The Muscular System

• Structural and functional organization of muscles

• The system of the little mouse

Structural and Organization of Muscles

• 600 Human skeletal muscles– Also smooth & cardiac muscles

• General structural & functional organization– functions of muscle– connective tissues of muscle– general anatomy of skeletal muscles– muscle shape and function– coordinated actions of muscle groups – intrinsic and extrinsic muscles– muscle innervation

The Functions of Muscles

• Movement of body parts and organ contents

• Maintain posture and prevent movement

• Communication - speech, expression & writing

• Control of openings and passageways

• Body heat production

Non-Verbals

Interspecies non-verbals

Connective Tissues of a Muscle

Perimysium

Epimysium

Endomysium

Tendon

Deep fascia

Connective Tissues of a Muscle• Epimysium

– covers whole muscle belly – blends into connective tissue that separates

muscles

• Perimysium– slightly thicker layer of connective tissue– surrounds a bundle of cells called a fascicle

• Endomysium– thin layer of areolar tissue surrounding each cell– allows room for capillaries and nerve fibers

Fascicle, c.s.

Fascicles, Perimysium & Endomysium

Endomysium

Location of Fascia

Superficial Fascia

Deep Fascia

• Deep fascia– found between adjacent muscles

• Superficial fascia (hypodermis)– found between skin and muscles– contains adipose tissue

Muscle Attachments• Direct (fleshy) attachment to bone

– epimysium is continuous with periosteum– intercostal muscles

• Indirect attachment to bone– epimysium continues as tendon or aponeurosis that

merges into periosteum as perforating fibers– biceps brachii or abdominal muscle

• Attachment to dermis

• Stress will tear the tendon before pulling the tendon loose from either muscle or bone

Parts of a Skeletal Muscle

• Origin– attachment to stationary

end of muscle

• Belly– thicker, middle region of

muscle

• Insertion– attachment to mobile end of

muscle

Skeletal Muscle Shapes

• Fusiform muscles– thick in middle & tapered at

ends

– biceps brachii m.

• Convergent muscle– broad at origin and tapering to

a narrower insertion

• Parallel muscles– parallel fascicles

– rectus abdominis m.

Skeletal Muscle Shapes (2)

• Circular muscles– act as sphincters

– ring around body opening

– orbicularis oris

• Pennate muscles– fascicles insert obliquely

on a tendon

– unipennate, bipennate or multipennate

– palmar interosseus, rectus femoris & deltoid

• Biceps Tendon Rupture: As a result of chronic tendonitis or truama, the long head of the biceps may rupture. When this occurs, the biceps muscle appears as a ball of tissue and there is a loss of function.

Healthy Bicep

In september 2005 Maria Sharapova from Russia withdrew from the China Open due to a pectoral injury

Healthy Pectorals

Top European Golfer: David Howell

• Ranked 30th in the world one of England’s best withdrew from the U.S. Open in June of 2005.

• He suffered a rip

To the left oblique

• You can hit these abdominals with a pike and that pike will shatter

Ptosis

• Ptosis is a drooping of the entire upper eyelid. It can be due to trauma, disorders (IE: neurological, myasthenia, auto-immune), surgery, and medication.

• Terrell Owens, leaving the field and wincing in pain after suffering a regular season ending, lower leg injury against the Cowboys.

• Terrell Owens has been kicked 800 feet up in the air by the lower leg of Chuck Norris

↑

Coordinated Muscle Actions• Prime mover or agonist

– produces most of force

• Synergist aids the prime mover– stabilizes the nearby joint

– modifies the direction of movement that occurs

• Antagonist– opposes the prime mover

– preventing excessive movement and injury

• Fixator– prevents movement of bone that prime mover is attached to

Example

Muscle Actions during Elbow Flexion

• Prime mover (agonist) = biceps brachii m.

• Synergist = brachialis m.

• Antagonist = triceps brachii m.

• Fixator = muscle that holds scapula firmly in place such as rhomboideus m.

Definitions

Methods used to diagnose structural muscle disorders

• Myopathies: Muscle disorders– Can be confused with skeletal/nervous disorders

• Physical tests– Can you lift against gravity?

– Can you lift against resistance?

– Can you lift repeatedly?

• Physicians judge the amount of force and assign a grade; percentage, verbal grade, or numeric

• Myometers/Dynometers measure the amount of force a muscle exerts

• MRIs distinguish soft tissues making them more useful than X-Rays

• Electromyography records electrical activity of a muscle

• Biopsies: remove a small tissue sample

Blood and Urine tests

• Show muscle enzymes that have leaked into blood– Creatine Kinase

– Lactate Dehydrogenase

– Aldolase

– Aspartate transaminase

• Changes in conc. of electrolytes which are usually more conc. in skeletal muscle than blood.

• How much muscle myoglobin is in the urine.

Creatine kinase (CK)

• Its function is the catalysis of the conversion of creatine to phosphocreatine.– Where do you think the phosphorous comes from?

• Creatine/Phosphocreatine help buffer fluctuations in ATP usage.

• Studies suggest taking creatine can improve muscle performance under high energy aerobic training– Creatine use is not considered doping and is not banned

by sport-governing bodies. In some countries however, like France, creatine is banned.

Structural Disorders of Skeletal Muscle

• Rhabdomyolysis• the breakdown of muscle due to injury, either

mechanical, physical or chemical. The principal result of this process is acute renal failure due to accumulation of muscle breakdown products in the bloodstream, several of which are injurous to the kidney. Treatment is with intravenous fluids, and dialysis if necessary.

Photomicrograph of muscle biopsy sample shows swollen and necrotic muscle fibers without any inflammatory infiltrate

Caution• Things get gross from

here on out. Feel free to look at something calming.

• Edema is the medical term for swelling as a result of fluid in the skin or muscle.

• A hematoma is a collection of blood under the skin. It can occur in any soft tissue such as skin or muscle. A hematoma is caused when blood leaks from an injured vessel.

Contracture: Abnormal shortening of muscles

• Dupuytren's contracture is a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended.

Myositis Muscle inflammation

• Viral, bacterial, or parasitic infection• Trichinois: Larva of parasitic rounworms Tricinella get

encysted in muscles.

Caused by eating undercooked pork or bear

~ 12 cases a year in US

~500 cases a year in Thailand

Polymyositis

Degenerated skeletal muscle fibers (amorphous pink) with infiltrating macrophages and regenerating fibers with multiple nuclei and more lavender cytoplasm.

• Crush injuries are associated with significant mechanisms of injury. If a force is great enough, soft tissue (muscles, vessels, skin) can be crushed leading to extensive tissue damage and subsequent swelling and pain. Crush injuries in the lower extremities and forearm can lead to compartment syndrome that generally takes a few hours to develop.

• In the eyes of a ranger,The unsuspecting stranger,Had better know the truth of wrong from right,

'Cause the eyes of a ranger are upon you,Any wrong you do, he's gonna see,

When you're in Texas, look behind you,

'Cause that's where the rangers gonna be.

Intrinsic and Extrinsic Muscles

• Intrinsic muscles are contained within a region such as the hand.

• Extrinsic muscles move the fingers but are found outside the region.

Skeletal Muscle Innervation

• Cranial nerves arising from the brain– exit the skull through foramina– numbered I to XII

• Spinal nerves arising from the spinal cord– exit the vertebral column through

intervertebral foramina

How Muscles are Named

• Nomina Anatomica– system of Latin names developed in 1895– updated since then

• English names for muscles are slight modifications of the Latin names.

• Table 10.1 = terms used to name musclesdigiti = of a finger

levator = elevates a body part

profundus = deepest

quadriceps = having 4 heads

Learning Strategy

• Explore the location, origin, insertion and innervation of 160 skeletal muscles using the tabular information in this chapter.

• Increase your retention & understanding by:– examining models and photographic atlases– palpating yourself using the images in Atlas B– observe an articulated skeleton– say the names aloud and check your pronunciation

The Muscular System

Muscles of Facial Expression

• Small muscles that insert into the dermis

• Innervated by facial nerve (CN VII)

• Paralysis causes face to sag

• Found in scalp, forehead, around the eyes, nose and mouth, and in the neck

Occipitofrontalis is found in the scalp. Frontalis m. raises the eyebrows while Occipitalis m. fixes the galea aponeurotica

Muscles of the Scalp and Forehead

Frontalis

Occipitalis

Corrugator supercilii

Muscles around the Eyes

Nasalis

Orbicularis oculi closes the lips. Corrugator draws the eyebrows together. Procerus pulls down the skin of forehead. Nasalis widens nostrils.

Procerus

Orbicularis Oculi

• Orbicularis oris encircles mouth & other mm blend into it• Levator & depressor of labii (lip) & anguli (angle of mouth)• Risorius & zygomaticus curl corner of mouth up in smile• Buccinator keeps food on top of teeth, blowing & sucking

Muscles around the Mouth

Orbicularis oris

Risorius

Depressor labii inferioris

BuccinatorZygomaticus major

Depressor anguli oris

Levator labii superioris

Some of the Muscles used in Facial Expression

Some of the Muscles used in Facial Expression

Musculature of the Tongue• Intrinsic muscles = vertical, transverse & longitudinal• Extrinsic muscles connect tongue to hyoid, styloid

process, palate and inside of chin• Tongue shifts food onto teeth & pushes it into pharynx

Intrinsic tongue muscles

Extrinsic tongue muscles

Muscles of Mastication• 4 Major muscles

• Arise from skull & insert on mandible

• Temporalis & Masseter elevate the mandible

• Medial & Lateral Pterygoids help elevate, but produce lateral Swinging of jaw used to grind with molars

Temporalis

Masseter

Lateral pterygoid

Medial pterygoid

Suprahyoid Muscles and Swallowing• Digastric and Mylohyoid = open mouth• Geniohyoid = widens pharynx during swallowing• Stylohyoid = elevates hyoid• Thyrohyoid (an infrahyoid m.) = elevates larynx, closing glottis

Digastric Mylohyoid

StylohyoidThyrohyoid

Triangles of the Neck

Other Muscles involved in Swallowing

• Pharyngeal constrictors push food down throat• Infrahyoid muscles pulls the larynx downward • Intrinsic laryngeal muscles used to control speech

Pharyngeal constrictors

Muscles of Respiration• Breathing requires the use of muscles

– diaphragm– external intercostal muscles– internal intercostal muscles

• Contraction of the first 2 produces Inspiration• Contraction of the last produces Forced Expiration• Normal Expiration requires little muscular activity

– elastic recoil of tissues and gravity collapsing the chest– only inspiratory muscles active in braking action, so

exhalation is smooth

Muscles of Respiration -- Diaphragm

• Muscular dome between thoracic and abdominal cavities

• Muscle fascicles extend to a fibrous central tendon

• Contraction flattens it– increases the vertical dimension of the thorax drawing air into

the lungs

– raises the abdominal pressure to help expel urine, feces and facilitating childbirth

Central tendon

Muscles of Respiration -- Intercostals

• External intercostals– extend downward and anteriorly

from rib to rib

– pull ribcage up & outward during inspiration

• Internal intercostals– extend upward and anteriorly from

rib to rib

– pull ribcage downward during forced expiration

Muscles of Respiration - Serratus

• Serratus posterior superior– elevates ribs 2-5 during

inspiration

• Serratus posteriori inferior – depresses ribs 9-12 during

inspiration

Muscles of the Abdomen

• 4 Pairs of sheetlike muscles– external oblique– internal oblique– transverse abdominis– rectus abdominis

• Functions– support the viscera– stabilize the vertebral column– help in respiration, urination, defecation & childbirth

Rectus Abdominis & External Oblique• External oblique

– superficial

– downward

– anteriorly

– inguinal ligament

• Rectus abdominis– vertical, straplike

– tendinous intersections

– rectus sheath

– linea alba

External oblique Rectus abdominis

Internal Oblique -Transverse Abdominis

• Internal oblique– anteriorly

– upwards

• Transverse abdominis– horizontal fiber

orientation

– deepest layer

Transverse abdominisInternal oblique

Superficial Muscles of the Back

Trapezius

Latissimus dorsi

SemispinalisSplenius

Levator scapulaeRhomboideusSupraspinatusInfraspinatusTeres major

Gluteus maximusGluteus medius

Muscles of the Back• Erector spinae group

– 3 columns muscle

– extends from sacrum to ribs

– extends vertebral column

• Semispinalis group– vertebrae to vertebrae

– extends neck

• Multifidis– vertebrae to vertebrae

– rotates vertebral column

• Quadratus lumborum– ilium to 12th rib

– lateral flexion

Multifidis

Erector spinae

Quadratus lumborum

Semispinalis

Muscles of the Pelvic Floor• 3 Layers of muscles span pelvic outlet

– support pelvic viscera

• Region is called perineum – diamond-shaped region bounded by pubic symphysis, coccyx

and ischial tuberosities– penetrated by anal canal, urethra & vagina– anteriorly = urogenital triangle; posteriorly= anal triangle

• 3 Layers or compartments of the perineum– superficial layer = Superficial perineal space– middle layer = Urogenital diaphragm & Anal sphincter– deep layer = Pelvic diaphragm

•

Muscles in Superficial Perineal Space

• 3 Muscles found just deep to the skin• Ischiocavernosus = arises from ischial & pubic ramus• Bulbospongiosus = covers bulb of penis or encloses vagina• Superficial transverse perineus = extends from the ischial tuberosities to the central tendon

of the perineum• Function during sexual intercourse & voiding of urine

Bulbospongiosus

Ischiocavernosus

Superficial transverse perineus

Muscles of the UG diaphragm

• Middle layer of pelvic floor contains Urogenital diaphragm and External anal sphincter

• Urogenital diaphragm = 2 muscles– deep transverse perineus m. supports pelvic viscera– external urethral sphincter m. inhibits urination

External anal sphincter

Urogenital diaphragm

Muscles of the Pelvic Diaphragm

• Deepest compartment of the perineum • Pelvic diaphragm = 2 muscles

– levator ani m. supports viscera & functions during defecation

– coccygeus m. supports and elevates pelvic floor

Levator ani

Coccygeus

Hernias• Protrusion of viscera through muscular wall of

abdominopelvic cavity

• Inguinal hernia– most common type of hernia (rare in women)– viscera enter inguinal canal or even the scrotum

• Hiatal hernia– stomach protrudes through diaphragm into thorax– overweight people over 40

• Umbilical hernia– viscera protrude through the navel

Muscles Acting on the Pectoral Girdle

• Originate on axial skeleton & insert onto clavicle or scapula

• Anterior muscle group = 2 muscles

• Posterior muscle group = 4 muscles

• Scapular movements produced include– medial and lateral rotation of the scapula– elevation and depression of the scapula– protraction and retraction of the scapula

• Clavicle braces the shoulder & limits movement

Anterior Scapular Muscle Group• Pectoralis Minor

– ribs 3-5 to coracoid process of scapula

– protracts & depresses scapula

– lifts ribs during forced expiration

• Serratus Anterior– ribs 1-9 to medial

border of scapula

– abducts & rotates or depresses scapula

– throwing muscle

Muscles Acting on the Scapula

Posterior Scapular Muscle Group

• 4 Muscles – superficial = Trapezius– deep = Rhomboids & Levator scapulae

• Trapezius– rotate scapula upward– retract scapula– depress scapula

• With Levator scapulae & Rhomboids elevates scapula

• With Serratus anterior depresses scapula

• Rhomboideus mm.– medial border of

scapula to C7-T1

Posterior Scapular Muscle Group

• Levator scapulae– from superior angle of

scapula to C1-C4

Muscles Acting on the Humerus• 9 Muscles cross the shoulder joint to the humerus

– 2 axial muscles arise from axial skeleton– prime movers of humerus in flexion & extension– arise from sternum & clavicle OR T7-L5 & ilium

Pectoralis major Latissimus dorsi

• 7 scapular muscles arise from scapula

– Deltoid is prime mover• flexion, extension and abduction

of humerus

– Coracobrachialis assists in flexion

– Teres major assists in extension

– Remaining 4 form the rotator cuff muscles that reinforce the shoulder joint capsule

Muscles Acting on the Humerus

Posterior View of Chest in Cadaver

Rotator Cuff Muscles

• Extending from posterior scapula to humerus – supraspinatus

– infraspinatus

– teres Minor

• Extending from anterior scapula to humerus – subscapularis

All 4 help reinforce joint capsule.

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

Anterior View of Chest in Cadaver

Muscles Acting on the Elbow• Principal flexors

– biceps brachii • inserts on radius

– brachialis • inserts on ulna

• Synergistic flexor– brachioradialis

• Prime extensor– triceps brachii

• inserts onto ulna

CS Through Upper Limb & Forearm

Supination & Pronation of the Forearm

Supination• Supinator muscle• Palm facing anteriorly

Pronation• Pronator teres and Pronator

quadratus mm.• Palm faces posteriorly

Muscles of the Anterior Forearm• Flex/extend wrist and fingers, adduct/abduct wrist• Digitorum = inserts into fingers• Carpi = inserts onto carpal bones• Pollicis = inserts into thumb

Muscles of the Posterior Forearm• Extension of wrist and fingers, Adduct/abduct wrist• Extension and abduction of thumb (pollicis)• Brevis = short, Ulnaris = on ulna side of forearm

Extensors

• Thenar group = fleshy base of thumb muscles• Hypothenar group = base of little finger muscles• Midpalmar group = Interosseus mm. & Lumbrical mm.

Intrinsic Hand Muscles

Interosseus

Lumbrical

Carpal Tunnel Syndrome

repetitive motions causes inflammation and

pressure on median nerve

Anterior Muscles Acting on the Hip

• Iliopsoas muscle– crosses anterior surface of hip joint & inserts on femur

– iliacus portion arises from iliac fossa

– psoas portion arises from lumbar vertebrae

– major hip flexor

Iliopsoas

Posterior Muscles Acting on the Hip

• Gluteus maximus– forms mass of the

buttock

– prime hip extensor

– provides most of lift when you climb stairs

• Iliotibial band– band of fascia lata

attached to the tibia

Gluteus maximus

Gluteus medius

Iliotibial band

Deep Gluteal Muscles

• Most laterally rotate femur• Except: Gluteus minimus medially rotates femur• Important in walking to shift body weight when foot is

lifted• Quadratus femoris is adductor of hip• Piriformis & Gluteus minimus are abductors of hip

Quadratus femoris

Piriformis

Gluteus minimus

Adductors of the Hip Joint

• 5 muscles act as adductors• Adductor magnus is also an

extensor of hip joint• Gracilis also is flexor of knee• Pectineus, Adductor brevis

and Adductor longus adduct the femur

Adductor longus

Adductor brevis

Pectineus

Adductor magnus

Muscles Acting on the Knee

• 4 headed muscle attaches to tibial tuberosity– extends knee joint

• rectus femoris arises from ilium so flexes hip joint

• quadriceps femoris tendon attaches to patella

• patellar ligament attaches to tibia

Anterior Thigh Muscles in Cadaver

Muscles of the Leg

• Crural muscles are separated into 3 compartments.– anterior compartment (green)– fibular (lateral) compartment (blue)– posterior (superficial = brown) (deep = purple)

Anterior Compartment of the Leg

• Extensor digitorum longus = extension of toes & ankle• Extensor hallucis longus = extension of big toe & ankle• Fibularis tertius = dorsiflexes and everts foot• Tibialis anterior = dorsiflexes and inverts foot

Extensor digitorum longus

Peroneus tertius

Extensor hallucis longus

Tibialis anterior

Posterior Compartment of the LegSuperficial Group of Plantar Flexors

• Gastrocnemius = flexes knee and plantar flexes ankle• Soleus = plantar flexes ankle• Plantaris = flexes knee and plantar flexes ankle

GastrocnemiusSoleus

Plantaris

Posterior Compartment of the LegDeep Group of Plantar Flexors

• Tibialis posterior, Flexor digitorum longus, and Flexor hallucis longus and are plantar flexors.

• Popliteus unlocks the knee joint for knee flexion.

Lateral Compartment of the Leg

• 2 muscles in this compartment

• Both plantar flex and evert the foot

• Provides lift and forward thrust

Fibularis brevis

Fibularis longus

Leg Muscles in the Cadaver

Intrinsic Muscles of the Sole

• Four muscle layers • Support for the arches

– abduct & adduct the toes

– flex the toes

• One dorsal muscle– extensor digitorum brevis

extends toes

Dorsal view

Athletic Injuries• Vulnerable to sudden and intense stress

• Proper conditioning and warm-up is needed

• Common injuries – shinsplints– pulled hamstrings– tennis elbow

• Treat initially with rest, ice, compression and elevation

• “No pain, no gain” is a dangerous misconception.