L3 Anatomy and Physiology Learner Workbook 1A Mar12

Personal Trainer Workbook 1A
Level 3
Anatomy and Physiology for Exercise
L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 1 08/03/2012 16:02

PERSONAL TRAINER WORKBOOK 1A
Introduction Contents
These workbooks have been designed Workbook 1A

to help you learn the contents of the
Section 1 The circulatory system 1
Level 3 Anatomy and Physiology unit.
Completing the learning activities Section 2 The musculoskeletal system
throughout as you learn will help you (anatomy and physiology) 21
prepare for your assessment. You can
Section 3 The musculoskeletal system (movement) 53
also use the online resources in the
Lifetime E-learning Zone, or speak to Section 4 Learning activity answers 71
Learner Services, your tutor or trainer,
should you require further support. Workbook 1B
Section 5 Posture and core stability 83
Section 6 Stretching and flexibility 95
Section 7 The nervous system 103
Section 8 The endocrine system 117
Section 9 Energy systems 133
Section 10 Learning activity answers 143
Section 11 References and recommended reading 149
The following colours are used in this workbook:
Key
Learning activities
Need to know
Definition

LEVEL 3 ANATOMY AND PHYSIOLOGY FOR EXERCISE
Section 1: The circulatory system
Section 1
What you will cover
By the end of this section you will be able to:
FFdescribe coronary circulation
FFexplain the function of the heart valves
FFexplain the electrical control of the heart beat
FFdescribe the effects of disease on the structure

and function of the blood vessels
FFexplain the cardiovascular benefits and risks
of endurance and aerobic training exercise, and
Myocardium
FFexplain the short- and long-term effects of exercise on
The heart muscle.
blood pressure, and define blood pressure classifications
Myo=muscle
and the associated health risks. Cardium = heart
Coronary circulation
The coronary arteries
The heart is a working muscle, so it needs a blood supply to
The two main coronary arteries are:
function. Coronary circulation refers to the movement of
blood through the arteries and veins that serve the heart 1. The left coronary artery
which branches into:
muscle or myocardium.
• the left anterior descending artery
The coronary arteries supply oxygenated blood to the • the circumflex artery.
heart muscle (myocardium) and the cardiac veins remove 2. The right coronary artery
deoxygenated blood. The myocardium requires oxygen as
almost all of the heart’s energy is produced aerobically.
Coronary arteries Figure 1.1 The coronary arteries
There are two main coronary arteries which deliver oxygenated

blood to the myocardium: the left coronary artery and the
right coronary artery. They originate from the base of the aorta
behind the aortic semi-lunar valves and branch into smaller
Circumflex
arteries in order to supply all areas of the heart with blood. artery
The left coronary artery branches into the left anterior Right
coronary
descending artery and the circumflex artery. The right artery
Left anterior
coronary artery also branches into two. descending
artery

Learning activity 1.1

On the diagram provided, label the:
Left anterior descending artery

Circumflex artery
Right coronary artery
Cardiac veins
The coronary arteries supply blood to the network of

capillaries that serve every part of the heart. These capillaries The main cardiac veins are:
then drain into one of the cardiac veins. The main cardiac • the great cardiac vein, which
veins empty into the coronary sinus, a collection of veins that receives blood from the left
join together to form a large vessel that collects blood from atrium and both ventricles
the myocardium. The deoxygenated blood from the coronary
• the small cardiac vein, which
sinus drains into the right atrium.
collects blood from the posterior
part of the right atrium and
ventricle, and
• the middle cardiac vein, which
collects blood from the ventricles.

The function of the heart valves
Section 1
The heart consists of four chambers: two atria and two ventricles. Figure 1.2 The position of the AV valves
The atria collect blood from the body and the ventricles and semilunar valves
despatch it. Valves are found between the chambers and the
blood vessels, where they prevent the backflow of blood.
Pulmonary
valve
The position of the valves
Aortic valve
There are four one-way valves that control the flow of
blood through the heart by opening or closing during the
contraction of the heart muscle (see figure 1.2 and the orange
box below).
The flow of blood through the heart
To understand the function of the valves, it is easiest

Tricuspid valve Bicuspid valve
to think of the flow of blood through the heart.
Figure 1.3 The role of the valves in the flow of blood through
the heart
Vena cava Right atrium Left atrium Pulmonary vein Heart valves
The AV valves:
AV VALVES Tricuspid valve Bicuspid valve
• the tricuspid valve prevents backflow
Right ventricle Left ventricle of blood between the right ventricle
and the right atrium
• the bicuspid valve prevents backflow
of blood between the left ventricle and
SEMILUNAR Pulmonary valve Aortic valve
VALVES
the left atrium
The semilunar valves:
Pulmonary artery Aorta • the pulmonary valve prevents backflow
of blood between the pulmonary artery
and the right ventricle
As an example, deoxygenated blood enters the right atrium. • the aortic valve prevents backflow
When the right atrium is full, it contracts (atrial systole) and of blood between the left ventricle
the tricuspid valve opens briefly, allowing blood to flow into and the aorta.
the right ventricle. The valve then closes to prevent blood
flowing back into the right atrium.


Which of the heart valves are the following statements describing?
This valve is located between the left ventricle and the aorta:
This valve is located between the right ventricle and the pulmonary artery:
This valve is located between the left atrium and the left ventricle:
This valve is located between the right atrium and the right ventricle:

In the space provided, label the diagram showing the flow of blood through the heart
and the position of the heart valves:

Control of the heart beat
Section 1
The rhythmical contraction and relaxation of the atria and The heartbeat
ventricles within the heart is stimulated through electrical
signals, which are initiated within the myocardium itself. The electrical signal from the SA
node initiates every heartbeat. It
The sino-atrial and atrio-ventricular nodes travels through the atria and causes
them to contract, pushing the blood
The sino-atrial (SA) node is a cluster of cells located near the
through the open valves and into the
top of the right atrium, which acts as the heart’s ‘pacemaker’
ventricles.
(see figure 1.4). It generates an electrical signal that
stimulates the heart to beat at a rate of approximately 70 to
80 beats per minute. This internal control of the heartbeat
The signal arrives at the AV node
makes the heart muscle unique, as it occurs without any
before being released to the
stimulation from the nervous system.
Purkinje fibres, which are specialised
If the SA node fails, battery-powered pacemakers can be cells located along the walls of the
inserted into the heart to emit electrical signals that trigger ventricles.
the heartbeat.
The atrio-ventricular (AV) node is the secondary pacemaker

The Purkinje fibres carry the signal
of the heart (see figure 1.4). This node is found between
to the apex (most inferior point)
the right atrium and the right ventricle, and it receives the
of the heart. They quickly carry
electrical signal sent out from the SA node. The AV node is
the signal through the walls of the
responsible for passing the stimulus on to the ventricles via
ventricles causing them to contract.
the Purkinje fibres. The AV node, however, delays the signal
to the ventricles by approximately one tenth of a second,
which ensures that the atria and ventricles do not contract
simultaneously.
Figure 1.4 The electrical signal travelling through

the myocardium
Sino-atrial
(SA) Node
Atrio-ventricular
(AV) Node Purkinje
fibres


Use the following terms to fill in the gaps in the sentences below:
1. The AV node is found between the

SA node
and the .
2. The carry the signal to the apex contract

(most inferior part of the heart).
AV node
3. The is a cluster of cells located near the
top of the right atrium, which acts as the heart’s pacemaker. right ventricle
4. The Purkinje fibres quickly carry the signal through the walls
of the ventricles, causing them to . right atrium
5. The is the secondary pacemaker Purkinje fibres

of the heart.
The electrocardiogram (ECG) trace
An electrocardiogram (ECG) trace is created when electrodes Figure 1.5 A typical ECG trace
are placed on the chest to monitor the electrical activity
within the heart. This is done by medical professionals to
check that the heart is functioning properly. A typical ECG R
trace is shown in Figure 1.5.
T
The ECG trace has three distinctive waves: P
• the P-wave: this is the electrical signal that spreads

Q S
from the SA node through the atria causing 0.2 0.4 0.6
the atria to contract Time (seconds)
• the QRS complex: this represents the contraction
of the ventricles (the heart beat), and
• the T-wave: this represents the relaxation of the ventricles,
after which the whole process of the heart beat begins again.

Disease and the blood vessels
Section 1
When functioning normally, the blood vessels efficiently carry blood to
and from all parts of the body. If blood vessels become diseased, the
consequences can be fatal.
Normal cross-section
of artery wall
Atherosclerosis Artherosclerosis
If a person develops atherosclerosis it can deprive parts of their This is a thickening or hardening
of the artery walls.
body of blood. If the brain or heart is deprived of blood, this can
lead to a stroke, coronary heart disease or heart attack. Athero = artery
Sclerosis = scarring
1. T
he majority of scientists believe that atherosclerosis begins following damage
to the endothelium (innermost layer of cells) of the artery, and that the major
causes of this damage are elevated blood cholesterol or triglyceride levels, high
blood pressure and smoking. This damage leads to the deposition of material
such as LDL cholesterol, fats, platelets and calcium in the artery wall that
1. Tear in artery wall
eventually hardens, forming a deposit called an atheroma.
2.If enough material is deposited and the atheroma becomes large enough,
the artery wall thickens and the artery narrows. This leads to a reduction
in the blood flow through the artery, and less oxygen and nutrients being
supplied to the artery’s target cells.
2. Fatty material is
deposited in vessel wall
3. If the atheroma ruptures, it can form a clot in the artery. A clot causes
a partial or complete blockage of the artery, causing blood supply to
the target tissue to be severely limited or cut off. This increases the
likelihood a heart attack or stroke.
3. Narrowed artery becomes
blocked by a blood clot
Risk factors that can accelerate the process of atherosclerosis include:

• a family history of the • being overweight • having a diet high
disease • having diabetes in harmful fats
• smoking • environment (opportunities • low activity levels
• excessive alcohol for activity, access to healthy • stress
• high blood pressure foods) • age, and
• high blood cholesterol • Hormone replacement therapy • gender.

The impact of atherosclerosis

The brain
Atherosclerosis in the arteries that

The heart
supply the brain can lead to a
If one of the arteries supplying the stroke. The severity of a stroke will
heart is affected by atherosclerosis, depend on which area of the brain
the blood supply to the heart is affected. Strokes can be fatal
muscle (myocardium) can become and they can also lead to paralysis,
limited. This is known as coronary speech difficulties and problems with
heart disease (CHD). balance and coordination.
Angina is the most A stroke is the loss of brain

function due to a disruption of
common symptom of blood supply, caused by either
CHD, affecting two a clot in, or a rupture of the
million people in the UK. diseased arteries.
The main symptom of

this condition is pain on
exertion, which subsides
after a few minutes of
rest. CHD is the UK’s
biggest killer.
A heart attack or myocardial The legs

infarction can occur if one of
Peripheral vascular disease occurs
the coronary arteries becomes
when the arteries that supply the
blocked. If the blood supply to the
legs become damaged.
myocardium is cut off, the part of
the muscle that is starved of oxygen This can cause pain, due to the fact
and nutrients dies. that the blood supply is inadequate
and does not meet the demand of
the calf muscles. In the early stages,
Coronary heart disease occurs when the pain may subside following a
the main arteries supplying the
heart become narrowed. brief period of rest. More advanced
atherosclerosis can lead to constant
pain at rest, ulcers in the lower leg,
and potentially gangrene in the toes
and feet.

Benefits and risks of cardiovascular training
Section 1
When a personal cardiovascular (CV) exercise routine
is performed regularly and in accordance with the FITT Changes to heart rate
principles, it is likely to offer more benefits than risks.
With lower resting and sub-maximal
Negative outcomes can occur, however, when inappropriate heart rate caused by regular exercise,
training is undertaken. the time for the heart to refill between
beats increases. The coronary arteries
receive their greatest blood supply
Cardiac benefits of cardiovascular training at this time, and therefore regular
exercise is beneficial for managing
The benefits of regular CV exercise include: the symptoms of pain associated with
diseases such as angina.
Decreased Increased
• Submaximal heart rate (HR) • Heart muscle size
• Resting heart rate (RHR) • Blood volume Heart rate, stroke volume and
cardiac output
• Stroke volume
• Cardiac output Heart rate: the number of times that
the heart beats per minute.
• Capillarisation
Stroke volume: the amount of blood
• Oxygen delivery.
pumped by the heart in one beat.
Cardiac output: the amount of blood
Submaximal heart rate (HR) pumped by the heart in one minute
(heart rate x stroke volume).
Regular aerobic training will result in a person’s submaximal
heart rate (HR) being 12 to 15 bpm lower at any given
exercise intensity (Seals & Chase, 1989). This is a result of
several other training adaptations, namely increased stroke
volume (volume of blood pumped from the ventricles in
one heartbeat), increased cardiac output (volume of blood
pumped by the heart per minute) and improved oxygen
extraction from blood.
These adaptations combine to produce an increase in the

amount of blood being pumped around the body, and an
increase in the amount of oxygen that can be taken from the
blood by the working muscles. This results in the heart having
to beat fewer times per minute in order to deliver the required
amount of oxygen and nutrients to the working muscles.
Resting heart rate (RHR)
Due to the increase in stroke volume, a person’s resting heart

rate (RHR) will fall following regular aerobic exercise. This is
because each heartbeat delivers more oxygen and nutrients
to the body and the heart does not need to beat as often to
meet resting demands. The extent of this decrease, however,
is not as large as the fall in submaximal HR (Wilmore, 2001).

Heart muscle size
Regular cardiovascular exercise will increase the size, mass

and volume of the heart muscle, especially the left ventricle.
This is called cardiac hypertrophy.
Blood volume
Plasma volume can increase by up to 20 per cent after six

weeks of cardiovascular training. Alongside this, red blood cell
mass increases. The combination of these factors leads to
increased total blood volume. With an increase in red blood
cell mass comes an increase in haemoglobin levels, which will
enhance the blood’s oxygen-carrying capacity.

Answer the following questions:
1. What is atherosclerosis?
2. If atherosclerosis affects the arteries supplying the heart, what can occur?
3. If atherosclerosis affects the arteries supplying the brain, what can occur?
4. If atherosclerosis affects the arteries supplying the legs, what can occur?
10

Increased stroke volume
Section 1
As the heart becomes stronger and is able to contract more
forcefully, more blood can be pumped out of the ventricles in
one contraction.
Increased cardiac output
As a result of the stronger heart muscle more blood can be

pumped out of the heart per minute during exercise. At rest,
however, cardiac output remains roughly the same, as the
decrease in resting heart rate offsets the increased stroke volume.
Increased capillarisation
More capillaries in the muscles and organs develop and this

means a greater blood supply to those areas.
Increased oxygen delivery
Increased capillarisation means a greater supply

of oxygen-rich blood.
Health benefits of cardiovascular training
The health benefits of regular CV training include:
• reduced health risks

• improved blood profile
• weight management
• increased bone mineral density (if load-bearing)
• improved mental health.
Reduced health risks
Regular CV exercise will reduce the risk of heart disease, ‘If you are physically active you will
diabetes, stroke and certain types of cancer. This is the increase your life span, regardless
reason why exercise referral programmes are recommended of any adverse inherited factors.
for inactive individuals who are at risk of these conditions. Physical activity, at any age,
Sedentary lifestyles increase the likelihood of storing fat protects against a multitude of
around the middle. This is commonly known as being ‘apple- chronic health problems including
shaped’ and is associated with an increased risk of diabetes all forms of cardiovascular disease.’
and heart disease. Exercise helps to reduce this risk by (World Heart Foundation)
decreasing fat storage around the middle.
11

Improved blood profile
Scientific evidence consistently shows that regular CV exercise

LDL
of an appropriate intensity and duration can improve a
Low density lipoproteins are responsible
person’s blood profile and reduce their health risks. Two of
for the deposits on the innermost layers
the most important changes as far as a person’s health is of the arteries. They transport cholesterol
concerned are: from the liver around the body.
HDL
• increased HDL cholesterol concentration: low HDL or ‘good’
High density lipoproteins remove
cholesterol levels are linked to an increased risk of CV disease;
excess cholesterol from the body
regular CV exercise can increase HDL concentration which and return it to the liver.
helps to protect against CV disease, and
• decreased triglyceride concentration (TGC): people with
high TGC’s are 30 per cent more likely to have a stroke
and three times more likely to have a heart attack than
people with normal levels. Regular CV exercise can help to
moderate high TGC’s.
Weight management
Being overweight or obese increases the risk of numerous

diseases and conditions, including heart disease. Regular CV ‘Overweight and obesity lead to
exercise, combined with a sensible dietary intake, can help adverse metabolic effects on blood
a person to reach and maintain a healthy weight and reduce pressure, cholesterol, triglycerides
their health risks. and insulin resistance. Risks of
coronary heart disease, stroke and
Increased bone mineral density
type 2 diabetes increase steadily
Low bone mineral density (BMD) increases the risk of with increasing BMI (Body Mass
developing osteoporosis. Performing regular weight-bearing Index). Raised BMI also increases
exercise, such as jogging or running, can help to improve the risk of cancer of the breast,
BMD and lower the risk of osteoporosis. colon, prostate, endometrium,
kidney and gallbladder.’
Improved mental health
WHO, World Health Report 2002
There is a growing body of evidence which shows that
physical activity can improve mental well-being, and prevent
the development of mental health problems. Taking part in
regular CV exercise can improve a person’s feeling of mental
well-being, self-esteem, cognitive function and sleep quality
and quantity, as well as lowering stress and anxiety levels.
12

Risks associated with cardiovascular exercise
Section 1
Whilst appropriately programmed, person-specific
cardiovascular exercise offers a variety of benefits, there are The risks associated with
some potential risks. Most risks can be minimised, however, CV exercise include:
through well-implemented pre-exercise screening processes • cardiac events
and careful monitoring during exercise.
• injury
Risk of cardiac events • over-reaching.
There is a very small, temporary risk of an individual having a
cardiac event whilst they are exercising. A cardiac event could
be a heart attack, angina attack or a heart-rhythm disorder.
This risk, however, is believed to be very small. For individuals
with an existing heart condition, the risk is thought to be
greater but still small.
Although exercise seems to be safe, it is vital that thorough

pre-exercise screening takes place to identify those individuals Risk of cardic events
who could be at risk of cardiac events and those who have a
history of heart conditions. It is also crucial that all individuals It is important to understand that the risk
of cardiac events is smaller amongst
working in the fitness industry are able to identify the signs of people who take part in regular
a cardiac event. exercise. The majority of heart attacks
(up to 90 per cent) occur whilst an
Risk of injury individual is resting, not whilst they
are exercising.
If a person is taking part in regular CV exercise, they are at
an increased risk of injury simply because they are increasing
the amount of time they are active. With thorough pre-
exercise screening and a well-structured, appropriate exercise
programme, however, the likelihood of injury is minimised.
A well-structured training programme can actually reduce

the risk of injury during sporting and everyday activities by
enhancing functional strength and fitness. This is particularly
evident in older individuals, who can lower their risk of falls by
improving their functional strength and balance.
13

Risk of over-reaching
Taking part in a poorly planned exercise programme, and not

Over-training is the state where rest
allowing for adequate recovery, can lead to excessive, chronic
is no longer adequate to result in
overload. This can lead to fatigue, illness, injury and burn-out: recovery.
this is referred to as over-reaching. Short periods of fatigue
following heavy training are to be expected but they are
normally reversed following a period of rest or reducing the Some of the most commonly cited
training load. early signs and symptoms of over-
training include:
If inadequate rest or recovery is allowed and a person is
constantly over-reaching, they may become over-trained. If • increased resting heart rate
a person becomes over-trained, they will need a long period • slow heart rate recovery after
of rest in order to recover from this state. training
A well-structured, periodised CV training programme will • weight loss
help to limit the likelihood of over-training. This is often • decreased appetite
the best prevention, as it is difficult to define a consistent
• altered sleep patterns
set of symptoms which identify when a person is over-
trained. If training is always performed at a high intensity no • altered mood state
improvements in fitness are being experienced and a person is • recurrent colds or viral illnesses
constantly tired, they may be over-trained. Unfortunately, these • persistent muscle soreness
are often the late signs and, by this point, the only recovery
• feelings of burn-out and
from over-training will be rest.
staleness, and
• overuse injuries.
14

Section 1
Place the following changes that occur with regular exercise into the correct column
in the table below:
• capillarisation • blood volume

• stroke volume • heart muscle size
• submaximal heart rate (HR) • resting heart rate (RHR)
• cardiac output • oxygen delivery.
Decreased Increased

Fill in the following table about the risks of CV exercise, using your own words.
Factor How does the risk increase?

Cardiac
events
Injury
Over-
reaching
15

Blood pressure and the effects of exercise
What is blood pressure?
Blood pressure (BP) is the measurement of pressure exerted Table 1.1 ACSM Guidelines 2010
on the walls of the arteries. It is measured in mmHg Category Systolic Diastolic
(millimetres of mercury) and recorded as systolic and diastolic. blood blood
pressure pressure
• systolic pressure: the highest pressure, when the (mmHg) (mmHg)
contraction of the heart forces blood around the body
Normal blood <120 <80
• diastolic pressure: the lowest pressure, when the heart pressure
is relaxed between beats. Hypertension 140+ 90+
Blood pressure within the vessels
Blood pressure is not constant throughout all of the blood Figure 1.7 Graph of pressure changes
vessels, as shown in figure 1.7. around the circulation
As blood travels from the aorta, the pressure in the systemic
blood vessels falls until it re-enters the heart. Pressure is at its 140
120 Systolic pressure
lowest in the veins.
Pressure (mm Hg)
100
80
Short-term effects of exercise on blood pressure
60
Diastolic
In healthy adults, normal systolic BP ranges from 40 pressure
110 mmHg to 139 mmHg. 20
0
At the onset of exercise, involving large muscle groups, systolic
ca i n s
Ar rta
pi s
d ule es
Ar ies
Ca iole
ri
va
na ve
Ao
lla
te
BP will rise rapidly. This is due to the increase in blood flow that
r
te
ve s,
an en
occurs during the first few minutes of activity in order to meet

V
the muscles’ increased demands for oxygen and nutrients.
Systolic BP normally levels off at 140 mmHg to 160 mmHg The Valsalva effect
during steady-state activity in healthy individuals. As exercise
The Valsalva effect (also known as the
intensity increases, however, systolic BP continues to rise and Valsalva manoeuvre) involves exerting
it can reach 200 mmHg during maximal exercise. against a closed airway.
It is often seen in exercise when people
Normal diastolic BP in healthy adults ranges from hold their breath whilst attempting to
60 mmHg to 89 mmHg. perform resistance training or stretches.
It can be dangerous as it can
During steady-state exercise, diastolic BP remains largely
cause an increase in heart rate and
unchanged in healthy individuals. Similarly, as exercise blood pressure. This can lead to
intensity increases, diastolic BP will remain relatively complications, especially in those
with cardiovascular disease.
unchanged and it may even decline slightly as arteries dilate.
16

Long-term effects of exercise on blood pressure
Section 1
Regular CV exercise performed over a prolonged period
Short-term effects of exercise:
of time can reduce both systolic and diastolic BP. These
• increased systolic BP
decreases can be up to 10 mmHg at rest and during
submaximal exercise. • decreased diastolic BP.
Long-term effects of exercise:
High blood pressure complications • decreased systolic BP
• decreased diastolic BP.
Individuals with high blood pressure or hypertension have
an increased risk of developing certain conditions including:
Atherosclerosis
Atherosclerosis begins following damage to the endothelium Some common complications of high
(inner wall) of the artery. Additional pressure on the artery walls blood pressure are:
caused by chronic high blood pressure increases the risk of this • atherosclerosis • stroke
damage. • heart attack • kidney damage.
Heart attack
Hypertension increases the risk of a heart attack. This

increased risk occurs because high blood pressure stresses the
heart and contributes to atherosclerosis, which can block the
blood vessels in the heart.
Stroke
High blood pressure increases the risk of some of the small Someone with a blood pressure level
blood vessels in the brain rupturing as well as the risk of them of 135/85 is twice as likely to have
becoming clogged due to atherosclerosis. Both of these can a heart attack or stroke as someone
cause a stroke. with a reading of 115/75.
Kidney damage Blood Pressure Association (2008)
The kidneys are responsible for regulating blood pressure but

they can be damaged by hypertension. High blood pressure
can damage the area of the kidney that is responsible for
regulating the amount of fluid in the body. Unfortunately, this
is a vicious circle because high blood pressure causes damage
which leads to further increases in blood pressure.
17


Answer the questions below by filling in the gaps:
1. In healthy adults, normal systolic BP ranges from to .
2. Systolic BP normally levels off at to during steady-state activity in healthy individuals.
3. Normal diastolic BP in healthy adults ranges from to .
4. As exercise intensity increases, diastolic BP will remain relatively unchanged and it may even
slightly.
5. Regular CV exercise performed over a prolonged period of time can both systolic and diastolic BP.
6. The involves exerting against a closed airway during exercise. It is

dangerous to practise as it causes in heart rate and blood pressure.
18

Summary
Section 1
You should now be able to:
1.1 Explain the function and 1.2 Describe coronary circulation:

location of the heart valves:
• the movement of blood through the arteries and
• the atrio-ventricular valves veins supplying the myocardium
(tricuspid and bicuspid) • the main coronary arteries (right, left anterior
• the semilunar valves (pulmonary descending and circumflex)
and aortic) • the main cardiac veins (great, middle and small)
• their role in preventing backflow • the role of the SA node, AV node and Purkinje
of blood. fibres, in transmitting the electrical impulse.
1.3 Explain the effect

of disease on the
blood vessels:
• atherosclerosis and its

effects
1.6 Define blood pressure • atheromas and clots
classifications and associated • risk factors for
health risks: atherosclerosis.
• systolic (contracting phase)
and diastolic (relaxing phase)
blood pressure 1.4 Explain the short- and
• normal blood pressure long-term effects of exercise
(120/80mmHg) and on blood pressure:
hypertension (140/90mmHg+) • short-term (systolic increases,
• health risks including diastolic stays the same)
atherosclerosis, stroke, heart • long-term (systolic and diastolic
attack and kidney damage. decrease)
• the risks of the Vasalva effect.
1.5 Explain the cardiovascular benefits

and risks of CV exercise:
• health benefits
• cardiovascular changes
• risks including cardiac events, injury and over-reaching.
19

Section 2: The musculoskeletal system

(anatomy and physiology)
What you will cover Nucleus
By the end of this section you will be able to: The control centre of the cell which
regulates DNA and RNA. The carrier
FFexplain the cellular structure of muscle fibres of genetic code that gives the cell
FFdescribe the anatomy of a muscle instructions.
Section 2
FFdescribe the process of sliding filament theory Mitochondria
FFexplain the adaptations that occur within a muscle
The ‘powerhouses’ of cells,
fibre in response to different types of exercise, and
mitochondria are the sites where the
FFlocate the major muscles of the body by name chemical processes that re-synthesise
and identify their attachment sites. adenosine triphosphate aerobically
take place.
Muscle fibre anatomy and physiology Myofilaments
Muscles are made up of hundreds of thousands of individual These are the contractile proteins –
muscle fibres, or cells. Understanding the cellular structure of actin and myosin – that are involved
a muscle fibre helps to gain a greater understanding of the in the sliding filament process.
way muscles work.
Myofibrils
Each cellular structure has a number of functions and those
most relevant to physical activity and exercise are explained A myofibril is a basic unit of a muscle
on the right. composed of actin and myosin.
Sarcolemma
The sarcolemma is the cell

membrane of a muscle cell.
Sarcoplasmic reticulum
Releases calcium ions that trigger

the contraction of muscle fibres.
Cell walls
Complex structures, made of fats and

proteins, that regulate the internal
environment of the cell to maintain
homeostasis, a state of normality.
21

Muscle anatomy
Anatomy of a skeletal muscle
Skeletal muscles have an organised structure of fascia –

Sarcomere
connective tissue wrappings – which house the functional
WIthin the myofibrils, these repeating
units of contraction, the muscle fibres. Figure 2.1 illustrates
sections, seen as light and dark bands
the structure of a generic skeletal muscle to show the under a microscope are made up of
arrangement of these fascia and fibres within the muscle actin and myosin. They are responsibile
for the process of muscle contraction
as a whole.
suggested in the sliding filament theory.
When a muscle contraction takes place, tension is generated The sarcomere shortens during muscle
and passed to the connective tissue wrappings on the muscle contraction, as actin and myosin
slide over each other.
which merge to form a tendon. They pull on the tendinous
attachments on the bones to bring about joint actions.
Muscle Structure
Epimysium: surrounds the entire muscle

Perimysium: surrounds a fascicle
(bundle of muscle fibres)
Figure 2.1 The cellular components of a skeletal Endomysium: surrounds a muscle fibre.
(striated) muscle fibre
Muscle fibre
Perimysium
Epimysium
Myofibril
(showing sarcomeres)
Skeletal
(striated)
muscle
Endomysium Fascicle (bundle
of muscle fibres)
22

The sliding filament theory
Figures 2.2 and 2.3 respectively illustrate Figure 2.2 The structure of a sarcomere
the structure of the contractile filaments
within a sarcomere and the step-by-step
Myosin
process of muscle contraction. heads (cross
bridges)
Cross-bridges
Actin
Section 2
The name given to the connections filaments
between the contractile filaments actin
and myosin.
Sarcomere
Figure 2.3 The stages of the sliding filament process

Sliding filament theory
The process whereby actin and myosin
‘slide’ over each other to bring
about muscle contraction.
ATP ADP + P
ATP ADP + P ATP ADP + P
Stage 1: Calcium released from

the sarcoplasmic reticulum
unlocks binding sites on the actin
myofilament allowing the myosin
ADPcross-bridge to attach. ADP
P ATP ADP + P P
ADP ADP ADP ADP
P P P P
Stage 4: As ATP is split into Stage 2: The working stroke

ADP and P, cocking of the occurs as the head of the
myosin head occurs ready
ATP ATP myosin cross-bridge pivots and
ADP ADP
for the next power stroke. P pulls the actin filament towards
P
ATP ATP 3: The head of the myosin
Stage ATP ATP the middle of the sarcomere,
cross-bridge releases from the actin causing it to shorten.
binding site and more ATP attaches
to the myosin head.
ATP
ATP ATP
23


Label the diagram of a muscle fibre below:

In your own words, summarise the stages of the sliding filament process in the space below:
You may find it helpful to stand up and walk through the process, standing in different parts of a room
and anchoring those locations to a particular stage of the contraction process. It may even help to
draw or write out each stage on a separate piece of paper and put these in different places around
the room.
1.
2.
3.
4.
24

The adaptations of muscle to exercise

The purpose of regular exercise, or training, is to stimulate
adaptation within the body. Adaptation of the musculoskeletal
system is a common goal of training and the adaptations that
occur are specific to the type of stimulus applied. It is important
that personal trainers understand what the muscles are capable
of under different conditions in order to determine the optimal
training programme for an individual.
The types of training stimulus can be broadly divided into
Section 2
three categories:
• endurance,
• hypertrophy, and
• strength.
Each training type produces different results within the

neuromuscular and musculoskeletal systems, so programmes
must be carefully designed to achieve the client’s goals.
Muscle fibre types
Type 1 (slow oxidative):
• also known as slow twitch muscle fibres

• have large amounts of myoglobin (protein that carries
oxygen and therefore gives type 1 muscle fibres their
red colour), and
• produce energy aerobically and are found in high
quantities in endurance athletes.
Type 2a (fast oxidative glycolytic):
• have characteristics of both type 1 and type 2b

muscle fibres
• these adapt to work better aerobically or anaerobically
depending on the training carried out, and
• can be thought of as pinkish in colour.
Type 2b (fast glycolytic):

• also known as fast twitch muscle fibres
• explosive powerful muscle fibres
• they work anaerobically and fatigue quickly
• are found in high quantities in sprinters, and
• are white in colour.
25

Endurance
Training for endurance can be defined as:
• submaximal aerobic cardiovascular exercise

• submaximal interval training, and
• resistance training using loads of less than 70 per cent
of one repetition maximum (1RM) which is equivalent to
reaching muscle fatigue at around 12 to 15 repetitions.
Performing this type of training will lead to the following

adaptations:
Table 2.1 Endurance training adaptations
Characteristic Effect of muscular endurance training

Fibre cross-sectional Selective increase of type 1 fibre
area diameter but overall muscle mass may
decrease as type 2a and 2b fibres
atrophy (decrease in size)
Number and size Increased number and size
of mitochondria of mitochondria
Creatine phosphate Little or no increase
stores
Tolerance and The ability of the fibres to contract in
removal the presence of lactic acid improves as
of lactic acid does the ability to remove lactic acid
from the muscle fibres
Glycogen stores Increase
Aerobic pathway Increase
enzymes
Creatine phosphate Little or no increase
pathway enzymes
Capillarisation Increase
Myoglobin levels Increase
26

Hypertrophy
Hypertrophy training, where increased lean body mass is

the primary goal, is defined as moderate to heavy resistance
training without a specific functional or sport-specific goal.
This type of training requires the following:
• slow to moderate movement speeds to increase the ‘time

under tension’ or time the muscles spend contracting
• an intensity of 60 – 80% 1RM (typically reaching fatigue
at eight to 12 repetitions), and
Section 2
• multiple sets (typically three to four) of resistance training
exercises per muscle group.
Split training routines are commonly used in this type of

training to allow a higher volume of work. A periodised
programme will optimise results. Performing this type of
training will lead to the adaptations described below:
Table 2.2 Hypertrophy training adaptations
Characteristic Effect of hypertrophy training

Fibre cross- Optimal increase in type 1, type 2a and
sectional area type 2b fibre diameter leads to a significant
increase in muscle mass
Number and size Limited increase in the number
of mitochondria and size of mitochondria
Creatine Increase
phosphate stores
Tolerance and The ability of the fibres to contract in the
removal of lactic presence of lactic acid improves as does
acid the ability to remove lactic acid from the
muscle fibres. The effect is more significant
if multiple set protocols are used
Glycogen stores Increase
Aerobic pathway Increase
enzymes
Creatine Increase
phosphate
pathway
enzymes
Capillarisation Increases but not as much as with
endurance training
Myoglobin levels Some increase but less than endurance
training
27

Strength
Training for strength is defined as ‘developing maximal force’.

This type of training can be considered a precursor to power Programming resistance training
training, where the aim is to develop maximal force in the
minimum time possible. Strength training utilises: It is important to consider the type of
muscle when programming resistance
• heavy to maximal, or even supramaximal loads (a weight training. Tonic muscles, which contain
a high proportion of type 1 muscle
greater than you can lift for one full ROM repetition) fibres, respond best to endurance
• explosive intent to generate maximal or near maximal training, whereas phasic muscles, with
a higher proportion of type 2 fibres, are
force within muscle groups, and more responsive to hypertrophy and
• compound exercises are typically used as they stimulate strength training.
more muscle fibres. As a general guide, deeper muscles

and those of the trunk and core, with a
Strength training adaptions are listed below: primary role of stabilising the body, tend
to be tonic and the larger, superficial
Table 2.3 Strength training adaptations muscles of the limbs tend to be phasic
to generate movement.
Characteristic Effect of strength training
Fibre cross- Increase in cross-sectional diameter
sectional area (hypertrophy) is secondary to improved
neuromuscular coordination of motor unit
recruitment, so it occurs but to a lesser extent
than in hypertrophy training. Increased
number of actin and myosin filaments.
Number and size Little or no increase
of mitochondria
Creatine Significant increase
phosphate stores
Tolerance and No change
removal of lactic
acid
Glycogen stores Some increase
Aerobic pathway No change
enzymes
Creatine Significant increase
phosphate
pathway
enzymes
Capillarisation Negligible improvements as the aerobic
system is not being recruited
Myoglobin levels Negligible improvements as the aerobic
system is not being recruited
28

Gross muscle anatomy

Figure 2.4 The general location of the muscles of the body from the anterior view
Anterior muscles
Section 2
Sternocleidomastoid
Pectoralis minor
Pectoralis major Deltoid
Biceps brachii Serratus anterior

Brachialis Rectus abdominis
Brachioradialis External oblique
Transverse abdominis Internal oblique (deep)

(deep)
Hip flexors (Iliacus and

psoas major) (deep)
Tensor
fasciae
latae Adductors:
(longus,
magnus,
Rectus femoris brevis and
pectineus)
Vastus lateralis
Vastus intermedius Sartorius
(sits underneath
rectus femoris)
Gracilis
Vastus medialis Gastrocnemius
Tibialis anterior
29

Figure 2.5 The general location of the muscles of the body from the posterior view
Posterior muscles
Sternocleidomastoid Trapezius
Sitting underneath:
Rhomboid major
Levator scapulae (deep) Rhomboid minor
Deltoid
Rotator cuff (deep): Teres major

Supraspinatus
Infraspinatus
Teres minor
Subscapularis Latissimus dorsi
Multifidus (deep, runs up Triceps brachii

entire length of spine)
Erector spinae Gluteus medius

Iliocostalis Gluteus minimus
Spinalis
Longissimus Piriformis (deep)
(run up entire length
of spine) Gluteus maximus
Quadratus Lumborum
Adductor magnus
Iliotibial band
Biceps femoris
Semitendinosus
Semimembranosus
Gastrocnemius
Soleus Calcaneal (achilles) tendon
30


Study the training adaptations for each type of resistance training and summarise the differences
in the table below:
Characteristic Endurance Hypertrophy Strength

Fibre cross-sectional
area
Number and size
Section 2
of mitochondria
Creatine phosphate
stores
Tolerance and removal

of lactic acid
Glycogen stores
Aerobic pathway
enzymes
Creatine phosphate
pathway enzymes
Capillarisation
Myoglobin
31


Label the blank diagram below with the muscles identified on the anterior muscle anatomy diagram:
Anterior muscles
32


Label the blank diagram below with the muscles identified on the posterior muscle anatomy diagram:
Posterior muscles
Section 2
33

Origins and insertions
All muscles attach to bones via tendons. It is these

Origins and insertions
attachments that allow muscles to pull on bones when they
Origin: the point where the muscle
contract, bringing about joint actions to create the required
attaches to the bone that stays fixed
movements. It is necessary for personal trainers to have an during movement
understanding of where muscles attach as this will help them Insertion: the opposite end of the
to understand what movements they can create. Muscles muscle where it attaches and
attach to bones at both ends and these attachments are movement takes place.
known as the origin and insertion points.
The definitions of these are given in the box to the right.

As an example, the biceps brachii muscle has its origin on
the scapula and its insertion on the radius. During a biceps
curl (elbow flexion) the movement occurs at the elbow joint
insertion as the contraction of the biceps pulls on the radius
causing it to move. No movement occurs at the biceps
attachment at the shoulder joint (origin).
Anterior upper body muscles
Sternocleidomastoid
Origin Sternum and clavicle

Insertion Mastoid process
Joints crossed Cervical vertebrae
Joint actions Flexion, rotation and lateral flexion
of the neck
Pectoralis major
Origin Clavicle, sternum, ribs 1 to 6

Insertion Humerus
Joints crossed Shoulder joint
Joint actions Horizontal flexion, adduction and internal
rotation of the humerus
34

Anterior upper body muscles continued
Pectoralis minor
Origin Ribs 3 to 5
Insertion Scapula
Joints crossed Shoulder girdle
Joint actions Protraction and depression of the scapula
Section 2
Serratus anterior
Origin Lateral surface of ribs 1 to 12

Insertion Anterior surface of medial border of scapula
Joint actions Protraction and rotation of scapula
Deltoid
Origin Clavicle and scapula

Insertion Humerus (lateral)
Joint actions Anterior head: flexion, horizontal flexion,
internal rotation and abduction of humerus
© Primal pictures 2009
Lateral head: abduction of humerus

Posterior head: extension, horizontal
extension, external rotation abduction
of humerus
35

Anterior upper body muscles continued
Biceps and forearm
Biceps brachii
Origin Scapulae
Insertion Radius
Joints crossed Shoulder and elbow joint
Joint actions Flexion of elbow, assists flexion
of shoulder, supination of forearm
Brachialis
Origin Humerus
Insertion Ulna
Joints crossed Elbow joint
Joint actions Flexion of elbow
Brachioradialis
Origin Humerus
Insertion Radius
Joints crossed Elbow joint
Joint actions Flexion of elbow
36

Posterior upper body muscles
Trapezius Scapulae
The plural of scapula.
Origin Occipital bone of skull, cervical

and thoracic vertebrae
Insertion Clavicle and spine of scapulae
Section 2
Joint actions Stabilises scapulae, elevation, rotation
and retraction of scapulae
Levator scapulae
Origin Cervical vertebrae 1 to 4

Insertion Top of scapulae
Joints crossed Shoulder girdle and cervical vertebrae
Joint actions Elevation of scapulae, rotation and lateral
flexion of neck
Rhomboid major
Origin Thoracic vertebrae 1 to 4

Insertion Medial border of scapulae
Joint actions Stabilises scapulae, assists in retraction
of scapulae
Rhomboid minor
Origin Cervical vertebrae 6 and 7

Insertion Medial border of scapulae

Joint actions Stabilises scapulae, assists in retraction
of scapulae
37

Posterior upper body muscles continued
Rotator cuff
Supraspinatus Infraspinatus
Origin Upper posterior

surface of scapulae
Insertion Head of humerus
(lateral)
Joint actions Stabilises head of
humerus in glenoid
fossa, abduction
of humerus
Teres minor Subscapularis

Roles of the rotator cuff
muscles
• all muscles: stabilise the

shoulder joint
• subscapularis: internal rotation
• supraspinatus: abduction
• infraspinatus and teres minor:
external rotation.
For example, during a lateral raise
supraspinatus assists the deltoids in
abducting the shoulder, whilst the
other three rotator muscles fixate the
shoulder joint.
38

Posterior upper body muscles continued
Latissimus dorsi
Origin Thoracic vertebrae 7 to 12, thoraco-lumbar

fascia and iliac crest
Insertion Humerus
Section 2
Joint actions Adduction, extension and internal rotation
of humerus
Teres major
Origin Lower lateral border of scapulae

Insertion Humerus
Joint actions Internal rotation and adduction of humerus
Triceps brachii (long, medial and lateral heads)
Origin Scapulae and humerus

Insertion Ulna
Joints crossed Shoulder and elbow joint
Joint actions Extension of elbow
39

Anterior core muscles
Obliques
External obliques
Origin Lateral surface of ribs 5 to 12

Insertion Abdominal aponeurosis (linea alba)
Joints crossed Thoracic and lumbar vertebrae
Joint actions Rotation, lateral flexion and flexion of spine
Internal obliques
Origin Iliac crest and thoraco-lumbar fascia

Joint actions Rotation, lateral flexion and flexion of spine
40

Anterior core muscles continued
Rectus abdominis
Origin Pubis
Insertion Costal cartilage, ribs 5 to 7, xyphoid process,
(base of sternum)
Section 2
Joint actions Flexion of spine
Transverse abdominis
Origin Ribs 7 to 12 thoraco-lumbar fascia, iliac crest

Joint actions Generates intra-abdominal pressure
41

Posterior core muscles
Erector spinae spinalis
Origin
Connects transverse and spinous process of vertebrae
Insertion
Joints crossed Vertebral column
Joint actions Bilaterally extends the spine and an unilaterally lateral
flexion of the spine
Erector spinae longissimus
Origin Transverse process of thoracic and cervical vertebrae,

sacrum and iliac crest
Insertion Transverse process of thoracic and cervical vertebrae,
mastoid process and ribs
Joint actions Bilaterally extends the spine and an unilaterally

lateral flexion of the spine
Erector spinae iliocostalis
Origin Sacrum, iliac crest and ribs

Insertion Ribs and cervical vertebrae
Joint actions Bilaterally extends the spine and an unilaterally lateral

flexion of the spine
42

Posterior core muscles continued
Multifidus
Origin Connects transverse and spinous process

Insertion of vertebrae

Joint actions Stabilises the spine, assists all movements
Section 2
Quadratus lumborum
Origin Iliac crest

Insertion 12th rib, lumbar vertebrae 1 to 4 or 5

Joints crossed Lumbar vertebrae
Joint actions Bilaterally extends the spine and
unilaterally lateral flexion of the spine
43

Anterior lower body muscles
Hip flexors
Iliacus
Origin Internal surface of ilium

Insertion Anterior of femur
Joints crossed Hip joint
Joint actions Flexion and internal rotation of hip
Psoas major
Origin Thoracic vertebrae 12 and lumbar

vertebrae
Insertion Anterior of femur
Joints crossed Hip joint and lumbar vertebral joints
Joint actions Flexion and internal rotation of hip, lateral
flexion and flexion of spine
44

Anterior lower body muscles continued
Adductors and external rotators
Adductor magnus Adductor brevis Adductor longus
Origin Pubis and ischium

Insertion Femur
Section 2
Joint actions Adduction of hip
Pectineus
Origin Pubis
Insertion Femur
Joint actions Adduction and internal rotation of hip
Gracilis
Origin Pubis
Insertion Medially on tibia
Joints crossed Hip and knee joints
Joint actions Adduction of hip, internal rotation,
assists flexion of knee and hip
45

Quadriceps
Rectus femoris
Origin Ilium (anterior)

Insertion Tibia via patella tendon
Joint actions Hip flexion and knee extension
Vastus lateralis Vastus medialis Vastus intermedius
Origin Femur
Insertion Tibia via patella
and patella tendon
Joints crossed Knee joint
Joint actions Knee extension
46

Tensor fascia latae
Origin Anterior iliac spine

Insertion Laterally on tibia via ilio-tibial band
Section 2
Joint actions Abduction of hip, assists flexion and internal
rotation of hip, stabilises knee
Sartorius
Origin Anterior of ilium

Insertion Medially at the top of tibia
Joint actions Flexion of hip and knee, external rotation
of hip, abduction of hip
Tibialis anterior
Origin Laterally on tibia

Insertion Inferior surface of 1st metatarsal
and tarsals
Joints crossed Ankle and subtalar joint
Joint actions Dorsiflexion of ankle and inversion of foot
47

Posterior lower body muscles
Gluteals and abductors
Gluteus maximus
Origin Medial iliac crest and sacrum

Insertion Ilio-tibial ban and laterally on femur
Joint actions Hip extension and external rotation of hip
Gluteus medius
Origin Upper surface of ilium

Insertion Laterally on femur
Joints crossed Hip
Joint actions Abduction, internal and external rotation
and flexion of hip
Gluteus minimus
Origin Lower surface of ilium

Joint actions Abduction and internal rotation of hip
Piriformis
Origin Anterior surface of sacrum

Joint actions Abduction and external rotation of hip
48

Posterior lower body muscles continued
Hamstrings
Semitendinosus Semimembranosus Biceps femoris
Origin Ischium
Insertion Medially at top
of tibia
Section 2
Joint actions Hip extension and
knee flexion
Calves
Gastrocnemius
Origin Posterior of femur

Insertion Calcaneus via Achilles tendon
Joints crossed Knee and ankle
Joint actions Plantar flexion at ankle, flexion at knee
Soleus
Origin Tibia and Fibula

Insertion Calcaneus via Achilles tendon
Joints crossed Ankle
Joint actions Plantar flexion at ankle
49


Study the previous table of muscle locations and functions and fill in the blanks in the table below:
Muscle
Pectoralis major Origin:
Insertion:
Joint actions:
Trapezius Origin:
Insertion:
Joint actions:
Deltoids Origin:
Insertion:
Joint actions:
Rectus femoris Origin:
Insertion:
Joint actions:
Gluteus maximus Origin:
Insertion:
Joint actions:
Gastrocnemius Origin:
insertion:
Joint actions:
50

The musculoskeletal system

(anatomy and physiology) summary
2.2 Describe the sliding filament theory:
2.1 Explain the cellular structure • the role of actin and myosin within
of muscle fibres: the sarcomere
• how myosin binds with actin to form
Section 2
• including the components of a muscle a cross bridge
fibre and their functions • the importance of calcium and ATP
• the gross anatomy of a muscle, in the process
including the epimysium, • the shortening of the sarcomere
perimysium, endomysium, and therefore the muscle, causing
fascicles and muscle fibres. movement to occur.
2.4 Identify and locate the muscle 2.3 Explain the effects of
attachment sites for the major different types of exercise
muscles of the body: on muscle fibre types:
• understand the terms ‘origin’ and • d efine type 1, type 2a and type 2b
‘insertion’ and what they mean fibres and their characteristics
• know the origin, insertion, joints • define endurance, hypertrophy
crossed and joint actions for the and strength training
major anterior and posterior • know how muscle fibres
muscles of the body. adapt with the different
types of training.
51

Section 3: The musculoskeletal

system (movement)
What you will cover The roles of muscles

in movement
By the end of this section you will be able to:
• Agonist: the muscle primarily
FFidentify the roles of the major skeletal muscles during responsible for the joint action
joint actions
• Antagonist: the opposing muscle
FFidentify the anatomical planes in which movement to the agonist which is relaxing and
lengthening while joint action occurs
takes place
• Synergist: a muscle which assists the
FFexplain the joint actions brought about by specific muscle agonist in the joint action
group contractions • Fixator: any muscle that contracts
FFanalyse a variety of exercises in terms of muscles and to stabilise and prevent unwanted
joint actions.
their roles, joint actions and planes of movement
FFdescribe joint structure with regard to range of movement
and injury risk
Section 3
FFdescribe movement potential and joint actions, and
FFdescribe the structure of the pelvic girdle and associated

muscles and ligaments.
The purpose of skeletal muscles is to produce voluntary

movements by acting on bones across joints. Muscles also Types of muscles
prevent unwanted movement in their role as fixators, which contraction
can be equally important.
• Isotonic: the name for concentric and
The following things are important to remember when looking eccentric contractions
at the role of muscles in movement: • Concentric: when the muscle shortens

under tension against gravity, lifting the
• muscles can generate force only by pulling on their weight upwards towards the clouds
attachment sites; they cannot push • Eccentric: the muscle lengthens under
tension with gravity, lowering the weight
• muscles do not work independently. They can only function under control towards the earth
effectively to produce movement when activated in • Isometric: the sarcomere shortens but
coordination with other muscles that stabilise, guide and no muscle action takes place. This type
of contraction causes increases in blood
assist the action of the agonist pressure which can be dangerous in
some populations.
• muscles can contract in various ways depending on
what they are doing: concentrically when shortening
under tension, eccentrically when lengthening under
tension and isometrically when contracting without
movement occuring.
53

Table 3.1 Muscle pairs

Agonist Antagonist
Deltoids Latissimus dorsi
Pectoralis major Trapezius and rhomboids
Biceps (brachii and brachialis) Triceps (brachii - long, medial and lateral heads)
Rectus abdominis Erector spinae (spinalis, longissimus and iliocostalis)
Hip flexors (iliacus and psoas) Gluteus maximus
Hip adductors (longus, magnus and brevis) Hip abductors (gluteus maximus, medius and piriformis)
Quadriceps (rectus femoris, vastus lateralis, Hamstrings (biceps femoris, semitendinosus and
intermedius and medialis) semimembranosus)
Tibialis anterior Gastrocnemius and soleus
Anatomical terms
When looking at how the body moves, it is useful to
understand the commonly used anatomical terms. All of these Anatomical zero
refer to the position of muscles on the body in relation to
Anatomical zero joint position is the
anatomical zero. beginning point of any joint’s range
of movement.
Figure 3.1 Commonly used anatomical terms
It is depicted as standing with all joints
in a neutral position, palms supinated
(facing upwards) by the sides.
Anterior Posterior
On the front of the body On the back of the body
Medial Lateral
Closer to the midline Further away from

of the body the midline of the body
Superior Inferior
Upper/above Lower/below
54

Joint actions, planes and axes

of movement
Figure 3.2 The planes of movement
Planes of movement
The body can move in three planes of movement:
• sagittal plane: any movement anterior or posterior

of anatomical zero position
• frontal (coronal) plane: any movement lateral
or medial of anatomical position
• transverse (horizontal) plane: any rotation or any
horizontal anterior or posterior movement from the
anatomical position. Sagittal
• Flexion and extension, plantar
Figure 3.2 shows the joint actions that take place in each
and dorsi-flexion
plane and example exercises. Movements can occur in a
combination of planes. To be truly multi-planar a movement • For example: squats and biceps curls
must occur in more than one direction simultaneously during
an exercise (for example, a lunge with rotation).
Section 3
It is essential to relate all movement back to the anatomical
zero position when using technical terminology to describe it,
regardless of body position, orientation or the equipment being
used. Even if an exercise is being performed lying prone on a
bench, the movement of the joints involved in the exercise must
be described in relation to their movement from the anatomical
zero position.
Frontal
Multi-planar exercise example • Adduction, abduction and lateral
As stated some exercises can occur in more than one plane at flexion, inversion and eversion
the same time. A cable row is an example: • For example: lateral raises and
sidebends
Table 3.2 Planes of movement in a cable row exercise
Joint Joint action Plane of

movement
shoulder girdle retraction transverse
shoulder joint horizontal extension transverse
elbow flexion sagittal
Transverse
wrist pronation or supination transverse
• Rotation, horizontal flexion and
or sagittal
extension, protraction and retraction
Whilst the exercise is considered to be transverse plane, some • For example: Russian twists and
movements take place in the sagittal plane. woodchops
55


Identify the joint/joints involved, joint actions in the concentric and eccentric phases, agonists and
antagonists, synergists and fixators, and planes of movement for the exercise examples given below:
Exercise Joint/joints Joint actions (concentric phase) Joint actions (eccentric phase)
Biceps curl
Elbow
Leg
extension
Knee
Lat pull-
down
Shoulder
Lat pull-
down
Elbow
Chest press
Shoulder
Chest press
Elbow
56

Agonist Antagonist Synergist Fixator Plane of movement
Section 3
57

Movement potential of the major joints

When considering the movement potential of joints, it is
important to remember that all individuals have different
potential for movement at each joint. This potential is
determined by their joint’s skeletal and connective tissue
structure, their age, gender, past training history and
other factors.
When teaching any exercise, the ROM used must be

considered carefully based on the individual’s ability to move
with comfort and safety through that range, the effect this
has on other joints and posture, and the load passing through
the joint. Whilst working through a full ROM is important for
resistance training exercises in particular, it is essential that
the full ROM used is specific to, and safe for, each client.
Injury risk for major joints

Joints are at risk of injury during exercise because forces are
passing through them. Provided the joint can withstand the
magnitude of the force in the direction it is passing, the risk
is minimal.
If the force is applied in a direction in which the joint has

little stability, or if the force is too great for the structures
supporting the joint, injury is certain. Each joint has its own
strengths and weaknesses.
58

Major joint structures, actions and injury risks
Shoulder (gleno-humeral) joint

Shoulder (glenohumeral)
• this is a ball and socket joint
joint actions:
• it is incredibly mobile and very unstable, making it prone
to dislocation • flexion • extension
• the bony structure of the joint provides almost no • extension • internal and
external rotation,
stability as the head of the humerus is held against the • adduction
and
shallow glenoid fossa • abduction
• circumduction.
• the ligaments which pass through and around the joint • horizontal flexion
reinforce the fibrous joint capsule. They provide little
support, however, as the capsule is ‘baggy’ to allow a
Shoulder (gleno-humeral) joint
large ROM to occur in multiple directions
• the muscles of the shoulder offer most of the stabilising
force, particularly the four rotator cuff muscles (see page
38) which, despite having individual movement functions,
primarily serve to stabilise the joint
• the larger muscles that surround the shoulder also
Section 3
provide a degree of stability. Significant imbalances in
the strength of muscles surrounding the joint can lead to
instability and increase injury risk
• the most common position for shoulder joint injury is
abduction combined with external rotation. The majority
of shoulder dislocations occur from this position.
59

Shoulder girdle
Shoulder girdle joint actions:
• this is a complex structure consisting of the
sternoclavicular (SC) joint and the acromioclavicular (AC) • protraction • elevation
joint along with the associated bones (sternum, clavicle • retraction • depression.
and scapula) and surrounding muscles
• the whole structure relies heavily on the surrounding
muscles for support and stabilisation Acromioclavicular joint
Sternoclavicular joint
• deep muscles such as the serratus anterior, rhomboids,
pectoralis minor and levator scapulae attach the scapulae
to the spine and ribs
• superficial muscles such as the trapezius and deltoids,
whilst mostly focussed on movement, are also responsible
for support and stability. The lower part of the trapezius
muscle is often undertrained
• despite their small size and limited movement potential, the
SC and AC joints of the shoulder girdle are strong and not
prone to injury. There is a greater risk of the muscles that
support the scapulae becoming strained than of damage
to the joints.
Elbow joint
Elbow joint actions:
• this is a true hinge joint with a bony structure called the
olecranon process that restricts its ROM in extension, • flexion
but allows a large degree of flexion • extension.
• the elbow is most at risk when force is applied directly
to the joint, or when the distal (far) end of the humerus
is in a fixed position, and excessive extension forces are
applied across the joint. These situations are rare in gym
exercise technique and are more common in sport.
60

Proximal radioulnar joint

The proximal and distal
• this joint is fibrous with limited movement and composed of
radioulnar joint actions:
a ligament ring that runs around the head of the radius. It is
at greater risk of injury than to other bony structures • rotation (leading to pronation
and supranation.
• excessive force in any direction can cause damage to the
cartilage, ligament or tendon of this joint, although injury
is more likely to be caused by a force passing along the
axis of the radius (for example, from a fall)
Proximal
• ligament damage can occur from excessive pronation- radioulnar joint
supination activity
• a dislocation – of the head of the radius from the
ligament that encircles it – can occur with abrupt
‘yanking’ of the arm when the hand is pronated.
Distal radioulnar joint

Distal
radioulnar joint
• This joint is a pivot-joint formed between the head of the
ulna and the ulnar notch on the distal radius
Section 3
• this joint is generally very stable and has limited
movement potential
• excessive internal or external rotation under force may cause
dislocation, as can severe impact through the wrist with the
hand pronated (falling over onto an outstretched arm, for
example), which is the most common injury to this joint.
Spine
• the spine is a series of 33 vertebrae. The top 24 are moveable

and connected to one another by intervertebral discs The vertebral structure is different
in each spinal region as shown on
• these discs are semi-moveable, fibrocartilage joints.
pages 62 and 63.
The discs fix adjacent vertebrae to one another at the
centrum with a jelly-like substance in the middle that
distributes pressure
• this arrangement provides a small degree of movement at
each joint and a shock-absorbing function. The total effect
of these small movements is significant, although it varies
in impact from one region of the spine to the next.
61

The cervical vertebrae have the following properties:

Cervical joint actions:
• they are small
• range of movement is relatively large • rotation
• flexion
• they are able to move through all three planes
of movement • extension
• hyperextension, and
• the intervertebral joints are supported on the posterior
• lateral flexion.
of the vertebrae by synovial facet joints, between the
transverse processes of each pair of adjacent vertebrae.
These prevent excessive movement of the cervical spine Transverse process
that could endanger the spinal cord
• due to their size, the cervical intervertebral joints are
at risk from direct impact or excessive movement under
force in any direction
• ligaments support the vertebrae and the muscles of the
neck to prevent damage to the joint structures.
Centrum
Spinous process
The thoracic vertebrae have the following properties:

Thoracic joint actions:
• the intervertebral joints have a similar structure to those
of the cervical spine. They are larger, however, and their • limited flexion
transverse processes articulate with the ribs which reduces • extension

the ROM possible in the sagittal and frontal planes • lateral flexion, and
• the thoracic region has the greatest range of movement • rotation.

of the three spinal regions. This is partly because it has
more vertebrae than the other sections
• the ROM in the transverse plane between each vertebra Centrum
is also significant as it allows the torso to rotate
• direct impact is less of a risk for the thoracic
intervertebral joints so they are less prone to injury
• they are, however, the vertebrae most affected
by osteoporosis.
Spinous process
Transverse process
62

The lumbar vertebrae have the following properties:

Lumbar joint actions:
• the intervertebral discs, like the centrum of the lumbar
vertebrae, are large • flexion, and
• they provide limited ROM, particularly in the transverse • extension.

plane, but they do provide significant movement in the
sagittal plane
• these joints are at risk of injury due to the high forces that
pass through them (they carry the full weight of the upper
body, plus whatever is being carried in the arms) Transverse
process Centrum
• the action most frequently responsible for damage to
the cartilaginous intervertebral joints of the lumbar spine
is excessive flexion combined with rotation. The resulting
injury is a weakening of the fibrous cartilage and bulging
of this structure. The more severe form of damage is a Spinous process
herniation of the disc: a complete rupture of an area
of the cartilage (see figure 3.1). This can put pressure
Figure 3.3 A herniated disc
on the spinal nerves that travel from the spinal cord to
Section 3
the lower limbs, and the sciatic nerve can be impinged,
leading to the painful condition, sciatica.
Intervertebral
disc
Sacroiliac
• this is complex and connects the sacrum of the spine to

the ilium of the pelvis Sacroiliac joint
• it is a partly synovial joint that is strongly reinforced by

ligaments on its anterior and posterior surfaces
• it is generally very stable yet it retains some shock-
absorbing properties
• this joint can be damaged by high forces if heavy loads
are carried unevenly through the spine, or through
impact being transferred ineffectively from the lower
limbs when running and jumping. This can affect

the normal processes that help to maintain the
joint alignment.
63

Knee
Knee joint actions:
• this is one of the most complex synovial joints in the body
• it is one of the least stable in terms of its bony structure, • flexion, and
with a fairly large degree of flexion and extension • extension.

possible. Hyperextension is prevented by the patella
• the knee is often represented as a hinge joint because of
the movements it performs. In reality, the knee joint is a
bicondylar joint, with two convex surfaces at the end of
the femur
• these surfaces rest on the slightly concave surfaces at the
end of the tibia (the fibula is not a part of the knee joint)
• cartilaginous menisci run around the articular surface
of the tibia in a figure-of-eight shape. They provide an
additional wedge-shaped lip to prevent slippage of the
bones on top of one another, and they help to maintain
the alignment of movement at the knee joint
• the ligaments are the real champions of stability in the
knee, with the anterior and posterior cruciate ligaments
attaching the tibia to the femur between the condylar-
articulating surfaces. It is strongly reinforced laterally
and medially by collateral ligaments and the anterior
surface of the joint is protected by the patella. This is
held in place by the patellar ligament and embedded in
the patella tendon of the quadriceps muscle group
• due to the complexity of the knee joint, various injuries
can occur affecting the different structures. Damage to
the cruciate ligaments, or medial and collateral ligaments,
can occur in sports, especially in those requiring twisting
and turning such as rugby and football
• damage to the meniscus with ageing, or patella
tendonitis that occurs with over-training in repetitive
sports, such as running, are also common injuries.
64

Ankle and sub-talar

Ankle and sub-talar joint actions:
• the true hinge joint of the lower limb, the ankle is a
Ankle Sub-Talar
complex structure comprising the articulation of the
distal surfaces of the tibia and fibula with the superior • plantar flexion • inversion
aspect of the talus bone • dorsi-flexion • eversion
• it is prone to fracture if subjected to high lateral forces,

or more commonly to ligament damage from twisting
or rolling over on the ankle Sub-talar joint
• the ankle joint itself only moves in the sagittal plane,

hence the risk of injury from lateral or rotational forces
with the foot in a fixed position
• the sub-talar joint of the foot provides the inversion
and eversion movements in the frontal plane. These
are often confused with movements of the ankle, as
Ankle joint
the two joints work closely together to produce the
various movements of the foot
• the sub-talar joint is a synovial gliding joint. It can be
Section 3
injured by forces being poorly transmitted through the
heel or excessive inversion/eversion movements.
Hip
The hip actions:
• this is a stable ball-and-socket joint
• flexion • horizontal flexion
• the forces carried through the hip are greater than
• extension • horizontal
those transmitted through the shoulder, which is why
extension, and
the ball and socket joint of the hip is deeper, allowing • adduction
• internal/ external
less movement than at the shoulder • abduction
rotation.
• circumduction
• around two thirds of the spherical head of the femur is
enclosed by the acetabulum (socket) of the pelvis, so
the risk of dislocation is low
• the hip joint can be damaged by repetitive impact over
time, particularly if muscle imbalances cause uneven
forces to pass through the joint
• osteoarthritis of the hips is common in old age and
can be exacerbated by a lifestyle involving regular high
impact activities such as running.
65


Match the joints below with the correct characteristics by drawing a line between boxes:
Shoulder The supporting muscles of this
structure are more at risk of injury than
the joints themselves.
Shoulder girdle Has large intervertebral discs that carry
the full weight of the upper body
Elbow A ball-and-socket joint with a large range
of movement which is prone to dislocation
Lumbar spine A hinge joint with a bony structure that
prevents hyperextension
Now attempt the same by drawing a line between the following joints and joint characteristics
Sacroiliac Wear and tear from uneven forces on

the head of the femur increase the risk
of osteoarthritis occurring in this joint
Hip One of the least stable synovial joints
in terms of structure
Knee Can be damaged by high forces
if heavy loads are carried unevenly
through the spine
Ankle Commonly prone to ligament damage
by twisting or rolling over
Functional anatomy of the pelvic girdle

The pelvis transfers large impact forces from the lower limbs Figure 3.4 Diagram of the pelvis showing
up to the spine, and is also responsible for helping to maintain bones and the SI joint
spinal alignment by providing a broad, solid foundation for
the lumbar vertebrae. Ilium
The bony structures of the pelvic girdle are:
• the two coxal bones (made of a fused complex

of the pubis ilium, ischium), and
• the sacrum.
Figure 3.4 shows these structures.

SI joint
The sacrum comprises five fused sacral vertebrae and it acts
as a single bone with foramen for nerves to pass through. This
wedge-shaped bone sits at the posterior of the pelvis between
Sacrum
the coxal bones. Ischium Pubis
66

The coxal bones are joined at the anterior of the pelvis by Figure 3.5 Ligaments of the pelvis
the symphysis pubis joint. This joint is incredibly strong and
stable, held in place by the inguinal and sacroiliac ligaments.
During childbirth and occasionally in the late stages of
pregnancy, the joint becomes unstable allowing the pelvic
outlet to enlarge slightly so the baby’s head can pass through.
Also, during pregnancy, some women experience symphysis
pubis dysfunction (SPD): an incredibly painful condition
which causes the cartilage to soften and permits movement
between the pubis bones.
Sacroiliac Inguinal
The differences between the male and female pelvis (anterior)
• shape and size of the pelvic bowl: this is larger in

females and more oval in shape
• angle of the pelvis: this is near vertical in males, with a
larger anterior tilt in females
• angle of the acetabulum: this is near vertical in males,
Section 3
with a larger posterior tilt in females
• the Q-angle and the associated higher risk of
injury in females: the small Q-angle in males allows
efficient transfer of force between hip and knee Sacroiliac Sacrotuberous
reducing stress on the knee joint. The larger Q-angle in (posterior)
females increases the risk of injury due to less efficient

Figure 3.6 The Q-angle
biomechanics.
Q-angle
The Q angle represents the relationship and alignment
between the pelvis, leg and foot.
Q-angle
67

Form closure and force closure
The acetabulum, or socket of the hip joint, is positioned almost

centrally on the lateral aspect of each of the coxal bones. This Form closure:
allows the forces transmitted to the bones to be distributed
As force passes through the SI joint,
evenly across the large, flat bony surface of the ilium. it causes the bony structures to fit
together and form a stable structure.
The sacroiliac (SI) joint
The SI joint is the joint between the spine (sacrum) and the
Force closure:
pelvis (ilium) that is held in place by strong ligaments. It is
fundamental in the efficient transfer of force from the lower
The latissimus dorsi and gluteus maximus
limbs to the spine.
on opposing sides work together to pull
the TLF tight across the SI joint, pulling
As force passes through the SI joint, it causes the bony the bones together and stabilising them.
structures to fit together and form a stable structure. This
is known as ‘form closure’. The ligaments that support
the joint, particularly the sacrotuberous ligament, assist in
holding these bony structures together, absorbing impact
and providing stability.
The muscles acting across the SI joint via the thoraco-lumbar

fascia (TLF) include the latissimus dorsi and the gluteus
maximus. These muscles work in contralateral pairs as
illustrated in figure 3.7 to pull the TLF taut across the SI joint
and create ‘force closure’ of the joint, as the tension in the
muscles pulls the bones together and stabilises them.
Figure 3.7 Thoraco-lumbar fascia demonstrating force closure

through action of latissimus dorsi and gluteus maximus
Latissimus
dorsi
Gluteus maximus
68


Label the diagram of the pelvis:
Now complete the table below to show the difference between the male and female pelvis:
Section 3
Area of the pelvis Differences between male and female pelvis
Shape and size of the
pelvis bowl
Angle of the pelvis
Angle of the
acetabulum
The Q-angle and the

associated higher risk
of injury in females
69

The musculoskeletal system (movement) summary

3.1 Identify the roles muscles can play 3.2 Identify the anatomical planes with
during joint actions: regard to joint actions and exercises:
• agonist, antagonist, synergist and fixator • sagittal, frontal and transverse
• concentric, eccentric and isometric muscle • identify the joint actions that take place
contractions in each plane.
• risk of increased blood pressure
with isometric contractions
• analyse a variety of exercises to identify
the roles of muscles and type of
contraction.
3.3 Describe joint structure

with regard to range of
movement and injury risk:
• identify the structure,

range of movement and
injury potential for the
major joints of the body.
3.5 Describe the 3.4 Describe joint

structure of the pelvic movement potential
girdle including associated and joint actions:
muscles and ligaments:
• identify the possible joint
• the bones of the pelvic girdle including the coxal bones actions for the major joints
and the sacrum of the body.
• the key ligaments of the pelvic girdle including the
sacroiliac and inguinal
• the structure and function of the sacroiliac joint
• the role of the pelvis in transferring forces and
maintaining spinal alignment
• form closure and force closure
• the difference between the male and female pelvis.
70

Section 4: Learning activity answers
Section 1
Learning activity 1.1 Learning activity 1.2
Which of the heart valves are the following

statements describing?
This valve is located between the left ventricle

and the aorta:
Aortic valve
Right
coronary This valve is located between the right ventricle
artery Left circumflex
artery and the pulmonary artery:
Pulmonary valve
Left anterior
descending This valve is located between the left atrium
artery
and the left ventricle:
Bicuspid valve
This valve is located between the right atrium

and the right ventricle:
Tricuspid valve.
Vena cava Right atrium Left atrium

Answers
Pulmonary vein
AV VALVES Tricuspid valve Bicuspid valve
Right ventricle Left ventricle
SEMILUNAR Pulmonary valve Aortic valve

VALVES
Pulmonary artery Aorta
71

Use the following terms to fill in the gaps Place the following changes that occur with
in the paragraph below: regular exercise into the correct column in the
table below:
AV node, left, ventricles, atria, right, SA node.
The electrical signal from the SA node initiates Decreased Increased

every heartbeat. It travels through the atria
• submaximal heart • heart muscle size
and causes them to contract, pushing the blood
rate (HR) • blood volume
through the open valves and into the ventricles.
• resting heart rate • stroke volume
The signal arrives at the AV node before being
(RHR)
released to the special fibres, which are specialised • cardiac output
cells located along the walls of the ventricles. The
• capillarisation
special fibres quickly carry the signal through the
• oxygen delivery
walls of the ventricles causing them to contract. It
takes just three one-hundredths of a second for the
special fibres to transmit the impulse to all of the
muscle fibres in the ventricles. The left ventricle
contracts slightly before the right ventricle.
Answer the following questions
1. A
therosclerosis is the thickening of the artery
walls and it can deprive parts of the body of
blood, oxygen and nutrients.
2. I f atherosclerosis affects the heart, it can cause
coronary heart disease if the main arteries to the
heart are narrowed. The most common result of
this is angina which causes pain on exertion.
3. If atherosclerosis affects the brain, it can lead
to a stroke. This is caused by a blockage of
the arteries in the brain or a rupture of the
diseased arteries.
4. If atherosclerosis affects the legs, it can cause
peripheral vascular disease.
72

Fill in the following table using your own words. Fill in the gaps.
1. In healthy adults, normal systolic BP ranges

Risks of CV exercise
from 110mmHg to 139mmHg.
Factor How does the risk increase?
2. Systolic BP normally levels off at 140mmHg
Cardiac There is a very small risk of an to 160mmHg during steady-state activity in
events individual having a heart attack healthy individuals.
or angina attack whilst they are
3. Normal diastolic BP in healthy adults ranges
exercising. The risk is higher for
from 60mmHg to 89mmHg.
individuals with existing heart
conditions. The risk of cardiac events 4. As exercise intensity increases, diastolic BP will
is smaller, however, for those who remain relatively unchanged and it may even
take part in regular exercise than it is decrease slightly.
for sedentary people. 5. Regular CV exercise performed over a
Injury People taking part in CV exercise are prolonged period of time can decrease both
at an increased risk of injury, simply systolic and diastolic BP.
because they are increasing the 6. The Valsalva manoeuvre involves exerting
amount of time when they are active. against a closed airway during exercise. It
However, a well-structured training is dangerous practise to use as it causes
programme can actually reduce a increases in heart rate and blood pressure. .
person’s risk of injury during sporting
and everyday activities, as it will
enhance their functional strength and
fitness. Older individuals can lower
their risk of falls by improving their
functional strength and balance.
Over- Excessive, chronic overload combined
reaching with inadequate recovery can lead
Answers
to fatigue, illness, injury and burn-
out or ‘over-reaching’. If a person is
constantly over-reaching, they may
become ‘over-trained’. Over-training
is the state where rest is no longer
adequate to result in recovery and it
takes a long period of rest in order to
recover from it.
73

Section 2
Stage 1: Calcium binds to troponin molecules on

Perimysium
Epimysium the tropomyosin strands and causes the binding
sites on the actin filaments to be unlocked and
exposed allowing myosin heads to attach. Energy
from ATP enables the myosin head to attach to
the exposed actin-binding site
Skeletal Stage 2: The power stroke or working stroke

(striated) occurs as the head of the myosin cross-bridge
muscle pivots and pulls the actin filament towards the
Endomysium Fascicle (bundle
of muscle fibres)
middle of the sarcomere
Stage 3: The head of the myosin cross-bridge
releases from the actin-binding site and more ATP
attaches to the myosin head
Stage 4: Energy from ATP is used to cock the
myosin head back to the original position ready
for the next power stroke.
Study the training adaptations for each type of resistance training and summarise
the differences in the table below:
Characteristic Endurance Hypertrophy Strength

Fibre cross-sectional area Type 1 increase Optimal Type 1 and 2
Type 2 decrease increase increase
Number and size of mitochondria Big increase Increase No increase
Creatine phosphate stores No increase Increase Big increase
Tolerance and removal Big improvement Improvement No improvement

of lactic acid
Glycogen stores Increase Increase Some increase
Aerobic pathway enzymes Increase Increase No increase
Creatine phosphate pathway No increase Increase Big increase
enzymes
Capillarisation Increase Small increase Negligible
Myoglobin Increase Small increase Negligible
74

Label the diagram below with the muscles identified on the anterior
muscle anatomy diagram:
Sternocleidomastoid
Pectoralis minor
Pectoralis major Deltoid
Biceps brachialis Serratus anterior

Brachialis Rectus abdominus
Brachioradialis External oblique
Transversus abdominis Internal oblique

(deep) (deep)
Iliopsoas
(deep)
Tensor
fasciae
latae
Rectus femoris Adductor longus
Vastus lateralis
Sartorius
Vastus intermedius
Answers
(sits underneath rectus
femoris) Gracilis
Gastrocnemius
Vastus medalis
Tibialis anterior
75

Label the diagram below with the muscles identified on the

posterior muscle anatomy diagram:
Sternocleidomastoid Trapezius
Sitting underneath:
Rhomboid major
Levator scapulae (deep) Rhomboid minor
Deltoid
Rotator cuff (deep): Teres major

Supraspinatus
Infraspinatus
Teres minor
Subscapularis Latissimus dorsi
Multifidus (deep, runs up Triceps brachii

entire length of spine)
Erector spinae Gluteus medius

Iliocostalis Gluteus minimus
Spinalis
Longissimus Piriformis
(run up entire length
of spine) Gluteus maximus
Quadratus Lumborum
Adductor magnus
Iliotibial band
Biceps femoris
Semitendinosus
Semimembranosus
Gastrocnemius
Soleus Calcaneal (achilles) tendon
76


Study the previous table of muscle locations and functions and fill in the blanks in the table below.
Muscle Origin and insertion
Pectoralis Origin: Clavicle, sternum, ribs 1 to 6
major
Insertion: Humerus
Joint actions: Horizontal flexion, adduction and internal rotation of the humerus
Trapezius Origin: Occipital bone of skull, cervical and thoracic vertebrae
Insertion: Clavicle and spine of scapulae
Joint actions: Stabilises scapulae, elevation, rotation and retraction of scapulae
Deltoids Origin: Clavicle and scapula
Insertion: Humerus (lateral)
Joint actions: Anterior head: flexion, horizontal flexion, internal rotation
and abduction of humerus
Abduction of humerus
Posterior head: extension, horizontal extension, external rotation
abduction of humerus
Rectus femoris Origin: Ilium (anterior)
Insertion: Tibia via patella tendon
Joint actions: Hip flexion and knee extension
Gluteus Origin: Medial iliac crest and sacrum
maximus
Insertion: Ilio-tibial ban and laterally on femur
Joint actions: Hip extension and lateral rotation of hip
Gastrocnemius Origin: Upper surface of ilium
Insertion: Laterally on femur
Answers
Joint actions: A
nterior fibres: Flexion and internal rotation of hip.
Posterior fibres: Abduction and external rotation of hip
77

78
Identify the joint/joints involved, joint actions in the concentric and eccentric phases, agonists and
antagonists, synergists and fixators, and planes of movement for the exercise examples given below:
Section 3
Exercise Joint/ Joint actions Joint Agonist Antagonist Synergist Fixator Plane of
joints (concentric actions movement
phase) (eccentric
phase)
Biceps Elbow Flexion Extension Biceps (brachii and Triceps brachii Brachoradialis Transversus Sagittal
curl brachialis) abdominis
L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 78

Rotator cuff
Deltoids
Latissimus
dorsi
Leg Knee Extension Flexion Quadriceps: Hamstrings: None Transversus Sagittal

extension abdominis
Rectus femoris, Semitendinosus
Vastus lateralis, Semimembranosus Abductors
Vastus medialis Biceps femoris and
Vastus intermedius adductors
Lat pull- Shoulder Adduction Abduction Latissimus dorsi Deltoids Biceps Transversus Frontal
down abdominis
Rotator cuff
Lat pull- Elbow Flexion Extension Trapezius
down
Rhomboids
Chest Shoulder Horizontal Horizontal Pectalis major Trapezius Biceps brachii Transversus Transverse
press flexion extension abdominis
Rhomboids Anterior
Chest Elbow Extension Flexion deltoids Rotator cuff
press
08/03/2012 16:04
Match the characteristics to the correct joint:
Shoulder A ball-and-socket joint with a large range of movement which is prone to dislocation
Shoulder The supporting muscles of this structure are more at risk of injury than
girdle the joints themselves
Elbow A hinge joint with a bony structure that prevents hyperextension
Lumbar spine Has large intervertebral discs that carry the full weight of the upper body
Now attempt the same by drawing a line between the following joints and joint characteristics
Sacroiliac Can be damaged by high forces if heavy loads are carried unevenly through the spine
Wear and tear from uneven forces on the head of the femur increase the risk
Hip
of osteoarthritis occurring in this joint
Knee One of the least stable synovial joints n terms of structure
Ankle Commonly prone to ligament damage by twisting or rolling over
Label the diagram of the pelvis: Now complete the table below to show the
difference between the male and female pelvis:
Area of the Differences between male

Ilium pelvis and female pelvis
Shape and size of Larger in females and more
the pelvis bowl oval in shape
Angle of the More vertical in males.
pelvis Anteriorly tilted in females
Answers
SI joint
Angle of the Near vertical in males.
acetabulum Posteriorly tilted in females
The Q-angle and The Q-angle and the
Sacrum the associated
associated higher risk of injury
Ischium Pubic bone higher risk of
injury in females in females – Small Q-angle
in males allowing efficient
transfer of force between hip
and knee reducing stress on
the knee joint. Larger Q-angle
in females increasing the risk
of injury due to less efficient
biomechanics
79

80

81

Lifetime
Clifton Heights
Triangle West
LHF11-314 MAR12
Bristol
BS8 1EJ
e: info@lifetimetraining.co.uk
w: www.lifetimetraining.co.uk

L3 Anatomy and Physiology Learner Workbook 1A Mar12

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

L3 Anatomy and Physiology Learner Workbook 1A Mar12

Uploaded by

Copyright:

Available Formats

Personal Trainer Workbook 1A

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 1 08/03/2012 16:02

These workbooks have been designed Workbook 1A

Section 5 Posture and core stability 83

Section 6 Stretching and flexibility 95

Section 7 The nervous system 103

Section 8 The endocrine system 117

Section 9 Energy systems 133

Section 10 Learning activity answers 143

Section 11 References and recommended reading 149

The following colours are used in this workbook:

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 2 16/03/2012 12:05

Section 1: The circulatory system

FFdescribe coronary circulation

FFexplain the function of the heart valves

FFexplain the electrical control of the heart beat

FFdescribe the effects of disease on the structure

Coronary arteries Figure 1.1 The coronary arteries

There are two main coronary arteries which deliver oxygenated

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 1 08/03/2012 16:02

Learning activity 1.1

Left anterior descending artery

The coronary arteries supply blood to the network of

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 2 08/03/2012 16:02

The function of the heart valves

The flow of blood through the heart

To understand the function of the valves, it is easiest

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 3 08/03/2012 16:02

Learning activity 1.2

Learning activity 1.3

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 4 08/03/2012 16:02

Control of the heart beat

The atrio-ventricular (AV) node is the secondary pacemaker

Figure 1.4 The electrical signal travelling through

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 5 08/03/2012 16:02

Learning activity 1.4

1. The AV node is found between the

2. The carry the signal to the apex contract

5. The is the secondary pacemaker Purkinje fibres

The electrocardiogram (ECG) trace

• the P-wave: this is the electrical signal that spreads

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 6 08/03/2012 16:02

Disease and the blood vessels

Risk factors that can accelerate the process of atherosclerosis include:

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 7 08/03/2012 16:02

The impact of atherosclerosis

Atherosclerosis in the arteries that

Angina is the most A stroke is the loss of brain

The main symptom of

A heart attack or myocardial The legs

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 8 08/03/2012 16:02

Benefits and risks of cardiovascular training

These adaptations combine to produce an increase in the

Resting heart rate (RHR)

Due to the increase in stroke volume, a person’s resting heart

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 9 08/03/2012 16:02

Heart muscle size

Regular cardiovascular exercise will increase the size, mass

Plasma volume can increase by up to 20 per cent after six

Learning activity 1.5

L3 Workbook 1A PT Anatomy and Physiology for Exercise ART.indd 10 08/03/2012 16:02

Increased stroke volume

Increased cardiac output

As a result of the stronger heart muscle more blood can be

6. The involves exerting against a closed airway during exercise. It is