Understanding the Neuromusculoskeletal System

So, today we are doing the musculoskeletal system. And we said that the musculoskeletal system is more like the neuromusculoskeletal system. Because if it wasn't for the neurons, if it wasn't for the action potential, if it wasn't for the membrane voltage change, We will not be able to elicit contractions. If there is no contractions, there's no movement of the bone. So if you can flex your elbow joint, how are you able to use your elbow joint like a lever to pick things up? So this flexion movement, how is it happening? It's happening because there's action potentials that cause contraction of the muscle. and the muscle pulls the bone so the bone on its own cannot move it is only moved because the muscle pulled it and the muscle is not going to move unless the nerve so it's the nerve stimulating the muscle so you have the nerve stimulating the muscle and then the muscle stimulating and pulling the bone That's how we're able to elicit our movement. So remember when we talked about the neuron. How does the neuron look like? This, what is this afro structure here? What is that called? What are these called here? These afro hairs. What are these called? Dendrites. These are the dendrites. Then you have this nucleus here. And this place where there is integration, where there is control in the neuron, what is that place called? What is this place called right here? That is your cell body. That's the cell body, also known as the soma. Then the soma has an axon. And the Acton has this swollen ends. Swollen ends. Swollen ends. These swollen ends are full of bubbles. Full of balloons. The balloons have a chemical inside them. What is that chemical called? What is this chemical called inside these blue bubbles? Inside these orange? vesicle what is that substance called neurotransmitter for this orange is a neurotransmitter so when the action potential when the action potential depolarization repolarization depolarization repolarization depolarization depolarization of the membrane membrane depolarization membrane membrane depolarization Membrane repolarization, when we get there, what's going to happen? We're going to empty, empty all of the neurotransmitters into this gap here. Who's waiting on the other side? Usually, another neuron. So that's how the synapses communicate, between a neuron and another neuron. But in our case, there's a muscle, there's a muscle. Here, this muscle has on its surface, on its surface it has receptors. So these receptors are going to bind to this orange neurotransmitter. This neurotransmitter, known as ACH or acetyl. Choline, acetylcholine. Then when acetylcholine binds the receptor, what's gonna happen? That's gonna cause membrane depolarization, repolarization, depolarization, repolarization, depolarization, and contraction. So you see that's how we contract the muscle with the nerve. That's why all of the muscles, when we look at them, they have nerves piercing through the muscle called innervation. Muscle is innervating. The nerve is innervating the muscle and the muscle moves the bone. Now you see why I think it should be called the neuromusculoskeletal system. Three in one. The neuro, the neuron, musculo, the muscle, skeleton, the bone. So the bone cannot move except when the muscle contracts. And the muscle is not going to contract. Except when it's, when it's what? Yes, yeah, when the neuron innervated. That's why people who are paralyzed, if you look at their lower limb muscles, somebody who has paralysis, they cannot walk, they are on a wheelchair. If you look at their thigh, if you look at their buttock, if you look at their thigh, if you have... You can see that they are asthma-fied. It is small. Why is that? Because they're not compressive and it's hard to work with. That's why our tissues look like that. Because the nerves, the nerves are not innervating. No electricity, no action potential. No depolarization, repolarization. No depolarization, no repolarization. Because no depolarization, no depolarization, the muscle gets weaker. You know what they say, if you don't use it, you lose it. If you don't use it, you lose it. The same thing. Your nerve, you're going to use them, so the muscles don't get stimulated, then the muscles get atrophied. They get smaller. Yes? So the reason why paralysis happens is because the nerve can't connect to the neuron in the brain? So what happens in paralysis, you know your butterfly. Remember the butterfly? The butterfly represents your central nervous system, the brain and the spinal cord. That's where the processing happens. That's where the integration happens. So it depends. Some people have a car, road traffic accident that damaged their spinal cord. Some people have a stroke. But in the end, something wrong with the butterfly. It's damaged, so you cannot elicit an output, a motor output. You cannot elicit an afferent or efferent. If you cannot generate a motor output, is that a defect in afferent or efferent? Efferent. So I told you, when you go to the effector... the muscle is an effector. The sweat gland, who makes the sweat gland squeeze all the sweat out? That is your nerve innervating the sweat gland, the effector. So if you're touching the effector, the muscle is an effector. So this neuron here dealing with the muscle, that's definitely not after. That is definitely ether because it's dealing with an effector with the muscle. That's why we call this the neuromuscular. junction because it's between the neuron that is the neuro that is the muscle muscular the neuromuscular junction between the neuron and the muscle the neuromuscular junction between the neuron and the muscle there is also between a neuron and another neuron but here is between the neuron and the muscle so you gotta understand You have a neuron stimulating a muscle and the muscle stimulating who? And the muscle stimulating? Stimulating the bone. So no bone movement except with muscle contraction. No muscle contraction except with nerve, nerve, nerve signal. Okay. So what do we see here? Bones support the movement. So bones act as levers. when the muscles span a joint and they contract so the bone is your living tissue obviously bone is made up of cells okay this bone is not rock people think that blood vessels are like plastic tubes no blood vessels are cells they're made up of cells your blood vessels are made up of cells known as endothelial cells so blood vessels are made up of endothelial cells Blood vessels are made up of endothelial cells. Blood vessels are made up of heli cells. Blood vessels are made up of endothelial cells. You see? Endothelial cell, endothelial cell, endothelial cell, endothelial cell, endothelial cell, endothelial cell. That makes your blood vessel. And you have your mountain, your bone mountain. That's bone, bone, calcium phosphate, calcium phosphate. That is your bone. Now what happens if you have too much calcium? Too much calcium. 2+++, too much calcium. Is that hypercalcemia or hypocalcemia? That is hypercalcemia. So now when there is hypercalcemia to restore, so where is hypercalcemia? Is it in the blood or in the bone? Hypercalcemia is inside the blood. You see that's why I drew it here. I drew it inside the blood vessel because there is so much calcium in the blood. So how do we repair that? By taking calcium from the blood, depositing it in the bone. So that's going to deplete the too much calcium, because we take from the blood, we build up on the mountain. And that's going to restore our calcium homeostasis. So the cells that do that, they are known as osteoblasts. Osteoblasts. They build up. Blast. for build up. They build up the bone, the osteoblast, they take calcium from the blood vessel, and they build up the bone, restoring, restoring calcium homeostasis. What about the opposite? If I have too little calcium now, calcium level in my blood dropping, and I have hypocalcemia, excellent, hypocalcemia, I have hypocalcemia. So what's going to happen now is, yes? Some calcium will go down the... Exactly. So the bone is going to release calcium through the tissue, and the cells who will do that, they are known as osteoclasts. And the osteoclasts, you know they have the jackhammer? The jackhammer, the construction workers? So that's exactly what the osteoclasts do, but they don't have a jackhammer. They have enzymes. They have proteolytic enzymes. They have degradative enzymes. They have lysosomal enzymes. And they have acid. They have reactive oxidative species. Remember our old friend peroxidase? So that reactive oxidative species is going to destroy our bone. These are all weapons to destroy our bone. And then calcium powder is going to be liberated into the bone to bring up our calcium. So now you see your bone is... people think bone is just important for walking and movement. and lifting things up no what is important for calcium homeostasis what about phosphate same thing to the phosphate hypofosfateemia we break down bone too much phosphate in the blood we build up in the bone so that is called hypofosfateemia hyperfosfateemia hypocalcemia hypercalcemia so it is mineral bank We store minerals in it and we took minerals out when we need. We need calcium, we degrade bone. We need phosphate, we degrade bone. We need to store calcium, we put it in the bone. We need to store phosphate, we put it in the bone. Okay, also the bone is important for protection. You see, you put the money, the jewelry inside the safe so nobody can break in the safe and take it. Your brain is more precious and valuable than the jewelry and the money. That's why it is encapsulated with the... Cranium. And you'll get a skull. The skull. That's the layman in the street. See the skull. It's Dunkin Donuts. The skull. But you guys gotta see the cranium. Cranium. Cranium. It's protecting your brain. Your rib cage. Protecting your heart. Protecting your lungs. Your pelvic. Girdle, protecting your bladder, protecting the urinary bladder. Digestive system is also protected with your rib cage. Yeah, the lower part is protected with fat. Yeah, because it needs to descend, right, to compress. If it was just, if your digestive system was all just about surrounded with bone, it cannot perform the contractions freely. Yeah, it's protected by the pelvis from damage. Yes, you're right. Yeah. It's protecting your digestive system. So the same way your bone is not part of your nervous system, but it's protecting your brain, your central nervous system. Your vertebral column is protecting your spinal cord sandwich in the middle. So you have your spinal cord inside and the vertebral column from the outside. Okay. What is that? That is the cranium. What is that? If I say what is that on the exam? Halloween. That is the cranium. Okay, you're bored. You know guys, if you have a boiled egg, last class when they saw this, and I said, okay guys, if you have a boiled egg, they said, that's an egg? I didn't say that. If you have a boiled egg. They said, wow, that's an egg? No egg looks that. I'm just saying, if you have histological sample, you have to cut it in the middle. If you don't cut the boiled egg in the middle, will you ever know there's yellow yolk inside? No. So that's why we slice the bone in half. So here, that's a bone that is cut in half. So look what's inside the bone. So the bone from inside looks like that. There's a red marrow and yellow marrow. So this red marrow from the name, red marrow, what do you think it makes? Red blood cells. Excellent. Excellent. Red blood cells. And the yellow marrow, what is that? White blood cell and not yellow. No, yellow is butter, butter. Lipids. So you know we need lipids. We need lipids. Why? For ATP. We need lipids. So your bone needs the supply, fat supply to break down the lipids to get ATP. Your bone needs ATP all the time. Okay, so that's why we have yellow marrow. If I tell you what is that, tell me that in the head. That is a bone cut in half. You have the red marrow and the yellow marrow. These are the bones. I'm going to show you now the bones you need to know for the practical. Okay, this is your femur, the biggest bone in your thigh. As a sternum, as a flat bone, some bones are flat, some bones are long, some bones are short, some bones are irregular, some bones are like this. It's a sesamoid bone, like an M&M. The patella, if you look at the patella, you'll see that it's like a sesame. The kneecap is called the kneecap. Can you find the kneecap on that skeleton? The kneecap is gone, but it's there. You can still find it. Bone, iron, is not stone. It's cells. Different types of cells. I'm trying to get it in shock. Like my elementary school teacher. Okay. We have four different types of cells that make up cells. Bone tissue. What are they? Number one, we talked about osteoclasts. What are the osteoclasts? Oh no. What is this? Osteoclasts, they degrade the bone. They have the jackhammer. What do they have that helps them break down the bone? They have the reactive oxidative species, they have the acid, they have the proteolytic enzymes, they have the degradative enzymes. They have all the enzymes to break down osteoclasts. So when do we initiate osteoclasts? When we have so much calcium in the blood or when we have too little calcium in the blood? Too little, so we can degrade the bone to get powder. Excellent. Now, the osteoblast from the B, blast, build up, blast, build up. When do we initiate osteoblast? When we have too much calcium or too little calcium? Too much. When we have too much calcium, we take from the blood too much calcium, we build up the bone. That's why the baby drinks a lot of milk, so he can have a lot of calcium in the blood. then the osteoblast will take the calcium from the blood into the bone. What is an osteocyte? An osteocyte is a retired osteoblast. Like a professor, you know, he's a young professor, then associate professor, then assistant professor, then school professor, then retired department head. So that's the osteocyte. That's a cell that used to be in the past, osteoblast. It dumped so much matrix and now it's retired. The osteogenic cell is the computer cell. That's the cell, that's the brain of the bone. It says there's too much calcium. Let me initiate the osteoblast. There's too little calcium. Let me initiate the osteoplasty. The osteogenic cells, these are the stem cells, the progenitor cells. These are the ones responsible for the buildup of the bone. These are the different types of cells. So you see here in our bone, you have red. You have red blood vessels because our bone is stale. They need oxygen. Why do the bone cells need oxygen? They need oxygen for oxidative, for correlation, and aerobic respiration. Aerobic respiration. And they need oxygen for metabolism. And they need ATP energy for the breakdown of metabolites. Break down of nutrients, carbohydrates, proteins, lipids. Yeah, we break down lipids to get ATP. That's why there's a yellow marrow. No, we break it down to get ATP. Yeah. So you, like in an accident, right? What's that on the back? That's when they were just being caught, right? Yeah, and also your bone itself, it needs you to utilize the back, that's the yellow marrow. So you have all the fire back, besides the pad that's in the front. What's the picnic happening in the back and the coffin? Are you guys talking about bone homeostasis and the yellow marrow on the corner? Of course you are, Lucas. Okay, now why do the bone have red and blood circulation in the bone? I thought bone is just stone. They're not a cell, so they need oxygen. They need nutrients, and they need what else? What's the third one they need? Besides oxygen, what does the blood provide to the cells? Besides giving it oxygen, besides giving it nutrients, the third one is? One second. They need to get calcium. Huh? They need to get calcium. So, Calc is for nutrients. So, nutrients, solutes, hormones, um, energy, nutrients, oxygen, besides all of that, what is there to remove away the blood? The blood. Yeah, the metabolic way, the toxic metabolic way. Right. Also, your bone tissue is important for Vitamin D. Why is Vitamin D important? Vitamin D will help you absorb Absorb calcium. You can drink all the calcium in the world. If you don't have vitamin D, that calcium is gonna get in number two. It's gonna get removed from your body. It's gonna get flushed out. Remember we said food is not what you get inside. It's what you absorb from your digestive system into the circulatory system into your tissues. So three trips, not one. The food you get in when you take a bite from that cheeseburger, it has three tricks. From your intestine to the blood and from the blood to the tissue. But if you don't have vitamin D, you're drinking the milk, the milk is never going to get absorbed. If you drink, if you have vitamin D but no calcium, you're never going to, your bone is not going to grow. You have calcium but no vitamin D, you're not going to grow. You need both. It's calcium and vitamin D for homeostasis of calcium. So vitamin D supplement is going to increase the concentration of the coffee, the ergo called sifirol in your body. So that's going to, it's like you have a lot of vitamin D. If you don't have vitamin D, because it's the sun actually that helps you. Make vitamin D in your body. You need ultraviolet radiation, the photon. Remember when we did the photosynthesis and we said that the sunlight is going to excite the electrons? When that ultraviolet radiation helps your body, your skin, make vitamin D. But because we live in an industrialized society with pollution and the gas coming out from the car engine, there's a lot of lung fibrosis in the urban inner cities, especially in New York City. There's a lot of rats, there's a lot of contamination, and you're always inside the office, no sunlight, so then you have low vitamin D. Everybody has low vitamin D, unless they take supplements, and that's going to get to something that's like eminence. Okay, moving on. Peak bone mass. You see men have a higher peak bone mass than women. But if you notice, it takes men a while, in their 50s, then their bone mass starts to deteriorate. But for females, they have a short drop, and that is because of the menopause. So the hormone estrogen is known as the essential female hormone, and testosterone is the essential male hormone. The testosterone makes the guy's voice change really big. and the muscle that's what make that the essential hormone so the guys like they take the testosterone with steroids so that his muscles can be really big and then he's technical too small that's the side effect of testosterone exogenous therapy for females menopause meaning the end of the essential estrogen so that's the female essential hormone so now females they do the Exogenous estrogen therapy. It has to be moderate because too much estrogen, exogenous estrogen therapy is going to cause breast cancer. For men, exogenous testosterone therapy causes infertility and peritestinal. Because who makes the testosterone? Pesticles. And he's taking testosterone exorbitantly, so that's going to inhibit his testicles. So don't do anything exogenous, be natural. Yeah. No, they don't balance out because they don't co-exist. Testosterone is in the body of the man. Estrogen is in the body of the woman. I don't have an estrogen, but if they're taking like, estrogen, like, first, their body won't actually be able to eat it, because they'll be like, if I already have it, I'm already gonna have to put some amount of it. Why would I need to produce myself? I don't think that's a problem. Yeah. Yeah. They don't coexist. You're not gonna have a balance between estrogen and the stuff on your body, as a female and for male. You're not going to have a balance between estrogen and testosterone. There is a different metabolite. That's a different thing that I learned in endocrine system. But they don't coexist. There's an essential hormone for males, essential hormone for females. But the use of exogenous testosterone for males, the bodybuilder, or exogenous estrogen for the actress in Hollywood that doesn't like the menopause. So the more estrogen they take, that's gonna cause the breast cancer. Okay, but if I ask you one thing again, why is there a sharp drop in female bone mass at the age of 50 years old? Menopause. Yes? But does she feel like she's in the delay of menopause during the cycle? Yeah, she's delayed it, but it may cause cancer. Yeah, so you have to be very careful with how much It does give like the increase the bone mass for females. It's very effective But then again you have to be careful. So the best thing is natural so females who are athletic and who are like practicing they Really struggle bone mass and it doesn't affect their menopause We just want exercise. So these are the things that are natural. So that's what you have to do. But people, they want the easy way out. They just go and they want to take exogenous testosterone and exogenous estrogen and that's dangerous. So what's your question? Yeah, that happens. That's different. That is some people, they have like a defect. So sometimes they're born that way. So they are born with excessive, so nailed with a chromosome XY. But they can have due to a congenital defect, excessive secretion of testosterone. It happens. But it's not a natural thing. But when we talk about naturally, you know, menopause is going to be the decline. You know, like the T-bone mass, all of the features of the essential, the essence. You know the word essence of the essence of the male testosterone. Now, the way people deal with challenges is different. Some people, naturally, they like exercise. So men who exercise, eat healthy, okay, don't smoke the... The cigarette, the alcohol, all of that, they have a lot better quality of life. Also females who exercise, who eat healthy, and they don't do the unhealthy, abdostic things, then they are better. But don't go and take the exogenous estrogen, because these doctors, they cannot wait. They want to swipe your insurance, and they want to give you... All the estrogen and then you end up with cancer and then we're going to be in trouble because you find the paper. Eating healthy herbs. You know the herbs, the vegetables and all that kind of stuff is very good, but don't take those exogenous supplies. That's what we talked about. The balance between calcium and phosphate in your body. Too much calcium, we result, we kill the bone. Too little calcium, we result the bone. Now the muscles, we talked about that. We have to be able to contract the muscles with nerves. Then the muscles are going to pull our bones. We have two kinds of muscles. A muscle that is agonist, the one we need to contract. And the muscle on the back, the antagonist, we need to relax that one. Because if you contract both, you cannot move. So you activate one muscle and you deactivate the opposing muscle. If you want to relax your elbow, then you activate. your agonist muscles in the back and we deactivate the muscles in the front. So we are constantly cycling, oscillating which muscles get innervation, which muscles get relaxation for us to get our optimal, our optimal. Okay, so now for your practicals. These are the muscles we have to know for your practicals. The very big ones. Everybody knows, everybody knows the deltoids. Who does not know where the deltoid muscle is? That's the deltoid muscle, the muscle of the shoulder. So on the exam, I'll have like a number up here, and tell you what is this muscle, and you say that's the deltoid. Then I'm going to ask you, this big muscle in your chest, that's the pectoralis. The pectoralis is the muscle. Then you have muscles around your lips. That's the orvecularis. Orvecularis oris. Around your eyes, orvecularis oculi. Then your kneecap has a muscle in the middle known as the rectus femoris. And then there's this muscle that is the helicob, known as the subtoid muscle. And the biceps, everybody knows these are biceps. If you want to have a point, say biceps. But these are actually biceps brachii. That's a full point. Biceps brachii. On the bottom, these are your triceps brachii. Knowing where they are and how to spell them. Biceps. Reiki eye biceps triceps vibration, reiki You don't need to know all of this. This is just for you to know, but you might have to be tested on it. You see these are the muscles. These ones you gotta know. What is happening? There are muscles around the eye known as the orbecularis oculi. Orbecularis oculi. Muscles around the lips known as the orbecularis oris. So on the exam... What's the muscle around the lip? Orbicularis. Oris. What's the muscle around the eye? Orbicularis. Ocular. What's this big triangle on the back? Trapezius. You know the traps. That's the gym bro. The deltoid and the trap. But trapezius. The gym bro. Okay. You know you did a assignment on this, the intercostal muscle. These are the muscles that increase exactly your rib cage, decrease your rib cage for breathing. So when you take a deep breath, they expand your thoracic cage. These are your intercostal, your intercostal muscles. Alright, so what you need to know is this. Everybody.

So if you can flex your elbow joint, how are you able to use your elbow joint like a lever to pick things up? So this flexion movement, how is it happening? It's happening because there's action potentials that cause contraction of the muscle. and the muscle pulls the bone so the bone on its own cannot move it is only moved because the muscle pulled it and the muscle is not going to move unless the nerve so it's the nerve stimulating the muscle so you have the nerve stimulating the muscle and then the muscle stimulating and pulling the bone That's how we're able to elicit our movement. So remember when we talked about the neuron.

How does the neuron look like? This, what is this afro structure here? What is that called?

What are these called here? These afro hairs. What are these called?

Dendrites. These are the dendrites. Then you have this nucleus here.

And this place where there is integration, where there is control in the neuron, what is that place called? What is this place called right here? That is your cell body.

That's the cell body, also known as the soma. Then the soma has an axon. And the Acton has this swollen ends.

Swollen ends. Swollen ends. These swollen ends are full of bubbles.

Full of balloons. The balloons have a chemical inside them. What is that chemical called? What is this chemical called inside these blue bubbles? Inside these orange?

vesicle what is that substance called neurotransmitter for this orange is a neurotransmitter so when the action potential when the action potential depolarization repolarization depolarization repolarization depolarization depolarization of the membrane membrane depolarization membrane membrane depolarization Membrane repolarization, when we get there, what's going to happen? We're going to empty, empty all of the neurotransmitters into this gap here. Who's waiting on the other side?

Usually, another neuron. So that's how the synapses communicate, between a neuron and another neuron. But in our case, there's a muscle, there's a muscle.

Here, this muscle has on its surface, on its surface it has receptors. So these receptors are going to bind to this orange neurotransmitter. This neurotransmitter, known as ACH or acetyl.

Choline, acetylcholine. Then when acetylcholine binds the receptor, what's gonna happen? That's gonna cause membrane depolarization, repolarization, depolarization, repolarization, depolarization, and contraction. So you see that's how we contract the muscle with the nerve.

That's why all of the muscles, when we look at them, they have nerves piercing through the muscle called innervation. Muscle is innervating. The nerve is innervating the muscle and the muscle moves the bone.

Now you see why I think it should be called the neuromusculoskeletal system. Three in one. The neuro, the neuron, musculo, the muscle, skeleton, the bone.

So the bone cannot move except when the muscle contracts. And the muscle is not going to contract. Except when it's, when it's what?

Yes, yeah, when the neuron innervated. That's why people who are paralyzed, if you look at their lower limb muscles, somebody who has paralysis, they cannot walk, they are on a wheelchair. If you look at their thigh, if you look at their buttock, if you look at their thigh, if you have...

You can see that they are asthma-fied. It is small. Why is that?

Because they're not compressive and it's hard to work with. That's why our tissues look like that. Because the nerves, the nerves are not innervating. No electricity, no action potential.

No depolarization, repolarization. No depolarization, no repolarization. Because no depolarization, no depolarization, the muscle gets weaker. You know what they say, if you don't use it, you lose it.

If you don't use it, you lose it. The same thing. Your nerve, you're going to use them, so the muscles don't get stimulated, then the muscles get atrophied.

They get smaller. Yes? So the reason why paralysis happens is because the nerve can't connect to the neuron in the brain?

So what happens in paralysis, you know your butterfly. Remember the butterfly? The butterfly represents your central nervous system, the brain and the spinal cord.

That's where the processing happens. That's where the integration happens. So it depends. Some people have a car, road traffic accident that damaged their spinal cord. Some people have a stroke.

But in the end, something wrong with the butterfly. It's damaged, so you cannot elicit an output, a motor output. You cannot elicit an afferent or efferent.

If you cannot generate a motor output, is that a defect in afferent or efferent? Efferent. So I told you, when you go to the effector...

the muscle is an effector. The sweat gland, who makes the sweat gland squeeze all the sweat out? That is your nerve innervating the sweat gland, the effector. So if you're touching the effector, the muscle is an effector. So this neuron here dealing with the muscle, that's definitely not after.

That is definitely ether because it's dealing with an effector with the muscle. That's why we call this the neuromuscular. junction because it's between the neuron that is the neuro that is the muscle muscular the neuromuscular junction between the neuron and the muscle the neuromuscular junction between the neuron and the muscle there is also between a neuron and another neuron but here is between the neuron and the muscle so you gotta understand You have a neuron stimulating a muscle and the muscle stimulating who? And the muscle stimulating?

Stimulating the bone. So no bone movement except with muscle contraction. No muscle contraction except with nerve, nerve, nerve signal.

Okay. So what do we see here? Bones support the movement. So bones act as levers. when the muscles span a joint and they contract so the bone is your living tissue obviously bone is made up of cells okay this bone is not rock people think that blood vessels are like plastic tubes no blood vessels are cells they're made up of cells your blood vessels are made up of cells known as endothelial cells so blood vessels are made up of endothelial cells Blood vessels are made up of endothelial cells.

Blood vessels are made up of heli cells. Blood vessels are made up of endothelial cells. You see? Endothelial cell, endothelial cell, endothelial cell, endothelial cell, endothelial cell, endothelial cell. That makes your blood vessel.

And you have your mountain, your bone mountain. That's bone, bone, calcium phosphate, calcium phosphate. That is your bone. Now what happens if you have too much calcium? Too much calcium.

2+++, too much calcium. Is that hypercalcemia or hypocalcemia? That is hypercalcemia. So now when there is hypercalcemia to restore, so where is hypercalcemia?

Is it in the blood or in the bone? Hypercalcemia is inside the blood. You see that's why I drew it here. I drew it inside the blood vessel because there is so much calcium in the blood. So how do we repair that?

By taking calcium from the blood, depositing it in the bone. So that's going to deplete the too much calcium, because we take from the blood, we build up on the mountain. And that's going to restore our calcium homeostasis.

So the cells that do that, they are known as osteoblasts. Osteoblasts. They build up. Blast.

for build up. They build up the bone, the osteoblast, they take calcium from the blood vessel, and they build up the bone, restoring, restoring calcium homeostasis. What about the opposite?

If I have too little calcium now, calcium level in my blood dropping, and I have hypocalcemia, excellent, hypocalcemia, I have hypocalcemia. So what's going to happen now is, yes? Some calcium will go down the... Exactly. So the bone is going to release calcium through the tissue, and the cells who will do that, they are known as osteoclasts.

And the osteoclasts, you know they have the jackhammer? The jackhammer, the construction workers? So that's exactly what the osteoclasts do, but they don't have a jackhammer.

They have enzymes. They have proteolytic enzymes. They have degradative enzymes.

They have lysosomal enzymes. And they have acid. They have reactive oxidative species. Remember our old friend peroxidase? So that reactive oxidative species is going to destroy our bone.

These are all weapons to destroy our bone. And then calcium powder is going to be liberated into the bone to bring up our calcium. So now you see your bone is... people think bone is just important for walking and movement.

and lifting things up no what is important for calcium homeostasis what about phosphate same thing to the phosphate hypofosfateemia we break down bone too much phosphate in the blood we build up in the bone so that is called hypofosfateemia hyperfosfateemia hypocalcemia hypercalcemia so it is mineral bank We store minerals in it and we took minerals out when we need. We need calcium, we degrade bone. We need phosphate, we degrade bone.

We need to store calcium, we put it in the bone. We need to store phosphate, we put it in the bone. Okay, also the bone is important for protection. You see, you put the money, the jewelry inside the safe so nobody can break in the safe and take it. Your brain is more precious and valuable than the jewelry and the money.

That's why it is encapsulated with the... Cranium. And you'll get a skull. The skull.

That's the layman in the street. See the skull. It's Dunkin Donuts. The skull. But you guys gotta see the cranium.

Cranium. Cranium. It's protecting your brain.

Your rib cage. Protecting your heart. Protecting your lungs. Your pelvic. Girdle, protecting your bladder, protecting the urinary bladder.

Digestive system is also protected with your rib cage. Yeah, the lower part is protected with fat. Yeah, because it needs to descend, right, to compress.

If it was just, if your digestive system was all just about surrounded with bone, it cannot perform the contractions freely. Yeah, it's protected by the pelvis from damage. Yes, you're right.

Yeah. It's protecting your digestive system. So the same way your bone is not part of your nervous system, but it's protecting your brain, your central nervous system. Your vertebral column is protecting your spinal cord sandwich in the middle.

So you have your spinal cord inside and the vertebral column from the outside. Okay. What is that?

That is the cranium. What is that? If I say what is that on the exam?

Halloween. That is the cranium. Okay, you're bored. You know guys, if you have a boiled egg, last class when they saw this, and I said, okay guys, if you have a boiled egg, they said, that's an egg? I didn't say that.

If you have a boiled egg. They said, wow, that's an egg? No egg looks that.

I'm just saying, if you have histological sample, you have to cut it in the middle. If you don't cut the boiled egg in the middle, will you ever know there's yellow yolk inside? No.

So that's why we slice the bone in half. So here, that's a bone that is cut in half. So look what's inside the bone.

So the bone from inside looks like that. There's a red marrow and yellow marrow. So this red marrow from the name, red marrow, what do you think it makes?

Red blood cells. Excellent. Excellent.

Red blood cells. And the yellow marrow, what is that? White blood cell and not yellow. No, yellow is butter, butter. Lipids.

So you know we need lipids. We need lipids. Why?

For ATP. We need lipids. So your bone needs the supply, fat supply to break down the lipids to get ATP. Your bone needs ATP all the time.

Okay, so that's why we have yellow marrow. If I tell you what is that, tell me that in the head. That is a bone cut in half.

You have the red marrow and the yellow marrow. These are the bones. I'm going to show you now the bones you need to know for the practical.

Okay, this is your femur, the biggest bone in your thigh. As a sternum, as a flat bone, some bones are flat, some bones are long, some bones are short, some bones are irregular, some bones are like this. It's a sesamoid bone, like an M&M.

The patella, if you look at the patella, you'll see that it's like a sesame. The kneecap is called the kneecap. Can you find the kneecap on that skeleton? The kneecap is gone, but it's there. You can still find it.

Bone, iron, is not stone. It's cells. Different types of cells. I'm trying to get it in shock. Like my elementary school teacher.

Okay. We have four different types of cells that make up cells. Bone tissue.

What are they? Number one, we talked about osteoclasts. What are the osteoclasts?

Oh no. What is this? Osteoclasts, they degrade the bone.

They have the jackhammer. What do they have that helps them break down the bone? They have the reactive oxidative species, they have the acid, they have the proteolytic enzymes, they have the degradative enzymes. They have all the enzymes to break down osteoclasts.

So when do we initiate osteoclasts? When we have so much calcium in the blood or when we have too little calcium in the blood? Too little, so we can degrade the bone to get powder.

Excellent. Now, the osteoblast from the B, blast, build up, blast, build up. When do we initiate osteoblast? When we have too much calcium or too little calcium?

Too much. When we have too much calcium, we take from the blood too much calcium, we build up the bone. That's why the baby drinks a lot of milk, so he can have a lot of calcium in the blood.

then the osteoblast will take the calcium from the blood into the bone. What is an osteocyte? An osteocyte is a retired osteoblast. Like a professor, you know, he's a young professor, then associate professor, then assistant professor, then school professor, then retired department head.

So that's the osteocyte. That's a cell that used to be in the past, osteoblast. It dumped so much matrix and now it's retired. The osteogenic cell is the computer cell. That's the cell, that's the brain of the bone.

It says there's too much calcium. Let me initiate the osteoblast. There's too little calcium. Let me initiate the osteoplasty.

The osteogenic cells, these are the stem cells, the progenitor cells. These are the ones responsible for the buildup of the bone. These are the different types of cells. So you see here in our bone, you have red. You have red blood vessels because our bone is stale.

They need oxygen. Why do the bone cells need oxygen? They need oxygen for oxidative, for correlation, and aerobic respiration.

Aerobic respiration. And they need oxygen for metabolism. And they need ATP energy for the breakdown of metabolites. Break down of nutrients, carbohydrates, proteins, lipids.

Yeah, we break down lipids to get ATP. That's why there's a yellow marrow. No, we break it down to get ATP.

Yeah. So you, like in an accident, right? What's that on the back?

That's when they were just being caught, right? Yeah, and also your bone itself, it needs you to utilize the back, that's the yellow marrow. So you have all the fire back, besides the pad that's in the front. What's the picnic happening in the back and the coffin?

Are you guys talking about bone homeostasis and the yellow marrow on the corner? Of course you are, Lucas. Okay, now why do the bone have red and blood circulation in the bone?

I thought bone is just stone. They're not a cell, so they need oxygen. They need nutrients, and they need what else? What's the third one they need?

Besides oxygen, what does the blood provide to the cells? Besides giving it oxygen, besides giving it nutrients, the third one is? One second.

They need to get calcium. Huh? They need to get calcium. So, Calc is for nutrients. So, nutrients, solutes, hormones, um, energy, nutrients, oxygen, besides all of that, what is there to remove away the blood?

The blood. Yeah, the metabolic way, the toxic metabolic way. Right. Also, your bone tissue is important for Vitamin D. Why is Vitamin D important?

Vitamin D will help you absorb Absorb calcium. You can drink all the calcium in the world. If you don't have vitamin D, that calcium is gonna get in number two.

It's gonna get removed from your body. It's gonna get flushed out. Remember we said food is not what you get inside. It's what you absorb from your digestive system into the circulatory system into your tissues. So three trips, not one.

The food you get in when you take a bite from that cheeseburger, it has three tricks. From your intestine to the blood and from the blood to the tissue. But if you don't have vitamin D, you're drinking the milk, the milk is never going to get absorbed.

If you drink, if you have vitamin D but no calcium, you're never going to, your bone is not going to grow. You have calcium but no vitamin D, you're not going to grow. You need both. It's calcium and vitamin D for homeostasis of calcium.

So vitamin D supplement is going to increase the concentration of the coffee, the ergo called sifirol in your body. So that's going to, it's like you have a lot of vitamin D. If you don't have vitamin D, because it's the sun actually that helps you.

Make vitamin D in your body. You need ultraviolet radiation, the photon. Remember when we did the photosynthesis and we said that the sunlight is going to excite the electrons? When that ultraviolet radiation helps your body, your skin, make vitamin D. But because we live in an industrialized society with pollution and the gas coming out from the car engine, there's a lot of lung fibrosis in the urban inner cities, especially in New York City.

There's a lot of rats, there's a lot of contamination, and you're always inside the office, no sunlight, so then you have low vitamin D. Everybody has low vitamin D, unless they take supplements, and that's going to get to something that's like eminence. Okay, moving on. Peak bone mass.

You see men have a higher peak bone mass than women. But if you notice, it takes men a while, in their 50s, then their bone mass starts to deteriorate. But for females, they have a short drop, and that is because of the menopause. So the hormone estrogen is known as the essential female hormone, and testosterone is the essential male hormone.

The testosterone makes the guy's voice change really big. and the muscle that's what make that the essential hormone so the guys like they take the testosterone with steroids so that his muscles can be really big and then he's technical too small that's the side effect of testosterone exogenous therapy for females menopause meaning the end of the essential estrogen so that's the female essential hormone so now females they do the Exogenous estrogen therapy. It has to be moderate because too much estrogen, exogenous estrogen therapy is going to cause breast cancer. For men, exogenous testosterone therapy causes infertility and peritestinal. Because who makes the testosterone?

Pesticles. And he's taking testosterone exorbitantly, so that's going to inhibit his testicles. So don't do anything exogenous, be natural. Yeah. No, they don't balance out because they don't co-exist.

Testosterone is in the body of the man. Estrogen is in the body of the woman. I don't have an estrogen, but if they're taking like, estrogen, like, first, their body won't actually be able to eat it, because they'll be like, if I already have it, I'm already gonna have to put some amount of it. Why would I need to produce myself? I don't think that's a problem.

Yeah. Yeah. They don't coexist. You're not gonna have a balance between estrogen and the stuff on your body, as a female and for male. You're not going to have a balance between estrogen and testosterone.

There is a different metabolite. That's a different thing that I learned in endocrine system. But they don't coexist. There's an essential hormone for males, essential hormone for females.

But the use of exogenous testosterone for males, the bodybuilder, or exogenous estrogen for the actress in Hollywood that doesn't like the menopause. So the more estrogen they take, that's gonna cause the breast cancer. Okay, but if I ask you one thing again, why is there a sharp drop in female bone mass at the age of 50 years old?

Menopause. Yes? But does she feel like she's in the delay of menopause during the cycle? Yeah, she's delayed it, but it may cause cancer.

Yeah, so you have to be very careful with how much It does give like the increase the bone mass for females. It's very effective But then again you have to be careful. So the best thing is natural so females who are athletic and who are like practicing they Really struggle bone mass and it doesn't affect their menopause We just want exercise.

So these are the things that are natural. So that's what you have to do. But people, they want the easy way out. They just go and they want to take exogenous testosterone and exogenous estrogen and that's dangerous.

So what's your question? Yeah, that happens. That's different.

That is some people, they have like a defect. So sometimes they're born that way. So they are born with excessive, so nailed with a chromosome XY.

But they can have due to a congenital defect, excessive secretion of testosterone. It happens. But it's not a natural thing. But when we talk about naturally, you know, menopause is going to be the decline. You know, like the T-bone mass, all of the features of the essential, the essence.

You know the word essence of the essence of the male testosterone. Now, the way people deal with challenges is different. Some people, naturally, they like exercise.

So men who exercise, eat healthy, okay, don't smoke the... The cigarette, the alcohol, all of that, they have a lot better quality of life. Also females who exercise, who eat healthy, and they don't do the unhealthy, abdostic things, then they are better. But don't go and take the exogenous estrogen, because these doctors, they cannot wait.

They want to swipe your insurance, and they want to give you... All the estrogen and then you end up with cancer and then we're going to be in trouble because you find the paper. Eating healthy herbs.

You know the herbs, the vegetables and all that kind of stuff is very good, but don't take those exogenous supplies. That's what we talked about. The balance between calcium and phosphate in your body.

Too much calcium, we result, we kill the bone. Too little calcium, we result the bone. Now the muscles, we talked about that.

We have to be able to contract the muscles with nerves. Then the muscles are going to pull our bones. We have two kinds of muscles.

A muscle that is agonist, the one we need to contract. And the muscle on the back, the antagonist, we need to relax that one. Because if you contract both, you cannot move. So you activate one muscle and you deactivate the opposing muscle. If you want to relax your elbow, then you activate.

your agonist muscles in the back and we deactivate the muscles in the front. So we are constantly cycling, oscillating which muscles get innervation, which muscles get relaxation for us to get our optimal, our optimal. Okay, so now for your practicals. These are the muscles we have to know for your practicals. The very big ones.

Everybody knows, everybody knows the deltoids. Who does not know where the deltoid muscle is? That's the deltoid muscle, the muscle of the shoulder. So on the exam, I'll have like a number up here, and tell you what is this muscle, and you say that's the deltoid.

Then I'm going to ask you, this big muscle in your chest, that's the pectoralis. The pectoralis is the muscle. Then you have muscles around your lips.

That's the orvecularis. Orvecularis oris. Around your eyes, orvecularis oculi.

Then your kneecap has a muscle in the middle known as the rectus femoris. And then there's this muscle that is the helicob, known as the subtoid muscle. And the biceps, everybody knows these are biceps.

If you want to have a point, say biceps. But these are actually biceps brachii. That's a full point.

Biceps brachii. On the bottom, these are your triceps brachii. Knowing where they are and how to spell them.

Biceps. Reiki eye biceps triceps vibration, reiki You don't need to know all of this. This is just for you to know, but you might have to be tested on it.

You see these are the muscles. These ones you gotta know. What is happening?

There are muscles around the eye known as the orbecularis oculi. Orbecularis oculi. Muscles around the lips known as the orbecularis oris.

So on the exam... What's the muscle around the lip? Orbicularis.

Oris. What's the muscle around the eye? Orbicularis. Ocular. What's this big triangle on the back?

Trapezius. You know the traps. That's the gym bro.

The deltoid and the trap. But trapezius. The gym bro.

Okay. You know you did a assignment on this, the intercostal muscle. These are the muscles that increase exactly your rib cage, decrease your rib cage for breathing.

So when you take a deep breath, they expand your thoracic cage. These are your intercostal, your intercostal muscles. Alright, so what you need to know is this.

Everybody.

Transcript for:Understanding the Neuromusculoskeletal System

Transcript for:
Understanding the Neuromusculoskeletal System