JOINTS AND MUSCLES

MUSCLES

Types

Movement

Working

Ligaments

Tendons

TYPESSMOOTH – all involuntary muscles like those of the intestines. Controlled by the autonomic nervous system; may either be generally inactive and then respond to neural stimulation or hormones or may be rhythmic. STRIATED – also called skeletal muscles, all voluntary/ movement oriented muscles like of hand or legCARDIAC – specific to the heart only due to its unique function. It is striated but involuntary, with no cell wall and can produce its own electrical impulse. It is a rhythmic smooth muscle, modulated by neural activity and hormones

Smooth muscle structure

Striated or Skeletal Muscle structure

Cardiac Muscle structure

How muscles move

Movement of muscles is by:

Flexion - contraction of flexor muscles, drawing in of a limb

Extension - opposite of flexion, produced by contraction of extensor muscles (antigravity). Opens out or moves limb/part of limb away from body.

Muscular contraction:The movement of a muscle is a series of neural and chemical

changes starting from the brain and finishing at the muscle. It involves impulses or reflexes which in turn trigger muscle movement.

The space between the nerve endings and the muscle fibre is called a neuromuscular junction.Neuromuscular junction - synapse between efferent terminal neuron fiber and the membrane of a muscle fiber Motor endplates (postsynaptic membrane) Acetylcholine - released by efferent axon’s (nerve cell) terminal buttons, result in depolarization at endplate; this effects the endplate potential in an all or none capacity, and if it is greater than the threshold, produces contraction or "twitch" of the muscle fiber (calcium channels open) Single impulse produces single twitch, the muscle need series of action potentials to produce a sustained contraction of the muscle fiber

Major muscle groupsArm – Biceps, Triceps, Deltoid,Forearm – BrachoradialisFlexors of the hand and wrist – Superficial group

Flexor Carpi Radialis Palmaris Longus Flexor Carpi Ulnaris Flexor digitorum superficialis (sublimis)

Intrinsic forearm muscles Pronator Teres

Deep Group Flexors of the hand and wrist

Flexor Digitorum Profundus Flexor Pollicis Longus

Intrinsic forearm muscles Pronator Quadratus

Muscle goups 2

Neck muscles

Anterior -Superficial – platysma

Deep – Sternocleidomastoid

Vertabral – Lateral- scalenus anterior, medius and posterior

Muscle group 3

Chest – Pectoralis major, minorIntercostal musclesAbdomen – External and Internal oblique, transverse Abdominus, Rectus Abdominus, PyramidalisBack – Trapezius, Lattismus dorsi, Rhomboidus, Serratus anterior and posterior, Levator scapulae, Multifidus Spinae

Muscle group 4Hip muscles

Gluteal group- gluteus maximus, medius and minimus, Tensor fascia latae

Adductor group- Adductor brevis, longus, magnus, Gracilis and Pectinius.

Iliopsoas Group – Iliacus and psoas major

Lateral rotator group – Externus and Internus Obturator, Piriformis and Quadratus femoris

Other – rectus femoris and Sartorius or Tailor’s muscle.

Muscle group 5

Hamstring muscles - biceps femoris semitendinosus, semimembranosus

Leg – calf muscles – Gastrocnemius, Soleus which join to form the Achilies tendon. Tibilais Anterior and Posterior.

Tendons and Ligaments

Tendons are those structures that attach the muscle to the bone. Tougher fibre, less elasticity but increased strength.

Ligaments are fibrous structures that connect bones to bones within the body, providing support, while allowing flexibility and movement

Tendon Bursa and Cartilage

Joints Joints can most simply be described as the hinges that hold the skeletal system together. An animal's joints are what gives its skeleton flexibility and thus, along with muscles, the ability to move. Tendons and ligaments help stabilize and hold the joint together, while synovial fluid surrounds and lubricates the joint for smooth action. A joint has cartilage, a spongy material that coats and protects the bones making up the hinge, the presence of cartilage is crucial to overall joint health.

Types of Joints

Fibrous – immovable – held together by strong layer of connective tissue. Eg. Skull and teeth

Cartilagenous – held together by white fibro-cartilagenous tissue and ligaments, allowing only limited degree of movement. Eg. Vertebrae and symphysis pubis.

Synovial JointsFreely movable

End of bones covered by smooth hyaline cartilage – reduces friction

Enclosed by bag like capsular ligament which holds joint together – acts like a seal as it water-proofs the joint and contains synovial fluid- which lubricates the joint

Bones attached together by tough dense ligaments which prevent dislocation during movement

Typical synovial joint

Types of Synovial JointsBall and socket joint – when rounded end of one bone fits into cup shaped socket of the other bone- with movement in all directions. Eg shoulder/hip joint

Hinge JointsThese joints occur where the convex surface of one bone fits into the concave surface of another bone, so making movement possible in one plane only. Examples of these joints are the knee and the elbow joints

Gliding JointsThis type of joint allows for gliding movements between flat surfaces as the surfaces slide over one another. Only a limited amount of movement is allowed such as the joints between the carpal bones/ tarsal bones

Pivot jointsThese joints occur where:

A bony ring rotates round the pivot (axis) of another bone such as the ring-like atlas rotating around the odontoid process of the axis, allowing the head to turn from side to side. The end of one bone rotates round the axis of another bone such as the end of the radius rotating around the ulna as the palm of the hand is turned inwards or outwards.

Compound jointsThese joints are made up of several joints between a number of different bones. The bones articulate with one another in different ways, allowing for a variety of movements eg. the set of joints which operate the movement of the skull on the vertebral column. The condyles at the base of the skull fit into the facets of the atlas, allowing for the nodding movement of the head. While one moves one's head, the atlas is able to rotate round the odontoid process of the axis, allowing the head to turn from side to side.

Shoulder jointIt is made up of 3 joints:-

Glenohumeral – the scapula and the humerous. It is a ball and socket joint with many ligaments including the coracohumeral ligament. The capsule encompasses the joint and is lined by synovial membrane. Acromioclavicular – the scapula and the clavicleSternoclavicuar – the sternum and the clavicleThe rotator cuff is a structure composed of tendons that, with associated muscles (supraspinatus, infraspinatus, teres minor and subscapularis), holds the ball at the top of the humerus in the glenoid socket and provideoulder joint. The tendons of the rotator cuff muscles also connect to the capsule of the glenohumeral joint. Blood supply – Axillary arteryNerve Supply – Brachial plexusSome Remedies – frozen – Chel, Ferr, Rhus tox, Sang

Movements at the ShoulderShoulder Girdle –

Adduction, Abduction, Elevation, Depression

Shoulder Joint-Flexion ExtensionAdductionAbductionOutward medial RotaionInward medial RotationCircuduction

Hip JointIt is a multiaxial jt, formed by the articulation of the Head of the Femur and the Acetabulum.The strong but loose fibrous capsule of the hip joint permits the hip joint to have the second largest range of movement (second only to the shoulder) and yet support the weight of the body, arms and head 3 main ligaments – iliofemoral, pubofemoral and ischiofemoral. Also Ligamentum teres – attached from acetabulum to fovea (on head of femur).Movements at the jt- flexion, extension, adduction, abduction, medial and lateral rotation.Blood supply – medial and lateral circumflex femoral arteriesNerve supply – femoral, obturator, superior gluteal and Nerve to quadratus femoris.Some Remedies – inflamed- aesc, coloc, sil

Muscles producing flexion at the hip include iliopsoas, rectus femoris, pectineus and sartorius The muscle action is also more powerful when the hip is fully extended.  Since the muscle also crosses the knee joint it contributes to the extenso action of the quadriceps muscle on the knee. Adduction is done by the adductor group -This group of muscles lies on the medial side of the thigh Abduction is done by the Gluteal group -The abductors lie lateral to the hip joint in the lateral gluteal region Extension - The major extensor is the gluteus maximus muscle. The hamstring muscles also contribute to hip extension

Hip Joint

Knee jointFormed by the distal end of Femur, Patella and proximal end of Tibia.2 joints – femo-patellar and femorotibialEncapsulated, synovial and posterior is called popliteal fossa

The human knee is associated with the following ligaments:Anterior cruciate ligament -The critically important ACL prevents the tibia from being pushed too far anterior relative to the femur. Posterior cruciate LigamentCapsular ligament Ligamentum patellae Medial collateral ligament (tibial collateral ligament). This protects the medial side of the knee from being bent open by a stress applied to the lateral side of the knee (a valgus force). Lateral collateral ligament ( fibular collateral ligament). This protects the lateral side from an inside bending force (a varus force). Oblique popliteal ligament Medial and lateral meniscus

Knee JointBlood supply – Popliteal Artery and veinNerve supply – branches of the Femoral and Sciatic nerveMovements – flexion and extension, locking unlocking and slight rotation.Muscles involved in Flexion – Hamstrings or gastrocnemiusMuscles involved in Extension – Quadriceps femoris and Ligamentum PatellaeMuscle involved in Lateral Rotation – Popliteus.

The Patella:-The patella is the best example of a sesamoid bone (a bone contained within a tendon which keeps the tendon clear of a joint). The patella is contained within the tendon of the quadriceps muscle which continues on as the patellar ligament to be inserted onto the tibial tuberosity

Some major Remedies – Inflammation - Bry, Puls, Rhustox; Stiffness – Caust, Led , Lyco, Thuja

Homeopathic interestGeneral muscular remedies –

Arn, Caust, Lactic Ac, Rhus tox, Mag Phos, Cimic, Bellis per,

Ligament/ tendon remedies –

Ruta, Rhus tox, Symphytum, Actea spicata, Natrum carb,

Joint affinity – Bell, Benz Ac, Bry, Calc, Calc Fl, Colchicum, Kalicarb, Kalmia, Rhus tox, Ruta, Sil

Bursitis – Apis Ruta Sil Arn Nat M