connect ribs to sternum),
respiratory cartilages (in larynx & upper respiratory passageways) & nasal cartilages,Elastic Cartilages: similar to hyaline cartilage, more elastic fibers (very flexible) – found in
external ear & epiglottis (larynx covering)Fibrocartilage: rows of chondrocytes with thick collagen fibers;highly compressible with great tensile strength- found in menisci of knee,
intervertebral discs & pubic symphysis Injuries: The snap and pop of overstressed cartilage Common aerobics injury Repaired with arthroscopic surgery
Types of Bone Cells: 1. Osteoblasts – bone forming cells synthesize and secrete unmineralized ground substance and are found in areas of high metabolism within the
bone, osteoprogenitor cells differentiate into osteoblasts, which form bone. 2. Osteocytes – mature bone cells made from osteoblasts that have made bone tissue around
themselves. These cells maintain healthy bone tissue by secreting enzymes and controlling the bone mineral content; they also control the calcium release from the bone
tissue to the blood,they form concentric layers around the central canal. Bone lining cells - made from osteoblasts along the surface of most bones in an adult. Bone-lining
cells are thought to regulate the movement of calcium and phosphate into and out of the bone 4. Osteogenic cells - respond to traumas, such as fractures, by giving rise to
bone-forming cells and bone destroying cells Osteoclasts – bone absorbing cell, large cells that break down bone tissue, important to growth, healing, and remodeling
Bone Marrow: the formation of blood cells (hematopoiesis) takes place mainly in the red marrow of the bones. In infants, red marrow is found in the bone cavities. With
age, it is largely replaced by yellow marrow for fat storage. In adults, red marrow is limited to the spongy bone in the skull, ribs, sternum, clavicles, vertebrae and pelvis.
Red marrow functions in the formation of red blood cells, white blood cells and blood platelets.
Salter-Harris Fracture Classification - Fractures can be classified using the Salter-Harris classification system. The mnemonic used for Salter-Harris fractures is “Straight
across, Above, Lower (or beLow), Two (or Through), and ERasure of growth plate (or cRush).Type I - : These fractures pass through the growth plate. Symptoms: These are
the least concerning fractures and heal the quickest. Treatment: Type I fractures heal rapidly and cause minimal issues with growth. Prevalence: About 5% of Salter-Harris
fractures are Type I.Type II - : Involves a fracture of the growth plate (physis) and metaphysis (the bone just above the growth plate). Symptoms: These fractures heal quickly
and cause minimal growth disturbance. Treatment: Type II fractures heal quickly with minimal long-term effects on bone growth. Prevalence: About 75% of Salter-Harris
fractures are Type II.Type III - : Involves a fracture of the growth plate (physis) and epiphysis (the end of the bone). Symptoms: These fractures can lead to joint deformities
and may require reduction and fixation. Treatment: Requires joint reduction and fixation. These fractures may result in growth deformities. Prevalence: About 10% of
Salter-Harris fractures are Type III.Type IV - : Involves a fracture that passes through the growth plate (physis), metaphysis, and epiphysis. Symptoms: These fractures can
lead to growth disturbances and angular deformities. Treatment: May result in growth disturbances and angular deformities. Prevalence: About 10% of Salter-Harris fractures
are Type IV.Type V - : Involves compression or crushing of the growth plate (physis). Symptoms: This is the most serious type and leads to growth deformities. Treatment:
This usually results in growth deformities and disturbances. Prevalence: Less than 5% of Salter-Harris fractures are Type V. Bone Repair Process: 1. Injury – broken blood
vessels, hematoma 2. Invasion of blood vessels & generalized cells (2-3 days) 3. Fibroblasts develop (1 week) 4. Chondroblasts develop 5. Callus forms (4 weeks) 6.
Remodeling with osteoclasts (8 weeks) Sprains: ligaments reinforcing a joint are stretched or torn, partially torn ligaments slowly repair themselves, completely torn ligaments
require prompt surgical repair Dislocations: occur when bones are forced out of alignment, usually accompanied by sprains, inflammation, and joint immobilization, caused by
serious falls and are common sports injuries, subluxation – partial dislocation of a joint
Joint Classification: Joints are classified functionally based on the amount of movement allowed. Synarthroses are immovable joints, amphiarthroses are slightly
movable joints, and diarthroses are freely movable joints.
Fibrous joints are connected by dense fibrous connective tissue with no joint cavities. Sutures are synarthroses found in the skull; they ossify and form synostoses in
adulthood. Syndesmoses are amphiarthroses connected by ligaments. Short fibers limit movement ( distal tibiofibular joint), while long fibers allow ample movement
(interosseous membrane between the radius and ulna). Gomphoses are peg-in-socket joints, classified as synarthroses, and are only found in the articulations of teeth
with their alveolar sockets.
Cartilaginous joints are joined by cartilage without joint cavities. Synchondroses are amphiarthroses connected by hyaline cartilage ( epiphyseal plates, first sternocostal
joint). Symphyses are amphiarthroses connected by fibrocartilage ( pubic symphysis, intervertebral discs).
Synovial joints are diarthroses with a synovial cavity filled with synovial fluid that reduces friction and protects joint surfaces. Ball and socket joints allow a wide range of
movements (hip and shoulder) Condyloid joints allow all movements except axial rotation(wrist, metacarpophalangeal joints). Saddle joints allow similar movement to
condyloid joints (thumb carpometacarpal joint). Hinge joints allow flexion and extension (elbow, knee,interphalangeal). Pivot joints allow one bone to rotate around
another (atlantoaxial joint in the neck, proximal radioulnar joint). Plane joints allow side-to-side movement (intercarpal and intertarsal joints, acromioclavicular)
Skeletal Disorders Osteoarthritis - Definition: The cartilage that cushions bones wears down over time, often due to joint strain or injury. Symptoms: Joint pain, stiffness, limited movement, tenderness, and swelling. Treatment: Acetaminophen, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). Prevention: Exercise, maintain a healthy weight, avoid joint
injuries. Effects: Causes pain and wears down joint cartilage.Osteoporosis - Definition: The body loses too much bone or doesn’t make enough bone, leading to fragile bones. Symptoms: Back pain, stooped posture, broken bones easily, loss of height. Treatment: Calcitonin, bisphosphonates, calcium and vitamin D supplements. Prevention: Eat a healthy
diet, exercise regularly, avoid smoking and excessive alcohol consumption. Effects: Fragile bones that break easily, height loss, and postural changes.Fracture - Definition: Caused by trauma, pathologies, and overuse. Symptoms: Swelling and tenderness in a localized area, bruising, and deformity. Treatment: Cast, brace, traction, and fixation. Prevention:
Proper diet and exercise. Effects: Can damage skin, nerves, blood vessels, muscles, and organs.Disc Herniation - Definition: Herniated discs are caused by wear and tear, injuries, and excess strain on intervertebral discs. Symptoms: Numbness, weakness, leg pain, and muscle pain. Treatment: Limiting activities, ice/heat, aspirin, and NSAIDs.
Prevention: Healthy weight, exercise, avoiding smoking, good posture. Effects: May cause stumbling or inability to lift items. Scoliosis - Definition: A sideways curvature of the spine, often developing during growth spurts. Symptoms: Uneven shoulders, waist, or hips; back pain; difficulty breathing in severe cases. Treatment: Braces, physical therapy,
surgery in severe cases. Prevention: Regular check-ups and early detection. Effects: Can affect posture, lead to back pain, and affect lung/heart function.ACL Tear - Definition: A sprain or tear of the anterior cruciate ligament, often during sports involving sudden stops or changes in direction. Symptoms: Knee swelling, instability, and pain. Treatment:
Arthroscopy, ACL reconstruction, therapy. Prevention: Practice good technique and balanced diet. Effects: Difficulty walking, stumbling, and falling.MCL Damage - Definition: Occurs when the medial collateral ligament is stretched, partially torn, or completely torn. Symptoms: Knee swelling, instability, and pain. Treatment: Arthroscopy, MCL reconstruction,
therapy. Prevention: Good technique and balanced diet. Effects: Difficulty walking, stumbling, and falling.Spinal Stenosis - Definition: Caused by narrowing of spaces in the spine due to osteoarthritis and bone spur formation. Symptoms: Pain, loss of balance, loss of bladder control (some cases are asymptomatic). Treatment: Physical therapy, NSAIDs,
rest, limiting activity, back brace. Prevention: Exercise, proper body mechanics, healthy weight, good posture. Effects: Puts pressure on spinal nerves, leading to pain and nerve issues.Achondroplasia - Definition: A congenital disease caused by a gene alteration in the FGFR3 gene. Symptoms: Dwarfism, limited range of motion, large head size, small
fingers, normal intelligence. Treatment: Hormones, surgery in rare cases. Prevention: None, as it is congenital. Effects: Prevents cartilage in arms/legs from converting to bone.Juvenile Rheumatoid Arthritis - Definition: An autoimmune disease where the immune system attacks the body’s own joints. Symptoms: Joint pain, swelling, and irritability.
Treatment: NSAIDs, DMARDs (Disease Modifying Anti-Rheumatic Drugs), exercise, assistive devices. Prevention: No known prevention. Effects: Causes joint destruction and chronic pain.Spinal Fracture - Definition: Often caused by car accidents, falls, gunshots, or sports. Symptoms: Back/neck pain, numbness, tingling, weakness, bowel or bladder
changes, paralysis. Treatment: Braces, orthotics, instrumentation, fusion, vertebroplasties, kyphoplasties. Prevention: Avoiding accidents and injuries. Effects: Bone fragments can pinch and damage spinal nerves.Ankylosing Spondylitis - Definition: Linked to the HLA-B27 gene and typically appears in early adulthood. Symptoms: Reduced spinal
flexibility, hunched-forward posture, back/joint pain. Treatment: Physical therapy, NSAIDs, immunosuppressants, steroids, surgery. Prevention: None, as it is genetic. Effects: Leads to less spinal flexibility and hunched posture.Osteosarcoma - Definition: Caused by acquired gene changes, often linked to radiation therapy. Symptoms: Localized bone pain
and swelling. Treatment: Surgery, chemotherapy, radiation. Prevention: Maintaining healthy weight and not smoking. Effects: May metastasize to other tissues.Kyphosis- Definition a spinal deformity characterized by an excessive outward curvature of the upper back (thoracic spine) Symptoms:Rounded or "hunchback" appearance, Back pain, especially
with activities like bending or standing.Dwarfism Dwarfism is a group of genetic and medical conditions that result in significantly short stature. Individuals with dwarfism typically have an adult height of 4 feet 10 inches (147 cm) or less.
Depressions and Openings: 1. Meatus – canal like passageway 2. Sinus – cavity within a bone 3. Fossa – shallow, basinlike depression 4. Cervical vertebrae – The seven
vertebrae in the neck region, labeled C1 Random info-Osteoclasts have several key characteristics. They possess a
Groove – furrow 5. Fissure – narrow, slitlike opening 6. Foramen – round or oval opening through a bone ruffled border, which helps in resorbing bone, and are stimulated by
Bone Markings-tuberosity is a lange, rounded projection that is often roughened. A good example is the ischial tuberosity,crest is a narrow, to C7, support the head, facilitate neck
movement, and protect the spinal cord, parathyroid hormone (PTH), which increases bone resorption. They also
prominent ridge of bone. A good example is the iliac crest. typically have around 50 nuclei on average, and their activity is regulated, in
A trochanter is a very large, blunt, irregularly shaped process. The only trochanters are the greater and lesser trochanters of the femur, line is C1, also called the atlas, allows for the part, by osteoblasts. The smallest bone in the human body, excluding sutural
a narrow ridge of bone that is less prominent than a crest. A good example of a line is the intertrochanteric line of the femur, tubercle is a nodding motion of the head, while C2, or and sesamoid bones, is the stapes, while the bone in the skull that articulates
small, rounded projection or process. A good example is the adductor tubercle of the femur. epicondyle is a raised area located on or above a axis, enables rotation of the head. with all other cranial bones is the sphenoid. The hyoid is the only bone in the
condyle. A good example is the medial epicondyle of the femur, which is located above the medial condyle of the femur.spine is a sharp, Thoracic vertebrae – The twelve body that does not articulate with any other bone. In adults, red marrow is
slender, pointed projection. A great example of a spine is the ischial spine.process is a bony prominence. These are abundant markings and vertebrae in the upper and mid-back, primarily found in the tibia and calcaneus, and approximately 65% of bone is
an example is the spinous processes of the vertebrae. labeled T1 to T12, are attached to the inorganic. A major component of synovial fluid is hyaluronic acid, and the bones
Bone markings for joints. head is the expanded articular end of an epiphysis, separated from the diaphysis or shaft by a neck. A good ribs and support the chest region, they that do not contribute to the orbit include the parietal, lacrimal, maxilla, and
example is the head of the humerus,neck is a narrow connection between the epiphysis and diaphysis. A good example is the neck of the are less mobile compared to cervical and frontal. The olecranon process, trochlear notch, coronoid process, and
humerus.facet is a smooth, nearly flat articular surface. A good example is the costal facet located on each rib.condyle is a smooth, rounded lumbar vertebrae due to their connection radial tuberosity are important anatomical structures, with the olecranon found
articular process. A good example is the medial condyle of the femur.ramus is an armlike or branchlike bar of bone. An example of a ramus is to the ribs and sternum. Lumbar at the end of the ulna, the trochlear notch serving as part of the elbow, the
the ramus of the mandible.trochlea is a smooth, grooved articular process shaped like a pulley. An example is the trochlea of the femur. vertebrae – The five vertebrae in the
Bone markings for depressions and openings. groove, or sulcus, is a furrow in a bone. An example is the mylohyoid groove, or sulcus of the lower back, labeled L1 to L5, are the coronoid process assisting in elbow movement, and the radial tuberosity being
mandible.fissure is a narrow, slitlike opening. A great example is the inferior orbital fissure. foramen is a round opening through a bone that largest and strongest, bearing much of the attachment site for muscles in the forearm. Through remodeling, the
serves as a passageway for structures to pass through. Most foramina are found in the skull, an example being the foramen magnum.meatus the body’s weight, they allow for flexion, skeleton regenerates approximately every 20 years,The inner elastic component
is a canal-like passageway through a bone. An example is the internal acoustic meatus.sinus is a cavity within a bone, filled with air and lined extension, and limited rotation of the of intervertebral discs, known as the nucleus pulposus, plays a significant role
with mucous membrane. An example is the paranasal sinus.fossa is a shallow, basinlike depression in a bone. Good examples include the torso, making them essential for in cushioning the vertebrae. Aging results in a number of changes to the skeletal
posterior, middle, and anterior cranial fossa. movement and posture. system, such as the breakdown of costal cartilages, dehydration of
RANKL (Receptor Activator of Nuclear Factor-κB Ligand): A protein essential for regulating bone intervertebral discs, ossification of articular cartilages, and a decrease in bone
remodeling by promoting osteoclast formation and activity. Osteoclast Activation: RANKL binds to mass leading to an increased risk of fractures. The bones that contain
paranasal sinuses include the frontal, ethmoid, sphenoid, and maxilla.
its receptor RANK on osteoclast precursors, stimulating their maturation into active osteoclasts. Primary curvatures of the spine are found in the thoracic and sacral regions,
Bone Resorption: Mature osteoclasts resorb bone tissue, releasing calcium into the bloodstream. while elastic cartilage can be found in the external ear, epiglottis, and part of
Regulation: RANKL is controlled by osteoprotegerin (OPG), a decoy receptor produced by the nose. For calcium absorption in the digestive tract, calcitriol is the most
osteoblasts that binds to RANKL, preventing its interaction with RANK and inhibiting osteoclast important component. Rotation is restricted in the lumbar and thoracic
activation. An imbalance of RANKL and OPG can lead to increased bone resorption, contributing vertebrae, but cervical vertebrae have a greater range of motion. The bones
to osteoporosis. produced via intramembranous ossification include the clavicle, mandible,
and humerus, and the structure that prevents backward sliding of the femur
Bone Homeostasis: Daily, up to 0.5 grams of calcium leaves the adult skeleton. Weekly, 5-7% of relative to the tibia is the PCL. The olfactory foramina are found in the
bone mass is recycled. Spongy bone is replaced every 3-4 years, compact bone every 10 years. cribriform plate of the ethmoid, and the bone that articulates with all facial
Bone remodeling consists of bone deposit (osteoblasts deposit hydroxyapatite into the matrix) bones, except the mandible, is the maxilla. Some skull bones are not paired,
and bone resorption (osteoclasts secrete lysosomal enzymes, breaking down bone and such as the vomer and mandible.Ankylosis refers to the immobilization and
transferring calcium into the blood). Calcitriol inhibits calcitonin release. Calcitonin reduces ossification of joints due to rheumatoid arthritis, while crepitus is the term for
calcium release from bone, lowering blood calcium. Parathyroid hormone (PTH) is released when the crunching noise heard in osteoarthritis. Blows to the lateral knee typically
blood calcium is low, stimulating bone resorption and increasing calcium. Leptin regulates bone result in tearing of the LCL. The most common type of fracture in children is a
greenstick fracture
density, and serotonin produced outside the brain inhibits bone formation.
Types of Body Movements: Every one of our 640-odd skeletal muscles is attached to bone, or to other connective tissue structures, at no fewer than two Interactions of Muscles in the Body: Muscles are arranged in such a way that whatever one muscle can do, other muscles can reverse. Because of this, muscles are able to bring
points.Origin - is attached to the immovable or less movable bone. Insertion. The insertion is attached to the movable bone, and when the muscle contracts, the about an immense variety of movements. Prime mover. The muscle that has the major responsibility for causing a particular movement is called the prime mover. Antagonists.
insertion moves toward the origin. Flexion. Flexion is a movement, generally in the sagittal plane, that decrease the angle of the joint and brings two bones closer Muscles that oppose or reverse a movement are antagonists; when a prime mover is active, its antagonist is stretched and relaxed.Synergists help prime movers by producing the
together; it is a type of hinge joints, but it is also common at ball-and-socket joints. Extension. Extension is the opposite of flexion, so it is a movement that increases same movement or by reducing undesirable movements. Fixators. Fixators are specialized synergists; they hold a bone still or stabilize the origin of a prime mover so all tension can
the angle, or the distance, between two bones or parts of the body. Rotation. Rotation is movement of a bone around a longitudinal axis; it is a common movement ofbe used to move the insertion bone.Location of the muscle. Some muscles are named for the bone with which they are associated; for example, the temporalis and frontalis muscles
ball-and-socket joints. Abduction. Abduction is moving the limb away from the midline, or median plane, of the body.Adduction. Adduction is the opposite of overlie the temporal and frontal bones of the skull.
abduction, so it is the movement of a limb toward the body midline. Circumduction. Circumduction is a combination of flexion, extension, abduction, and adduction Skeletal Number of origins. When the term biceps, triceps, or quadriceps forms part of a muscle name, one can assume that the muscle has two, three, or four origins. Location of
commonly seen in ball-and-socket joints; the proximal end is stationary, and its distal end moves in a circle. the muscle’s origin and insertion. Occasionally, muscles are named for their attachment sites. Shape of the muscle. Some muscles have a distinctive shape that helps to identify
Special Movements: Certain movements do not fit into any of the previous categories and occur at only a few joints. Dorsiflexion and plantar flexion. Lifting the foot them. Action of the muscle. When muscles are named for their actions, terms such as flexor, extensor, and adductor appear in their names.Arrangement of Fascicle : Skeletal
so that its superior surface approaches the shin is called dorsiflexion, whereas depressing the foot is called plantar flexion. Inversion and eversion. To invert the foot, muscles consists of fascicles, but fascicle arrangement vary, producing muscles with different structures and functional properties.Circular-when the fascicles are arranged in
turn the sole medially; to evert the foot, turn the sole laterally. concentric rings;typically found surrounding external body openings which they close by contracting. Convergent-the fascicles converge toward a single insertion tendon; such a
Supination and pronation. Supination occurs when the forearm rotates laterally so that the palm faces anteriorly and the radius and ulna are parallel; pronation muscle is triangular or fan-shaped. Parallel-the length of the fascicles run parallel to the long axis of the muscle; these muscles are straplike; a modification of the parallel
occurs when the forearm rotates medially so that the palm faces posteriorly.Opposition. In the palm of the hand, the saddle joint between metacarpal 1 and the arrangement, called fusiform, results in a spindle-shaped muscle with an expanded belly. Pennate- short fascicles attach obliquely to a central tendon; in the extensor digitorum
carpals allows opposition of the thumb. muscle of the leg, the fascicles insert into only one side of the tendon and the muscle is unipennate; if the fascicles insert into opposite sides of the tendon or from from several
Homeostatic Imbalance: Age Related - With age, connective tissue increases and muscle fibers decrease, muscles become stronger and more sinewy, by age 80, different sides, the muscle is bipennate or multipennate.
50% of muscle mass is lost (sarcopenia), regular exercise reverses sarcopenia, aging of the cardiovascular system affects every organ in the body, atherosclerosis Types of Muscle Fibers: Skeletal muscle fibers are classified into Type I fibers (slow-twitch), which rely on oxidative metabolism (aerobic respiration) for ATP, supporting endurance
may block distal arteries, leading to intermittent claudication and causing severe pain in leg musclesExercise: helps muscles become more effective and efficient, activities and being fatigue-resistant, and Type II fibers (fast-twitch), which are used for high-intensity, explosive activities, with Type IIa fibers using both oxidative metabolism and
tendons will become thicker and able to withstand greater force, high intensity exercise for short duration produces strength, size and power gains in muscles, low glycolysis for ATP and Type IIb fibers relying mainly on anaerobic glycolysis, providing quick but short-lasting energy.Motor Unit and Recruitment: A motor unit consists of a motor
intensity exercise for long durations will give endurance benefits, trained muscles have better tone or state of readiness to respond, exercise promotes good posture neuron and all the muscle fibers it innervates, with small motor units controlling fine motor movements and large ones generating more force, motor unit recruitment occurs as force
enabling muscles to work effectively and helps prevent injury, during exercise the muscle cells use up more oxygen and produce increased amounts of carbon requirements increase, starting with smaller motor units (Type I fibers) and recruiting larger units (Type II fibers) for greater strength, frequency summation refers to rapid action
dioxide, lungs and heart have to work harder to supply the extra oxygen and remove the carbon dioxide, heart rate also increases in order to transport the potentials that result in a sustained contraction or tetanus.Muscle Fiber Adaptation to Exercise: Hypertrophy occurs with strength training, increasing the size of Type II fibers and
oxygenated blood to the muscles, muscle cell respiration increases - more oxygen is used up and levels of carbon dioxide rise, brain also tells the heart to beat enhancing muscle strength, while endurance training boosts mitochondrial density and capillary networks, improving oxidative capacity and delaying fatigue during prolonged
faster so that more blood is pumped to the lungs for gaseous exchange. More oxygenated blood gets to the muscles and more carbon dioxide is removed. exercise.Muscle Fatigue: Muscle fatigue results from lactic acid buildup during anaerobic glycolysis, reducing pH and inhibiting enzymatic function, ATP depletion limits the muscle's
Energy Systems in Muscle Contraction: Muscle fibers use creatine phosphate for rapid ATP regeneration in short bursts (10-15 seconds), anaerobic glycolysis for ability to sustain contraction, and neurological fatigue happens when the nervous system cannot maintain rapid stimulation, leading to reduced muscle performance.Calcium and
Muscle Relaxation: Muscle relaxation occurs when calcium ions are actively pumped back into the sarcoplasmic reticulum by the calcium ATPase pump, removing calcium from the
high-intensity, short-term energy (30 seconds to 2 minutes), producing lactic acid, and aerobic respiration for sustained ATP production through oxidative sarcoplasm, which causes myosin heads to detach from actin filaments and the muscle to relax.
metabolism, supporting long-term low to moderate-intensity activities.
Muscle Recovery and the Role of Rest: Recovery is vital for muscle repair and growth, with active recovery (low-intensity exercise) promoting circulation to clear Calcium (Ca²⁺) in Muscle Contraction: essential for linking electrical signals to mechanical Sliding Filament Theory: explains how muscles contract at the molecular level, describing
metabolic waste, while rest allows for protein synthesis, promoting hypertrophy, and nutrition, particularly carbohydrates and proteins, aids in replenishing glycogen action, regulates contraction and relaxation. Storage and Release: Stored in the the interaction between thin (actin) and thick (myosin) filaments within the sarcomere.
stores and repairing muscle tissue. Resting State: In a relaxed muscle, the myosin heads are in a low-energy state, and
sarcoplasmic reticulum (SR) and released into the sarcoplasm through ryanodine receptors tropomyosin
Muscle Plasticity: Skeletal muscle is plastic, capable of adapting to physical demands, with hypertrophy occurring with regular strength training and increased (RyR) in response to action potentials traveling along the sarcolemma and T-tubules. blocks the binding sites on actin. Activation: Upon stimulation, calcium is
muscle size, and endurance training improving efficiency, whereas disuse can lead to muscle atrophy and loss of strength. released from the sarcoplasmic reticulum, binds to troponin C, causing tropomyosin to shift
Characteristics of Muscle Tissue: Excitability- receive and respond to stimuli, Contractility- ability to shorten and thicken , Extensibility- ability to stretch , Elasticity- Troponin-Tropomyosin Complex: Calcium binds to troponin C (TnC), causing tropomyosin and expose
to shift and expose actin myosin-binding sites, enabling contraction. Cross-Bridge Cycling: ATP hydrolysis, actin’s binding sites. Cross-Bridge Formation: Myosin heads, energized by
ability to return to its original shape after contraction or extension bind to the exposed actin binding sites, forming cross-bridges. Power
Muscle Types:Heart muscle - also called cardiac muscle,makes up the wall of the heart. Throughout life, it contracts some 70 times per minute pumping about 5 Calcium removes tropomyosin block on actin, allowing myosin to bind and generate force. Stroke: Myosin heads pivot, pulling actin filaments toward the center of the sarcomere,
liters of blood each minute.Smooth muscle is found in the walls of all the hollow organs of the body (except the heart). Its contraction reduces the size of these Reuptake for Relaxation: Calcium is pumped back into the SR by SERCA (Ca²⁺-ATPase), shortening the muscle. ATP is required to release myosin from actin, allowing the cycle to
structures. Thus it regulates the flow of blood in the arteries, moves your breakfast along through your gastrointestinal tract, expels urine from your urinary bladder, lowering cytosolic calcium levels and causing muscle relaxation. Key Proteins: Troponin
sends babies out into the world from the uterus, regulates the flow of air through the lungs. The contraction of smooth muscle is generally not under voluntary complex (TnC binds calcium, TnI inhibits actin-myosin interaction, TnT anchors troponin to repeat. Reattachment: A new ATP molecule binds to myosin, detaching it from actin and
re-energizing the myosin head. Relaxation: When stimulation stops, calcium is pumped
control. Skeletal muscle is the muscle attached to the skeleton. It is also called striated muscle. The contraction of skeletal muscle is under voluntary control. tropomyosin), tropomyosin (blocks binding sites at rest), SERCA (reuptake pump), and back into the SR, tropomyosin covers the binding sites, and the muscle relaxes. Key
Skeletal Muscle Anatomy: Each skeletal muscle is served by one nerve, one artery, and one or more veins. Nerve endings control muscle contraction.Arteries deliver calsequestrin (stores calcium in the SR). Muscle Types: In skeletal muscle, calcium Proteins: Myosin (thick filament, generates force), Actin (thin filament, interacts with
oxygen and nutrients, while veins remove waste.A muscle is made up of muscle fibers, blood vessels, nerves, and connective tissue. release is tightly linked to action potentials; in cardiac muscle, calcium-induced calcium
Connective tissue layers: Epimysium surrounds the entire muscle.Perimysium surrounds bundles of muscle fibers (fascicles).Endomysium surrounds individual release (CICR) amplifies the signal; in smooth muscle, calcium modulates contraction via myosin), Tropomyosin (blocks binding sites), Troponin (regulates actin-myosin
muscle fibers. calmodulin and myosin light chain kinase. interaction), ATP (provides energy for contraction and relaxation).
RICE method- Rest: Avoid using the injured area to prevent further damage, Ice: Apply ice to the injury for 15-20 minutes every hour to reduce swelling and pain,Compression: Use an elastic bandage to wrap the injured area to help reduce swelling,Elevation: Raise the injured area above the level of the heart to help reduce swelling.
Muscular Disorders:Poliomyelitis - Description: A viral disease affecting the nerves, potentially leading to paralysis It includes four types: paralytic, bulbar, spinal, and bulbospinal polio. Cause: Infection with the poliovirus, transmitted through contaminated food, water, or contact with an infected person. Symptoms: Paralysis, difficulty breathing and
swallowing, fever, sore throat, vomiting, loss of appetite, stiffness, and flu-like symptoms. Prevention: Passive immunization and vaccines (Salk inactivated vaccine and oral polio vaccine). Treatment: Bed rest, pain relievers, and portable ventilators.Muscular Dystrophies - Description: A group of inherited diseases characterized by weakness and
deterioration of muscle tissue. The tissue is slowly replaced by fat, resulting in immobility. Duchenne muscular dystrophy (DMD) is the most common form in children, and myotonic muscular dystrophy (MMD) is the most common in adults. Cause: Muscular dystrophies are caused by mutations in the DMD gene, which provides instructions for dystrophin
protein that strengthens muscle fibers. Symptoms: Progressive muscle weakness, difficulty breathing or swallowing, and reliance on a wheelchair. Prevention: No prevention due to the genetic nature of the disease. Treatment: Corrective surgery, exercise, and physical therapy may help manage the condition.
Myasthenia Gravis - Description: A chronic autoimmune disease that causes weakness and rapid fatigue of voluntary muscles. Cause: Caused by antibodies blocking acetylcholine receptors at the neuromuscular junction, impeding communication between the nervous and muscular systems. Symptoms: Weakness in the arms and legs, drooping
eyelids, difficulty chewing, swallowing, talking, and double vision. Prevention: Not preventable, as it results from the immune system mistakenly attacking the body. Treatment: Medications such as anticholinesterase agents, immunosuppressive drugs, and surgeries like thyroidectomy.Tetanus - Description: A rare bacterial infection that causes painful
muscle spasms, often leading to death. Cause: Infection with Clostridium tetani bacteria, which produces a neurotoxin called tetanospasmin. Symptoms: Muscle spasms in the jaw, neck, chest, back, and abdominal muscles, leading to fractures and muscle tears. Difficulty breathing, fever, irritability, and swallowing issues. Prevention: Tetanus is
preventable through the Tdap vaccine, which contains the tetanus toxoid. Treatment: Antibiotics, tetanus immunoglobulin, muscle relaxers, sedatives, and surgery to help manage symptoms.Myositis - Description: Myositis refers to muscle inflammation, often caused by infections, injuries, autoimmune diseases, or drugs. Cause: Myositis is caused by
various conditions, including infections and drug reactions. Symptoms: Muscle weakness, pain, fatigue, difficulty climbing stairs, standing, reaching, and swallowing. Prevention: Preventable in cases of infectious or drug-induced myositis through vaccination, avoiding unprescribed drugs, and following medical instructions. Treatment: Corticosteroids,
immunosuppressants, anti-inflammatory drugs, exercise, and rest.Carpal Tunnel Syndrome - Description: Numbness and tingling in the hand and arm caused by a pinched nerve in the wrist. Cause: A pinched median nerve in the wrist, often due to repetitive motions. Symptoms: Numbness and tingling in the thumb-side of the hand or palm. Pain
may radiate to the elbow, wrist, or hand, and coordination and hand strength may be affected. Prevention: Avoid repetitive hand and wrist motions or use ergonomic aids. Treatment: Splints, anti-inflammatory drugs, heat or ice application, wrist support, and surgery in severe cases.Botulism - Description: A rare and potentially fatal poisoning caused
by toxins produced by Clostridium botulinum bacteria. Cause: Toxins from C. botulinum bacteria infect the body. Symptoms: Difficulty swallowing, speaking, facial weakness, and paralysis. Prevention: Proper food handling, cooking food thoroughly, and avoiding damaged or bulging containers. Treatment: Antitoxin injections and breathing assistance
if needed.Fibromyalgia - Description: A disease causing widespread musculoskeletal pain, fatigue, and issues with sleep, memory, and mood. Cause: The cause is unknown, though it is linked to injuries, rheumatoid arthritis, and autoimmune disorders. Symptoms: Long-term pain and tenderness in muscles, joints, tendons, and soft tissues
throughout the body. Prevention: There is no known prevention, though a healthy lifestyle may help manage symptoms. Treatment: SSRIs, analgesics, NSAIDs, nerve pain medications, muscle relaxants, physical therapy, and counseling.Chronic Fatigue Syndrome - Description: A chronic condition characterized by extreme fatigue that worsens with
activity and doesn't improve with rest. Cause: The cause is unknown, but it mainly affects women aged 30-50. Symptoms: Persistent fatigue lasting at least six months, which worsens with activity and doesn’t improve with rest. Treatment: No cure, but treatments include maintaining a healthy diet, using antidepressants, cognitive behavioral therapy,
and graded exercise and relaxation techniques.LEMS is primarily caused by antibodies that attack the voltage-gated calcium channels (VGCCs) at the neuromuscular junction. These channels are essential for the release of acetylcholine, a neurotransmitter that triggers muscle contraction. Symptoms Muscle Weakness: This is the hallmark symptom of
LEMS, particularly affecting the muscles of the thighs, hips, shoulders, and upper arms.Fatigue: Generalized tiredness or difficulty in performing everyday tasks is common.Difficulty Walking: Due to weakness in the lower body muscles, walking can become challenging. Radial nerve palsy is a condition that occurs when the radial nerve is damaged or
compressed. This nerve runs from the shoulder down the back of the arm and into the hand, controlling movement and sensation in the wrist, fingers, and part of the forearm.
Sarcomere Structure and Function: Z-disk (Z-line) - Located at sarcomere borders, anchors thin filaments (actin), maintains structural integrity, and is involved in signaling; key proteins include actin (anchored via CapZ and α-actinin), α-actinin (cross-links
actin), desmin (connects Z-disks of myofibrils), titin (extends from Z-disk to M-line, provides elasticity), and nebulin (regulates actin filament length). M-disk (M-line) - Found at the center of sarcomeres, aligns and stabilizes thick filaments (myosin), and aids in
force transmission; key proteins are myosin, myomesin (cross-links myosin filaments), M-protein (stabilizes thick filaments), and creatine kinase (regenerates ATP). H-disk (H-zone) - Central region of the A-band with only thick filaments (no actin overlap),
appears during relaxation and disappears during contraction; primarily contains myosin and titin, which maintains alignment and passive tension. I-band - The region containing only thin filaments (actin), spanning two adjacent sarcomeres, narrows during
contraction; contains actin, tropomyosin, troponin, and nebulin, which regulate filament stability and contraction. A-band - The entire length of thick filaments, overlapping with thin filaments except in the H-zone, remains constant during contraction, key
proteins include myosin, titin, and regulatory proteins. Titin - The largest known protein, extends from Z-disk to M-line, provides structural support, maintains sarcomere elasticity, and prevents overstretching. Nebulin - Wraps around thin filaments, regulates
their length and stability, and plays a role in actin filament organization. Dystrophin - Links actin filaments to the sarcolemma, stabilizing the muscle fiber during contraction, mutations in this protein cause muscular dystrophies. Costameres - Protein complexes
connecting sarcomeres to the cell membrane, help transmit contractile force, key components include dystrophin-glycoprotein complex (DGC) and integrins. Intercalated Discs - Found in cardiac muscle, facilitate electrical coupling and mechanical
connection between cells, composed of desmosomes (mechanical stability), gap junctions (electrical communication), and fascia adherens (anchors actin filaments). ATP (Adenosine Triphosphate) in Muscles - Primary energy source for muscle
contraction, provides energy for cross-bridge formation and power stroke, broken down into ADP and Pi during contraction, small amounts stored in muscle fibers, rapidly depleted, must be replenished continuously. ATP Sources - Direct Phosphorylation
(creatine phosphate donates phosphate to ADP to form ATP, lasts 15-20 seconds), Anaerobic Respiration (glycolysis, produces 2 ATP per glucose, lasts 30-40 seconds), Aerobic Respiration (requires oxygen, produces 36-38 ATP per glucose, long-term
energy). ATP Depletion and Muscle Fatigue - Occurs when ATP production can’t meet energy demand, depletion of glycogen, buildup of lactic acid, Pi accumulation disrupts muscle function, reduces force generation. Key Roles - Powers sliding filament
mechanism, cross-bridge cycling, active transport of calcium into the SR, ion gradient maintenance (sodium-potassium pump). Synthesis - Regenerated from ADP and inorganic phosphate through cellular respiration and creatine kinase activity, stored in limited
amounts, supplemented by phosphocreatine, glycogen, and fatty acids. Calcium’s Role in Muscle Contraction - Released from the sarcoplasmic reticulum (SR), binds to troponin, causing a conformational change that moves tropomyosin away from actin’s
binding sites, allowing myosin heads to attach and initiate contraction. Excitation-Contraction Coupling - The process linking electrical stimulation of the muscle fiber to contraction, involves T-tubules carrying action potentials, calcium release, and activation
of actin-myosin interactions. Myosin Heads and Power Stroke - Myosin heads attach to actin, undergo conformational changes powered by ATP hydrolysis, pulling actin filaments toward the M-line, leading to sarcomere shortening. Sliding Filament Theory -
Explains muscle contraction as actin filaments sliding over myosin filaments, causing sarcomere shortening, with ATP required for detachment and reattachment of myosin heads. power stroke moves filaments, shortening the sarcomere.

Muscle Fiber Types & Functions, Type I (Slow-Twitch Fibers) have a high mitochondria count, rich in
myoglobin giving them a red color, and are fatigue-resistant. They function in endurance activities like
marathon running and posture maintenance and rely on aerobic respiration (oxidative metabolism).
Type IIa (Fast-Twitch Oxidative Fibers) are intermediate fibers with moderate fatigue resistance, using
a mix of aerobic and anaerobic energy, functioning in activities requiring both endurance and power like
middle-distance running. Type IIb/X (Fast-Twitch Glycolytic Fibers) have a large diameter, low
mitochondria and myoglobin making them white in color, and fatigue quickly. They function in short
bursts of strength and power like sprinting or weightlifting and rely on anaerobic respiration/
Frontalis: O: Frontal bone | I: Skin of eyebrows | M: Raises eyebrows
Orbicularis oris: O: Maxilla, mandible | I: Skin around lips | M: Puckers lips
Orbicularis oculi: O: Orbit | I: Skin around eyes | M: Closes eyelids
Occipitofrontalis: O: Occipital/Frontal bone | I: Galea aponeurotica | M: Moves scalp, raises eyebrows
Zygomaticus major: O: Zygomatic bone | I: Corner of mouth | M: Smiling
Masseter: O: Zygomatic arch | I: Ramus of mandible | M: Elevates mandible
Sternocleidomastoid: O: Sternum, clavicle | I: Mastoid process | M: Flexes and rotates head
Trapezius: O: Occipital, thoracic vertebrae | I: Clavicle, scapula | M: Elevates, retracts scapula
Buccinator: O: Maxilla, mandible | I: Orbicularis oris | M: Compresses cheeks
Pectoralis major: O: Sternum, clavicle | I: Humerus | M: Adducts, flexes arm
Latissimus dorsi: O: Thoracic/lumbar vertebrae | I: Humerus | M: Extends, adducts arm
Deltoid: O: Clavicle, scapula | I: Humerus | M: Abducts arm
Teres major: O: Scapula | I: Humerus | M: Adducts, medially rotates arm
Biceps brachii: O: Scapula | I: Radius | M: Flexes, supinates forearm
Triceps brachii: O: Scapula, humerus | I: Ulna | M: Extends forearm
Brachialis: O: Humerus | I: Ulna | M: Flexes forearm
Brachioradialis: O: Humerus | I: Radius | M: Flexes forearm
Palmaris longus: O: Humerus | I: Palmar aponeurosis | M: Flexes wrist
Flexor carpi radialis: O: Humerus | I: Metacarpals | M: Flexes, abducts wrist
Flexor digitorum superficialis: O: Humerus, radius | I: Middle phalanges | M: Flexes fingers
Extensor carpi radialis: O: Humerus | I: Metacarpals | M: Extends, abducts wrist
Extensor digitorum: O: Humerus | I: Phalanges | M: Extends fingers
Infraspinatus: O: Scapula | I: Humerus | M: Laterally rotates arm
Supraspinatus: O: Scapula | I: Humerus | M: Abducts arm
Subscapularis: O: Scapula | I: Humerus | M: Medially rotates arm
Teres Minor: O: Scapula | I: Humerus | M: Laterally rotates arm
External intercostals: O: Rib above | I: Rib below | M: Elevates ribs (inspiration)
Internal intercostals: O: Rib below | I: Rib above | M: Depresses ribs (expiration)
Transverse abdominis: O: Iliac crest, ribs | I: Linea alba | M: Compresses abdomen
Rectus abdominis: O: Pubic crest | I: Sternum, ribs | M: Flexes trunk
Serratus anterior: O: Ribs | I: Scapula | M: Protracts scapula
Diaphragm: O: Ribs, lumbar vertebrae | I: Central tendon | M: Flattens for inspiration
Iliopsoas: O: Ilium, lumbar vertebrae | I: Femur | M: Flexes thigh
Sartorius: O: Iliac spine | I: Tibia | M: Flexes, rotates thigh
Gluteus maximus: O: Ilium, sacrum | I: Femur | M: Extends, laterally rotates thigh
Gluteus medius: O: Ilium | I: Femur | M: Abducts thigh
Tensor fasciae latae: O: Iliac crest | I: Tibia | M: Abducts, flexes thigh
Adductor longus: O: Pubis | I: Femur | M: Adducts thigh
Gracilis: O: Pubis | I: Tibia | M: Adducts, flexes thigh
Semimembranosus: O: Ischium | I: Tibia | M: Extends thigh, flexes leg
Semitendinosus: O: Ischium | I: Tibia | M: Extends thigh, flexes leg
Biceps femoris: O: Ischium, femur | I: Fibula | M: Extends thigh, flexes leg
Rectus femoris: O: Ilium | I: Patella | M: Extends leg, flexes thigh
Vastus lateralis: O: Femur | I: Patella | M: Extends leg
Vastus intermedius: O: Femur | I: Patella | M: Extends leg
Vastus medialis