7. Musculatory System Flashcards by Dina Patoonie

Formative immature cells of muscle; present in fetal stage; func: Mitosis

Myoblast

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Nonstriated
Involuntary
Can divide

Smooth muscle

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Spindle-shaped muscle tissue

Smooth muscle

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Only mature muscle tissue that can divide

Smooth muscle

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Striated
Voluntary
Multinucleated
Hypertrophy only
Cannot multiply

Skeletal muscle

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Location of nucleus of skeletal muscle

Lateral surface

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Striated
Involuntary
Cannot multiply;
Hypertrophy only

Cardiac muscle

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What type of muscle cell or tissue is the Heart

Cardiac muscle

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What connects cardiac muscle cells together

Intercalated discs

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Cellular junctions in cardiac muscles

Desmosomes

Gap junctions

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Outermost connective tissue layer that covers MUSCLE BELLY

Epimysium

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Middle layer covers FASCICLES

Perimysium

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Innermost; covers muscle cells or fibers

Endomysium

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Connects muscle to bone

Tendon

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Connects bone to bone

Ligaments

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Group of muscle fibers covered by perimysium

Fascicle

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Cell membrane or plasma membrane of muscles made up of phospholipid bilayer

Sarcolemma

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Structures that makes up the muscle cell or fiber

Myofibrils

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Structures that makes up myofibrils

Myofilaments

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2 kinds of Myofilaments

Thin filaments

Thick filaments

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Thin filaments is composed of what protein

Actin

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Thick filaments are composed of what protein

Myosin

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Shape of myosin

Golf club 🏑

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Functional/contractile unit of muscle; from Z disc to another Z disc

Sarcomere

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🔹Separates one sarcomere to another. 🔹Attachment for thin filaments. 🔹Passes in the middle of the I band

Z discs

Contains thick but no thin filaments (MYOSIN ONLY)

H zone

Passes in the middle of H zone

M line

aka dArk band

A band

aka l"i"ght band

I band

Blocks the myosin binding sites in actin (relax muscle)

Tropomyosin

🔹Holds the tropomyosin in place. | 🔹Binding site for Ca ions to allow movt of tropomyosin.

Troponin

Perpendicular sarcolemma

Transverse tubules or T tubules

Endoplasmic reticulum of muscle fiber

Sarcoplasmic reticulum

Storage for calcium

Sarcoplasmic reticulum

Most impt substance for muscular contraction

Calcium

Dilated end sac of sarcoplasmic reticulum

Terminal cisterns

Cytoplasm of a muscle fiber

Sarcoplasm

Stored chains of glucose

Glycogen

Glycogen is mainly stored in

✔️Liver ✔️Skeletal muscle ✔️Adipocytes

Process: glycogen to glucose

Glycogenolysis

Maximum storage of glycogen

2 lbs

Process: glucose to glycogen

Glycogenesis

When does the body produce glycogen

Hyperglycemic state

Hormone responsible for production of insulin (glycogen stored in insulin sensitive cells)

Beta cells of pancreas

🔹Protein that binds OXYGEN = red color of muscle. | 🔹Counterpart of RBC (hemoglobin = red color)

Myoglobin

Largest protein of the body found in muscles

Titin

Total muscles in the body

650 muscles

Attachment for THICK filaments

M line

Overlapping thick and thin filaments

A band

Attachment of THIN filaments

Z line or disc

Filaments seen in light or I band

Thin filaments only

aka Theory of muscle contraction

Sliding filament mechanism

% of ICF

40% ICF

% of ECF

20%

What is the resting membrane potential? (mV)

-70mV (-90mV in Guyton)

Most numerous cation in ECF

Na+

Most numerous cation in ICF

K+

Charge inside the cell when it is in resting state or polarized state

Resting membrane potential

1st channel to open once there's electrical current

Voltage-gated Na+ channels

Why is depolarization and repolarization happens? What process? (Na goes IN, K goes OUT)

Because of simple diffusion

🔹Na+ influx = cell more + = ______ 🔹Wherein, cell from negative to a positive state. 🔹Remove a cell in a polarized state(-)

Depolarization

Channels that are delayed to open (opens after action potential)

Voltage-gated K+ channels

K+ efflux(out) = cell goes back to resting state = ______ | 🔹Change charge of cell from (+) to (-)

Repolarization

What is the Threshold stimulus to generate an action potential

-55mV

Signal that has potential to trigger an axon

Action potential

Corrects position of Na+(out) and K+(in)

Sodium potassium pumps

Ratio in Na-K pumps

"2PISO3" 2 Potassium IN 3 Sodium OUT

In precontraction phase, an ACTION POTENTIAL from nerve fiber stimulates _____ to open

Voltage-gated calcium channels

Calcium influx causes release of _____ in the NMJ

Acetylcholine (Ach)

It is a neurotransmitter or a chemical messenger (LIGAND)

Acetylcholine

Part of the NMJ where Ach binds

Nicotinic receptors / "Ligand"-gated Na+ channels

Na+ enters muscle fiber (Depolarization) creating a ______

Muscle action potential

Muscle action potential travels to what part of the muscle cell

Sarcolemma and T tubules

Muscle action potential opens _____ which stores Calcium

Sarcoplasmic reticulum

Responsible in releasing calcium ions into the sarcoplasm

Sarcoplasmic reticulum

Where does calcium ions bind

Troponin

What happens when calcium binds to troponin

Troponin moves tropomyosin away from blocking the myosin heads sa actin binding sites

Myosin head will attach to actin known as

Cross bridging

ATP in the myosin head is broken down by (what enzym) into ______

ATP / ATPase = ADP + P

Immediate source of energy

ADP + Phospate

Source of energy

ATP

Occurs when actin moves towards the M line and ADP is released

Power stroke

Actin moves towards M line, Z discs moves towards each other, sarcomere shortens.

Muscle contraction

When does myosin detach from actin

When there is another ATP that binds to myosin head

Detachment of myosin to actin = sarcomere _______

Sarcomere goes back to original place

As long as there are high amounts of _____ and ______ in the sarcoplasm, contraction cycle continues

Ca+ and ATP

This moves calcium back to the sarcoplasmic reticulum

Ca+ active transport pumps

Enzyme that breaks down Ach after it binds to Nicotinic receptors

Acetylcholinesterase

Phenomenon seen in dead body. Muscles are in state of RIGIDITY due to cross bridging (Lysosymes digest SR causing release of Ca resulting to crossbridging but no ATP so myosin doesnt detach to actin = muscles remain contracted)

Rigor mortis

Causative agent or bacteria of botulinum toxin

Clostridium botulinum

Prevents release of Ach in the NMJ resulting to muscle paralysis or relaxation

Botulinum toxin

Poisonous plant; blocks NICOTINIC receptors (close: Ach cannot bind =cant stimulate muscle contraction) Resulting to Muscle paralysis

Curare

Drug derived from Curare

Pancuronium bromide

Drugs used in lethal injection

✔️Thiopental (sedative) ✔️Potassium chloride (to stop heart) ✔️Pancuronium bromide (from curare)

Other name of Succinylcholine

Suxamethonium

Succinylcholine is for

Laryngospasm

Binds to Ach receptors resulting to muscle paralysis. | Used in laryngospasm

Succinylcholine

Other name for creatine phosphate mechanism

Direct phosphorylation

Fuel for creatine phosphate mechanism

Creatine phosphate

End products of creatine phosphate mechanism

1 ATP | 1 Creatinine

Other name for GLYCOLYSIS

Anaerobic respiration

Process of breaking down glucose

Glycolysis

Fuel for glycolysis

Glucose

End products of glycolysis

2 ATP | 2 Pyruvate

🔹Subpathway of glycolysis. 🔹Glucose to Lactic Acid. 🔹Happens if there is insufficient oxygen. 🔹Example during heavy exercises.

Anaerobic glycolysis

End product of anaerobic glycolysis

Lactic acid

Muscle pain is caused by accumulation of

Lactic acid

pH of blood and average

7.35-7.45 (7.4)

Most impt buffer that prevents sudden change in pH in the blood

Bicarbonate HCO3-

Blood is what pH

Slightly basic

What happens to pH of blood if there's accumulation of lactic acid

Blood becomes acidic | ⬆️H ⬇️pH = acidic

HCO3- + H =

H2O | CO2

⬆️CO2 ⬇️O2 | What is the response of the body?

Hyperventilation

4 other names for Aerobic Glycolysis

🔹Aerobic respiration 🔹Krebs cycle 🔹Citric acid cycle 🔹Tricarboxylic acid cycle

Happens when there is enough oxygen in the body

Aerobic glycolysis

Fuel for Aerobic glycolysis

✔️Fatty acids ✔️Amino acids ✔️Oxygen ✔️Pyruvate

End products of Aerobic glycolysis

36-38 ATP H2O CO2

Glycolysis and Creatine phosphate mechanism happens in what part of the cell?

Cytoplasm

Kreb cycle happens in what part of the cell?

Mitochondria

Type of skeletal muscle fiber that produces SLOW and WEAK contractions but is RESISTANT to FATIGUE

Slow oxidative fibers or RED muscle fibers

Postural muscles are examples of what type of skeletal muscle fibers

Red muscle fibers

Responsible for the red pigment of the muscle fibers and also carries oxygen

Myoglobin

Red muscle fibers undergoes what type of glycolysis

Aerobic glycolysis (⬆️ATP)

Produces fast and strong contractions but NOT RESISTANT to fatigue

Fast glycolytic fibers | White muscle fibers

White muscle fibers undergoes what type of glycolysis

Anaerobic glycolysis (⬇️myoglobin, ⬇️O2)

Connects end of cardiac muscle to one another

Intercalated discs

Which muscle has the most numerous mitochondria to allow continuous contraction (⬆️kreb, ⬆️ATP)

Heart or CARDIAC muscle

What 2 cellular junctions found between cardiac muscle cells

🔹Gap junctions | 🔹Desmosomes

Shape of smooth muscle tissue

Spindle-shaped

For binding of Calcium in smooth muscle tissue

Calmodulin

For binding Calcium in Skeletal and Cardiac muscle

Troponin

Blocks myosin from binding to actin in Smooth muscle

Myosin light chain kinase

Blocks myosin from binding to actin in skeletal and cardiac muscle

Tropomyosin

Scalp muscles are innervated by what nerve

CN VII Facial nerve

Moves scalp posteriorly

Occipitalis

Moves scalp anteriorly

Frontalis

Raises eyebrow; SURPRISE

Frontalis

🔹Aponeurosis in the head | 🔹connects occipitalis and frontalis

Galea aponeurotica

Muscle to muscle attachment

Aponeurosis

Mouth muscles are innervated by what nerve

CN VII Facial nerve

Closes lips Kissing Pouting(major)

Orbicularis oris

Elevates upper lip

``` Zygomaticus major Zygomaticus minor Lev anguli oris Lev labii superioris ala que nasi Lev labii superioris ```

Caninus muscle

Levator anguli oris

🔹Longest name | 🔹Elevates upper lip and ala of nose

Levator labii superioris ala que nasi

Depresses lower lip

Depressor labii inferioris

Depresses angle of mouth

Depressor anguli oris

Other names of Buccinator (3)

Cheek muscle Kissing muscle Trumpeter's muscle

🔹Presses cheeks 🔹whistling, blowing, sucking, kissing 🔹keeps food away from vestibular area

Buccinator

Moves angle of mouth laterally. | Fake/sardonic smile; Grimace

Risorius

Protrudes lower lip; pouting

Mentalis

🔹Neck muscle 🔹depresses lower lip and mandible 🔹major muscle for Grimace

Platysma

Angle of mouth where 8 muscles meet

Modiolus muscle

Mneumonic for modiolus muscles

"LLORDD BuZy" ``` Lev anguli oris Lev labii superioris Orbicularis oris Risorius Dep anguli oris Dep labii inferioris Buccinator Zygo major ```

5 branches of CN V or Facial nerve

Mnemonic: The Zebra Bump My Car ``` Temporal n. Zygomatic n. Buccal n. Mandibular n. Cervical n. ```

Muscle penetrated in classic mandiblock

Buccinator

Where to deposit in mandiblock

Pterygomandibular space

Why contralateral side in doing Mandiblock

To avoid parotid = Bell's palsy

Muscles that comprises the pterygomandibular raphe

✔️Superior pharyngeal constrictor m. | ✔️Buccinator

Nerves anesthesize in classic mandiblock

✔️IAN | ✔️Lingual nerve

What muscle to incise to drain abscess on pterygomandibular space

Buccinator

Muscle that closes eyes

Orbicularis oculi

Nerve that innervates orbicularis oculi

CN 7

Moves eyebrows inferiorly; wrinkles forehead | FROWNING 😠

Corrugator supercilli "Corrugator supersaiyan 😠"

Move eyeballs inferiorly and laterally

Superior oblique

Move eyeballs superiorly and laterally

Inferior oblique

Elevates eyelids = eye opening

Levator palpebrae superioris

What innervates levator palpabrae superioris

CN 3

Mnemonic for innervation of extrinsic muscles of the eye

SO4 LR6 R3 IO3

Innervation for superior oblique

CN 4 Trochlear nerve

Innervation of Lateral Rectus

CN 6 Abducens

Moves eyeball laterally

Lateral Rectus

Moves eyeball superiorly

Superior rectus

Moves eyeball inferiorly

Inferior rectus

Moves eyeball medially

Medial rectus

CN V1

Opthalmic branch

CN V2

Maxillary branch

CN V3

Mandibular branch

Muscles of mastication

"TIME" Temporalis m. Internal pterygoid m.(medial) Masseter m. External pterygoid m.(lateral)

Only muscle that retracts the mandible

Temporalis

Only muscle that depresses the mandible (open)

Lateral or external pterygoid

Muscles of mastication are innervated by

CN V3

Fan-shaped muscle

Temporalis

``` Temporalis O: I: A: -Anterior/Vertical fibers: -Posterior/Horizontal fibers: ```

``` Temporalis O: tempral bone I: coronoid process and ramus(Lat. side) A: -Ant/vertical fibers: elevates md -Post/horizontal fibers: retracts md ```

Only muscle that retracts the mandible

Posterior fibers of Temporalis

Muscles of mastication that elevates mandible

"TIM" Temporarlis Internal pterygoid Masseter

Internal pterygoid is aka

Medial pterygoid

External pterygoid is aka

Lateral pterygoid

Internal/medial pterygoid O: I: A:

Internal/medial pterygoid O: medial surface of the lateral pterygoid plate of the sphenoid bone I: ramus (medial side) and angle of md A: elevates md and bennett movement

Masseter O: I: A:

Masseter O: maxilla and zygomatic arch I: angle of md and ramus (Lateral) A: elevates md

External/Lateral pterygoid O: I: A: (3)

``` External/lateral pterygoid O: lateral surface of the lateral pterygoid plate of the sphenoid bone I: TMJ/Condyle A: -depresses md -bennett movt -protrudes md ```

Only muscle of mastication for mouth opening or depression of md

Lateral/external pterygoi

What is the major muscle for mouth opening

Anterior belly of digastric muscle

Anterior belly of digastric muscle is innervated by

CN V3

What innervates the posterior belly of digastric muscle

CN VII Facial nerve

Moves tongue inferiorly and anteriorly

Genioglossus

Genioglossus O: I: A:

Genioglossus O: genial tubercle I: tongue A: moves tongue inf and ant

Styloglossus OIA

Styloglossus O: styloid process of temporal bone I: tongue A: moves tongue sup and post

Hyoglossus OIA

Hyoglossus O: hyoid bone I: tongue A: moves tongue inferiorly

Extrinsic muscles are innervated by ✔️Genioglossus ✔️Styloglossus ✔️Hyoglossus ✔️Palatoglossus(except)

CN XII Hypoglossal nerve

What innervates Palatoglossus

Pharyngeal plexus (9/10/11) ix - Glossopharyngeal x - Vagus xi - Accessory

``` Palatoglossus O: I: A: -tongue: -palate: ```

``` Palatoglossus O: soft palate I: tongue A: -moves tongue SUP. towards palate -moves palate INF. towards tongue ```

Intrinsic tongue muscles

"VITS" Vertical m. Inferior longitudinal Transverse Superior longitudinal

Intrinsic muscles of tongue OIA

Intrinsic muscles of tongue O: tongue I: tongue A: changes SHAPE of tongue

Changes action of tongue

Extrinsic muscles of tongue

Changes shape of tongue

Intrinsic muscles of tongue (VITS)

Flattens and broadens tongue

Vertical

Shortens and thickens tongue (2)

Inf longitudinal | Sup longitudinal

Elongates and narrows tongue

Transverse

What innervates the intrinsic muscles of tongue (VITS)

CN XII Hypoglossal nerve

4 suprahyoid muscles

🔹Digastric muscle - ant and post belly 🔹Mylohyoid 🔹Stylohyoid 🔹Geniohyoid

Action of suprahyoid muscles (2)

Suprahyoid muscles depresses mandible and elevtaes hyoid

Muscle of floor of the mouth

Mylohyoid

Muscle that causes difficulty when taking radiograph on lower molars

Mylohyoid

What innervates the mylohyoid and anterior belly of digastric muscle

CN V3

What innervates the stylohyoid and post belly of digastruc m.

CN VII Facial nerve

Infrahyoid muscles

"TOSS Thyrohyoid Omohyoid Sternohyoid Sternothyroid

Action of all infrahyoid m.

Infrahyoid muscles depresses hyoid

Rotator cuff muscles

"SITS" Supraspinatus Infraspinatus Teres MINOR Subscapularis

Action of supraspinatus and sybscapularis

Medial rotation

Action of infraspinatus and teres MINOR

Lateral rotation

BQ: muscle used in pitching a baseball

Rotator cuff muscles

Hamstring muscles

(Hams3ngs - Bi Semi Semi) Biceps femoris Semimembranosus Semitendinosus

Action of hamstring muscles

Flexes legs

"Running muscles"

Hamstring muscles

What innervates the hamstring muscles

Sciatic nerve

Longest nerve in the human body

Sciatic nerve

Longest/largest CRANIAL NERVE in the BODY

CN X Vagus

Longest/largest CRANIAL NERVE in the HEAD and NECK

CN V Trigeminal

Longest INTRACRANIAL nerve

CN IV Trochlear

Smallest or shortest cranial nerve

CN IV Trochlear

Quadriceps muscles

Rectus femoris Vastus Lateralis Vastus Intermedius Vastus Medialis "Sa RECTO may 3 VASTUS"

Most common muscle for IM injection

Vastus Lateralis

Muscles for IM injection

✔️Vastus Lateralis ✔️Gluteus maximus ✔️Deltoid

Safest part of Gluteus Maximus to inject to avoid sciatic nerve

Superolateral or upper outer corner

Degree of IM injection

90 degrees

Action of all quadriceps muscles

Extend legs

Flexes legs: | Extends legs:

Flexes legs: hamstrings (bi semi semi) | Extends legs: quadriceps (3 vastus sa recto)

Innervation of quadriceps muscles

Femoral nerve

Needle angulation: INTRADERMAL

0-15 | choices: go for lowest value. 0 kung meron

Needle angulation: IV

35 degrees

Most common site for IV injection

Antecubital

Needle angulation: SUBCUTANEOUSLY

45 degrees

Most common drug injected subcutaneously

Insulin

Needle angulation: IM

90 degrees

Type of muscle adaption where there is healing fibrous scar tissue

Fibrosis

Enlargement of muscle fiber

Muscular hypertrophy

Type of enlargement of muscle fiber or muscle hypertrophy assoc with CONGESTIVE HEART FAILURE

Pathologic muscular hypertrophy

Type of enlargement of muscle hypertrophy assoc with patient exercising

Physiologic muscular hypertrophy

Increase in number or muscle fibers or cells

Muscular hyperplasia

Type of muscle cells that can undergo hyperplasia

Smooth muscles

"Muscle wasting"; loss of myofibrils

Muscle atrophy

Painfully twisted and tilted neck due to contraction of sternocleidomastoid

Torticollis

Other name for torticollis

Wry neck

Px with torticollis or wry neck: contraction of RIGHT sternocleidomastoid = chin goes to what side

Right SCM = Chin LEFT side

General term for muscle degeneration

Muscular dystrophy

It is the most common muscular dystrophy. It is a genetic disorder characterized by progressive muscle degeneration

Duchenne Muscular Dystrophy

Abnormal, random, spontaneous muscle contractions

Fibrillation

Pacemaker of heart

Sinoatrial node (SA node)

SA node is seen in the

Crista terminalis which is located in the SUPERIOR portion of RIGHT ATRIUM

Tx for fibrillation: administering a controlled electrical shock to restore nrmal rhythym

Defibrillation

Stop in effective blood flow due to FAILURE OF HEART TO CONTRACT effectively

Cardiac arrest

An example of cardiac arrest aka "flat line"

Asystole

Management for Asystole or flat line

CPR

Ration of compressions: breaths in CPR

30 compressions : 2 breaths

Compression rate

100 compressions per minute