THE

MUSCULOSKELETAL
SYSTEM
 PLAN
1. THE SKELETAL SYSTEM
• BONE HISTOLOGY, TYPES STRUCTURE AND GROWTH
• AXIAL AND APPENDICULAR SKELETON
• JOINTS TYPES AND FUNCTIONS
2. THE MUSCULAR SYSTEM
• MUSCLE HISTOLOGY, TYPES AND STRUCTURE
• MUSCLE CONTRACTION MECHANISMS
3. PATHOLOGIES OF THE MUSCULOSKELETAL
SYSTEM
 THE
SKELETAL
SYSTEM
INTRODUCTION
The skeleton
- A network of bone connected through articulations and supported by muscles
- Its functions include support, protection, mineral homeostasis, movement, blood
cell production, storage of energy.

Bone
-
 BONE HISTOLOGY
The cells consist of:
1. Osteoprogenitor cells from mesoderm of the embryonic disc.
2. Osteoblasts: bone forming cells
3. Osteoclasts: bone resolving cells
4.Osteocytes: mature bone cells.
The matrix comprises mineral salts and collagen Type I fibres.
the main salt is hydroxyapatite (Ca10(PO4)6(OH)2)
Other specific proteins include: osteoponctin and osteonectin.
COMPACT BONE
Surrounds the spongy bone and consists of Osteons (harversian system)
An osteon is cylinder, possessing an innermost harversian canal, an endosteum and
transverse Volkmann canals.
Bone lamellae are concentrically arranged around the major canal.
SPONGY BONE
Softer and more porous, it is tissue made of trabeculae
and surrounding red bone marrow
It functions mainly in the storage of this marrow.
BONE FORMATION/ OSSIFICATION
It begins during the 6th-7th week of intrauterine life
where mesenchyma cells of transform into
osteoprogenitor cells which undergo differentiation
to give osteoblasts and eventually osteocytes. This
process continues throughout adulthood.
Two types exist: Intramembranous and
endochondral ossification.
A.) INTRAMEMBRANOUS OSSIFICATION

Also called direct ossification.

Occurs within condensations(membranes) of embryonic mesenchymal tissue.
Here, osteoblasts secrete bone matrix and collagen fibers forming primitive bone
called the Osteoid.
Maturation of the osteoid (calcification) leads to encapsulation of osteoblasts
forming osteocytes.
Usually occurs in flat bones resulting in 2 compact bone layers sandwiching a
spongy or cancellous bone layer known as Diploe.
B.) ENDOCHONDRAL OSSIFICATION

Also called indirect ossification

Occurs within hyaline cartilage with the model of the bone to be formed
Made of 3 main steps:
1. Hypertrophy of the chondrocytes
2. Destruction of the chondrocytes
3. Invasion of spaces by osteogenic precursors (osteoprogenitor cells) which
differentiate into osteoblasts.
From here it follows on just like intramembranous ossification.
SCHEMA ILLUSTRATING
ENDOCHONDRAL OSSIFICATION
 BONE TYPES
LONG BONES: These are bones made of a central portion called the diaphysis and terminally dilated
portions called the epiphysis. Examples are: clavicle, femur

SHORT BONES: Bones with approximately equal dimensions. They are made of a central cortical region and
an external spongy region. Ex: Carpal and tarsal bones.

FLAT BONES: These are thin flattened structures. Ex: ribs, some bones of the skull.

IRREGULAR BONES: They don’t fit into any of the abovementioned characteristics examples are: the hyoid
bone, the sphenoid bone, hip bones.

Other types of bones are: Wormian bones ( bones found within sutures) and Sesamoid bones ( bones found in
a joint passing over tendons)
STRUCTURE OF A LONG BONE
A layer of articular cartilage covers the epiphyseal surface (hyaline).
Erythropoietic (red) bone marrow is found in the epiphysis.
The metaphysis (or shaft) is the zone just between the epiphysis and the diaphysis.
A tough fibrous coat called Periosteum lies on the external surface of the shaft. Its
purpose is muscle attachment and growth in diameter of the bone.
At the center of the diaphysis is the medullary canal. The medullary canal contains
the fatty (yellow) bone marrow.
Lining the borders of the canal is the endosteum which assists in the growth in
diameter.
Blood supply to the bone comes from the epiphyseal and periosteal arteries.
 BONE GROWTH
The growing portion of the bone is the epiphyseal plate which is made of hyaline cartilage.
An increase in the length of the bone is due to ossification of the cartilage at the plate
(endochondral ossification). Diameter growth occurs through addition of bone new bone tissue by
periosteal osteoblasts.

FACTORS FAVOURING BONE GROWTH

 Growth hormones
 Thyroid hormones
 Testosterone and oestrogen
 Minerals
 Vitamins A and D (Vit D calcitriol whose deficiency leads to Rickets)
 Exercise and stress

NB: Osteoporosis is a situation due to aging in which the bones lose calcium and
experience a reduction in the production of collagen fibres exposing it to fractures; the
compact bone loses its density and pores prevails.
 THE AXIAL SKELETON 1/5
THE SKULL
1/2
• Made of 22 bones
• Consists of the cranium and the face
• Sutures are immovable joints which can be found between bones of the skull.
These include:
1. Coronal suture between the frontal and parietal bones.
2. Lambdoid suture found between the parietal and occipital bones.
3. Sagittal suture between both parietal bones.
4. Squamous suture between the parietal and temporal bones.
The cranial bones which are 8 in number include:
 Frontal 1x
 Parietal 2x BONES OF THE CALVARIA
 Occipital 1x
 Temporal 2x
 Sphenoid 1x
 Ethmoid 1x
 THE AXIAL SKELETON 2/5
THE SKULL 2/2
Some of these bones have air sacs within them called Sinuses.
 Frontal sinuses
 Ethmoidal sinuses Paransal sinuses
 Sphenoidal sinuses
 Maxillary sinuses
Sinuses have two main functions:
1. They reduce the weight of the skull
2. Serve as resonating chambers for sound production (phonation)

The facial bones which are 14 in number include

• Nasal bones 2x
• Zygomatic bones 2x
• Palatine bone 2x
• Lachrymal bone 2x
• Inferior nasal conchae 2x
• Vomer 1x
• Mandible 1x
FORAMINA: Holes for the passage of blood vessels and nerves.
 THE AXIAL SKELETON 3/5
THE FOETAL
SKULL
 Has two frontal bones which emerge later on in life
 membranous connective tissue occurs between/within foetal cranial
bones called Fontanels.
 There are 6 in number:
1. A kite shaped anterior fontanel (Bregma): Found between the frontal
bones and the parietal bones. It fuses between the 18th and 22nd
month of life.
2. A triangular shaped posterior fontanel: Found between the parietal
and occipital bones and fuses between the 3rd-6th month of life.
3. 2 Sphenoidal/ anterolateral fontanels
4. 2 Mastoid/ posterolateral fontanels
 THE AXIAL SKELETON 4/5
THE HYOID BONE
 Found between the mandible and the larynx.
 It is the only non-articulated bone in the body.
 It is U-shaped and provides attachment for the muscles of the neck and the tongue.

THE VERTEBRAL COLUMN

A vertebra is a body that has an anterior and posterior arch with 7 processes.
i. Cervical region:
7 vertebrae, with the 7th being the most prominent.
Between C1 (atlas) and C2 (axis) is a freely movable joint.
ii. Thoracic region:
12 vertebrae in relation with the ribs
iii. Lumbar region:
Has 5 vertebrae.
iv. Sacral region:
Has 5 fused vertebrae forming the sacrum.
v. Coccygeal region:
Has 4 fused bodies forming the coccyx.
The Lateral view of the vertebral column reveals a structure with 4 curves.
 THE AXIAL SKELETON 5/5
THE THORACIC CAGE
Functions in protecting the vital organs in the chest and the upper
abdomen. It is divided into:
 Sternum: A flat bone located at the midline of the anterior portion of the
thoracic cage. From superior to inferior, it is divided into the
manubrium, the body and the xiphoid process.
 Costal cartilages: Links the ribs to the sternum. The 1st costal cartilage
attaches to the manubrium, the 2nd attaches to both the manubrium and
the body and the 3rd-7th attach only to the body.
 The ribs: These are 12 pairs of elongated flat bones. Ribs no. 1-7 are
termed the true ribs, 8-10 are the false ribs and 11 and 12 are the
floating ribs,
 THE Appendicular SKELETON
a) THE PECTORAL GIRDLE: Made of the scapula and the clavicle
b) THE UPPER LIMB:
• It has 60 bones (30 for each limb)
• The arm made of the humerus
• The forearm made of the ulna and the radius
• The Wrist made of 8 carpal bones
• The palm made of 5 metacarpals
• The fingers which are made of phalanges
c. THE PELVIC GIRDLE:
• Has 2 hip bones which are irregular bones
• Each hip bone is made of a pubis, an ischium and an ilium
d. THE LOWER LIMBS
• Made of 60 bones
• The thigh made of the femur
• The knee which contains the patella,
• The calf containing the tibia (shin bone) and the fibula
• The ankle that has 7 tarsals
• The toes that contain 14 phalanges
JOINTS
These are surfaces where two or more bones meet.
They are classified according to their degree of mobility:
a. Diarthrosis: These are freely movable joints.
b. Amphiarthrosis: These are semi-movable joints.
c. Synarthrosis: These are immovable joints e.g. sutures
With regards to the structure, a joint can either be fibrous, cartilaginous or synovial
e.g. the intervertebral discs, sternocostal joints and the hip joint respectively.
BONE AND SKELETAL DISORDERS
Osteogenesis imperfecta
THE MUSCULAR
SYSTEM
MUSCLE HISTOLOGY
a) Cardiac muscles:
•Red striated muscles
•Branched uninucleate cells with a centrally located nucleus
•Cells are joint through intercalated discs
•Action potentials occur through ionic imbalance
•Contraction is fast and uniform
•Long refractory periods ( period from one action potential to the next) hence
tetani not possible.
•Possess specialized cells which form nodes
•Their cells are known as Cardiomyocytes
MUSCLE HISTOLOGY
b. Smooth muscles:
•Non striated
•One centrally located nucleus
•Involuntary
•Spindle-shaped cells
•Cells are known as leiomycoytes
MUSCLE HISTOLOGY
b. Skeletal muscles:
•Striated
•Eccentric multinucleation
•Voluntary
•Elongated cylindric/prismatic cells called fibres/rhabdomyocytes.
•A muscle block is covered by connective tissue called epimysium.
•A muscle fascicle is enclosed in perimysium
•The muscle fiber is covered by endomysium
•Muscle block muscle fascicle muscle cell myofibrils
myofilaments
 SKELETAL MUSCLE FIBERS
Each cell is made up of 2 contractile proteins (filaments)
i. Thin filaments:
a) Actin: This could be a globular protein (G-actin) or a filamentous polymer (F-actin).
F-actin is formed from the fusion of G-actin
b) Troponin: Globular proteins which serve as central regulatory proteins in skeletal
muscle contraction. It is made up of 3 components:
• Troponin-T which binds to tropomyosin
• Troponin-I which inhibits F-actin/myosin interaction
• Troponin-C which possesses sites for Calcium ions
c. Tropomyosin: Protein that covers the F-actin binding site in a relaxed muscle
ii. Thick filaments:
 Made up of 2 heavy chains and 2 light chains
 The heavy chains wrap spirally to form the myosin tail and bilaterally to form the
myosin head.
 The light chains equally come into the constitution of the head.
 The head possesses an enzyme- ATPase
 SKELETAL MUSCLE FIBERS
 The skeletal muscle fiber is called the Sarcolemma
 The endoplasmic reticulum is the sarcoplasmic reticulum
 The sarcolemma possesses an inner true plasma membrane and an outer
coat made of polysaccharides.
 Just above the sarcolemma are cells for regeneration called Satellite cells
 Invaginations of the sarcolemma are called T-tubules
 On each side of these tubules we find dilated portions of the
sarcoplasmic reticulum known as terminal cisternae
 An association of a T-tubule and 2 terminal cisternae is called a Triad
 The Triad is located at the junction between the A and I bands
 SKELETAL MUSCLE FIBERS
ELECTRON MICROGRAPHY
This micrograph shows the thin actin filaments interwound with the thick myosin filaments.
a. A-band
• Its width corresponds to the length of the thick myosin filaments
• Made up of both actin and myosin filaments
• Its width remains unchanged during muscle contraction
b. I-band
• Made of thin actin filaments only
• Its width reduces during contraction
• Here actin filaments merge at a point called the Z-line by means of proteins (e.g. α-actinin)
c. H-zone
• Lighter portion of the A-band where we find just myosin filaments
d. M-line
• Central darker portion of the H-zone
• Points of linkage for myosin filaments

The sarcomere is the functional unit of the muscle fiber. Two Z-lines define a sarcomere. During
muscle contraction it reduces in length.
 SKELETAL MUSCLE FIBERS
Neuromuscular Junction
 It is the portion where an axon terminal meets with the sarcolemma.
 It consists of a presynaptic membrane, a synaptic cleft and a postsynaptic membrane.
 When the action potential reaches the axon terminal, depolarization of the membrane causes opening of the Calcium-gated
channels.
 enter the axon terminal, causes synaptic vesicle containing Ach to fuse with the synaptic mb
 By so doing, Ach is liberated into the cleft.
 At the postsynaptic mb, proper response to Ach involves opening of chemically gated channels
 Na enters the cell and Ca leaves the cell in a ratio of 3:2.
 The exchange causes depolarization of the sarcolemma and leads to the action potential (AP) which is transmitted through
out the sarcolemma.
 At the T-tubules, the AP causes release of the Ca from the sarcoplasmic reticulum through ryanodine channels.
 The ca then binds to troponin-C thus initiating muscle contraction.
 After depolarizing the postsynaptic membrane, some Ach is degraded by acetylcholinesterase. Some of it is reabsorbed into
the axon of the post-synaptic knob.
 After a fraction of a second Ca are pumped back into the sarcoplasmic reticulum by the Ca membrane pump (active) and
are stored there till the next AP
 The removal of Ca from the myofibrils causes contraction to stop.
 THE SLIDING FILAMENT THEORY
•The ca liberated from the sarcoplasmic reticulum binds to troponin-C
•This causes a conformational change on tropomyosin hence free binding sites on F-actin.
•The myosin head binds to the actin filaments.
•ATPase from the myosin head converts ATP to ADP and Pi.
• This releases energy necessary for pulling the actin filament past the myosin filament.
(pulling is done by the myosin head on actin)
•ATP is also needed for separation of myosin heads from actin binding sites and hence for
muscle relaxation.
The sliding filament theory is best explained together with the “Walking-along theory”.
RACHET’S MECHANISM
(WALKING ALONG THEORY)
•Before contraction, ATP binds to myosin cross-bridge heads.
•This immediately cleaves ATP leaving the products on the head.
•Binding of these sets on the actin binding sites provokes movement of the cross-bridge
head towards its arm.
•The energy provides a power stroke for these tilt.
•After the tilt, ADP and Pi are released and another ATP molecule binds to the myosin
head.
•The procedure repeats itself on the subsequent active sites, hence, actin walks along
myosin.
in isometric contractions, there is no change in length and in isotonic contractions, there is no change in tone
or strength.
TYPES OF MUSCLE CELLS
1. Slow fibers (type 1)
Contains a lot of myoglobin, responsible for O2 carriage in muscles.
Contracts slowly and for a long period of time.
They are required for strenuous activity.
2. Twitch Fibers (type 2)
They are poor in myoglobin and are used for swift activity.

 A motor unit is a neuron plus the muscle cells it innervates.

MUSCULAR DISORDERS
1. Myasthenia gravis; Failure of muscle to contract due to autoimmune destruction
of cholinergic receptors.
2. Tetany; It is neurologic syndrome characterized by sustained muscle contraction
due to increase in AP frequency arrival at the sarcolemma.
3. Rigor mortis; Is not a muscle disorder but a post mortem condition accruing to
ATP shortages for relaxation. Hence the muscle remains stiff from 1- 7hrs.
Relaxation occurs as muscle proteins degrade.