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A voluntary contraction begins in the brain's frontal lobe and primary motor cortex, which activates an alpha motor neuron in the anterior horn of the spinal cord. The signal travels down a nerve to the muscle fiber, where action potentials terminate at the motor end plate, triggering acetylcholine release and initiating the contraction cascade.

Acetylcholine is a neurotransmitter released by the motor neuron at the motor end plate. It diffuses across the synaptic cleft and binds to receptors on the sarcolemma, increasing sodium ion permeability and generating action potentials that spread along the muscle fiber surface and into its interior through T-tubules.

Action potentials traveling through T-tubules trigger calcium ion release from the sarcoplasmic reticulum into the myofibrils. This calcium initiates actin-myosin crossbridge activity, which causes the muscle fiber to shorten and contract. The cross bridge cycle is the fundamental mechanism driving muscle contraction.

In myasthenia gravis, antibodies attack acetylcholine receptors, preventing neurotransmitter binding and blocking electrical signal transmission between motor neurons and muscle fibers. This impairs skeletal muscle contraction. Treatment involves drugs that inhibit acetylcholinesterase or suppress immune system antibody formation to restore muscle function.

Smooth muscles in internal organs are controlled by the autonomic nervous system and contract involuntarily. Contraction requires calcium to bind to calmodulin, which activates myosin light chain kinase. This phosphorylates myosin, allowing actin-myosin interaction, unlike the direct calcium-troponin mechanism in skeletal muscle.

Calcium enters smooth muscle cells through sarcolemma calcium channels or is released from the sarcoplasmic reticulum in response to neurotransmitter signals, hormones, or muscle stretching. Once inside, calcium binds to calmodulin, initiating the cascade that leads to muscle contraction through myosin phosphorylation.

Acetylcholinesterase breaks down acetylcholine at the motor end plate, preventing excessive muscle stimulation and allowing precise control of contraction. Without this enzyme activity, acetylcholine would accumulate in the synaptic cleft, causing uncontrolled muscle activation and loss of normal motor control and coordination.