skeletal muscles - khaleelya.files.wordpress.com

SKELETAL MUSCLESKHALEEL ALYAHYA, PHD, MED

www.kha lee la lyahya.net

By Elaine Marieb and Suzanne Keller

By Frank NetterBy Richard Drake,

Wayne Vogl & Adam Mitchell

RESOURCES

Khaleel Alyahya, PhD, MEd 3

(فكسون العظام لحما )

INTRODUCTION

▪ Musculoskeletal is a general term which is defined as relatingto muscles and bones of the skeleton.

▪ The musculoskeletal system comprises bones, joints, cartilage,bursae, tendons, muscles and ligaments.

▪ It is the system that moves the body and maintains its form.

▪ Study of this system consists of osteology (the study of bones),arthrology (the study of joints), and myology (the study of muscles).

▪ The musculoskeletal system does not work in isolation.

▪ It is closely linked with many other systems in the body, includingthe nervous system, genitourinary system, circulatory system,immune system, respiratory system, digestive system andendocrine system.

Khaleel Alyahya, PhD, MEd4

MUSCLES

▪ Describe the main criteria of skeletal muscles.

▪ Describe the attachments of skeletal muscles.

▪ Describe the different directions of skeletal muscle fibers.

▪ Describe the mode of action of skeletal muscles.

▪ Describe briefly the naming of skeletal muscles.

▪ Describe briefly the nerve supply of skeletal muscles.

▪ Clinical anatomy

Khaleel Alyahya, PhD, MEd

OBJECTIVES

6

MUSCLES TISSUES

▪ Muscle tissue is a unique tissue which has the ability to contract.

▪ As a result of this ability, muscles are responsible for all the bodymovements.

▪ The structural and functional unit of muscle tissue is “muscle cell”.

▪ All muscle cells are elongated and are called “muscle fibers”.

▪ The ability of muscle to contract, or to shorten depends on twotypes of myofilaments (actin & myosin) in the muscle fibers


CLASSIFICATIONS

Muscles are classified based on the following:

▪ Location

▪ Action

▪ Microscopic structure


BASED ON LOCATIONS

SKELETAL MUSCLES

ATTACHED TO BONES AND PRODUCE MOVEMENT

SMOOTH MUSCLES

WALLS OF VISCERAL ORGANS

CARDIAC MUSCLES

WALLS OF THE HEART


BASED ON ACTIONS

VOLUNTARY INVOLUNTARY INVOLUNTARY


BASED ON MICROSCOPIC STRUCTURES

SKELETAL (STRIATED) CARDIAC (STRIATED) SMOOTH (NONSTRIATED)


SKELETAL MUSCLE CARDIAC MUSCLE SMOOTH MUSCLE

Voluntary Involuntary Involuntary

Striated Striated Nonstriated

CLASSIFICATION OVERVIEW


SKELETAL MUSCLES

▪ The ske l et a l mus c les are at t achedt o bones at not le s s t han t wopo i n t s :

o O r i g i n

• A t t a c h e d t o l e s s m o b i l e o ri m m o v a b l e b o n e .

• L e a s t m o v a b l e .

• M o s t l y f l e s h y .

• P r o x i m a l e n d .

o I n se r t i o n

• A t t a c h e d t o t h e m o v a b l e b o n e s .

• M o s t m o v a b l e .

• M o s t l y f i b r o u s .

• D i s t a l e n d .

▪ When t he mus c l e cont r act s , thei n s e r t ion mov es t oward t he or i g in .

▪ A t i ns er t ion , t he musc les a reat t ached by means o f s t rong cord-l i ke t endons or by s heet - l i keaponeuros i s .


SKELETAL MUSCLES


MAIN CRITERIA

▪ St r ia ted .

▪ A ttached to ske leton .

▪ Produce mov ement of ske leton .

▪ Voluntary .

▪ Supp l ied by Somat ic Nerv es .


FUNCTIONS

▪ Body Movement

▪ Maintain Posture

▪ Generate Heat

▪ Stabilizing Joints


ATTACHMENTS

o O r i g i n

• L e a s t m o v a b l e

• M o s t l y f l e s h y

• P r o x i m a l e n d

o I n se r t i o n

• M o s t m o v a b l e

• M o s t l y f i b r o u s

• D i s t a l e n d


ATTACHMENTS


TYPES OF ATTACHMENTS

▪ Ske l et a l musc les a re at tached t obones , car t i lage or l i gaments by :

o T e n d o n s

• A t o u g h c o r d o f f i b r o u sc o n n e c t i v e t i s s u e t h a t u s u a l l yc o n n e c t s m u s c l e t o b o n e a n d i sc a p a b l e o f w i t h s t a n d i n g t e n s i o n .

o A p o n e u r o s i s

• A t h i n b r o a d a n d s t r o n g s h e e t o ff i b r o u s t i s s u e .

o R a p h e

• A n i n t e r d i g i t a t i o n o f t h et e n d i n o u s e n d s o f t h e f l a tm u s c l e s .

• E x a m p l e : m y l o h y o i d r a p h e


TENDONS

RAPHE

APONEUROSIS


DIRECTIONS OF MUSCLES

▪ Th e r a n g e o f m o t i o n a n d t h e p o w e r o f am u s c l e d e p e n d s o n t h e a r r a n g e m e n t o fi t s f a s c i c l e s .

▪ Th e f i b e r a r r a n g e m e n t c a n b e :

o P a r a l l e l

• M o r e r a n g e o f m o v e m e n t , l e s s p o w e r f u l .

o P e n n a t e

• M o r e p o w e r f u l , l e s s r a n g e o f m o v e m e n t .

• U n i p e n n a t e

• B i p e n n a t e

• m u l t i p e n n a t e

o T r i a n g u l a r

• H a v e a b r o a d a t t a c h m e n t f r o m w h i c h t h ef a s c i c l e s c o n v e r g e t o a s i n g l e t e n d o n .

o F u s i f o r m

o S p i n d l e - s h a p e d ( r o u n d , t h i c k b e l l y , &

t a p e r e d e n d s ) .

o C i r c u l a r

o S u r r o u n d a b o d y o p e n i n g o r o r i f i c e ,c o n s t r i c t i n g i t w h e n c o n t r a c t e d .

▪ Th e l o n g p a r a l l e l a r r a n g e m e n t g i v em o r e r a n g e o f m o t i o n b u t i s n o t u s u a l l yv e r y p o w e r f u l .

▪ Th e p e n n a t e m u s c l e s s h o r t e n v e r y l i t t l eb u t a r e v e r y p o we r f u l .


DIRECTIONS OF MUSCLES


MODE OF ACTIONS

▪ P r ime Mover (Agon i s t )o I t i s t h e c h i e f m u s c l e r e s p o n s i b l e f o r a

p a r t i c u l a r m o v e m e n t .

▪ Antagon i s to I t o p p o s e s t h e a c t i o n o f t h e p r i m e

m o v e r .

o B e f o r e c o n t r a c t i o n o f p r i m e m o v e r ,a n t a g o n i s t m u s t b e r e l a x e d .

▪ Synerg i s to M u s c l e s t h a t a s s i s t t h e p r i m e m o v e r i n a

p a r t i c u l a r m o v e m e n t .

▪ F ixa to ro I t s c o n t r a c t i o n d o e s n o t p r o d u c e

m o v e m e n t b y i t s e l f , b u t i t s t a b i l i z e s t h eo r i g i n o f t h e p r i m e m o v e r s o t h a t i t c a na c t e f f i c i e n t l y .


MODE OF ACTIONS

PRIME MOVER ANTAGONIST SYNERGI ST F I XATOR


PRIME MOVER (AGONIST)

▪ I t i s the chief musclerespons ible for a part icularmovement.

▪ Example:

o B i ceps B r ach i i i s th e p r i me mo v e rfo r f l ex i o n o f t h e e l bo w jo i n t an df o r e a r m .

o Q u a d r i ceps F emo r i s i s th e p r i memo v e r fo r ex t e n s i o n o f t h e k ne ej o i n t .


PRIME MOVER


ANTAGONIST

▪ I t opposes the action of thepr ime mover .

▪ Before contract ion of pr imemover , antagoni s t must berelaxed.

▪ Example:

o T r i ceps B r ach i i i s th e a n t ago n i s t fo rp r i me mo v er fo r f l e x i o n o f t h ee l bow j o i n t a n d f o r e a r m .

o B i ceps F e m o r i s ( F l e xo r o f k n e e ) .

o I t o ppo s es t he a c t i o n o f qu a d r i cepsw h e n t h e k n e e j o i n t i s e x t e n d e d .


ANTAGONIST


SYNERGIST

▪ Muscles that ass i s t the pr imemover in a part icularmovement.

▪ Synergi s ts are sometimescal led neutral i zers becausethey help cancel out , orneutra l i ze, extra motion fromthe agonists to make surethat the force generatedworks wi thin the desi redplane of mot ion.

▪ Example:

o B r ach i a l i s musc l e fo r B i ceps p r i mem o v e r m u s c l e .


SYNERGIST


FIXATOR

▪ I t s contract ion does notproduce movement by i tsel fbut i t s tabi l i zes the or igin ofthe pr ime mover so that i tcan act eff ic ient ly .

▪ Example:

o D el to i d mu sc l e fo r B i ceps p r i mem o v e r m u s c l e .

o M usc l es a t ta ch i ng th e s hou l de rgi r d l e to t he t r u nk c o n t r ac t to f i xs ho u l de r g i r d l e , a l l ow i ng d e l to i dm usc l e ( t a k i ng o r i g i n f ro m s ho u l de rg i r d l e ) to mo v e s ho u l de r jo i n t(h u m e r u s ) .


FIXATOR


NAMING OF MUSCLES

▪ S i zeo M a j o r o r M a x i m u s ( l a r g e )

▪ Pos i t ion

o P e c t o r a l i s ( p e c t o r a l r e g i o n )

▪ Depth

o S u p e r f i c i a l i s ( s u p e r f i c i a l )

▪ Shape

o D e l t o i d ( t r i a n g u l a r )

▪ Number o f Heads

o B i c e p s ( 2 h e a d s )

o T r i c e p s ( 3 h e a d s )

▪ At tachments

o C o r a c o b r a c h i a l i s

▪ Act ion

o F l e x o r d i g i t o r u m : f l e x i o n o f d i g i t s


TYPES OF BODY MOVEMENTS

▪ F l e x i o n

o M o v e m e n t t h a t b r i n g s t h e t w o b o n e s c l o s e rt o e a c h o t h e r ( d e c r e a s e s t h e a n g l e o fj o i n t ) .

▪ E x t e n s i o n

o M o v e m e n t t h a t i n c r e a s e s t h e a n g l e , o r t h ed i s t a n c e b e t w e e n t h e t w o b o n e s .

▪ A d d u c t i o n

o M o v e m e n t o f t h e l i m b t o w a r d t h e m i d l i n e

o f t h e b o d y .

▪ A b d u c t i o n

o M o v e m e n t o f t h e l i m b a w a y f r o m t h e

m i d l i n e o f t h e b o d y .

▪ R o t a t i o n

o M o v e m e n t o f a b o n e a r o u n d a v e r t i c a l

a x i s .

▪ C i rc u m d u ct i o n

o C o m b i n a t i o n o f a l l t h e a b o v e m o v e m e n t s .


TYPES OF BODY MOVEMENTS


MUSCLE EXERCISE

▪ T h e amo u n t o f w o rk do ne by a m usc l ei s r e f l ec t e d i n c ha nge s i n t h e m usc l ei t s e l f .

▪ M usc l e i nac t i v i ty l e ad s t o m usc l ew e a k n es s a n d w a s t i ng .

▪ R egu l a r e xe r c i se i nc r e ase s m usc l es i z e , s t r e n g t h a n d e n d u r a n c e .


MUSCLES INNERVATION

▪ T h e som a t i c ne rvo u s sy s t e m ( i s th e

p a r t o f t he p e r i phe r a l n e rv o us

s y s t em ) as so c i a t e d wi th sk e l e ta l

m usc l e v o l un t a r y co n t ro l o f bo dy

m o v e men t s .

▪ T h e n e rv es supp l y i ng t h e sk e l e t a l

m u s c l e s a r e M i xe d .

o 6 0 % a r e M o t o r

o 4 0 % a r e S e n s o r y

▪ I t c o n t a i n s s o m e A u t o no mi c f i b e r s

o S y m p a t h e t i c

▪ T h e n e rv e e nt e r s t h e mu sc l e a t abo u t

th e m i d d l e p o i n t o f i t s d e e p s u r f a c e.


BLOOD SUPPLY

▪ D u r i ng e x t r em e phy s i ca l e x e r t i on ,

mo r e t h a n 80% o f ca r d i ac o u tp u t ca n

b e d i r e c t e d t o c o n t r a ct i ng m u s c l e s .

▪ T h e v ascu l a r i n f l ow to sk e l et a l m usc l es

i s p ro v i de d by p r i ma ry a r t e r i e s , w h i ch

r e p re s en t t he l a s t b r anch e s o f th e

a r te r i a l supp l y th a t a r i se b efo r e en t r y

i n t o t h e t i s s u e .

▪ T h e p r i ma ry a r t e r i e s a r e app ro p r i a te l y

d i s t r i bu t e d a l o ng th e l o ng a x i s o f th e

m usc l e a n d g i v e r i se t o fe e d a r t e r i e s

t h a t co u r s e to w a r d t he ep i mys i um o f

t h e mu sc l e at r i g h t o r o b l i qu e ang l es

t o th e p r i ma r y a r te r i e s .


CLINICAL ANATOMY

Muscular Dystrophy

A genetic disease

that cause a

damage of muscle

fibers.

Muscle Cramps

Can occur suddenly

and involuntarily in one

or more muscles.

Fibromyalgia

People experience

long-term,

widespread pain

and tender points in

joints, muscles,

tendons and other

soft tissues.

Strains

Overstretching or

tearing muscles or

tendons results in

a strain.

Contusions

Often caused by a

direct trauma or

repeated blow to the

muscle. In some cases,

the condition can be

caused by falling on a

hard surface.

MUSCLE DISEASES

▪ M usc l e d i se as e s an d i n j u r i e s a r e co mmo n , e s pec i a l l y i n spo r t s ac t i v i t i e s . A sev ere

m usc l e i n j u ry c a n k eep y o u f ro m p a r t i c i pa t i ng i n th e ac t i v i t i e s t h a t yo u l o v e a n d

e n j o y f o r l i v i ng .

▪ M usc l e d i se a se s a nd i n j u r i e s cou l d be o ne o f th e m a jo r f ac to r s t h a t th r e a t som eon e ’ s

p r o f es s i o na l c a r e e r ( s ) .


▪ F i b r o m y a l g i a i s a t e r m u s e d t o d e s c r i b e a

c o m m o n s y n d r o m e i n w h i c h p e o p l e

e x p e r i e n c e l o n g - t e r m , w i d e s p r e a d p a i n

a n d t e n d e r p o i n t s i n j o i n t s , m u s c l e s ,

t e n d o n s a n d o t h e r s o f t t i s s u e s .

▪ I t a l s o r e s u l t s i n d i s t u r b e d s l e e p a n d

e x h a u s t i o n .

▪ T h e c a u s e i s u n k n o w n b u t p o s s i b l e

t r i g g e r s i n c l u d e v i r a l i n f e c t i o n , p h y s i c a l

a n d e m o t i o n a l s t r e s s .

▪ I t t e n d s t o b e m o r e c o m m o n i n p e o p l e

w i t h p r e - e x i s t i n g l u p u s , r h e u m a t o i d

a r t h r i t i s , o r a n k y l o s i n g s p o n d y l i t i s .

▪ T h e r e i s n o c u r e b u t s y m p t o m a t i c

t r e a t m e n t c a n h e l p s o m e p a t i e n t s .

FIBROMYALGIA


▪ T h e m u s c l e c r a m p i s a s u d d e n a n d i n v o l u n t a r y

c o n t r a c t i o n o f o n e o r m o r e o f y o u r m u s c l e s .

▪ I f y o u ' v e e v e r b e e n a w a k e n e d i n t h e n i g h t o r

s t o p p e d i n y o u r t r a c k s , y o u k n o w t h a t m u s c l e

c r a m p s c a n c a u s e s e v e r e p a i n .

▪ M u s c l e c r a m p s c a n m a k e i t t e m p o r a r i l y i m p o s s i b l e

t o u s e t h e a f f e c t e d m u s c l e .

▪ L o n g p e r i o d s o f e x e r c i s e o r p h y s i c a l l a b o r ,

p a r t i c u l a r l y i n h o t w e a t h e r , c a n l e a d t o m u s c l e

c r a m p s .

▪ S o m e m e d i c a t i o n s a n d c e r t a i n m e d i c a l c o n d i t i o n s

a l s o m a y c a u s e m u s c l e c r a m p s .

▪ O v e r u s e o f a m u s c l e , d e h y d r a t i o n , m u s c l e s t r a i n

o r s i m p l y h o l d i n g a p o s i t i o n f o r a p r o l o n g e d

p e r i o d c a n c a u s e a m u s c l e c r a m p .

▪ Y o u m i g h t b e a t h i g h e r r i s k o f m u s c l e c r a m p s i f

y o u h a v e d i a b e t e s , o r n e r v e , l i v e r o r t h y r o i d

d i s o r d e r s .

MUSCLE CRAMP


▪ M u s c u l a r d y s t r o p h y ( M D ) r e f e r s t o a g r o u p o f

h e r e d i t a r y d i s e a s e s t h a t w e a k e n d i ff e r e n t m u s c l e

g r o u p s i n v a r i o u s w a y s .

▪ A p e r s o n a ff e c t e d w i t h M D h a s a g e n e t i c m u t a t i o n

t h a t p r e v e n t s t h e r e p a i r o f m u s c l e t i s s u e .

▪ T h i s m u s c l e w e a k e n i n g o c c u r s g r a d u a l l y o v e r t i m e .

▪ S y m p t o m s m a y s t a r t a t a n y t i m e f r o m i n f a n c y

t h r o u g h t o a d u l t h o o d .

▪ B y a g e 1 0 t o 1 2 y e a r s c h i l d r e n w i l l o f t e n b e i n a

w h e e l c h a i r .

▪ T h i s d i s e a s e a l s o a ff e c t s o t h e r b o d y s y s t e m s s o

p a t i e n t s n e e d r e g u l a r r e s p i r a t o r y a n d c a r d i a c

a s s e s s m e n t .

▪ I t i s l i k e l y t h a t t h e s e p a t i e n t s w i l l e v e n t u a l l y n e e d

a v e n t i l a t o r t o b r e a t h e .

▪ P e o p l e w i t h D M D u s u a l l y d o n o t s u r v i v e b e y o n d

t h e i r l a t e t e e n s o r e a r l y a d u l t h o o d .

MUSCULAR DYSTROPHY


▪ A s t r a i n o ccur s w h e n a m usc l e a nd /o r

t e n d o n i s o v e r s t r e t che d o r t o r n .

▪ T h e r e i s no f r ac t u re o r d i s l o ca t i o n

p r e s e n t .

▪ P a i n , w e akn es s an d m usc l e sp asm s a re

c o m m o n symp to ms e xpe r i enc e d a f te r a

s t r a i n o c cur s .

▪ R e s t , app l i ca t i o n o f i ce an d a

co mpr es s i o n b an d age a r e effect i v e

t r e a t m e n t s .

STRAIN


▪ O f t en c aus ed b y a di r ec t t r aum a o r

r e p e a t e d b l o w t o t h e m u s c l e .

▪ I n so me c as es , t h e co n di t i o n ca n b e

c a u s e d b y f a l l i ng o n a h a r d s u r f a c e .

▪ C h a r a c t e r i s t i c s i n c l ud e :

• d i s c o l o r e d s k i n t h a t l o o k s r e d , g r e e n ,

p u r p l e , b l u e , o r b l a c k

• a s m a l l b u m p o v e r t h e a r e a i n s o m e

c a s e s

• p a i n t h a t ’ s u s u a l l y w o r s e w h e n p r e s s u r e

i s a p p l i e d t o t h e a r e a .

CONTUSIONS


▪ T h e EM G i s a d i ag no s t i c t e s t u se d to

i de n t i f y n e u ro pa t h i c a n d myo path i c

d i s o r d er s .

▪ E l ec t ro d es a re p l ace d o n t h e m usc l e

a n d a r e us ed t o r eco r d mo t o r un i t

a c t i v i t y a t r es t a n d a l so du r i ng m usc l e

c o n t r a ct i on .

ELECTROMYOGRAPHY


▪ T h e CT i s a d i agno s t i c t es t p e r fo rm e d

t o i de n t i f y d i so r de r s o f t h e so f t t i s s u es ,

b o n e a n d m u s c l e .

▪ C ro ss - s ect i o na l i mage s a r e t a k en u s i ng

a co mpu t e r i n co n ju nct i on w i t h x - r ay

b e a m s .

COMPUTED TOMOGRAPHY


▪ M RI i s a d i agno s t i c t es t t h a t c r e a t es

i mages o f so f t t i s su e us i ng r a d i o w av e s

a n d a m a g n e t i c f i e l d

MAGNETIC RESONANCE IMAGING


▪ M i n o r m u s c l e i n j u r i e s m a y b e t r e a t e d

w i t h s i m p l e h o m e r e m e d i e s , s u c h a s

r e s t , a p p l y i n g i c e , u s i n g c o m p r e s s i o n

b a n d a g e , a n d e l e v a t i n g y o u r i n j u r e d

l i m b .

▪ A n t i - i n f l a m m a t o r y m e d i c a t i o n .

▪ P h y s i o t h e r a p y

▪ S e v e r e m u s c l e i n j u r i e s n e e d t o b e

c h e c k e d b y a q u a l i f i e d h e a l t h c a r e

p r o v i d e r .

▪ A t o r n m u s c l e o r t e n d o n m a y n e e d t o

b e s u r g i c a l l y r e p a i r e d .

MUSCLE TREATMENTS


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@khaleelya

EMAIL

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