Medical Physiology Muscular System Physiology

Excitation–Contraction Coupling

Topic overview

Start with the big picture

An action potential spreads along the sarcolemma and into T-tubules, where depolarization changes the conformation of DHPR voltage sensors. In skeletal muscle, DHPRs mechanically open nearby RyR1 channels; in cardiac muscle, calcium entering through DHPRs triggers further release through RyR2. The rise in cytosolic calcium allows calcium to bind troponin C, shifting tropomyosin and exposing actin’s myosin-binding sites. Myosin cross-bridge cycling then generates force. Relaxation follows as ATP-powered SERCA returns calcium to the sarcoplasmic reticulum, with other calcium-removal mechanisms contributing as well. The broader topic connects these steps to force, sustained stimulation, clinical conditions, pharmacology, and coupling latency.

Learning objectives

What you'll learn

  • Trace the sequence from sarcolemma depolarization to calcium release and muscle contraction.
  • Distinguish DHPR–RyR coupling in skeletal muscle from calcium-triggered release in cardiac muscle.
  • Explain how calcium binding to troponin C enables cross-bridge cycling.
  • Describe how SERCA and other calcium-removal mechanisms contribute to relaxation.
  • Relate calcium handling to force generation, tetanus, and malignant hyperthermia.
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