Muscle Physiology and Contraction · USMLE Step 1

In the absence of sufficient intracellular calcium, muscle contraction cannot proceed because:

  1. Myosin heads are unable to hydrolyze ATP
  2. ATP cannot bind to the myosin head
  3. Tropomyosin still blocks actin's myosin-binding sites
  4. The sarcoplasmic reticulum cannot refill with calcium
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Correct answer: Tropomyosin still blocks actin's myosin-binding sites

Without Ca²⁺, tropomyosin remains in a position that blocks myosin-binding sites on actin — preventing cross-bridge formation and thus muscle contraction.

Difficulty: Medium Question 5 of 20

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