LIGAMENTS

Ligaments are tough connective tissues that connect bones to provide guide and limit joint motion as
well as provide important proprioceptive signals and kinesthetic signals about joint movement and
positions.

Like other connective tissues ,ligament too remodel to the stresses applied to it .

Ligaments are heterogeneous structures containing a small amount of cells and large amount of
extracellular matrix . The fibrillar component of the extracellular matrix in most ligaments is composed
of mainly type 1 collagen, with lesser amount of type 3, 4 & 5 and varing amount of elastin.

Type 1 collagen fibrils also densely packed with fibers arranged according to applied tensile forces.
ligaments are subjected to varying tensile forces depending on the joint angle so the fibers run in many
directions,enabling the ligament to resist forces in morethan one directions.

The appearance and composition of ligaments change near entheses ,the attachment to bone.In fibrous

attachments,collagen fibers blend into periosteum of bone and is attached to cortical bone via
sharpey’s fibers.

Ligaments are named according to the shape ,location,bone attachments and the person who identified.
example –anterior cruciate ligament for location and shape y ligament of bigelow of hip is named after
the person who identified and its shape.

CARTILAGE
Cartilage is a dense fibrous connective tissues capable of withstanding a great amount of pressure and
tension .These are three types of cartilages in the body –hyaline, elastic and fibrocartilage .

Hyaline cartilage is also as articular cartilage covering on the ends of the bones in synovial joints.

The greek word hyalos meaning ‘’glass’’, forms relatively thin .

Hyaline cartilage provides smooth,resilient,,low friction surface that is capable of bearing and
distributing weight over a person lifetime.

Once injured hyaline cartilage has limited and imperfect mechanism for repair.

Like other connective tissues ,articular cartilage has small intracellular component and a large
extracellular component .The cell in articular cartilage are chondroblast and chondrocytes.

Hyaline cartilage has no separate blood or nerve supply of its own it nutrition supply solely is from the
synovial fluid .

Articular cartilage contains more of proteoglycon than other tissues. The major proteoglycons is
aggrecans which contains more keratin sulfate and chondroitin sulfate GAG chains.
Higher the chondroitin sulfate concentration is ,better the tissues can resists compressive forces. If
amount of keratin sulfate increases the amount of chondroitin sulfate, weight bearing ability of the
joint is compromised.

Zones of articular carlige:

Zone 1:

Outermost layer, collagen type 2 fibers are really oriented arranged parallel to the surface.

This smooth layer helps reduce friction between opposing joint surface and distributes forces equally.

Zone 2 & 3:

Type 2 collagen forms a open meshwork, The collagen keeps the water and proteoglycon contained to
absorb compressive forces.

The third layer ,prepandicular collagen cross across calcified and uncalcified cartilage.

Zone 4:

The calcified cartilage is reffered to as fourth zone, lies adjacent to the subchondral bone and anchors
the cartilage securely to bone.

The interference between calcified and uncalcified cartilage is called tidemark. It is important because
of its relation to growth , ageing, injury &healing.

Cartilage in matured joints:

Cartilage have no cellular turnover because the tissues is hypocellular and avascular ,relies on diffusion
for nutrients supply and contains only terminally differentiated cells.

Replacement of cartilage layer of cartilage with bone occurs by endochondral ossification.

In ageing, balance changes as deeper layers of cartilage replaced by bone resulting in cartilage thining
superficially.

In injuries , involving micro fractures to subcondral bone, a secondary ossification centre in bone is
activated to produce new bone growth,which expands to cartilage and causes thinning.

Cartilage resistance to compressive forces depends on 1 (i) large volume of aggregating proteoglycons
and (ii) an intact collagen network.

Cartilage degeneration occurs initially by loss of superficial collagen fibers which allows more water to
enter the swelling the cartilage.

Without collagen network proteoglycons and glycosaminoglycons begins to escape into joint, the
cartilage narrows and and loses its ability to resist compression, the cartilage is worn completely.
The proteoglycons and glycosaminoglycons escaped into synovial eroding the cartilage completely
resulting in osteoarthritis.

Injury due to frictional forces for trauma removes collagen meshwork and makes cartilage to swell
initially and thicker lately because the PG attract more cortex with the absence of superficial collagen
network.

Fluid moment slows later reducing cell nutrition and synthetic ability.

Muscles
Muscles are connective tissues which are designed to do mobility function. They have two composition,
the contractile and non contractile tissues. Contractile tissues develops tension in response to chemical ,
electrical or mechanical stimuli connective tissue response by passive loading.

There are three types of muscle. The cardiac smooth and skeletal muscles.

Smooth muscle:

Found on the walls of intestine , stomach , bladder , uterus and pupillary area.

These muscles are beyond one’s control. The intestinal muscles do peristaltic movement to push food.

Pupillary muscles contracts pupil on seeing bright light. uterine muscles push the fetus during
parturition.

Cardiac muscles:

These are unique to the heart and are active for the whole day with the rest period below one seconds.

Cardiac muscles have rhythmicity property which creates its own impulse for muscle contraction.

Skeletal muscles:

Skeletal muscles are for mobility and stability function.

Composition of muscle fiber:

Contractile proteins:

A single muscle is composed of many fascicles are made of myofibrils which is a composition of
myofilaments.

Muscle fiber is enclosed in a cell membrane called sarcoplasm.

Myofibrils are the contractile structures of a muscle fiber . non contractile structures are ribosomes
,glycogen, mytocontria are for cell metabolism .
Myofilaments consist of acting and myosin filament proteins. Troponin and tropomyosin are binding
filament binds to myosin.

There proteins play a major role in muscular relaxation and contraction.

Structural proteins:

These proteins provides structural scafford for muscle fiber , where as others involved in transmission of
force along fiber.

Protein titin as important role in maintaining position of myosin during contraction.

Contractile unit:

Sarcomere is the structural and contractile unit of muscles ,which consist of actin filament,myosin
filaments, troponin, tropomyosin, titin and sarcoplasmic reticulam.

Contraction of muscle fiber:

Muscle contraction is initiated by thr arrival of impulse at motor end plate which evokes action
potential.

Action potential initiates release of calcium ions cause troponin to reposition tropomyosin molecules so
that receptor sites of actin are free and the head groups of myosin can bind with actin .This is known as
cross bridge formation.

Tension is generated with hydrolysis of adenosine triphosphate to adenosine diphosphate from myosin
head.

Types of muscle contraction:

Concentric contraction:

The sliding of thin filaments towards the thick filaments cause shortening of muscle is concentric or
towards center is concentric contraction.

Excentric contraction:

In this type of contraction,the thin filaments are pulled away from thick filaments is known as excentric
contraction.

Muscle fibers types:

Slow oxidative (type i):

Slow oxidative fibers use oxidative phosphorylation to generate ATP.

Rich in myoglobulin and are said as red muscle which are rich in oxygen.
Highly resistant to fatigue

Soleus,gatronemius,spinal extensors are example of type 1 fibers.

Fast oxidative glycolytic fibers :

Contract on a faster rate and produce large peak force.

Rich in oxidative and glycolytic enzymes.

Anaerobic respiration is done in muscle to sustain over prolonged intervals of time.

Fast glycolytic fibers:

Can exert very larger force and contract at a faster rate.

Fatigue easily.

Anaerobic respiration is done for short duration of time.

Function of muscles:

Muscle tension:

Passive tension:

Refers to tension developed in parallel component of muscle (ie) non contractile tissues of muscle when
muscle is lengthened beyond the slack length.

Active tension:

Refers to contractile tissues of muscle

Active tension is created by cross bridge formation.

Active tension can be created by neural factors and mechanical properties of muscle muscle .Neural
factors include frequency , number and size of motor units firing , mechanical factors include isometric
length tension relationship .

Length tension relationship:

Active tension in muscle depends on the length of the muscle fiber is greater the length of the muscle
fiber is the greater the contraction of muscle fibres.

Shorter muscle length reduces the muscle contraction and muscle force.

Force velocity relationship:

It is the speed of shortening of muscle fibre. (ie) the rate at which the myofilaments slide past one
another to form and deform cross bridges .

Speed of shortening also depends on the muscle fibre type .

Force velocity relationship describes the relationship between velocity of muscle contraction and force
produced.

NERVES
The structural and functional unit of nervous system is neurons. It contains a cell body with fibres
branching in and out of it.

Dendrons are fiber branches which receive and send impulses from and to other dendrites.

Axon transmits impulses from the cell body to the axon terminals. The inner part of the axon is
surrounded by a sheath called myelin sheath. The axon travels through the spinal cord and continues as
peripheral nerve and terminates as motor end plates. Break in myelin sheath is known as node of
ranvier.

Transmission of impulse from one neuron to another neuron as a synapse transition of impulse by
jumping from node of ranvier to another node is saltatary conduction.

Types of nerves:

Motor nerves:

Motor nerves are afferent nerves which sends impulses from brain or spinal cord to the peripheral
muscles.

The cell body will be in the coxlin and axons on the spinal cord and as peripheral nerves and axon
terminal in muscle motor unit.

Sensory nerves:

Sensory nerves carry sensation .These sensation are present in the ligaments ,skin, golgi tendon organs,
joints etc, sends sensory changes from the targeted area and to the brain via spino thalamic ,spino
cerebellar,spino cerebral tracts via dorsal column of spine.

Cranial nerves:

Cranial nerves arise at the brain and supplies face,pharynx,heart,intestines,etc.

Spinal nerves:

Spinal nerves arise from the spine and supplies upper limb ,lower limb and trunk.
 MYOFASCIA

Based on the interconnected nature of fascial tissues ,fascia is designed as all collageneous fibrous
connective tissues that can be seen as elements of a body wide tensional transmission network. In
contrast to bone on cartilage, specific morphology of these tissues is shaped by dominance of tensional
rather than compression loading.

Protyoglycons in myofascia contains dertamatan sulfate which resist tensile loading.

Superficial fascia:

The fascial sheet underlying the skin made of loose areolar tissue with varying amount of fat.

Superficial fascia is more distinct in lower part of anterior abdominal wall, perineum and limbs.

Very thin in dorsal aspect of hands, feet, sides of neck and around anus.

It is very dense in scalp, palm and soles of foot.

Functions:

Facilitates movements of skin

Soft medium for passage of nerves, vessels to skin

Conserves body heat because by nature, fat is a bad heat conductor.

Deep fascia:

It is dense connective tissue that interpenetrates and surrounds muscles, bones, nerves, and blood
vessels of body.

It is devoid of fat and is usually inelastic and tough.

Features:

(i) Extension on prolongation of deep fascia form:

⮚ Intermuscular septa
⮚ Fibro areolar sheath for muscles.

(ii) Thickening of deep fascia form:

⮚ Retinacula around wrist or ankles.

⮚ Palmar & plantar aponeurosis
(iii) Deep fascia nerves crosses a subcutaneous bone,instead it blends with periosteum.

Functions:

Keep underlying structures in position and pressure characteristic surface contour of limbs and neck.

Provides inter surface for muscular attachments.

Retinacula act as pulleys and serve to prevent loss of power.

Myofascial unit:

Myofascial unit composed of a group of motor units that move a body segment in specific direction
together with fascia that connects these force rectors.

In every myofascial unit, there is center of coordination that directs the muscular forces . A center of
perception that perceives movement occurring at a joint.

BONES
Bones are the hardest of all other connective tissues the organic fibrillar extra cellular matrix with
mainly type 1 collagen and is also impregnated with organic materials like hydroxypatits

Organic material gives bones tensile strength and in organic material give compressive strength bone
cells includes osteocytes, osteoblast, osteoclast ,fibroblast and progenitor cells. Fibroblast produces
collagen type 1 fibers. osteoblast are bone forming cells synthesis bone and also secret pro collagen
.osteoblast are responsible for bone resorption.

Bone has two layers . the spongy inner layer is known as cancellous bone or spongy or trabacular bone.

In trabacular bone, the calcified tissues forms thin plates called trabaculae are laid down in the line with
stresses placed on them.

Loading history of trabaculae including loading from multiple directions, influences distribution of bone
density and trabacular orientation.

Cancellous bone is covered by a thin layer of dense compact called cortical bone which is laid down in
concerntric circles.

Bones can with stand greater stress and will undergo less strain in compression than in tension the
physiologic response of trabacular bone to increased loading is hypertrophy.if loading is decreased or
absent the trabaculae becomes weaker.Repeated loads , either high numbers of low loads can cause
permanent strain and bone failure bone loses stiffness and strength with repetitive loading as a result of
creep strain.