Generation of heat

Heat generation is vital in maintaining normal body temperature, and skeletal muscles, which
account for 40% of the body’s mass, are the muscle type mostly responsible for the body’s heat
generation. During muscle contraction, adenosine triphosphate (ATP) is used to release the
needed energy, with nearly three‐quarters of its energy escaping as heat.
Composition of skeletal muscle tissue
As muscles contain other types of tissues, such as blood vessels and connective and nervous
tissue, they are considered to be organs (Logenbaker, 2013). Each cell in skeletal muscle tissue
is known as a single muscle fibre, which, owing to its large size, contains hundreds of nuclei
(i.e. are multinucleate). A skeletal muscle consists of individual muscle fibres that are markedly
different from a ‘typical’ cell (not least by their size) bundled into fascicles and surrounded by
three layers of connective tissue.
Gross anatomy of skeletal muscles
Muscle is separated from skin by the hypodermis, which consists of adipose tissue (which
provides insulation and protects the muscle from physical damage) and a dense, broad band of
connective tissue known as fascia, which supports and surrounds muscle tissue and provides a

pathway for nerves and the lymphatic and blood vessels to enter and exit a muscle. Extending
from the fascia are three layers of connective tissue that also play a role in supporting and
protecting the muscle and are necessary to ensure that the force of contraction from each muscle
cell is transmitted to its points of attachment to the skeleton (see Figure 6.1). These include:
•• the epimysium, which is wrapped around the entire muscle;
•• the perimysium, which surrounds bundles of muscle fibres known as fascicles;
•• the endomysium, which is wrapped around each individual muscle cell.
The epimysium, perimysium and endomysium blend into either strong, cord‐like tendons or
into sheet‐like aponeuroses that attach muscles indirectly to bones, cartilages or connective
tissue (Marieb, 2013).
Clinical considerations
Intramuscular injection
An intramuscular (IM) injection is given directly into a selected muscle, and while there are
several sites on the body that are suitable for IM injections, the most common areas used are:
• the deltoid muscle of the upper arm;
• the vastus lateralis muscle, which forms part of the quadriceps muscle group of the upper
leg;
• the gluteus medius (ventrogluteal site) muscle, which runs beneath the gluteus maximus
from the ilium to the femur.
IM injections are used for the delivery of certain drugs that (for various reasons) cannot be
given via an oral, intravenous or subcutaneous route. The IM route enables a large amount
(up to 5 mL) of drug to be introduced at one time, minimises tissue irritation and provides a
faster route than subcutaneous/intradermal injections.
Microanatomy of skeletal muscle fibre
When examined microscopically, skeletal muscle cells appear cylindrical in shape, have a
distinctive banded appearance of alternate light and dark stripes and lie parallel to each other
(see Figure 6.2). Table 6.2 provides a summary of the cellular components of a muscle fibre.
The sarcolemma and transverse tubules
Each muscle fibre is covered by a plasma membrane called the sarcolemma and cylindrical
structures called myofibrils that are suspended inside the muscle fibre in a matrix called the
sarcoplasm (cytoplasm), which extends along the entire length of the muscle fibre. The urface
of the sarcolemma is scattered with openings that lead into a network of narrow tubules
called transverse or ‘T’ tubules that are filled with extracellular fluid and form passageways
though the muscle fibre (Martini and Bartholomew, 2012).
The sarcoplasm
The sarcoplasm contains multiple mitochondria, which produce large amounts of ATP during
muscle contraction (Tortora and Derrickson, 2012) and it is here that the T tubules make
contact with a membrane known as the sarcoplasmic reticulum (SR). The SR stores calcium
ions (essential for muscle contraction) in structures called cisternae and myoglobin (a
reddish‐brown pigment that is similar to haemoglobin), which stores oxygen until needed to
generate ATP.