Anatomy, Physiology, & Disease: Deborah Roiger Nia Bullock

ANATOMY,
PHYSIOLOGY,
& DISEASE
FOUNDATIONS FOR
THE HEALTH PROFESSIONS
DEBORAH ROIGER
NIA BULLOCK
© 2019 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education.
2
Chapter 5
The Muscular System
© 2019 McGraw-Hill Education

3
Learning Outcomes 1
5.1 Use medical terminology related to the muscular

system.
5.2 Define terms concerning muscle attachments
and the ways muscles work in groups to aid,
oppose, or modify each other’s actions.
5.3 Demonstrate actions caused by muscles.
5.4 Identify muscles, giving the origin, insertion, and
action.
5.5 Describe the structural components of a muscle,
including the connective tissues.
4
Learning Outcomes 2
5.6 Describe the structural components of a skeletal

muscle fiber, including the major proteins.
5.7 Explain the five physiological characteristics of
all muscle tissue.
5.8 Explain how a nerve stimulates a muscle cell at
a neuromuscular junction.
5.9 Describe a muscle contraction at the molecular
level.

5
Learning Outcomes 3
5.10 Compare and contrast a muscle twitch and

tetany with regard to the steps of a muscle
contraction at the molecular level.
6.11 Define motor unit and explain the effect of
recruitment.
5.12 Compare and contrast isotonic and isometric
contractions.
5.13 Describe an example of a lever system in the
human body, giving the resistance, effort, and
fulcrum.
6
Learning Outcomes 4
5.14 Compare aerobic and anaerobic respiration in

terms of amount of ATP produced, speed, and
duration.
5.15 Explain the basis of muscle fatigue and
soreness.
5.16 Compare and contrast skeletal, cardiac, and
smooth muscle tissue in terms of appearance,
structure, type of nerve stimulation, type of
respiration, and location.
5.17 Explain the nutritional requirements of the
muscular system.
7
Learning Outcomes 5
5.18 Summarize the five functions of the muscular

system and give an example or explanation of each.
5.19 Summarize the effects of aging on the
muscular system.
5.20 Describe a common diagnostic test used to
diagnose disorders of the muscular system.
5.21 Describe muscle disorders and relate abnormal
function to pathology.

8
Overview 1
Word Roots and Combining Forms

• muscul/o: muscle
• my/o: muscle
• sarc/o: flesh
• sthen/o: strength

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Overview 2
Skeletal muscles are primary structures in

the muscular system.

10

11
Anatomy of the Muscular System 1
Anatomical Terms
• Terms such as origin and insertion are used to
indicate muscle attachments.
• Intrinsic muscle
• Refers to a muscle having its origin and insertion
located in the same body region
• Extrinsic muscle
• Refers to a muscle having its origin in a different
body regi\on and the insertion

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Anatomical Terms
• Fixator: a muscle that holds an origin stable for
another muscle.
• Synergists: muscles that have the same action.
• Prime mover: the main muscle of the synergists
that performs the action.
• Antagonist: a muscle that has an opposing
action.

13
Muscle Actions
• Muscle actions are the motions produced by
muscles.

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Muscle Actions
• Flexion: action that bends a part of the body
anteriorly, such as flexing the elbow.
• The exception is the knee. Flexion of the knee moves
the lower leg posteriorly.
• Extension: action that bends a part of the body

posteriorly, such as straightening the arm at the
elbow.
• As with flexion, the exception is the knee. Extending
the knee straightens the lower leg.
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Flexion and Extension
Jump to long description

© 2019 McGraw-Hill Education ©McGraw-Hill Education/Timothy L. Vacula
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Muscle Actions
• Abduction: movement of a part of the body
away from the midline
• Adduction: movement of a part of the body
toward the midline
• Protraction: movement that brings part of the
body forward
• Retraction: movement that brings part of the
body backward

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Abduction and Adduction

18
Protraction and Retraction

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Muscle Actions
• Lateral excursion: movement of the jaw laterally
to either side
• Medial excursion: movement of the jaw back to
the midline

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Lateral Excursion and Medial Excursion

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Muscle Actions
• Dorsiflexion: position of standing on the heels
with the toes pointing up off the floor
• Plantar flexion: position of standing on tiptoes
with the heels off the floor
• Inversion: position in which the soles of the feet
are together, facing each other
• Eversion: position in which the soles of the feet
point away from each other

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Dorsiflexion, Plantar Flexion,
Inversion, and Eversion

23
Muscle Actions
• Rotation: the act of spinning on an axis
• Circumduction: the act of making a circle with
part of the body
• Supination: rotation that turns the palms up
• Pronation: rotation that turns the palms down

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Rotation and Circumduction

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Supination and Pronation

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Muscle Actions
• Opposition: the act of bringing the thumb to the
palm
• Reposition: the act of taking the thumb away
from the palm
• Elevation: the act of closing the jaw or raising
the shoulders
• Depression: the act of opening the jaw or
lowering the shoulders

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Opposition

28
Elevation and Depression

29
Muscles (Anterior View)

30
Muscles (Posterior View)

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Muscles by Region
• Muscles of the head and neck include:
• orbicularis oris
• orbicularis oculi
• frontalis
• occipitalis
• temporalis
• buccinator
• masseter
• platysma
• sternocleidomastoid
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Muscles of the Head and Neck

© 2019 McGraw-Hill Education (c) ©McGraw-Hill Education/Rebecca Gray
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Muscles by Region
• Muscles of the thorax and abdomen:
• pectoralis major
• pectoralis minor
• serratus anterior
• diaphragm
• external intercostals
• internal intercostals
• external abdominal obliques
• internal abdominal obliques
• rectus abdominis
• transverse abdominal
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Muscles of the Thorax
and Abdomen 1

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and Abdomen 2

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and Abdomen 3
© 2019 McGraw-Hill Education (c) ©Christine Eckel

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Muscles by Region
• Muscles of the back and buttocks include:
• trapezius
• latissimus dorsi
• erector spinae
• gluteus maximus
• gluteus medius

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Muscles of the Neck, Back, and
Buttocks 1

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Muscles of the Neck, Back, and
Buttocks2
© 2019 McGraw-Hill Education (b) ©McGraw-Hill Education/Rebecca Gray

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Muscles by Region
• Muscles of the arm include:
• deltoid
• biceps brachii
• triceps brachii
• brachialis
• brachioradialis

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Pectoral and Brachial Muscles

42
Muscles by Region
• Muscles of the forearm include:
• extensor carpi radialis
• extensor carpi ulnaris
• palmaris longus
• flexor carpi radialis
• flexor carpi ulnaris
• extensor digitorum
• flexor digitorum
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Muscles of the Forearm

44
Muscles by Region
• Carpal Tunnel Syndrome
• Prolonged repetitive motions of the fingers and
hands, such as typing on a computer keyboard or
regularly working with hand tools, can cause
inflammation of the tendons traveling under the
carpal ligament.

45
Carpal Tunnel Syndrome

46
Muscles of the thigh include:

• tensor fasciae latae
• gracilis
• adductor longus
• pectineus
• iliacus
• iliopsoas
• psoas major
• sartorius
• rectus femoris, vastus lateralis, vastus medialis, and vastus
intermedius: quadriceps femoris
• biceps femoris, semitendinosus and semimembrinosus: hamstrings
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Anterior Muscles of the Thigh

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Posterior Muscles of the Thigh

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Muscles by Region
• Muscles of the leg include:
• gastrocnemius
• soleus
• peroneus/fibularis
• tibialis anterior

50
Muscles of the Leg

© 2019 McGraw-Hill Education (c) ©McGraw-Hill Education/Rebecca Gray
51
Anatomy of a Skeletal Muscle

• A muscle has a fibrous covering called the
epimysium.
• A muscle is composed of a bundle of fascicles.
• Each fascicle is surrounded by perimysium.
• A fascicle is composed of muscle cells (muscle fibers)
surrounded by endomysium.
• The connective tissues of the muscle come

together at the end of the muscle cell, or fiber,
to form a tendon.
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Connective Tissues and Structural
Components of a Thigh Muscle 1

53
Connective Tissues and Structural
Components of a Thigh Muscle 2

54
Anatomy of a Skeletal Muscle Cell

• Sarcolemma is the plasma membrane.
• The sarcoplasmic reticulum is the name given
to the smooth endoplasmic reticulum in a
muscle cell.
• Stores calcium (Ca2+) ions

55

• A muscle cell is composed of myofibrils.
• Each myofibril is composed of thick and thin
myofilaments arranged in sarcomeres.
• Thick and thin myofilaments are composed of
protein molecules.

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Structure of a Muscle Fiber

57

• Each myofibril consists of repeating contractile
units called sarcomeres.
• Sarcomere extends from Z line to Z line.
• Actin filaments are attached to Z lines and extend
towards center of sarcomere but do not meet.
• Myosin filaments reside in the A band and do not
contact the Z lines.

Muscle Fiber (Cell) Striations and 58
Sarcomeres
© 2019 McGraw-Hill Education (a) ©Don W. Fawcett/Science Source

59

• Thick myofilament
• Myosin subunits look like a doubleheader golf club.
• Head is referred to as a cross-bridge.
• Thin myofilament
• Actin subunits make up a double chain of beads
twisted together.
• Tropomyosin is a thread that holds the actin chained
together.
• Troponin is a calcium regulatory molecule.
Protein Structure of Thick and Thin 60
Myofilaments

61
Physiology of the Muscular System 1
Physiological Characteristics of Muscle

Tissue
1. Excitability. A muscle cell can be stimulated by a
nerve to contract.
2. Conductivity. The stimulation from the nerve
moves quickly along the length of the muscle
cell.
3. Contractility. A muscle cell can shorten with
force. Muscles can only pull; they cannot push.

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Physiological Characteristics of Muscle

Tissue
4. Extensibility. A muscle cell can be stretched. If
the biceps brachii contracts to flex the arm, the
triceps brachii needs to stretch to accommodate
the motion. Muscles are stretched by the
contraction of other muscles.
5. Elasticity. If a muscle cell is stretched, it will
return to its original shape.

63
Neuromuscular Junction
• Stimulation of a muscle cell by a nerve happens
at a neuromuscular junction.
• Generically referred to as a synapse
• An electrical stimulation along the nerve cell

results in the release of acetylcholine.
• Acetylcholine fits into receptors on the muscle
cell to stimulate it to contract.

64
A Neuromuscular Junction

© 2019 McGraw-Hill Education (b) ©Dr. Thomas Caceci, Virginia-Maryland Regional College of Veterinary Medicine
65
Neuromuscular Junction
• A minimal amount of stimulus called a
threshold is needed for the muscle to respond.
• As long as the threshold is reached, the muscle
cell will contract in an all-or-nothing manner.

66
Muscle Contraction at the Molecular Level

• The sliding filament theory of muscle
contraction involves thick myofilaments grabbing
thin myofilaments and pulling them toward the
center of the sarcomere.
• As all of the sarcomeres are shortened, so too is
the muscle cell.

67
Sliding Filament Model

68
Muscle Contraction at the Molecular Level

• Energy contained in ATP is needed for the
contraction to happen and to actively transport
calcium ions back to the sarcoplasmic reticulum
so that the muscle can relax.

69
Types of Muscle Contractions

• A twitch is a contraction of a muscle cell in
response to a single nerve stimulus.
• A twitch has a latent phase, contraction
phase, relaxation phase, and refractory
phase.

70
Graph of a Muscle Twitch

71
Types of Muscle Contractions

• Tetany is a sustained contraction due to
repetitive nerve signals.
• It is the frequency of the nerve impulses that
determines whether the contraction will be a
twitch or tetany.

72
Graph Showing Tetany

73
Motor Units and Recruitment

• A motor unit is a single nerve cell and all of the
muscle cells it stimulates.
• Small motor units are needed for fine, precise
movements.
• Getting more motor units involved is recruitment.
• More and more motor units can be recruited to
achieve a larger motion.

74
Isotonic and Isometric Contractions

• In an isotonic contraction, tension in the
muscle remains constant as the muscle
shortens.
• In an isometric contraction, tension in the
muscle increases, but there is no shortening of
the muscle.

75
Levers
• Muscles move bones in lever systems.
• There are three parts to a lever system:
1. Resistance is a weight to be lifted.
2. Effort is the force applied to lift the weight. In a
muscle system, the effort is the insertion of the
muscle.
3. Fulcrum is a pivot point on the lever that does not
move. In muscle lever systems, the fulcrum is a joint.

76
Levers
• Lever systems are classified as first, second, or
third class on the basis of the location of the
fulcrum, effort, and resistance.
• Most levers in the human body are third-class
levers.

77
Lever Systems

78
Muscle Metabolism
• Muscle cells can do either aerobic or anaerobic
respiration to process energy.
• Aerobic respiration is a many-step process
that produces enough energy to generate 36
ATP molecules for every glucose molecule, but
requires the addition of oxygen. It occurs in the
mitochondria of cells.

79
Muscle Metabolism

80
Muscle Metabolism
• Creatine phosphate
• Storage form of readily available energy
• Stores energy from excess ATP
• Formed by aerobic respiration when muscle is resting

• Energy transferred back to ADP when ATP levels
decrease
• Depleted quickly in rapidly contracting muscle

81
Muscle Metabolism
• Anaerobic respiration is a shorter process that
produces enough energy to generate 2 ATP
molecules per glucose molecule and does not
require oxygen.
• Anaerobic respiration results in lactic acid, which
must be removed by adding oxygen.
• Aerobic respiration can be done for long periods
of time, while anaerobic respiration can be done
only for short periods of time.
82
Fatigue
• Fatigue is the inability of a muscle to fully
respond to a nerve stimulus.
• Physiological contracture is complete fatigue in which
the muscle appears to be stuck. It can no longer
contract or relax.
• Fatigue can result from the buildup of lactic acid,

the lack of acetylcholine, or the lack of glucose.
• The amount of oxygen needed to remove the lactic
acid is called oxygen debt.

83
Fatigue
• Slow-twitch fibers are specialized for aerobic
respiration, so they do not fatigue quickly.
• Fast-twitch fibers are specialized for anaerobic
respiration and therefore fatigue quickly.

84
Comparison of Muscle Tissues

• Skeletal muscle tissue is composed of long,
striated cells with multiple nuclei pushed off to
the side.
• The cells are under voluntary control, rely on aerobic
or anaerobic respiration for energy production, and are
associated with bones, skin, and body openings.

85

• Cardiac muscle tissue is composed of
branched, striated cells with a single nucleus and
junctions between cells called intercalated disks.
• The cells are autorhythmic, rely on aerobic respiration
for energy production, and are located in the heart.

86

• Smooth muscle tissue is composed of spindle-
shaped cells with a single nucleus.
• The cells are not under voluntary control, rely on
aerobic respiration for energy production, and are
located in the walls of blood vessels and hollow
organs.

87
Nutritional Requirements of Muscle

Tissue
• Muscle tissue must maintain the proteins needed
for contraction. Therefore, amino acids, the
building blocks of proteins, must be included in
the diet.

88
Nutritional Requirements of Muscle Tissue

• The body can make nonessential amino acids.
• Essential amino acids must be supplied through
the diet.
• Complete proteins have all of the amino acids.
• Incomplete proteins are missing one or more
essential amino acids.
• The mineral potassium is also needed for proper

muscle function.
89
Functions of the Muscular System

1. Movement
• A gradual recruitment of additional motor units makes
a smooth contraction.
2. Stability
• Some of the motor units in the trapezius muscle are
taking turns in isometric contractions to maintain the
stability of the head.
• This is called muscle tone. A person’s posture is the
result of muscle tone.
90
Functions of the Muscular System

3. Control of body openings and passages
• Urinary and anal sphincters are under a person’s
voluntary control.
4. Communication
• Facial muscles can be used to communicate.
• Muscles in the throat, jaw, tongue, and diaphragm
are used to communicate through speech.
5. Heat production
• Muscles provide body heat
Effects of Aging on the Muscular 91
System1
Lean muscle mass decreases with age.

The amount of loss is genetically
determined.
Fast-twitch fibers are more affected than
slow-twitch fibers.

Effects of Aging on the Muscular 92
System 2
The effects of decreased muscle mass

include the following:
• strength is decreased
• fatigue occurs more quickly
• stability is reduced
• movement slows and becomes more limited
• gait shortens
Exercise is the best way to limit the effects of
aging.
Diagnostic Test for Muscular System 93
Disorders
Electromyography (EMG) can be used in
various ways to determine pathological
conditions associated with muscular
dysfunction.
An EMG assesses the health of muscles by
testing how a muscle responds to electric
stimuli.

94
Muscular System Disorders 1
Hernia is the protrusion of viscera through

the muscle of the abdominal wall.
Cramp is a painful muscle spasm that may
have many causes.
Muscular Dystrophy is a term for a group
of hereditary disorders that result in the
progressive degeneration of muscle tissue.

95
Inguinal Hernia

96
Sprains are ligament tears.

Muscle strain is a tear in a muscle from overuse or
overstretching.
Myalgia refers to muscle pain.
Fibromyalgia involves myalgia, fatigue, and pain in soft
tissues, tendons, and ligaments.
Tendinitis is tendon inflammation resulting from injury,
overuse, or aging.
Atrophy is a decrease in muscle size due to a decrease in
muscle tissue.
Shin splints refer to pain along the anterior, lower leg
commonly occurring after physical activity.
97
Muscular Atrophy

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ANATOMY,

The Muscular System

© 2019 McGraw-Hill Education

5.1 Use medical terminology related to the muscular

5.6 Describe the structural components of a skeletal

© 2019 McGraw-Hill Education

5.10 Compare and contrast a muscle twitch and

5.14 Compare aerobic and anaerobic respiration in

5.18 Summarize the five functions of the muscular

© 2019 McGraw-Hill Education

Word Roots and Combining Forms

© 2019 McGraw-Hill Education

Skeletal muscles are primary structures in

© 2019 McGraw-Hill Education

© 2019 McGraw-Hill Education

Anatomy of the Muscular System 1

© 2019 McGraw-Hill Education

Anatomy of the Muscular System 2

© 2019 McGraw-Hill Education

Anatomy of the Muscular System 3

© 2019 McGraw-Hill Education

Anatomy of the Muscular System 4

• Extension: action that bends a part of the body

Flexion and Extension

Jump to long description

Anatomy of the Muscular System 5

© 2019 McGraw-Hill Education

Abduction and Adduction

Jump to long description

Protraction and Retraction

Jump to long description

Anatomy of the Muscular System 6

© 2019 McGraw-Hill Education

Lateral Excursion and Medial Excursion

© 2019 McGraw-Hill Education ©McGraw-Hill Education/Timothy L. Vacula

Anatomy of the Muscular System 7

© 2019 McGraw-Hill Education

Jump to long description

Anatomy of the Muscular System 8

© 2019 McGraw-Hill Education

Rotation and Circumduction

Jump to long description

Supination and Pronation

© 2019 McGraw-Hill Education ©McGraw-Hill Education/Timothy L. Vacula

Anatomy of the Muscular System 9

© 2019 McGraw-Hill Education

© 2019 McGraw-Hill Education ©McGraw-Hill Education/Timothy L. Vacula

Elevation and Depression

© 2019 McGraw-Hill Education ©McGraw-Hill Education/Timothy L. Vacula

Muscles (Anterior View)

© 2019 McGraw-Hill Education

Muscles (Posterior View)

© 2019 McGraw-Hill Education

Anatomy of the Muscular System 10

Muscles of the Head and Neck

Jump to long description

Anatomy of the Muscular System 11

© 2019 McGraw-Hill Education

© 2019 McGraw-Hill Education

© 2019 McGraw-Hill Education (c) ©Christine Eckel

Anatomy of the Muscular System 12

© 2019 McGraw-Hill Education

Jump to long description

© 2019 McGraw-Hill Education (b) ©McGraw-Hill Education/Rebecca Gray

Anatomy of the Muscular System 13

© 2019 McGraw-Hill Education