Skeletal Muscle Tissue骨骼肌

陈晓

Chenxiao.610@gmail.com

浙江大学医学院干细胞与组织工程中心

人体结构与功能学

Human Anatomy and Physiology

• 人类所有改造世界、改造自己的意

识活动都需要通过骨骼肌运动实现

课程设置--骨骼肌理论课程内容，2.5学时

• 课程目标：– 能分析大关节运动时肌肉力学模式

– 从肌肉、肌腱组织结构分析损伤时修复的策略

• 总论： 人体的重要骨骼肌分布、分类和生物力学模型。

• 一、肌肉的构造与各部分的功能： 肌腹、肌腱、神经血管，筋膜

• 二、肌肉的组织成分与功能：细胞（肌肉细胞/肌纤维、卫星细胞、间质干细胞、血管内皮细胞，肌腱细胞，肌腱干细胞）、细胞外基质（胶原，多糖，糖蛋白）。

• 三、肌肉的收缩机制和功能

• 四、肌肉营养、生长、维持和愈合过程。

课程设置--骨骼肌课程内容

• 总论： 人体的重要骨骼肌分布、分类和生物力学模型。

• 一、肌肉的构造与各部分的功能： 肌腹、肌腱、神经血管，筋膜

• 二、肌肉的组织成分与功能：细胞（肌肉细胞/肌纤维、卫星细胞、间质干细胞、血管内皮细胞，肌腱细胞，肌腱干细胞）、细胞外基质（胶原，多糖，糖蛋白）。

• 三、肌肉的收缩机制和功能

• 四、肌肉营养、生长、维持和愈合过程。

思考题-课堂提问、周测及应用

• 课前测试（主要关节见后面PPT所示）：

– 画图：选择一个重要关节，画出主要附着肌肉及解释功能

– 肌肉主要组织结构有哪些（组织、细胞）

– Which types of stem cells could be used for skeletal

muscle disorders,

– 课堂提问：主要肌群名字及功能

思考题-课堂提问、周测及应用• 周测：学习完后可应用知识分析日常生活、临床损伤（1，

2，3）及研究（4）

– 若想拥有施瓦辛格式的胸肌，请从相关肌肉及关节的类型、功能做

出肌肉运动的力学模型及实际动作。（从人体主要肌群的功能解释

肌肉针对性训练的动作，选一：股四头肌，胸大肌，肱二头肌等）

– 从肌肉-骨形成的力学杠杆特性简述各种关节的运动特征（选二）：

力学强度、运动速度，灵活性及从关节所受力学分析其易损伤程度

（肩，肘、膝，踝关节）。

– 根据弯腰时背部肌肉收缩对椎间盘的压力模式，估计竖脊肌收缩时

椎间盘所受的压力（特别是搬重物，坐车时颠簸等等常见不正确姿

势），如何避免生活中椎间盘急性及慢性损伤。

– 简述肌肉、肌腱组织干细胞种类，并简要分析及在损伤修复过程中

应用

Pandect—muscle system • 1/3 OF HUMAN BODY

• Skeletal 骨骼肌– only voluntary muscle

tissue （自主运动）

– Striated 横纹肌

• Heart 心肌– Involuntary

– Striated

• Smooth 平滑肌– Involuntary

– Non-Striated

Pandect—skeletal muscle system

• properties – Contractible – Extensible – Excitable

• Function –Action of body:

Powerful contraction (100W/Kg)–Joint stabilization–Heat

Do you know the magic power of your muscles?

Cherish your health and bodies!!

衰老导致肌力、协调力下降是摔倒主因：do exercise to

delay aging!!! How and why you can anti-aging???

人类不借外力和杠杆作用所

能移动的最大重量：

正常成年人肌肉的力量：

1.Jonas Rantanen深蹲575公斤

2.Donnie Thompson深蹲573公斤

3 Vladislav Alhazov深蹲567公斤

4 Mike Miller深蹲553公斤

腿举1870公斤（德国

大力士Hermann

Gorner）

40N/cm2 ，10-20t/ person

why don’t you know you are so

strong ?？

Jeff Lewis

台式腿举37.15吨？

How about you ,…..100kg?

Pandect—classify of skeletal muscle type

Size: vastus (huge); maximus (large); longus (long); minimus (small); brevis

(short).

Shape: deltoid (triangular); rhomboid (like a rhombus with equal and parallel

sides); latissimus (wide); teres (round); trapezius (like a trapezoid, a four-sided

figure with two sides parallel).

Direction of fibers: rectus (straight); transverse (across); oblique (diagonally);

orbicularis (circular).

Location: pectoralis (chest); gluteus (buttock or rump); brachii (arm); supra-

(above); infra- (below); sub- (under or beneath); lateralis (lateral).

Number of origins: biceps (two heads); triceps (three heads); quadriceps (four

heads).

Origin and insertion: sternocleidomastoideus (origin on the sternum and clavicle,

insertion on the mastoid process); brachioradialis (origin on the brachium or arm,

insertion on the radius).

Action: abductor (to abduct a structure); adductor (to adduct a structure); flexor

(to flex a structure); extensor (to extend a structure); levator (to lift or elevate a

structure); masseter (a chewer).

Pandect—morphological skeletal muscle type

Some skeletal muscles are broad in shape and some narrow.

In some muscles the fibers are parallel to the long axis of the

muscle; in some they converge to a narrow attachment; and

in some they are oblique：请举例

Pandect— skeletal muscle mechanical model

Force by muscle

contractionTypical skeletal muscle

structure

Muscle

Muscle-tendon junction

Tendon

Tendon –bone junction

从重要关节分析重要肌肉的分布及功能

shoulder joint

肩关节：

pectoralis major胸

大肌，三角肌，

斜方肌，背阔肌，

肩袖相关肌肉

Elbow肘关节：

肱二头肌

biceps brachii，

肱三头肌，前

臂群

髋、膝、踝关

节：臀大肌、

内收肌群，股

四头肌

quadriceps

femoris、小

腿三头肌，

（伸肌群）

脊柱：竖脊肌

erector spinae

（视频资料均来自互联网）

Pandect—skeletal muscle mechanical model

muscle lever system First class lever: elbow（肘关节）

动力点、阻力点分别在支点的两边

Pandect—skeletal muscle mechanical model

Third class lever: elbow

（肘关节）

费力杠杆

Second class lever: elbow（踝关节）

省力杠杆

课程设置--骨骼肌课程内容

• 总论： 人体的重要骨骼肌分布、分类和生物力学模型。

• 一、肌肉的构造与各部分的功能： 肌腹、肌腱、神经血管，筋膜

• 二、肌肉的组织成分与功能：细胞（肌肉细胞/肌纤维、卫星细胞、间质干细胞、血管内皮细胞，肌腱细胞，肌腱干细胞）、细胞外基质（胶原，多糖，糖蛋白）。

• 三、肌肉的收缩机制和功能

• 四、肌肉营养、生长、维持和愈合过程。

肌肉的结构与功能

From single molecular to muscle tissue

Structure of muscle : from whole muscles to myofilaments

Ultra- structure:

myosin

Macro- structure:

Muscle tissue, nerve,

vascular etc.

Micro- structure

Muscle cells, blood,

ECM

Structure of muscle tissue• A whole skeletal muscle is considered an organ of

the muscular system：肌肉结构相关视频（视频资料均来自互联网）– skeletal muscle tissue：肌腹– nerve tissue– connective tissue– blood or vascular tissue.

肌内膜

肌腱

肌外膜

筋膜

肌纤维

肌束膜

Function of muscle tissue

– Contract to create force: 肌纤维收缩视频

– Move body

– Stable body

Structure and Function of Nerve tissue• Nerve tissue: Neuromuscular

spindle, neuromuscular junction• Neuromuscular spindle肌梭

– 1mmX 0.05-13mm– Essential for controlling muscle

contraction– proprioceptive information

http://baike.baidu.com/picview/821152/821152/0/574e9258d109b3deb341a6d

8ccbf6c81810a4c87.html#albumindex=0&picindex=0

Structure and Function of Nerve tissue

• Histology of Neuromuscular spindle

Structure and Function of Nerve tissue: neuromuscular junction

• neuromuscular junction– 神经肌肉信号传递视频– Terminals of motor neurons– Release neurotransmitter to

control muscle contraction– Nutrition

Function of nerve tissue on muscle determination: Innervate muscles

• 营养性作用– 切断运动神经后，肌肉因失去神经的营养性作用而出现萎缩

– 将支配慢肌和支配快肌的神经分别切断，然后将支配快肌的中枢端与支配慢肌的神经的外周缝合，待神经再生后，慢肌就可转变成快肌。

• Question: 如何延缓肌肉衰老？– “机体自己并不知道如何保持肌肉的修复功能。80岁的男性平均

损失40%的肌肉重量，上了年纪的人容易摔倒或骨折并因此住院治疗。在医院他们又会失去更多的肌肉力量，而且不会再恢复。”

Structure and Function of Nerve tissue

• Golgi tendon organs: – 500X100um– Losser collagen fibers– Larger fibroblasts– Near MTJ(肌肉-肌腱连接)– Activated by stretch of the tendon– Providing proprioceptive information(本体感

觉,位置) – Very sensitive (much higher than muscles)– No one knows its function on tendon

regeneration and development

• Question : what is your opinion on Golgi tendon organs regeneration?

Blood supply of muscle• Abundant

• Generally, an artery and at least one vein accompany each nerve that penetrates the epimysiumof a skeletal muscle.

• Branches of the nerve and blood vessels follow the connective tissue components of the muscle of a nerve cell and with one or more minute blood vessels called capillaries

Blood supply of muscle

• Classification of blood supply

Connective tissue： Tendon

• Tendon：– Dense fibrous connective tissue– Connect muscle to bone– Transmit the forces when movement– Heterogeneous fibril diameter and

crimp pattern

• Structure– collagen molecules

• Cells– tendon cells (tenocytes)– chondrocytes– synovial cells – vascular cells

• smooth muscle cells• capillary endothelial cells

2013年3月11日星期一3时36

分15秒2828Structure of collagen

Tendon biology• Biomechanics

– 17 to 117 MPa (Ultimate tensile stress)– 100 to 1400MPa (Linear modulus) – Energy-storing– In vivo peak forces (10% - 30% of failure forces)

2013年3月11日星期一3时36

分15秒

stress–strain curve

课程设置--骨骼肌课程内容

• 总论： 人体的重要骨骼肌分布、分类和生物力学模型。

• 一、肌肉的构造与各部分的功能： 肌腹、肌腱、神经血管，筋膜

• 二、肌肉的组织成分与功能：细胞（肌肉细胞/肌纤维、卫星细胞、间质干细胞、血管内皮细胞，肌腱细胞，肌腱干细胞）、细胞外基质（胶原，多糖，糖蛋白）。

• 三、肌肉的收缩机制和功能

• 四、肌肉、肌腱营养、生长、维持和愈合过程。

Structure of muscle : from whole muscles to myofilaments

Ultra- structure:

myosin

Macro- structure:

Muscle tissue, nerve,

vascular etc.

Micro- structure

Muscle cells, blood,

ECM

肌肉的组织成分与功能

肌细胞

Muscle cells , core of skeletal musclescontraction mechanism

• Each skeletal muscle fiber is a single cylindrical muscle cell. Very large cell

• An individual skeletal muscle may be made up of hundreds, or even thousands, of muscle fibers bundled together and wrapped in a connective tissue covering.

Structure of muscle fibers

Muscle cells , contraction mechanism

TEM

TEM

contraction

细肌丝向粗肌丝滑行

肌动蛋白

收缩相关

视频

Structure and Function of tendon tissue

粗肌丝

细肌丝

myosin heavy chain divided into type I, type IIa, type IIx, and type Iib

Question: why 博尔特 run so fast?

肌肉收缩机制

• 肌肉收缩机制(视频解说)

Summary : muscle tissue , from single molecular to tissue

Other cells in skeletal muscle

Other cells in muscle and tendon and their function

• 肌肉的组织成分与功能：细胞（肌肉细胞/肌纤维、肌卫星细胞/干细胞、间质干细胞、血管内皮细胞，肌腱细胞，肌腱干细胞）、细胞外基质（胶原，多糖，糖蛋白）。

Stem cells and its niche in skeletal muscle

• Muscle stem cells• Muscle satellite cell肌卫星细胞• Tendon stem/progenitor cells

肌腱干细胞• MSC间充质干细胞• EPC血管内皮祖细胞• ECM niche

Stem cells in muscles and repair• Muscle stem cells

• Muscle satellite cell– resident mononuclear stem cells– intimately associated with the myofibers– Sitting tightly in grooves on the myofiber

surface– receive and respond to signals coming

from their partner myofibers– main driver of endogenous skeletal

muscle repair– identified by their tissue localization and

their expression of a panel ofmolecularmarkers including Pax7, CXCR4, b1-integrin, and CD34 (Sherwoodet al. 2004).

Repaired muscle

Cells in tendon

• Tendon stem/progenitor cells (Nat Med, 2007)– MSC like– Multipotential– Self-renew – May involve in tendon repair

• Tenocytes– Mature fibroblast form tendon

• No specific markers for tendon stem cells and tenocytes hinder to clarify tendon biology and regeneration mechanism

ECM in muscles and tendon

• Collagen： connect tissues and transfer mechanical stress–Main ECM of muscles and

tendon– Type I, III, V, XIV

课程设置--骨骼肌课程内容

• 总论： 人体的重要骨骼肌分布、分类和生物力学模型。

• 一、肌肉的构造与各部分的功能： 肌腹、肌腱、神经血管，筋膜

• 二、肌肉的组织成分与功能：细胞（肌肉细胞/肌纤维、卫星细胞、间质干细胞、血管内皮细胞，肌腱细胞，肌腱干细胞）、细胞外基质（胶原，多糖，糖蛋白）。

• 三、肌肉的收缩机制和功能

• 四、肌肉、肌腱营养、生长、维持和愈合过程。

肌肉营养、生长、维持和愈合过程。

• 1. 肌肉发育• 2. 肌肉损伤修复过程及目前存在的问题

Schematic representation of somitogenesis. （From: J Anat. 2003）

Skeletal muscle formation in the limb（From: J Anat. 2003）

Stages of muscle development

Repair of skeletal muscles

肌腱生长、维持和愈合过程。

• 1. 肌腱发育过程• 2. 肌腱成熟过程• 3. 肌腱损伤修复过程及目前存在的问题

Tendon development

• Tissue interactions required for tendon progenitor induction in vertebrate embryos.

Tendon development • The main stages and regulators of tendon induction and

differentiation in vertebrate embryos.(Devlopment 2011)

Tendon maturation:cell ￬ collagen ￪

Rat tendon maturation(provided by Prof. Ouyang Hong Wei欧阳宏伟)

0d 1d 2.5d 4d

7d 14d 28d 56d

Tendon maturation: collagen maturation

10d1d 7d4d

28d14d 56d

Rat tendon maturation (provided by Prof. Ouyang Hong Wei)

Tendon injury:肌腱损伤对于运动员而言可能意味着运动生涯的结束

Especially common (in USA)

1.Shoulder’s rotator cuff tendons (51,000

/year)

2.Achilles tendon (44,000 /year)

3.Patellar tendon (42,000 /year)

4.Anterior cruciate ligament (over 200,000

/year)

Rafael Nadal: 慢性髌腱炎

Tendon repair: current therapy

• Autografts– “gold standard”, avoid rejection– Additional surgery, lack of resource

• Allografts and Xenografts– Primarily type I collagen – Tendons, dermal, pericardium, SIS-ECM – Transmit disease– Immunogenic response

• Decellularized allografts and Xenografts

2013年3月11日星期一3时36

分15秒58

Allograft

Adult Tendon repair: big challengenever regeneration

Skeletal muscle injury and reconstruction

• Stem cells and regenerative medicine– Tissue engineering– Tendon regeneration

What kind of tissue engineering?

Stem cells and tissue engineering

Milestone of tissue engineering

骨骼肌系统实验课

0.5学时

常见肌肉疾病-实验课

• 肌肉常见疾病表现• 肌腱相关疾病表现

人体骨骼肌整体标本

• 博物管中进行：–辨认人体主要肌肉，肌腱–肌肉、肌腱组织的力学模型

• 容易损伤 的肌肉、肌腱及其损伤原因？

讨论

目标

• 根据知识分析运动的生理过程及损伤预防• 解释常见损伤、疾病的发病机制、提供治

疗策略

讨论课题目

• 运动模型：起跑时左腿（前腿）的生理运动模型说明参与的主要的骨骼、关节、肌肉、肌腱韧带的名称和功能。博尔特百米视频

• 利用解剖和组织学知识讨论刘翔跟腱疾病的发病机制和治疗过程变化。

要求

• 学生以5人一组，各人分工，根据参考文献课外完成讨论PPT

• 课堂每组PPT讨论15min, 10+5分钟提问

参考文献：红色为必读，其余为有能力者选读

• 肌肉的生物学综述：肌肉干细胞/肌肉重塑，肌肉疾病综述。– Muscle repair and regeneration: stem cells, scaffolds, and the contributions of

skeletal muscle to amphibian limb regeneration.

– Stem cell therapies for muscle disorders.

– Satellite cells and the muscle stem cell niche.

– Tissue-specific stem cells: lessons from the skeletal muscle satellite cell.

• 肌腱：生物学和病理过程，肌腱修复再生。– Tendon-Derived Stem Cells (TDSCs): From Basic Science to Potential Roles in Tendon

Pathology and Tissue Engineering Applications

– Transcription factor EGR1 directs tendon differentiation and promotes tendon repair

– Musculoskeletal diseases--tendon.肌腱修复再生

– Platelet rich plasma in tendinopathies: how to explain the failure.病理过程

– Connecting muscles to tendons: tendons and musculoskeletal development in flies and vertebrates. 肌腱、肌肉生物学与再生过程