Semin Musculoskelet Radiol 2010; 14(2): 097-105
DOI: 10.1055/s-0030-1253154
© Thieme Medical Publishers

Skeletal Muscle: Functional Anatomy and Pathophysiology

Dan Exeter1 , David A. Connell1
  • 1Department of Radiology, The Royal National Orthopaedic Hospital, Middlesex, United Kingdom
Further Information

Publication History

Publication Date:
18 May 2010 (online)


Muscle is generally divided into three subtypes—skeletal, cardiac, and smooth—but because this edition focuses on the musculoskeletal system, this article concentrates on skeletal muscle. We review ultrastructure and function and then look at the latest scientific ideas concerning the physiological basis of muscle contraction. It is important to appreciate the different muscle types and how they act with respect to muscle growth and adaptation. Finally, what happens to muscle cells when they are damaged and the reparative response is considered.


  • 1 Mauro A. Satellite cell of skeletal muscle fibers.  J Biophys Biochem Cytol. 1961;  9 493-495
  • 2 White T P, Esser K A. Satellite cell and growth factor involvement in skeletal muscle growth.  Med Sci Sports Exerc. 1989;  21(5, suppl) S158-S163
  • 3 Staron R S, Malicky E S, Leonardi M J, Falkel J E, Hagerman F C, Dudley G A. Muscle hypertrophy and fast fibre type conversions in heavy resistance-trained women.  Eur J Appl Physiol Occup Physiol. 1990;  60 71-79
  • 4 Rico-Sanz J, Rankinen T, Joanisse D R HERITAGE Family Study et al. Familial resemblance for muscle phenotypes in the HERITAGE Family Study.  Med Sci Sports Exerc. 2003;  35(8) 1360-1366
  • 5 Jacobs I, Esbjörnsson M, Sylvén C, Holm I, Jansson E. Sprint training effects on muscle myoglobin, enzymes, fiber types, and blood lactate.  Med Sci Sports Exerc. 1987;  19(4) 368-374
  • 6 Wilmore J H, Costill D L, Kenney W L. Physiology of Sport and Exercise. 4th ed. Champaign, IL; Human Kinetics 2008
  • 7 Armstrong R B, Warren G L, Warren J A. Mechanisms of exercise-induced muscle fibre injury.  Sports Med. 1991;  12(3) 184-207
  • 8 Bischoff R. Analysis of muscle regeneration using single myofibers in culture.  Med Sci Sports Exerc. 1989;  21(5, suppl) S164-S172
  • 9 Schultz E. Satellite cell behavior during skeletal muscle growth and regeneration.  Med Sci Sports Exerc. 1989;  21(5, suppl) S181-S186
  • 10 Schultz E, Jaryszak D L, Gibson M C, Albright D J. Absence of exogenous satellite cell contribution to regeneration of frozen skeletal muscle.  J Muscle Res Cell Motil. 1986;  7(4) 361-367
  • 11 Malina R M. Growth of muscle tissue and muscle mass. In: Falkner F, Tanner JM Human Growth a Comprehensive Treatise. Vol. 2. New York; Plenum Press 1986: 77-99
  • 12 Goldspink G. Development of muscle. In: Goldspink G Differentiation and Growth of Cells in Vertebrate Tissue. London, United Kingdom; Chapman & Hall 1974: 69-99
  • 13 Rosenblatt J D, Yong D, Parry D J. Satellite cell activity is required for hypertrophy of overloaded adult rat muscle.  Muscle Nerve. 1994;  17(6) 608-613
  • 14 Phelan J N, Gonyea W J. Effect of radiation on satellite cell activity and protein expression in overloaded mammalian skeletal muscle.  Anat Rec. 1997;  247(2) 179-188
  • 15 Shepstone T N, Tang J E, Dallaire S, Schuenke M D, Staron R S, Phillips S M. Short-term high- vs. low-velocity isokinetic lengthening training results in greater hypertrophy of the elbow flexors in young men.  J Appl Physiol. 2005;  98(5) 1768-1776
  • 16 Kadi F, Thornell L E. Concomitant increases in myonuclear and satellite cell content in female trapezius muscle following strength training.  Histochem Cell Biol. 2000;  113(2) 99-103
  • 17 McCall G E, Byrnes W C, Dickinson A, Pattany P M, Fleck S J. Muscle fiber hypertrophy, hyperplasia, and capillary density in college men after resistance training.  J Appl Physiol. 1996;  81(5) 2004-2012
  • 18 Gonyea W J. Role of exercise in inducing increases in skeletal muscle fiber number.  J Appl Physiol. 1980;  48(3) 421-426
  • 19 Chambers R L, McDermott J C. Molecular basis of skeletal muscle regeneration.  Can J Appl Physiol. 1996;  21(3) 155-184
  • 20 Kalimo H, Rantanen J, Järvinen M. Muscle injuries in sports.  Baillieres Clin Orthop. 1997;  2(special issue) 1-24
  • 21 Järvinen T AH, Kääriäinen M, Järvinen M, Kalimo H. Muscle strain injuries.  Curr Opin Rheumatol. 2000;  12(2) 155-161
  • 22 Hurme T, Kalimo H. Activation of myogenic precursor cells after muscle injury.  Med Sci Sports Exerc. 1992;  24 197-205
  • 23 Rantanen J, Hurme T, Lukka R, Heino J, Kalimo H. Satellite cell proliferation and the expression of myogenin and desmin in regenerating skeletal muscle: evidence for two different populations of satellite cells.  Lab Invest. 1995;  72(3) 341-347
  • 24 Kääriäinen M, Kääriäinen J, Järvinen T LN, Sievänen H, Kalimo H, Järvinen M. Correlation between biomechanical and structural changes during the regeneration of skeletal muscle after laceration injury.  J Orthop Res. 1998;  16(2) 197-206
  • 25 Järvinen M. Healing of a crush injury in rat striated muscle. 4. Effect of early mobilization and immobilization on the tensile properties of gastrocnemius muscle.  Acta Chir Scand. 1976;  142(1) 47-56
  • 26 Järvinen M, Sorvari T. A histochemical study of the effect of mobilisation and immobilisation on the metabolism of healing muscle injury. In: Landry F Orban WAR Sports Medicine. Miami, FL; Symposia Specialists 1978: 177-181
  • 27 Rantanen J, Ranne J, Hurme T, Kalimo H. Denervated segments of injured skeletal muscle fibers are reinnervated by newly formed neuromuscular junctions.  J Neuropathol Exp Neurol. 1995;  54(2) 188-194

1 Some texts use sarcolemma and plasmalemma interchangeably, but in this article it can be assumed that they will be used as defined earlier.

2 ATP binding to release myosin from actin is needed to allow the myosin head to move to the next binding site as contraction continues.

3 The exact timing of ATP hydrolysis and phosphate release with respect to the power stroke is still a matter of debate.

4 It is accepted that resistance training does cause muscle injury at a microscopic level. The pathophysiology of delayed onset muscle soreness, a condition where muscles are sore a day or two after heavy exercise, highlights this.

5 Given that we are discussing skeletal muscle, the focus is on physiologic hypertrophy, rather than pathological hypertrophy, such as that seen in cardiac failure.

6 It may be that muscle fiber numbers do increase with resistance training but that some of the methods used to detect these changes are not entirely accurate.

7 Hyperplasia is defined as an “increase in the number of cells in an organ or tissue, which may then have increased volume” (Kumar V, Fausto N, Abbas A. Robbins & Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, PA: Saunders; 2004:272).

David A ConnellF.R.A.C.R. 

Department of Radiology, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore

Middlesex HA7 4LP UK