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Musculoskeletal System Case scenario 3

Mr DR, a keen cyclist, is brought into A&E having been injured in a road traffic accident. A car stuck his right leg fracturing the femur and causing extensive muscle damage. His leg is put into a splint. Once the fracture has healed it will take several months of physiotherapy for him to regain the full strength of his leg muscles.

Revision Guide Questions

The adult skeleton is composed of 206 bones. Bones are classified into four groups: long, short, flat and irregular. 1. What is the structure of a long bone and what are the various parts called? Long bones are longer Long bones are longer than they are wide with has heads at both ends. a shaft that has heads bone. The long bone at both ends. compact composed ofLong bones are that is nearest head)mostly compactto bone. The long bone epiphysis that is the consists of a wide with a shaft) than they arediaphysis (or shaft that composed are mostly compact Long bonesof compact bone with a proximal epiphysis (or head) that consists of a diaphysis (or shaft) is nearest to the body at one end and bone with a proximal epiphysis (or a distal epiphysis that is a distal the body at one end andthe furthest away at the other . 2. What is the microscopic structure of bone tissue: Bone is made up of cells separated from each other by a noncellular material called matrix. Within a living bone are blood vessels, nerves, collagen and three special types of cells osteoblasts (bone forming cells), osteoclasts (bone cells that break down old bone) and osteocytes (mature osteoblasts that can no longer form bone). The non-living part of bone, which provides strength, is made up of the inorganic salts calcium and phosphate embedded in a non-cellular matrix of collagen fibres. a. What is the microscopic structure of compact bone? Compact bone is dense and if viewed under a microscope has a complex structure. The bone is riddled with passageways carrying nerves, blood vessels and other similar essentials which provide the living bone cells with nutrients and also get rid of waste products. b. What is the microscopic structure of spongy bone? The microscopic structure of spongy bone is quite different from compact bone in its arrangement. Instead of regular osteons, spongy bone has an irregular arrangement of thin bony plates called trabeculae. Nerves and blood vessels pass through the spaces between the bones.

3. What are the cells involved in forming and maintaining bone and what are their roles? There are four types of bone cells. Osteoblasts - These are commonly called bone-forming cells. They secrete osteoid with contains calcium, which forms the bone matrix this process is called ossification. They also begin mieralization, and are unable to divide. Osteocytes - A mature osteoblast which no longer secretes matrix, yet is surrounded by it. Maintains metabolism, and participates in nutrient/waste exchange via blood. Unable to divide. Osteoclasts - These function in resorption and degradation of existing bone, the opposite of osteoblasts. Monocytes (a type of white blood cell) fuse together to create these huge cells, which are concentrated in the endosteum. Osteoprogenitors - Immature cells which differentiate to make osteoblasts. May divide.

4. What is the microscopic structure of striated muscle tissue? Skeletal striated muscle is made up of individual components known as muscle fibers. These fibers are formed from the fusion of developmental myoblasts. The muscle fibers are long, cylindrical, multinucleated cells composed of myofibrils. The myofibrils are composed of actin and myosin myofibrils repeated as a sarcomere, the basic functional unit of the muscle fiber and responsible for skeletal muscle's striated appearance and forming the basic machinery necessary for muscle contraction.

5. Describe the sliding filament theory to explain how muscle contacts:-

Sliding Filament Theory

The process of a muscle contracting can be divided into 5 sections: 1. A nervous impulse arrives at the neuromuscular junction, which causes a release of a chemical called Acetylcholine. The presence of Acetylcholine causes the depolarisation of the motor end plate which travels throughout the muscle by the transverse tubules, causing Calcium (Ca+) to be released from the sarcoplasmic reticulum. 2. In the presence of high concentrations of Ca+, the Ca+ binds to Troponin, changing its shape and so moving Tropomyosin from the active site of the Actin. The Myosin filaments can now attach to the Actin, forming a cross-bridge. 3. The breakdown of ATP releases energy which enables the Myosin to pull the Actin filaments inwards and so shortening the muscle. This occurs along the entire length of every myofibril in the muscle cell. 4. The Myosin detaches from the Actin and the cross-bridge is broken when an ATP molecule binds to the Myosin head. When the ATP is then broken down the Myosin head can again attach to an Actin binding site further along the Actin filament and repeat the 'power stroke'. This repeated pulling of the Actin over the myosin is often known as the ratchet mechanism. 5. This process of muscular contraction can last for as long as there is adequate ATP and Ca+ stores. Once the impulse stops the Ca+ is pumped back to the Sarcoplasmic Reticulum and the Actin returns to its resting position causing the muscle to lengthen and relax.