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Hello and welcome to chapter 5 of the new NASM-CPT 7th edition manual.
This chapter 5 is a little bit different than the 6th edition so we work only with the 7th edition now because as of August 31st that transition time has passed.
So this chapter revolves around the nervous, muscular and skeletal systems.
You can see your learning objectives there but it's basically going through the structures, types of really just the main nuts and bolts of each one of those systems.
So 45 slides of very important material that will be very demanding on you to remember but also very important for you to understand as you're going through and taking your tests.
So again, as we go through, there's your learning objectives one more time.
So let's get into the human movement system.
Now the human movement system is basically, it's a bunch of components that are put together and structures that work together so that we can get you to take a step forward, to jump up in the air, to basically do whatever kind of movement you're talking about.
Now again, we talked about it in the intro slide but the nervous system, skeletal system, muscular system, they're all going to be what makes up the human movement system and they all work together in a really efficient and effective manner if you train your body to be in that way.
So again, if you don't though, like it says here, if you have one component that doesn't function correctly, it's going to move down what we would call the kinetic chain or all those links that you would see on the right-hand side and all of those links, if one of them starts to either break down, move in a different direction, or basically just has a faulty pattern to it, it'll affect the whole system.
So if something is going on in the ankles, that could affect anything all the way up into the cervical spine.
Hips, we know that hips really work in conjunction with the lumbar spine.
So you can see how if one is affected, the other could be as well and we always think about one above, one below, but at the same time, depending upon the situation, it could be more than one checkpoint above or below.
So just kind of something to think about, basically, again, human movement system is all about efficient movement of everything working together, but if that kinetic chain is broken down, then we're going to have to find a way to correct those imbalances and asymmetries so that we can get you to be functioning correctly.
So the nervous system, again, all based off of nerves, those neurons that we would talk about, like it says here, it's one of the main organ systems of the body and the central nervous system, if we want to be more specific, we're talking about the brain and the spinal cord, whereas the peripheral nervous system, the PNS, that is your peripheral nerves.
That's going to be what's more getting into the limbs outward.
So without neurons, we don't have that functioning of the nervous system.
We don't have that ability to make basically an electrical current turn into a chemical signal to then create a firing of a muscle.
So it's very, very important.
As we go through here, a couple of terms that we really want to pay attention to are these bottom ones down here, afferent or afferent and efferent or efferent, and both of those are very important because they are the specific signaling that occurs as we move through a specific muscle contraction or just in general.
The afferent information that's basically processed, it's a sensory information.
It could be, just say that you take your finger and touch it down on an oven.
When you do that, that basically creates a signal sent to the brain that, oh man, this is hot.
The brain processes that through inner neurons and the workings up there, and then basically sends an efferent signal to say, hey, you need to move your hand because you're going to get burnt, dummy, and then that's how it would basically work.
You sense it, process it, send the signal to do whatever movement or function that you're trying to do, and that's how that pathway kind of works.
So that's part of that whole nervous system functioning.
Here's your nerve, your neuron.
This is your true neuron.
Make sure that you understand each component.
You have your nucleus, and surrounding that nucleus, you do have the cell body.
That cell body is what has the attachments that come off of it, which we call dendrites.
Dendrites meaning that they are the transfer connections between one neuron and another.
Then you also have a terminal point, which is your axon.
That axon has basically the tail.
That tail can end in what we would call synaptic terminals.
Now at the ends of those synaptic terminals is where typically you would have those connection points to the sarcolema, or basically the muscle.
That's where, like we said in the previous slide, the electrical current turns into the chemical component at that point, and that's where muscle contraction can start happening.
Now, like other things, there are four primary ingredients that are needed for nervous systems to fire, sodium, potassium, magnesium, and you also need water.
So if you're dehydrated, that can also have an improper function for you.
So again, just kind of paying attention to the structure points for this, making sure you know what an axon is, what a dendrite is, and that'll help you to be able to kind of understand the main parts that we're looking at.
For the central nervous system, we said it's divided into that brain and spinal cord.
The peripheral nervous system, the PNS, that is the point where you have everything going out to the periphery.
So you have 12 cranial nerves, excuse me, 31 pairs of spinal nerves, and you also have sensory receptors that will detect changes in touch, changes in pressure, changes in tension so that you can have those sensory information sent back afferently to then relay information efferently to move as we need.
Then I spoke a couple slides ago about interneurons.
They are within the spinal cord, and basically when you look at it, it is a function where once you have that afferent signal, so follow the blue line.
The blue line you'll see is that sensory nerve.
It's sent into what we would call the horns of the spinal cord, and you'll see the blue part there.
It goes into the interneuron.
There's detection agencies there, and at that point, that interneuron processes, takes the process information and sends it out efferently to move your bicep, move your forearm to then be able to take your finger off of whatever the stimulus was of it.
So that's basically how you break down that whole process, afferent, efferent, and that's what we would call the reflex arc, and that's that whole process that we would talk about right down here on the bottom with the peripheral nerves and the interneurons and how they work all together to provide a reflex to move in the proper manner.
Also for the nervous system, we talked about touch and pressure.
We have mechanoreceptors for that.
Now mechanoreceptors are really big on, again, working with sensory nerves to be able to provide us with proper information to then either move correctly, react correctly, sit down, stand up, take a sip out of the water fountain, whatever it may be.
Again, mechanical force, nociceptors, which are for pain, chemoreceptors, we're going to be talking more about smell and taste, and then photoceptors for vision.
So all of those there, again, working within our senses, and all of them have a specific receptor that will be able to dictate what you sense to what you react to.
So as you look at the central nervous system, and you see on the right there the complete breakdown, your true nervous system is broke down to central and peripheral nervous systems.
The central nervous system is its own entity.
The peripheral system, you can see here, it gets broken down into those sensory nerves we talked about, and also the motor neurons for movement.
Now movement-based, we have two types, somatic and autonomic.
Autonomic, I'll start with that one first, even though it's the second one listed.
Autonomic is going to be the one that is really automatic.
You don't require, it's not voluntary, you don't tell it to.
It just naturally does it on its own.
But if you are stimulated in a certain way, whether relaxatively or excitedly, then basically you will end up with a change.
Now if you go down a little bit more onto the last two bullet points here, you'll see the autonomic nervous system is broken down into two other components there, which we call sympathetic and parasympathetic nervous systems.
The sympathetic nervous system, it reacts more to the heightened state, more fight or flight, where parasympathetic works with, again, more relaxative portions of everything.
On the inverse side of it, the somatic nervous system, we're talking here more about the basics to our movement, our motor movement.
How our nerves will provide that stimulus to move skeletal muscle because we tell it to.
If you need to reach up in a cupboard and reach up and grab a can of green beans, then you have to be able to tell your body the proper mechanism to be able to do that.
So you're not physically telling yourself, hey, now make sure you get up onto your tip toe.
You're not doing it in that manner, but you understand that your body is telling you what you need to do and your body is reacting in that way, but it has to be you that makes that conscious effort and movement.
So again, we talked about that sensory function with all five senses.
There's also something called proprioception, or basically just understanding where you are in your environment, where your body parts are located.
And that works a lot with balance and coordination, a little bit of agility.
It also works around your posture.
So with proper posture comes proper detecting agents of where you are in space, and that's what proprioception is really more about.
Also within your nervous system, you have what we call integrated functioning, and that's being able to basically take in information, analyze it, interpret it, and then send out the proper decision-making signal to then act accordingly.
That's really what it comes down to.
And then your motor function, again, is your true movement that we would talk about.
So again, the sensory function, more afferent, proprioception, integrated functioning.
That again is the afferent to the inner neuron, sensing, decision-making, and then the motor function is more of your output or your efferent, efferent pathway.
And that's really the main way that we go through each process.
And then once your motor function occurs, the sensory function may have to react in another manner so that we can then react in another way to do another task that we have in front of us.
When you're multitasking, you're always going through sensory function, motor function, sensory function, motor function, and everything in between, so you're doing a lot of decision-making.
So if you're a great multitasker and you're doing it second nature, then you're going through all four of these steps very handily without really worrying too much about it.
Definitely something that's going to be on your test, pay attention to it for sure, is the difference between what we call a muscle spindle and a Golgi tendon body or Golgi tendon organ.
We'll hit on the muscle spindle first.
Now, don't make it more difficult on yourself.
Make sure for your sake, muscle spindles are found in the muscle.
Their job is to detect changes in length or stretch and the rate that that happens.
So when we have muscle spindles, we're always, your body is basically preserving itself, meaning that when it's part of your sensory system, so when the muscle gets stretched in a manner, so, you know, and I know it's kind of far fetched here, but think about a person, a male in particular, and they slip a little bit and they get into that split position that, you know, males typically are not as flexible as females, but in this sense, a male who is not very flexible and he gets into that, you know, that position of a split.
Now he is going to feel that very handily and his muscle spindles are going to try to do whatever they can to avoid excessive stretching.
But when you, if you slip and fall too much, that's why, you know, you'll get injuries because muscle spindles weren't able to preserve and basically avoid that from happening.
Another way to kind of talk about a muscle spindle, and this goes along with what we call the stretch reflex.
If you were to have somebody lay down on the ground, have them put one leg straight, so just say the left leg straight, you take their right leg and you do a hamstring stretch.
So if they're lying on their back, you're going to try to bring the toes up into the air and try to flex the hip.
Well, as you start going up into that stretch, when a person hits that kind of max limit for themselves, what you're going to feel if you do it slow enough is when you feel that end range of motion, right when you hit that end range of motion for that person, you might feel the leg involuntarily kick back on you.
And that's the muscle spindle basically engaging to say, I'm sensing I don't like this length.
I've, I'm processing, I've processed it already and I've sent a signal to say, don't go anymore.
So what you do, you go to that point and then once it kicks back a little bit, you hold it right there and you stretch a person.
And what you can then tell them to do is, Hey, I want you to contract.
So push back against me.
Then you let it down, relax for a second, then do it again.
What you'll see is that the muscle spindle has been overpowered a little bit and it's going to be able to release a little bit more tension and you can stretch the person a little bit for farther.
Now that is the true advent of, of your, uh, PNF, um, uh, proprioceptive neuromuscular facilitation.
And that's a different type of stretch that we can work with and it helps with end range of motion.
Very, very important for that.
So again, we talked about the muscle spindle.
Let's talk about the Golgi tendon organ or the GTO.
Now again, like the muscle spindle, very, very simplistic here.
We are going to say that the Golgi tendon organ is found in the tendon, okay?
Its job is really to be, it's very sensitive to tension and that rate of tension.
So when we talk about, you know, tension, we're talking about like if you have that issue where you're, you know, feel like there's pressure being put down on a, on a 10 or there's a pull on that tendon, it'll feel that.
And when it feels that, it'll end up having a, again, a reverse effect where it's going to try to stop you from going any farther than where you are.
So if there's a lot of tension on that, you know, that muscle that provide, and then the
Golgi tendon receptors sense that, they'll send out a signal to the brain saying, stop what you're doing.
Um, uh, another example of that would be as if you get down into a squat, all right, and you go to push up out of the squat.
Well, you know that there's a lot of compression, there's a lot of tension being put onto the joint in particular being put onto the skeletal muscle of the quads.
So the body will shut you down if you're providing too much tension because maybe you're trying to do a one rep max or something like that.
So hopefully you have the pins set up in the rack so that all you do is just lower yourself back down to those pins and walk out without an injury.
Okay?
So again, you can overpower your muscle spindles and your Golgi tendon organs, but usually when you overpower them, it leads to injury on the back end of everything.
Okay?
So the other thing too, a couple more, you know, one more aspect here of mechanoreceptors, we're talking about joint receptors.
You're talking about nerve endings that you find inside of the joint capsule.
Um, they're found all around, you know, on the ligament components on the capsules themselves.
And they're, they're basically reacting to differences in pressure.
You know, they're reacting to what we would say is acceleration, deceleration.
So think about acceleration, you know, trying to pop up the stairs, just say you're going up to a second flight of, you know, the second, second floor and you're trying to pop up the flight of stairs two at a time.
You're accelerating as you go up.
So your, your joint receptors are sensing that and they're like, ah, we're good.
All right.
And then just think about the other way, going down the stairs, you're decelerating the whole time.
Because if you accelerated, you probably would go, you know, head over heels on that one and that wouldn't be a good thing.
So deceleration slowing the body down.
Okay.
Um, so that is where we want to make sure that we're, you know, we're always paying attention to that because if you feel those sensations, we know that we got to shut it down.
So as we go through, you know, really the life course here, you know, there always is this sense of development as we go from older to, you know, younger to older and then older to, you know, older adult and then into senior because there is this development and then there's this decline in development, you know, or, or decline in general.
So there's no more development at that point.
So really if we look at it, there's a couple of concepts here, neuroplasticity and neurocircuitry understand that neuroplasticity, and I'm sure you've probably heard this on commercials and things like that.
What you're talking about with neuroplasticity is your brain is always changing and growing and what you're doing is you're always forming or reformulating or forming, reformulating new pathways as you go through your lifespan.
And what that means is that you can always, whenever we say we're always learning, well, this is one of those ways with neuroplasticity as opposed to neurocircuitry, which is basically those neuron connections that we have.
Those are those, you know, the interconnections between the neurons and the brain and the spinal cord all in one.
And that's those, those interconnections, the more we work with them can be sped up or slowed down, you know, depending upon what our lifestyle is, how we, our dietary plans, things like that.
Okay.
Now with physical activity in the nervous system, we would talk about what we would say here is the motor skills, okay?
There's specific, like I said, specific movements to the coordinated effort of the sensory and motor subsystems.
So basically your motor skills are through neuroplasticity, through neurocircuitry, we are able to sense things better and then be able to use the correct subsystems of our motor units to then be able to move in a better manner.
So our motor skills will continue to develop and get better.
So there is a three stage process, which we would call, you know, stage one, stage two, stage three, cognitive, associative, autonomous.
So again, with the cognitive part, that's the learning part.
That's the education part.
That's the brain part.
You know, we're, we're trying to create new strategies.
At that point there, after stage one, if you're starting to get better at something, the associative part is now the understanding of it.
There's a slight refinement, there's better strategies and there's less error.
There's more error detection and more, and usually typically less error that is made.
Okay.
So and then stage three is autonomous, where basically the skill has been mastered.
So again, think about a kid, a three year old kid picks up a tennis ball and just picks up and you know, someone says, throw it to me.
And he throws it and it's like an underhand, it's like a part sidearm part underhand throw.
Well, as that child learns, meaning sees things, sees other people doing it, feels it on his own, starting to detect that, you know, that, that pattern, the associative is taking over at that point until that child has a good, what we would call, you know, in motor learning is a good step, twist and throw.
Okay.
And that step, twist and throw is just a development part to that.
So again, refining through practice.
Then as that child has, again, still, maybe they're not three years old anymore.
Maybe they're eight and they're playing like a farm league, you know, eight to 10 year olds or whatever it may be.
Now they can take a ball and throw it from the outfield to second base.
They can be a pitcher.
All those, that's autonomous.
They don't work, they don't worry about it.
They are independent of having to think about it.
They just do it.
Okay.
And that's really how that process works.
So we kind of hit on the nervous system, but let's talk about the skeletal system.
All right.
We know the skeletal system itself shapes us.
Okay.
It supports us and it provides structure on the movement that we're doing.
Also, interestingly enough, it does produce specifics for our blood.
So our bone stores minerals, but it also has a storage of marrow.
Now in the long part, the shaft of the bone, which we call a diaphysis, that diaphysis has a cavity in it and in that cavity is what we would, we'd find is yellow bone marrow.
That yellow bone marrow is what we would use and what it makes white blood cells.
Okay.
White blood cells for immune system.
So white blood cells are there about 1% of our blood.
On the ends of our bone in the epiphysis, the mesh like area, the ends of the bone, there we would make red.
We have red marrow and red marrow actually makes red blood cells.
So we can make red blood cells in that area.
So not just a, you know, not mineral store, not just a structural component.
It really does help with red and white blood cells and keeping that count up and accurate so we can stay healthy.
All right.
A couple of things to pay attention to here.
Understanding that, you know, poor nutrition, lack of activity.
So being sedentary or low activity can lead to osteoporosis later on.
Also understand too that osteoporosis can be something that is dealt with and this may be talked about later in the book, but you're talking about how early onset osteoporosis can occur with females who have basically had a stoppage of their period, so a menorrhea, and they are, you know, they're hormonally imbalanced.
So therefore it could lead to early onset osteoporosis.
So just again, some other aspects to think about.
So again, with the skeletal system, a few things we want to pay attention to.
Anything that, you know, a muscle that connects to a bone that is connected via a tendon, any bone that is connected to another bone is connected by a ligament, and two or more bones coming together and creating a junction is what we would call a joint.
That's definitely something that will be on, this most likely will be on your CPT exam if you were to take that.
So make sure you know what a joint is, and it's just again, two or more bones coming together in some sort of format and some, you know, depending upon what type of joint it is to create a movement and create torque at that area to supply us with movement is a joint.
So with our skeletal system, broken up into the axial and the appendicular, now the axial skeleton is usually, is more, think about your axle compared to a tire, okay?
The axle is the center section, it's what revolves, everything revolves around.
So your skull, your rib cage, and your vertebral column, that's your axial skeleton.
Anything else, arms, leg, and your pelvic girdle are actually considered to be your appendicular.
So again, with the appendicular skeleton, that's more for movement base, axial skeleton is more for stabilization and, not to say that the appendicular is not, but the axial is more about the structure and maintaining form for the body and protective measures as well.
So again, with bones, again, we know that they serve two very important parts.
They create a movement pattern using them as a lever, and levers we'll get into in another chapter.
Then again, with a lever, it provides an axis of rotation and where the forces are placed will create a movement in some way, shape, or form.
And then your support system for proper posture, and that with proper posture you can have proper distribution of force, okay?
So with bone, with bone growth, particularly post exercise or going through growth patterns, we are constantly breaking down, building up, breaking down, building up.
But if we stay in positive bone growth, that means that we remodel constantly and whatever we broke down, we build back up, okay?
So when we break down bones, think of osteoclasts.
When bones are broken down, think osteoclasts and osteoclasts with that C, think about crash, okay?
And osteoblasts with B, for the blast, B means build.
So osteoclasts crash, osteoblasts build.
So we break down a new bone, build it back up, and with that remodeling, typically you'll follow the Wolff's Law, and Wolff's Law just means that wherever the line of stress was on that bone is where the remodeling will occur.
So if it's right down the center, then Wolff's Law would dictate that that line of stress would be where we would start to remodel for that area, okay?
The right-hand picture over here, you can definitely see where it says the point of stress, that area where all those arrows are going is that's probably where you're going to have a lot more breakdown, and that's most likely going to be where you would have your remodeling occur.
Now there are different types of bones, we're going to go through each one of them, but long, short, flat, irregular, and sesamoid, alright?
And they give you the examples over here on the right, so if you're looking for study purposes, just kind of pay attention to what they look like characteristic-wise, and then some examples of it, because on the test there may be examples that, you know, the humerus would be an example of this type of bone, and you wouldn't say flat, you would say long, okay?
So long bones, usually your more traditional bone that you would think of, your femur, alright, your humerus, your radius, your ulna, alright, tib, fib, those are all, you know, long bones, alright?
Now the ends of the bone are going to vary, but understand that we're talking more about their larger bone structures, okay?
And if you look, you know, again, long cylindrical body with irregular or widened bony ends, whereas a short bone, alright, like it says here, similar in length and width and appears somewhat cubical in shape, so if you look at the example of a short bone, we're talking about the carpals of the wrist, or, you know, you could also have, you know, the ankle components of the carpals of the ankle.
Flat bones are those that are thin, and they usually typically have two layers of compact bone, and they're usually surrounded by some spongy bone tissue, so an example of that is your scapula, very flat.
It does have protrusions, like your chromion process up here, okay, follow the arrow, alright, and up in this area here, where you have your protrusion, you know, again, it's still, it's just because the scap itself is flatter, that is more, the protrusions are more for muscle attachment sites.
Regular bones are those that are just, you know, they're kind of misshapen, they've got a unique shape, they don't really fit the category of what we would consider a long bone or a short bone or a flat bone, an example of that would be your vertebrae, and, you know, different levels of your vertebrae have different looks to them too, okay.
And then lastly, you have your sesamoid bones, bones that are basically encapsulated inside of connective tissue, now typically it's usually a tendon.
Now your patella is that, your patellar tendon actually keeps the patella engulfed inside of that tendon, alright, so, and that's why your patella kind of is like one of those floating bones because it's really, because engulfed by a tendon it really doesn't have another connection point.
Other things we want to talk about, bone markings, now bone markings are usually where we would have, like I said here, depressions, you know, those depressions for one, there's other examples we'll talk about in a second, but those bone markings are typically there for, and that's usually attachment sites for muscles, alright.
So if you look here, this is what we would call the intraspinous fossa of the scapula on the left, but it's flattened, that depression is flattened and it's actually sitting a little bit lower than what the true, you know, it's a little bit more what we would say recessed than anything.
Another one would be the inner tubercle solstice of the humerus, there's a depression right down through the center here, again, more markings for understanding a solstice being a depression, a dip, okay, kind of like in your brain you have the divots in your brain, it's the same premise.
Then on the left side here, you'll see here that we have what we call a spinal process or a spinous process of your vertebrae, it's what sticks out in the back and that's again for muscle attachment.
You notice here in your knee, on the anterior side of your knee we have what we call condyles, condyles of the femur, again, you know, contact points for muscle, and then you have epicondyles like you would find in your humerus or that were basically surrounding your elbow joint and that again, attachment sites for those regions as well.
So processes, condyles, epicondyles, we also go into what we call tubercles.
Now a tubercle is basically a bump that you would have and one example of a bump that you would have is the end of your humerus, that bump that kind of protrudes off the top part of your humerus, again, another muscle attachment site.
And then lastly, your trochanter, typically you have, you might hear greater trochanter or just trochanter in general, but kind of like the bump that comes off your humerus, it's a little bit larger, the trochanter is, and that's going to be found on your femur.
So all examples of each of those different types of bone markings, and again, usually typically those are muscle attachment sites that you know, or ligament attachment sites that you have that are going to protrude a little bit so that they will connect to a certain point.
Moving through, going to our vertebral column, you know, the rule of thumb here, and I'm not sure if it's, nope, it wasn't there.
The vertebral column is more, you know, think about your, how we would say you eat throughout the day.
Your cervical spine has seven, seven processes.
So you got C7, so think about eating breakfast at seven o'clock.
Your thoracic spine has T1 to T12, think about eating lunch at noon, okay?
And then your lumbar spine has five, so eating, you know, a little bit earlier than most people, but you know, the lumbar spine has five, so eating dinner at five o'clock, okay?
And then lastly, you have your sacrum, and then you also have your coccyx, okay?
And with those, that makes up your complete vertebral column from atlas all the way down to coccyx.
Now atlas is C1, and then the axis is C2.
Now within that vertebral column, you do have intervertebral discs, and intervertebral discs are those spongy-like structures that are made of cartilage that basically act as really a shock absorber, and they actually help allow movement or sliding and gliding of that vertebral column with some rotation in there as well.
And they basically, with that shock absorption, don't allow those to be bone-on-bone, okay?
Now with the vertebral column, we always talk about how there is a neutral spine.
Well there is a slight, what we would call rounding in the cervical spine, there is a, and that would be more of what we would call concave, so more inward rounding.
The thoracic spine has a rounding more outward, more convex, and then the lumbar spine has a little bit more of a concave or inward rounding again.
So if you look on the right there, you'll see that line, C1 to C5, C7, T1 to T12, and then L1 to L5, you'll see here that makes a really nice neutral spine.
What it does is it creates a better positioning for the head, it creates a better positioning for the ribcage, and it creates a better positioning for the pelvic region, which helps your femur stay in alignment, which doesn't affect your knees and ankles.
So this neutral spine really makes a big difference when it comes to, again, movement, posture, and imbalances that may occur throughout the system.
We talked about what joints are when they interact with each other, but it just really depends on how these joints interact and how the movement would occur.
Now if you look, there are two terms down there, osteokinematics, arthrokinematics.
Osteokinematics is basically the movement of a limb that you can see.
Where arthrokinematics is on those joint surfaces, you're going to have three other types, what we call roll, slide, and spin.
You'll see here, rolling is the example that you would see right at the top of your, that would be your elbow, going into some either flexion or extension, depending upon which way it's moving.
The slide, you'd see here, there is a slide where you would have your knee, the way that your femur moves.
Now this isn't two bones, it's just showing you that from a more vertical position to if you were to squat down.
There's a slide there that occurs, sliding across the tib-fib.
Then lastly, you have spin or rotation.
Think about going from a palms-up position, which we call supination, to a palm-down position, which we would call pronation, and you can see that there is a spin and also a rotation of the thumb-side radius crossing over the pinky-side ulna.
So those roll, slide, and spin are very important.
Those are your arthrokinematics, whereas osteokinematics are, if you see the joint move, that's osteokinematics.
For classification purposes, though, when we look at everything, you'll see here you have synovial joints.
Those synovial joints typically have a capsule.
Like it says here, 80% of those joints in the body do have the greatest range of motion that's out there.
And typically, like I said before, it has a capsule.
Within that capsule, you also have a membrane, you have cartilage padding.
You also have what we would call synovial fluid that's also in there as well.
Think of synovial fluid as oil in your engine where it's not allowing for excessive wear.
It actually provides an ability to have more nutrients so that everything stays healthy.
So when we look at everything, they do have some classifications down here, gliding and condyloid.
Those are two of the ways that we would work.
Now, carpals, so in your wrist in particular, they do what we would call glide.
They move, we call that translation, they go back and forth over each other.
If you think about gliding, think about curling.
If you know what curling is, the sport of curling, when you throw the, I don't remember the name of the device, but you throw the piece down the ice and it's sliding across the ice.
Well, that's gliding.
But think about it if you had another one of those devices and one was on top, one was on bottom and they were passing each other.
That would be your glide.
Whereas, condyloid joints, more of your metacarpals and those are more, like in your finger, are going to be providing you with that bending motion.
But that's what they're classified as, condyloid joints.
Your hinge joint is going to be kind of like your elbow or your knee.
They give you the example of the elbow on the bottom.
And then saddle joint is really your thumb.
So when we are working with our thumb, there's a little bit of that motion because it can rotate a little bit, it can go forward and backwards.
Those are components that we would work with with a saddle joint.
And again, typically found in your thumb.
Other ones, pivot joints.
You might see a pivot joint located in, again, with that radius ulna.
And that pivot joint allows for one direction.
And typically it's more of that rotational piece.
Then ball and socket, your most mobile, that provides the most range of motion.
Your shoulder has more range of motion because it can go in multiple directions.
Whereas your hip is a little bit less range of motion simply because it is, it basically will have more musculature that gets in the way.
So that's what we're working on there.
Also going through, we have non-synovial joints.
So although they do have connection pieces like the sutures of your skull, they do not allow or they lack movement.
So they have little to no movement.
They're more for stability.
Now if you think about it though, in your skull, those sutures that are in your skull, although they are pretty fixed, they can allow for some expansion.
So although it's not really warranted that we want that to happen, it can happen for that purpose.
So what are we looking at?
What's the function of a joint?
Well, we want to obviously allow it for movement.
That's the bottom line for us in particular with exercise.
We want to make sure that there's stability.
So we want to make sure there's an optimal level of mobility or movement and we want to make sure that there's an optimal level of stability.
Too stable, that could cause problems with movement.
Too mobile, that can make you too lax and that basically creates an issue where we are ultimately working on being hyper-mobile where you have to be able to put some strength in there and you have to be able to put some stability in there so that you don't end up causing too much stress on the joint because you're too mobile.
So making sure that we know that with proper mobility and stability we can be a better mover.
We talked about ligaments before but understand that ligaments are a little bit different with their connective tissue base.
They do have collagen in them and they do have elastin in them.
But skin has elastin in it too, tendons do have that as well.
Collagen though, it's what makes it up, that's what makes it strong.
And then elastin is what will help it be able to be a little bit more stretch like.
So that's one of the reasons, if you see there the bottom, bottom bullet though is very important.
Not all ligaments have the same elastin mounts.
So that's why things like your ACL, MCL, PCL, and LCL, MCL, ACL, PCL, your four ligaments of your knee, I have to remember all the letters.
With those, they're a little bit less elastin based and that's why when they get injured they're very hard to repair.
Or they might have some other technique that needs to be repaired.
So just be aware of that.
Whereas if it's in the hip, the hip provides a little bit more movement, probably has a little bit more elastin in it than the knee would.
So as we go through the life span of everything here, you will notice that the growth plate is going to be the dictating point.
If you see where all those blue lines are on the right hand side, those blue lines are really important to understand because what you're looking at there is those ends of those bones that will provide the growth.
And that's typically, it's not exactly where, but usually it's where the epiphysis meets.
Where the epiphysis meets the diaphysis and there's a connection point there.
So if that gets damaged, that can cause some growth problems as people age.
So again, with bone mass, we want to make sure we're fighting off osteoporosis, but also understand too that with resistance training and what we would call weight bearing exercise.
Now weight bearing exercise, we're talking about running, jogging, walking, things that provide ground force.
Now rowing, biking, using a skier, all of those things are not, swimming are not weight bearing.
So anything that provides weight bearing will have a better reaction to bone mass.
So when we talk about this, we're basically looking at it from the standpoint that the more weight bearing and resistance training we do, number one, it's going to affect our strength, but we're also going to help with agility, posture and balance, which helps the bone in general.
But also as we age through the lifespan, if we can strengthen, if we can make someone more agile, we can keep their posture in a positive manner and create their balance better.
Then as an older adult into your senior living, we can decrease the risk of falls and therefore less prone for fractures or other styles of breaks that may occur.
But particularly fractures, but with fractures it doesn't just injure the bone, it injures blood vessels and nerves, which also can have a massive impact on a person's health.
And then lastly, we'll finish up with the last very important muscular system.
So understanding that the nerves in the skeletal system will interact with the muscle system to be able to move us.
So the muscles are going to be, the nerves are going to excite the muscles, which will, the muscles will interact with the bone to move us in a manner.
So there's three different types, skeletal, cardiac and smooth.
Of those, skeletal is the most important for movement.
Cardiac is obviously found in the heart and smooth muscle is typically found around organs.
And all of those are going to, they have different tasks and they require, they're basically slightly different in a certain way.
Skeletal muscle, when we talk about skeletal muscle, that is more, it's very, it's more related to cardiac muscle.
They're very similar.
Mitochondria are in there.
They have all their nuclei.
I'm just a little bit different shape where skeletal muscle is like long, whereas cardiac muscle is a little bit more cylindrical.
Okay.
So just a slight variation.
But with skeletal muscle, we have to know the breakdown.
Okay.
Basically understanding that the fascia is the direct covering of the belly of the muscle.
Your epimysium is that really what we would call deep fascia or the true outlie of the whole belly of them or the whole muscle itself.
Okay.
And then you can follow along on the right side with that picture there, the, the, the, the facet, the fascicles, or, you know, they're basically bundles of muscle fibers.
And those fascicles are, those bundles are surrounded by what we would call the perimysium.
All right.
And if you kind of follow along, that's the bottom one here, you can see they, they, you know, encompass a bundle of muscle fibers.
And then your true muscle fiber within that, that, that fascicle is your, your, your true muscle fiber is your endomysium, right?
Endomysium being within that, you know, that covering of the muscle fiber itself.
Okay.
So that's the breakdown of the bulk musculature because we're going to get down into a little bit more of the contractile elements, which you will find in this picture a little bit more.
Okay.
So, when we talk about your contractile units, understand that within a fiber, you're going to find a lot of different components.
Okay.
You're going to find sarcoplasm.
Okay.
Sarcoplasm, fluid base.
You're going to find glycogen, fat, minerals.
You're going to find myoglobin.
So again, myoglobin is muscular red blood cells.
You're going to find mitochondria and, you know, really taking food and food stuff and turning it into energy within the cells.
Okay.
We are also made up, you know, within that fiber where we have the smallest contractile units that are there.
Those myofibrils are broken down to what we call myofilaments.
Those are the actual contractile pieces of the muscle.
Those myofilaments are what we would call actin and myosin, and we'll talk about those in a second.
All right.
And the actin and the myosin from Z line to Z line is what we would call a sarcomere.
Okay.
That sarcomere is the most important part because it contains all the actin and myosin, and it's truly the contractile piece that will shorten or lengthen a muscle.
Now if we look here, this right here is a true one muscle fiber.
Now within that muscle fiber, you can see there's your myofibrils, which again is the bundles.
They're bundles of myofibrils and within each myofibril, if you come to the right over here, you will see that from Z line right here up top to Z line on the bottom, that's your sarcomere.
The thick filaments in the center with the heads are what we would call myosin and the thin blue colored ones are what we would call actin.
Okay.
And all those are important for again, shortening and lengthening the muscles.
We talked about it before, but the neural part, the neurons, the motor neurons have to be supplied to them fibers so we can send an electrical signal across what we would call the neuromuscular junction, which is right here across the, you know, which we would say in the neuromuscular junction, the connection point that doesn't really connect.
All right.
That neuromuscular junction will send chemical signals, meaning ACH, acetylcholine across the boundaries.
If you look here through what we would call the synaptic gap and those, that ACH, the pink things, they will connect to a receptor site and then that will turn on the action to keep the action potential up.
So it gets into the working muscle to then provide it with a stimulus to contract.
All right.
All of that revolves around what we would call your sliding filament theory.
So when you have that ACH get in and it creates an action potential, that action potential gets into what we would call, and I'll go down right here, into what we would call your sarcoplasmic reticulum, this meshy like substance.
That sarcoplasmic reticulum will then release calcium into the muscle, which is the CA2 plus right here.
That calcium, once it's released into the muscle, will then take and go myosin and actin connecting to each other, the heads of the myosin connecting to the thin actin, and it'll basically, you ever seen Rock'em Sock'em Robots when you have the fist come up and it makes contact with maybe the head of the other opponent?
But what it does is it pulls and ratchets everything to make it shorter and shorter and shorter, and that's when you know you have your muscles starting to contract.
But it happens so quickly and so often in the presence of ATP that we always have what we call a power stroke or that connection point and pull, okay?
So what happens here is if the nerve stops firing, then we have the reverse that happens.
If the nerve stops firing or all the nerves that supply the muscles stop firing, then what would happen is we'd have calcium is put back into the sarcoplasmic reticulum, it's pulled back in like a vacuum, and when there's no calcium, what'll happen is the myosin that was connecting to the actin will release and everything will go back to resting length until another stimulus comes back down the line, okay?
Now I know I went through that pretty quickly, but all of that is in, and it's all listed in here so that you can understand piece by piece how that all happens, okay?
But again, it cannot happen unless you have a actual nervous system impulse that comes down the line that creates the release of acetylcholine that will then make an action potential on the muscles.
And once that happens, we are good to go for a muscle to contract.
So what that is called is the all or none principle.
So when you have a motor unit, now remember, a motor unit is the nerve and the muscles that it supplies.
Okay, that's a motor unit.
Now there's two different types, type one, type two.
Type one is more aerobic, it's hard to fatigue, okay?
It provides a lot less force, whereas a larger type two motor unit is going to supply muscles that are more explosive, they're easily fatigable, but they create a lot of power and generate a lot of force, okay?
So all of those are important because a type one is going to be more like what we use to stabilize our body every day because type one muscles, if they're not type one to hold us into proper posture, then we would fatigue out and be bent over all the time.
Whereas a type two is more about the really fast explosive running and jumping types of things that we do that require a lot of force.
So what I was talking about before was the all or none principle.
So if a nerve sends a signal down the line, then what that means is that if that nerve's signal is sent, unless there is damage to the nerve, that will send out and it will create all or none.
If a nerve sends a signal and an impulse, it will create a muscular contraction.
It'll maximally do it.
It's not a partial, you don't get a little bit of it.
It's no, that whole nerve fires and it gives you whatever it gave you, whatever power was in that electrical current, all right?
And that's the part of the all or none principle where if a nerve sent, you're going to have some movement and even if it's voluntary or involuntary.
So again, motor units are type one, type two, but understand that motor units of that are type one have muscle fiber, type one muscle fibers, whereas motor type two motor units will have type two muscle fibers.
Now again, depending, and if you look here, the characteristics will help you, but understand type one is what we would call more aerobic.
They're typically like it says here, they have more capillaries, mitochondria and myoglobin.
So think about the, if you think about dark meat of a chicken, that would mean that there's more capillary beds in there, which means that that meat is more type one.
It's more red, whereas type two is more, it has fewer capillaries and it, because of that, that's usually like your, your breast meat, your, your white meat.
So that's more type two.
Now type two is broken up into type two a and type two X, but there's also other ones, but those are the major ones type two X and the X doesn't mean that, but X really means explosive.
It's your true hard, forceful muscle fiber where type two a is more of a hybrid.
It's still very, very strong, very powerful and in their approach, but they can, they're a hybrid.
So they have, they're a little bit less fatiguing, meaning they won't fatigue out as fast, but they still have a lot of power to them.
Okay.
So depending upon who you are, all right, genetics will make that up.
You know, if you come from a, if you both, your parents played basketball, you know, you might be more type two muscle fiber oriented.
So genetics will play a part in that.
And then the function of it, you know, again, type one is more aerobic, more endurance based, whereas type two is more powerful, more forceful.
Okay.
So the function will dictate what you can do for your movements.
So type one, slow twitch, type two, fast twitch.
And then lastly, just understand that over the course of our lifespan, you know, we do, we grow.
Okay.
We eventually hit what we would call peak mass, peak power.
All right.
And we also hit a, a peak strength cycle and that's usually anywhere between 20 and 30 years old.
Now, there are subtle changes that happen from 30 to 50, right?
It says here, you also, after the age of 50, start losing about one to 2% of your muscle mass per year.
Now, that doesn't seem like a lot, but over the course of time it can.
So what do we always say?
If you don't use it, you, if you don't use it, you lose it.
But we know that ultimately at some point we're going to start losing muscle mass.
So what we want to do is maintain what we have as to the greatest capacity.
Okay.
So we have to be aware of that.
So again, resistance training is going to help come, you know, combat that loss.
So over the lifespan to keep our muscles strong and healthy, you know, we want to make sure that we do add in resistance training to any other style of training that we do because we want to preserve what we have.
Okay.
So nervous system, muscular system, skeletal system, their interactions, how that you put everything together and a nerve will fire a muscle which will move the skeletal, which will move a bone.
So very, very important as we pull through each part of that.
So thanks for listening to this, this chapter five.
And if you need to, we'll be continuing on to chapter six.
So have a great day.