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