#separator:Tab
#html:false
#tags column:5
IMF-032-01-0001-en	Why can musculoskeletal disease arise from failures other than the contractile machinery?	Function depends on muscle, motor control, matrix, bone, cartilage, synovium, tendons, vessels and nerves, so failure of connective tissue, mineralisation, perfusion, innervation, immune tolerance or mechanical adaptation can all cause disease.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0002-en	How does a sarcomere shorten even though its filaments do not shorten?	Actin slides past myosin through repeated cross-bridge cycling, so the sarcomere shortens while the thin and thick filaments keep their own length.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0003-en	What does adenosine triphosphate do in the cross-bridge cycle, and what happens in its absence?	Its binding releases myosin from actin and its hydrolysis recocks the myosin head; without it, cross-bridges cannot release and remain attached.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0004-en	Why does muscle force fall with both excessive shortening and excessive stretch?	Force depends on actin and myosin overlap, and both extremes reduce the number of productive cross-bridges that can form.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0005-en	What functional trade-off distinguishes parallel from pennate fibre architecture?	Parallel fibres permit greater excursion and speed, whereas pennate fibres pack more contractile material into a given volume and generate greater force; physiological cross-sectional area predicts force better than visible bulk.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0006-en	How does tendon compliance change the link between fibre shortening and joint movement?	A compliant tendon temporarily stores elastic energy, so fibre shortening and joint movement are no longer in a fixed relation.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0007-en	How does a muscle action potential lead to cross-bridge cycling?	It spreads along sarcolemma and transverse tubules, where voltage-sensitive proteins activate ryanodine receptors to release calcium from sarcoplasmic reticulum; calcium binds troponin C and moves tropomyosin off actin sites.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0008-en	Why does rapid repeated stimulation increase force until tetanus occurs?	Each stimulus arrives before calcium pumps have fully returned calcium to sarcoplasmic reticulum, so force summates, and sufficiently rapid stimulation produces tetanus.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0009-en	Why do slow oxidative fibres resist fatigue while fast glycolytic fibres do not?	Slow oxidative fibres have abundant mitochondria, myoglobin and capillaries and produce lower force economically, whereas fast glycolytic fibres generate high power but fatigue rapidly.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0010-en	How do energy systems supply adenosine triphosphate as activity lengthens?	Stored adenosine triphosphate lasts only briefly, phosphocreatine buffers it rapidly, anaerobic glycolysis gives fast substrate-level phosphorylation, and oxidative phosphorylation supplies most energy in sustained activity.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0011-en	Why is lactate not merely waste, and why does it not explain delayed soreness after eccentric exercise?	Lactate is a transferable fuel and gluconeogenic substrate; delayed soreness after unfamiliar eccentric exercise reflects microinjury and inflammation rather than retained lactate.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0012-en	Why is muscle fatigue not a single mechanism?	It can arise from metabolite accumulation, substrate limitation, excitation-contraction changes, impaired transmission, reduced central drive, pain, heat or cardiorespiratory limitation.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0013-en	Why does the same muscle force produce different joint torque through the range of movement?	Moment arm and joint angle change mechanical advantage, so an identical muscle force yields different torque at different positions.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0014-en	How do resistance and endurance training differ in the adaptations they produce?	Resistance training first increases neural activation, then hypertrophy through protein synthesis and satellite cells; endurance training increases mitochondria, oxidative enzymes, capillaries and fuel handling, because adaptation is specific to demand.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0015-en	Why does rehabilitation use progressive loading early when it is safe?	Disuse rapidly reduces neural drive, fibre size, strength, oxidative capacity, tendon tolerance and bone loading, and bed rest also impairs cardiovascular and metabolic function.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0016-en	How do collagen and mineral divide the mechanical work of bone?	Collagen provides tensile toughness, while hydroxyapatite mineral provides compressive stiffness.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0017-en	How do osteoblast-lineage cells, osteocytes and osteoclasts cooperate in remodelling?	Osteoblast-lineage cells make osteoid and coordinate mineralisation, osteocytes sense strain and signal through canaliculi, and osteoclasts resorb; coupling resorption to formation repairs microdamage and adjusts architecture.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0018-en	Why does bone mass alone not fully determine fracture risk?	Strength also depends on geometry, microarchitecture and material quality and on accumulated damage, and fracture additionally depends on falls.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0019-en	What distinguishes primary fracture healing from healing through callus?	Callus healing passes from haematoma and soft callus to hard woven-bone callus and remodelling; primary healing occurs with little callus across rigidly compressed, anatomically reduced surfaces.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0020-en	How do collagen and proteoglycans divide load-bearing in articular cartilage?	Type-two collagen resists shear and maintains shape, while negatively charged proteoglycans attract water and resist compression; loading expresses fluid and unloading lets it recover.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0021-en	Why is cartilage repair limited, and why does prolonged immobilisation harm it?	Cartilage is avascular and fed mainly by synovial fluid, which movement circulates; prolonged immobilisation removes this and weakens multiple joint tissues.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0022-en	Why does rest without graded reloading often fail in tendinopathy?	Tendinopathy reflects disordered matrix and load response, not simple inflammation alone, and matrix, which adapts more slowly than muscle, gains stiffness and capacity through progressive loading.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0023-en	Why does joint flexibility alone not establish an inherited connective-tissue syndrome?	Inherited matrix defects produce variable combinations of hypermobility, skin fragility, vascular risk, eye disease, bone weakness and organ dysfunction, so phenotype and family history guide genetic evaluation.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending
IMF-032-01-0024-en	Why must examination separate loss of force from other causes of perceived weakness?	Failure at different levels, including pain inhibition, stiffness, instability, fatigue and poor coordination, can all feel like weakness while needing different management.	Integrated Medical Foundations; chapter 32, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: eab19f101b93674e8b3da2fa8c48b8f46de3f7564f9123c230dff969b2ed78a3; editorial review pending	imf lang::en chapter::032 module::032-01 review::pending