1. Kinesiology for Manual Therapies
Chapter 2
Neuromuscular Fundamentals
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

2. Learning Outcomes
2-1 Review the basic anatomy and function of the muscular and nervous systems.
2-2 Identify terminology used to describe muscular locations, arrangements, characteristics, and roles, as well as neuromuscular functions.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

3. Learning Outcomes
2-3 List the different types of muscle contractions and the factors involved in each.
2-4 Define neuromuscular concepts in relation to how muscles function in joint movement and work together to achieve motion.
2-5 Describe the neural control mechanisms for movement.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

4. Introduction
Muscle contraction produces the force that causes joint movement.
Muscles provide protection, contribute to posture, and support and produce a major portion of body heat.
There are more than 600 skeletal muscles.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5. Introduction (cont.)
Aggregate muscle action – muscles work in groups to achieve joint movement
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

6. Muscle Nomenclature Shape, size, number of divisions
Muscles are named for:
Shape, size, number of divisions
Direction of fibers, location, points of attachment
Action, action and shape, action and size
Shape and location, location and attachment
Location and number of divisions
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

7. Shape of Muscles and Fascicle Arrangement
Skeletal muscles may be grouped in two major types of fiber arrangements: parallel and pennate.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

8. Shape of Muscles and Fascicle Arrangement
Parallel muscles have fibers arranged parallel to the length of the muscle and are categorized into shape.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

9. Shape of Muscles and Fascicle Arrangement (cont.)
Parallel muscles include:
Flat
Fusiform
Strap
Radiate
Sphincter
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

10. Shape of Muscles and Fascicle Arrangement (cont.)
Classification of Muscles
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

11. Shape of Muscles and Fascicle Arrangement (cont.)
Pennate muscles have shorter fibers that are arranged obliquely similar to a feather.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

12. Shape of Muscles and Fascicle Arrangement (cont.)
Pennate muscles are categorized on the basis of the exact arrangement between the fibers and the tendon:
Unipennate
Bipennate
Multipennate
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

13. Muscle-Tissue Properties
Skeletal muscle tissue has four properties related to its ability to produce force and movement about the joints.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

14. Muscle-Tissue Properties (cont.)
Irritability
Contractibility
Extensibility
Elasticity
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

15. Muscle Terminology Intrinsic Gaster Extrinsic Tendon Action Origin
Innervation Insertion
Amplitude
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

16. The Muscular System Anterior View
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

17. The Muscular System (cont.)
Posterior View
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

18. Contraction: The Sliding-Filament Theory
Myofilaments in muscle do not shorten during a contraction, but thin filaments slide over thick ones and pull the Z disks behind them.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19. Contraction: The Sliding-Filament Theory (cont.)
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

20. Types of Muscle Contractions (Actions)
Isometric – static contractions
Isotonic – dynamic contractions
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

21. Types of Muscle Contractions (Actions)
Isotonic contractions
Concentric - shortening
Eccentric - lengthening
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

22. Types of Muscle Contractions (Actions) (cont.)
Roles of Muscles
Agonists, Antagonists, Stabilizers, Synergists, and Neutalizers
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

23. Tying Roles of Muscles All Together
Actions of muscles that are performed depend on several factors, such as the motor units activated, joint position, muscle length, and relative contraction or relaxation of other muscles acting on the joint.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

24. Tying Roles of Muscles All Together (cont.)
Agonist muscles are primarily responsible for a given movement.
Antagonist muscles must perform the opposing action.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

25. Tying Roles of Muscles All Together
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

26. Determination of Muscle Action
The specific action of a muscle may be determined through a variety of methods.
Lines of pull, anatomical dissection, palpation, models, electromyography, and electrical stimulation
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

27. Determination of Muscle Action Lines of Pull
Combining the knowledge of a particular joint’s functional design and the specific location of a musculotendinous unit as it crosses a joint is extremely helpful in understanding the muscle’s action on the joint.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

28. Determination of Muscle Action Lines of Pull (cont.)
The following factors will help the student understand the line of pull:
Bony landmarks
Planes of motion
Axes of rotation
Ability of the line of pull to change
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

29. Determination of Muscle Action Lines of Pull (cont.)
Other muscles contraction or relaxation
Muscle length-tension relationship
Biarticular or multiarticular muscles
The direction of the fibers of muscles
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

30. Neural Control of Voluntary Movement
All voluntary movement is the result of the muscular and nervous system working together.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

31. Neural Control of Voluntary Movement (cont.)
Five levels of control:
Cerebral cortex
Basal ganglia
Cerebellum
Brainstem
Spinal cord
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

32. Neural Control of Voluntary Movement (cont.)
PNS – peripheral nervous system
Sensory and motor divisions
Spinal nerves
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

33. Neural Control of Voluntary Movement (cont.)
The spinal nerve roots and plexuses
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

34. Neural Control of Voluntary Movement (cont.)
Dermatome
Myotome
Neurons
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

35. Proprioception and Kinesthesis
Proprioceptors are internal receptors located in the skin, joints, muscles, and tendons that provide feedback relative to tension, length, contraction of muscles, position of body, and movement of joints.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

36. Proprioception and Kinesthesis (cont.)
Muscle spindles
Stretch reflex
Golgi tendon organ
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

37. Proprioception and Kinesthesis (cont.)
Muscle spindles
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

38. Proprioception and Kinesthesis (cont.)
The patellar tendon reflex arc
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

39. Proprioception and Kinesthesis (cont.)
A Golgi tendon organ
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

40. Neuromuscular Concepts
All-or-none principle - the individual muscle fibers within a given motor unit will fire and contract either maximally or not at all.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

41. Neuromuscular Concepts (cont.)
Factors affecting muscle tension development include the action potential, subthreshold stimulus, threshold stimulus, and the submaximal stimuli.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

42. Neuromuscular Concepts (cont.)
Treppe is another type of muscle contraction that occurs when multiple maximal stimuli are provided at a low-enough frequency to allow complete relaxation between contractions.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

43. Neuromuscular Concepts (cont.)
Muscle length-tension relationship - The maximal ability of a muscle to develop tension and exert force varies depending on the length of the muscle during contraction.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

44. Neuromuscular Concepts (cont.)
Muscle length-tension relationship
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

45. Neuromuscular Concepts (cont.)
Muscle force-velocity relationship – When the muscle is either concentrically or eccentrically contracting, the rate of length change is significantly related to the amount of force potential.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

46. Neuromuscular Concepts (cont.)
Angle of pull is defined as the angle between the line of pull of the muscle and the bone on which it inserts.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

47. Neuromuscular Concepts (cont.)
Uniarticular, biarticular, and multiarticular muscles
Reciprocal inhibition
Active and passive insufficiency
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

48. Review the chapter summary for highlights of chapter content.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

49. The questions are designed for the students to test their knowledge.
Chapter Review
The Chapter Review is divided into true and false, short answers, and multiple choice questions.
The questions are designed for the students to test their knowledge.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

50. Explore and Practice
Various levels of practice are explored with lab questions and charts to help review the material from this chapter.
McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved