Shoulder

Muscle Origin Insertion Innervation Actions

Latissimus Spinous processes of T7 to L5 and sacrum, Floor of intertubercular sulcus of Thoracodorsal nerve (C6 to C8) Extends, adducts, and medially rotates the humerus
Dorsi thoracolumbar fascia, iliac crest, ribs 10 to 12, and has a humerus
small slip of origin at the inferior angle
Teres Major Elongated oval area on the posterior surface of the Medial lip of intertubercular Inferior subscapular nerve (C5, Medial rotation and extension of the humerus at the glenohumeral
inferior angle (inferior aspect of the lateral border) of the sulcus on the anterior surface of C6, & C7) joint
scapula humerus
Deltoid Lateral 1/3 of anterior clavicle, lateral acromion, and Deltoid tuberosity Axillary nerve (C5 & C6) Abducts arm with supraspinatus till 15​○​ (​MF​), solo abduction till 90​○
inferior edge of the crest of the scapular spine (​MF​), flexion and medial rotation of the arm (​AF​), and extension and
lateral of the arm (​PF)​
Subclavius Superior border of the 1​st​ rib and its cartillage Inferior medial 1/3 surface of Nerve to subclavius (C5, C6) Pulls tip of shoulder (aromioclavicular joint) down, anchors and
clavicle depressed the clavicle, and pulls clavicle medially to stabilize
sternoclavicular joint
Serratus Lateral surfaces of upper 8-10 ribs (T1 to T8/T9/T10) Costal (anterior) surfaces of the Long thoracic nerve (C5, C6, & Protraction and rotation of the scapula and keeps the medial border
Anterior and deep fascia overlying the related intercostal spaces medial border of the scapula C7) and inferior angle of scapula opposed (attached) to the thoracic wall
Subscapularis Medial 2/3 of subscapular fossa Lesser tubercle of the humerus Superior and inferior subscapular Rotator cuff muscle, medial rotation and adduction of the arm at the
nerves (C5, C6, & C7) glenohumeral joint
Supraspinatus Medial 2/3 of supraspinous fossa and the deep fascia Superior facet of greater tubercle Suprascapular nerve (C5 & C6) Rotator cuff muscle and abduction of humerus to 15​○​ with deltoid
covering the muscle of humerus (​MF​)
Infraspinatus Medial 2/3 of infraspinous fossa and the deep fascia Middle facet on posterior surface Suprascapular nerve (C5 & C6) Rotator cuff muscle and lateral rotation of the humerus at the
covering the muscle of the greater tubercle of glenohumeral joint
humerus
Teres Minor Middle 1/3 to upper 2/3 of posterior lateral border of Inferior facet on the posterior of Axillary nerve (C5 & C6) Rotator cuff muscle and lateral rotation of the humerus at the
scapula greater tubercle of humerus glenohumeral joint

Superficial back

Muscle Origin Insertion Innervation Actions

Trapezius UF​: Superior nuchal line, external occipital Superior aspect of the lateral 1/3 of Motor: CN XI (Accessory nerve) Elevation of scapula (​UF​), scapular rotation, abduction of
protuberance clavicle, acromion, and scapular spine Sensory: Ventral rami C3 & C4 humerus above 90​○​, retract scapula (​MF​), and depress scapula
MF​: medial margin of the ligamentum nuchae (​LF​)
LF​: C7 to T12 and the related supraspinous ligament
Rhomboid Inferior aspect of ligamentum nuchae and spinous Posterior medial border of scapula at the Dorsal Scapular nerve (C4 & C5) Elevates and retracts the scapula, fixes scapula to the thoracic
Minor processes of C7 & T1 root of scapular spine wall, and rotates the scapula to depress the glenoid cavity
Rhomboid Spinous processes of T2-T5 and intervening Posterior medial border of scapula from Dorsal Scapular nerve (C4 & C5) Elevates and retracts the scapula, fixes scapula to the thoracic
Major supraspinous ligaments root of scapular spine to inferior angle wall, and rotates the scapula to depress the glenoid cavity
Levator Transverse processes of C1 & C2 and posterior Posterior medial border of scapula from Ventral rami of C3, C4, and dorsal Elevates the scapula medially, and inferiorly rotates the glenoid
Scapulae tubercles of transverse processes of C3 & C4 superior angle to root of scapular spine scapular nerve (C5) cavity

Pectoral region/axilla

Muscle Origin Insertion Innervation Actions

Pectoralis Clavicular head: anterior medial half of clavicle Lateral lip of intertubercular Medial and lateral pectoral nerves; Flexion, adduction, and medial rotation of arm at
Major Sternocostal head: anterior surface of sternum, T1-T7 costal sulcus on the anterior surface of Clavicular head (C5, C6); Sternocostal glenohumeral joint; Clavicular head: flexion of extended
cartillages, sternal end of T6, and aponeurosis of external oblique humerus head (C6-T1) arm; Sternoclavicular head: extension of flexed arm
Pectoralis Outer anterior surfaces of the superior border T3-T5 and deep Medial border of coracoid Medial and lateral pectoral nerves Protract scapula and lowers the lateral angle of scapula
Minor fascia overlying the related intercostal spaces process (C5-T1)
Arm

Muscle Origin Insertion Innervation Actions

Biceps Brachii LH – supraglenoid tubercle of scapula (goes True tendon – Radial tuberosity Musculocutaneous nerve (C5 & C6) Powerful flexor of the forearm at the elbow joint (true
through the intertubercular sulcus and through Aponeurosis – Bicipital aponeurosis tendon) and powerful supinator (aponeurosis); accessory
the glenohumeral capsule) into deep fascia on medial part of flexor of the arm at the glenohumeral joint
SH – apex of coracoid process forearm
Coracobrachialis Apex of coracoid process Middle 1/3 of (linear roughening) Musculocutaneous nerve (C5, C6, & C7) Flexes and adducts the arm at the glenohumeral joint
midshaft of humerus on the medial side
Brachialis Anterior aspect of the humerus (distal 1/2 of Coronoid process and ulnar tuberosity Musculocutaneous nerve (C5 & C6) and Powerful flexor of the arm at the elbow joint
the humerus) small contribution from the radial nerve (C7)
to the lateral aspect
Triceps Brachii LH – infraglenoid tubercle on scapula Common tendon of insertion with Radial nerve (C6, C7, & C8) for Lat. H and Extension of forearm at the elbow joint; long head also
MH – distal 2/3 of medial and posterior medial, lateral, and long heads on the MH and Axillary nerve for LH (C5 & C6) stabilizes the head of abducted humerus while also adducting
surface of the humerus posterior surface of olecranon process of and extending the arm at the glenohumeral joint
Lat.H – upper 1/2 on the posterior surface of ulna
the humerus

Anterior forearm

Muscle Origin Insertion Innervation Actions

Pronator Teres Humeral head – medial epicondyle and lower part of the Roughening on the lateral surface, Median nerve (C6 & C7) Pronation of the forearm and weak flexor of the elbow
medial supracondylar ridge midshaft of radius (most prominent part
Ulnar head – medial side of the coronoid process of its outward convexity)
Flexor Carpi Medial epicondyle of the humerus Base of the metacarpals 2 and 3 Median nerve (C6 & C7) Flexes and abducts (radial deviation) the wrist joint
Radialis
Palmaris Longus Medial epicondyle of the humerus Distal half of flexor retinaculum and Median nerve (C7, C8) Flexes the wrist joint and tenses the palmar aponeruosis
palmar aponeurosis of the hand
Flexor Carpi Humeral head – medial epicondyle of the humerus Pisiform bone, hook of the hamate (via Ulnar nerve (C7, C8, & T1) Flexes and adducts (ulnar deviation) the wrist joint
Ulnaris Ulnar head – Olecranon and posterior border of ulna the pisohamate and pisometacarpal
ligaments), and base of metacarpal 5
Flexor Digitorum Humeroulnar head – medial epicondyle of humerus and Bodies of the middle phalanges of the Median nerve (C8 & T1) Flexes the proximal interphalangeal joints,
Superficialis medial margin of coronoid process of ulna index, middle, ring, and little fingers (4 metacarpophalangeal joints of the index, middle, ring,
Radial head – anterior proximal half (oblique line) of radius tendons) and little fingers, and the wrist joint
Flexor Pollicis Anterior surface of the radius (below the anterior oblique Palmar surface of base of the distal Median nerve (anterior Flexes the interphalangeal and metacarpophalangeal
Longus line and above the insertion of pronator quadratus) and phalanx of the thumb interosseus nerve; C7 & C8) joints of the thumb
anterior lateral half of the interosseous membrane
Flexor Digitorum Anterior and medial surfaces of the proximal 3/4 of the ulna Palmar base of distal phalanges of the Median (anterior interosseous Flexes the distal interphalangeal joints,
Profundus and anterior medial half of interosseous membrane index, middle, ring, and little fingers (4 nerve – lateral half) and Ulnar metacarpophalangeal joints of the index, middle, ring,
tendons) nerves (medial half (C8 & T1) and little fingers, and the wrist joint
Pronator Linear ridge on distal 1/4 of the anterior surface of ulna Distal 1/4 of the anterior surface of the Median nerve (anterior Pronation of the forearm
Quadratus radius interosseous nerve; C7 & C8)

Posterior forearm

Muscle Origin Insertion Innervation Actions

Brachoradialis Proximal 2/3 of the lateral supracondylar Base of the radial styloid process Radial nerve (branch arising from above Flex the elbow joint
ridge of humerus the elbow joint prior to deep and
 superficial cutaneous branching; C5 &
C6)
Anconeus Posterior surface of lateral epicondyle of Lateral surface of olecranon and proximal posterior Radial nerve (C5-T1) via a branch to Abduction of ulna in pronation and assists triceps in
humerus surface of ulna medial head of triceps brachii extension of elbow
Extensor Carpi Lateral epicondyle of the humerus and Base of metacarpal 5 Radial nerve (posterior interosseous Extends and adducts (ulnar deviation) the wrist
Ulnaris the posterior border of the ulna nerve; C7 & C8)
Extensor Digiti Lateral epicondyle of the humerus Extensor hood (tendon turned into aponeurosis) of the Radial nerve (posterior interosseous Extends the little finger
Minimi little finger nerve; C7 & C8)
Extensor Lateral epicondyle of humerus Inserts into the dorsal aspects (via extensor hoods – Radial nerve (posterior interosseous Extensor of the interphalangeal, metacarpophalangeal,
Digitorum tendons that convert into aponeurosis) of the bases of nerve; C7 & C8) and the wrist joints
the middle and distal phalanges of the index, middle,
ring and little fingers (4 tendons)
Extensor Carpi Lateral epicondyle of the humerus Dorsal surface of the base of metacarpals 2 and 3 Radial nerve (posterior interosseous Extends and abducts (radial deviation) the wrist joint
Radialis Brevis nerve; C7 & C8)
Extensor Carpi Distal 1/3 of the lateral supracondylar Dorsal surface of the base of metacarpal 2 Radial nerve (branch arising from above Extends and abducts (radial deviation) the wrist joint
Radialis Longus ridge the elbow joint prior to deep and
superficial cutaneous branching; C6 &
C7)
Supinator Superficial part – lateral epicondyle of Lateral surface of the radius in between the anterior Radial nerve (posterior interosseous Fixes the forearm in supination; prime supinator only
the humerus, lateral collateral ligament and posterior oblique lines nerve; C6 & C7) when the elbow joint is fully extended
of the elbow, and the annular ligament of
the radius
Deep part – Supinator crest of the ulna
and the fossa in front of it
Extensor Indicis Posterior surface of ulna (distal to Extensor hood of the index finger Radial nerve (posterior interosseous Extends the index finger and helps extend the wrist joint
extensor pollicis longus) and adjacent nerve; C7 & C8)
interosseous membrane
Extensor Policis Posterior surface of the middle 1/3 of Dorsal base of the distal phalanx of the thumb Radial nerve (posterior interosseous Extends the interphalangeal and metacarpophalangeal
Longus ulna and adjacent interosseous nerve; C7 & C8) joints of the thumb, draws the thumb back from
membrane opposed position, and assists in extension and abduction
of the wrist
Extensor Policis Posterior surface of the radius and Dorsal base of the proximal phalanx of the thumb Radial nerve (posterior interosseous Extends the metacarpophalangeal and carpometacarpal
Brevis adjacent interosseous membrane nerve; C7 & C8) joints of the thumb
Abductor Policis Posterior surfaces of ulna, radius, and Lateral surface of metacarpal 1 Radial nerve (posterior interosseous Extends and abducts the carpometacarpal joints of the
Longus adjacent interosseus membrane nerve; C7 & C8) thumb

Hand

Muscle Origin Insertion Innervation Actions

Palmaris Brevis Palmar aponeurosis and flexor retinaculum Dermis of the skin on the medial margin of the Ulnar nerve (superficial branch of the ulnar Improves grip
hand nerve; C8 &T1)
Opponens Tubercle of trapezium and flexor retinaculum Lateral margin and adjacent palmar surface of Median nerve (recurrent branch; C8 & T1) and Opposition of the thumb
Pollicis metacarpal 1 Ulnar nerves (deep branch)
Abductor Flexor retinaculum and tubercles of scaphoid and Lateral margin of the base of the 1​st​ proximal Median (recurrent branch; C8 & T1) Abduction of the thumb
Pollicis Brevis trapezium phalanx and the tendon extensor pollicis longus
Flexor Pollicis Superficial head – flexor retinaculum and Radial sesamoid of the thumb and radial side of Median (recurrent branch; C8 & T1) and/or Ulnar Flexes the metacarpophalangeal joint of the
Brevis tubercle of trapezium the base of the proximal phalanx nerve (deep branch) thumb and assists in opposition
Deep head – trapezoid and capitate
Opponens Flexor retinaculum and convexity of hook of Medial border of metacarpal 5 and medial half Ulnar nerve (deep branch; C8 & T1) Assists in cupping the palm by raising the
Digiti Minimi hamate of its anterior surface medial edge of the hand
Flexor Digiti Flexor retinaculum and convex surface of hook Medial side of the base of the 5​th​ proximal Ulnar nerve (deep branch; C8 & T1) Assists in cupping the palm by raising the
Minimi Brevis of hamate phalanx medial edge of the hand
Abductor Digiti Pisiform, tendon of flexor carpi ulnaris, and Medial border of the base of the 5​th​ proximal Ulnar nerve (deep branch; C8 & T1) Assists in cupping the palm by raising the
Minimi pisiohamate ligament (guyon’s ligament) phalanx and dorsal digital expansion medial edge of the hand
Lumbricals Lateral side of the tendons of flexor digitorum Extensor hoods of the index, middle, ring, and Ulnar (deep branch – 2 medial bipenate muscles) Flexes the metacarpophalangeal joints and
profundus little fingers and Median nerves (recurrent branch – 2 lateral extends the interphalangeal joints
unipenate muscles)
Adductor Transverse head – distal 2/3 of the anterior aspect Through the ulnar sesamoid bone to the ulnar Ulnar nerve (deep branch C8 & T1) Adducts the thumb
Pollicis of metacarpal 3 side of the 1​st​ proximal phalanx and the tendon
Oblique head – capitate, bases of metacarpals 2 of the extensor pollicis longus
and 3, palmar carpal ligaments, and tendon
sheath of flexor carpi radialis
Palmar Medial side of metacarpal 2 and lateral sides of Bases of proximal phalanges and extensor Ulnar nerve (deep branch; C8 & T1) Adduction of the digits 2, 4, and 5, flexes the
Interossei metacarpals 4 and 5 expansions metacarpophalangeal joints, extension of the
interphalangeal joints
Dorsal Attached to sides of the adjacent metacarpals in Lateral sides of the 2​nd​ and 3​rd​ extensor Ulnar nerve (deep branch; C8 & T1) Abduction of the digits 2, 3, 4, and 5, flexes
Interossei web spaces 1-4 by biciptal heads expansions and medial sides of the 3​rd​ and 4​th the metacarpophalangeal joints, extension of
extensor expansions and bases on the proximal the interphalangeal joints
phalanges of the respective sides

Gluteal region

Muscle Origin Insertion Innervation Actions

Gluteus Ilium posterior to posterior gluteal line, dorsal 3/4 of the fibres insert in to the illiotibial tract (which inserts into Inferior Gluteal nerve (L5, Extends the flexed hip joint, assists in lateral
Maximus surface of sacrum and coccyx, and sacrotuberous Gerdy’s tubercle – a smooth circular facet on the lateral condyle S1, & S2) rotation, abducts the thigh, and stabilizes the hip
ligament of the tibia)
Gluteus Gluteal surface of ilium between the middle and Lateral surface of the greater trochanter of the femur Superior Gluteal nerve (L4, Abduct the hip joint and the anterior fibres medially
Medius posterior lines (posterior third is covered by gluteus L5, & S1) rotate the thigh, and steadies pelvis when opposite
maximus) leg is raised
Gluteus Gluteal surface of ilium between the middle and Anterior surface of the greater trochanter of the femur Superior Gluteal nerve (L4, Abduct the hip joint and the anterior fibres medially
Minimus inferior lines (arises from under cover of gluteus L5, & S1) rotate the thigh, and steadies pelvis when opposite
medius) leg is raised
Piriformis Anterior surface of the sacral segments 2-4, Medial surface of the superior border of the greater trochanter Ventral rami of S1 & S2 Laterally rotates the extended thigh and abducts the
sacrotuberous ligaments flexed thigh at the hip joint
Obturator Pelvic surface (internal surface) of obturator Medial surface of the greater trochanter above the trochanteric Nerve to Obturator Internus Laterally rotates the extended thigh and abducts the
Internus membrane and surrounding bone fossa (L5, S1, & S2) flexed thigh at the hip joint
Superior Outer surface of the ischial spine Medial surface of the greater trochanter above the trochanteric Nerve to Obturator Internus Laterally rotates the extended thigh at the hip joint
Gemellus fossa (L5, S1, & S2)
Inferior Upper margin of ischial tuberosity Medial surface of the greater trochanter above the trochanteric Nerve to Quadratus Laterally rotates the extended thigh at the hip joint
Gemellus fossa Fermoris (L4, L5, & S1)
Quadratus Lateral margin of ischial tuberosity Quadrate tubercle on the intertrochanteric crest of the femur Nerve to Quadratus Laterally rotates thigh at the hip joint
Femoris Fermoris (L4, L5, & S1)

Posterior Thigh

Muscle Origin Insertion Innervation Actions

Biceps Femoris LH: Lateral aspect of the ischial tuberosity (inferior to
semimembranous; common origin to semitendinosus)
SH: Whole length of the lateral linea aspera and the proximal
part of the lateral suprcondylar line of the femur
Semitendinosus Lateral aspect of the ischial tuberosity (inferior to
semimembranous; common origin to LH of biceps femoris)
Semimembranosus Lateral aspect of the ischial tuberosity (origin is superior to long
head of biceps and semitendinosus origin)
Lateral side of the head of the fibula via the fibular LH is by the Tibial Flex the knee joint, extend the hip joint, lateral
(lateral) collateral ligament Branch & SH is by the rotation of the leg when the knee is semiflexed
Peroneal of the Sciatic
nerve (L5-S1)
Upper part of the medial shaft of the tibia (“pes Tibial division of the Flex the knee joint, extend the hip joint, medial
anserine”) Sciatic nerve (L5-S1) rotation of the leg when the knee is semiflexed
Posterior part of the medial condyle of the tibia Tibial division of the Flex the knee joint, extend the hip joint, medial
(groove for insertion of semimembranous tendon) Sciatic nerve (L5-S1) rotation of the leg when the knee is semiflexed
Anterior Thigh

Muscle Origin Insertion Innervation Actions

Iliopsoas/Psoas Slides of vertebra T12-L5 and the transverse processes of Lesser trochanter of the femur Anterior rami of L1, L2, & L3 – mainly L2) Powerful flexor of the hip joint and
Major L1-L5 stabilizes the hip joint
Iliacus Superior 2/3 of the iliac fossa Inserted into the front of the psoas Femoral nerve (L2 & L3) Powerful flexor of the hip joint (with
tendon and a small area of femoral shaft psoas major) and stabilizes the hip joint
just below the lesser trochanter
Tensor Fascia 5 cm length of the external lip of the iliac crest between the Illiotibial tract (which inserts into Superior Gluteal nerve (L4, L5, & S1) Abducts, medially rotates, & flexes thigh
Latae anterior superior iliac spine and the tubercle of the crest Gerdy’s tubercle – a smooth circular at the hip joint, extends the knee, and
facet on the lateral condyle of the tibia) helps stabilize the pelvis during walking
Sartorius Anterior superior iliac spine and the superior pat of the Upper part of the medial surface of the Anterior division of the Femoral nerve (L2, L3, & Flexes, laterally rotates, & abducts the
notch below it thigh in front of gracilis and L4) thigh, and flexes the knee
semitendinosus by an aponeurosis
Rectus Femoris Reflected head: Superior aspect of the groove of the Base of the patella via the quadriceps Femoral nerve (L3 & L4) Extends the knee joint and flexes the hip
acetabulum tendon (anterior lamina) and to tibial joint
Straight head: Anterior inferior iliac spine tuberosity via patellar ligament
Vastus Lateralis Upper part of the intertrochanteric line, greater trochanter, Base of the patella via the quadriceps Femoral nerve (L3 & L4) Extends the knee joint
and the lateral lip of the linea aspera of the femur tendon (anterior lamina) and to tibial
tuberosity via patellar ligament
Vastus Anterior and lateral surfaces of the upper 2/3 of the shaft of Base of the patella via the quadriceps Femoral nerve (L3 & L4) Extends the knee joint
Intermedius the femur tendon (anterior lamina) and to tibial
tuberosity via patellar ligament
Vastus Medialis Lower part of the intertrochanteric line, the medial lip of Base of the patella via the quadriceps Femoral nerve (L3 & L4) Extends the knee joint
the linea aspera, and from the tendon of the adductor tendon (anterior lamina) and to tibial
magnus (below the hiatus for the femoral vessels) tuberosity via patellar ligament
Pectineus Pectineal line of the pubis Pectineal line of the femur Anterior division of the Femoral nerve (L2 & L3); Flexes and adducts the thigh
occasionally receives a twig from the anterior
division of the Obturator nerve (L2 & L3)

Medial Thigh

Muscle Origin Insertion Innervation Actions

Adductor Body of the pubis, in the angle between the Middle 1/3 of the medial linea aspera of the femur by an aponeurotic Anterior division of the Obturator Adducts thigh
Longus pubic crest and symphysis flat tendon nerve (L2 & L3)
Adductor Body and inferior pubic ramus (deep to Upper 1/3 of the medial linea aspera and pectineal line of the femur Anterior division of the Obturator Adducts thigh and weak hip flexor
Brevis pectineus and adductor longus) immediately behind pectineus and above adductor longus insertion nerve (L2 & L3)
Gracilis Inferior ramus of the pubis and the adjoining Upper medial surface of the shaft of the tibia Anterior division of the Obturator Adducts thigh, flexes and medially
ischial ramus nerve (L2 & L3) rotates leg
Adductor Hamstring part: Ischial tuberosity Hamstring part: Adductor tubercle of the femur with an expansion to Hamstring part: Tibial division of the Hamstring part: extends thigh
Magnus Adductor part: Inferior pubic and ischial rami the medial supracondylar line Sciatic nerve (L4) Adductor part: adducts and flexes thigh
Adductor part: superior to the “hamstring part” insertion along the Adductor part: Posterior division of
medial supracondylar line, the linea aspera and up to the gluteal the Obturator nerve (L2 & L3)
tuberosity
Obturator Whole of the obturator membrane and from Medial surface of the greater trochanter (trochanteric fossa) Posterior division of the Obturator Laterally rotates the hip and stabilizes
Externus the anterior bony margin of the obturator nerve (L3 & L4) the head of the femur in the acetabulum
foramen

Posterior Leg
 Muscle Origin Insertion Innervation Actions
Gastrocnemius ​(S) Lat.H: lateral surface of the femoral condyle Tendo calcaneus (achilles tendon) which is inserted into a Tibial nerve (S1 & S2) Plantarflex the foot and assists in flexion of the knee
Med.H: posterior part of the medial condyle smooth transverse area on the middle third of the posterior joint and raises the heel during walking
and the popliteal surface of the shaft of the surface of the calcaneus
femur
Soleus ​(S) Proximal 1/4 of the back of the fibula Tendo calcaneus (achilles tendon) which is inserted into a Tibial nerve (S1 & S2) Plantarflex the foot and stabilizes the leg over the
including the head of the bone, soleal line of smooth transverse area on the middle third of the posterior foot when standing
the tibia and the middle 1/3 of the posterior surface of the calcaneus
border of the tibia
Plantaris ​(S) Distal part of the lateral supracondylar line of Tendo calcaneus (achilles tendon) which is inserted into a Tibial nerve (S1 & S2) Weakly assists Gastrocnemius
the femur smooth transverse area on the middle third of the posterior
surface of the calcaneus
Popliteus ​(D) Triangular area on the posterior surface of the Attached to a pit at the anterior end of a groove on the lateral Tibial nerve (L4, L5, & S1) Laterally rotates the femur to unlock the joint, in the
tibia above the soleal line surface of the lateral condyle of the femur seat position, it mediall rotates the tibia at the
commencement of flexion, and is a weak flexor of
the knee (possibly retracts the lateral meniscus)
Flexor Hallucis Flexor surface (posterior) of the fibula and the Base of the distal phalanx of the big toe Tibial nerve (S1 & S2) Flex the big toe, plantarflex the foot at the ankle
Longus ​(D) adjacent interosseous membrane joint, and the pull of this muscle is an important
factor in maintaining the medial longitudinal arch
Tibialis Posterior Posterior tibia below the soleal line, Tuberosity of the navicular bone, all the cuneiforms, cuboid, and Tibial nerve (L4) Inverts and adducts the forefoot, plantarflexes the
(D) interosseous membrane, and proximal half of bases of the 2nd, 3​rd​, & 4​th​ metatarsals ankle joint, and contributes to maintaining the
the posterior fibula medial longitudinal arch of the foot
Flexor Digitorum Posterior surface of the tibia below the soleal Pass into the fibrous sheaths of the lateral four toes, perforate the Tibial nerve (S1 & S2) Flex the lateral four toes, plantarflex the foot at the
Longus ​(D) line tendons of flexor digitorum brevis and inserts into the bases of ankle joint, and assists with maintaining the
the distal phalanges (medial two tendons receive a strong slip longitudinal arch of the foot
from flexor hallucis longus)

Anterior Leg

Muscle Origin Insertion Innervation Actions

Extensor Proximal 3/4 of the extensor surface (anterior) of the Dorsal extensor expansions of the proximal phalanx Deep Peroneal nerve (L5 Extend the lateral four toes and dorsiflex the foot
Digitorum fibula, a small area on the lateral condyle of the tibia and (central/middle and side slips insert into the base of the & S1) at the ankle joint
Longus the adjacent interosseous membrane middle and distal phalanx respectively)
Fibularis Distal 1/3 of the extensor surface (anterior) of the fibula Dorsum of the base of the fifth metatarsal bone and by an Deep Peroneal nerve (L5 Eversion of the foot and dorsiflexion of the foot
(Peroneus) extension into the superior surface of that bone & S1) at the ankle joint
Tertius
Extensor Middle half of the extensor surface (anterior) of the Dorsal aspect of the base of the terminal phalanx of the big Deep Peroneal nerve (L5) Extend the big toe and dorsiflex the foot at the
Hallucis Longus fibula and the adjacent interosseous membrane toe ankle joint
Tibialis Upper 2/3 of the extensor surface (anterior) of the tibia Medial and inferior surfaces of the medial cuneiform and Deep Peroneal nerve and Inversion of the foot, dorsiflexion of the foot at
Anterior and the interosseous membrane the base of the first metatarsal bone Genicular nerve (L4) the ankle joint, and helps to maintain the medial
longitudinal arch of the foot

Lateral Leg

Muscle Origin Insertion Innervation Actions

Fibularis Head and upper 2/3 of the peroneal surface Below the peroneal trochlea into the lateral side of the Superficial Peroneal Eversion of the foot at the ankle joint, weakly plantarflex the
(Peroneus) of the fibula and from the intermuscular base of the 1st metatarsal and the medial cuneiform nerve (L5 & S1) foot, and helps to maintain the lateral longitudinal and transverse
Longus septa (plantar surface) arches of the foot
Fibularis Lower 2/3 of the fibula Above the peroneal trochlea and into the tubercle of the Superficial Peroneal Eversion of the foot at the ankle joint and weakly plantarflex the
(Peroneus) Brevis 5th metatarsal bone (dorsal surface) nerve (L5 & S1) foot
Dorsum of the Foot

Muscle Origin Insertion Innervation Actions

Extensor Proximal surface of the calcaneus and from the deep surface of Ext. Hal. Brev. – base of the proximal phalanx of the Deep Peroneal nerve Extend the medial four toes (particularly of value
Digitorum the inferior extensor retinaculum big toe (S1 & S2) when the long extensor is out of action – in the
Brevis Remaining three insert into the dorsal extensor fully dorsiflexed ankle)
expansions of the 2nd, 2rd, & 4th toes

Sole of the Foot

Muscle Origin Insertion Innervation Actions

Flexor Digitorum Medial part of calcaneus and the deep surface of Each of the four tendons enter the fibrous Medial Plantar nerve (S2 & S3) Flex the toes with equal effect in any
Brevis ​(1) the central part of the plantar aponeurosis flexor sheath and eventually divides to insert position of the ankle joint
into the sides of the middle phalanx
Abductor Hallucis Medial process of the calcaneus and from the Medial side of the base of the proximal Medial Plantar nerve (S2 & S3) Abducts the big toe
(1) flexor retinaculum phalanx of the big toe
Abductor Digiti Medial and lateral processes of the calcaneus deep Lateral side of the base of the proximal Branch from the Lateral Plantar nerve (S2 & S3) Abducts the little toe
Minimi ​(1) to flexor digitorum brevis phalanx and the tubercle of the fifth metatarsal
Tendon of Flexor *See posterior leg
Hallucis Longus ​(2)
Tendon of Flexor *See posterior leg
Digitorum Longus
(2)
Quadratus Plantae Medial and lateral sides of the plantar surface of Posterlateral edge of flexor digitorum longus Lateral Plantar nerve Corrects for oblique pull of flexor
(2) calcaneus tendon digitorum longus tendon and assists in
flexion of the toes
Lumbricals ​(2) Tendons of the flexor digitorum longus Goes to the dorsal aspect of the foot to be Medial Plantar nerve (1st lumbrical; S2 & S3) Extends the interphalangeal joints while
inserted into the extensor expansions and Lateral Plantar nerve (2nd, 3rd, & 4th flexing the metatarsophalangeal joints
lumbricals; S2 & S3)
Flexor Hallucis Cuboid, lateral cuneiform, and the tendon of Medial and lateral sides of the base of the Medial Plantar nerve (S1 & S2) Flex the proximal phalanx of the big toe
Brevis ​(3) tibialis posterior plantar surface of the proximal phalanx of the
big toe
Adductor Hallucis Oblique head:​ long plantar ligament and the 2nd, Lateral side of the plantar surface of the base Lateral Plantar nerve (S2 & S3) Adducts the big toe and assists in
(3) 3rd, & 4th metatarsal bones of the proximal phalanx of the big toe maintaining the transverse arch
Transverse head:​ deep transverse ligament and
from the plantar ligaments of the lateral four
metatarsophalangeal joints
Flexor Digiti Minimi Base of the fifth metatarsal bone and the adjoining Base of the proximal phalanx medial to the Superficial branch of the Lateral Plantar nerve Assists in flexing the little toe
Brevis ​(3) fibrous sheath of peroneus longus insertion of abductor digiti minimi (S2 & S3)
Plantar Interosseous Arises from the metatarsal bone of the respective Bases of the proximal phalanges and into the Lateral Plantar nerve (those of the 4th space are Adducts the toes, extends the
(4) toe dorsal extensor expansions supplied by the superficial branch; remainder by interphalangeal joints, and flexes the
the deep branch; S2 & S3) metatarsophalangeal joints
Dorsal Interosseous Arises as two heads from the two metatarsals Bases of the proximal phalanges and into the Lateral Plantar nerve (those of the 4th space are Abducts the toes, extends the
(4) between which it lies dorsal extensor expansions supplied by the superficial branch; remainder by interphalangeal joints, and flexes the
the deep branch; S2 & S3) metatarsophalangeal joints
Tendon of Peroneus *See posterior leg
Longus ​(4)
Tendon of Tibialis *See posterior leg
Posterior ​(4)
* Yellow means that you do not have to know. It is additional information.
Glenohumeral Joint

1. Type:​ Typical synovial ball and socket with 3 degrees of freedom

2. Articulation:​ Humeral head (large articular surface) is a 2/3 spherical structure which articulates with the shallow glenoid fossa (small
articular surface); hyaline cartilage on the articulating surface; joint socket is deepend by glenoid labrum (fibrocartilaginous ring)
3. Capsular attachments​: Medial attachments: attached to the scapula, medial to the glenoid labrum and medial to the supralgenoid tubercle;
lateral attachments: to the anatomical neck of the humerus except medially where it extends down 1.5 cm down the surgical neck to allow for
slack during abduction; openings exist at the insertion of the long head of the biceps brachii superalaterally and where the joint cavity
communicates with the bursa of subscapularis anteriorly
4. Intracapsular structure:​ Synovial membrane, glenoid labrum, hyaline cartilage, and biceps brachii long head (extra-synovial); superior
labrum blends together with the biceps brachii long head tendon
5. Intrinsic ligaments:​ superior, middle, and inferior (anterior and posterior) ligaments which strengthen the capsule anteriorly and
coracohumeral ligament strengthens the joint superiorly; ​Extrinsic ligaments:​ coracoacromial (prevents upwards movement), and transverse
humeral ligament (holds biceps brachii long head tendon in place in the intertubercular sulcus)
6. Movements and muscles:​ Deltoid, latissimus dorsi, teres major, and pectoralis major; stabilizers: suprspinatus, infraspinatus, teres minor,
and subscpularis
7. Dynamic restraints:​ 40% rotator cuff, 40% primary movers; ​Static restraints:​ 20% ligamentous capsule; minimal effect from the labrum
8. Relations (nearby structures):​ Associated musculature, vasculature passing to and from the upper limb and brachial plexus (especially the
cords)
9. Blood supply:​ Anterior and posterior circumflex humeral arteries (wraps around the surgical neck of the humerus to anastamose),
suprscapular artery, transverse cervical artery, and subscapular artery; ​Nerve supply:​ Posterior cord of the brachial plexus (capsule is
supplied by axillary nerve, suprascapular nerve, and lateral pectoral nerve)
10. Bursae:​ Subscapular bursae (between subscapularis tendon and neck of scapula) and subacromial bursa (between deltoid, suprspinatus
tendon, and glenohumeral capsule)
11. Clinical:​ Fractures, dislocation, impingement, rotator cuff tears, tendonitis, tendenosis, labral tears, bursitis etc.
Elbow Joint

1. Type:​ Typical synovial hinge joint with 1 degree of freedom

2. Articulation:​ Trochlea (medial side) and capitulum (lateral side) of the humerus articulates with the trochlear notch of the ulna and the
concave superior surface of the head of the radius respectively; the articular surfaces is covered by hyaline cartilage; the head of the radius
articulates with the radial notch of the ulna to make the proximal radioulnar joint
3. Capsular attachments:​ Articular capsule is attached to articular margins of each bone; the capsule projects upwards to enclose the radial and
coronoid fossae anteriorly and the olecranon fossa posteriorly; it also passes inferiorly onto the neck of the radius to enclose the proximal
radio ulnar joint; the capsule blends in with the annular ligament distally and does not attach to the radius; that capsule is weak anteriorly and
posteriorly as this is the direction of movement for hinge joints
4. Intracapsular structure:​ hyaline cartilage on the bony articulating surfaces and synovium, fat pads of the olecranon, radial and coronoid
fossa, and some include the annular ligament; the fat pads are extra-synovial but intra-capsular and contain pressure sensitive
mechanoreceptors that initiate reflex contraction to prevent joint damage
5. Intrinsic ligaments:​ None; ​Extrinsic ligaments:​ ulnar collateral ligament (medial – critical for valgus stability and is the primary elbow
stabilizer) and radial collateral ligament (lateral – debated as to whether it exists); annular ligament (wraps around the radial head from the
anterior to the posterior radial notch on the ulna)
6. Movements:​ 150​○​ from the extended position (limited by contact of flexor surfaces of the arm and forearm); the extension is limited by the fit
of the olecranon into its fossa and the associated fat pads; the contact surfaces in the trochlea change during flexion/extension and this can
cause a side-to-side wobble during movement; brachialis, biceps brachii, triceps brachii, brachoradialis, muscles of the common extensor and
common flexor regions
7. Stability:​ Articular surfaces, collateral ligaments; 90​○​ degree flexion and in the mid prone position allows for the greatest contact area
between the humerus, ulna, and radius
8. Relations:​ Anterior: Brachialis (floor of the median cubital fossa), biceps brachii aponeurosis (roof of the median cubital fossa), muscles
from the medial and lateral epicondyle and supracondylar ridge; radial nerve is lateral and ulnar nerve is medial
9. Blood supply:​ Anastomosis formed by 4 collateral branches from the brachial artery, and two recurrent branches each from ulnar and radial
arteries; ​Nerve supply:​ Mainly musculocutaneous and radial nerves (ulnar, median, and sometimes anterior interosseous nerve contribute)
10. Bursae:​ Subcutaneous olecranon bursa (overlies olecranon in subcutaneous tissue), Subtendinous olecranon bursa (between olecranon and
triceps tendon), and Bicipital bursa (between biceps tendon and anterior part of radial tuberosity)
11. Clinical:​ Ulnar collateral ligament injury (valgus injury), students elbow (bursa bleeding), golfers elbow – medial epicondylitis (tendinosis),
tennis elbow – lateral epicondylitis (tendinosis) etc.
Proximal Radioulnar Joint

1. Type:​ Uniaxial, synovial pivot joint

2. Articulation:​ Head of radius and radial notch of the ulna
3. Capsular attachments:​ Enclosed by the elbow joint capsule
4. Intracapsular structure:​ None
5. Intrinsic ligaments:​ None; ​Extrinsic ligaments:​ Ulnar collateral ligament (medial epicondyle to the coronoid process and olecranon), radial
collateral ligament (lateral epicondyle to the annular ligament), and annular ligament (wraps around the radial head from the anterior to the
posterior radial notch)
6. Movements:​ Pronation and supination with rotation of the head of the radius within the annular ligament
7. Stability:​ Has a good bony congruency to the capitulum, trochlea, and radial notch; annular ligament holds the radial head in the radial notch
8. Relations: ​Medial and lateral collateral ligaments, common flexor and extensor origins, lateral and medial supracondylar origin muscles,
ulnar nerve (medial), and radial nerve (lateral)
9. Blood supply:​ Anterior and posterior interosseous arteries; ​Nerve supply:​ Musculocutaneous, median, and ulnar nerves (may have some
radial nerve supply)
10. Bursae:​ Same as the elbow joint
11. Clinical:​ Subluxation of the radial head and bursitis of the elbow

Distal Radioulnar Joint

1. Type:​ Atypical synovial pivot joint

2. Articulation:​ Head of ulna and ulnar notch of the radius
3. Capsular attachments:​ Fibrocartillaginous articular disc binds the ends of radius and ulna
4. Intracapsular structure:​ articular disc
5. Extrinsic ligaments:​ Palmar and dorsal radioulnar ligament
6. Movements:​ Pronation and supination with rotation of the radius anteromedially
7. Stability:​ Has a good bony congruency to the scaphoid, lunate, and triquetral bones; anterior and posterior ligaments holds the ulnar head in
the ulnar notch
8. Relations: ​Flexor compartment muscles and median nerve anteriorly, extensor compartment muscles posteriorly, radial nerve (lateral), and
ulnar nerve (medial)
9. Blood supply:​ Anterior and posterior interosseous arteries; ​Nerve supply:​ Posterior interosseous nerve
10. Bursae:​ None
11. Clinical:​ Colles fracture (falling to cause hyper extension and fracturing the distal radius to the posterior compartment) and smiths fracture
(falling to cause flexion and fracturing the distal radius to the anterior compartment)
Hip Joint

1. Type:​ Typical synovial ball and socket joint with three degrees of freedom
2. Articulation:​ Concave acetabulum of the hip bone (os coxae), with its C-shaped articular (lunate) suface covered by hyaline cartillage, the
spherical head of the femur, acetabular labrum (made of fibrocartilage)
a. The fovea, the acetabular fossa, and the acetabular notch are non-articular surfaces
3. Capsular attachments:​ Attached proximally to the margin of the acetabulum outside the labrum,, the free edge of the labrum and the
transverse acetabular ligament; distally attached to the neck of the femur, anteriorly, to the intertrochanteric line, and posteriorly, 2 cm
proximal to the intertrochanteric crest; retinacular fibers are reflected from these attachments on the neck of the femur and proximally along
the neck to the articular margin of the femoral head, eventually blending in with the periosteum of the bone
4. Intracapsular structure:​ Acetabular labrum, transverse acetabular ligament, and fat pads in the acetabular fossa
5. Intrinsic ligaments:​ Iliofemoral (inverted “V” – very strong), pubofemoral (not as strong as iliofemoral), and ischofemoral (weakest) and
Ligamentum teres (not strong – this along with the haversin fat pads are invested with a sleeve of synovium as far as the acetabular fossa);
Extrinsic ligaments:​ None
6. Movements:​ Flexion (iliopsoas and assisted by rectus femoris), extension (superior fibers of gluteus maximus and hamstrings), abduction
(gluteus maximus upper fibers, tensor fascia latae, and assisted by piriformis, gluteus medius, and gluteus minimus), adduction (adductors,
pectineus, and gracilis), medial rotation (anterior fibers of gluteus medius and minimus, and assisted by tensor fascia latae), and lateral
rotation (inferior fibers of gluteus maximus and quadratus femoris, and assisted by obturator internus and externus, superior and inferior
gemelli, piriformis, and sartorius)
7. Stability:​ Stable joint due to the deep acetabular cup and well-fitting femoral head (fitting is enhanced by the acetabular labrum); the strong
ligaments (iliofemoral, pubofemoral, and ischiofemoral) and muscles surrounding the joint increases the stability
8. Relations: ​Anterior (iliopsoas and pectineus), posterior (piriformis, gemelli, obturator internus, quadratus femoris, and sciatic nerve),
superficial (gluteal muscles posteriorly and tensor fascia latae anteriorly), and inferiorly (obturator externus)
9. Blood supply:​ medial and lateral circumflex humeral arteries off of the profunda femoris artery (they may give off retinacular arteries
directly from the ascending branches or supply them through two anastomoses – trochanteric [ascending branches of medial and lateral
circumflex femoral arteries, and cruciate; the lateral epiphyseal arteries off of the retinacular arteries are the most important blood suppliers to
the femoral head); ​Nerve supply:​ Femoral nerve via the rectus femoris, obturator nerve, nerve to quadratus femoris, and articular twigs from
the sciatic nerve
10. Bursae:​ Trochanteric bursa (between gluteus maximus and the greater trochanter), iliopsoas bursa (between the ilipsoas and the iliopubic
ramus/head of the femur
11. Clinical:​ Fracture of the neck of the femur, avascular necrosis of the femoral head, congenital dislocation of the hip, traumatic dislocation
with sciatic nerve damage (posterior dislocation), slipped epiphysis (fracture through the growth plate), Perthes disease (avascular necrosis of
 the head of the femur due to blood flow disruption at a young age causing improper growth of the femoral head – necrosed bone is replaced
but never fully recovers to the fully size as would have with complete blood flow)
Knee Joint

1. Type:​ Typical synovial pivotal hinge joint (mobile trocho-ginglymus) or typical synovial condyloid joint, with two degrees of freedom
a. Each femoral condyle has two curvatures – anterposterior and mediolateral
b. 6​○ ​of freedom clinically: valgus/varus, flexion/extension, internal/external rotation, anterior/posterior translation, medial/lateral
translation, and compression/distraction
2. Articulation:​ Femoral condyles (fused anteriorly by trochlear notch and posteriorly by the intercondylar notch/fossa), two articular facet on
the upper surface of the tibia, and two C-shaped fibrocartilaginous menisci in between the articulating facet and the condyles
3. Capsular attachment:​ Posteriorly (proximal margins of the femoral condyles, intercondylar fossa, and distal margins of the tibial condyles),
medially (articular margins), laterally (proximal to attachment of popliteus), and anteriorly (capsule is deficient above the patella [thus there is
a suprapatellar bursa,which is superficial to the lower part of the femur and deep to the rectus femoris tendon], blends in with the retinacular
fibres of the vasti, attaches to the patella and the patellar ligament)
4. Intracapsular structures:​ Anterior cruciate ligament (prevents hyper extension of the knee – goes from the anterior intercondylar area
upwards, backwards, and laterally to the medial aspect of the lateral condyle), posterior cruciate ligament (prevents the femur slipping off the
fixed tibia – goes from the posterior intercondylar area upwards, forwards, and medially to the lateral aspect of the medial condyle), menisci
(the medial 1/2 of the popliteus fibres are attached to the posterior convexity of the lateral meniscus; the deep fibres of the tibial (lateral)
collateral ligament are attached to the lateral convexity of the medial meniscus), popliteus tendon, suprapatellar bursae, and superficial and
deep infrapatellar bursae
5. Intrinsic ligaments:​ Anterior and posterior cruciate ligaments (both are extrasynovial) , transverse ligament (attaches the anterior edges of
the menisci), and posterior meniscofemoral ligament (attaches the posterior lateral meniscus to the medial condyle of the femur); ​Extrinsic
ligaments:​ Patellar ligament (attaches the patella to the tibial tuberosity), medial and lateral collateral ligament (both prevent valgus and
varus movements), arcuate popliteal (fibular head to the knee joint capsule), and oblique popliteal (lateral femur to the posterior tibia)
6. Movements:​ Flexion (hamstrings – 120​○​ when hip is extended, 140​○​ when hip is flexed, and 160​○​ when sitting on heels), extension
(quadriceps muscle – 5-10​○​ beyond straight, limited by collateral ligaments, iliotibial band, cruciate ligaments, posterior capsule, and oblique
popliteal ligamaent), medial and lateral rotation may be active (60-70​○​ ) or passive (only occurs at the end of extension for 20​○​ – done by
popliteus) both of which is caused by the hamstrings acting on the fixed tibia
a. Rotation takes place between the menisci and the tibia while flexion and extension occur between the menisci and the femur
7. Stability:​ Most unstable joint of the lower limb since there is a low degree of bone articulation between the femur and the tibia; ligaments and
muscles are the main contributors to stability
 8. Relations:​ Anteriorly (quadriceps tendon, patella, and patellar ligament), posteriorly (popliteal fossa and its contents), medially (sartorius and
gracilis), and laterally (iliotibial band)
9. Blood supply:​ Genicular anastomosis; ​Nerve supply:​ Tibial, common peroneal, femoral, and obturator nerves
10. Bursae:​ 15 in total around the knee (main ones – suprapatellar, anserine, prepatellar, subcutaneous infrapatellar, and deep infrapatellar)
11. Clinical:​ Baker’s cyst (posterior herniation of the synovial membrane), patellar reflex (L2-4), knee replacement (total knee arthroscopy) etc.
Ankle Joint (Talocrural joint)

1. Type:​ Typical modified synovial hinge joint (mortise joint) with one degree of freedom
2. Articulation:​ Inferior facet of the tibia (weight bearing), trochlea of the talus (weight bearing), medial facet of the talus (not weight bearing),
lateral facet of the talus (not weight bearing), facet on the lateral malleolus of the fibula (not weight bearing), and facet on the medial
malleolus of the tibia (not weight bearing)
3. Capsular attachment:​ Attached to the articular margins of the tibia, fibula, and talus; anteriorly it extends to the neck of the talus and
posteriorly it is attached to the posterior tibiofibular ligament; the capsule is thinner anteriorly and posteriorly in the direction of movement
4. Intracapsular structure:​ None
5. Intrinsic ligaments:​ None; ​Extrinsic ligaments:​ Lateral collateral ligament (broken into three parts since the lateral malleoulus is more
mobile than the medial malleolus – anterior talofibular ligament [anterior border of the lateral malleolus to the neck of the talus],
calcaneofibular ligament [medial side of the lateral malleolus to a groove on the lateral surface of the calcaneus – houses most of the
proprioceptors], and posterior talofibular ligament [malleolar fossa to the posterior tubercle of the talus]), anterior and posterior tibiofibular
ligaments, and deltoid/medial collateral ligament (anterior tibiotalar ligament [medial malleolus to the medial aspect of the neck of the talus],
posterior tibiotalar ligament [medial malleolus to the posterior tubercle of the talus], tibionavicular ligament​ ​[medial malleolus to the
tuberosity of the navicular], and tibiocalcaneal ligament [medial malleolus to the sustenticulum tali])
6. Movements:​ Plantarflexion (60​○​ – most powerfully produced by soleus and gastrocnemius) and dorsiflexion (15-20​○​ – produced by tibialis
anterior, peroneus tertius, extensor halicus longus, and extensor digitorum longus)
7. Stability:​ Stable joint and the most important factor contributing to its stability is the integrity of the inferior tibiofibular joint (syndesmosis)
whose interosseous fibres hold the malleoli together; collateral ligaments further stabilises the joint
a. Greater bony congruence when the foot in dorsiflexed thus the joint is more stabilised in that position
8. Relations:​ Anterior (extensor muscles, peroneus tertius, tibialis anterior, anterior tibial artery and vein, and deep peroneal nerve), posterior
(flexor muscles, posterior tibial artery, tibialis posterior, tibial nerve, and tendo calcaneus), medial (deltoid ligament), and lateral (lateral
collateral ligament)
9. Blood supply:​ Anterior and posterior tibial arteries and to some extent by the peroneal artery; ​Nerve supply:​ Tibial and deep peroneal nerve
10. Bursae:​ None that we need to know
11. Clinical:​ Avulsion fracture of the lateral malleolus, anterior talofibular and posterior talofibular ligament tears, avascular necrosis of the
lateral process of the talus etc.
Talocalcaneonavicular joint

1. Type:​ Synovial ball and socket joint,

2. Articulation:​ Ball – head of the talus; socket – navicular, calcaneus and the spring ligament
3. Capsular attachments:​ The anterior end of the upper surface of the calcaneus, the sustentaculum tali, and the head of the talus. Between
these navicular and calcanean surfaces the head of the talus articulates with the fibro cartilaginous spring ligament. All of these structures are
enclosed in a single capsule
4. Intrinsic ligaments:​ None;​ Extrinsic ligaments:​ Dorsal talonavicular ligament (neck of the talus to the navicular bone on the dorsal surface)
and the plantar calcaenonavicular ligament (spring ligament – calcaneus to the navicular bone on the plantar surface)
5. Movements:​ Eversion and inversion of the foot
9. Nerve supply:​ Deep peroneal and medial plantar nerves

Talocalcanean joint

● Type:​ Posteriorly it is modified multiaxial joint (Grays) or a hinge/uniaxial joint (Rodgers); Anteriorly it is a plane synovial joint with one
degree of freedom
Axilla

● Borders
o Apex: Bounded by 1​st​ rib, clavicle, and superior border of the scapula
o Base: Skin of armpit and axillary fascia from arm to thoracic wall
o Anterior: Pectoralis major and minor
o Posterior: Subscapularis, teres major, and latissimus dorsi
o Medial: 1​st​ through 4​th​ ribs, serratus anterior, and intercostal muscles
o Lateral: Intertubercular groove of the humerus
● Contents: Axillary artery (and branches), axillary vein (and tributaries), axillary lymph nodes (apical, pectoral, subscapular, humeral, and
central), and brachial plexus

Quadrangular Space

● Borders
o Superior: Teres minor
o Inferior: Teres major
o Medial: Long head of triceps
o Lateral: Surgical neck of humerus
● Contents: Axillary nerve and posterior circumflex humeral artery

Triangular Interval (Lateral Triangular Space)

● Borders
o Superior: Teres major
o Medial: Long head of triceps
o Lateral: Shaft of humerus
● Contents: Radial nerve and profunda barchii artery
Triangular Space (Medial Triangular Space)

● Borders
o Superior: Teres minor and subscapularis
o Inferior: Teres major
o Lateral: Long head of triceps
● Contents: Scapular circumflex artery

Median Cubital Fossa

● Borders
o Superior (proximal): Imaginary line connecting the medial and lateral condyles
o Medial: Pronator teres
o Lateral: Brachoradialis
o Floor (deep): Brachialis, supinator, and median cubital vein
o Superficial (roof): Deep fascia, bicipital aponeurosis, subcutaneous tissue, and skin
● Contents: Superficial and deep branches of the radial nerve, biceps brachii tendon, brachial artery (and its terminal branches), and median
nerve (lateral to medial ​ ​ NTAN)

Anatomical Snuffbox

● Borders:
o Medial: Extensor pollicis longus
o Lateral: Extensor pollicis brevis and abductor policis longus
o Superficial (roof): Cutaneous branches of the radial nerve
o Deep (floor):Extensor carpi radialis longus and radial artery
● Contents: Cephalic vein; radial styloid process, scaphoid, trapezium, and the base of the first metacarpal is palpable in the snuffbox

Carpal Tunnel
 ● Transverse carpal ligament connecting the hamate & pisiform to the scaphoid & trapezium
● Contents: Flexor digitorum superficialis (4 tendons), Flexor digitorum profundus (4 tendons), flexor pollicis longus, and median nerve

Extensor Tendon Compartments

1. Abductor pollicis longus and extensor pollicis brevis

2. Extensor carpi ulnaris longus and extensor carpi radialis brevis
3. Extensor pollicis longus
4. Extensor digitorum and extensor indicis
5. Extensor digiti minimi
6. Extensor carpi ulnaris

Femoral Triangle

● Borders
o Superior (proximal): Inguinal ligament
o Medial: Medial border of adductor longus
o Lateral: Medial border of Sartorius
o Superficial (roof): fascia lata/cribiform fascia
o Deep (floor): adductor longus and pectineus
● Contents: Popliteal artery and vein, tibial and common peroneal nerves, and a small group of popliteal lymph nodes

Popliteal Fossa

● Borders
o Superolateral: Biceps femoris
o Superomedial: Semitendinosus and semimembranosus
o Inferolateral: Lateral head of gastrocnemius
o Inferomedial: Medial head of gastrocnemius and plantaris
o Superficial (roof): Fascia lata pierced by the lesser (small) saphenous vein
o Deep (floor):Popliteal surface of the femur, knee joint capsule, and popliteus muscle
● Contents: Popliteal artery and vein, tibial and common peroneal nerves, and a small group of popliteal lymph nodes
Types of Joints – Less relevant joints

● Sternoclavicular: Atypical double plane synovial with three degrees of freedom

o Contains a complete articular disc in the joint capsule
o Joint is strengthened by the costaclavicular and the interclavicular ligaments
o Inherently unstable; rarely dislocated (clavicular fractures in the midshaft is more common)
● Acromioclavicular: Atypical plane synovial with one degree of freedom
o Contains an incomplete articular disc
o Joint is strengthened acromioclavicular, coracoclavicular (conoid and trapezoid ligaments), and coracoacromial ligaments
o Inherently unstable joint that can be dislocated (or subluxed – partial/incomplete dislocation)
▪ Coracovlavicular ligament rupture leads to dropped shoulder and needs immediate surgery
● Radiocarpal: Typical biaxial synovial joint with two degrees of freedom
o A capsule surrounds the entire joint and is thickened to form palmar, dorsal, and collateral ligaments
● Midcarpal: Synovial planar joint
● 1​st​ carpometacarpal joint: Synovial saddle joint
● Carpometacarpal: Synovial planar joints
● Metacarpophalangeal: Synovial condyloid joints
● Interphalangeal (hand): Synovial hinge joints
● Sacroiliac: Diarthroidal joint
● Pubic: Symphysis joint
● Patellofemoral: Typical Saddle joint
● Superior Tibiofibular: Typical plane synovial joint
● Inferior Ibiofibular: Syndesmosis joint held together by anterior and posterior tibiofibular ligaments
● 1​st​ tarsometatarsal joint: only moves in the vertical plane
● 2​nd​ tarsometatarsal joint: immobile
● Interphalangeal (foot): hinge joints
Major Blood Vessel Branches – Upper Limb

Superficial veins
● Cephalic vein starts in the in the anatomical snuff box and goes up the lateral part of the arm and forearm via the deltopectoral groove and
pierces the clavipectoral fasci and inserts into the axial vein
o Communicates with the brachial vein via the median cubital vein at the median cubital fossa
● Basilic vein originates from the medial side of the dorsal venous network of the hand and travel up the medial part of the arm and forearm and
pierces the brachial fascia above the medial epicondyle to enter into the brachial vein

Deep Artery
● Subclavian artery turns into the axillary artery at the lateral margin of the first rib
o Branches off the axillary artery
▪ 1​st​ part (artery medial to pectoralis minor): Superior Thoraccic
▪ 2​nd​ part (posterior to pectoralis minor): Thoracoacromical and Lateral Thoraccic
▪ 3​rd​ part (lateral to pectoralis minor): Subscapular (gives off circumflex scapular which goes through the triangular space),
Anterior Circumflex Humeral, and Posterior Circumflex Humeral (goes through the quadrilateral space)
● Axillary artery turns into the brachial artery at the lower margin of the teres major
o Almost immediately the brachial artery gives off the profunda brachii branch which goes through the triangular interval and travels
along the radial groove to meet with the radial artery after the brachial artery splits
● The brachial artery splits into the radial and the ulnar arteries (halfway down the median cubital fossa) which travel down the lateral and
medial aspects of the forearm respectively
o The ulnar artery gives off the common interosseous artery which splits into the anterior and posterior interosseous arteries
o The ulnar artery primarily supplies the superficial palmar arch
▪ Primary blood supply to the lateral side of the 2​nd​ digit, and the 3​rd​, 4​th​, and 5​th​ digits completely
o The radial artery primarily supplies the deep palmar arch
▪ Primary blood supply to the medial side of the 2​nd​ digit and the 1​st​ digit (thumb) completely
Upper Limb Nerve injuries

● Erb’s Palsy (C5 and C6 root injury): waiter’s tip (arm hanging by the side, extended at the elbow, medially rotated, and pronated
● Klumpke’s Paralysis (C8 and T1 root injury): ulnar claw hand (inability to extend fingers and sensory loss on the ulnar side of the forearm)
● Axillary nerve damage (dislocations of the shoulder (5%) or fractures of the neck of the humerus): shoulder abduction is weak
o Complete division of the axillary nerve is unlikely
● Radial nerve damage (mid shaft humeral fracture around the radial groove region): can still extend the elbow but causes wrist drop (unable to
extend the wrist and metacarpophalageal joints)
o Radial nerve is more likely to be damaged high up (in brachial region instead of the elbow and further down)
● Ulnar nerve damage (most commonly damaged at the elbow or at the wrist): claw hand (hyperextension of the meracarpophalangeal joints,
flexion of the interphalangeal joints due to interossei and lateral two lumbricals being paralysed)
o Injury at the elbow or above gives straighter fingers because the medial half of the flexor digitorum profundus is also paralysed
● Median Nerve (most commonly injured at the wrist): wasting of the abductor pollicis brevis (primary sign)
Major Blood Vessel Branches – Lower Limb

Superficial veins
● Greater Saphenous vein starts at the medial aspect of the dorsum of the foot and courses upwards anterior to the medial malleolus along the
medial side of the leg, moving posteriorly around the medial condyle of the femur and up the medial aspect of the thigh, piercing the
cribiform fascia (3 cm below and lateral to the pubic tubercle) to join the femoral vein
o Incompetence valves in the vein can be the cause of varicosity
● Lesser Saphenous vein originates from the lateral side of the dorsum of the foot and travels up posterior to the lateral malleolus up the medial
part of the leg and pierces the popliteal fascia to enter into the popliteal vein

Deep Artery
● External iliac artery turns into the femoral artery once it crosses the inguinal canal midway between the anterior superior iliac spine and the
pubic symphysis
o Branches off the femoral artery
▪ 4 small branches immediately: superficial circumflex iliac, superficial epigastric, superficial external pudendal, and deep
external pudendal
▪ Profunda femoris branch is given off just after the termination of the femoral sheath
● The profunda femoris gives rise the medial (gives off an ascending, transverse and a descending branch) and lateral
circumflex femoral arteries
▪ The descending genicular artery is given off just prior to the femoral artery going through the adductor hiatus
▪ There is a risk of aneurysm occurrence in the femoral artery after the profunda femoris branching and prior to the descending
genicular artery origination
● After passing through the adductor hiatus the artery is known as the popliteal artery
o Popliteal artery branches
▪ Anastamotic branches: superior medial genicular, inferor medial genicular, superior lateral genicular, inferior lateral genicular,
middle genicular
▪ There is a risk of aneurysm occurrence in the popliteal artery
● The popliteal artery splits into the anterior tibial (goes to the anterior aspect through the oval opening at the proximal aspect of the
interosseous membrane) and the posterior tibial arteries (this provides another branch, peroneal artery which runs along the back of the fibula)
o The posterior tibial continues on to separate into the medial plantar (mainly supplies the big toe) and the lateral plantar (supplies the
plantar arch and connects to the dorsaelis pedis (via the connecting deep plantar artery) artery by passing through the first cleft
o The anterior tibial artery becomes the dorsaelis pedis artery once it crosses the imaginary line connecting the tow malleoli