The human muscular system is made up of over 600
Tendons, which are cords or
muscles, which act in groups. Muscles, in turn, are made
up of fibers and cells. Muscles are what enable you to do
just about everything – from walking to lifting heavy
objects to helping to pump blood throughout the body.
Muscles are distinguished as either involuntary or
voluntary. Involuntary muscles function within the body
automatically, without you being able to control them.
Voluntary muscles are the ones that are under your
control.
All muscles are made up of the same type of material –
a kind of an elastic tissue, akin to what rubber bands are
made of. Each muscle is made up of thousands of tiny
fibers. There are three kinds of muscles in the human
muscular system: the skeletal muscle; the cardiac
muscle; and the smooth muscle. Plus, the facial muscles
and the tongue are a unique kind by themselves.
Muscle (from Latin musculus, diminutive of mus
"mouse"[1]) is the contractile tissue of the body and is
derived from the mesodermal layer of embryonic germ
cells. Muscle cells contain contractile filaments that
move past each other and change the size of the cell.
They are classified as skeletal, cardiac, or smooth
muscles. Their function is to produce force and cause
motion. Muscles can cause either locomotion of the
organism itself or movement of internal organs. Cardiac
and smooth muscle contraction occurs without
conscious thought and is necessary for survival.
Examples are the contraction of the heart and peristalsis
which pushes food through the digestive system.
Voluntary contraction of the skeletal muscles is used to
move the body and can be finely controlled. Examples
are movements of the eye, or gross movements like the
quadriceps muscle of the thigh. There are two broad
types of voluntary muscle fibers: slow twitch and fast
twitch. Slow twitch fibers contract for long periods of time
but with little force while fast twitch fibers contract quickly
and powerfully but fatigue very rapidly.
Types of muscle
All muscles are made up of the same type of material –
a kind of an elastic tissue, akin to what rubber bands are
made of. Each muscle is made up of thousands of tiny
fibers. There are three kinds of muscles in the human
muscular system: the skeletal muscle; the cardiac
muscle; and the smooth muscle. Plus, the facial muscles
and the tongue are a unique kind by themselves.
The Skeletal Muscles: These are the voluntary type of
muscles in the human muscular system. This means that
they can be controlled by you. For example, you cannot
pick up that mug of coffee with your hand unless you
want your hand to do so. They are referred sometimes
as striated muscles, because the dark and light fibrous
material make them seem striped. These are also known
as the musculoskeletal system, or the combination of the
muscles and the bones that make up the skeleton.
Generally, skeletal muscles are attached to the ends of
bones, stretching all across the joint and then attached
once more to another bone.
bands of inelastic tissue, are what attach the muscles to
the bones. Skeletal muscles are of different shapes and
sizes, which enable them to perform a variety of tasks.
The gluteus maximus, or the muscle that occurs in the
buttocks, is the largest skeletal muscle in the human
muscular system. Some of the other major skeletal
muscles are the deltoid muscle in the shoulders, the
biceps and triceps in the arm, the pectoralis in the chest,
the rectus abdominus in the abdomen, the quadriceps
and the hamstring muscles in the legs.
The Cardiac Muscle: The heart is made up of the
cardiac muscle, which is also referred to as the
myocardium. These muscles are thick and contract in
order to pump out the blood and then relax in order to
allow more blood in. The cardiac muscle is an
involuntary muscle, or the type that works without your
volition. Special type of cells in the cardiac muscle,
called the pacemaker, help in controlling the heartbeat.
The Smooth Muscles: These are the involuntary
muscles of the human muscular system, and they
generally occur in layers or sheets, with one muscle
layer behind another. These muscles are not under your
control. The brain and the body control these muscles in
performing their functions without any conscious volition
from your part.
Some of the examples of smooth muscles are the
stomach and the digestive system, which contract and
relax in order to pass food through the alimentary canal
of the body. The bladder is another example of smooth
muscle, and so is the uterus in women. Smooth muscles
also occur in the eyes, which help to keep the eyes
focused. According to scientists, the eyes can move over
100,000 times in a day, making them the busiest
muscles in the human muscular system.
The Facial Muscles: There are more than 30 muscles
in the face. Not all of the facial muscles are attached to
bones, as is the case in the other parts of the body.
Many of the facial muscles are attached to the underside
of facial skin. The contractions of these muscles are
what give the face its various expressions, such as
frowning, laughter, surprise, sadness and so on.
The Tongue: And another unique muscle is the tongue,
which is free at one end and only attached on the other
end. The tongue actually comprises of a group of
muscles, which work in unison, enabling you to chew
and swallow food, and talk.
Cardiac and skeletal muscles are "striated" in that they
contain sarcomeres and are packed into highly-regular
arrangements of bundles; smooth muscle has neither.
While skeletal muscles are arranged in regular, parallel
bundles, cardiac muscle connects at branching, irregular
angles (called intercalated discs). Striated muscle
contracts and relaxes in short, intense bursts, whereas
smooth muscle sustains longer or even near-permanent
contractions.
Skeletal muscle is further divided into several subtypes:
• Type I, slow oxidative, slow twitch, or "red"
muscle is dense with capillaries and is rich in
mitochondria and myoglobin, giving the muscle
tissue its characteristic red color. It can carry
more oxygen and sustain aerobic activity.
• Type II, fast twitch muscle, has three major kinds
that are, in order of increasing contractile
speed:[2]
o Type IIa, which, like slow muscle, is
aerobic, rich in mitochondria and
capillaries and appears red.
o Type IIx (also known as type IId), which
is less dense in mitochondria and
myoglobin. This is the fastest muscle
type in humans. It can contract more
quickly and with a greater amount of
force than oxidative muscle, but can
sustain only short, anaerobic bursts of
activity before muscle contraction
becomes painful (often incorrectly
attributed to a build-up of lactic acid).
N.B. in some books and articles this
muscle in humans was, confusingly,
called type IIB.[3]
o Type IIb, which is anaerobic, glycolytic,
"white" muscle that is even less dense in
mitochondria and myoglobin. In small
animals like rodents this is the major
fast muscle type, explaining the pale
color of their flesh.
Anatomy
The anatomy of muscles includes both gross anatomy,
comprising all the muscles of an organism, and, on the
other hand, microanatomy, which comprises the
structures of a single muscle.
Gross anatomy
The gross anatomy of a muscle is the most important
indicator of its role in the body. The action a muscle
generates is determined by the origin and insertion
locations. The cross-sectional area of a muscle (rather
than volume or length) determines the amount of force it
can generate by defining the number of sarcomeres
which can operate in parallel. The amount of force
applied to the external environment is determined by
lever mechanics, specifically the ratio of in-lever to out-
lever. For example, moving the insertion point of the
biceps more distally on the radius (farther from the joint
of rotation) would increase the force generated during
flexion (and, as a result, the maximum weight lifted in
this movement), but decrease the maximum speed of
flexion. Moving the insertion point proximally (closer to
the joint of rotation) would result in decreased force but
increased velocity. This can be most easily seen by
comparing the limb of a mole to a horse - in the former,
the insertion point is positioned to maximize force (for
digging), while in the latter, the insertion point is
positioned to maximize speed (for running).
One particularly important aspect of gross anatomy of
muscles is pennation or lack thereof. In most muscles,
all the fibers are oriented in the same direction, running
in a line from the origin to the insertion. In pennate
muscles, the individual fibers are oriented at an angle
relative to the line of action, attaching to the origin and
insertion tendons at each end. Because the contracting
fibers are pulling at an angle to the overall action of the
muscle, the change in length is smaller, but this same
orientation allows for more fibers (thus more force) in a
muscle of a given size. Pennate muscles are usually
found where their length change is less important than
maximum force, such as the rectus femoris.
There are approximately 639 skeletal muscles in the
human body. However, the exact number is difficult to
define because different sources group muscles
differently.
Microanatomy
Muscle is mainly composed of muscle cells. Within the
cells are myofibrils; myofibrils contain sarcomeres, which
are composed of actin and myosin. Individual muscle
fibres are surrounded by endomysium. Muscle fibers are
bound together by perimysium into bundles called
fascicles; the bundles are then grouped together to form
muscle, which is enclosed in a sheath of epimysium.
Muscle spindles are distributed throughout the muscles
and provide sensory feedback information to the central
nervous system.
Skeletal muscle is arranged in discrete muscles, an
example of which is the biceps brachii. It is connected by
tendons to processes of the skeleton. Cardiac muscle is
similar to skeletal muscle in both composition and action,
being comprised of myofibrils of sarcomeres, but
anatomically different in that the muscle fibers are
typically branched like a tree and connect to other
cardiac muscle fibers through intercalcated discs, and
form the appearance of a syncytium.
muscle contraction
The three (skeletal, cardiac and smooth) types of muscle
have significant differences. However, all three use the
movement of actin against myosin to create contraction.
In skeletal muscle, contraction is stimulated by electrical
impulses transmitted by the nerves, the motor nerves
and motoneurons in particular. Cardiac and smooth
muscle contractions are stimulated by internal
pacemaker cells which regularly contract, and propagate
contractions to other muscle cells they are in contact
with. All skeletal muscle and many smooth muscle
contractions are facilitated by the neurotransmitter
acetylcholine.
Muscular activity accounts for much of the body's energy
consumption. All muscle cells produce adenosine
triphosphate (ATP) molecules which are used to power
the movement of the myosin heads. Muscles conserve
energy in the form of creatine phosphate which is
generated from ATP and can regenerate ATP when
needed with creatine kinase. Muscles also keep a
storage form of glucose in the form of glycogen.
Glycogen can be rapidly converted to glucose when
energy is required for sustained, powerful contractions.
Within the voluntary skeletal muscles, the glucose
molecule can be metabolized anaerobically in a process
called glycolysis which produces two ATP and two lactic
acid molecules in the process (note that in aerobic
conditions, lactate is not formed; instead pyruvate is
formed and transmitted through the citric acid cycle).
Muscle cells also contain globules of fat, which are used
for energy during aerobic exercise. The aerobic energy
systems take longer to produce the ATP and reach peak
efficiency, and requires many more biochemical steps,
but produces significantly more ATP than anaerobic
glycolysis. Cardiac muscle on the other hand, can
readily consume any of the three macronutrients
(protein, glucose and fat) aerobically without a 'warm up'
period and always extracts the maximum ATP yield from
any molecule involved. The heart, liver and red blood
cells will also consume lactic acid produced and
excreted by skeletal muscles during exercise.
Efferent leg
The efferent leg of the peripheral nervous system is
responsible for conveying commands to the muscles and
glands, and is ultimately responsible for voluntary
movement. Nerves move muscles in response to
voluntary and autonomic (involuntary) signals from the
brain. Deep muscles, superficial muscles, muscles of the
face and internal muscles all correspond with dedicated
regions in the primary motor cortex of the brain, directly
anterior to the central sulcus that divides the frontal and
parietal lobes.
In addition, muscles react to reflexive nerve stimuli that
do not always send signals all the way to the brain. In
this case, the signal from the afferent fiber does not
reach the brain, but produces the reflexive movement by
direct connections with the efferent nerves in the spine.
However, the majority of muscle activity is volitional, and
the result of complex interactions between various areas
of the brain.
Nerves that control skeletal muscles in mammals
correspond with neuron groups along the primary motor
cortex of the brain's cerebral cortex. Commands are
routed though the basal ganglia and are modified by
input from the cerebellum before being relayed through
the pyramidal tract to the spinal cord and from there to
the motor end plate at the muscles. Along the way,
feedback, such as that of the extrapyramidal system
contribute signals to influence muscle tone and
response.
Deeper muscles such as those involved in posture often
are controlled from nuclei in the brain stem and basal
ganglia.
Afferent leg
The afferent leg of the peripheral nervous system is
responsible for conveying sensory information to the
brain, primarily from the sense organs like the skin. In
the muscles, the muscle spindles convey information
about the degree of muscle length and stretch to the
central nervous system to assist in maintaining posture
and joint position. The sense of where our bodies are in
space is called proprioception, the perception of body
awareness. More easily demonstrated than explained,
proprioception is the "unconscious" awareness of where
the various regions of the body are located at any one
time. This can be demonstrated by anyone closing their
eyes and waving their hand around. Assuming proper
proprioceptive function, at no time will the person lose
awareness of where the hand actually is, even though it
is not being detected by any of the other senses.
Several areas in the brain coordinate movement and
position with the feedback information gained from
proprioception. The cerebellum and red nucleus in
particular continuously sample position against
movement and make minor corrections to assure
smooth motion.
Exercise
Exercise is often recommended as a means of improving
motor skills, fitness, muscle and bone strength, and joint
function. Exercise has several effects upon muscles,
connective tissue, bone, and the nerves that stimulate
the muscles.
Various exercises require a predominance of certain
muscle fiber utilization over another. Aerobic exercise
involves long, low levels of exertion in which the muscles
are used at well below their maximal contraction strength
for long periods of time (the most classic example being
the marathon). Aerobic events, which rely primarily on
the aerobic (with oxygen) system, use a higher
percentage of Type I (or slow-twitch) muscle fibers,
consume a mixture of fat, protein and carbohydrates for
energy, consume large amounts of oxygen and produce
little lactic acid. Anaerobic exercise involves short bursts
of higher intensity contractions at a much greater
percentage of their maximum contraction strength.
Examples of anaerobic exercise include sprinting and
weight lifting. The anaerobic energy delivery system
uses predominantly Type II or fast-twitch muscle fibers,
relies mainly on ATP or glucose for fuel, consumes
relatively little oxygen, protein and fat, produces large
amounts of lactic acid and can not be sustained for as
long a period as aerobic exercise. The presence of lactic
acid has an inhibitory effect on ATP generation within the
muscle; though not producing fatigue, it can inhibit or
even stop performance if the intracellular concentration
becomes too high. However, long-term training causes
neovascularization within the muscle, increasing the
ability to move waste products out of the muscles and
maintain contraction. Once moved out of muscles with
high concentrations within the sarcomere, lactic acid can
be used by other muscles or body tissues as a source of
energy, or transported to the liver where it is converted
back to pyruvate. The ability of the body to export lactic
acid and use it as a source of energy depends on
training level.
Humans are genetically predisposed with a larger
percentage of one type of muscle group over another. An
individual born with a greater percentage of Type I
muscle fibers would theoretically be more suited to
endurance events, such as triathlons, distance running,
and long cycling events, whereas a human born with a
greater percentage of Type II muscle fibers would be
more likely to excel at anaerobic events such as a 200
meter dash, or weightlifting. People with high overall
musculation and balanced muscle type percentage
engage in sports such as rugby or boxing and often
engage in other sports to increase their performance in
the former.[citations needed]
Delayed onset muscle soreness is pain or discomfort
that may be felt one to three days after exercising and
subsides generally within two to three days later. Once
thought to be caused by lactic acid buildup, a more
recent theory is that it is caused by tiny tears in the
muscle fibers caused by eccentric contraction, or
unaccustomed training levels. Since lactic acid disperses
fairly rapidly, it could not explain pain experienced days
after exercise.[4]
Disease
Main article: Neuromuscular disease
Symptoms of muscle diseases may include weakness,
spasticity, myoclonus and myalgia. Diagnostic
procedures that may reveal muscular disorders include
testing creatine kinase levels in the blood and
electromyography (measuring electrical activity in
muscles). In some cases, muscle biopsy may be done to
identify a myopathy, as well as genetic testing to identify
DNA abnormalities associated with specific myopathies
and dystrophies.
Neuromuscular diseases are those that affect the
muscles and/or their nervous control. In general,
problems with nervous control can cause spasticity or
paralysis, depending on the location and nature of the
problem. A large proportion of neurological disorders
leads to problems with movement, ranging from
cerebrovascular accident (stroke) and Parkinson's
disease to Creutzfeldt-Jakob disease.
A non-invasive elastography technique that measures
muscle noise is undergoing experimentation to provide a
way of monitoring neuromuscular disease. The sound
produced by a muscle comes from the shortening of
actomyosin filaments along the axis of the muscle.
During contraction, the muscle shortens along its
longitudinal axis and expands across the transverse
axis, producing vibrations at the surface.[5]
Atrophy
There are many diseases and conditions which cause a
decrease in muscle mass, known as muscle atrophy.
Example include cancer and AIDS, which induce a body
wasting syndrome called cachexia. Other syndromes or
conditions which can induce skeletal muscle atrophy are
congestive heart disease and some diseases of the liver.
During aging, there is a gradual decrease in the ability to
maintain skeletal muscle function and mass, known as
sarcopenia. The exact cause of sarcopenia is unknown,
but it may be due to a combination of the gradual failure
in the "satellite cells" which help to regenerate skeletal
muscle fibers, and a decrease in sensitivity to or the
availability of critical secreted growth factors which are
necessary to maintain muscle mass and satellite cell
survival. Sarcopenia is a normal aspect of aging, and is
not actually a disease state.
Physical inactivity and atrophy
Inactivity and starvation in mammals lead to atrophy of
skeletal muscle, accompanied by a smaller number and
size of the muscle cells as well as lower protein
content.[6] In humans, prolonged periods of
immobilization, as in the cases of bed rest or astronauts
flying in space, are known to result in muscle weakening
and atrophy. Such consequences are also noted in small
hibernating mammals like the golden-mantled ground
squirrels and brown bats.[7] Representatives of the Ursid
species make for an interesting exception to this
expected norm.
Bears are famous for their ability to survive unfavorable
environmental conditions of low temperatures and
limited nutrition availability during winter by means of
hibernation. During that time Ursids go through a series
of physiological, morphological and behavioral
changes.[8] Their ability to maintain skeletal muscle
number and size at time of disuse is of a significant
importance. During hibernation bears spend four to
seven months of inactivity and anorexia without
undergoing muscle atrophy and protein loss.[7] There are
a few known factors that contribute to the sustaining of
muscle tissue. During the summer period, Ursids take
advantage of the nutrition availability and accumulate
muscle protein. The protein balance of bears at time of
dormancy is also maintained by lower levels of protein
breakdown during the winter time.[7] At times of
immobility, muscle wasting in Ursids is also suppressed
by a proteolytic inhibitor that is released in circulation.[6]
Another factor that contributes to the sustaining of
muscle strength in hibernating bears is the occurrence of
periodic voluntary contractions and involuntary
contractions from shivering during torpor.[9] The three to
four daily episodes of muscle activity are responsible for
the maintenance of muscle strength and responsiveness
in bears during hibernation.[9]
Strength
A display of "strength" (e.g. lifting a weight) is a result of
three factors that overlap: physiological strength
(muscle size, cross sectional area, available
crossbridging, responses to training), neurological
strength (how strong or weak is the signal that tells the
muscle to contract), and mechanical strength (muscle's
force angle on the lever, moment arm length, joint
capabilities). Contrary to popular belief, the number of
muscle fibres cannot be increased through exercise;
instead the muscle cells simply get bigger. Muscle fibres
have a limited capacity for growth through hypertrophy
and some believe they split through hyperplasia if
subject to increased demand.[citation needed]
The "strongest" human muscle
Since three factors affect muscular strength
simultaneously and muscles never work individually, it is
misleading to compare strength in individual muscles,
and state that one is the "strongest". But below are
several muscles whose strength is noteworthy for
different reasons.
• In ordinary parlance, muscular "strength" usually
refers to the ability to exert a force on an
external object—for example, lifting a weight. By
this definition, the masseter or jaw muscle is the
strongest. The 1992 Guinness Book of Records
records the achievement of a bite strength of
4,337 N (975 lbf) for 2 seconds. What
distinguishes the masseter is not anything
special about the muscle itself, but its advantage
in working against a much shorter lever arm
than other muscles.
• If "strength" refers to the force exerted by the
muscle itself, e.g., on the place where it inserts
into a bone, then the strongest muscles are
those with the largest cross-sectional area. This
is because the tension exerted by an individual
skeletal muscle fiber does not vary much. Each
fiber can exert a force on the order of 0.3
micronewton. By this definition, the strongest
muscle of the body is usually said to be the
quadriceps femoris or the gluteus maximus.
• A shorter muscle will be stronger "pound for
pound" (i.e., by weight) than a longer muscle.
The myometrial layer of the uterus may be the
strongest muscle by weight in the human body.
At the time when an infant is delivered, the
entire human uterus weighs about 1.1 kg (40
oz). During childbirth, the uterus exerts 100 to
400 N (25 to 100 lbf) of downward force with
each contraction.
• The external muscles of the eye are
conspicuously large and strong in relation to the
small size and weight of the eyeball. It is
frequently said that they are "the strongest
muscles for the job they have to do" and are
sometimes claimed to be "100 times stronger
than they need to be." However, eye movements
(particularly saccades used on facial scanning
and reading) do require high speed movements,
and eye muscles are exercised nightly during
rapid eye movement sleep.
• The statement that "the tongue is the strongest
muscle in the body" appears frequently in lists of
surprising facts, but it is difficult to find any
definition of "strength" that would make this
statement true. Note that the tongue consists of
sixteen muscles, not one.
• The heart has a claim to being the muscle that
performs the largest quantity of physical work in
the course of a lifetime. Estimates of the power
output of the human heart range from 1 to 5
watts. This is much less than the maximum
power output of other muscles; for example, the
quadriceps can produce over 100 watts, but only
for a few minutes. The heart does its work
continuously over an entire lifetime without
pause, and thus does "outwork" other muscles.
An output of one watt continuously for eighty
years yields a total work output of two and a half
gigajoules.
The Skeletal Muscles: These are the voluntary type
of muscles in the human muscular system. This
means that they can be controlled by you. For
example, you cannot pick up that mug of coffee with
your hand unless you want your hand to do so. They
are referred sometimes as striated muscles,
because the dark and light fibrous material make
them seem striped. These are also known as the
musculoskeletal system, or the combination of the
muscles and the bones that make up the skeleton.
Generally, skeletal muscles are attached to the ends
of bones, stretching all across the joint and then
attached once more to another bone. Tendons,
which are cords or bands of inelastic tissue, are
what attach the muscles to the bones. Skeletal
muscles are of different shapes and sizes, which
enable them to perform a variety of tasks. The
gluteus maximus, or the muscle that occurs in the
buttocks, is the largest skeletal muscle in the human
muscular system. Some of the other major skeletal
muscles are the deltoid muscle in the shoulders, the
biceps and triceps in the arm, the pectoralis in the
chest, the rectus abdominus in the abdomen, the
quadriceps and the hamstring muscles in the legs.
The Cardiac Muscle: The heart is made up of the
cardiac muscle, which is also referred to as the
myocardium. These muscles are thick and contract
 in order to pump out the blood and then relax in
order to allow more blood in. The cardiac muscle is
an involuntary muscle, or the type that works without
your volition. Special type of cells in the cardiac
muscle, called the pacemaker, help in controlling the
heartbeat.
The Smooth Muscles: These are the involuntary
muscles of the human muscular system, and they
generally occur in layers or sheets, with one muscle
layer behind another. These muscles are not under
your control. The brain and the body control these
muscles in performing their functions without any
conscious volition from your part.
Some of the examples of smooth muscles are the
stomach and the digestive system, which contract
and relax in order to pass food through the
alimentary canal of the body. The bladder is another
example of smooth muscle, and so is the uterus in
women. Smooth muscles also occur in the eyes,
which help to keep the eyes focused. According to
scientists, the eyes can move over 100,000 times in
a day, making them the busiest muscles in the
human muscular system.
The Facial Muscles: There are more than 30
muscles in the face. Not all of the facial muscles are
attached to bones, as is the case in the other parts
of the body. Many of the facial muscles are attached
to the underside of facial skin. The contractions of
these muscles are what give the face its various
expressions, such as frowning, laughter, surprise,
sadness and so on.
The Tongue: And another unique muscle is the
tongue, which is free at one end and only attached
on the other end. The tongue actually comprises of a
group of muscles, which work in unison, enabling
you to chew and swallow food, and talk.
Muscle cells (also called muscle fibers) are cylindrical,
and are multinucleated (in vertebrates and insects). The
nuclei of these muscles are located in the peripheral
aspect of the cell, just under the plasma membrane,
which vacates the central part of the muscle fiber for
myofibrils. (Conversely, when the nucleus is located in
the center it is considered a pathologic condition known
as centronuclear myopathy.)
Skeletal muscles have one end (the "origin") attached to
a bone closer to the centre of the body's axis and the
other end (the "insertion") is attached across a joint to
another bone further from the body's axis. The bones
rotate about the joint and move relative to one another
by contraction of the muscle (lifting of the upper arm in
the case of the origin and insertion described here).
There are several different ways to categorize the type
of skeletal muscle fibers (see below). One method uses
the type of protein contained in myosin (one of the
important proteins that is responsible for the ability of
muscle to contract). Using this classification scheme,
there are two major types of fibers for skeletal muscles:
Type I and Type II. Type I fibers appear reddish. They
are good for endurance and are slow to tire because
they use oxidative metabolism. Type II fibers are whitish;
they are used for short bursts of speed and power, and
use both oxidative metabolism and anaerobic
metabolism depending on the particular sub-type, and
are therefore quicker to fatigue.
Muscle force is proportional to physiologic cross-
sectional area (PCSA), and muscle velocity is
proportional to muscle fiber length[1]. The strength of a
joint, however, is determined by a number of
biomechanical principles, including the distance between
muscle insertions and pivot points and muscle size.
Muscles are normally arranged in opposition so that as
one group of muscles contract, another group 'relaxes'
(in fact simply stretched) or lengthens. Antagonism in the
transmission of nerve impulses (epsp and ipsp lateral
balance) to the muscles means that it is impossible to
stimulate the contraction of two antagonistic muscles at
any one time. During ballistic motions such as throwing,
the antagonist muscles act to 'brake' the agonist
muscles throughout the contraction, particularly at the
end of the motion. In the example of throwing, the chest
and front of the shoulder (anterior Deltoid) contract to
pull the arm forward, while the muscles in the back and
rear of the shoulder (posterior Deltoid) also contract and
undergo eccentric contraction to slow the motion down
to avoid injury. Part of the training process is learning to
relax the antagonist muscles to increase the force input
of the chest and anterior shoulder.
Skeletal muscle cells are stimulated by acetylcholine,
which is released at neuromuscular junctions by motor
neurons[2]. Once the cells are "excited", their
sarcoplasmic reticulum will release ionic calcium (Ca2+)
which interacts with the myofibrils to induce muscular
contraction (via the sliding filament mechanism). This
process also requires adenosine triphosphate (ATP).
The ATP is produced by metabolizing creatine
phosphate and glucose (stored as glycogen or absorbed
from blood) within the muscle cells by mitochondria, as
well as by metabolizing fatty acids obtained from the
blood and within the cell. Each motor neuron activates a
group of muscle cells, and collectively the neurons and
muscle cells are known as motor units. When more
strength is required than can be obtained from a single
motor unit, more units will be stimulated; this is known as
motor unit recruitment. This is spatial summation. If more
strength is required than can be obtained from the
current number of motor units, the motor neurons
continue to recruit more motor units. When all the motor
units are recruited, there will be no further increase in
contraction strength. To increase the force of contraction,
it is necessary to increase the frequency of neuronalT
firing. This results in tetanic contraction, which is a
smooth contraction. This is temporal summation...
TENDON
A tendon (or sinew) is a tough band of fibrous
connective tissue that usually connects muscle to bone[1]
and is capable of withstanding tension. Tendons are
similar to ligaments and fascia as they are both made of
collagen except that ligaments join one bone to another
bone, and fascia connect muscles to other muscles.
Tendons and muscles work together and can only exert
a pulling force.
Structure
Normal healthy tendons are composed of parallel arrays
of collagen fibers closely packed together. The fibers are
mostly collagen type I, however there are also collagen
type III and V present. These collagens are held together
with other proteins, particularly the proteoglycan, decorin
and, in compressed regions of tendon, aggrecan. The
tenocytes produce the collagen molecules which
aggregate end-to-end and side-to-side to produce
collagen fibrils. Fibril bundles are organized to form
fibers with the elongated tenocytes closely packed
between them. Collagen fibers coalesce into
macroaggregates. Groups of macroaggregates are
bounded by connective tissue endotendon and are
termed fascicles. Groups of fascicles are bounded by the
epitendon and peritendon to form the tendon organ.
Blood vessels may be visualized within the endotendon
running parallel to collagen fibers, with occasional
branching transverse anastomoses.
The internal tendon bulk is thought to contain no nerve
fibers, but the epi- and peritendon contain nerve
endings, while Golgi tendon organs are present at the
junction between tendon and muscle.
Tendon length varies in all major groups and from
person to person. Tendon length is practically the
discerning factor where muscle size and potential
muscle size is concerned. For example, should all other
relevant biological factors be equal, a man with a shorter
tendons and a longer biceps muscle will have greater
potential for muscle mass than a man with a longer
tendon and a shorter muscle. Successful bodybuilders
will generally have shorter tendons. Conversely, in
sports requiring athletes to excel in actions such as
running or jumping, it is beneficial to have longer than
average Achilles tendon and a shorter calf muscle.[2]
Tendon length is determined by genetic predisposition,
and has not been shown to either increase or decrease
in response to environment, unlike muscles which can
be shortened by trauma, use imbalances and a lack of
recovery and stretching.
Function
Tendons have been traditionally considered to simply be
a mechanism by which muscles connect to bone,
functioning simply to transmit forces. However, over the
past two decades, much research focused on the elastic
properties of tendons and their ability to function as
springs. This allows tendons to passively modulate
forces during locomotion, providing additional stability
with no active work. It also allows tendons to store and
recover energy at high efficiency. For example, during a
human stride, the Achilles tendon stretches as the ankle
joint dorsiflexes. During the last portion of the stride, as
the foot plantar-flexes (pointing the toes down), the
stored elastic energy is released. Furthermore, because
the tendon stretches, the muscle is able to function with
less or even no change in length, allowing the muscle to
generate greater force.
Pathology
Tendinitis refers to inflammation of a tendon.
Tendinosis refers to non-inflammatory injury to the
tendon at the cellular level. The tendons in the foot are
highly complex and intricate. If any tendons break it is a
long painful healing process, not to mention the intricacy
of the repairing (if fully severed) process. Most people
that do not receive medical attention within the first 48
hours of the injury will suffer from severe swelling, pain,
and an on-fire feeling where the injury occurred. They
are very painful when they are inflamed or not in use.
Muscular disorders
Muscular dystrophy (MD) is a group of more than 30
inherited diseases. It causes weakening and breaking
down of muscle fibers. The muscles become weak and
susceptible to damage. This disease affects the
voluntary or skeletal muscles, which control the
movements of legs, arms and trunk. It can also affect the
heart muscles and other involuntary muscles, such as
muscles in the gut. Some forms of MD are found in
infancy or childhood, while some may not appear until
middle age. This progressive disease is more common
in boys than girls.
Arthrogryposis, also known as Arthrogryposis
Multiplex Congenita, is a rare congenital disorder that
is characterized by multiple joint contractures and can
include muscle weakness and fibrosis. It is a non-
progressive disease. The disease derives its name from
Greek, literally meaning 'curved or hooked joints'.
Centronuclear myopathies (CNM) are a group of
congenital myopathies where cell nuclei are abnormally
located in skeletal muscle cells. In CNM the nuclei are
located at a position in the center of the cell, instead of
their normal location at the periphery. Although all forms
of centronuclear myopathy are considered rare, the most
commonly known form of CNM is Myotubular Myopathy
(MTM). Symptoms of CNM include severe hypotonia,
hypoxia-requiring breathing assistance, and
scaphocephaly. Among centronuclear myopathies, the
X-linked myotubular myopathy form typically presents at
birth, and is thus considered a congenital myopathy.
However, some centronuclear myopathies may present
later in life
Diastasis recti (also known as abdominal separation)
is a disorder defined as a separation of the rectus
abdominis muscle into right and left halves. [1] Normally,
the two sides of the muscle are joined at the linea alba at
the body midline. Diastasis of this muscle occurs
principally in two populations: newborns and pregnant
women. In the newborn, the rectus abdominis is not fully
developed and may not be sealed together at midline.
Diastasis recti is more common in premature and African
American newborns. In pregnant or postpartum women,
the defect is caused by the stretching of the rectus
abdominis by the growing uterus. It is more common in
multiparous women due to repeated episodes of
stretching. When the defect occurs during pregnancy,
the uterus can sometimes be seen bulging through the
abdominal wall beneath the skin.
Sporadic inclusion body myositis (sIBM) is an
inflammatory muscle disease, characterized by slowly
progressive weakness and wasting of both distal and
proximal muscles, most apparent in the muscles of the
arms and legs. In sporadic inclusion body myositis [MY-
oh-sigh-tis] muscle, two processes, one autoimmune
and the other degenerative, appear to occur in the
muscle cells in parallel. The inflammation aspect is
characterized by the cloning of T cells that appear to be
driven by specific antigens to invade muscle fibers. The
degeneration aspect is characterized by the appearance
of holes in the muscle cell (vacuole)s, deposits of
abnormal proteins within the cells and in filamentous
inclusions (hence the name inclusion body myositis).
Macrophagic Myofasciitis, or MMF, is a rare muscle
disease identified in 1993. The disease is characterized
by microscopic lesions found in muscle biopsies that
show infiltration of muscle tissue by PAS-positive
macrophages. [1] Specific causes of MMF are unknown,
but the disease is most often associated with the
pathological persistence of aluminium hydroxide used in
some vaccines. Clinical symptoms include muscle pain,
joint pain, muscle weakness, fatigue, fever, and muscle
tenderness. A diagnosis can only be identified with an
open muscle biopsy of the vaccinated muscle. [2]
Nemaline myopathy (also called rod myopathy or
nemaline rod myopathy) is a congenital, hereditary
neuromuscular disorder that causes muscle weakness,
generally nonprogressive, of varying severity."Myopathy"
means "muscle disease," and a biopsy of muscle from a
person with nemaline myopathy shows abnormal thread-
like rods, called nemaline bodies, in the muscle cells.
People with nemaline myopathy (or NM) usually
experience delayed motor development and weakness
in the arm, leg, trunk, throat, and face muscles.
Pelvic Floor Muscle Disorder the muscles of the pelvic
floor remain tightened. Normally these muscles are
under voluntary control, but for some excessive tension
can develop. Reasons for this are not well known but
can be resultant from a natural disposition, learned
reaction to stress or pain, trauma, or any combination of
these. Excessive pelvic floor tension can result in
various problems including frequent urination (due to the
bladder's inability to expand) or pain. Treatments involve
relaxing the muscles, using medication (such as
Tamsulosin), Biofeedback, or physical therapy.
Thyrotoxic Myopathy (TM) is a neuromuscular disorder
that develops due to the overproduction of the thyroid
hormone thyroxine. Also known as hyperthyroid
myopathy, TM is one of many myopathies that lead to
muscle weakness and muscle tissue breakdown.
Evidence indicates the onset of TM may be caused by
hyperthyroidism (Kazakov, 1992). There are currently
two known causes of hyperthyroidism that lead to
development of TM including a multinodular goiter and
Graves disease. Physical symptoms of TM may include
muscle weakness, the breakdown of muscle tissue,
fatigue, and heat intolerance (Quin, 1951).� Physical
acts such as lifting objects and climbing stairs may
become increasingly difficult (Horak, 2000). If untreated
TM can be an extremely debilitating disorder that can, in
extreme rare cases, lead to death. If diagnosed and
treated properly the effects of TM can be controlled and
in most cases reversed leaving no lasting effects.
Writer's cramp, also called mogigraphia and
scrivener's palsy, causes a cramp or spasm
affecting certain muscles of the hand and/or
fingers[1]. Writer's cramp is a task-specific focal
dystonia of the hand [2]. 'Focal' refers to the
symptoms being limited to one location (the hand in
this case), and 'task-specific' means that symptoms
first occur only when the individual engages in a
particular activity. Writer's cramp first affects an
individual by inhibiting their ability to write.[3]
Almost all skeletal muscles either originate or insert on
the skeleton. When a muscle moves a portion of the
skeleton, that movement may involve flexion, extension,
adduction, abduction, protraction, retraction, elevation,
depression, rotation, circumduction, pronation,
supination, inversion, eversion, lateral flexion, or
opposition.
Actions can be described by one of two methods. The
first, a muscle such as the biceps brachii is said to
perform "flexion of the forearm." The second method, of
increasing use among specialists such as kinesiologists,
identifies the joint involved. With this method, the action
of the biceps brachii muscle would be "flexion at (or of)
the elbow." Both methods are valid, and each has its
advantages. We shall primarily use the latter method.
When complex movements occur, muscles commonly
work in groups rather than individually. Their cooperation
improves the efficiency of a particular movement. For
example, large muscles of the limbs produce flexion or
extension over an extended range of motion. Although
these muscles cannot develop much tension at full
extension, they are generally paired with one or more
smaller muscles that provide assistance until the larger
muscle can perform at maximum efficiency. At the start
of the movement, the smaller muscle is producing
maximum tension while tension production by the larger
muscle is at a minimum. The importance of this smaller
"assistant" decreases as the movement proceeds and
the efficiency of the primary muscle increases.
On the basis of size and range of motion, muscles are
described as follows:
• An agonist, or prime mover, is a muscle whose
contraction is chiefly responsible for producing a
particular movement. The biceps brachii muscle
is an agonist that produces flexion at the elbow.
• Antagonists are muscles whose actions
oppose that of the agonist under consideration.
The triceps brachii muscle is an agonist that
extends the elbow. It is therefore an antagonist
of the biceps brachii muscle, and the biceps
brachii is an antagonist of the triceps brachii.
Agonists and antagonists are functional
opposites; if one produces flexion, the other will
produce extension. When an agonist contracts
to produce a particular movement, the
corresponding antagonist will be stretched, but it
will usually not relax completely. Instead, it will
contract eccentrically, with the tension adjusted
to control the speed of the movement and
ensure its smoothness. You may find it easiest
to learn about muscles in agonist/antagonist
pairs (flexors/extensors, abductors/adductors)
that act at a specific joint. This method highlights
the functions of the muscles involved, and it can
help organize the information in a logical
framework. The tables in this chapter are
arranged to facilitate this approach.
• When a synergist contracts, it helps a larger
agonist work efficiently. Synergists may provide
additional pull near the insertion or may stabilize
the point of origin. Their importance in assisting
a particular movement may change as the
movement progresses. In many cases, they are
most useful at the start, when the agonist is
stretched and unable to develop maximum
tension. For example, the latissimus dorsi
muscle is a large trunk muscle that extends,
adducts, and medially rotates the arm at the
shoulder joint. A much smaller muscle, the teres
major muscle, assists in starting such
movements when the shoulder joint is at full
flexion. Synergists may also assist an agonist by
preventing movement at another joint and
thereby stabilizing the origin of the agonist. Such
synergists are called fixators.
NAMES OF SKELETAL MUSCLES
Except for the platysma and the diaphragm, the
complete names of all skeletal muscles include the term
muscle. Although the full name, such as the biceps
brachii muscle, will usually appear in the text, for
simplicity only the descriptive name (biceps brachii) will
be used in figures and tables.
You need not learn every one of the approximately 700
muscles in the human body, but you will have to become
familiar with the most important ones. Fortunately,
anatomists assigned names to the muscles that provide
clues to their identification. If you can learn to recognize
the clues, you will find it easier to remember the names
and identify the muscles. The name of a muscle may
include information about its fascicle organization,
location, relative position, structure, size, shape, origin
and insertion, or action.
Fascicle Organization
A muscle name may refer to the orientation of the
muscle fibers within a particular skeletal muscle. Rectus
means "straight," and rectus muscles are parallel
muscles whose fibers generally run along the long axis
of the body. Because we have several rectus muscles,
the name typically includes a second term that refers to
a precise region of the body. For example, the rectus
abdominis muscle is located on the abdomen, and the
rectus femoris muscle on the thigh. Other directional
indicators include transversus and oblique for muscles
whose fibers run across or at an oblique angle to the
longitudinal axis of the body, respectively.
Location
They are common as modifiers that help identify
individual muscles, as in the case of the rectus muscles.
In a few cases, the muscle is such a prominent feature
of the region that the regional name alone will identify it.
Examples include the temporalis muscle of the head and
the brachialis muscle of the arm.
Relative Position
Muscles visible at the body surface are often called
externus or superficialis, whereas deeper muscles are
termed internus or profundus. Superficial muscles that
position or stabilize an organ are extrinsic; muscles
located entirely within the extrinsic organ are intrinsic.
Structure, Size, and Shape
Some muscles are named after distinctive structural
features. The biceps brachii muscle, for example, has
two tendons of origin; the triceps brachii muscle has
three; and the quadriceps group, four. Shape is
sometimes an important clue to the name of a muscle.
For example, the trapezius, deltoid, rhomboideus, and
orbicularis muscles look like a trapezoid, a triangle, a
rhomboid, and a circle, respectively. Long muscles are
called longus (long) or longissimus (longest), and
teres muscles are both long and round. Short muscles
are called brevis. Large ones are called magnus (big),
major (bigger), or maximus (biggest); and small ones
are called minor (smaller) or minimus (smallest).
Origin and Insertion
Many names tell you the specific origin and insertion of
each muscle. In such cases, the first part of the name
indicates the origin, and the second part the insertion.
The genioglossus muscle, for example, originates at the
chin (geneion) and inserts in the tongue (glossus).
Action
Many muscles are named flexor, extensor, retractor,
abductor, and so on. These are such common actions
that the names almost always include other clues as to
the appearance or location of the muscle. For example,
the extensor carpi radialis longus muscle is a long
muscle along the radial (lateral) border of the forearm.
When it contracts, its primary function is extension at the
carpus (wrist).
A few muscles are named after the specific movements
associated with special occupations or habits. The
sartorius muscle is active when you cross your legs.
Before sewing machines were invented, a tailor would sit
on the floor cross-legged, and the name of this muscle
was derived from sartor, the Latin word for "tailor." On
the face, the buccinator muscle compresses the cheeks,
as when you purse your lips and blow forcefully.
Buccinator translates as "trumpet player." Another facial
muscle, the risorius muscle, was supposedly named
after the mood expressed. The Latin term risor, however,
means "laugher"; a more appropriate description for the
effect would be "grimace."
AXIAL AND APPENDICULAR MUSCLES
The separation of the skeletal system into axial and
appendicular divisions provides a useful guideline for
subdividing the muscular system as well:
1. The axial musculature arises on the axial
skeleton. It positions the head and spinal column
and also moves the rib cage, assisting in the
movements that make breathing possible. It
does not play a role in movement or support of
either the pectoral or pelvic girdle or the limbs.
This category encompasses roughly 60 percent
of the skeletal muscles in the body.
2. The appendicular musculature stabilizes or
moves components of the appendicular skeleton
and includes the remaining 40 percent of all
skeletal muscles.
The major axial and appendicular muscles of the human
body. These are the superficial muscles, which tend to
be relatively large. The superficial muscles cover deeper,
smaller muscles that cannot be seen unless the
overlying muscles are either removed or reflected--that
is, cut and pulled out of the way. Later figures that show
deep muscles in specific regions will indicate whether
superficial muscles have been removed or reflected for
the sake of clarity.
Paying attention to patterns of origin, insertion, and
action, we will now examine representatives of both
muscular divisions. This discussion assumes that you
already understand skeletal anatomy. As you examine
the figures in this chapter, you will find that some bony
and cartilaginous landmarks are labeled for orientation
purposes. These labels are shown in italics, to
differentiate them from the muscles that are the primary
focus of each figure.
Innervation is the distribution of nerves to a region or
organ; the tables indicate the nerves that control each
muscle. Many of the muscles of the head and neck are
innervated by cranial nerves, such as the facial nerve, or
seventh cranial nerve (N VII), which innervates the facial
musculature. Cranial nerves originate at the brain and
pass through the foramina of the skull. Spinal nerves are
connected to the spinal cord and pass through the
intervertebral foramina. For example, spinal nerve L1
passes between vertebrae L1 and L2 . Spinal nerves may
form a complex network, or plexus; one branch, such as
the sciatic nerve of the thigh, may contain axons from
several spinal nerves. Thus, many tables include the
spinal nerves as well as the names of the peripheral
nerves.
The axial muscles fall into logical groups on the basis of
location, function, or both. The groups do not always
have distinct anatomical boundaries. For example, a
function such as extension of the vertebral column
involves muscles along its entire length and flexion at
each of the intervertebral joints. We will discuss the axial
muscles in four groups:
1. The muscles of the head and neck. This group
includes muscles that move the face, tongue,
and larynx. They are therefore responsible for
verbal and nonverbal communication—laughing,
talking, frowning, smiling, whistling, and so on.
You also use this group of muscles when you
eat—especially in sucking and chewing—and
even when you look for something to eat, by
controlling your eye movements. This group
does not include muscles of the neck that are
involved with movements of the vertebral
column.
 2. The muscles of the spine. This group includes
numerous flexors, extensors, and rotators of the
vertebral column.
3. The oblique and rectus muscles. This group
forms the muscular walls of the thoracic and
abdominopelvic cavities between the first
thoracic vertebra and the pelvis. In the thoracic
area these muscles are partitioned by the ribs,
but over the abdominal surface they form broad
muscular sheets. The neck also has oblique and
rectus muscles. Although they do not form a
complete muscular wall, they share a common
developmental origin with the oblique and rectus
muscles of the trunk.
4. The muscles of the pelvic floor. These muscles
extend between the sacrum and pelvic girdle.
This group forms the perineum, a muscular
sheet that closes the pelvic outlet.
MUSCLES OF THE HEAD AND NECK
We can divide the muscles of the head and neck into
several groups by function. The muscles of facial
expression, the muscles of mastication (chewing), the
muscles of the tongue, and the muscles of the pharynx
originate on the skull or hyoid bone. Muscles involved
with sight and hearing are also based on the skull. We
will consider here the extrinsic eye muscles--those
associated with movements of the eye. We shall discuss
the intrinsic eye muscles, which control the diameter of
the pupil and the shape of the lens, and the tiny skeletal
muscles associated with the auditory ossicles. In the
neck, the extrinsic muscles of the larynx adjust the
position of the hyoid bone and larynx.
Muscles of Facial Expression
The muscles of facial expression originate on the
surface of the skull. At their insertions, the fibers of the
epimysium are woven into those of the superficial fascia
and the dermis of the skin: When they contract, the skin
moves. These muscles are innervated by the facial
nerve.
The largest group of facial muscles is associated with
the mouth. The orbicularis oris muscle constricts the
opening, and other muscles move the lips or the corners
of the mouth. The buccinator muscle has two functions
related to eating (in addition to its importance to
musicians). During chewing, it cooperates with the
masticatory muscles by moving food back across the
teeth from the space inside the cheeks. In infants, the
buccinator provides suction for suckling at the breast.
Smaller groups of muscles control movements of the
eyebrows and eyelids, the scalp, the nose, and the
external ear. The epicranius, or scalp, contains two
muscles, the frontalis and the occipitalis muscles.
These muscles are separated by the galea
aponeurotica, a collagenous sheet. The platysma
covers the ventral surface of the neck, extending from
the base of the neck to the periosteum of the mandible
and the fascia at the corner of the mouth.
Extrinsic Eye Muscles
Six extrinsic eye muscles, or oculomotor muscles,
originating on the surface of the orbit control the position
of each eye. These muscles are the inferior rectus,
medial rectus, superior rectus, lateral rectus, inferior
oblique, and superior oblique muscles. The extrinsic
eye muscles are innervated by the third (oculomotor),
fourth (trochlear), and sixth (abducens) cranial nerves.
Muscles of Mastication
The muscles of mastication move the mandible at the
temporomandibular joint. The large masseter muscle is
the strongest jaw muscle. The temporalis muscle
assists in elevation of the mandible. The pterygoid
muscles, used in various combinations, can elevate,
depress, or protract the mandible or slide it from side to
side, a movement called lateral excursion. These
movements are important in making efficient use of your
teeth while you chew foods of various consistencies. The
muscles of mastication are innervated by the fifth cranial
nerve, the trigeminal nerve.
Muscles of the Tongue
The muscles of the tongue have names ending in
glossus, the Greek word for "tongue." Once you can
recall the structures referred to by palato-, stylo-, genio-,
and hyo-, you will follow this group. The palatoglossus
muscle originates at the palate, the styloglossus
muscle at the styloid process of the temporal bone, the
genioglossus muscle at the chin, and the hyoglossus
muscle at the hyoid bone. These muscles, used in
various combinations, move the tongue in the delicate
and complex patterns necessary for speech, and they
manipulate food within the mouth in preparation for
swallowing. Most are innervated by the hypoglossal
nerve (N XII), a cranial nerve whose name indicates its
function and its location
Muscles of the Pharynx
The muscles of the pharynx are responsible for initiating
the swallowing process. The pharyngeal constrictors
(superior, middle, and inferior) move materials into the
esophagus. The laryngeal elevators elevate the larynx.
The palatal muscles, the tensor veli palatini and the
levator veli palatini, raise the soft palate and adjacent
portions of the pharyngeal wall and also pull open the
entrance to the auditory tube. As a result, swallowing
repeatedly can open the entrance to the auditory tube to
help you adjust to pressure changes when you fly or
dive.
Anterior Muscles of the Neck
The anterior muscles of the neck include (1) muscles
that control the position of the larynx, (2) muscles that
depress the mandible and tense the floor of the mouth,
and (3) muscles that provide a stable foundation for
muscles of the tongue and pharynx. The
digastric muscle has two bellies, as the name implies.
One belly extends from the chin to the hyoid bone, and
the other continues from the hyoid bone to the mastoid
portion of the temporal bone. Depending on which belly
contracts and whether fixator muscles are stabilizing the
position of the hyoid bone, the digastric muscle can open
the mouth by depressing the mandible, or it can elevate
the larynx by raising the hyoid bone. The digastric
muscle overlies the broad, flat mylohyoid muscle, which
provides a muscular floor to the mouth. The stylohyoid
muscle forms a muscular connection between the hyoid
bone and the styloid process of the skull. The
sternocleidomastoid muscle extends from the clavicle
and the sternum to the mastoid region of the skull. The
omohyoid muscle attaches to the scapula, the clavicle
and first rib, and the hyoid bone. The other members of
this group are straplike muscles that extend between the
sternum and larynx (sternothyroid) or hyoid bone
(sternohyoid), between the larynx and hyoid bone
(thyrohyoid), and between the hyoid bone and chin
(geniohyoid).