Muscle Physiology and Contraction · USMLE Step 1

How does an increase in intracellular Ca²⁺ concentration lead to force generation in muscle fibers?

  1. By hyperpolarizing the muscle sarcolemma
  2. By directly increasing cellular ATP synthesis
  3. By shifting troponin–tropomyosin to expose actin's binding sites
  4. By fragmenting the thick myosin filaments
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Correct answer: By shifting troponin–tropomyosin to expose actin's binding sites

Elevated Ca²⁺ binds to troponin, shifting troponin–tropomyosin and unmasking actin binding sites; myosin heads can then bind actin and perform the power stroke, generating force.

Difficulty: Medium Question 17 of 20

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