Musculoskeletal systemIt is composed of bones, muscles, connective tissues, and joints.pptx

Musculoskeletal system
Presenter: Dr. Dheeraj Kumar
MRIT, Ph.D. (Radiology and Imaging)
Assistant Professor
Medical Radiology and Imaging Technology
School of Health Sciences, CSJM University, Kanpur

Musculoskeletal system By- Dr. Dheeraj Kumar, Assist. Prof. 2
Introduction
• The musculoskeletal system
provides the framework and support
for the body, enabling movement
and protecting vital organs.
• It is composed of bones, muscles,
connective tissues, and joints, each
playing a crucial role in body
mechanics.

Bones:
• Serve as the rigid framework of the body.
• Protect internal organs (e.g., the skull protects
the brain, the rib cage protects the heart and
lungs).
• Act as levers that muscles pull on to produce
movement.
• Store minerals such as calcium and phosphorus.

Muscles:
• Facilitate movement by contracting
and relaxing.
• Support posture and help stabilize
joints.
• Generate heat to help maintain
body temperature.

Connective Tissues:
• Include tendons, ligaments,
cartilage, and membranes.
• Support and bind other
tissues and organs.
• Provide structural support
and elasticity.

Joints:
• Sites where two or more
bones meet.
• Allow for various types of
movement, depending on the
joint type (e.g., hinge joints,
ball-and-socket joints).

Function of the Musculoskeletal System:
• Support: Provides a structural framework for the body.
• Movement: Facilitates movement through muscle contractions and joint articulation.
• Protection: Shields vital organs from injury.
• Mineral Storage: Stores essential minerals that can be released into the bloodstream
as needed.
• Blood Cell Production: Houses bone marrow, which produces red and white blood
cells and platelets.

Connective Tissue and Its Modifications
Definition of Connective Tissue:
1. Connective tissues are diverse types of tissues that support, connect, or
separate different types of tissues and organs in the body.
2. They are characterized by the presence of an extracellular matrix composed of
fibers and ground substance.

Types of Connective Tissues:
Loose Connective Tissue:
• Example: Areolar tissue.
• Function: Provides support, elasticity, and a
medium for nutrient diffusion. Found beneath
epithelial tissues, around blood vessels and
nerves.
• Characteristics: Contains a loose arrangement of
fibers (collagen, elastic, and reticular) and cells
(fibroblasts, macrophages, mast cells).

Dense Connective Tissue:
Example: Tendons and ligaments.
• Function: Provides strong
connections between different
tissues. Tendons connect muscles to
bones, while ligaments connect
bones to bones.
• Characteristics: High density of
collagen fibers aligned in parallel
bundles, providing tensile strength.

Special Connective Tissues: Cartilage:
Semi-rigid tissue that provides support and
flexibility (e.g., hyaline cartilage in joints,
fibrocartilage in intervertebral discs).
• Bone: Rigid tissue that supports and protects the
body, stores minerals, and facilitates movement.
• Adipose Tissue: Stores fat, provides insulation,
and cushions organs.
• Blood: Fluid tissue that transports nutrients,
gases, and waste products throughout the body.

Functions of Connective Tissue:
• Protection: Cushions and protects organs (e.g., adipose tissue around the kidneys).
• Support: Provides a structural framework for the body (e.g., bones).
• Binding: Connects and holds together other tissues (e.g., tendons, ligaments).
• Storage: Stores nutrients, minerals, and lipids (e.g., adipose tissue stores fat, bones store
calcium).
• Repair: Plays a role in wound healing and tissue repair (e.g., fibroblasts produce
collagen).

Tendons and Membranes
Tendons:
1. Definition: Tendons are strong, fibrous connective
tissues that connect muscles to bones, enabling the
transmission of force from muscle contraction to
skeletal movement.
2. Structure:
1. Composed primarily of parallel bundles of collagen
fibers.
2. Contains a small amount of elastin for some flexibility.
3. Surrounded by a sheath called the epitenon that
reduces friction and allows smooth gliding.

Function:
1.Transmit the force generated by muscle contractions to bones to produce movement.
2.Act as springs in certain movements, storing and releasing elastic energy.
3.Help stabilize joints by maintaining muscle attachment and tension.
Examples:
4.Achilles Tendon: Connects calf muscles to the heel bone, essential for walking, running,
and jumping.
5.Rotator Cuff Tendons: Connect shoulder muscles to the bones, enabling a range of
shoulder movements.

Membranes:
Types:
• Synovial Membranes: Line the cavities of synovial joints (e.g.,
knee, elbow). They secrete synovial fluid that lubricates the
joint, reduces friction, and provides nutrition to the cartilage.
• Serous Membranes: Line closed body cavities (e.g.,
pericardium around the heart, pleura around the lungs,
peritoneum in the abdominal cavity). They secrete serous fluid
that reduces friction between moving organs.
• Mucous Membranes: Line body passages that open to the
exterior (e.g., respiratory, digestive, and urogenital tracts). They
secrete mucus, which traps pathogens and particles and keeps
tissues moist.

Functions:
• Synovial Membranes: Reduce friction between articulating bones in a joint.
• Serous Membranes: Prevent friction between organs by allowing smooth
movement.
• Mucous Membranes: Protect body openings from pathogens and debris and
prevent tissue dehydration.

Special Connective Tissue
Types of Cartilage:
1. Hyaline Cartilage: The most common type,
found in the nose, trachea, larynx, and at the ends
of long bones in synovial joints.
2. Fibrocartilage: Contains dense bundles of
collagen fibers, providing toughness and
elasticity. Found in intervertebral discs, pubic
symphysis, and menisci of the knee.
3. Elastic Cartilage: Contains more elastin fibers,
providing flexibility. Found in the ear pinna and
epiglottis.

Function:
1.Provides flexible support and cushioning in joints.
2.Absorbs shock and reduces friction between bones in joints.
3.Maintains shape and structure in flexible areas (e.g., ear, nose).

Bone:
Types of Bone:
• Compact Bone: Dense and strong,
forming the outer layer of bones.
Provides strength and resistance to
bending.
• Spongy Bone: Porous and
lightweight, found inside bones (e.g.,
ends of long bones, pelvis, ribs, skull,
vertebrae). Contains bone marrow
and supports lightweight strength.

Functions:
• Provides structural support and shape to the body.
• Protects vital organs (e.g., skull protects the brain, rib cage protects the heart
and lungs).
• Stores minerals, such as calcium and phosphorus, essential for various body
functions.
• Houses bone marrow, which produces red and white blood cells and platelets.

Adipose Tissue:
Definition: A type of connective tissue that stores
fat in adipocytes (fat cells).
Function:
• Stores energy in the form of fat.
• Provides cushioning and insulation for the body,
protecting organs and maintaining body
temperature.
• Serves as an endocrine organ, secreting hormones
like leptin, which regulates hunger and metabolism.

Blood:
Definition: A specialized connective tissue that
circulates throughout the body, composed of cells (red
blood cells, white blood cells, platelets) suspended in
plasma.
Function:
• Transports oxygen, nutrients, hormones, and waste
products.
• Regulates body temperature and pH balance.
• Protects against infections through immune response
and clot formation.

Bone Structure and Classification
Bone Structure:
Macroscopic Anatomy:
1. Diaphysis: The shaft or central part of a long bone, primarily composed of compact
bone that provides strength.
2. Epiphyses: The rounded ends of a long bone, which are filled with spongy bone and
contain red bone marrow.
3. Metaphysis: The region between the diaphysis and epiphysis; in growing bones, it
contains the epiphyseal (growth) plate.
4. Periosteum: A dense layer of vascular connective tissue covering the outer surface of
bones except at the joints. It contains nerves and blood vessels, which nourish the
bone.
5. Endosteum: A thin membrane lining the inner surface of the bone’s medullary cavity,
containing bone-forming cells.

Microscopic Anatomy:
Compact Bone: The dense outer layer that gives bone
its strength. It consists of osteons (Haversian systems)
– cylindrical structures that contain a central canal
(Haversian canal) surrounded by concentric rings
(lamellae) of bone matrix.
Spongy Bone (Cancellous Bone): The inner layer
composed of a network of trabeculae (thin columns
and plates). It is lighter and less dense than compact
bone, providing structural support and flexibility
without the weight.

Bone Classification:
Long Bones:
Cylindrical in shape;
longer than they are
wide. Examples include
the femur, humerus, and
tibia. Function in
leverage and movement.

Short Bones:
Cube-like shape,
approximately equal in length,
width, and thickness. Examples
include the carpals and tarsals.
Provide stability and support
while allowing some motion.

Flat Bones:
Thin, flat, and often curved.
Examples include the bones
of the skull (frontal,
parietal), sternum, and ribs.
Provide protection to internal
organs and a broad surface
for muscle attachment.

Irregular Bones:
Complex shapes that do
not fit into other
categories. Examples
include vertebrae and
certain facial bones.
Provide protection to
internal organs.

Sesamoid Bones:
Small, round bones embedded in
tendons. Example: the patella.
Protect tendons from stress and
wear.

Blood Supply and Growth of Bones
Blood Supply to Bones:
1. Nutrient Arteries:
1.The primary blood vessels that enter
bones through nutrient foramina.
2.Supply the inner layers of bone,
including the marrow.
3.Critical for delivering oxygen and
nutrients to bone cells (osteocytes).

Periosteal Arteries:
1.Supply the periosteum and outer
layers of compact bone.
2.Provide nutrients to the bone
surface and are involved in bone
repair and growth.

Epiphyseal and Metaphyseal Arteries:
1.Supply the ends of bones
(epiphyses) and the growth plate
area (metaphysis).
2.Essential during growth and
development for the expansion and
health of bone tissue.

Bone Growth:
Longitudinal Growth:
• Occurs at the epiphyseal plates (growth
plates) found at each end of long bones.
• Chondrocytes (cartilage cells) divide and
produce cartilage, which is then replaced by
bone, contributing to the lengthening of
bones.
• Growth continues until the epiphyseal
plates close during late adolescence or early
adulthood, after which bones no longer
increase in length.

Appositional Growth:
• Increases bone diameter by the
addition of new layers of bone
tissue on the outer surface.
• Osteoblasts in the periosteum lay
down new bone material, while
osteoclasts resorb bone tissue from
the inner surface, helping to expand
the medullary cavity proportionally.

Ossification and Bone Development
Types of Ossification:
1. Intramembranous Ossification:
1. Direct formation of bone from mesenchymal
tissue (embryonic connective tissue).
2. Process:
1. Mesenchymal cells differentiate into
osteoblasts.
2. Osteoblasts secrete bone matrix, which
hardens to form trabeculae.
3. Occurs in flat bones such as the skull,
clavicle, and mandible.

Endochondral Ossification:
Bone forms by replacing hyaline cartilage,
which acts as a template.
1. Process:
1. Begins with a cartilage model surrounded
by a perichondrium.
2. Chondrocytes in the center of the cartilage
model enlarge and die, leaving cavities.
3. Blood vessels invade the cavities, bringing
in osteoblasts and osteoclasts that replace
cartilage with bone.
4. This process continues until the entire
cartilage is replaced by bone, forming the
structure of long bones (e.g., femur, tibia).

Bone Remodeling:
A continuous process where old bone tissue is replaced
by new bone tissue.
• Osteoblasts: Cells that form new bone.
• Osteoclasts: Cells that break down old or damaged
bone.
• Purpose:
• Maintains bone strength and integrity by repairing
micro-damage.
• Regulates calcium and phosphate levels in the body.

Factors Influencing Bone Remodeling:
• Mechanical stress (e.g.,
exercise stimulates bone
formation).
• Hormonal regulation
(e.g., parathyroid
hormone, calcitonin).
• Nutritional intake (e.g.,
calcium and vitamin D).

Muscle Classification and Structure
Muscle Types:
Skeletal Muscle:
1.Description: Voluntary, striated muscles
attached to bones by tendons.
2.Function: Facilitate body movement, posture,
and heat production.
3.Examples: Biceps brachii, quadriceps, and
deltoids.

Cardiac Muscle:
1.Description: Involuntary, striated muscle
found only in the heart.
2.Function: Pump blood throughout the
body.
3.Unique Features: Contains intercalated
discs for synchronized contractions.

Smooth Muscle:
1. Description: Involuntary, non-striated
muscle found in the walls of hollow
organs (e.g., blood vessels, digestive
tract, bladder).
2. Function: Regulates the flow of
substances through hollow organs by
contracting and relaxing.
3. Examples: Muscles in the
gastrointestinal tract, blood vessels,
and uterus.

Muscle Structure:
Microscopic Anatomy:
• Muscle Fiber (Cell): The basic unit of a muscle, long
and cylindrical in skeletal muscle, branched in
cardiac muscle, and spindle-shaped in smooth
muscle.
• Myofibrils: Bundles of actin (thin) and myosin
(thick) filaments within muscle fibers, responsible for
contraction.
• Sarcomeres: The structural and functional unit of a
myofibril, defined by Z-lines; the region where actin
and myosin filaments overlap, allowing for muscle
contraction.

Connective Tissue Layers:
• Epimysium: Surrounds the entire
muscle, protecting it and allowing for
force transfer.
• Perimysium: Surrounds bundles of
muscle fibers (fascicles), providing a
pathway for nerves and blood vessels.
• Endomysium: Surrounds each
individual muscle fiber, providing
support and separation.

Functional Aspects of Muscles
Muscle Contraction:
Sliding Filament
Theory: Muscles
contract by the sliding
of actin (thin)
filaments over myosin
(thick) filaments
within the sarcomere.

Mechanism:
• Nerve Impulse: A signal from the motor neuron triggers the release of calcium ions from the
sarcoplasmic reticulum into the muscle fiber.
• Calcium Binding: Calcium ions bind to troponin, causing a change in the tropomyosin position,
exposing binding sites on actin.
• Cross-Bridge Formation: Myosin heads attach to the exposed binding sites on actin, forming cross-
bridges.
• Power Stroke: Myosin heads pivot, pulling the actin filaments toward the center of the sarcomere,
shortening the muscle.
• ATP Binding: ATP binds to myosin heads, causing them to release actin and reset for another cycle.

Neuromuscular Junction:
Definition: The synapse between a motor
neuron and a skeletal muscle fiber.
Function: Transmits the nerve impulse to the
muscle fiber, initiating muscle contraction.
Process: The release of acetylcholine (ACh)
from the motor neuron binds to receptors on
the muscle fiber, leading to depolarization and
an action potential in the muscle.

Muscle Function:
Types of Muscle Contraction:
• Isometric Contraction: Muscle generates
tension without changing length. Example:
Holding a weight steady without moving it.
• Isotonic Contraction: Muscle changes
length while generating tension. Includes:
• Concentric Contraction: Muscle shortens as it
contracts. Example: Lifting a weight.
• Eccentric Contraction: Muscle lengthens while
under tension. Example: Lowering a weight.

Roles in Movement:
• Prime Movers (Agonists): The main muscles responsible for
producing a specific movement. Example: Biceps brachii during
elbow flexion.
• Antagonists: Muscles that oppose the action of the prime movers.
Example: Triceps brachii during elbow flexion.
• Synergists: Muscles that assist the prime movers by adding force
or reducing unnecessary movement. Example: Brachialis assisting
the biceps brachii.
• Stabilizers: Muscles that stabilize joints, allowing other muscles
to perform movements more effectively. Example: Rotator cuff
muscles stabilizing the shoulder joint.

Joint Classification and Structure
Fibrous Joints:
1. Description: Immovable or very limited movement,
connected by dense connective tissue.
2. Types:
1. Sutures: Found in the skull, where bones are tightly
bound by a minimal amount of fibrous tissue.
2. Syndesmoses: Bones connected by ligaments or
interosseous membranes. Example: The connection
between the tibia and fibula.
3. Gomphoses: Peg-in-socket fibrous joints. Example:
The connection between teeth and their sockets
(alveoli).

Cartilaginous Joints:
Description: Slightly movable joints
connected by cartilage.
Types:
• Synchondroses: Bones united by
hyaline cartilage. Example: The
epiphyseal plate in growing long bones.
• Symphyses: Bones united by
fibrocartilage. Example: The pubic
symphysis, intervertebral discs.

Synovial Joints:
Description: Freely movable joints characterized by a joint cavity filled with
synovial fluid.
Types:
• Plane Joints: Allow gliding or sliding movements. Example: Intercarpal joints in the
wrist.
• Hinge Joints: Allow flexion and extension. Example: Elbow and knee joints.
• Pivot Joints: Allow rotational movement. Example: The atlantoaxial joint between
the first and second cervical vertebrae.
• Condyloid (Ellipsoid) Joints: Allow movement in two planes. Example: The wrist
joint.
• Saddle Joints: Allow movement in multiple directions, including opposition.
Example: The thumb joint (carpometacarpal joint).
• Ball-and-Socket Joints: Allow movement in multiple planes and rotation. Example:
The shoulder and hip joints.

Structure of Synovial Joints:
Components:
1. Articular Cartilage: Covers the ends of bones in synovial joints,
providing a smooth, frictionless surface for movement.
2. Joint (Synovial) Cavity: The space between the articulating bones,
filled with synovial fluid.
3. Synovial Fluid: A viscous fluid within the joint cavity that lubricates
the joint and reduces friction.
4. Joint Capsule: A fibrous envelope surrounding the joint, providing
stability and enclosing the joint cavity.
5. Synovial Membrane: The inner lining of the joint capsule that secretes
synovial fluid.
6. Ligaments: Bands of dense connective tissue that connect bones and
provide stability to the joint.
7. Bursae: Small fluid-filled sacs that reduce friction between tendons and
bones or skin and bones.

Movements and Range of Motion in Joints
Types of Movements:
1. Flexion and Extension:
1. Flexion: Decreasing the angle between
two bones or bending a joint. Example:
Bending the elbow or knee.
2. Extension: Increasing the angle between
two bones or straightening a joint.
Example: Straightening the elbow or
knee.

Abduction and Adduction:
• Abduction: Moving a limb away from
the midline of the body. Example:
Raising the arm or leg sideways.
• Adduction: Moving a limb toward the
midline of the body. Example:
Lowering the arm or leg back to the
side.

Rotation:
• Medial (Internal) Rotation: Rotating
a limb toward the midline. Example:
Turning the foot inward.
• Lateral (External) Rotation: Rotating
a limb away from the midline.
Example: Turning the foot outward.

Circumduction:
A circular movement that
combines flexion, extension,
abduction, and adduction.
Example: Moving the arm in a
circular motion, like in a
windmill.

Special Movements:
• Dorsiflexion and Plantarflexion: Dorsiflexion is
lifting the foot upward, and plantarflexion is
pointing the foot downward.
• Supination and Pronation: Supination is rotating
the forearm to turn the palm upward, and pronation
is turning the palm downward.
• Inversion and Eversion: Inversion is turning the
sole of the foot inward, and eversion is turning it
outward.

Range of Motion (ROM):
Definition: The full movement potential of a joint, usually measured in degrees
of a circle.
• Factors Affecting ROM:
• Joint Structure: The shape and fit of the articulating surfaces, such as the depth of
the socket in a ball-and-socket joint.
• Ligaments: The length and elasticity of ligaments and joint capsules can limit or
allow a range of motion.
• Muscle Flexibility: The length and flexibility of muscles and tendons crossing the
joint.
• Soft Tissue: The amount of soft tissue surrounding the joint, such as fat or muscle
mass.
Measurement: ROM can be measured using a goniometer, which measures the
angle of the joint during movement.

Joint Stability and Limiting Factors
Joint Stability:
1. Factors Contributing to Stability:
1. Shape of Articular Surfaces: The congruence and fit of the bones at the joint can enhance stability. For example,
the deep socket of the hip joint provides more stability than the shallow socket of the shoulder joint.
2. Ligaments: Strong ligaments reinforce joints by connecting bones and limiting excessive movement. Ligaments
prevent dislocations by maintaining proper alignment.
3. Muscle Tone: The constant, slight contraction of muscles (muscle tone) around the joint helps maintain joint
stability. Muscles and tendons are key stabilizers in joints, especially in dynamic movements.
4. Joint Capsule: The fibrous tissue that surrounds a joint provides structural support and contains synovial fluid,
which lubricates the joint.

Examples:
• Shoulder Joint: A ball-and-socket
joint with high mobility but less
stability, stabilized by rotator cuff
muscles, ligaments, and the labrum.
• Knee Joint: A hinge joint stabilized
by ligaments (ACL, PCL, MCL,
LCL) and muscles (quadriceps,
hamstrings).

Limiting Factors:
Bony Structures:
• The shape and interaction of bone surfaces at the joint can limit movement. For example, the olecranon
of the ulna limits the extension of the elbow joint.
Ligamentous Factors:
• Ligaments restrict certain movements to prevent injury. For example, the anterior cruciate ligament
(ACL) in the knee prevents excessive forward movement of the tibia.
Muscular Factors:
• Muscle flexibility and strength influence joint range of motion and stability. Tight muscles can restrict
movement, while weak muscles may fail to stabilize the joint.

Soft Tissue:
• The amount of soft tissue, such as fat or muscle, can limit movement by
physically blocking joint motion.
Injury and Inflammation:
• Damage to the joint structures, such as ligaments or cartilage, or inflammation
can decrease joint stability and range of motion.

Blood and Nerve Supply to Joints
Blood Supply:
1. Articular Arteries:
1. Branch from major arteries around the joint,
supplying oxygen and nutrients to the joint
tissues, including the synovium and the
periarticular structures.
2. These arteries penetrate the joint capsule and
form an anastomosis (network) around the
joint, ensuring a consistent blood supply even
when the joint is in different positions.

Synovial Fluid Nutrition:
• Synovial fluid provides nutrients to
the avascular structures within the
joint, such as articular cartilage.
• The fluid facilitates the exchange of
nutrients and waste products
between the cartilage and the blood.

Nerve Supply:
Articular Nerves:
• Joints are richly innervated by sensory and
motor nerves that transmit pain,
proprioception (sense of joint position), and
control muscle movements around the joint.
• Sensory nerves within the joint capsule and
ligaments detect pain, stretch, and pressure,
providing feedback to the central nervous
system to protect the joint from damage.

Hilton's Law:
• The relationship between the nerve supply
to a joint, the muscles that move the joint,
and the skin over the joint.
• Nerves that innervate the muscles acting
on a joint also supply the joint and the skin
covering it. This integrated supply ensures
coordinated movement and sensation.

Clinical Relevance:
Pain and Injury:
• The blood and nerve supply is essential for diagnosing and treating joint
injuries, such as sprains, arthritis, or bursitis.
Surgical Considerations:
• Surgeons must be aware of the blood and nerve supply to minimize damage
during joint surgeries, such as arthroscopy or joint replacement.

Joint Dislocations and Applied Anatomy
Joint Dislocations:
1. Definition:
1.A joint dislocation occurs when the
bones in a joint are forced out of their
normal positions.
2.This can happen due to trauma, falls,
or high-impact sports.

Types of Dislocations
• Anterior Dislocation: The most common type, where the
bone is displaced forward. Example: Anterior shoulder
dislocation.
• Posterior Dislocation: Less common; the bone is displaced
backward. Example: Posterior hip dislocation.
• Inferior Dislocation: Also known as luxatio erecta, where
the bone is displaced downward. Example: Rare in the
shoulder.
• Complete Dislocation: The joint surfaces are entirely
separated.
• Subluxation: A partial dislocation where the bones are
misaligned but still in partial contact.

Symptoms:
• Intense pain at the site of dislocation.
• Visible deformity or misalignment of the joint.
• Swelling and bruising.
• Inability to move the joint.
• Numbness or tingling due to nerve
compression or damage.

Treatment and Management:
• Reduction: The process of repositioning the bones back into their normal position, either
manually or surgically.
• Immobilization: After reduction, the joint may be immobilized using a splint or cast to
allow healing.
• Rehabilitation: Physical therapy is often needed to restore strength and range of motion.
• Surgery: In severe cases, surgery may be required to repair damaged ligaments or other
tissues.

Applied Anatomy:
Clinical Relevance:
• Joint anatomy is crucial for diagnosing and treating dislocations, fractures, and other joint injuries.
• Rotator Cuff Injuries: Common in athletes and elderly individuals, these involve tears in the
tendons of the rotator cuff muscles, leading to shoulder pain and weakness.
• ACL Tears: Anterior cruciate ligament tears are common in sports like football and basketball,
requiring surgical intervention and extensive rehabilitation.
• Hip Replacements: A surgical procedure where a damaged hip joint is replaced with a prosthesis,
often due to severe arthritis or fractures.

Prevention and Maintenance:
• Strengthening muscles around the joints can prevent dislocations and
other joint injuries.
• Proper warm-up and stretching before physical activity reduce the risk
of injury.
• Maintaining a healthy weight reduces stress on weight-bearing joints
like the knees and hips.

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