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A skinny, 22 year-old male visits the local medical clinic complaining of…

- - - - Since changing your weight in any many is equal parts diet and exercise the patient had the right idea of putting himself on a diet
        
        The issue with this particular vegan diet is he is not getting enough nutrients
        
        He is struggling to maintain weight and build muscle because he is not getting key nutrients like protein, calcium, vitamin D, and carbs
      - Skipping meals before his workouts is also inhibiting him from maintaining weight and gaining muscle
        
        During exercise the body first burns off ATP, then it burns simple sugars and then complex sugars
        
        Without having food in the system the body skips to burning fat reserves for energy during exercise
        
        This plan would be more ideal for someone who is trying to lose weight
      - Hie unwillingness to drink sports drinks also leads to his cramping
        
        Sports drinks have electrolytes one of which is sodium
        
        Sodium is needed in the body and helps the NaK pump function which assists in action potentials firing down the sarcolemma and without the pump functioning this process is slowed down
    - - The patient is on the right track with the commitment he is putting towards going to the gym
        
        Although, in order to gain muscle he should lean towards low rep high impact weight lifting so the muscles can tear and rebuild faster
        
        When used actively or strenuously, muscles may become larger or stronger, or more efficient and fatigue resistant
        
        Exercise gains are based on the overload principle.
        
        Forcing a muscle to work hard increases its strength and endurance. As muscles adapt to greater demand, they must be overloaded to produce further gains
        
        The patient should also focus on eccentric contractions that work against opposing forces
        
        His focus on cardio is good in the sense that its working on his heart health but doesn't need to be his focus
- - - - Like other organs, they have structures that range from the organ level all the way down to the chemical level
        
        There are 3 types of muscles
        
        2 of these are involuntary and 1 is voluntary
        
        The voluntary muscle type is skeletal muscle
        
        Organization of a skeletal muscle
        
        Muscle
        
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        Muscle fiber
        
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        Myofibril
        
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        Fascicle
        
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        Sarcomere
        
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        Myofilament
        
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        The 2 involuntary types are cardiac and smooth muscle
        
        Cardiac muscle is found only in the heart
        
        It is involuntary meaning it is only stimulated by the nervous system
        
        The function of cardiac muscle is to contract allowing it to pump blood
        
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        It is made up of striated cardiac muscle cells
        
        Smooth muscle consists of smooth muscle tissue
        
        Smooth muscle tissue
        
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      - The main functions of muscles
        
        Maintain posture and body position
        
        Muscles function continuously to pull against the force of gravity
        
        Stabilize joints
        
        Muscles strengthen and stabilize the joints of the skeleton
        
        Produce movement
        
        Smooth muscles move substances through the organs and along the tract
        
        Cardiac and smooth muscles work in tandem to move blood through the body
        
        Skeletal muscles are responsible for movement of the skeleton
        
        Generate heat
        
        Muscles generate heat when they contract
  - - - Excitation-contraction coupling is the sequence of events by which transmission of an action potential along the sarcolemma leads to the sliding filaments
        
        The change in shape opens the calcium release channels in the SR allowing the calcium to flow into the cytosol
        
        Calcium then binds to troposin and removes the blocking action of tropomyosin
        
        Transmission of the action potential causes the voltage-sensitive tubule proteins to change shape
        
        This begins contraction
        
        The action potential travels down along the sarcolemma and down the T tubules
        
        Myosin binding to actin forms cross bridges that contract
  - - - ATP stored in muscles is utilized early on in exercise
        
        This runs out very quickly so creatine phosphate and ADP are used to form more ATP
        
        Once this runs out complex sugars like glycogen are broken down and oxidized to generate ATP
        
        During prolonged exercise ATP is generated by utilizing the aerobic pathway
  - - - Fatigue involves alterations in excitation-contraction coupling and certain chemical changes like:
        
        Increased inorganic phosphate
        
        This interferes with the release of calcium from the SR
        
        It also interferes with the release of inorganic phosphate from myosin
        
        Decreased ATP and increased magnesium
        
        The change in levels of ATP and magnesium act on the proteins in the T tubule and decreases calcium release from the SR
        
        Decreased glycogen
        
        Decreased glycogen is a common cause of muscle fatigue
        
        Ionic imbalances
        
        Action potentials result in ionic changes across the cells
        
        This changes the membrane potential of the muscle cells
        
        Which reduces the size of the action potential
        
        Which reduces the movement of proteins in the T tubules and amount of calcium released from the SR