Histology of the

Muscles and Nerves

Sierra Roma S. Hernandez, M.D.
 To know the different types of muscle tissue.

GENERAL
OBJECTIVE
 1. To describe the structure and function of the
different types of muscle.
2. To differentiate their appearance in tissue section.
SPECIFIC 3. To describe the fiber–types of skeletal muscle.
OBJECTIVES 4. To define a motor unit.
5. To define myoepithelial cells and its function.
6. To discuss muscular growth, dystrophy and repair.
  responsible for movement of the body and for change in
the size and shape of internal organs.
MUSCLES
 basis of movement is the conversion of ATP to
mechanical energy by myofilaments.
 cells have excitable cell membrane important for
propagation of initial stimuli.
 almost all muscle tissues are of mesodermal origin.
 Characteristics:
1. irritability – ability to respond to stimuli
2. contractility – ability to shorten
MUSCLES 3. extensibility – ability to stretch
4. elasticity – ability to regain its original length.
 1. Skeletal muscle

THREE TYPES
of MUSCLE 2. Cardiac muscle
TISSUES

3. Smooth muscle
 Location:
Muscles of:
SKELETAL axial and appendageal skeleton
MUSCLE visceral skeletal muscles
 Organization:
Muscle fibers run parallel and straight muscle tissue has
many fasciculi
Fasciculus - a bundle of muscle fibers (muscle cells)
Myofiber - comprised of myofibrils in cross-
SKELETAL section, the myofibrils are arranged in
MUSCLE polygonal structure
Myofibrils are bundles of myofilaments and consist of :
Thick filaments – myosin and titan
Thin filaments are actins and tropomyosin –
troponin complex.
 Connective Tissue
Endomysium: loose connective tissue that is found
between each muscle fiber composed of collagenous
and reticular fibers in which small capillaries and
neuronal branches course
SKELETAL Perimysium: connective tissue + fat + blood vessels and
nerves group muscle fibers into fascicles
MUSCLE
Epimysium: dense connective tissue that surrounds
muscle groups large blood vessels and nerves penetrate
this layer to reach muscle fibers.
Each muscle fiber is surrounded by a basement
membrane.
 CHARACTERISTICS of SKELETAL MUSCLE
1. consists of very long tubular cells called muscle fibers
e.g.: Sartorius muscle up to 30 cm, stapedius muscle only about 1 mm.
diameters vary from 10 to 100 µm.
CHARACTERIS
2. contain many peripherally placed nuclei, several hundred rather
small nuclei with 1 or 2 nucleoli are located just beneath the
ITIC plasma membrane.
3. show cross-striations called striated muscle.
4. innervated by the somatic nervous system.
5. makes up the voluntary muscle.
 CHARACTERISTICS of SKELETAL MUSCLE…
6. Contractile Apparatus
- responsible for striated appearance of the skeletal muscle
- myofilaments myosin and actin
- contractile unit sarcomere – the portion of a myofibril between two adjacent Z lines.
CHARACTERIS
- striation – alternate dark and light bands under microscope
ITIC A band: stained dark  the myosin filaments
I band: stained light  the actin filaments not overlapping myosin
H band: myosin not overlapping actin
Z disk: disk in the center of I band from which actin anchors and extends
M line: myomesin and C protein, function to anchor the myosin.
tendon
 Motor neuron – delivers the nervous stimulus that
ultimately causes a muscle tissue to contract.
Motor unit – refers to one motor neuron plus all of the
skeletal muscle cells it stimulates.
A single motor neuron makes contact and thus
MOTOR UNIT stimulates about 150 individual skeletal muscle cells.
All the cells contract and relax together, as a unit.
The total strength of any particular muscle is determined
by the total number of motor units being used at any given
time.
 Muscles that control precise body movements may
have as few as 2-3 muscle cells per motor neuron (eye
muscles), while muscles that control gross body
MUSCLE movements may have as many as 2,000 muscle cells per
motor neuron (gluteal muscles).
 Excitable cells (muscle and nerve) make contact and
communicate with one another at specialized regions called
synapses.
At each synapses a small gap, called the synaptic cleft,
separates the two excitable cells.
The The first cell, the motor neuron, communicates with
the second cell, the skeletal muscle cell, across the synaptic
neuromuscular cleft via neurotransmitters.
junction The type of synapse formed between the motor neuron
and the skeletal muscle cell is called the neuromuscular
(myoneural) junction.
At the synapse, the motor neuron branches into
clusters of bulb-shaped axon terminals (end bulbs), each
cluster forming a synapse with a group of muscle cells (motor
unit). The region of the muscle cell membrane that participates
in the synapse with the axon terminal is the motor end plate.
NMJ
 Location:
Heart, base of great vessels
(aorta and pulmonary arteries),
pulmonary veins, superior and
inferior vena cava
CARDIAC
MUSCLE
 CHARACTERISTICS of CARDIAC MUSCLE:
1. the myocardium, consists of muscle cells, cardiomyocytes, with one centrally
placed nucleus. Nuclei are oval, rather pale and located centrally in the muscle
cell which is 10 - 15 µm wide.
2. cells exhibit cross-striations; contractile apparatus are similar to skeletal
CARDIAC
muscles.
MUSCLE
3. cells are short, narrow with branching
4. innervated by the autonomic nervous system, which adjusts the force
generated by the muscle cells and the frequency of the heart beat.
5. involuntary striated muscle
 CHARACTERISTICS of CARDIAC MUSCLE…
6. Intercalated disks: specialized attachment sites between adjacent cardiac cells
a. fascia adherens (adhering junctions)
- major constituent of the transverse component of the intercalated disk
- responsible for its staining in routine H&E preparations
b. maculae adherents (desmosomes)
CARDIAC
- bind the individual muscle cells to one another
MUSCLE- help prevent the cells from pulling apart under the strain of regular
repetitive contractions
- serves to reinforce the adhering junctions
c. gap junctions
- constitute the major structural element of the lateral component of the
intercalated disk
- provides ionic continuity between adjacent cardiac muscle cells
Rheumatic
Heart Disease
 Location:
Blood vessels tunica media, ducts,
GI system, respiratory system,
urogenital system, etc.
SMOOTH
MUSCLE
 CHARACTERISTICS of SMOOTH MUSCLE:

Shape: Short, elongate fusiform cells

Nucleus: Mononucleated, centrally placed

SMOOTH
MUSCLE
Lack T Tubule System:
Smooth muscle cells have a membrane system of sarcolemmal invaginations
that are analogous to T system to deliver Ca2+ to the cytoplasm
CHARACTERISTICS of SMOOTH MUSCLE…
Contractile Apparatus
Myofilaments: 1. actin and myosin
2. no striation

Myofilaments
- not regularly arranged, oriented obliquely to the long axis of the cell
- actin filaments attach to sarcolemma via dense bodies, which function as
Z disk analogues
- gap junctions are present for united contraction
- Ca2+ regulation of contraction
a. at the level of the thick filament
b. Ca2+ calmodulin complex leads to the phosphorylation of myosin,
 contraction
 Muscle type Skeletal Smooth Cardiac
Location Muscles of skeleton, Viscera Heart
visceral striated (GI system, (mediastinal space)
(tongue, esophagus, respiratory system,
diagraphm) etc)
blood vessels, organs

Nucleus polynucleated, single nucleus single nucleus

peripheral

Type of Innervation Voluntary Involuntary Involuntary

Striation Yes No Yes

Shape Long and elongate Short and elongate Short, branching
 1. Muscular Dystrophy
- genetic disease, a group of muscle diseases cause the damage of muscle fiber
- no specific cure for it and the symptoms include weakness, immobility and imbalance.
- Duchenne, myotonia, Becker, limb girdle

2. Cerebral Palsy
- very common congenital disorder that affects the posture, balance and motor functions.
COMMON - - loss of muscle tone during pregnancy or during child birth.

MUSCULAR 3. Fibrodysplasia Ossificans Progressiva

- soft tissue hardens and becomes bone-like permanently.
DISEASES - bone grows between joints and movements get permanently restricted.
- no effective cure available. Only pain management can be done through medication.

4. Dermatomyositis
- inflammatory myopathy affecting skin and muscle.
- an autoimmune disease harming the connective tissue and weakening the muscles.
- no cure for this condition, but the progression can be controlled by taking corticosteroids
and immunosuppressive drugs.
 5. Compartment Syndrome
- the blood vessels, muscles and nerves get compressed in a
closed area, which ends up in cutting off the oxygen supply.
- result is tissue death which can even lead to paralysis.
Immediate treatment: fasciotomy.
- pressure on muscles will be released after the surgery.
COMMON
MUSCULAR 6. Myasthenia Gravis
- an autoimmune disease
DISEASES - muscle weakness and fatigue caused by breakdown of the
neuromuscular junction.
- the brain does not have control over these muscles.
- can cause drooping eyelids, difficulty in breathing or
swallowing and loss of facial muscle control.
- Treatment: medication or surgery.
 7. Amyotrophic Lateral Sclerosis
- a very serious neurodegenerative disease; also known as Lou Gehrig’s disease.
- neurons get destroyed  loss of control on voluntary muscles
- initial symptoms: dyspnea, difficulty in speaking and swallowing
- Paralysis: advanced stage symptom.

8. Mitochondrial Myopathies
COMMON - mitochondria get damaged  weakness of muscles, deafness, blindness,

MUSCULAR arrhythmia and heart failure

- can cause seizures, dementia, vomiting and droopy eyelids
DISEASES - nausea, headache and difficulty in breathing are seen.

9. Rhabdomyolysis
- rapid destruction of the skeletal muscle
- muscle fibers break down into myoglobin which gets excreted in urine
- muscle weakness, pain and stiffness
- Treatment is possible when it is detected in early stages by means of IV fluids,
dialysis or hemofiltration.
 10. Polymyositis
- degenerative and inflammatory in nature
- affects the systemic connective tissue causing weakness and muscle
atrophy.

11. Fibromyalgia
COMMON - a chronic and debilitating muscle disorder
MUSCULAR - causes pain, fatigue, tenderness and stiffness of muscles

DISEASES - considered a genetic disorder and affects more women than men.

12. Myotonia
- muscles relax slowly after stimulation or contraction
- causes problem when grip is released and when you get up from sitting
or sleeping position
- Treatment: medication, physiotherapy and anticonvulsants.
 13. Myofascial Pain Syndrome
- a chronic pain disorder of the muscles
- causes aching and burning sensation on trigger points which are sensitive spots
of muscles
COMMON - cause joint stiffness, knot in the muscles and sleeplessness due to pain

MUSCULAR - managed by corticosteroids, injections of botulinum, massage and

physiotherapy.
DISEASES
14. Rotator Cuff Tear
- rigorous, fast or hard movements (baseball and tennis) can cause a tear in the
tendon which causes pain and reduced mobility
- Torn tendon can be repaired by surgery.
 15. Muscle Cramps
- can occur suddenly and involuntarily, in one or more muscles
- can happen late night or after exercising and can be caused due to a
variety of reasons, lasting for seconds to minutes
- Gentle massage helps temporarily.
COMMON 16. Sprains and Strains
MUSCULAR - twist or pull in the muscles or tendons which can either be sudden or
DISEASES over a period of time may cause sprains and strains
- back and hamstring muscles are commonly affected
- cause pain, swelling and difficulty in movement
- rest and ice compress are advised. It’s important to keep the area
immobile and take medicine for the pain.
 17. Talipes
- also known as flat feet in which the muscles supporting the arch
weaken and cause flattening of the arch due to the downward
pressure.
- 2 types of flat feet: rigid and flexible.
- Flexible one is not painful and does not have symptoms. It can be
COMMON treated by wearing corrective footwear, exercise and massage.
MUSCULAR
DISEASES 18. Tendonitis
- tendon gets inflamed or irritated, ithe inflammation can occur in any
tendon of the body
- seen more commonly in wrists, elbows, shoulders and heels. It causes
pain, mild swelling, tenderness and can be treated with pain relievers,
rest and ice compress.
 Learning objectives:
1. Know the components of tissue in the central
and peripheral nervous systems.
NERVOUS 2. Understand the meaning of terms gray
TISSUE matter and white matter.
3. Relate nerve function to the properties of
neurons and their cell processes: axons and
dendrites.
 The central nervous system (CNS) includes:
1. nerve cells: neuronal cell bodies and their
dendrites and axons (both myelinated and
NERVOUS unmyelinated)
TISSUE 2. supporting cells (the neuroglia):
oligodendroglia, astrocytes and microglia
3. meninges: dura, arachnoid, and pia
4. blood vessels
 The peripheral nervous system (PNS) contains:
1. neurons organized into clusters called ganglia
2. supporting cells including satellite cells
NERVOUS associated with the ganglionic neurons and
TISSUE Schwann cells which form the myelin sheath
3. connective tissue elements (endoneurium,
perineurium and epineurium)
4. blood vessels
 - the structural and functional unit of the
nervous system.

NEURON
 Made up of neurons and neuroglial cells
I. Neurons transmit impulses
II. Neuroglial cells are involved with:
NERVOUS Support, nutrition and defense of
TISSUE the nervous system
Nerve – made up of many nerve cell fibers
(neurons) bound together by connective tissue.
 CONNECTIVE TISSUE

Epineurium – a sheath of dense connective

tissue surrounds the nerve.
NERVOUS Perineurium - surrounds bundles of nerve fibers.
TISSUE Blood vessels of various sizes can be seen
in the epineurium.
Endoneurium – consists of a thin layer of loose
connective tissue, surrounds the individual nerve
fibers.
 Two fundamental properties of neurons:
1. Excitability – can react to stimulus by
NERVOUS generation of an impulse
TISSUE 2. Conductivity – impulse generated can be
propagated
 Three parts:
1. Dendrites – multiple elongated processes
– the main receptive domain.

2. Cell body/perikaryon – trophic center.

Structure of a - contain granules called Nissl bodies,
neuron found in the cytoplasm of the cell body.
Synthesis of neurotransmitters, proteins, trophic
factors
- an integration domain
 Three parts…
3. Axon – generates/conducts impulses to other nerve cells.
- forms the transmission domain
Distal portion of the axon forms the terminal arborization.
Each branch terminates in a dilatation called boutons.
Structure of a
neuron Axon hillock – short region where the axon gets origin from
the perikaryon
Axolemma – plasma membrane that covers the axon
Axoplasm – the extension of the neuron cytoplasm into
the axon
Initial segment – the point between the axon hillock and
point at which myelination begins.
 I. STRUCTURAL CLASSIFICATION
- multipolar neurons
- bipolar neurons
Classification - unipolar neurons
of neurons
II. FUNCTIONAL CLASSIFICATION
- sensory or afferent
- motor or efferent
Classification of neurons
I. Structural Classification Neurons
- grouped structurally according to the number of processes extending from
their cell body.

Three major groups:

1. multipolar (polar = end, pole)
- 3+ processes; most common neuron type (>99%)
- major neuron type in the CNS
2. bipolar
- spindle-shaped, with a dendrite at one end and an axon at the other
3. unipolar
- have only a single process or fiber which divides close to the cell body into two
main branches (axon and dendrite).
  At rest, the membrane of nerve cells is
positively charged on the outside and
negatively charged on the inside  called
Generation of resting potential.
nerve impulse  When activated, ion channels open and there is
differential efflux/influx of ions creating an
electrical potential (an impulse).
 Five main types:
1. Astrocytes
- nutritional and physical support
- scarring in case of neuronal damage
- regulates cerebral blood flow
Neuroglial 2. Microglial cells
cells - belong to MPS in the CNS
- not excitable 3. Ependymal cells
- line ventricles and provide physical support
4. Oligodendrocytes
- myelination in the CNS
5. Schwann cells
- myelination in the PNS
 Each synapse has:
1. Presynaptic area
Synapses 2. Synaptic cleft
- communication
between neurons. 3. Post synaptic area.
Electrical impulse is carried via chemical
messengers in the synapse then reconverted to
electrical impulse in the postsynaptic area.
 NEUROGLIAL CELLS
CELL TYPE FUNCTION
Astrocytes nutritional and physical support
scarring in case of neuronal damage
regulates cerebral blood flow
Microglial cells belong to MPS in the CNS

Ependymal cells line ventricles and provide physical support

Oligodendrocytes myelination in the CNS

Schwann cells myelination in the PNS

CEREBELLUM
CEREBELLUM
CEREBELLUM
SPINAL CORD
  Trauma
 Infections
Common  Degeneration
Disorders of  Structural defects
the Nervous
 Tumors
System
 Blood flow disruption
 Autoimmune disorders
Vascular disorders
stroke, transient ischemic attack (TIA), subarachnoid
hemorrhage, subdural hemorrhage and hematoma, and
extradural hemorrhage

Infections
meningitis, encephalitis, polio, and epidural abscess

Structural disorders
brain or spinal cord injury, Bell's palsy, cervical
spondylosis, carpal tunnel syndrome, brain or spinal cord
tumors, peripheral neuropathy, and Guillain-Barré syndrome

Functional disorders
headache, epilepsy, dizziness, and neuralgia

Degeneration
Parkinson disease, multiple sclerosis, amyotrophic lateral
sclerosis (ALS), Huntington chorea, and Alzheimer disease