The Muscular System

1.

For the terms 1-25 use the corresponding definitions a-y:

1.
2.
3.

actin
aponeurosis
bundle

4.
5.
6.

contract
creatine phosphate
endomysium

7.
8.
9.

epimysium
fibre
filament

10. glycogen
11. impulse
12.
13.
14.
15.
16.
17.
18.

ligament
mitosis
myoglobin
myology
myosin
neurotransmitter
perimysium

19. relax
20. sarcomere
21. smooth
22. stimulus
23. striation
24. tendon
25. troponin

a.
b.
c.

a filament in myofibril
a group of nerves running in the same direction
a muscle haemoglobin, which takes oxygen
from blood and passes it to the muscle
d. a series of ridges, furrows or linear marks
e. a store of energy-giving phosphate in muscles
f. a type of starch, converted from glucose by the
action of insulin, and stored in the liver as a
source of energy
g. become less tense
h. become smaller or tighter
i. chemical substance which transmits nerve
impulses from one neuron to another
j. complex of three regulatory proteins that is
integral to muscle contraction in skeletal and
cardiac muscle, but not smooth muscle
k. connective tissue around and between muscle
fibres
l. connective tissue binding striated muscle fibres
m. long thin structure like a thread
n. flat, not rough
o. layer of flat broad tendons
p. message transmitted by a nerve
q. protein found in muscle
r. sheath which surrounds a bundle of muscle
fibres
s. something which has an effect on a person or a
part of the body and makes them react
t. strip of connective tissue which attaches a
muscle to a bone
u. structure in the body shaped like a thread
v. the commonest protein in muscle cells,
responsible for the elastic and contractile
properties of muscle
w. the process of cell division, where the mother
cell divides into two identical daughter cells
x. the study of muscles and associated structures
and diseases
y. thick band of fibrous tissue which connects the
bones at a joint and forms the joint capsule

2.

For gaps 26-40 use ONE word only:

More than 600 skeletal muscles make 26. ...... the muscular system, and
technically each 27. ...... is an organ it is composed of skeletal muscle tissue, connective
tissue, and nervous tissue. Each muscle also has a particular function, 28. ...... as moving
a finger or blinking an eyelid. Collectively, the skeletal muscles account 29. ...... less than
half of the body weight. There are three kinds of muscle tissue: smooth, cardiac, and
skeletal muscle.
Smooth muscle makes up the walls 30. ...... the hollow body organs as well 31.
...... those of the blood vessels and respiratory passageways. It moves involuntarily and
produces the wavelike motions of peristalsis 32. ...... move substances through a system.
Smooth muscle 33. ...... also regulate the diameter of an opening, such as the central
opening of blood vessels, or produce contractions of hollow organs, such as the uterus.
Smooth muscle fibres are tapered 34. ...... each end and have a single, central nucleus.
The cells appear smooth under the microscope because they do not contain the visible
bands, or striations, that are seen in the other types of muscle cells. Smooth muscle may
contract in response 35. ...... a nerve impulse, hormonal stimulation, stretching, and other
stimuli. The muscle contracts and relaxes slowly and can remain contracted 36. ...... a
long time.
Cardiac muscle, also involuntary, makes up the wall of the heart and creates the
pulsing action of the organ. The cells of cardiac muscle are striated, 37. ...... those of
skeletal muscle. They differ 38. ...... having one nucleus per cell and branching
interconnections. The membranes between the cells are specialised to allow electrical
impulses to travel rapidly through them, so 39. ...... contractions can be better
coordinated. These membranes appear as dark lines between the cells and are called
intercalated disks, because they are inserted between the cells. The electrical impulses
that produce contractions of cardiac muscle are generated within the muscle 40. ...... but
can be modified by nervous stimuli and hormones.
3.

For gaps 41-55 make a new word from the one in brackets whish fits in the gap:

When viewed under the microscope, skeletal muscle cells appear 41. ......
(HEAVY) striated. The cells are very long and 42. ...... (CYLINDER) and have multiple
nuclei per cell. During 43. ...... (DEVELOP), the nuclei of these cells divide 44. ......
(REPEAT) by mitosis without division of the cell contents, resulting in a large,
multinucleated cell. Such cells can contract as a large unit when stimulated. The nervous
system stimulates skeletal muscle to contract, and the tissue usually contracts and relaxes
45. ...... (RAPID). Because it is under conscious control, skeletal muscle is described as
voluntary.
Skeletal muscle is named this way because most of these muscles are attached to
bones and produce 46. ...... (MOVE) at the joints. There are a few 47. ...... (EXCEPT). The
1

The Muscular System

muscles of the 48. ...... (ABDOMEN) wall, for example, are partly attached to other muscles,
and the muscles of 49. ...... (FACE) expression are attached to the skin. Skeletal muscles
constitute the largest amount of the bodys muscle tissue, making up about 40% of the total
body weight. Although each muscle is a distinct structure, muscles usually act in groups to
execute body movements. The three primary functions of skeletal muscles are:
- movement of the skeleton: muscles are attached to bones and contract to change the
position of the bones at a joint
- 50. ...... (MAINTAIN) of posture: a steady 51. ...... (PART) contraction of muscle,
known as muscle tone, keeps the body in position. Some of the muscles involved in
maintaining posture are the large muscles of the thighs, back, neck, and shoulders as
well as the abdominal muscles.
- 52. ...... (GENERATE) of heat: muscles generate most of the heat needed to keep the
body at 37 C. Heat is a natural by-product of muscle cell metabolism. When we are
cold, muscles can boost their heat 53. ...... (PUT) by the rapid small contractions we
know of as shivering.
In forming whole muscles, individual muscle fibres are arranged in bundles, or
fascicles, held together by 54. ...... (FIBRE) connective tissue. The deepest layer of
this connective tissue, the endomysium surrounds the individual fibres in the fascicles.
Around each fascicle is a connective tissue layer known as the perimysium. The entire
muscle is then encased in a tough connective tissue sheath, the epimysium, which
forms the 55. ...... (INNER) layer of the deep fascia, the tough, fibrous sheath that
encloses a muscle.
All of these supporting tissues merge to form the tendon, the band of
connective tissue that attaches a muscle to a bone.
4.

For gaps 56-65 choose the best variant A, B, C or D:

The following 56. ...... properties characterise all muscle tissue:

a. Irritability. Muscle tissue is 57. ...... to stimuli from nerve impulses.
b. Contractility. Muscle tissue responds to stimuli by contracting
lengthwise, or shortening.
c. Extensibility. Once a stimulus has subsided and the fibres within
muscle tissue are 58. ...... , they may be stretched even beyond their resting length
by the contraction of an opposing muscle. The fibres are then prepared for another
59. ...... .
d. Elasticity. Muscle fibres, after being stretched, have a tendency to
recoil to their original resting length.
Muscles are usually described in groups according to anatomical 60. ...... and
cooperative function. The muscles of the axial skeleton include the facial muscles, neck
muscles, and anterior and posterior 61. ...... muscles. The muscles of the appendicular
skeleton include those that act on the pectoral and pelvic girdles and those that move limb
joints.

Nerve impulses coming from the brain and the spinal cord 62. ...... skeletal
muscle fibres. Because these impulses are travelling away from the central nervous
system, they are described as motor impulses, as contrasted to sensory impulses travelling
toward the CNS, and the neurons that 63. ...... these impulses are described as motor
neurons. As the neuron contacts the muscle, its axon (fibre) branches to 64. ...... from a
few to hundreds of individual muscle cells, or in some cases more than one thousand.
A single neuron and all the muscle fibres it stimulates comprise a motor unit.
Small motor units are used in fine 65. ...... , as in movements of the eye. Larger motor
units are used for maintaining posture or for broad movements, such as walking or
swinging a tennis racquet.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
5.

A.
A.
A.
A.
A.
A.
A.
A.
A.
A.

critical
sensitive
cool
reduction
site
stem
stimulate
hold
give
coordination

B.
B.
B.
B.
B.
B.
B.
B.
B.
B.

basis
sensible
tranquil
contraction
situation
trunk
rouse
take
contribute
harmonisation

C.
C.
C.
C.
C.
C.
C.
C.
C.
C.

basic
aware
comfortable
tightening
condition
stalk
inspire
carry
supply
organisation

D.
D.
D.
D.
D.
D.
D.
D.
D.
D.

root
observant
relaxed
retrenchment
location
shaft
arouse
seize
furnish
management

Use the words in the box to fill in gaps 66-75. There are five words that you do
not need to use:
actin
excitability
impulse
receptors

body
fibre
junction
region

cleft
filament
neuron
synapse

endomysium
folds
phosphate

The point at which a nerve fibre contacts a muscle cell is called the
neuromuscular 66. ...... . It is here that a chemical classified as a neurotransmitter is
released from the 67. ...... to stimulate the muscle fibre. The specific neurotransmitter
released here is acetylcholine which is found elsewhere in the 68. ...... as well. The
neuromuscular junction is an example of a 69. ...... , a point of communication
between cells. Between the cells there is a tiny space, the synaptic 70. ...... , across which
the neurotransmitter must travel.
Until its release, the neurotransmitter is stored in tiny membranous sacs, called
vesicles, in the endings of the nerve 71. ...... . Once released, the neurotransmitter crosses
the synaptic cleft and attaches to 72. ...... , which are proteins embedded in the muscle cell
membrane. The membrane forms multiple 73. ...... at this point that increase surface area
and hold a maximum number of receptors. The receiving membrane of the muscle cell is
2

The Muscular System

known as the motor end plate. Muscle fibres, like nerve cells, show the property of 74.
...... , that is, they are able to transmit electrical current along the plasma membrane.
When the muscle is stimulated at the neuromuscular junction, an electrical 75. ...... is
generated that spreads rapidly along the muscle cell membrane. This spreading wave of
electrical current is called the action potential because it calls the muscle cell into action.
6.

For gaps 76-85 choose the correct ending A-J:

Another important property of muscle tissue is contractility. This is the capacity

of a muscle fibre 76. ...... . Each skeletal muscle fibre contains many threads, or filaments,
made of two kinds of proteins, called actin and myosin. Filaments made of actin are thin
and light; those made of myosin are thick and dark. The filaments are present in
alternating bundles within the muscle cell. It is the alternating bands of light actin and
heavy myosin filaments 77. ...... . They also give a view of what occurs when muscles
contract.
The actin and myosin filaments overlap where they meet. A contracting subunit of
skeletal muscle is called a sarcomere. It consists of a band of myosin filaments 78. ...... . In
movement, the myosin filaments hold onto the actin filaments in their overlapping region
by means of many paddle-like extensions called myosin heads. In this way, the myosin
heads form attachments between the actin and myosin filaments 79. ...... . Using the energy
of ATP for repeated movements, the myosin heads, pull all the actin strands closer together
within each sarcomere. As the overlapping filaments slide together, the muscle fibre
contracts becoming shorter and thicker. Once the cross-bridges form, the myosin heads
move the actin filaments forward, then they detach 80. ...... . The filaments overlap
increasingly as the cell contracts. Not all the myosin heads are moving at the same time,
about one half are forward at any time 81. ...... . During contraction, each sarcomere
becomes shorter, but the individual filaments do not change in length.
In additional to actin, myosin, and ATP, calcium is needed for muscle
contraction. It enables cross-bridges 82. ...... . When muscles are at rest, two additional
proteins called troponin and tropomyosin block the sites on actin filaments where crossbridges can form. When calcium attaches 83. ...... . In resting muscles, the calcium is not
available because it is stored within the endoplasmic reticulum (ER) of the muscle cell. It
is released into the cytoplasm only when the cell is stimulated by a nerve fibre. Muscles
relax when nervous stimulation stops 84. ...... .
All muscle contraction requires energy in the form of ATP. The source of this
energy is the oxidation (commonly called burning) of nutrients within the cells. Muscle
contraction actually occurs at a microscopic level within the sarcomeres working parts:
the thick and thin filaments. Thick filaments are composed of many myosin molecules,
each shaped like two golf clubs twisted together with the myosin heads projecting away
from the sarcomeres centre. Each myosin head can bind ATP 85. ...... . The chemical
energy released during this reaction charges the myosin head, enabling it to do work.

A.
B.
C.
D.
E.
F.
G.
H.
I.
J.

and convert it into ADP and a phosphate molecule, which remain bound
and move back to position for another power stroke
and the actin filaments on each side of them
and the calcium is then pumped back into the ER, ready for the next contraction
and the rest are preparing for another swing
that are described as cross-bridges
that give skeletal muscle its striated appearance
to form between actin and myosin so the sliding filament action can begin
to these proteins, they move aside, uncovering the binding sites
to undergo shortening and to change its shape, becoming thicker

7.

Use a word for each set 86-90 to fill in the gaps:

86. When calcium shifts troponin and tropomyosin away from the binding sites, the
following cycle of events occurs:
1. The charged myosin ...... attach to the actin molecules and form cross-bridges
between the thick and thin filaments.
2. Using their stored energy, the myosin ...... pull the thin filaments to the centre of
the sarcomere, releasing the ADP and phosphate molecules.
3. New ATP molecules bind to the myosin ...... , causing them to detach from actin
and breaking the cross-bridges.
4. The myosin ...... convert ATP into ADP and phosphate, which recharges them.
87. To produce ATP, muscle cells must have an adequate supply of oxygen and ...... or other
usable nutrient. The circulating blood constantly brings these substances to the cells, but
muscle cells also store a small reserve supply of each to be used when needed, during
vigorous exercise, for example. The following are compounds that store oxygen, energy,
or nutrients in muscle cells:
- myoglobin stores additional oxygen. This compound is similar to the bloods
haemoglobin but is located specifically in muscle cells.
- glycogen stores additional ...... . It is a polysaccharide made of multiple ...... molecules
and it can be broken down into ...... when needed by the muscle cells.
- creatine phosphate stores energy. It is a compound similar to ATP, in that it has a high
energy bond that releases energy when it is broken. This energy is used to make ATP
for muscle contraction when the muscle cell has used up its ATP.
88. During most activities of daily life, the tissues receive adequate ...... , and muscles
can function aerobically. During strenuous activity, however, a person may not be
able to breathe in ...... rapidly enough to meet the needs of the hardworking muscles.
At first, the myoglobin, glycogen, and creatine phosphate stored in the tissues meet
the increased demands, but continual exercise depletes these stores. For a short time,
glucose may be used anaerobically, that is, without the benefit of ...... . This
anaerobic process generates ATP rapidly and permits greater magnitude of activity
3

The Muscular System

than would otherwise be possible. However, anaerobic metabolism is inefficient; it
does not produce as much ATP as does metabolism in the presence of ...... .
89. Also, an organic ...... called lactic ...... accumulates in the cells when this alternate
pathway of metabolism is used. Anaerobic metabolism can continue only until the
build-up of lactic ...... causes the muscles to fatigue. Muscles operating
anaerobically are in a state of oxygen debt. After stopping exercise, a person must
continue to take in extra oxygen by continued rapid breathing until the debt is paid
in full. That is, enough oxygen must be taken in to convert the lactic ...... to other
substances that can be metabolised further. In addition, the glycogen, myoglobin,
and creatine phosphate that are stored in the cells must be replenished. The time
after strenuous exercise during which extra oxygen is needed is known as the period
of recovery oxygen consumption.
90. Regular ...... results in a number of changes in muscle tissue. These changes
correspond to the three components of ...... : stretching, aerobics, and resistance
training. When muscles are stretched, they contract more forcefully, as the internal
filaments can interact over a greater length. Stretching also helps with balance and
promotes flexibility at the joints. Aerobic ...... , ...... that increases oxygen
consumption, such as running, biking, or swimming, leads to improved endurance.
Resistance training, such as weight lifting, causes muscle cells to increase in size, a
condition known as hypertrophy. This change can be seen in the enlarged muscles
of body-builders.
8.

For gaps 91-100 make a new word from the one given in brackets:

Some of the changes in muscle tissue that lead to improved 91. ...... (ENDURE)
and strength include:
- increase in the number of capillaries in the muscle tissue, which brings more
blood to the cells
- increase in the number of mitochondria to increase 92. ...... of ATP
- increase in reserves of myoglobin, glycogen, and creatine phosphate to promote
endurance
An exercise program should include all three methods stretching, aerobic
exercise, and 93. ...... (RESIST) training with periods of warm-up and cool-down before
and after working out.
In addition to affecting muscle tissue itself, exercise causes some 94. ......
changes. The vasodilatation that occurs during exercise allows blood to flow more easily
to muscle tissue. With continued work, more blood is pumped back to the heart. The 95.
...... (TEMPORARY) increased load on the heart 96. ...... (STRONG) the heart muscle
and improves its 97. ...... (CIRCULATE). With exercise training, the chambers of the
heart gradually enlarge to accommodate more blood. The resting heart rate of a trained
athlete is lower than the average rate because the heart can function more efficiently.
Regular exercise also improves breathing and respiratory efficiency. Circulation in the

capillaries surrounding the alveoli is increased, and this brings about enhanced gas
exchange. The more efficient 98. ...... (DISTRIBUTE) and use of oxygen delays the onset
of oxygen debt. Even moderate regular exercise has the 99. ...... (ADD) benefits of weight
control, 100. ...... (STRONG) of the bones, decreased blood pressure, and decreased risk
of heart attacks.
9.

Use ONE word for each gap 101-115:

Most muscles have two or more points 101. ...... attachment to the skeleton. The
muscle is attached to a bone 102. ...... each end by means of a cordlike extension called a
tendon. All of the connective tissue within and around the muscle merges 103. ...... form
the tendon, which then attaches directly 104. ...... the periosteum of the bone. 105. ......
some instances, a broad sheet called an aponeurosis may attach muscles to bones or to
other muscles. In moving the bones, 106. ...... end of a muscle is attached to a more freely
movable part of the skeleton, and the other end is attached to a relatively stable part. The
less movable attachment is called the origin; the attachment to the part of the body that
the muscle puts 107. ...... action is called the insertion. When a muscle contracts, it pulls
on both points of attachment, bringing the more movable insertion closer 108. ...... the
origin and thereby causing movement of the body part.
Many of the skeletal muscles function 109. ...... pairs. A movement is performed
by a muscle called the prime mover; the muscle that produces an opposite movement 110.
...... that of the prime mover is known 111. ...... the antagonist. Clearly, for 112. ...... given
movement, the antagonist must relax when the prime mover contracts. For example,
when the biceps brachii at the front of the arm contracts 113. ...... flex the arm, the triceps
brachii at the back must relax; when the triceps brachii contracts to extend the arm, the
biceps brachii must relax. In addition to prime movers and antagonists, 114. ...... are also
muscles that serve to steady body parts or to assist prime movers. These aiding muscles
are called synergists, because they work with the prime movers to accomplish a
movement.
As the muscles work together, body movements are coordinated, and a large
number of complicated movements can be carried 115. ...... .
10. For gaps 116-125 use the words in the box:
action
grouping

different
location
shape

direction
named
size

feature
number

The study of muscles is made simpler by 116. ...... them according to body
regions. Knowing how muscles are 117. ...... can also help in remembering them. A
number of 118. ...... characteristics are used in naming muscles, including the following:
4

The Muscular System

-

119. ...... , named for a nearby bone, for example, or for position, such as lateral,
medial, internal, or external
120. ...... , using terms such as maximus, major, minor, longus, brevis
121. ...... , such as circular (orbicularis), triangular (deltoid), trapezoid
(trapezius)
122. ...... of fibres, including straight (rectus) or angled (oblique)
123. ...... of heads (attachment points) as indicated by the suffix -ceps, as in
biceps, triceps, quadriceps
124. ...... , as in flexor, extensor, adductor, abductor, levator.
Often, more than one 125. ...... is used in naming.

11. For gaps 126-140 make a new word from the one in capitals:
The formation of skeletal muscle tissue begins during the fourth week of 126.
...... (EMBRYO) development as specialised 127. ...... (MESODERM) cells called
myoblasts begin rapid mitotic division. The 128. ...... (PROLIFERATE) of new cells
continues while the myoblasts migrate and fuse together into syncytial myotubes. A
syncytium is a multinucleated protoplasmic mass formed by the union of originally
separate cells. At 9 weeks, primitive myofilaments course through the myotubes, and the
nuclei of the 129. ...... (CONTRIBUTE) myoblasts are centrally located. Growth in length
continues through the addition of myoblasts. The process of muscle fibre development
occurs within specialised mesodermal masses called myotomes in the embryonic trunk
area and from 130. ...... (LOOSE) organised masses of mesoderm in the head and
appendage areas. At 6 weeks, the trunk of an embryo is segmented into distinct
myotomes that are associated 131. ...... (DORSAL) with specific sclerotomes, paired
masses of 132. ...... (MESENCHYME) tissue that give rise to vertebrae and ribs. Spinal
nerves arise from the spinal cord and exit between vertebrae to innervate developing
muscles in the adjacent myotomes.
As myotomes develop, additional myoblasts migrate 133. ...... (VENTRAL),
toward the midline of the body, or distally, into the developing limbs. The muscles of the
entire muscular system have been differentiated and correctly positioned by the eighth
week. The orientation of the developing muscles is preceded and influenced by 134. ......
(CARTILAGE) models of bones. It is not certain when skeletal muscle is sufficiently
developed to sustain contractions, but by week 17 the foetal movements known as 135.
...... (QUICK) are strong enough to be recognised by the mother.
The individual muscle fibres have now thickened, the nuclei have moved 136.
...... (PERIPHERY), and the filaments (myofilaments) can be recognised as alternating
dark and light bands. Growth in length still continues through addition of myoblasts.
Shortly before a baby is born, the formation of myoblast cells ceases, and all of the
muscle cells have been determined. Differences in strength, endurance, and coordination
are somewhat 137. ...... (GENE) determined but are primarily the result of individual
body conditioning. Muscle coordination is an 138. ...... (GO) process of achieving a fine

139. ...... (NEURON) control of muscle fibres. 140. ...... (MASTER) of muscle movement
is comparatively slow in humans. Although innervations and muscle contraction occur
early during foetal development, it is several months before a human infant has the
coordination to crawl, and about a year before it can stand or walk.
12. The words in italics 141-155 have been swapped. Use them in their correct
position:
Muscles of the upper extremities include the muscles that determine the 141.

surface of the shoulder, the anterior and posterior muscles that move the arm, and the
muscles that move the 142. chest and hand. The position of the shoulder depends to a
large 143. movement on the degree of contraction of the trapezius, a triangular muscle

that covers the posterior neck and extends across the posterior shoulder to insert on the
clavicle and 144. region. The trapezius muscles enable one to raise the shoulders and pull
them back. The upper portion of each trapezius can also extend the head and turn it from
side to side.
The latissimus dorsi is the wide muscle of the back and lateral 145. injection. It
originates from the vertebral 146. arm in the middle and lower back and covers the lower
half of the thoracic 147. trunk, forming the posterior portion of the axilla. The fibres of
each muscle converge to a tendon that inserts on the humerus. The latissimus dorsi
powerfully extends the 148. extent, bringing it down forcibly. A large pectoralis major is
located on either side of the superior part of the 149. position. This muscle arises from the
sternum, the upper ribs, and the clavicle and forms the anterior wall of the 150. cuff, or
axilla; it inserts on the superior part of the humerus. The pectoralis major flexes and
adducts the arm, pulling it across the chest.
The serratus anterior is below the axilla, on the lateral part of the chest. It
originates on the upper eight or nine 151. scapula on the lateral and anterior thorax and
inserts in the scapula on the side toward the vertebrae. The serratus anterior moves the
scapula forward. It also aids in raising the arm above the horizontal level.
The deltoid covers the shoulder joint and is responsible for the roundness of the
upper part of the arm just inferior to the shoulder. This muscle is named for its triangular
shape, which resembles the Greek letter delta. The deltoid is often used as an 152. armpit
site. Arising from the shoulder girdle (clavicle and scapula), the deltoid fibres converge to
insert on the lateral 153. forearm of the humerus. Contraction of this muscle abducts the
arm, raising it laterally to the horizontal position.
The shoulder joint allows for a very wide range of 154. spine. This freedom of
movement is possible because the humerus fits into a shallow socket, the glenoid cavity
of the scapula. This joint requires the support of four deep muscles and their tendons,
which compose the rotator 155. ribs. The four muscles are the supraspinatus,
infraspinatus, teres minor, and subscapularis, known together as SITS, based on the first
letters of their names.
5

The Muscular System

13. For gaps 156-170 choose the correct variant:
The tongue is a very 156. ...... organ. Both intrinsic and extrinsic muscle groups
are 157. ...... for its complex movements. The intrinsic muscles consist of 158. ......
numbers of vertical muscles that extend from the superior to inferior side of the tongue,
transverse muscles that extend from left to right, and longitudinal muscles that extend
from root to tip. The extrinsic muscles 159. ...... the tongue to other structures in the head
and neck. These 160. ...... the genioglossus, hyoglossus, styloglossus, and palatoglossus.
The tongue and buccinator muscle 161. ...... food into position between the molars for
chewing, and the tongue later forces the chewed food into the pharynx for swallowing.
There are four paired muscles of mastication: the temporalis, masseter, and medial and
lateral pterygoids.
The temporalis is a broad, fan-shaped muscle that 162. ...... from the temporal
lines of the skull, passes behind the zygomatic arch, and inserts on the coronoid process
of the mandible. The masseter is shorter and 163. ...... to the temporalis, arising from the
zygomatic 164. ...... and inserting on the lateral surface of the angle of the mandible. It is
a thick muscle easily palpated on the side of the jaw. The temporalis and masseter 165.
...... the mandible to bite and chew food; they are two of the most powerful muscles in the
body. Similar action is provided by the medial and lateral pterygoids. They arise from the
pterygoid processes of the sphenoid bone and 166. ...... on the medial surface of the
mandible. The pterygoids elevate and protract the mandible and produce the lateral
excursions used to 167. ...... food between the molars. Many of the actions of chewing
and swallowing are aided by eight pairs of hyoid muscles associated with the hyoid bone.
Four of them, superior to the hyoid, form the suprahyoid group the digastric,
geniohyoid, mylohyoid, and stylohyoid. Those 168. ...... to the hyoid form the infrahyoid
group the thyrohyoid, omohyoid, sternohyoid, and sternothyroid.
The digastric arises from the mastoid process and thickens into a posterior belly
beneath the 169. of the mandible. It then narrows, passes through a connective
tissue loop attached to the hyoid bone, widens into an anterior belly, and attaches to the
mandible near the protuberance. When it contracts, it pulls on the sling and elevates the
hyoid bone. When the hyoid is fixed by the infrahyoid muscles, however, the digastric
muscle opens the mouth. The mouth normally drops open by itself when the temporalis
and masseter muscles are relaxed, but the digastric, platysma, and mylohyoid can open it
more 170. .
156.
157.
158.
159.
160.
161.
162.
163.

A.
A.
A.
A.
A.
A.
A.
A.

agile
liable
inconsistent
fix
include
swing
occurs
external

B.
B.
B.
B.
B.
B.
B.
B.

responsive
answerable
incoherent
connect
embrace
shift
arises
apparent

C.
C.
C.
C.
C.
C.
C.
C.

swift
responsible
variable
tie
incorporate
swirl
happens
superficial

164.
165.
166.
167.
168.
169.
170.

A.
A.
A.
A.
A.
A.
A.

arch
bump
add
grind
mediocre
fringe
widely

B.
B.
B.
B.
B.
B.
B.

semicircle
rise
insert
mill
poorer
periphery
generally

C.
C.
C.
C.
C.
C.
C.

bow
elevate
slot
grate
inferior
margin
broadly

14. Use ONE word to fill in gaps 171-180:

The geniohyoid protracts the hyoid 171. widen the pharynx when food 172.
swallowed. The mylohyoid muscles fuse 173. the midline, form the floor of
the mouth, and work synergistically 174. the digastric to forcibly open the mouth.
The stylohyoid, named for 175. origin and insertion, elevates the hyoid bone. When
food enters the pharynx, the superior, middle, and inferior pharyngeal constrictors
contract 176. that order and force the food downward, into the esophagus. The
thyrohyoid, named for the hyoid bone and large thyroid cartilage of the larynx, helps to
prevent choking. It elevates the thyroid cartilage so 177. the larynx becomes sealed
178. a flap of tissue, the epiglottis. The sternothyroid then pulls the larynx down
again. These infrahyoid muscles 179. ...... act on the larynx are called the extrinsic
muscles of the larynx. The larynx also has intrinsic muscles, which are concerned 180.
...... control of the vocal cords and laryngeal opening.
15. Use the words in the box to fill in gaps 181-190. There are five unnecessary
words:
allow
converge
enclose
mean

apply
draws
fix
promote

contain
expel
flex
relax

contract
extend
maintain

People breathe primarily by means of muscles that 181. ...... the thoracic cavity
the diaphragm, which forms its floor; 11 pairs of external intercostal muscles, which lie
superficially between the ribs; and 11 pairs of internal intercostals muscles between the
ribs deep to the external intercostals. The lungs themselves 182. ...... no skeletal muscle;
they do not play an active part in their own ventilation. The diaphragm is a muscular
dome between the abdominal and thoracic cavities. It has openings that 183. ...... passage
of the oesophagus and major blood vessels. Its fascicles 184. ...... from the margins
toward a fibrous central tendon. When the diaphragm contracts, it flattens slightly,
increasing the volume of the thoracic cage and creating a partial vacuum that 185. ...... air
6

The Muscular System

into the lungs. Its contraction also raises pressure in the abdominal cavity below, thus
helping to 186. ...... the contents of the bladder and rectum.
The external intercostals extend obliquely downward and anteriorly from each
rib to the rib below it. When the scalenes 187. ...... the first rib, the external intercostals
lift the others, pulling them. This action pulls the ribs closer together and draws the entire
rib cage upward and outward, expanding the thoracic cage and promoting inhalation.
When the diaphragm and external intercostals 188. ...... , the thoracic cage springs back to
its prior size and expels the air. The only muscular effort normally expended in exhaling
is for the inspiratory muscles to 189. ...... partial tension and exert a braking action, so
exhalation is smooth and not explosive. However, forced expiration, exhaling more than
the usual amount of air or exhaling, is achieved mainly by the internal intercostals. These
also 190. ...... from one rib to the next, but they lie deep to the external intercostals and
have fascicles at right angles to them. The abdominal muscles also aid in forced
expiration by pushing the viscera up against the diaphragm.
16. For parts A-J find the correct place 191-200:
The wall of the abdomen has three layers of muscle 191. ...... . They are the
external oblique on the outside, the internal oblique in the middle, and the transversus
abdominis, the innermost. The connective tissue from these muscles extends forward and
encloses the vertical rectus abdominis of the anterior abdominal wall. The fibres of these
muscles, as well as their connective tissue extensions (aponeuroses), run in different
directions, resulting in a strong abdominal wall. The midline meeting of the aponeuroses
forms a whitish area called the linea alba, 192. ...... . It extends from the tip of the sternum
to the pubic joint. These four pairs of abdominal muscles act together to protect the
internal organs and compress the abdominal cavity as in coughing, emptying the bladder
and bowel, sneezing, vomiting, and childbirth. The two oblique muscles and the rectus
abdominis help bend the trunk forward and sideways.
The pelvic floor, or perineum, has its own form of diaphragm, shaped somewhat
like a shallow dish. One of the principal muscles of this pelvic diaphragm is the levator
ani, 193. ...... . The deep muscles of the back, 194. ...... , are thick vertical masses 195.
...... . The erector spinae muscles make up a large group located between the sacrum and
the skull. These muscles extend the spine and maintain the vertebral column in an erect
posture. The muscles can be strained in lifting heavy objects if the spine is flexed while
lifting. One should bend at the hip and knee instead and use the thigh and buttock
muscles to help in lifting. Deeper muscles in the lumbar area extend the vertebral column
in that region.
The gluteus maximus, 196. ...... , is relatively large in humans because of its
support function when a person is standing in the erect position. This muscle extends the
thigh and is important in walking and running. The gluteus medius, 197. ...... , abducts
the thigh. It is one of the sites used for intramuscular injections.

The iliopsoas arises from the ilium and the bodies of the lumbar vertebrae; it
crosses the anterior of the hip joint to insert on the femur. It is a powerful flexor of the
thigh 198. ...... . The adductor muscles are located on the medial part of the thigh. They
arise from the pubis and ischium and insert on the femur. These strong muscles press the
thighs together. They include the adductor longus and adductor magnus.
The sartorius is a long, narrow muscle 199. ...... . The hamstring muscles are
located in the posterior part of the thigh. Their tendons can be felt behind the knee as they
descend to insert on the tibia and fibula. The hamstrings flex the leg on the thigh, as in
kneeling. Individually, moving from lateral to medial position, they are the biceps
femoris, the semimembranosus, and the semitendinosus. The name of this muscle group
refers to the tendons at the back of the knee by 200. ...... .
A. that begins at the iliac spine, winds downward and inward across the entire
thigh, and ends on the upper medial surface of the tibia
B. that extend from the back and around the sides to the front
C. that lie under the trapezius and latissimus dorsi
D. which act on the vertebral column itself
E. which acts on the rectum and thus aids in defecation
F. which forms much of the fleshy part of the buttock
G. which helps keep the trunk from falling backward when one is standing erect
H. which is an important landmark on the abdomen
I. which is partially covered by the gluteus maximus
J. which these muscles insert on the leg

17. Use ONE word to fill in gaps 201-225:

Muscular dystrophy 201. ...... a group of disorders in which 202. ...... is
deterioration of muscles that still have intact nerve function. These disorders all progress
203. ...... different rates. The most common type, 204. ...... is found most frequently in
male children, causes weakness and paralysis. Death is 205. ...... to weakness of the
cardiac muscle or paralysis of the respiratory muscles. Life expectancy is about 20 years
206. ...... the most common type of muscular dystrophy, and about 40 years for the other
types. Progress toward definitive treatment for some forms of the disease may 207. ......
possible now that the genetic defects that cause them 208. ...... been identified.
Myasthenia gravis is characterised 209. ...... chronic muscular fatigue brought on
by the slightest exertion. It affects adults and begins with the muscles of the head.
Drooping of the eyelids is a common early symptom. This disease is caused by 210. ......
defect in transmission at the neuromuscular junction.
Myalgia means muscular pain; myositis is a term 211. ...... indicates actual
inflammation of muscle tissue. Fibrositis means inflammation of connective tissues and
refers particularly to 212. ...... tissues associated with muscles and joints. Usually, these
7

The Muscular System

disorders appear in combination as fibromyositis, which may be acute, with severe pain
213. ...... motion, or may be chronic. Sometimes, the application of heat, together with
massage and rest, relieves the symptoms.
Fibromyalgia syndrome is associated with widespread muscle aches, tenderness,
and stiffness along 214. ...... fatigue and sleep disorders. Fibromyalgia is difficult to
diagnose, and there is 215. ...... known cause, but it may be an autoimmune disease, in
which the immune system reacts to 216. ...... own tissues. Treatment may include a
controlled exercise programme and treatment with pain relievers, muscle relaxants, or
antidepressants.
Bursitis is the inflammation of a bursa, a fluid-filled sac that minimises friction
217. ...... tissues and bone. Some bursae communicate 218. ...... joints; others are closely
related 219. ...... muscles. Sometimes, bursae develop spontaneously 220. ...... response to
prolonged friction. Bursitis can be very painful, with swelling and limitation 221. ......
motion. There are different types of bursitis: olecranon bursitis, in which the bursa over
the point of the elbow (olecranon) is inflamed. Another name for the disorder is students
elbow, as 222. ...... can be caused by long hours of leaning 223. ...... the elbows while
studying; ischial bursitis, which is said to be common among people 224. ...... must sit for
long periods of time. In some cases a local anaesthetic, corticosteroids, or 225. ...... of
them may be injected to relieve the pain of bursitis.
18. For gaps 226-235 choose the best option A, B or C:
Bunions are 226. ...... commonly found at the base and medial side of the great
toe. Usually, 227. ...... pressure has caused the development of a bursa, which has then
become inflamed. Special shoes may be necessary if surgery is not 228. ...... .
Tendinitis, an inflammation of muscle tendons and their attachments, occurs
most often in athletes who 229. ...... themselves. It frequently involves the shoulder, the
hamstring muscle tendons at the knee, and the Achilles tendon near the heel.
Tenosynovitis, which involves the synovial sheath that 230. ...... tendons, is found most
often in women in their forties after an injury or surgery. It may involve swelling and
231. ...... pain with activity.
Shinsplints is experienced as pain and soreness along the tibia from stress injury
of structures in the leg. Some causes of shinsplints are tendinitis at the insertion of the
tibialis anterior muscle, sometimes with inflammation of the tibial periosteum, and even
stress 232. ...... of the tibia itself. Shinsplints commonly occurs in runners, especially
when they run on hard 233. ...... without adequate footwear.
Carpal tunnel syndrome involves the tendons of the flexor muscles of the fingers
as well as the nerves supplying the hand and fingers. Numbness and 234. ...... of the hand
is caused by pressure on the median nerve as it passes through a tunnel formed by the
carpal bones of the wrist. Carpal tunnel syndrome is one of the most common of the
repetitive-use disorders. It 235. ...... many workers who use their hands and fingers
strenuously, such as factory workers, keyboard operators, and musicians.

226.
227.
228.
229.
230.
231.
232.
233.
234.
235.

A.
A.
A.
A.
A.
A.
A.
A.
A.
A.

magnification
prolonged
performed
overestimate
attaches
cruel
fracture
exteriors
weakness
distresses

B.
B.
B.
B.
B.
B.
B.
B.
B.
B.

rise
delayed
achieved
overexert
includes
severe
breakage
surfaces
flaw
influences

C.
C.
C.
C.
C.
C.
C.
C.
C.
C.

enlargements
protracted
executed
overexcite
encloses
brutal
rupture
facades
failing
affects

19. Make a new word from the one in brackets to fill in gaps 236-250:
Rhabdomyolysis is a condition in which skeletal muscle is broken down or
basically destroyed. This condition can actually be fatal. Diagnosis is made by 236. ......
(ANALYSE) the results of lab tests that measure the amounts of certain substances in the
blood and urine. This condition may be a side effect of certain cholesterol-237. ......
(LOW) drugs called statins. Lying unconscious on a hard surface for an extended period
of time, infections, enzyme deficiencies, crush injuries and certain 238. ......
(METABOLISM) disorders can also cause rhabdomyolysis. Initial symptoms are
swelling and loss of use in the affected muscle group. This condition is 239. ......
(INITIAL) treated as a medical emergency, and the goal is to prevent acute renal failure,
a serious complication of rhabdomyolysis. Continued treatment involves correcting
imbalances and 240. ...... (HYDRATE) and treating any renal failure. The risk of
permanent muscle damage exists when treatment is delayed.
Polymyalgia rheumatica generally affects those over 50 years of age. It
manifests as 241. ...... (STIFF) and pain, typically in the shoulders, neck and thighs. No
true cause has yet been identified. It is 242. ...... (DIAGNOSIS) after other conditions
have been ruled out. Elevated 243. ...... (SEDIMENT) rate may be indicated in blood
tests. The symptoms tend to be controlled by oral 244. ...... (STEROID) medications such
as prednisone. The steroid dose may be 245. ...... (TEMPORARY) increased when there
is an increase in stiffness and 246. ...... (ACHE). Complications are related to adverse
effects of steroidal medication.
Mixed Connective Tissue Disease is thought to be an autoimmune condition.
Features of this condition resemble those of lupus, rheumatoid arthritis and scleroderma.
Common symptoms include pain, muscle weakness, swelling and 247. ...... (NUMB). It
appears to be 248. ...... (PROGRESS) in nature and can spread to other areas of the body.
This disease is more common in women but has been diagnosed in young children and
adults. A 249. ...... (DEFINITE) diagnosis is made when a specific antibody is discovered
in the blood and those antibodies 250. ...... (CHARACTER) of other autoimmune
conditions are absent. Typical treatment includes oral steroids.