Musculoskeletal system

The musculoskeletal system (locomotor system) is a human body system that provides our body with movement, stability, shape, and support. It is subdivided into two broad systems:

• Muscular system, which includes all types of muscles in the body. Skeletal muscles, in particular, are the ones that act on the body joints to produce movements. Besides muscles, the muscular system contains the tendons which attach the muscles to the bones.
• Skeletal system, whose main component is the bone. Bones articulate with each other and form the joints, providing our bodies with a hard-core, yet mobile, skeleton. The integrity and function of the bones and joints is supported by the accessory structures of the skeletal system; articular cartilage, ligaments, and bursae.

Besides its main function to provide the body with stability and mobility, the musculoskeletal system has many other functions; the skeletal part plays an important role in other homeostatic functions such as storage of minerals (e.g., calcium) and hematopoiesis, while the muscular system stores the majority of the body's carbohydrates in the form of glycogen.

This article will introduce you to the anatomy and function of the musculoskeletal system.

1. Muscular system
2. Skeletal muscles
   1. Structure
   2. Muscle contraction
   3. Tendons
   1. Bones
   2. Cartilage
   3. Joints
   4. Ligaments
   5. Bursae
   1. Osteoporosis
   2. Sarcopenia
   3. Arthritis
   4. Muscular dystrophy

   Muscular system

   The muscular system is an organ system composed of specialized contractile tissue called the muscle tissue. There are three types of muscle tissue, based on which all the muscles are classified into three groups:

   • Cardiac muscle, which forms the muscular layer of the heart (myocardium)
   • Smooth muscle, which comprises the walls of blood vessels and hollow organs
   • Skeletal muscle, which attaches to the bones and provides voluntary movement.

   Based on their histological appearance, these types are classified into striated and non-striated muscles; with the skeletal and cardiac muscles being grouped as striated, while the smooth muscle is non-striated. The skeletal muscles are the only ones that we can control by the power of our will, as they are innervated by the somatic part of the nervous system. In contrast to this, the cardiac and smooth muscles are innervated by the autonomic nervous system, thus being controlled involuntarily by the autonomic centers in our brain.

   Skeletal muscles

   The skeletal muscles are the main functional units of the muscular system. There are more than 600 muscles in the human body. They vary greatly in shape in size, with the smallest one being the stapedius muscle in the inner ear, and the largest one being the quadriceps femoris muscle in the thigh.

   The skeletal muscles of the human body are organized into four groups for every region of the body:

   • Muscles of the head and neck, which include the muscles of the facial expression, muscles of mastication, muscles of the orbit, muscles of the tongue, muscles of the pharynx, muscles of the larynx, and muscles of the neck
   • Muscles of the trunk, which include the muscles of the back, anterior and lateral abdominal muscles, and muscles of the pelvic floor
   • Muscles of the upper limbs, which include muscles of the shoulder, muscles of the arm, muscles of the forearm and muscles of the hand
   • Muscles of the lower limbs, which include hip and thigh muscles, leg muscles and foot muscles

   The fact that there are more than 600 muscles in the body can be quite intimidating. If you’re tired of all the big, comprehensive anatomy books, take a look at our condensed muscle anatomy reference charts, which contain all the muscle facts in one place organized into neat tables!

   Structure

   Muscle fiber Synonyms: Myocyte, Myofiber , show more.

   Structurally, the skeletal muscles are composed of the skeletal muscle cells which are called the myocytes (muscle fibres, or myofibrils). Muscle fibers are specialized cells whose main feature is the ability to contract. They are elongated, cylindrical, multinucleated cells bounded by a cell membrane called sarcolemma. The cytoplasm of skeletal muscle fibers (sarcoplasm), contains contractile proteins called actin and myosin. These proteins are arranged into patterns, forming the units of contractile micro-apparatus called sarcomeres.

   Each muscle fiber is enclosed with a loose connective tissue sheath called endomysium. Multiple muscle fibers are grouped into muscle fascicles or muscle bundles, which are encompassed by their own connective tissue sheath called the perimysium. Ultimately, a group of muscle fascicles comprises a whole muscle belly which is externally enclosed by another connective tissue layer called the epimysium. This layer is continuous with yet another layer of connective tissue called the deep fascia of skeletal muscle, that separates the muscles from other tissues and organs.

   This structure gives the skeletal muscle tissue four main physiological properties:

   • Excitability - the ability to detect the neural stimuli (action potential);
   • Contractibility - the ability to contract in response to a neural stimulus;
   • Extensibility - the ability of a muscle to be stretched without tearing;
   • Elasticity - the ability to return to its normal shape after being extended.

   Learn everything about the skeletal muscle structure with our articles, video tutorials, quizzes and labelled diagrams.

   Muscle contraction

   The most important property of skeletal muscles is its ability to contract. Muscle contraction occurs as a result of the interaction of myofibrils inside the muscle cells. This process either shortens the muscle or increases its tension, generating a force that either facilitates or slows down a movement.

   There are two types of muscle contraction; isometric and isotonic. A muscle contraction is deemed as isometric if the length of the muscle does not change during the contraction, and isotonic if the tension remains unchanged while the length of the muscle changes. There are two types of isotonic contractions:

   • Concentric contraction, in which the muscle shortens due to generating enough force to overcome the imposed resistance. This type of contraction serves to facilitate any noticeable movement (e.g. lifting a barbell or walking on an incline).
   • Eccentric contraction, in which the muscle stretches due to the resistance being greater than the force the muscle generates. During an eccentric contraction, the muscle maintains high tension. This type of contraction usually serves to slow down a movement (e.g. lowering a barbell or walking downhill).
   Eccentric and concentric muscle contractions (diagram) Motor neuron axon Axon motoneuri Synonyms: none

   The sequence of events that results in the contraction of a muscle cell begins as the nervous system generates a signal called the action potential. This signal travels through motor neurons to reach the neuromuscular junction, the site of contact between the motor nerve and the muscle. A group of muscle cells innervated by the branches of a single motor nerve is called the motor unit.

   The incoming action potential from the motor nerve initiates the release of acetylcholine (ACh) from the nerve into the synaptic cleft, which is the space between the nerve ending and the sarcolemma. The ACh binds to the receptors on the sarcolemma and triggers a chemical reaction in the muscle cell. This involves the release of calcium ions from the sarcoplasmic reticulum, which in turn causes a rearrangement of contractile proteins within the muscle cell. The main proteins involved are actin and myosin, which in the presence of ATP, slide over each other and pull on the ends of each muscle cell together, causing a contraction. As the nerve signal diminishes, the chemical process reverses and the muscle relaxes.

   Tendons

   Synonyms: none

   A tendon is a tough, flexible band of dense connective tissue that serves to attach skeletal muscles to bones. Tendons are found at the distal and proximal ends of muscles, binding them to the periosteum of bones at their proximal (origin) and distal attachment (insertion) on the bone. As muscles contract, the tendons transmit the mechanical force to the bones, pulling them and causing movement.

   Being made of dense regular connective tissue, the tendons have an abundance of parallel collagen fibers, which provide them with high tensile strength (resistance to longitudinal force). The collagen fibers within a tendon are organized into fascicles, and individual fascicles are ensheathed by a thin layer of dense connective tissue called endotenon. In turn, groups of fascicles are ensheathed by a layer of dense irregular connective tissue called epitenon. Finally, the epitenon is encircled with a synovial sheath and attached to it by a delicate connective tissue band called mesotenon.

   Learn more about the microstructure of tendon in this study unit:

   Functions of the muscular system

   The main function of the muscular system is to produce movement of the body. Depending on the axis and plane, there are several different types of movements that can be performed by the musculoskeletal system. Some of the most important ones include:

   Flexion of leg Flexio cruris Synonyms: Flexion of knee, Flexio genus
   • Flexion and extension: movement of decreasing or increasing the angle between the bones involved in the movement, respectively. This motion takes place in the sagittal plane around a frontal axis. An example of flexion is bending the leg at the knee joint, whereas extension would be straightening knee from a flexed position.
   • Adduction and abduction: movements of bringing the parts of the body towards or away from the midline, respectively. These movements are carried out in the frontal plane around a sagittal axis. For example, abduction of the arm at the shoulder joint involves moving the arm away from the side of the body, while adduction involves bringing it back towards the body.
   • Rotation is the movement in which a part of the body rotates around its vertical (longitudinal) axis in the transverse plane. This movement is defined relative to the midline, where internal rotation involves rotating the segment towards to the midline, while external rotation involves moving it away from the midline. Examples include lateral or medial rotation of the thigh.
   • Supination and pronation are special types of rotatory movements usually used to describe the movements of the forearm. Supination is essentially a lateral rotation of the forearm which turns the palms anteriorly (if the arm is anatomical position) or superiorly, when the elbow is flexed. These movements are also sometimes used to describe movements in the ankle and foot, in which supination means rolling the foot outwards, while pronation means rolling the foot inwards.

   Both during movement and stationary positions, muscles contribute to the overall support and stability of joints. Many muscles and their tendons pass over joints and thereby stabilize the articulating bones and hold them in position. In addition, the muscles also play an important role in maintaining posture. While the movements occur mainly due to muscles intermittently contracting and relaxing, the posture is maintained by a sustained tonic contraction of postural muscles. These muscles act against gravity and stabilize the body during standing or walking. The postural muscles include the muscles of the back and abdominal muscles.

   Another important function of muscles is heat production. Muscle tissue is one of the most metabolically active tissues in the body, in which approximately 85 percent of the heat produced in the body is the result of muscle contraction. This makes the muscles essential for maintaining normal body temperature.

   Wondering what’s the best way to learn and understand the functional anatomy of the muscles? Check out our 3D muscle anatomy videos!

   To improve your understanding of muscular system terminology, take a closer look at some commonly used roots, prefixes and suffixes related to the muscular system in the video below.

   How well do you know the main muscles of the body? Test your knowledge with our quiz in different difficulty levels!

   Skeletal system

   The adult human skeleton is composed of 206 bones and their associated cartilages. The bones are supported by ligaments, tendons, bursae, and muscles. The bones of the body are grouped within the two distinct divisions:

   • Axial skeleton, that includes the bones along the long axis of the body. The axial skeleton consists of the vertebral column, bones of the head and bones of the thoracic cage.
   • Appendicular skeleton, that involves the bones of the shoulder and pelvic girdle, as well as the bones of the upper and lower extremities.

   Bones

   Synonyms: Skeletal system, Systema skeletale

   Bones are rigid structures made of calcified dense connective tissue. Bone tissue is composed of a mineralized bone matrix that consists of type 1 collagen fibers dispersed throughout the ground substance. The cellular component of the bones is represented by three types of specialized bone cells called osteocytes, osteoblasts and osteoclasts.

   The bones consist of two distinct layers that differ in histological appearance and characteristics;

   • Compact (cortical) bone is the outer much denser layer of the bone which gives it its smooth, white, and solid appearance. The outer surface of the compact bone is covered with a layer of dense connective tissue called the periosteum. On its inner surface, the compact bone is covered with endosteum, which is the boundary between the compact and spongy bones.
   • Spongy (cancellous) bone is the deep airy layer of the bone. Unlike the compact bone, spongy bone is highly vascularized and more metabolically active. It is typically found within the ends of long bones and in the vertebrae. In certain bones, like the hip bone, sternum or femur, the central part of spongy bone houses the bone marrow, which is the site of hematopoiesis in the adult.

   Types of bones

   Bones can be classified according to their shapes as follows:

   Synonyms: none
   • Long bones have a tubular shape, with a longer longitudinal and a shorter transverse diameter. They are composed mostly of compact bone, while the spongy bone and bony marrow fill the ends of the bones. Examples of long bones include the humerus, ulna, tibia and clavicle.
   • Short bones have a roughly cuboid or round shape, and only contain a thin layer of compact bone surrounding the spongy bone. Examples include the tarsal and carpal bones.
   • Flat bones are mostly thin, flattened and usually curved. They contain two parallel layers of compact bones surrounding a layer of spongy bone. Examples include most of the skull bones, scapula, sternum and sacrum.
   • Sesamoid bones are small, rounded unique types of bones that are embedded in muscle tendons where the tendon passes over a joint. The largest sesamoid bone in the body is the patella, but several other smaller sesamoid bones can be found in the hand and foot, usually in close proximity to the joints.
   • Irregular bones do not fit into any of the other categories. Generally, irregular bones contain foramina through which soft tissue and neurovascular structures pass. Examples include the vertebrae, hip bone and some bones of the skull.

   Wondering how to cut time in learning the bones of the body? Try our skeletal system quizzes!

   A typical long bone consists of a long shaft (diaphysis) that extends into a neck (metaphysis) and head (epiphysis) on its proximal and distal ends. It also features various markings and formations that give passage to neurovascular structures, as well as the attachment sites to the ligaments and tendons. Some of those features include:

   • Sulcus – a shallow groove on the bone surface (e.g. radial sulcus of humerus)
   • Condyle – rounded articular area (e.g. lateral condyle of tibia)
   • Epicondyle – eminence superior to a condyle (medial epicondyle of femur)
   • Crest – ridge of bone (e.g. iliac crest)
   • Facet – smooth, flat area, usually covered with cartilage (e.g. articular facet on vertebrae)
   • Foramen – passage through a bone (e.g. foramen magnum on the occipital bone)

   Cartilage

   Hyaline cartilage Cartilago hyalina Synonyms: none

   Cartilage is a flexible connective tissue found in multiple organ systems of the body. Cartilage is composed of specialized cells called chondrocytes, collagen fibers and abundant ground substance rich in proteoglycan and elastin fibers.

   Cartilage is classified into the following types based on its composition:

   • Hyaline cartilage is composed of type II collagen and an abundance of ground substance, which gives it a glossy appearance. It is the most abundant type of cartilage found in joints (articular cartilage), as well as the nose, larynx, trachea and ribs.
   • Elastic cartilage is similar to hyaline cartilage but contains more elastic fibers. It is found in structures such as the pinna of the ear, auditory tube and epiglottis.
   • Fibrocartilage is composed of plenty of collagen fibers type I and a smaller amount of ground substance. Examples of fibrocartilage include intervertebral discs, pubic and other symphyses.

   The musculoskeletal system specifically contains articular cartilage, a type of cartilage that lines the articulating surfaces of bones. The articular cartilage provides congruence to the articulating bones and allows them to bear weight and glide over each other with very little friction.

   Joints

   Each bone of the musculoskeletal system is connected to one or more bones via a joint. Joints provide a fulcrum to the bones, on which they pivot and thereby allow movements of body parts. However, movement is not a necessary attribute of a joint as some joints do not move, such as joints between the bones of the skull. The integrity or stability of a joint is provided by several factors including the bony congruence and structures that cross the joint, such as tendons and ligaments.

   Based on the type of tissue that holds the neighboring bones together and the range of motion they exhibit, joints can be classified into the following:

   • Synovial joints are freely mobile joints in which the bones are not in direct contact, but are separated by a potential space called the synovial cavity. The synovial cavity is lined by a synovial membrane that secretes the synovial fluid which nourishes and lubricates the articulating surfaces in order to reduce friction. The articulating bones in most synovial joints are lined with hyaline cartilage. These joints usually have a wide range of motion, which is defined by the joint capsule, the supporting ligaments and muscles that cross the joint. Examples of synovial joints include the knee, shoulder, sternoclavicular and elbow joints.
   • Fibrous joints are the articulations in which the bones are connected by dense fibrous connective tissue. The bones in fibrous joints are firmly held together so that the joint allows negligible movement. Fibrous joints are found between the cranial sutures, the distal tibiofibular and cuboideonavicular joints.
   • Cartilaginous joints are articulations in which the bones are connected by cartilage. The bones have a range of motion between synovial and fibrous joints. Cartilaginous joints are subdivided into synchondrosis (e.g. costochondral joints) and symphysis joints (e.g. pubic symphysis).
   Ball and socket joint Articulatio sphaeroidea Synonyms: Spheroidal joint, Cotyloid joint , show more.

   According to the movements they allow and/or the shape of their articulating surface, the synovial joints can be further subdivided into 6 major types:

   • Ball and socket joints (e.g. hip joint)
   • Condyloid joints (e.g. metacarpophalangeal joint)
   • Hinge joints (e.g. elbow joint)
   • Pivot joints (e.g. atlanto-axial joint)
   • Saddle joints (e.g. carpometacarpal joint)
   • Plane joints (e.g. acromioclavicular joint)

   Ligaments

   Ligaments are fibrous bands made of dense regular connective tissue which are similar in structure to tendons. Unlike the tendons that connect muscles to bone, the ligaments connect bone to bone. Besides the musculoskeletal system, the ligaments are also found in many other parts of the body, where they usually stabilize and hold internal organs in place and transmit neurovascular structures.

   Iliofemoral ligament Ligamentum iliofemorale Synonyms: Y-ligament of Bigelow, Ligament of Bertin

   In the musculoskeletal system, ligaments stabilize the articulating bones and reinforce the joints. Depending on their anatomic position relative to the joint capsule, ligaments are classified into:

   • Capsular ligaments are essentially thickenings of the joint capsule that form either elongated bands or triangular structures. These ligaments serve to reinforce the integrity of the joint capsule. An example of the capsular ligament is the iliofemoral ligament of the hip joint.
   • Intracapsular ligaments are the ligaments that lie internal to the joint capsule. These ligaments reinforce the connection of the articulating surfaces of the joint, but allow a far wider range of motion than other ligaments. Examples include anterior and posterior cruciate ligament of the knee joint.
   • Extracapsular ligaments are ligaments that lie outside the joint capsule. These ligaments provide the most stability to the articulating bones, and are important for preventing dislocations. Extracapsular ligaments can lie in close proximity (e.g. medial collateral ligament of the ankle joint) or a bit further from the joint capsule (vertebral ligaments).

   Bursae

   Suprapatellar bursa Bursa suprapatellaris Synonyms: none

   Bursae are small sac-like outpouchings of the joint cavity lined by synovial membrane. They are found around the joints, providing cushioning of the associated bones, tendons and muscles and reducing friction between adjacent structures.

   The majority of synovial bursae are located near the large joints of the arms and legs. For example, one of the bursae of the knee joint is the suprapatellar bursa, found superior to the patella, between the femur and the tendon of the quadriceps femoris muscle. The suprapatellar bursa allows for these structures to slide over each other without friction during flexion and extension of the knee joint.

   To improve your understanding of skeletal system terminology, take a closer look at some commonly used roots, prefixes and suffixes related to the skeletal system in the video below.

   Time for a skeletal system workout with our integrated quiz!

   Functions of the skeletal system

   The skeletal system serves a variety of functions. The bones give the shape to the body and provide the site of attachment to muscles, tendons, ligaments and cartilage. These tissues function together as a whole to generate a force that provides the biomechanical basis of movement.

   Due to its structural integrity, the skeletal system protects the internal organs, most importantly the brain, which is surrounded by the skull, as well as the heart and lungs, which are protected by the rib cage.

   Moreover, the skeletal system serves several metabolic functions. The bones are the storage site of important minerals, most notably calcium and phosphorus. This makes the bones essential for balancing calcium levels in the blood, which is regulated by adjusting the rate of bone resorption.

   Lastly, the bone marrow found in spongy bone is the site of hematopoiesis, which is a process of production of new blood cells. Cells that are produced in the bone marrow are red blood cells, platelets and white blood cells, such as monocytes, granulocytes and lymphocytes.

   We created a custom summary quiz about the anatomy and histology of the main features of the musculoskeletal system. You can adjust and filter individual structures to make this quiz your own!

   Clinical correlation

   There is a variety of conditions that affect the muscles, bones, and joints. Disorders of the musculoskeletal system may range from diseases to minor physical disabilities. The following are some clinical conditions of the musculoskeletal system:

   Osteoporosis

   Osteoporosis is a condition that affects bone strength (the word osteoporosis literally means "porous bones"). It is a condition in which the bones become fragile and brittle, leading to a higher risk of fractures than in normal bone. As a result, even a minor bump or accident can cause serious fractures.

   Osteoporosis is the “bone of the old”, especially, in women. The hard, rock-like quality of bone is dependent upon calcium. When too much calcium is dissolved from bones or not enough is replaced, bones lose density and are easily fractured. Estrogen, the female sex hormone, helps maintain proper calcium levels in bones. Once the ovaries stop producing the hormone, women are at higher risk of developing osteoporosis. A collapse of bony vertebrae of the spinal column results in loss of height and stooped posture. Hip fractures are a common occurrence.

   Sarcopenia

   Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life and death.

   Arthritis

   Arthritis is a group of conditions affecting the joints. These conditions cause damage to the joints, usually resulting in pain and stiffness due to aging. Arthritis can affect many different parts of the joint and nearly every joint in the body.

   As an individual ages, the joint tissues become less resilient to wear and tear and start to degenerate. This degeneration manifest as swelling, pain, and often-times, loss of mobility of joints. Changes occur in both joint soft tissues and the articulating bones, a condition called osteoarthritis. A more serious form of disease is called rheumatoid arthritis. The latter is an autoimmune disease wherein the body produces antibodies against joint tissues causing chronic inflammation resulting in severe joint damage, pain and immobility.

   Muscular dystrophy

   Muscular dystrophy is a group of muscle diseases that weaken the musculoskeletal system and hamper locomotion. Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle fibres (muscle cells) and tissue.

   It is a group of inherited diseases in which the muscles that control movement progressively weaken. The prefix, dys-, means abnormal, while the root, -trophy, refers to maintaining normal nourishment, structure and function. The most common form in children is called Duchenne muscular dystrophy and affects only males. It usually appears between the ages of 2 to 6 and the afflicted live typically into late teens to early 20s.

   Other conditions involving the musculoskeletal system include:

   • Lupus erythematosus
   • Myasthenia gravis
   • Rotator cuff tear
   • Tendonitis
   • Carpal tunnel syndrome
   • Osteomalacia

   Sources

   All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.

   • Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Clinically Oriented Anatomy (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
   • Netter, F. (2019). Atlas of Human Anatomy (7th ed.). Philadelphia, PA: Saunders.
   • Standring, S. (2016). Gray's Anatomy (41st ed.). Edinburgh: Elsevier Churchill Livingstone.
   • Ross, Lawrence M; Lamperti, Edward D, eds. (2006). Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System.
   • R.M.H McMinn: Last's anatomy (Regional and Applied), 9th edition, Ana-Maria Dulea (2014
   • Musculoskeletal system - Irina Münstermann
   • Eccentric and concentric muscle contractions (diagram) - Yousun Koh

   Related articles

   Articles within this topic:

   • Actin
   • Ball and socket joint
   • Complete list of bone markings
   • Ellipsoid joint
   • Head and neck anatomy
   • Hinge-joint
   • How to learn all muscles with quizzes and labeled diagrams
   • Intercostal muscles
   • Lateral abdominal muscles
   • Learn skull anatomy with skull bones quizzes and diagrams
   • Lower limb anatomy
   • Muscle anatomy reference charts
   • Muscles of the neck: An overview
   • Muscles of the trunk
   • Musculoskeletal system development
   • Parietal bone
   • Pectoralis minor muscle
   • Perimysium
   • Periosteum
   • Pivot joint
   • Rectus abdominis muscle
   • Synovial membrane
   • Upper limb muscles and movements

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