General Principles of

Musculoskeletal System

dr. Muh. Ardi Munir, M.Kes, Sp.OT, FICS, M.H

Dept. of Anatomy / Orthopaedic &Traumatologi UnTad
 Functions of the
Musculoskeletal System

- Support and frame work

- Protect the body and its organs
- Provide motion / locomotors function
- Hemopoetik system
- storage & exchange of Calcium & phosphate ions
 Major Substructures

- skeleton
- joints
- ligaments
- muscles
- tendons
- neurological elements responsible for
locomotor control.
 Properties

- macroscopic
- microscopic
- physiologic
- biochemistry
- biomechanics
 Skeleton
Consists: bones & cartilages
Bones:
- provide a framework of levers
- protect organ
- contain marrow --> produce blood cells
- storage & exchange of Ca & phosphate ions

Cartilage:
- hyaline: articular, costal, respiratory, nasal
- elastic: external ear, epiglottis
- fibrocartilages: intervertebral disc, meniscus
 Bones
- Types: long, short, flat, irregular
- Parts: compact - spongious - medullary cavity
diaphysis, epiphysis, metaphysis
periosteum
- blood & nerve supply
- microscopic structure
- development:
osteogenesis & ossification
increase in size & maturity, & aging
Skeleton
Intramembranous Ossification
Endochondral Ossification
 Cartilages
Types:
- hyaline
in embryo, epiphysial disc, ribs, articular,
respiratory tract
- fibrocartilage
in certain cartilagineous joint, articular disc
- elastic cartilage
in auricle & auditory tube
 Joints (arthroses)
Classification:
synarthroses: - articulationes fibrosae &
cartilagineae
diarthroses : - articulationes synoviales

OR
Solid joints : - fibrous & cartilagineous joints
Cavitated joints: - synovial joints
Morphology of a Synovial Joint
 Synovial joints
Types:
according to axis of movement:
- uni-, bi-, triaxial

According to the shapes of articular surfaces:

- plane, hinge (ginglymus), condylar, spheroidal,
ellipsoidal, pivot (trochoid), saddle
 Synovial Joints
Movements:
- active
- passive
Blood supply: plexus subsynovial nerve supply :
- vasomotor fibers
- pain fibers
- fibers to detect speed and direction of
movement
- fibers to detect joint position
MUSCULAR SYSTEM
• Muscle cells/myocytes
function --> movement
• Classification -
Skeletal muscle -
Cardiac muscle -
Smooth muscle
Skeletal Muscle
• Muscle fibers
- extrafusal
- intrafusal (muscle
spindle)
• endomysium
• fasciculi
• perimysium
• epimysium
Attachment of skeletal muscle
• Tendons
• Aponeuroses
• Fascia

• Origin
• Insertion
 Naming of Muscles
o The names given to individual muscles
usually descriptive, based on their:
- shape
- size
- number of heads or bellies
- position
- depth
- attachment
- action
• These terms are often used in combination
 Blood Supply

• From adjacent vessels: one or several

anastomosing vessels
• Artery enters on the deep surface
• Form neurovascular bundle with veins and
nerves
• Veins have valves
• Lymphatic vessels commence at epimysium
& perimysium
 Motor Units
• A functional unit formed by a motor neuron and all the
muscle fibers that it innervates

• Accounts for simultaneous contraction of a number of

fibers within a muscle

• Size: small in muscles for precision tasks

large in postural muscles
 Gradation of muscle contraction

Strategy:

• Increase the impulse frequency of

motorneuron

• Increase the number of motor unit recruited

 Fiber type of adult skeletal muscle
• Classification of muscle fibers
– morphology: red, white
– histochemistry: myosin ATPase, myosin phenotype
– physiology: fast & slow contracting, fatigue
resistant.
– biochemistry: oxidative, glycolytic, etc.
Muscle Histochemistry
Functional implications of shape and
fiber architecture

Direction of action:
• The resultant force generated by a muscle is
directed along the line of tendon

• Muscle with twist geometry: the fibers

shorten and brought to the same plane
 Force and Range of Contraction
Force:
- Summation of actin-myosin cross-bridges
- depend on the cross sectional area

Range:
- Summation of subtraction of min-max
overlapping between actin and myosin
- depend on the length of the fibers
 Study of muscle action

• Anatomical method
• Localized electrical stimulation
• Manual palpation
• EMG
• EMG + other tools
• Clinical method
 Actions of muscles
• Isometric vs isotonic contraction

• concentric vs eccentric
 Classification of muscle role
• Prime mover

• antagonist

• fixator

• synergist
Biomechanics
• First Class Lever

• Second Class Lever

• Third Class Lever

PUSING ….. ??