PHYSIOLOGY of

MUSCULOSKELETAL
DR. Dr. H. Busjra M Nur MSc
Dept. Physiology FKUI / FKUMJ
Sarcomeres
Fundamental units of contraction
Composed of thick (myosin) and thin
(actin) myofilaments, joined by
crossbridges.
Contraction of individual sarcomeres
results in shortening or force development
of the whole muscle
Types of Contraction (duration)
Twitch
Tetanic
Types of Contraction (length)
Isotonic
Isometric
Motor unit
Motor unit recruitment
Reflexes in movement
Gamma motor neuron
Alfa motor neuron
Muscle spindle
Upper motor neuron
Lower motor neuron
Motor Unit
for precision function
- eye muscles
- fingers muscles

for strength
- legs muscles


Motor unit recruitment


All or none one motor unit
Degree of strength degree of
recruitment of motor units



Reflexes in movement



Upper motor neuron
Lower motor neuron
Spastic paralysis / paresis
Flaccid paralysis / paresis
Crossbridge cycle
(skeletal & cardiac)
Membrane potential Ca ion release
from sarcoplasmic reticulum
Ca binds to Troponin C
Energy from ATP cross bridge
Ca taken away Cross bridge release
(need ATP)
No ATP rigor mortis
Calcium antagonist in cardiac disease

Neuromuscular Junction
Motor neuron
Terminal button
Neuromyal cleft
Motor end-plate
Acetylcholine

Neuromuscular Junction
Acetylcholin
- neurotransmitter
- ligand gated depolarization
- in the neuromuscular junction,
preganglionic and parasympathetic
neurons
Black widow spider venom
- deadly effect
- explosive release of ACh
- prolonged depolarixation
diaphragm fail to relax properly
respiratory failure
Clostridium botulinum toxin
- food poisoning
- lethal blow
- blocks release of ACh
- prevents muscle contraction
respiratory failure
Curare
- blocks ACh receptor sites
no mucle tone / contraction
respiratory failure
in surgery
Myasthenia gravis
- autoimmune disease
- antibodies inactivate ACh receptor sites
Organophosphates
- pesticides
- inhibit AChE (irreversible) ACh
muscle failure to repolarize
respiratory failure
- antidote : atropine (ACh antagonist)
Neostigmine
- inhibit AChE (temporary)
- ACh in neuromuscular junction
+

Fatigue
Muscle fatigue
- lactic acid
- depletion of energy
Central fatigue
- psychological fatigue
Neuromuscular fatigue
- inability to synthesize ACh rapidly
Muscle fiber types
Slow Oxidative Fiber (TYPE I)
Fast Oxidative Fiber (TYPE IIa)
Fast Glycolytic Fiber (TYPE IIb)

Smooth Muscle
Highly Economical in Its Energy Usage
Cross bridge much more slowly
Can maintain high level of force
Can adapt to physiological needs: uterus
muscle in pregnancy
Composed of small, unstriated cells,
contained contractile proteins
Smooth Muscle
Single-Unit
Multi-Unit
Single-Unit Smooth Muscle
Gastrointestinal tract
Blood vessels
Respiratory tract
Uterus
Multi-Unit Smooth Muscle
iris
ciliary
Cardiac muscle
Small, striated cells
Sarcomeres are similar to skeletal muscle

Cardiac muscle
Atrium
Ventricle
Bone
Is living tissue
A form of connective tissue
Osteoblasts (bone formers) produce
the organic matrix (collagen fibers)
Osteoclasts (bone breakers)
Physiology of Bone
Matrix calcium deposit
Osteoblast bone deposition
Osteoklast bone resorption
Continously undergous remodeling

Calcium Deposit
Calcium Input
Vitamine D
Vitamine D activation in the kidney
Vitamine D in the liver
Calsium absorption in the intestine
Calsium reabsoption in renal tubulus

Additional Factors
Physical activity
Hormone estrogene
-- testosterone
-- growth hormone


PTH (parathyroid hormone)
Is essential for life
Ca ions in the plasma
reabsorption Ca ion in the kidney
reabsorption of phosphate in the kidney
Via vit D Ca absorption in intestine

Calcitonin : Ca level
Vit D : Ca absorption in intestine
Decreasing factors Osteoporosis
Inactivity
Long term Corticosteroid
Malnutrition
Menopause
Decrease calcium absorption in intestine