Chapter 7

Managing Muscles

We found out that there are a lot of bones in the body. Well, it should be no surprise that there
are also a lot of muscles. If you've ever watched modern dancers you might have appreciated
the number of muscles needed to move the human body in such complex ways. Hopefully we
can provide some help in learning about the muscular system. But before we dive into the
many muscles of the body let’s go over some background information.

Big Picture: Muscle Movements

Muscles move joints just like teeter-totters, wheelbarrows and fishing poles.

Muscles and joints act as levers. There are three types of levers (Fig. 7. 1). These are:
Class 1—the teeter-totter
Class 2—the wheelbarrow
Class 3—the fishing pole

Levers contain three basic parts: the fulcrum, pull and weight. The object is to lift something
(this is the weight). The fulcrum is the pivot point and the pull is where the force connects to
the system. Let’s take our three examples and explain them in a bit more detail.

The Teeter-totter
A class 1 lever is like a teeter-totter. Remember those cartoons where one character jumps off
of a cliff and lands on one end of a teeter-totter causing another character to launch into the
sky? Well the jumper is the pull and the poor unfortunate flyer is the weight. The fulcrum is in
the middle. So we describe first class levers in terms of the fulcrum being between the pull and
the weight.

The Wheelbarrow
A class 2 lever is like a wheelbarrow. Think of carting dirt to your garden. You lift the
wheelbarrow by the handles (pull) and carry the dirt (weight) as the wheelbarrow glides on the
wheel (fulcrum).

The Fishing Pole

A class 3 lever is like a fishing pole. Think of going to your favorite fishing spot and casting in the
calm, glittering lake. The fulcrum is where you hold the pole. The pull is provided by your arm
and the weight is the combination of hook, line and sinker at the end of the pole. So the
fulcrum and weight are at opposite ends while the pull is in the middle.
Fig. 7.1. Levers.

Big Picture: Muscle Contractions

Isotonic: lifting weights at the gym.

Isometric: pushing against a wall.
Isokinetic: walking on a treadmill.

There are three types of muscle contractions. All three are used in treating injuries in
rehabilitation and physical therapy settings. It is important to learn what these terms actually
mean. Iso means equal and tonic means tone or force. So in isotonic contractions (iso = equal,
tonic = tone) the force remains the same but the length of the muscle changes. An example of
an isotonic contraction is the classic biceps curl with a barbell. The force exhibited by the
barbell does not change. However the length of the bicep muscle can change by shortening
during the lifting phase and lengthening during the lowering phase. Isotonic exercises are used
in many gyms in which participants use barbells and selectorized weight equipment.

In isometric contractions (iso = equal, metric = length) the force can change but the length of
the muscle remains the same. In isometric contractions there is no movement of the joint since
the muscle length does not change. An example of an isometric contraction would be pushing
against an object that cannot be moved such as a wall. You can push with a little amount of
force or a lot of force (force can change) but there is no movement of the joint

In isokinetic contractions (iso = equal, kinetic = motion) both the force and length of the muscle
can vary but the contraction happens at a fixed speed. Isokinetic exercises are primarily used in
rehabilitation settings. Sophisticated machines are used to control the speed of the exercise
while allowing varying resistance. However a simple treadmill is a good example of isokinetic
exercise. You can exercise at a fixed speed with varying degrees of force provided by the
different incline angles of the treadmill.

Agonist—Antagonist
Some muscle terms (like agonist and antagonist) can be a bit confusing at first. The trick to
learning these terms is to think of them as follows:

1. Name the joint and the movement.

2. Figure out which muscle is moving the joint.
3. Apply the right term.

Let’s use an example. Let’s say I finally got my behind in the gym and picked up a 10 lb. barbell
to do a biceps curl. So how do I determine this agonist-antagonist stuff? Let’s use the above
steps:

1. Name the joint and the movement. Okay my elbow is moving into flexion during the curl.

2. Figure out which muscle is moving the joint. Okay I feel my biceps muscle contracting.

3. Apply the right term. Hmmm, that must mean my biceps is the agonist.

Great, so if the biceps is the agonist, which muscle is the antagonist? It’s the one that opposes
the movement (usually on the other side of the joint). This would be the triceps.

So, that’s great but what if the movement changes? Do the agonist and antagonist change as
well? Yes they can change. Let’s go back to the gym to find out. Let’s say that now I lift the
weight from behind my head by straightening my elbow.

1. Name the joint and the movement. Okay my elbow is now going into extension.
2. Figure out which muscle is moving the joint. Okay I feel my triceps is contracting.
3. Apply the right term. Hmmm, that must mean my triceps is now the agonist while my biceps
is now the antagonist.

See, use these steps and you will always get the right muscle.

Concentric—Eccentric Contractions
More muscle terms. These have to do with the shortening or lengthening of muscles. In
concentric contractions the muscle shortens against a load. Eccentric contractions are just the
opposite. Muscles lengthen against a load.

Back to the gym (I told you the gym was a great place to learn about muscles!). During my
biceps curl exercise when I lift the weight (elbow flexion) my biceps is shortening so it is
performing a concentric contraction. Likewise when I lower the weight (elbow extension) my
biceps is lengthening so it is now performing an eccentric contraction.
Muscles are more prone to injuries during eccentric contractions. A few years ago I attended a
training seminar where all of us attendees had to participate in an exercise sequence consisting
of lunges.

Lunges are where you take a big step forward with say your right foot and then bend your right
knee until your left knee touches the floor. Lunges incorporate an eccentric contraction of the
hamstrings. Needless to say the next day I could hardly get out of bed because of my sore
hamstrings!

Another classic example of an injury occurring from an eccentric contraction is the good ole
rotator cuff tear. One of the jobs of the rotator cuff muscles is to slow down the internal
rotation of the shoulder. Baseball pitchers (or dads who play ball with their kids) incorporate
eccentric contractions of the rotator cuff muscles when they throw the ball. In some cases this
can either aggravate or cause an injury to the rotator cuff.
Fig. 7.2 Major Muscles of the Body.

Fig. 7.3 Major Muscles of the Body (Posterior).

Overview of the Muscular System

How to Learn Muscles

Just as there are lots of bones in the body there are also lots of muscles that move the bones
(Figs. 7.2, 7.3). One trick to learning these is to group the muscles according to regions. For
example learn the shoulder muscles, then arm muscles, forearm muscles and so on. It also
helps to learn the superficial muscles first before learning the deep muscles. You can learn just
a few muscles in a region. Once you learn these then learn a few more and so on. The more you
repeat this process the more you will learn.

Another method to help you to learn muscles is to (heaven forbid) work out. Think about which
muscles are active during certain movements like walking, reaching, bending at the waist and
so on. Begin with the big ones and then move on to the more specific muscles.

Try to associate a muscle with the movement it produces.

I use my biceps to bend my arm.
I use my triceps to straighten my arm.
I use my deltoid to raise my arm.
I use my wrist flexors to bend the wrist.
I use my wrist extensors to straighten the wrist.
I use my quadriceps to kick a ball.
I use my hamstrings to bend my knee.
I use my gastrocs to walk on my toes.
I use my tibialis anterior to walk on my heels.
I can lift my leg with my psoas.
When I walk my glutes will talk.
I bend forward with my abdominals.
I straighten up nice and erect with the erector spinae.
I shrug my shoulders with my traps.
Put your hands together and squeeze your pecs.

Here’s a little rhyme to help you to remember the muscles and their movements.
I use my gastrocs to walk on my toes.
My biceps and deltoid help me touch my nose.
I bend my waist with my abs and wait…
Until my erector spinae makes my spine straight…
My quads let me kick a ball…
My triceps let me push on a wall…
I lift my leg to take a step…
My psoas muscle has a lot of pep…
As I walk my leg falls behind…
The behind that moves my leg this way is of the gluteal kind...
I turn my head to the right and left and then…
Tell my SCM (sternocleidomastoid) to stop contracting when…
I wave goodbye and as my wrist flops…
My wrist flexors and extensors stop.

Muscles, Muscles, and more Muscles!

A Big Picture Approach to Learning Muscles

So you need to memorize 50 muscles for the upcoming exam? Well, personally I am against the
brute force memorization technique. In my opinion I think relating the muscles to something
you already know is a better way to learn muscles. So what do you already know? Well, if you
have been studying how your limbs move you are actually well on your way to learning
muscles.

Hey, something’s gotta move those joints like the shoulder, elbow, hip and knee. That
something is a muscle (or groups of muscles). So let’s learn some muscles by relating them to
joint movements.

Arm, Forearm and Hand (Figs 7.4-7.7)

Let’s start with something a bit on the easy side. You probably know that you can bend your
elbow (flexion) and straighten your elbow (extension). Well, there must be some muscles that
pull on your bones to do this.
The forearm (antebrachium) can move into flexion, extension and rotation.
The flexors include the biceps brachii, brachioradialis and brachialis.
The biceps brachii attaches to the scapula and extends to the radial tuberosity. This muscle has
two heads at its proximal region. It works to flex the elbow.

The brachialis lies deep to the biceps brachii and extends to the ulna.
The brachioradialis attaches to the humerus and extends to the radius.

There is only one muscle that functions in elbow extension. This muscle is the triceps brachii.
This muscle is a large three headed muscle that attaches to the scapula and humerus and
extends to the ulna. It is the only muscle on the back side of the arm.

The rotators of the forearm include the supinator, pronator teres and pronator quadratus.
The supinator attaches to the ulna and extends to the lateral aspect of the humerus. It works to
move the wrist into supination (remember palms up—cup of soup—supination).

There are two pronators and their names include the word “pronation.” The pronator teres
attaches to the humerus and ulna and extends to the radius. It works to move the wrist into
pronation.

The pronator quadratus attaches to the distal ulna and radius.

Now let’s move to the wrist and hand. Which do you think can move in a more complex
manner, the elbow or wrist? If you said wrist you were right. The elbow can only flex, extend
and rotate but the wrist and hand can do some really complex things like write an essay or
conduct an orchestra. So there are a few more muscles that are needed to do this.

First of all you can group the wrist and hand flexors together. The name of the muscle also tells
you where it is located. For example the flexor carpi radialis longus can be translated into the
“long flexor running to the wrist (carpi) on the side of the radius bone (radialis)”. Likewise there
is a sister flexor on the other (ulnar) side as well called the flexor carpi ulnaris. There is a flexor
muscle running down the middle of the forearm called the palmaris longus that goes to, you
guessed it, the palm of the hand.

Okay so now we have some flexor muscles that move the wrist and hand but what about the
fingers? We have some deeper forearm muscles to take care of that as well. These are the
flexor digitorum superficialis (superficial flexor to the digits) and the flexor digitorum
profundus (profundus means deep).

The wrist area contains a large number of tendons from muscles that move the wrist and hand.
There is a large flat tendon on the palmar side of the wrist known as the flexor retinaculum.
This structure helps to form the infamous carpal tunnel. A few muscles travel through the
carpal tunnel on their way to the fingers.
Fig. 7.4. Muscles of anterior thorax and arm.

These muscles include:

• Flexor carpi radialis longus and brevis
• Flexor digitorum profundus
• Flexor digitorum superficialis

So much for the flexors, but what about the extensors? Well these are located on the back of
the arm and forearm. The wrist extensors have a common origin on the lateral epicondyle.
Wrist extensor tendonitis (lateral epicondylitis) known as tennis elbow can develop here.

The wrist and hand extensors include the extensor carpi radialis longus (long extensor muscle
on the side of the radius bone), extensor carpi radialis brevis (short extensor muscle on the
side of the radius bone), extensor carpi ulnaris, extensor digitorum and extensor digiti minimi.
Fig. 7.5. Anterior forearm muscles.

Fig. 7.6. Deep anterior forearm muscles.

Figure 7.7. Posterior forearm muscles.

Shoulder (Figs 7.8, 7.9)

The shoulder is a complex joint so there are a good number of muscles needed to move it.

The arm and scapula work together to allow the arm to move.
There are a couple of really important muscles in the shoulder. One of these sits right on top of
the shoulder. This is the deltoid muscle. If you see an athlete with broad shoulders chances are
he has some well developed deltoids (or as they say in the gym “delts”). The deltoid is located
on top of the humerus bone. It attaches to the spine of the scapula and acromion process and
extends to the deltoid tuberosity of the humerus. The deltoid works to flex, abduct and extend
the arm.

Another important muscle connects to the shoulder and spine. This one is the trapezius. It is a
large diamond shape (trapezoidal) muscle that begins at the occipital bone and reaches out to
the scapula and down to the end of the thoracic spine.

The trapezius has upper, middle and lower divisions. The trapezius attaches to the thoracic and
cervical vertebra and extends upward to the occipital bone and laterally to the scapula. The
upper portion raises the shoulder and scapula. The middle portion pulls the scapula toward the
vertebral column and the lower portion pulls the scapula downward. The divisions of the
trapezius are evidenced by the direction of the fibers.
The arm can move into flexion, extension, adduction, abduction, internal and external rotation
as well as combinations of these movements.

The flexors include the coracobrachialis, pectoralis major, and deltoid.

The coracobrachialis also tells you where it is located by virtue of its name. It attaches to the
coracoid process of scapula (coraco) and extends to the shaft of the humerus (brachialis).It runs
deep to the deltoid and biceps muscles. The pectoralis major (another great gym muscle—
pecs) attaches to the clavicle, sternum and costal cartilages of ribs and extends to the
intertubercular groove of the humerus.

The arm extensors include the teres major and latissimus dorsi. The teres major attaches to the
lateral border of the scapula and extends to the intertubercular groove of the humerus. The
latissimus dorsi attaches to the lower thoracic humerus. It abducts as well as externally rotates
the arm.

The infraspinatus attaches to the posterior portion of the scapula at the subscapular fossa and
extends to the greater tubercle of the humerus. It externally rotates the arm.
The subscapularis attaches on the anterior surface of the scapula and extends to the lesser
tubercle of the humerus. It is the only rotator cuff muscle that provides internal rotation.

The teres minor attaches to the lateral border of the scapula and extends to the greater
tubercle of the humerus. It externally rotates the arm.

Here is a way to help you learn the rotator cuff muscles.

We can think of these as the SITS muscles.
Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Since the rotator cuff muscles are often injured by pitching we can think of a baseball player
who SITS out for the rest of the game and then gets sent to the minor league.
Another way to learn the rotator cuff is to stand next to someone facing the same direction as
you and place your left hand on their left shoulder so it ends up on the backside with the index
finger on top. Your index finger is now over the supraspinatus. Your second finger is over the
infraspinatus and your third finger is over the teres minor and subscapularis.

There are two rhomboid muscles that pull the scapula upward and medially. The larger
rhomboid major is the inferior muscle of the two. The smaller rhomboid minor is superior to
the major.

The levator scapula is a long thin muscle that attaches to the superior border of the scapula
and extends upward to the occipital bone. As its name implies, the levator scapula works to
elevate the scapula.
The serratus anterior attaches to the anterior surface of the scapula and extends to the ribs.
The serratus anterior works to hold or stabilize the scapula against the ribcage.

The pectoralis minor muscle is located deep to the major. It attaches to the upper ribs and
extends to the coracoid process of the scapula. It works to pull the scapula anterior and
inferior. The pectoralis minor is also an accessory muscle of inspiration.

Fig. 7.8. Deep muscles of the thorax and shoulder.

Figure 7.9. Rotator cuff muscles.

Muscles of the Head and Neck

The muscles of the head and neck move the face, larynx and tongue. A sample of muscles of
facial expression follows.

Muscles of facial expression (Fig. 7.10)

Located on top of the head is a broad flat tendon called the epicranial aponeurosis.
There is one muscle with two parts attached to the anterior and posterior sections of this
tendon. The muscle is called the occipitofrontalis. The anterior portion lifts the eyebrows. The
posterior is a weak head extensor and can cause headaches.

There are two circular muscles called sphincters. The orbicularis oculi encircles the eye. It
compresses the lacrimal gland and closes the eye. The orbicularis oris encircles the mouth. It
causes the lips to pucker.

The buccinator is located in the cheek. It compresses the cheek against the teeth. The
zygomaticus muscle has major and minor divisions and attaches to the orbicularis oris and
zygomatic bone. It raises the lateral ends of the mouth when smiling. The platysma is a very
thin and superficial muscle located under the chin. It causes the action of frowning when
contracted.
Muscles of Mastication
The muscles of mastication (chewing) include the masseter, temporalis, medial and lateral
pterygoids. The masseter muscles attach to the mandible and allow for closing the jaw. The
temporalis is located in the lateral skull and attaches to the temporal bone. The temporalis aids
in closing the jaw. In fact you can feel your temporalis muscles contract when touching the
sides of your head when clenching your jaw. The medial and lateral pterygoids are deep
muscles in the jaw. These can elevate, depress, protract and cause lateral movement of the
mandible. These muscles are often involved in temporomandiblular joint (TMJ) disorder

Fig. 7.10. Head and neck muscles.

Head and Spine (Figs 7.11, 7.12)

There are a number of muscles that attach to the spine and move the head. The
sternocleidomastoid (SCM)(sterno—sternum, cleido—clavicle, mastoid—mastoid process on
temporal bone) attaches to the mastoid process of the temporal bone as well as the clavical
and sternum. It produces contralateral rotation when one muscle contracts and neck flexion
when both muscles contract.

The splenius capitus is located in the posterior portion of the neck. It helps bring head into an
upright position (head extension). It also causes ipsilateral rotation and lateral flexion when one
muscle contracts.

The semispinalus capitus also produces head extension as well as lateral flexion and rotation. It
connects to the occipital bone and vertebra of the cervical and thoracic spines.

The erector spinae group of muscles consists of several muscles running up and down the
spine. These consist of the spinalis, longissumus, iliocostalis and semispinalis muscles. They
are located in the cervical, thoracic and lumbar spines. The names of these muscles give you a
good clue as to their locations. For example the spinalis muscles are located medially attaching
directly to the spinal segments. The iliocostalis muscles attach to the ribs (iliocostalis thoracis)
(costal = ribs). The longissumus muscles have long fibers and the semispinalis muscles run just
lateral to the spinal segments.

Here is a trick to help you remember the erector spinae muscles:

To memorize these think “I Love Sex:”
Iliocostalis
Longissimus
Spinalis

Fig. 7.11. Muscles of the back.

Fig. 7.12. Deep muscles of the back.

Abdominal Wall Muscles (Figs 7.13, 7.14)

The contents of the abdomen are protected by a band of muscles. There are three layers of
abdominal muscles that include four muscles. The first layer consist of the rectus abdominis (six
pack) which lies in front and center in the abdomen and the external obliques which are
located on the sides of the abdomen. The second layer consists of the internal obliques which
lie deep to the external obliques and the third layer consists of the transverse abdominis.

Some of the abdominal muscles attach to a broad dense band of connective tissue known as
the linea alba. The linea alba extends from the xiphoid process to the symphysis pubis.

The abdominal muscles aid in trunk flexion. They also compress the contents of the abdominal
cavity, increase intra-abdominal pressure and help to transmit force through trunk to protect
the spine and contents of the abdominal cavity.

The transverse abdominis muscle is becoming a very important muscle in rehabilitation of low
back injuries. This muscle acts as a natural back brace since its fibers run in a transverse plane.

Here is a trick to help you remember the abdominal muscles:

We can think of someone with a spare tire around their abdomen.
TIRE
Transversus abdominis
Internal obliques
Rectus Abdominis
External obliques

As far as the way the fibers run, think of your hands in your pockets. Your fingers point in the
direction of the external oblique fibers. The internal oblique fibers go the opposite way.

Fig. 7.13. Superficial abdominal muscles.

Fig. 7.14 Transverse abdominis.

Pelvic and Upper Thigh Muscles (Fig. 7.15)

Muscles that move the thigh connect to the pelvis and femur. The anterior muscles include the
psoas and iliacus and the posterior muscles include the gluteus maximus, gluteus medius,
gluteus minimus, and tensor fasciae latae.

The psoas muscle actually has two divisions. The psoas major attaches to the lower lumbar
vertebra and extends to the lesser trochanter of the femur. The psoas minor muscle is smaller
and inserts on the pubic bone. The Iliacus muscle attaches to the ilium and also extends to the
lesser trochanter of the femur. Since both the psoas major and iliacus share a common
insertion point they are often referred to as the iliopsoas. The iliopsoas works to flex the hip.

The gluteus maximus is one of the strongest and largest muscles of the body. It attaches to the
iliac crest, sacrum, coccyx and the aponeurosis of the sacrospinalis. It extends to the linea
aspera of the femur and the iliotibial band. It works to produce hip extension.

The gluteus medius lies deep to the gluteus maximus. It attaches to the ilium and extends to
the greater trochanter of the femur. It works to produce hip abduction and extension.

The gluteus minimus lies deep to the gluteus medius. It is the smallest gluteal muscle.
The tensor fasciae latae is located on the lateral aspect of the thigh. It attaches to the iliac crest
and extends to a band of dense connective tissue called the iliotibial tract or band. The iliotibial
band extends down the lateral aspect of the femur to the tibia. It is a flat tendon or
aponeurosis. Tendonitis can develop in this tendon in a condition known as iliotibial band
syndrome.

Deep muscles in the posterior pelvic area include the piriformis, obturator internus, obturator
externus, superior and inferior gemellus and quadratus femorus muscles. All of these muscles
work to externally rotate and abduct the hip (Fig. 7.16) .

To learn the external rotators of the hip think “Play Golf Or Go on Quitting:”
Pirformis
Gemellus superior
Obturator internus
Gemellus inferior
Quadratus femorus

Muscles on the proximal medial aspect of the thigh include the adductor longus, adductor
brevis, adductor magnus, pectineus and gracilis. These muscles attach to the pubic bone and
extend down the thigh to various insertion points on the femur. They work to adduct the hip.

Fig. 7.15. Anterior thigh muscles.

Fig. 7.16. Deep posterior muscles of the pelvis.

Posterior Thigh Muscles (Fig. 7.17)

The posterior thigh muscles include the hamstring group. The hamstrings consist of three
muscles which include the biceps femorus, semimembranosus, and semitendinosus. The
hamstrings work to produce knee flexion.

The biceps femorus is a two-headed muscle. The long head attaches to the ischial tuberosity
and the short head attaches to the linea aspera and lateral supracondylar line of the femur. The
muscle then extends inferior to attach to the head of the fibula.

The semimembranosus attaches to the ischial tuberosity and extends inferior to attach to the
medial condyle of the tibia and lateral condyle of the femur.

The semitendinosus attaches to the ischial tuberosity and extends inferior to attach to the
medial aspect of the upper tibia.

Posterior Knee
Located in the posterior portion of the knee is the popliteus muscle. If the femur is fixed the
popliteus works to internally rotate the tibia. If the tibia is fixed it works to externally rotate the
femur.

Muscles of the Anterior Leg (Fig. 7.18)

The muscles of the anterior portion of the leg work to dorsiflex the foot. These include the
tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius.

The tibialis anterior is located just lateral to the tibia. It attaches to the lateral condyle of the
tibia, the lateral aspect of the proximal portion of the tibia and the interosseous membrane
that connects the tibia and fibula. It extends downward to attach to the medial cuneiform and
first metatarsal. The tibialis anterior is involved in shin splints.

The extensor hallucis longus lies deep to the tibialis anterior. It attaches to the anterior aspect
of the fibula and interosseous membrane and extends downward to attach to the first distal
phalanx. Besides being a synergist for dorsiflexion of the foot it also extends the big toe.

The extensor digitorum longus also lies deep to the tibialis anterior. It attaches to the lateral
condyle of the tibia, shaft of the fibula and interosseous membrane. It works as a synergist in
dorsiflexion of the foot and extends the toes. It also works to tighten the plantar aponeurosis.

The peroneus tertius is part of the peroneal group that includes the peroneus longus and
peroneus brevis. This muscle works to dorsiflex and evert the foot. It attaches to the medial
surface of the lower portion of the fibula and extends to the fifth metatarsal. The peroneal
group works together to evert the foot.
Fig. 7.17. Hamstrings.
Fig. 7.18. Anterior leg muscles.

Muscles of the Posterior and Lateral Leg (Fig. 7.19)

The muscles of the posterior leg work to plantarflex the foot (point your toe). These include the
gastrocnemius, soleus, flexor digitorum longus and tibialis posterior.
The gastrocnemius is a two-headed muscle that crosses both the knee and ankle joints. Its
action in the knee is to help with knee flexion. It also works to produce ankle plantarflexion. It
attaches to the femoral condyles and posterior surface of the distal femur and extends
downward to attach to the calcaneus.

The soleus lies deep to the gastrocnemius. It attaches to the posterior aspect of the proximal
fibula and tibia and extends downward to attach to the calcaneus. The soleus only crosses the
ankle joint and produces ankle plantarflexion.

The gastrocnemius and soleus both insert on the large Achilles (calcaneal) tendon and are
known collectively as the triceps surae.

The tibialis posterior is also a deep muscle of the posterior leg. It attaches to the posterior
proximal surface of the tibia and fibula and extend downward to attach to the navicular, medial
cuneiform and second to fourth metatarsals. It works to produce plantarflexion and also helps
to control pronation of the foot while walking.

The flexor digitorum longus is a deep muscle of the posterior leg. It attaches to the posterior
surface of the tibia and extends downward to attach to the second through fifth distal
phalanges. It works to flex the toes and stabilizes the metatarsal heads.
The peroneus longus is located on the lateral aspect of the lower leg. It attaches to the tibia
and fibula and extends to the medial cuneiform and first metatarsal.

The flexor hallucis longus is a deep muscle on the lateral aspect of the leg. It attaches to the
distal portion of the fibula and interosseous membrane and extends to attach to the big toe. It
works to flex the big toe.

Fig. 7.19. Muscles of the posterior leg.

Muscles of the Foot (Figs. 7.20, 7.21)

The top of the foot is known as the dorsum of the foot. The only muscle located exclusively on
the dorsum of the foot is the extensor digitorum brevis. This muscle attaches to the calcaneus
and extensor retinaculum of the ankle and extends to the big toe and tendons of the extensor
digitorum longus. It works to produce extension of the toes.

The bottom or sole of the foot is known as the plantar region of the foot. This area contains
four layers of muscles.

The layers from superficial to deep include:

Layer 1:
• Flexor digitorum brevis
• Abductor hallucis
• Abductor digiti minimi
Layer 2:
• Quadratus plantae
• Lumbricales
Layer 3:
• Adductor hallucis
• Flexor digiti minimi brevis
• Flexor hallucis brevis
Layer 4:
• Dorsal interossei
• Plantar interossei

Fig. 7.20 Muscles of the dorsum of the foot.

Fig. 7.21. Deep muscles of the dorsum of the foot.

How Muscle Tissue is put Together

Big Picture: Muscle Tissue Structure

Muscle tissue consists of bundles within bundles within more bundles. The smallest bundles
contain protein rods (filaments) that slide past each other when muscles contract.

Too bad the names for the bundles are not something simple like “big bundle,” “smaller
bundle,” and so on. Of course this is anatomy so the names are a bit more complex. So here’s
how it goes.

Muscle is surrounded by a covering called the epimysium. If you look inside you will see bundles
called fascicles. Each fascicle has a covering called the perimysium. Inside the fascicles are
smaller bundles of muscle fibers covered by the endomysium. Protein filaments are located
inside the fibers. See, that wasn’t too bad! (Fig. 7.22)
Fig. 7.22. Muscles consist of smaller and smaller bundles.
1. Bone 2. Perimysium 3. Blood vessel 4. Muscle fiber 5. Fascicle 6. Endomysium 7.
Epimysium 8. Tendon
2.
Now, there are two kinds of protein filaments. These are called actin and myosin. Actin is also
known as the thin filament and myosin is known as the thick filament. (Fig. 7.23)
Actin is actually a protein in the shape of a double helix (like DNA). Actin contains another
protein complex that wraps around it. This protein complex consists of two proteins called
troponin and tropomyosin and is known as the troponin-tropomyosin complex. Myosin
contains large globular protein heads.

Fig. 7.23. Actin and Myosin

Actin and myosin are arranged in an overlapping structure (Fig. 7.24) called a sarcomere. A
muscle cell consists of many sarcomeres. Each sarcomere can be thought of as a contractile
unit. A sarcomere begins and ends at the Z-discs. Titan protein helps to hold the myosin in
place. During muscle contraction the actin and myosin slide past each other and the sarcomere
shortens. Since the muscle contains many sarcomeres, the muscle shortens as well.

Fig. 7.24. Sarcomere

There is another important structure in muscle tissue we need to mention. The sarcoplasmic
reticulum (Fig. 7.25) is network of tubules that wraps around the muscle fibers. At each end of
the sarcoplasmic reticulum is an enlarged tube called the terminal cisterna. The outer
membrane of the muscle fiber is called the sarcolemma. The sarcolemma also contains tubular
structures called T-tubules. The T-tubules extend into the muscle fiber and wrap around the
sarcomeres. They also extend to the extracellular fluid surrounding the muscle fiber. The T-
tubules and terminal cistern form what is called a triad. The sarcoplasmic reticulum stores
calcium needed for muscular contraction.
Fig. 7.25. The sarcoplasmic reticulum is a network of membranous tubules that surrounds a
muscle cell.

The Big Picture: Muscle Contraction

Muscles respond to signals from the nervous system.

Muscles respond to nervous system signals by depolarizing.
Depolarization of muscles causes release of calcium.
Calcium causes actin and myosin to form cross bridges.
ATP causes myosin to pull actin along causing the muscle to contract.

Let's go through this process step by step.

Muscles respond to signals from the nervous system.

Muscle contraction begins with a message from the nervous system. Nervous system cells
called neurons connect to muscle cells at a special area called the motor end plate. Neurons
send messages to muscle cells by secreting a chemical called a neurotransmitter. The
neurotransmitter floats from neuron to the motor end plate on the muscle cell. In the case of
muscle contraction the neurotransmitter is chemical called acetylcholine.
Muscles respond to nervous system signals by depolarizing.
When acetylcholine moves to the motor end plate it connects to receptors and causes a change
in the muscle cell. Muscle cells typically like to live in a polarized state. This means that the
inside of the muscle cell is negative with respect to the outside. When acetylcholine attaches to
motor end plate receptors it causes the muscle cell to change its state from polarized to
depolarized. It does this by causing sodium gates to open in the muscle cell. Since there is more
sodium outside of the cell than inside, sodium flows into the muscle cell. Since sodium is
positively charged the muscle cell becomes less negative (because positive sodium charges are
moving in). We say the muscle cell is depolarizing.

Depolarization of muscles causes release of calcium.

The depolarization spreads across the muscle cell and reaches the sarcoplasmic reticulum.
Remember that the sarcoplasmic reticulum typically stores calcium by actively transporting it.
Depolarization causes the sarcoplasmic reticulum to release its stored calcium.

Calcium causes actin and myosin to form cross bridges.

Calcium reaches the actin and attaches to the troponin portion of the troponin-tropomyosin
complex. This causes the complex to move which exposes a binding site for myosin on the actin.
Myosin can now bind to actin forming a cross bridge.

ATP causes myosin to pull actin along causing the muscle to contract.
Myosin can now pull actin along but it need energy in the form of ATP to do so. Myosin
completes what is called a power stroke whereby it pulls actin and then releases so that it can
again form a cross bridge to further move actin along. This results in shortening of the
sarcomere and since the muscle cells contains many sarcomeres the cell contracts.
Take a look at the following sequence of diagrams.
Fig. 7.26. Neurons send messages in the form of neurotransmitter to the motor end plate on
muscle cells. Once the neurotransmitter (acetylcholine) attaches to receptors on the motor end
plate, the muscle cell depolarizes.
Fig. 7.27. Depolarization causes the sarcoplasmic reticulum to release calcium.

Fig. 7.28. Calcium attaches to the troponin portion of the troponin-tropomyosin complex.
Fig. 7.29. Calcium causes the troponin-tropomyosin complex to move. This exposes the myosin
binding site on the actin.
Fig. 7.30. Myosin can now bind with actin forming a cross bridge.
Fig. 7.31. Myosin pulls actin along powered by ATP.

Muscle Twitch

Big Picture: Muscle Twitch

When a muscle fiber receives a stimulus from the nervous system it contracts (twitches). The
response occurs in 3 phases.
The time between activation of a motor neuron and a muscle contraction is called the lag
phase.
The muscle contracts during the contraction phase.
The muscle relaxes during the relaxation phase.

We can improve our understanding of muscle contraction by examining the contraction of one
muscle fiber. A twitch occurs when one muscle fiber contracts in response to a message
(stimulus) by the nervous system. The time between the activation of a motor neuron until the
muscle contraction occurs is called the lag phase (sometimes called the latent phase). During
the lag phase a signal called an action potential moves to the end of the motor neuron. This
results in release of acetylcholine and depolarization of the motor end plate. The depolarization
results in the release of calcium by the sarcoplasmic reticulum and subsequent binding of
calcium to troponin which causes the myosin binding site to be exposed.

This is followed by the actual muscle contraction that develops tension in the muscle. This next
phase is called the contraction phase. During the contraction phase, cross-bridges form
between actin and myosin. Myosin moves actin, releases and reforms cross-bridges many times
as the sarcomere shortens and the muscle contracts. ATP is used during this phase and energy
is released as heat.

When the muscle relaxes the tension decreases. This phase is called the relaxation phase.
During this phase calcium is actively transported back into the sarcoplasmic reticulum using
ATP. The troponin moves back into position blocking the myosin binding site on the actin and
the muscle passively lengthens.

Muscle Stimulus and Contraction Strength

Big Picture Muscle Stimulus and Contraction Strength

If the stimulus is strong enough (reaches threshold) the muscle fiber will contract with a given
force (no more—no less).

A skeletal muscle fiber will produce a given amount of force if the stimulus is strong enough to
reach the threshold for contraction. This is called the all or none law. Let’s say that we are
electrically stimulating a muscle fiber. We begin with a low amount of stimulation that does not
reach the threshold to produce a contraction. The muscle fiber will respond by remaining
relaxed, it will not contract. Now if we increase the stimulation so that we reach the threshold
the muscle fiber will respond by contracting. Finally if we continue to increase the stimulus so
that it well exceeds the threshold the fiber will respond by contracting with the same force as
when we just reached the stimulus. The muscle will not contract with greater force if the
stimulus is greater. The muscle responds to stronger stimuli by producing the same force.

Motor Units
Big Picture: Motor Units
A motor unit is a motor neuron connected to a set of muscle fibers. As more force is needed,
more motor units contract.

In skeletal muscles a motor neuron can innervate many muscle fibers. This is called a motor
unit. There are numerous motor units throughout skeletal muscles. Motor units act in a
coordinated fashion. One stimulus will affect all of the muscle fibers innervated by a given
motor unit.

Whole muscles containing many motor units can contract with different amounts of force.
More motor units are recruited to increase the force of contraction when needed. This
phenomenon is called summation. In other words, increasing numbers of motor units are
activated in order to increase the muscle’s force of contraction.

Let’s look at an example. Let’s say that you are helping a friend move to a new house. You are
holding an empty box while your friend fills it up with various items. The weight of the box or
“load” is increasing. Your biceps muscles must respond by increasing their force of contraction
so that you will avoid dropping the box. As the load increases more motor units are recruited
and the force of contraction increases to accommodate the load.

Nerves contain many axons of neurons that innervate many motor units. If a nerve is stimulated
to produce a stimulus that is below the threshold no action potential is generated in the
neurons and there is no muscle contraction. This is called a subthreshold stimulus. If the
stimulus is strong enough to produce an action potential we say that the stimulus is a threshold
stimulus. As the stimulus increases more motor units are recruited. We call this stimulus a
submaximal stimulus.

When the stimulus is strong enough to cause activation of all of the motor units associated with
the nerve we say that the stimulus is a maximal stimulus. A stimulus greater than a maximal
stimulus (supramaximal stimulus) will not have any additional affect on contraction of motor
units.

The ratio of neurons to muscle fibers differs in various muscles. Muscles involved in more
precise movements such as in the hands have a smaller ratio of neurons to muscle fibers,
whereas muscles involved in gross movements such as the muscles in the thigh have a higher
number of fibers innervated by one neuron.

Muscle Contraction Frequency

Big Picture: Muscle Contraction Frequency

There is a maximum frequency of nervous system impulses that will cause a complete
contraction of a muscle (tetanus).

When a muscle is stimulated by the nervous system it will contract. The time it takes for the
nervous system signal to occur is much shorter that the time it takes to contract a muscle. This
means that another signal can produce another contraction. As the frequency of signals (called
action potentials) increases the frequency of muscle contraction also increases. There is a
maximal frequency of signals that will cause a sustained contraction of a muscle. We call this
phenomenon tetanus. Muscles in tetanus will not produce even a partial relaxation. The
tension produced by muscles increases along with the frequency of nervous system signals. This
phenomenon is known as multiple-wave summation.

During muscle contraction calcium is released by the sarcoplasmic reticulum in response to

depolarization. If a high frequency of nervous system signals stimulates a muscle cell the
calcium levels inside the cell remain high and the muscle responds by remaining in a contracted
state. This allows for more cross-bridge formation and subsequent increase in tension of the
muscle.

If a muscle is stimulated by a nervous system signal and then allowed to relax, the next stimulus
will produce a stronger contraction. This will continue for a few contractions then the strength
of contraction will level out. This phenomenon is called treppe.

Muscle Length-Tension Relationship

Big Picture: Muscle Length-Tension Relationship

As a muscle is stretched it produces more tension to a point. If the muscle is stretched beyond
this point the tension decreases.

The length of a muscle is related to the tension generated by the muscle. Muscles will generate
more force when stretched beyond their resting length to a point. Muscles stretched beyond
this point will produce less tension.
If the muscle is at its resting length it will not produce maximal tension because the actin and
myosin filaments excessively overlap. Myosin filaments can extend into the Z-discs and both
filaments interfere with each other limiting the number of cross-bridges that can form.

If the muscle is stretched to a point the tension will increase in the muscle. The actin and
myosin filaments can now optimally overlap so that the greatest number of cross bridges can
form.

If the muscle is overstretched the tension will decrease. The actin and myosin filaments do not
overlap causing a decrease in the number of cross-bridges that can form.

Types of Muscle Fibers

Big Picture: Muscle Fibers

There are 3 types of fibers:

Fast twitch = high force, low endurance (sprinter)
Slow twitch = low force, high endurance (marathoner)
Intermediate = kind a like both fast and slow twitch (average Joe)

There are three major types of skeletal muscle fibers. These are called fast twitch, slow twitch
and intermediate.

Generally, fast twitch fibers generate high force for brief periods of time. Slow twitch fibers
generate lower amounts of force but can do so for longer periods of time. Intermediate fibers
have some characteristics of both fast and slow twitch fibers. Fast twitch fibers are also called
Type II fibers.

Fast twitch fibers are the predominant fibers in the body. They respond quickly to stimuli and
can generate a good deal of force. They have a large diameter due to the large amount of
myofibrils. Their activity is fueled by ATP generated from anaerobic metabolism.

Slow twitch fibers respond much more slowly to stimuli than fast twitch fibers. They are smaller
in diameter and contain a large number of mitochondria. They are capable of sustaining long
contractions and obtain their ATP from aerobic metabolism.

Slow twitch fibers are surrounded by capillary networks that supply oxygenated blood for use in
the aerobic energy systems. They also contain a red pigment called myoglobin. Myoglobin can
bind oxygen (like hemoglobin) and provide a substantial oxygen reserve. Because of the
reddish color of myoglobin these fibers are often called red muscle fibers. Slow twitch fibers are
also called Type I fibers.

Intermediate fibers resemble fast twitch fibers because they contain small amounts of
myoglobin. They also have a capillary network around them and do not fatigue as readily as fast
twitch fibers. They contain more mitochondria than fast twitch but not as many as slow twitch
fibers. The speed of contraction and endurance also lie between fast and slow twitch fibers.
Intermediate fibers are also called Type IIa fibers.

Muscles that have a predominance of slow fibers are sometimes referred to as red muscles
such as in the back and areas of the legs. Likewise muscles that have a predominance of fast
fibers are referred to as white muscles. It is interesting to note that there are no slow twitch
fibers in the eye muscles or muscles of the hands.
The ratio of fast-slow-intermediate fibers is determined genetically. However training can
change the ratio of these fibers in skeletal muscles that contain all three types. For example
training for endurance can cause some fast twitch fibers to become more like intermediate
fibers.

Muscle Response to Exercise

Big Picture: Muscle Response to Exercise

Increases in strength come first from motor units contracting together (synchronous
contraction) and then from increases in size (hypertrophy and hyperplasia).

There are three basic ways the muscular system responds to exercise. Let’s look at this in the
context of Sally who is beginning an exercise program.

Sally is starting an exercise program. She has never been in a gym before and is excited to see
the results of her efforts. Part of her program is weight lifting. Her trainer tests her on the first
day and finds that she can lift 45 lbs. in a biceps curl. She then begins exercising three times per
week. After about two weeks she finds that she can now lift 50 lbs. She is excited about her
improvement in just two weeks of training. Sally asks her trainer to measure her biceps and
they find that there is no difference in size. If the muscle size has not changed, then what is
responsible for Sally’s increase in strength?
One of the first ways muscles respond to training is to increase synchronous contraction of
motor units. When motor units contract at different points in time (asynchronous contraction)
they cannot generate as much force as when they contract together. Training increases
synchronous contraction so that the motor units work together to generate higher amounts of
force.

Sally continues her program and finds that after about 8-10 weeks there is some increase in her
biceps circumference. This is primarily due to hypertrophy or an increase in the cross-sectional
diameter of muscles fibers. The number of muscle fibers does not change but the size of the
fibers increases. The number of protein filaments, mitochondria, enzymes, and glycogen
reserves increases.

Sally may also experience some small amount of hyperplasia. Hyperplasia is an increase in the
number of muscle fibers resulting from mitosis. The increase is slight as most of the increase in
size is attributed to hypertrophy.

Cardiac Muscle
Cardiac muscle is only found in the heart. Like skeletal muscle it has a high concentration of
myofilaments and is striated. There are a number of structural differences between skeletal and
cardiac muscles.

Cardiac muscles are smaller and generally contain one nucleus whereas skeletal muscles are
multinucleated. They have a different arrangement of T-tubules and no triads. The sarcoplasmic
reticulum does not have a terminal cisternae. Cardiac muscle fibers are powered by aerobic
metabolism and contain energy reserves in the form of glycogen and lipids. Cardiac muscle cells
contain large numbers of mitochondria to utilize aerobic energy systems.

Cardiac muscle cells also contain a specialized kind of cell junctions called intercalated discs that
allow the flow of chemicals between cells and help to maintain the structure of the muscle. This
allows for a greater transmission of electrical signals across large areas of cardiac muscles. The
discs also allow adjacent fibers to pull together in a more coordinated contraction. Instead of
motor units working separately in skeletal muscle, intercalated discs allow cardiac muscle to
contract in large uniform segments.
Cardiac muscle can also contract without a stimulus from the nervous system. Cardiac muscle
contains self-generating action potential cells called pacemaker cells or nodes. The pacemaker
cells however can respond to the nervous system by changing the rate and force of contraction
of cardiac muscle cells.

Cardiac muscle cannot undergo tetanic contractions due to the structure of the cell membrane.

Smooth Muscle
Smooth muscle cells are found throughout the body in organs, blood vessels and tubelike
structures. Smooth muscles contain actin and myosin and are long spindle shaped cells. Actin
and myosin are not arranged in sarcomeres so smooth muscle is not striated. Instead the actin
and myosin are scattered about throughout the muscle. Smooth muscle has no T-tubules and
the myosin has a larger number of globular protein heads.

Smooth muscle contraction differs from skeletal or cardiac contraction in that when calcium is
released by the sarcoplasmic reticulum it binds with a calcium-binding protein called
calmodulin that activates an enzyme called myosin light chain kinase. This enzyme allows for
the formation of cross-bridges. Because of the structure of smooth muscle, length and tension
are not related. When smooth muscle is stretched it adapts to its new resting length and can
continue to contract.

Smooth muscle cells are classified as multiunit or visceral. Multiunit smooth muscle is
organized into motor units that are innervated by the nervous system. However, each cell can
be connected to more than one motor unit. Visceral cells do not connect directly with motor
neurons and are arranged in layers. Gap junctions connect layers of smooth muscle so that one
area can influence others when contracting. This can produce a wave-like contraction called
peristalsis.
Image Credits
Chapter 7
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