Chapter 2 (Support and Movement) ProF:SM Khan

• Support: support in living organisms is necessary uphold and sustain the body
against gravity
• As the living organisms have been increased in size through the process of
evolution, the need for support became greater
• This was particularly true once living organisms left water and colonize land
• The skeleton in animals contributes to this support
• Movement:- movement means the movement of a particular body part
• For example:- shaking of your hands
• Locomotion:- locomotion means the movement of whole organisms from one
place to another in search of food-protection-reproduction etc
 Human skeleton
• The skeleton acts as frame work of the body
• It is inside the body so it is called endoskeleton
• Human endoskeleton comprises of bones and cartilages
• This skeleton provides shape of the body
• Makes blood cells through their red bone marrow(hip bone-skull-ribs-breast
bone-femur bone-humrus etc
• Protection of internal organs
• Store minerals(calcium-phosphate)
• Osteology:- science deals with the study of human bones is called osteology
• Bones and muscles are attached to form a musculoskeletal system
• Human have around 300 bones at birth but due to fusion of some bones it
becomes 206 bones
 Structure of bone
• Bones are toughest living structure
• Composed of different cells(osteocytes-osteoblasts-osteoclasts)
• Bones of skeletal system differ in size and shape but are similar in structure-
development and function
• Major proportion of the bone is formed by collagen fibers and different types of
cells-minerals and 10-20% water
• Collagen is fibrous protein which make the bones,
• Ossification, process of making of bones, calcification(deposition of calcium)
• A long bone has three distinct regions
• Terminal regions are called epiphysis, middle region is called diaphysis and in
between middle and terminal region is called metaphysis at both ends
• Epiphysis is a cancellous or spongy part of bone, having red bone marrow to
make RBC-WBC-platelets
• Periosteum:- overall covering of the bone is called periosteum, it allows for
attachement of muscle connective tissue/tendons to the bone and provide pathways
for blood and lymphatic vessels
• Endosteum:-inner layer is called endosteum, it is soft-thin layer and lines the inner
cavity of long bones, it has progenitor stem cells
• These osteogenic progenitor cells develop into osteoblast and chondroblast which
secrets the bone matrix
• It plays key role in the healing of fractures by creating new cells necessary for the bone
to fuse
• Epiphyseal line:- growth line-epiphyseal plate, marks the point of fusion between the
epiphysis and metaphysis
• Medullary cavity: central cavity of bone shafts where yellow bone marrow is stored,
also called marrow cavity, store fats/adipose tissue
• Red bone marrow:-it produces RBC-WBC-platelets
• Compact bone:- cortical bone-hard-dense outer layer of bones
• Spongy bone/cancellous bone/trabecular bone:- having red bone marrow
 Cancellous /spongy bone
• Cancellous tissue also known as cancellous bone/spongy bone or trabecular bone
• Trabeculae are thin columns and plates of bones
• Characterized by its spongy , porous, honey comb like structure
• Typically found at the ends of long bones(epiphysis)..it is 20% of total mass of skel
 Cortical bone/compact bone
• Cortical bone is dense and solid and surrounds the marrow space
• External part of the diaphysis is called cortical bone
• Cortical bone forms 80% of the skeletal structure
• It is consists of many small cylinders called osteons
• Each osteon is made of many lamellae, made up of organic part
collagen(protein) and inorganic part called hydroxyapatite(calcium & phosphate)
• In the center of every osteon is a haversian canal, contains blood vessels
• In the center of the bone is the medullary canal , contain bone marrow which is
the site of blood cell production
• Red bone marrow produces RBC-
WBC-Platelets etc
Yellow bone marrow deposits fats
Through the help of adipose tissues
 cartilages
• Cartilage is a soft flexible form of connective tissue
• Surrounded by a layer called perichondrium
• Cartilage is present in joints to provide cushion, reduce friction between bones
• Cartilage gets nutrition from their surrounding tissues by diffusion
• They lack blood vessels
• They grow and repair slower than other tissues
• Formation of cartilages is initiated by chondroblast cells
• They are concentrated in lacunae in the cartilage
• Produce firm matrix that contain collagen protein,proteoglycan(chondroitin
sulphate and protein/glycosamine) and some other non-collagenous proteins like
albumin protein, to develop cartilage
Structure of cartilage
 Types of cartilages
• Three types of cartilages
• 1. Hyaline cartilage:- present between ribs and sternum(coastal cartilages)-at
the bone surface in many joints(articular cartilage), has smooth surface , for
slippery movement---as well as at nose tip
• 2. Fibrocartilage:- found in the disks located between the vertebrae , cartilage
of knee.--pectoral girdle-pelvic girdle—hardest cartilages
• 3. Elastic cartilage :- most flexible and strong-found in the ear flaps and
epiglottis, larynx—-trachea
 Support and movement
Bone and cartilages
Human skeletal system consists of bones and cartilages.The study of bones and cartilages is
osteology
Coxal bone/hip bones
 Joints
• It is combination of 2 or more bones
• There are approximately 360 joints in our body
• Ligament is connective tissue which binds the bones with each other
• Joints are classified by the type of tissues that bind the bone at each junction
• The major groups of joints are
• 1. fibrous joints 2. cartilaginous joints 3. synovial joints
• Fibrous joints:-These joints hold the bone by dense connective tissue containing
collagenous fibers as in cranium/suture(between bones of skull)---between
radius and ulna------between tibia and fibula-------between teeth and alveolar
bone, these are immoveable joints/fixed joints
• Cartilage joints:- joints which join two bones articulated by hyaline or
fibrocartilage as in ribs-vertebral column/intervertebral disc-symphysis pubis
• These are partially/slowly moveable joints
Fibrous joints
Cartilaginous joint
Cartilaginous joint
 Synovial joints(Diarthroses joints)/freely moveable
• In these joints ends of the bones are enclosed in a capsule containing a thick,slippery
liquid called synovial fluid
This fluid is complex mixture of polysaccharides,proteins,and fats
These are freely moveable joints
• A. Ball and socket joints eg: shoulder-pelvis(move in all directions)
• B. Hinge joints eg:- elbow(Between humerus and ulna bones),allowing flexion and
extention in just one plane, also in phallanges)—knee joint(femur+tibia)
• C. Pivot joint eg:- radio-ulnar joint, allows twisting movement---b/w C1 and C2
vertebrae of vertebral column
• D. Gliding joints/plane joint eg: vertebrae/vertebral column-wrist(bending and
slipping one bone over to another--------clavicle+scapula joint
• E condyloid joint:- wrist joint,between radius and carpals, movement in all
directions
• F. Saddle joints:- between 1st metacarpal of thumb and carpal(trapezium)
• G Ellipsoidal joint:_ metacarpophalangeal and metatarsophalangeal joints
• H .Carpo-metacarpal joints:- between carpals and metacarpals…type of synovial
joint
Hinge joint
Ball and socket joint
Condyloid joint
Plane joint/move in many planes/gliding joint
YES and NO joint
 Disc slip
• Displacement of inter-vertebral disc is called disc slip
• Each disc has two parts- a soft, gelatinous inner portion(nucleus pulposus) and a tough
outer ring(annulus fibrosus)
• Causes:-a slipped disc occurs when the outer ring becomes weak or torn allows the
inner portion to slip out
• This is known as a slipped or herniated disc
• Lifting a very large and heavy object can place great strain on lower back
• Overweight individual are also at
Increased risk for a slipped disc
Injuries, falls ,accidents can cause
Disc slips
Some exercises may cause disc slip
• Like yoga
• Aging may causes the disc slip
 Disorders of skeleton
• Spondylosis:- spondylosis refers to degenerative changes in the intervertebral
discs, narrowing the space between two vertebrae,
• These changes may develop abnormal outgrowth(spur)
• the term can be used to describe degeneration in the
• Neck , called cervical spondylosis
• Lower back lumbar spondylosis
• Middle back called thoracic spondylosis
• Causes;- aging , your disc might develop cracks as you get older
• wear and tear of cartilage and bones of cervical spine (cervical spondylosis)
• Symptoms:- pain-numbness( sensation like burning-pins and needles feeling and
tingling(prickles or stings a tiny bite sensation)
spondylosis
 sciatica
• Sciatica refers to pain,weakness, numbness, in the leg
• Sciatica is nerve pain from irritation of the sciatic nerve
• The sciatica nerve is the largest nerve in the body
• Sciatica nerve that starts in the lower back and runs through the hip region and
down the lower limb
• Sciatica pain is typically felt from the low back to behind the thigh and radiating
down below the knee
• Causes:- sciatica occurs when there is pressure or damage to the sciatica nerve
• Lifting some thing heavy or moving quickly
• Sciatica nerve injury from intramuscular injection/IM injection
• Lumbar herniated disc:-(soft inner core of disc/nucleus pulposus) leaks out
through the annulus at lumbar region, spinal nerves are irritated
• Degenerative disc disease:-occurs with aging, lower back region
 Arthritis(Inflammation of joints)/pain in joints
• Arthritis is inflammation of one or more of your joints
• Main symptoms of arthritis are joint pain and stiffness
• Causes of arthritis are:- genetic cause-injury-infection-autoimmune diseases
• Types of arthritis:- osteoarthritis-ankylosing spondylitis-Gouty arthritis-
Rheumatoid arthritis
• Osteoarthritis:- also known as degenerative arthritis
• It is age related joint disease that result from breakdown of cartilage and
underlying bone-cartilage is shock absorber-bones rub together-pain occurs
• Ankylosing spondylitis arthritis:- genetic disorder(due to gene)--
it is arthritis of spine(usually lower back), cause inflammation in the joints and
ligaments of the spine—(hip—knee-ankle joints affected-pain during breathing)
• Gout arthritis:-it is due to deposition of uric acid(hyperuricemia) in joints
• Rheumatoid arthritis:-it is due to attack of immune system on joints, due to viral
or bacterial infection
 Repair of simple fractures
• Fractured or broken bones undergoes repair through four stages
• A. Hematoma stage/clot stage:- when fracture occurs,blood escape from blood vessels and it is
accumulated into the surroundings which form a clot called hematoma

• Immune system activates and induces swelling at the site of injury

• Sensation of pain occurs—bone cells begin to die---hematoma sealed the fracture
• B. fibrocartilaginous soft callus formation:- within weeks new blood vessels formed numerous
osteoblasts and fibroblast enter the hematoma
• Osteoblast quickly divides and gives rise to the spongy bone

• These osteoblasts in conjunction with fibroblast cells secrete a porous mass of bones called callus
(mass of undifferentiated cells), surrounding the break

• The callus replaces the original blood clot and hold the ends of bone together
• This process takes 3-4 weeks

• dead cells are phagocytosed by macrophages

 Types of bone fracture
• Bone fracture:- a fracture is the medical term for a broken bone
• Three types of fracture simple fracture-compound fracture-complicated fracture
• Simple fracture:- also called closed fracture in which bone is cracked but does not break
the skin and not exposed
• Compound fracture:- complete breaking of bone and piece of bone is visibly piercing
outside the skin……open fracture
• Complicated fracture:-when the
Fracture damages the surrounding
Structures including organs,veins,
Arteries or nerves, it is called
Complicated fracture
Symptoms of fracture include, pain
Inflammation-immobility- discoloration
Of skin at the point of injury
 Repair of broken/fractured bone
• Fractured or broken bone undergoes repair through four stages
• 1.Hematoma formation- 2. soft callus formation- 3. bony/hard callus formation-
4. remodeling
• 1. Hematoma formation/clot stage :-
• When a bone break, blood vessels in the bone and surrounding tissues are torn
• Hemorrhage occurs(escape of blood through blood vessels)
• As a result, a hematoma,a mass of clotted blood,forms at the fractured site,
which sealed the fracture
• Soon,bone cells deprived of nutrition die
• Immune system activated
• Tissues at the site becomes swollen,painful and inflammed
• Pain receptors(nociceptors) are activated
• It occurs within one week
2..Fibrocartilaginous callus formation/soft callus formation
• Within a weeks,several events takes place
• Formation of soft granulation tissue(fibroblast cells-osteoblast-endothelial cells-
phagocytic cells),also called the soft callus
• Capillaries grow into hematoma with the help of endothelial cells
• Phagocytic cells invade the area and begin cleaning up the debris
• fibroblast and osteoblast invade the fracture site and begin reconstructing bone
• Fibroblast produce collagen fibers that span the break and connect the broken
bone ends
• Some fibroblast differentiate into chondroblasts that secrete cartilage matrix
• Within this mass of repair tissue,Osteoblasts begin forming spongy bone
• This entire mass of repair tissue, now called the fibrocartilaginous callus
• This process takes 3 to 4 weeks
• 3 Bony callus formation:- soft callus is calcified and turned into hard bony callus
• Bony callus formation progress it is replaced with bone
• Hard callus formation is initiated around three weeks
• It is continued for three months
• osteoblast makes osteocytes
• These osteocytes make the soft callus into hard callus
• 4. remodeling:- it is the stage when old bone tissues are removed and replaced
with new ones
• Osteoclast cells resorb old bones/broken bones
• Osteoblast cells detect the fracture and induces monocytes to fuse together to
form a multinucleated osteoclast cells
• Fractured is healed, compact bone is formed
• This process can take many months(4-12 months)
 Dislocation of joints
• A dislocated joint is a joint that slips out of place
• It occurs when the ends of bones are forced from their normal position
• A severe dislocation can cause tearing of the muscles, ligaments and tendons that
support the joint
• Symptoms including, swelling,intense of pain and immobility of joint
• Most common causes are fall,other trauma to the joint
• Rheumatoid arthritis can also cause joint dislocation
• A trained medical profession can repair the dislocated joint
 sprain
• A sprain is an injury to a ligament
• Commonly injured ligaments are in the ankle, knee and wrist
• The ligaments can be injured by being stretched too far from their normal
position
• The sprain should be rested
• Sprains can be usually treated through icing and physical therapy
• Dressings,bandages or ice-wraps should be used to immobilize the sprain and
provide support------some time surgery is needed
 Muscles
• Muscles are special types of tissues which have ability to contract and relax
• They produce movement and locomotion in various parts of the body
• Muscles facilitate the movement of the body fluid, particularly lymph-blood etc
• 50% of our body weight is because of muscles
• In our body total number muscles is more than 600( approximately 640)
• There are three types of muscles in human body
• Skeletal muscles
• Smooth muscles
• Cardiac muscles
 Smooth muscles
• Smooth muscles do not show striation hence called smooth muscles
• These are present in hollow visceral organs like urinary bladder-respiratory tract-
blood vessels-reproductive system – Digestive system etc
• Smooth muscle cells are spindle shaped having single nucleus
• Instead of troponin, they contain calmodulin protein in actin filaments
• They are involuntary i-e controlled by autonomic nervous system
 Cardiac muscles
• They are located only in heart wall
• These muscles are striated in structure but involuntary in function
• These muscles are branched-bifurcated-contain single or double nucleus in each
cell.They have numerous mitochondria and continuous supply of blood
• Intercalated disc:- cardiac muscle cells are interconnected by a specialized
structure called intercalated disc
• Syncytium:-cardiac muscles are arranged in a branching network where cells are
joined together and make a syncytium(cardiac syncytium is a network of
cardiomyocytes.These are strongest muscles.work continuously but never fatigue

•
 Skeletal muscles
• Muscles attached with skeleton are called skeletal muscles
• Cells of skeletal muscles are striated-cylindrical-multinucleated
• These are located in those organs which can perform voluntary movement like
arms-legs-neck etc
• They are arranged in bundles
•
 Structure of skeletal muscle
• Muscle is composed of thousands of muscle fiber/muscle cells/myofiber
• Muscle fibers are grouped in bundles
• Overall muscle organ is surrounded by connective tissue sheath called epimysium
• Muscle fiber gathered inside the epimysium in many groups
• Each group of fibers is called a fascicle
• Fascicles are surrounded by perimysium
• Inside each fascicle , a muscle fiber is enveloped by a thin connective tissue(layer
of collagen) called endomysium
Muscles(structure of skeletal muscle)
 Ultra structure of skeletal muscle fiber/cell
• Muscle fiber is considered a cell of skeletal muscle with many myofibrils
• Each muscle fiber is surrounded by cell membrane called sarcolemma
• The cytoplasm or sarcoplasm contains numerous nuclei and mitochondria
• Each myofiber is connected with the axon of motor neuron at a place called
neuromuscular junction
• Sarcolemma is extensively folded as motor end plate
• Within the sarcoplasm, membranous network is present called sarcoplasmic
reticulum/ER, which store calcium ions used for muscle contraction
• sarcolemma extends inward to form a membranous channel called T-tubule
that runs perpendicular and connected with sarcoplasmic reticulum
 sarcomere
• Sarcomere is basic unit of striated muscle
• Sarcomere is the distance between two z-lines
• The functional unit of contraction is in skeletal muscle fiber is the sarcomere,
• A sarcomere is broken down into a number of sections
• I-band-(isotropic) contains only thin filaments/actin filaments, light pass
• A-band:- (Anisotropic) contains thick filaments/myosin filaments, light can not
pass, it includes some parts of thin filament also
• Z-line:- (zwischen means middle) where the actin filaments are anchored
• H-zone:- (Hellel means bright):- contains only myosin filaments
• M-line/disc:- middle disc/middle plate, made up of myomesin protein) where
myosin filaments are anchored/attached with each other
Structure of skeletal muscles
Sarcomere/contractile unit/functional unit of skeletal
muscle(Space between two Z-lines called sarcomere)
 Myofibril and myofilament
• Myofibril are bundles of very fine fibers that almost fill the sarcoplasm of a
muscle cell
• Myofilaments are ultramicroscopic , thread like structures found in myofibrils
• In other words , the myofilaments are bundled together to make a myofibril
• 1. thick myofilaments/myosin filaments, made up of myosin protein, 16nm
diameter,composed of myosin monomers(head-stalk-hinge), two twisted strands
• Head outward which form cross link with actin filament
• 2. thin myofilaments/ actin filaments/ made up of actin protein, 7-8 nm
diameter., double stranded, twisted and contains actin monomers associated
with two other proteins called troponin and tropomyosin
• Troponin is a complex of three different subunits called troponin C-I and T
• Troponin C(Tn-C) bind calcium, the troponin I(Tn-I) inhibit actomyosin interaction
• Troponin T(Tn-T) is used for binding tropomyosin
 Sliding filament model of muscle contraction
• The sliding filament model of muscle contraction, put forward by Hugh Huxley
and Jean Hanson in 1954
• According to this theory when sarcomere shortens, the thick and thin filaments
do not themselves change their length , they just slide past one another
• Thin filaments moving toward the center of sarcomere from both ends
• H-zone and I-bands
Get narrower.
The Z-lines move
Closer together
Shortening the
sarcomere
 Muscle fatigue/pain in muscles/tired muscles
• If muscles/skeletal exercised persistently for a longer period may lost its ability to
contract, a condition is called fatigue
• It occurs due to accumulation of lactic acid in the muscles due to anaerobic ATP
production
• The lowered PH (increase acidity)from lactic acid , causes the muscles to contract
less
• When lactic acid is produced it diffuses out from the muscle fibers and is carried
in the blood stream to liver
• Liver cells change lactic acid into glucose
• This requires ATP
• When a person rests and requires enough oxygen,(condition basis)
• Lactic acid quickly breaks down and the muscles return to normal
Control of muscle contraction
The contraction of a muscle depends upon three factors
1. Nerve impulse 2. calcium ions 3. ATP
 The cross bridge cycle
• The cycle begins when muscle fibers are stimulated by receiving the nerve
impulse at the motor end plate
• Motor neurons release a neurotransmitter acetylcholine that opens the proteinic
gateway in T-tubules and then in sarcoplasmic reticulum to release the stored
calcium ions that initiate muscle contraction
• The calcium ions are released and bind with the troponin of thin filament
• This binding depolarizes tropomyosin along the actin filament and exposes the
myosin binding sites located on actin monomers
• In the next step the myosin head rises by getting energy from ATP, when bind ATP
is hydrolyzed into ADP and phosphate by an enzyme ATPase
• This causes the myosin head to extend and attach to the bind site of an actin
• Actin and myosin filaments are crossed linked to form a cross bridge
• This action is called power stroke, which allowing myosin to pull the actin
filament toward the M-line, thereby shortening the sarcomere
• The myosin remains attached to the actin until new ATP binds freeing the myosin
 Relaxation
• When nerve impulse ceases, two events relax the muscle fiber
• During the first event the acetylcholine that remains in the synapse is rapidly
decomposed by an enzyme called acetylcholine-esterase
• This enzyme is present in synapse and on the membrane of the motor end plate
• The action of acetylcholine-esterase prevents the nerve impulse.
• In the second step, when acetylcholine broken down, the stimulus to the
sarcolemma within muscle fibers ceases
• The calcium pump(requires ATP) quickly moves calcium ions back into the
sarcoplasmic reticulum, decreasing the calcium ion concentration of the cytosol
• Consequently , the muscle fiber relaxes
Antagonistic muscles in the movement of knee joints
• Ability of a muscle to oppose the action or effect of another muscle is called
antagonstism
• An antagonsitic muscle is relaxed while the other side opposite to antagonist
muscle contracted called agonistic muscle
• Muscle which bring about a movement to complete a task is called agonistic
muscle
• Muscle that opposes the action of agonistic muscle is called antagonistic muscle
• Knee joint is the largest and the most complex of the synovial joints
• It is formed by articulation of distal end of femur and proximal end of tibia bone
• Anterior to the junction of these bones, patella bone is articulated
• antagonistic muscles(agonistic) of the knee joint are the group of hamstring
muscles as flexor muscles and the group of quadriceps muscles as extensor
muscles
 Hamstring muscles and quadricep muscles
• Hamstring muscles are made up of three individual muscles
• Located in the back of the thigh, originating from hip and inserting to knee
• Hamstring tendons attach to bones in pelvis,knee and lower leg
• They bending the knee joint, extending hip joint
• Quadricep muscles:- made up of four different muscles
• It is in the anterior region of the thigh
• Quadricep is knee extensor----hip flexor
• Most powerful muscles in the body
• Active in kicking-jumping-cycling-running
Hamstring muscles
quadriceps
 Cramps/muscle pull
• Commonly called muscle pull
• Muscle cramp is painful stiffness in a muscle, due to sudden involuntary
contraction
• A person feels sudden tightening of muscles
• It lasts for just few seconds or several hours
• Causing the muscle to become taut/tightly drawn) and painful
• Most common in thigh and hip muscles
• It usually occurs after exercise
• It is due to low blood sugar level, dehydration and electrolyte imbalance
• Low blood supply to the legs during physical activities
• Cramps can relief by stretching or gently massaging the muscle, applying heat
• Getting more fluid
 Tetany
• Tetany:- /tetanic seizures;- Involuntary contraction of muscles
• Caused by disorders that increase the action potential frequency of muscle cells
• Tetany can be result of an electrolyte imbalance
• Most often low calcium level/hypocalcemia, or megnesiun/hypomagnesemia,
potassium(hypokalemia) deficiency
• Increased acidic(acidosis) or alkali(alkalosis) in the body
• No toxin involve
• Severe vitamin D deficiency may be associated with hypocalcemia, may cause
tetany
• Common symptoms of tetany include numbness around the mouth,muscle
cramps and paresthesiasis affecting the hands and feet
• A person may only die if tetany occurs in respiratory tract
tatany
 tetanus
• Tetanus is infectious disease affecting central nervous system
• Painful muscle contraction occurs, also called lockjaw
• Caused by bacterium(Clostridium tetani)
• Tetanus can be caused by intravenous drugs inducted through contaminated
needles by the abusers
• Bacterium release neurotoxin called tetanospasmin
• This toxin acts on the synapses also
• Cause muscular spasms and neuromuscular junction blockage
• May cause flexor muscle spasm
• The impact of the toxin on the sympathetic nervous system causes autonomic
dysfunction
• A person may die when the infection becomes severe
• it may control through vaccination
• Treated through antibiotics