Muscular System: by Sisay A

8/2/2021
Introduction
 Muscle cells:
MUSCULAR SYSTEM  often called muscle fibers because they are long and narrow when
relaxed
 are specialized contractile cells, organized into tissues that move body
parts
By Sisay A.  The associated connective tissue conveys nerve fibers and capillaries to
the muscle fibers as it binds them
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Muscle: Function
Basic functional properties.
 Produces movement  Contractility – shortening of a muscle to apply a strong pulling
force to bring about movement.
 Maintains posture-
 Excitability – muscles are excited by nerve or other factors
 Stabilizes joints
carrying impulse that signal their contraction.
 Generates heat
 Extensibility – the ability of muscle to stretch to their original
length after contraction.
 Elasticity – the ability of muscles to recoil & resume their resting
length after a stretch.
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Types of muscles
 The three types of muscle tissue are skeletal, cardiac, and
smooth
 These types differ in structure, location, function, and
means of activation
1:skeletal muscle, which moves bones and other
structures
2:cardiac muscle, which forms most of the walls of the
heart, and is autonomic
3:smooth muscle, which forms part of the walls of most
vessels and hollow organs, moves substances through
viscera such as the intestine, and controls movement
through blood vessels.
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Skeletal muscle
 Wrapped by connective tissue into organs called muscles
 attached to the bone by a dense regular connective tissue (tendon or
aponeurosis) and some to skin
 As contracts it causes gross body movements
 Striated (fibers contain alternating light and dark bands)
 Is controlled voluntarily (i.e., by conscious control)
 Contracts rapidly but tires easily
 Is responsible for overall body motility
 There are about 600 skeletal muscles in the human body constituting about
40% of the body weight
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Connective Tissue Wrappings

 Each skeletal muscle is a discrete organ with thousands of fibers
 Muscle fibers predominate the tissue but it also contains blood
vessels, nerve fibers, and connective tissue
 Each muscle fiber is wrapped by fine sheath of areolar connective called
endomysium
 Several fibers are gathered side by side into bundles called fascicles
 Each fascicle is bound by collagen fiber layer called the perimysium
 The entire muscle is bound by a dense fibrous connective tissue
layer called the epimysium
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Connective Tissue Wrappings

 External to the epimysium is the deep fascia that binds muscles
Attachments
into functional groups
 All the connective tissue layers are continuous with one another as  Most muscles span joints and have at least two attachments
well as with the tendons that join muscles to bone  Origin
 When muscle fibers contract they pull these connective tissue sheaths  Attachment of a muscle that remains relatively fixed during muscular
contraction
which in turn transmit the force to the bone to be moved  Generally a more proximal or axial location
 Insertion
 Attachment of a muscle that moves during muscular contraction
 Generally a more distal or appendicular attachment
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Skeletal Muscle Fiber

 Long, cylindrical and multinucleated cells
 Diameter of 10-100 m up to 10 times average cell size
 Bellies :have a fleshy contractile portion composed of skeletal
 Length from few to several cm
striated muscle
 Their many nuclei lie at the cell periphery, just deep to the
 tendons (rounded) and aponeurosis (flat sheets) :white non-
sarcolemma
contractile portion composed mainly of collagen bundles
 Cytoplasm is referred as sarcoplasm
 Direct attachments have the epimysium attaching directly
 Enveloped by the sarcolemma (plasma membrane)
to the periosteum of the bone or perichondrium of a cartilage
 Striation is due to myofibrils; specialized contractile cellular
 Indirect attachments have the epimysium attaching to a
organelles unique to muscle fibers
tendon or an aponeurosis
 Myofibrils are un branched cylinders making up 80% of the sarcoplasm
 A myofibril is a long row of repeating segments called sarcomeres
 The sarcomere is the basic unit of contraction in skeletal muscle
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Skeletal Muscle
 Motor axons innervate skeletal muscle fibers at junctions called

Skeletal Muscle: Nerve and Blood Supply neuromuscular junctions, or motor end plates
 A single neuromuscular junction is associated with each muscle fiber
 These junctions are similar to the synapses between neurons
 Each muscle is served by one nerve, an artery, and one or
 Each muscle is served by at least one motor nerve which contains
more veins hundreds of motor neuron axons
 Each skeletal muscle fiber is supplied with a nerve ending that  As a nerve enters a muscle it branches into a number of axonal terminals,
each of which forms a neuromuscular junction with a single nerve fiber
controls contraction  A motor neuron and all the muscle fibers it supplies is called a motor
 Contracting fibers require continuous delivery of oxygen and unit
nutrients via arteries  When a motor neuron transmits an electrical impulse, all the muscle
fibers that it innervates respond by contracting
 The average number of muscle fibers per unit is 150, but it ranges from 4
to several hundred
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Nerve Stimulus of Skeletal Muscle

 Muscles that require very fine control, such as the muscles moving the
 Skeletal muscles are stimulated by motor neurons of the somatic
fingers and eyes, have few muscle fibers per motor unit
 Large muscles of locomotion and weight bearing have large motor units
nervous system
and as a consequence have less precise control  Axons of these neurons travel in nerves to muscle cells
 The muscle fibers in a unit are not clustered together but rather are spread  Axons of motor neurons branch profusely as they enter muscles
throughout the entire muscle
 Each axonal branch forms a neuromuscular junction with a single muscle
 Stimulation of a single unit causes a weak contraction of the entire muscle
 This allows control of the intensity of the contraction
fiber
 The functional unit of a muscle, consisting of a motor neuron and the
muscle fibers it controls, is a motor unit.
Contraction of Muscles
 When muscles contract, the fibers shorten to about 70% of their resting
length.
 Skeletal muscle can undergo contraction in three ways:
 Reflexive contraction -is automatic and not voluntarily controlled for
example, respiratory movements of the diaphragm. Muscle stretch is
produced by tapping a tendon with a reflex hammer.
 Tonic contraction -is a slight contraction (muscle tone) that does not
produce movement or active resistance but gives the muscle firmness,
assisting the stability of joints and the maintenance of posture
 Only during consciousness
Phasic contraction-
 There are two principal types of phasic contraction.
 In isometric contractions, the muscle length remains the same no
movement occurs but muscle tension is increased above tonic levels (e.g.,
the deltoid holds the arm in abduction).
 In isotonic contractions, the muscle changes length to produce
movement.
o concentric contraction, in which movement occurs owing to
muscle shortening (e.g., the deltoid shortens to raise the arm
into abduction)
o eccentric contraction, in which the contracting muscle
lengthens (e.g., the deltoid lengthens to lower arm in
adduction).
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Prime Movers
Functional Muscle Groups  A muscle that provides the major force for producing a specific
 Muscles can be classified into four functional groups movement is called a prime mover or agonist
 Prime mover: the muscle that has the major responsibility for  The biceps brachii is the prime mover of elbow flexion
causing a particular movement
 Antagonists: muscles that oppose or reverse a movement Antagonist
 Synergists: work together or help prime movers by producing  Muscles that oppose a particular movement are called antagonist
the same movement or by reducing undesirable movements
 When a prime mover is active, the antagonist muscles are often stretched
 Fixators: specialized synergists and may be in a relaxed state
 Hold a bone still or stabilize the origin of a prime mover
 Antagonists also regulate the action of prime mover
Synergist Naming Skeletal Muscles

 Synergists aid agonists by promoting the same movement and by reducing  Shape
extraneous movements that may be produced when the prime mover acts ◦ rhomboids (rhomboid), trapezius (trapezoid)
 In two joint muscles synergists stabilize a joint as the muscle acts on the  Location
other ◦ pectoralis (chest or pectus), intercostal (between ribs)
 Synergist can also restrict rotary movement at a joint so the muscle’s full  Attachment
effort be applied to the desired movement ◦ sternocleidomastoid (sternum, clavicle & mastoid process)
 Size
◦ maximus (largest), minimus (smallest), longus (long), brevis (short)
Fixators  Number of origins
◦ Biceps, triceps
 Serves to stabilize the bone upon which a prime mover acts  Orientation of fibers
◦ rectus (straight), transverse, oblique
 Serratus anterior holds the scapula against the thorax while a prime
 Relative position
mover acts upon the arm ◦ medial, lateral, internal & external
 Action
◦ adductor, flexor, extensor, levator
Arrangement of Fascicles
 Arrangement of fascicles within a muscle vary

 Arrangements result in differing shapes and capabilities
 Common forms are
 Parallel: fusiform
 Pennate: uni-, bi-, multi-
 Convergent
 Circular or sphincteral
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Parallel Pennate
 the long axis of the fascicles run  Pennate fascicles are short and Convergent Circular
parallel to the long axis of the they attach obliquely to a  Fascicular pattern is arranged in
 A convergent muscle has a broad
central tendon concentric rings
muscle origin and its fascicles converge
 Occur as unipennate, bipennate
 Form long strap like muscles toward a single tendon  Surround external body
and multipennate forms
that have greatest potential for  Muscle has a broad triangular openings which they close by
 Pennate muscles with the
shortening shape contracting
highest concentration of fibers,
 Not very powerful shorten little, but are very  Muscle can act upon the joint  This type of muscles are called
powerful from a variety of positions sphincters
 Pectoralis major
Division of skeletal muscles The Principal Skeletal Muscles

 The major divisions of the muscular system follow  There are about 650 muscles in the human body
that of the skeletal system:  Major muscles of the Head
1. Axial muscles:  Major muscles of the Neck
 – position head and spinal column  Major muscles of upper limb
 – move rib cage  Major muscles of the trunk
 – comprise about 60% of skeletal muscles  Major muscles of Lower limb
2. Appendicular muscles:
 – support pectoral and pelvic girdles
 – support limbs
 – comprise about 40% of skeletal muscles
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 Skin
face Boundaries  Very vascular; wounds bleed profusely but heal rapidly
 Superiorly – the  Rich in sebaceous and sweat glands

 Elastic and thick; wounds tend to gap
margins of the hair
 Superficial fascia
 Inferiorly – the chin
 Contain facial muscles, nerves, vessels and fat (buccal fat pad in cheeks)
 Laterally – the
 Deep fascia
auricle
 Absent except over parotid gland and over buccinator muscle
 N.B. the forehead is
common for the
scalp and the face
Muscles of the eyelids and eyebrow

Muscles of the face 1. Orbicularis Oculi
 Three parts - supplied by
 Lie in subcutaneous tissue temporal branches of facial
nerves
 Inserted in to the skin A. Palpebral
 Named as muscles of facial  Action: Close the palpebral
fissure firmly to protect from
expression danger
 Arranged in groups around B. Orbital
 Action: Gentle close , during
the orbit, nose, mouth and sleeping
auricles C. Lacrimal
 functionally considered as  Action: Passing tear in to
regulators of openings lacrimal puncta by drawing the
eye lids medially, dilating the
 Supplied from branches of lacrimal fossa
facial nerve 
Muscles around nose

2. Corrugators supercilli
Muscle Origin Insertion Action
 Origin: Medial part of superciliary arch
Proceruss Nasal bone & lateral Medial part of the Transverse wrinkles
 Insertion: Skin of eye brows cartilage skin of the eye brows (horror )
 Action: Vertical wrinkling of middle part of fore head (frowning )
Compressor naris Maxilla (frontal Join the fibers of its Compress anterior
 N.S. Temporal branch of facial nerve process ) opposite side nasal opening
 Levator palpebrae superioris
 Raises upper eye lid
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Dilator naris Maxilla Ala of nose Muscles around mouth

Dilates anterior nasal Levator labii Cartilage and skin of Skin of upper lip
Depressor septi Maxilla (above Nasal septum superioris alaeque ala of anterior nasal
central incisor ) openings
nasi opening
Levator labii Maxilla (frontal Cartilage and skin of Dilates anterior nasal
Mussels elevating Levator labi Maxilla and
superioris alaeque process ) ala of anterior nasal openings Elevate the superioris zygomatic bone
the upper lip
nasi opening upper lip
Skin of upper lip Zygomaticus minor Behind zygomatico
Nerve supply – buccal branch maxillary suture
Nerve supply – buccal branch of facial nerve
Mussels elevating Zygomaticus major Zygomatic bone Skin angle of the Muscle pulling the angle of Risorius Parotid fascia Skin of angle of the Buccal
the angle of the behind mouth mouth laterally mouth branch
mouth zygomatic minor
Buccal branch Muscles depressing the Depressor labi Oblique line of Angle of the mouth Mandibular
Levator anguli oris Maxilla below lower lip inferioris mandible Skin of lower lip branch
infraorbital Muscles protruding the Incisor fossa of Skin of the chin Mandibular
foramen lower lip and wrinkling the the mandible branch
Muscles depressing Depressor anguli oris Oblique line of Skin angle of the skin of the chin Mentalis
the angle of the mandible mouth Mandibular branch
mouth
Buccinator
Origin: Two site
 Pterogomandibular ligament
 Maxilla and mandible (opposite 3rd
molar tooth)
 Insertion:
 Upper fibers – upper lip
 Middle – decussate at the angle
 Lower- lower lip
 Nerve supply: Buccal branches of
facial nerve
 Action: Compress the cheek against
the gum
 prevent accumulation of food in the
vestibule
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Orbicularis Oris
 Three parts
 Origin:
 intrinsic fibers – connect the skin and
mucus membrane
 Incisive bundles- maxilla and
mandible
 extrinsic fibers – surrounds the
mouth
 Insertion: No attachment because
the fibers form concentric ring
 Nerve supply: Buccal and
mandibular branches of facial
nerves
 Action:
 Close the oral fissure
 Compress the lips against the teeth
 protrude the mouth
Muscles the
auricle
 Rudimentary in
human
 Anterior auricular
 Posterior
auricular
 Superior auricular
 All are not
functional in humans
and supplied by
branches of facial
nerve
Muscles of mastication  Lateral Pterygoid

 Origin – upper head (greater wing) and
 Move mandible at TMJ
lower head (lateral pterygoid plate)
 All are supplied by mandibular  Insertion – neck of mandible and
nerve capsule of TMJ
 Masseter  Action
 Origin – zygomatic arch  together – depress and protrude mandible
 Alone – side to side movement
 Insertion – ramus of mandible and
coronoid process  Medial pterygoid
 Action – elevates mandible  Origin – superficial head (maxilla) and
Deep head (lateral pterygoid plate and
 Temporalis
palatine bone)
 Origin – temporal fossa and fascia
 Insertion – ramus
 Insertion – coronoid process and
 Action
ramus
 together – elevates and protrude mandible
 Action – elevate and retract
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 sisay A - produce grinding motion
mandible
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Sternocleidomastoid muscle
 Runs superolaterally from sternum and clavicle to mastoid process
 Landmark muscle to divide the neck into anterior and posterior triangles
 Origin – two heads
 Sternal head – anterior surface of manubrium
 Clavicular head – medial third of the upper surface of the clavicle
 Between the two heads is lesser supraclavicular fossa, overlying internal jugular vein
 Insertion – mastoid process & lateral half of superior nuchal line
 Nerve supply – spinal root of accessory nerve and branches from ventral ramus of
C2 and C3
 Action
 one muscle acting alone - bend the head to the same side and rotate the face to
Triangles of the neckTriangles of the neck
the opposite side
 the two muscles acting together – draw head forwards and flex the neck
Introduction
 Applied anatomy  Each side of the neck is divided into anterior and posterior
 Torticollis (wry neck) – head bent to one side due to spasm of triangles by sternocleidomastoid
sternocleidomastoid muscle
 Levator scapulae
Muscles in posterior triangle  Origin – transverse process of C1 to C4

 Insertion – superior part of medial border of
 Form floor of the triangle scapula
 Splenius captis  Innervation – dorsal scapular and cervical
spinal nerves
 Origin – lower half of ligamentum nuchae, spines of C7, T1-6
 Action – elevates scapula
 Insertion – lateral third of superior nuchal line and mastoid process
 Scalenus medius
 Innervation – dorsal rami of middle cervical spinal nerves  Origin - transverse process of C2 to C7
 Action  Insertion – superior surface of first rib
 one muscle – bend the head and neck to the same side & turns the face to the  Innervation – ventral rami of cervical spinal
same side nerves (C3-C8)
 two muscles - extend the head and neck  Action – flex neck laterally and elevates first
rib
 Scalenus posterior
 Origin - transverse process of C4 to C8
 Insertion – external border of second rib
 Innervation – ventral rami of cervical spinal
nerves (C3-C8)
 Action – flex neck laterally and elevates
second rib
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Anterior triangle of the neck

 Lie b/n midline of the neck
& SCM
 It is subdivided in to
smaller triangles
 Boundaries
 Anterior - median line of the
neck from chin to manubrium
 Posterior- anterior border of
the sternocleidomastoid
 Base (superior) - inferior
border of mandible and plane
connecting angle of the
mandible to mastoid process
 Apex – at jugular notch
 Floor - formed by pharynx,
larynx and thyroid gland
Contents
 Hyoid muscles: Suprahyoid and infrahyoid
muscles
Suprahyoid muscles
 Mylohyoid muscle
 Forms the floor of the mouth below tongue
 Origin – mylohyoid line of the mandible
 Insertion – body of hyoid
 Nerve supply – mylohyoid nerve
 Action - elevate the hyoid bone
 Geniohyoid muscle
 Superior to mylohyoid; reinforce floor of
mouth
 Origin – from inferior genial tubercle of
mandible
 Insertion – into the anterior surface of the
body of the hyoid bone
 Nerve supply – C1 through the hypoglossal
nerve
 Action – pull the hyoid bone up and forward,
shorten mouth floor and widens pharynx
• Stylohyoid muscle
– Lies above the posterior belly of the digastric
Infrahyoid Muscles
muscle  Depressors of the larynx and the
– Origin – styloid process
– Insertion – body and greater horn of the hyoid
hyoid bone
– Nerve supply – suprahyoid branch of facial nerve  4 muscles arranged into two
– Action – pull the hyoid bone back & up ward
during swallowing layers
• Digastric Muscle  Superficial layer
– Has 2 bellies connected by tendon
 Medially - Sternohyoid
– Origin
• Anterior belly - digastric fossa of mandible  Laterally- Omohyoid
• Posterior belly – mastoid notch
– Insertion – intermediate tendon, that passes  Deep layer
through fibrous ring, connected to the body and  Superiorly - Thyrohyoid
greater horn of the hyoid bone
– Nerve supply  Inferiorly- Sternothyroid
• Anterior belly – nerve to mylohyoid ( branch of
mandibular nerve)
• Posterior belly – suprahyoid (branch of facial nerve)
– Action – two bellies elevate hyoid bone; the
anterior belly also depress the mandible
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Subdivisions of the anterior triangle

 By digastric muscle and
superior belly of omohyoid
anterior triangle is divided into
4 triangles
 Submental triangle
 Submandibular (digastric)
triangle
 Carotid triangle
 Muscular triangle
 Ligamentum nuchae
Back of the neck  strong triangular fibroelastic
septum
 Nerves
 Attachments
o Cutaneous nerves – medial branches of dorsal rami of C2-5
 Base – to the external occipital
 Greater occipital – medial branch of dorsal ramus of C2 protuberance
 Lesser occipital -medial branch of vental ramus of C2  Apex – to spine of C7
 Third occipital - medial branch of dorsal ramus of C3  Posterior – to spines of cervical
vertebrae
 Anterior – to investing deep fascia
of the neck
 Origin for – trapezius, splenius
& rhomboid minor
 Muscles of the back – 4 layers  Splenius

 1st layer – trapezius  Origin – lower half of ligamentum nuche, spines of C7 & T1-6
 2nd layer – splenius & levator scapulae  Insertion – two parts
 Upper part – splenius capitis - lateral part of mastoid process & superior
 3rd layer – semispinalis capitis & longissimus capitis nuchal line
 4th layer – sub occipital muscles, multifidius, rotators &  Lower parts - splenius cervicis – upper part of transverse process of C2-3
interspinalis  Nerve supply – dorsal rami of C4-8
 Action
 one muscle – bend the head and neck to the same side & turns the face to
the same side
 Two muscles - extend the head and neck
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 Semispinalis
 Origin - from the transverse
processes of T4-6
 Insertion – three parts
 Semispinalis capitis - deep to the
splenius capitis into the area
between superior and inferior
nuchal line
 Semispinalis cervicis – deep to
the semispinalis capitis into
spines of C2-4
 Semispinalis thoracis - upper
thoracic spines
 Nerve supply – dorsal rami of
cervical nerves
 Action
 one muscle – bend the
head to the same side &
turns the face to the
opposite side
 Two muscles - extend the
neck
 Longissimus capitis  Sub-occipital muscles

 lateral to the  four muscles on each side
semispinalis & deep to  Rectus capitis posterior
the splenius capitis major
 Origin - from the  Origin - spine of axis
transverse processes of  Insertion – lateral area below
T4-6 the inferior nuchal line
 Insertion – mastoid  Rectus capitis posterior
process minor
 Nerve supply – dorsal  Origin – spinous tubercle of
rami of cervical nerves atlas
 Action  Insertion – medial part of the
 one muscle – bend the skull below the nuchal line
head to the same side &
turns the face to the  Action of suboccipital
opposite side muscles – act as ligament
 Two muscles- extend the
neck to stabilize the head, atlas
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Suboccipital triangle of the neck

 Boundaries
 Above and medially- rectus
capitis posterior major and
minor
 Laterally – superior oblique
 Inferiorly – inferior oblique
 Roof
 Medially –
semispinalis
 Laterally – splenius
capitis
 Floor - posterior arch of
atlas and posterior
atlantooccipital membrane
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 Contents
 3rd part of vertebral artery Deep structures in neck
 suboccipital nerve (dorsal ramus of C1)
 suboccipital plexus of veins Prevertebral muscles
 Extend from skull base to
superior mediastinum,
covering vertebral column
 Covered by prevertebral
fascia
 Are flexors of head and
neck
 Supplied by ventral rami of
cervical nerves
 Longus Capitis
 Longus colli (cervicis)  Broad superiorly and narrow
 Upper and lower part is inferiorly
oblique and middle part is  Origin – transverse processes of
vertical C3- C6 vertebrae
 Origin  Insertion – base of skull
 upper oblique part – transverse  Nerve supply – C1 – C3
processes of C3-C5
 lower oblique part - bodies of  Rectus Captis Anterior
upper 2 or 3 thoracic vertebrae  Origin – lateral mass of atlas
 middle vertical part - bodies of  Insertion – base of skull
C5 – T3
 Nerve – C1
 insertion
 Rectus Captis Lateralis
 upper – anterior tubercle of
atlas  Origin – transverse process of
 lower – anterior tubercles of C5 atlas
and C6  Insertion – occipital bone
 middle – bodies of C2-C4
 Nerve supply – C1 and C2
 nerve supply – C3 – C8
Axioappendicular Muscles Pectoralis major

Anterior Axioappendicular Muscles  Origin - clavicle, sternum, and
cartilages of ribs 1 - 6
 Four muscles that move  Insertion – lateral lip of
the pectoral girdle intertubercular groove of
humerus
 Pectoralis major  Action - arm flexion, arm
 Pectoralis minor medial rotation, arm adduction
 Accessory muscle of respiration
 Subclavius in forceful inspiration
 Serratus anterior  Innervation – lateral and medial
pectoral nerves (C5-C7 &T1)
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Serratus anterior
Pectoralis minor
 Origin – lateral parts of
 Origin - anterior surfaces ribs 1-8
of ribs 3-5  Insertion - anterior
 Insertion - coracoid process surface of medial border
of scapula of scapula
 Action - ribs fixed draws  Action - protract the
scapula forward and scapula; rotates scapula
downward  Innervation - long thoracic
 Innervation - medial nerves (C5-C7)
pectoral nerve (C8 & T1)
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Paralysis of serratus anterior Subclavius

 Lies horizontally inferior to
 Due to injury of long thoracic clavicle
nerve  Small, round
 Medial border of the scapula  Protect subclavian vessels and
moves laterally and posteriorly superior trunk of brachial
plexus
away from thoracic wall
 Origin: Junction of 1st rib
 winged scapula and its costal cartilage
 Arm cannot be abducted  Insertion: Inferior surface of
above horizontal position middle third of clavicle
 Innervation: Nerve to
subclavius
 Action: Anchors and
depresses clavicle
87 88
Posterior Axioappendicular Muscles Trapezius

 Attach the superior  Origin - Occipital bone,
appendicular skeleton to the ligamentum nuchae,
axial skeleton spines of C7 & all thoracic
 Divided into three groups
vertebrae
 Insertion - acromion and
 Superficial (extrinsic shoulder)
muscles : trapezius and spine of scapula and
latissimus dorsi lateral 1/3 of clavicle
 Deep (extrinsic shoulder)  Action - elevate and rotate
muscles : levator scapulae and scapula
rhomboids  Innervation - spinal
 Scapulohumeral (intrinsic accessory nerve and
shoulder) muscles: deltoid, cervical nerves (C3 & C4)
teres major, and the four
rotator cuff muscles
(supraspinatus, infraspinatus,
89
teres
sisay Aminor, and subscapularis) 90 sisay A
89 90
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Rhomboid major
Rhomboid minor
 Origin - spinous processes
 Origin - spinous processes of C7 and T1
of T2 - T5
 Insertion - medial border of scapula
 Insertion - medial border
 Action – retract, rotate and stabilize
of scapula
scapula
 Action – retract, rotate and  Innervation - dorsal scapular nerve
stabilize scapula
 Innervation - dorsal
scapular (C5) and cervical
nerves (C3 & C4)
91 92
Latissimus dorsi Scapulohumeral Muscles

 Origin - spines of T6 - T12  Six muscles
and thoracolumbar fascia,  Deltoid
iliac crest and inferior ribs
 Insertion - intertubercular  Teres major
groove of humerus  Supraspinatus
 Action - arm extension,
adduction and medial  Infraspinatus
rotation
 Subscapularis
 Innervation -thoracodorsal
nerve (C6-C8)  Teres minor
 Short muscles that pass from
scapula to humerus
 Act on glenohumeral joint
93 94
Deltoid muscle
 Thick powerful muscle forming Teres major
the rounded contour of the  Origin: Posterior surface of
shoulder
 Divided into clavicular (anterior), inferior angle of scapula
acromial (middle), and spinal  Insertion: intertubercular groove
(posterior) parts that can act
separately or as a whole of humerus
 Origin: Lateral third of clavicle;  Innervation: Lower subscapular
acromion and spine of scapula nerve
 Insertion: Deltoid tuberosity of
humerus  Action: Adducts and medially
 Innervation: Axillary nerve rotates arm
 Action:
 Anterior part: flexes and medially
rotates arm
 Middle part: abducts arm
 Posterior part: extends and
laterally rotates arm
95 96
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Rotator cuff muscles

 Four of the scapulohumeral muscles:
supraspinatus, infraspinatus, teres minor,
and subscapularis
 Called rotator cuff because they form a
musculotendinous cuff around
glenohumeral joint
 All except the supraspinatus are rotators of
the humerus
 The supraspinatus initiates and assists the
deltoid in the abduction of the arm
 The tendons of the rotator cuff muscles
blend with the joint capsule of the
glenohumeral joint, which protects the
joint and gives it stability
 Tonic contraction of these muscles holds
the relatively large head of the humerus
firmly against the small and shallow glenoid
cavity during arm movements
97 98
Axilla: walls
 Anterior wall
 Formed by pectoralis major and
minor with their fascia
 Anterior axillary fold is inferior most
part of this wall
 Posterior wall
 Formed by scapula and subscapularis
and inferiorly by the teres major and
latissimus dorsi
 Posterior axillary fold is the inferior
most part of this wall
 Medial wall
 Formed by the thoracic wall (1st-4th
ribs and intercostal muscles) and
serratus anterior
 Lateral wall
 Narrow bony wall, formed by
humerus
99 100
Axilla: content Brachial plexus

 The axilla contains Formation
 axillary artery and its
branches  Brachial plexus is a major
 axillary vein and its
network of nerves supplying the
tributaries upper limb
 nerves of the cords and  It begins in the lateral cervical
branches of the brachial region (posterior triangle) and
plexus extends into the axilla
 lymphatic vessels  Formed by the union of the
 groups of axillary lymph anterior rami of C5 - T1 nerves,
nodes which constitute the roots of
brachial plexus
101 102
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Position Muscles of arm

 The roots lie between
 Four arm muscles
the anterior and middle  Three flexors
scalene muscles  biceps brachii, brachialis, and
 The trunks traverse the coracobrachialis
 in the anterior (flexor)
posterior triangle of the compartment
neck  supplied by musculocutaneous
nerve
 The divisions lie behind
 One extensor
the clavicle  triceps brachii
 The cords lie in the  in the posterior compartment
axilla  supplied by radial nerve
 Anconeus
 a small triangular muscle on the
posterior aspect of the elbow,
covers the posterior aspect of the
103 sisay A 104
ulna
sisay Aproximally
103 104
Biceps brachii Brachialis

 Has two heads; long head and  Flattened fusiform muscle
short head  Lies posterior (deep) to the
 Origin: biceps
 Short head: tip of coracoid  It is the only pure flexor
process of scapula  Origin: Distal half of anterior
 Long head: supraglenoid tubercle surface of humerus
of scapula  Insertion: Coronoid process
 Insertion: tuberosity of radius and
and tuberosity of ulna
fascia of forearm via bicipital  Innervation: Musculocutaneous
aponeurosis nerve (C5, C6)
 Action: Flexes forearm in all
 Innervation: Musculocutaneous positions; when the forearm is
nerve (C5, C6) extended slowly, the brachialis
 Action: Supinates forearm and, steadies the movement by
when it is supine, flexes forearm; slowly relaxing
105resists dislocation of shoulder
sisay A 106 sisay A
105 106
Coracobrachialis Triceps brachii

 Origin: Tip of coracoid  Large fusiform muscle in posterior
process of scapula compartment
 Insertion: Middle third  Origin:
 Long head: infra-glenoid tubercle of
of medial surface of scapula
humerus  Lateral head: posterior surface of
humerus, superior to radial groove
 Innervation:  Medial head: posterior surface of
Musculocutaneous humerus, inferior to radial groove
nerve (C5, C6, C7)  Insertion: Proximal end of
olecranon of ulna and fascia of
 Action: Helps flex and forearm
adduct arm; resists  Innervation: Radial nerve (C6, C7,
dislocation of shoulder C8)
 Action: Chief extensor of forearm;
long head resists dislocation of
humerus
107 108
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Anconeus Nerves of arm

 Origin: Lateral epicondyle of  4 main nerves
humerus  Median
 Insertion: Lateral surface of
 Musculocutaneous
olecranon and superior part of
posterior surface of ulna  Ulnar
 Innervation: Radial nerve (C7,  Radial
C8, T1)
 Action: Assists triceps in
extending forearm; stabilizes
elbow joint; may abduct ulna
during pronation

109 110
Cubital fossa  Contents

 Brachial artery and branches,
 Shallow triangular depression
on anterior surface of the radial and ulnar arteries
elbow  Accompanying veins of the
 Boundaries arteries
 Superiorly, an imaginary line  Biceps brachii tendon
connecting the medial and lateral
epicondyles  Median nerve
 Medially, pronator teres  Radial nerve, dividing into its
 Laterally, brachioradialis superficial and deep branches
 Floor  Median cubital vein
 brachialis and supinator muscles
 Medial and lateral cutaneous
 Roof
 the continuity of brachial and
nerves of the forearm
antebrachial (deep) fascia,
reinforced by the bicipital
aponeurosis, subcutaneous tissue
and skin
sisay A sisay A
111 112
111 112
Muscles of Forearm
 The tendons of the forearm muscles pass through the distal part
of the forearm and continue into the wrist, hand and fingers
 The flexors and pronators of the forearm are in the anterior
compartment and are served mainly by the median nerve
 The extensor and supinators are in posterior compartment and
are all innervated by the radial nerve

113 114
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Superficial (first) layer muscles

Flexor-pronator muscles of the forearm  Pronator teres
 The flexor-pronator muscles are  Origin
 Ulnar head: coronoid process
in the anterior compartment of
 common flexor origin
the forearm  Insertion: middle of lateral surface
 The tendons of most flexor of radius
muscles pass across the anterior  Innervation: median nerve (C6,
surface of the wrist and are held C7)
in place by palmar carpal  Action: pronates and flexes
ligament and flexor retinaculum forearm
 The flexor-pronator muscles are  Flexor carpi radialis
arranged in three layers  Origin: common flexor origin
 Superficial layer  Insertion: Base of 2nd metacarpal
 Intermediate layer  Innervation: median nerve (C6,
C7)
 Deep layer
 Action: Flexes and abducts hand
 (at wrist)
115 116
 Palmaris longus Intermediate (second) layer muscles

 Origin: common flexor origin
 Insertion: Distal half of flexor  Flexor digitorum
retinaculum and apex of palmar
aponeurosis superficialis (FDS)
 Innervation: median nerve (C7,  Origin
C8)  Humeroulnar head: Medial
 Action: Flexes hand (at wrist) and epicondyle (common flexor
tenses palmar aponeurosis origin and coronoid process)
 Radial head: Superior half of
 Flexor carpi ulnaris anterior border
 Origin  Insertion: Shafts of middle
 Humeral head: common flexor origin phalanges of medial four fingers
 Ulnar head: Olecranon and posterior  Innervation: Median nerve (C7,
border (via aponeurosis) C8, T1)
 Insertion: Pisiform, hook of  Action: Flexes middle phalanges
hamate, 5th metacarpal at proximal interphalangeal joints
 Innervation: ulnar nerve (C7, C8) of middle four fingers; acting
 Action: Flexes and adducts hand (at more strongly, it also flexes
wrist) proximal phalanges at
sisay A
metacarpophalangeal
sisay A
joints
117 118
117 118
Deep (third) layer muscles  Flexor pollicis longus

 Flexor digitorum profundus (FDP) (FPL)
 Origin: Anterior surface of radius and
 Origin: Proximal three quarters of medial adjacent interosseous membrane
and anterior surfaces of ulna and
interosseous membrane  Insertion: Base of distal phalanx of
thumb
 Insertion:
 Innervation: Anterior interosseous
 Medial part: Bases of distal phalanges of
4th and 5th fingers
nerve, from median nerve (C8, T1)
 Action: Flexes phalanges of 1st digit
 Lateral part: Bases of distal phalanges of
3rd and 2nd fingers
(thumb)
 Innervation:  Pronator quadratus
 Medial part: Ulnar nerve (C8, T1)  Origin: Distal quarter of anterior
 Lateral part: Anterior interosseous surface of ulna
nerve, from median nerve (C8, T1)  Insertion: Distal quarter of anterior
 Action: surface of radius
 Medial part: Flexes distal phalanges 4  Innervation: Anterior interosseous
and 5 at distal interphalangeal joints nerve, from median nerve (C8, T1)
 Lateral part: Flexes distal phalanges 2  Action: Pronates forearm; deep fibers
and 3 at distal interphalangeal joints bind radius and ulna together
119 120
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Extensor muscles of the forearm

 The extensor muscles are in the posterior (extensor-supinator)
compartment of the forearm
 All are innervated by branches of the radial nerve

121 122
Anatomical snuff box

 A triangular shallow
depression on the lateral
aspect of the wrist when the
thumb is extended fully
 The tendons of the APL and
EPB bound laterally, and
 tendon of EPL bounds
medially
 Radial artery lies on the floor
of the snuffbox

123 124
 Extensor carpi radialis longus

Muscles of the posterior compartment  Origin: Lateral supraepicondylar
ridge of humerus
Superficial layer  Insertion: Dorsal aspect of base of
 Brachioradialis 2nd metacarpal
 Innervation: Radial nerve (C6,C7)
 Origin: Proximal two thirds of
 Action: Extend and abduct hand at
supraepicondylar ridge of humerus wrist joint
 Insertion: Lateral surface of distal
 Extensor carpi radialis brevis
end of radius proximal to styloid
process  Origin: Lateral epicondyle of
humerus (common extensor origin)
 Innervation: Radial nerve
 Insertion: Dorsal aspect of base of
(C5,C6,C7) 3rd metacarpal
 Action: Relatively weak flexion of  Innervation: Deep branch of radial
forearm, maximal when forearm is nerve (C7 & C8)
in midpronated position  Action: Extend and abduct hand at
wrist joint
125 126
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 Extensor digitorum  Extensor digiti minimi

 Origin: Lateral epicondyle of  Origin: Lateral epicondyle of
humerus (common extensor humerus (common extensor
origin) origin)
 Insertion: Extensor expansions  Insertion: Extensor expansions of
of medial four fingers 5th finger
 Innervation: Posterior  Innervation: Posterior
interosseous nerve (C7,C8) interosseous nerve (C7,C8)
 Action: Extends medial 4  Action: Extends 5th finger at
fingers at metacarpophalangeal metacarpophalangeal and
and interphalangeal joints interphalangeal joints

127 128
 Extensor carpi ulnaris Deep layer

 Origin: Lateral epicondyle of
humerus; posterior border of
 Supinator
ulna via aponeurosis  Origin: Lateral epicondyle of
humerus; radial collateral and
 Insertion: Dorsal aspect of
anular ligaments; supinator
base of 5th metacarpal fossa; crest of ulna
 Innervation: Posterior  Insertion: Lateral, posterior,
interosseous nerve (C7,C8) and anterior surfaces of
 Action: Extend and abduct proximal third of radius
hand at wrist joint  Innervation: Deep branch of
radial nerve (C7, C8)
 Action: Supinates forearm;
rotates radius to turn palm
anteriorly or superiorly (if
elbow is flexed)
129 130
Outcropping muscles of deep layer  Extensor pollicis

 Abductor pollicis longus (APL)
longus (EPL)
 Origin: Posterior surface of
middle third of ulna and
proximal halves of ulna, interosseous membrane
radius, and interosseous  Insertion: Dorsal aspect of base
membrane of distal phalanx of thumb
 Insertion: Base of 1st  Innervation: Posterior
metacarpal interosseous nerve (C7, C8),
 Innervation: Posterior continuation of deep branch of
interosseous nerve (C7, C8), radial nerve
continuation of deep branch  Action: Extends distal phalanx
of radial nerve of thumb at interphalangeal
joint; extends
 Action: Abducts thumb and metacarpophalangeal and
extends it at carpometacarpal carpometacarpal joints
131
joint
sisay A 132 sisay A
131 132
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 Extensor pollicis  Extensor indicis

brevis (EPB) distal third of ulna and
 Origin: Posterior surface of interosseous membrane
distal third of radius and  Insertion: Extensor expansion
interosseous membrane of 2nd finger
 Insertion: Dorsal aspect of base  Innervation: Posterior
of proximal phalanx of thumb interosseous nerve (C7, C8),
 Innervation: Posterior continuation of deep branch of
interosseous nerve (C7, C8), radial nerve
continuation of deep branch of  Action: Extends 2nd finger
radial nerve (enabling its independent
 Action: Extends proximal extension); helps extend hand
phalanx of thumb at at wrist
metacarpophalangeal joint;
133 extends
sisay A carpometacarpal joint 134 sisay A
133 134

135 136
Nerves of the forearm Hand

Fascia of palm
 The major nerves of the
forearm are the median,  Continuous with
ulnar, and radial antebrachial fascia and the
fascia of the dorsum of the
 Although the radial nerve
hand
appears in the cubital region,
it soon enters the posterior  Thin over thenar and
compartment of the forearm hypothenar eminences, but it
is thick centrally where it
 Besides the cutaneous
forms the fibrous palmar
branches, there are only two
aponeurosis and in the
nerves of the anterior aspect
fingers where it forms the
of the forearm: the median
digital sheaths
and ulnar nerves
137 138
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 Palmar aponeurosis
 strong, well defined part of the deep Muscles of the hand
fascia of the palm  The intrinsic muscles of the hand are located in five compartments
 covers the soft tissues and overlies the
 Thenar compartment: abductor pollicis brevis, flexor pollicis brevis,
flexor tendons
and opponens pollicis
 apex is continuous with the flexor
retinaculum and palmaris longus  Hypothenar compartment: abductor digiti minimi, flexor digiti
tendon minimi brevis and opponens digiti minimi
 four longitudinal digital bands radiate  Adductor pollicis in adductor compartment
from the apex and attach distally to  Lumbricals in central compartment
the bases of the proximal phalanges  Interossei in interosseous compartment
 Fibrous digital sheaths
 ligamentous tubes that enclose the
flexor tendon and the synovial sheaths
that surround them as they pass along
the palmar aspect of their respective
digit
139 140
Adductor pollicis
Thenar muscles  Origin:
 Form thenar eminence on  Oblique head: bases of 2nd
lateral surface of palm and 3rd metacarpals, capitate,
adjacent carpal
 Responsible for opposition of
 Transverse head: anterior
thumb surface of shaft of 3rd
 Four muscles metacarpal
 Opponens pollicis  Insertion: medial of base of
 Abductor pollicis brevis proximal phalanx of thumb
 Flexor pollicis brevis  Innervation: deep branch of
ulnar nerve (C8 & T1)
 Adductor pollicis
 Action: adducts thumb

141 142
Hypothenar muscles
 In hypothenar
compartment
 Produce hypothenar
eminence
 3 muscles
 Abductor digiti minimi
 Flexor digiti minimi
brevis
 Opponens digiti minimi
 Palmaris brevis
 In subcutaneous tissue of
hypothenar eminence;
not in hypothenar
compartment
sisay A sisay A
143 144
143 144
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Short muscles Dorsal interossei, 1st

Lumbricals, 1st to 4th to 4th
 Origin:  Origin: Adjacent sides of
 1st and 2nd: Lateral two tendons two metacarpals (as
of flexor digitorum profundus (as bipennate muscles)
unipennate muscles)  Insertion: Bases of
 3rd and 4th: Medial three tendons
of flexor digitorum profundus (as proximal phalanges;
bipennate muscles) extensor expansions of 2nd
 Insertion: Lateral sides of to 4th fingers
extensor expansions of 2nd to  Innervation: Deep branch
5th fingers of ulnar nerve (C8, T1)
 Innervation:  Action: Abduct 2nd to 4th
 1st and 2nd: Median nerve (C8, fingers from axial line; act
T1) with lumbricals in flexing
 3rd and 4th: Deep branch of ulnar metacarpophalangeal joints
nerve (C8, T1)
and extending
 Action: Flex interphalangeal joints
metacarpophalangeal joints;
extend interphalangeal joints
of 2nd
145 sisay A- 5th fingers
145
146 sisay A
146
Palmar interossei, 1st to

3rd
 Origin: Palmar surfaces of 2nd,
4th, and 5th metacarpals (as
unipennate muscles)
 Insertion: Bases of proximal
phalanges; extensor expansions of
2nd, 4th, and 5th fingers
 Innervation: Deep branch of ulnar
nerve (C8, T1)
 Action: Adduct 2nd, 4th, and 5th
fingers toward axial line; assist
lumbricals in flexing
metacarpophalangeal joints and
extending interphalangeal joints
147 148
THE GLUTEAL REGION Muscles of the gluteal region

 is the prominent area posterior to  Organized into 2 layers:
the pelvis superficial and deep
Bounded:  Superficial layer: 3 gluteal muscles
 superiorly by the iliac crest, and tensor of fascia lata
greater trochanter and ASIS and  Deep layer: piriformis,
 inferiorly by the gluteal fold obturator internus, superior
 The intergluteal cleft separates and inferior gemilli, and
the buttocks from each other quadratus femoris
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Gluteus maximus Gluteus medius

Origin - dorsal surface of ilium,  Origin - between anterior
sacrum and coccyx and posterior gluteal lines on
 Insertion - iliotibial tract lateral surface of ilium
and gluteal tuberosity of  Insertion - greater
femur trochanter of femur on the
 Action - thigh extension, lateral surface
lateral rotation, assists in  Action - abducts and medially
rising from sitting position rotates thigh
 Innervation: inferior gluteal  Innervation - superior
nerves gluteal nerve
Gluteus minimus
Tensor fascia lata
 Origin - between anterior and
inferior gluteal lines on external  Origin - anterior superior
surface of ilium iliac spine and the outer lip of
 Insertion - greater trochanter of the iliac crest
femur on the anterior surface  Insertion - iliotibial tract
 Action - abducts and medially
rotates thigh and with gluteus  Action - flexes and abducts
medius prevent tilting of the thigh
pelvis  Innervation - superior gluteal
 Innervation - superior gluteal nerve
nerve
153 sisay A sisay A 154
Piriformis
 Key muscle – divide the greater sciatic
foramen
 structures passing above the muscle
 superior gluteal nerve and vessels
 structures passing below the muscle
 nerves - inferior gluteal, sciatic, posterior
femoral cutaneous, pudendal, nerve to
quadratus femoris and obturator internus
 vessels - inferior gluteal and internal
pudendal
 Origin: pelvic surface of sacrum
 Insertion: greater trochanter
 Innervation - branches of ventral rami of
S1 and S2
 All the deep group laterally rotates thigh
and steadies femoral head in acetabulum
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Superior gemillus
Quadratus femoris  Origin: ischial spine
 Origin: ischial tuberosity  Insertion: greater
 Insertion: intertrochanteric crest of trochanter
femur  Innervation: nerve to
 Innervation: nerve to quadratus femoris obturator internus
(L4, 5, S1) Inferior gemillus
 Origin: ischial tuberosity
 Insertion: greater
Obturator internus
trochanter
 Origin: pelvic surface of the obturator
 Innervation: nerve to
membrane quadratus femoris
 Insertion: greater trochanter
 Innervation: nerve to obturator internus
(L5, S1, 2)
 The only structure entering the gluteal
region via the lesser sciatic foramen
THE THIGH ANTERIOR COMPARTMENT OF THIGH

Thigh muscles are organized
into three compartments:  Contains the anterior thigh
muscles, which are
 anterior or extensor,
 Flexors of the hip and
 medial or adductor, and
 Extensors of the knee
 posterior or flexor by INCLUDE:
intermuscular septa  Quadriceps femoris (Rectus
femoris, Vastus lateralis, Vastus
intermedius, Vastus medialis)
 Pectineus
 Iliopsoas
 Sartorius
 Rectus femoris
 Origion--anterior inferior iliac spine and
Quadriceps femoris
Ilium superior to acetabulum
 Insertion--Quadriceps femoris tendonTo
Muscles Proximal Distal
patella and tibial tuberosity attachment attachment
 Vastus lateralis
Rectus femoris anterior inferior iliac Quadriceps femoris
 Origion--greater trochanter and lateral spine and Ilium superior tendon
lip of the linea aspera to acetabulum To patella and tibial
 Insertion--Quadriceps femoris tendonTo tuberosity
patella and tibial tuberosity
 Vastus intermedius Vastus lateralis greater trochanter and Quadriceps femoris
 Origion--anterior and lateral surfaces of
lateral lip of the linea tendon
shaft of femur aspera To patella and tibial
 Insertion--Quadriceps femoris tendon and
tuberosity
lateral margin of patella Vastus intermedius anterior and lateral Quadriceps femoris
 Vastus medialis surfaces of shaft of femur tendon and lateral
 Origion--intertrochanteric line and margin of patella
medial lip of the linea aspera
 Insertion--Quadriceps femoris tendon and Vastus medialis intertrochanteric line Quadriceps femoris
medial border of patella and medial lip of the tendon and medial
161 sisay A 162 sisay A linea aspera border of patella
27
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Muscles in the anterior compartment of the thigh

Quadriceps femoris muscles Proximal Distal innerv action
attachme attachment ation
 Innervation –all are nt
innervated by Femoral Sartorius Anterior superomedials Femoral Flexes , abduct
superior surface of nerve and laterally
nerve iliac spine tibia rotate the thigh
and flexes the leg
 Action- Rectus femoris at the knee joint
flex the thigh at the hip &
Psoas major Posterior Lesser Anterio Flexes the
extend the leg at the knee abdominal trochanter of r rami thigh at the hip
wall femur of L2-L4 joint
joint.
 While the others only Iliacus Posterior Lesser Femoral Flexes the thigh at
extend the leg at the knee abdominal trochanter of nerve the hip joint
wall (iliac femur
joint fossa)
Pectineus Superior Pectineal line of Femoral Adducts and

ramus of femur nerve flexes thigh
pubis
THE MEDIAL COMPARTMENT

Consists of:
 Adductor longus: the most
anterior muscle
 Adductor brevis: deep to the
pectineus and adductor longus
muscles.
 Adductor magnus: the largest,
composed of adductor and
hamstring parts;.
 Gracilis: a long, strap-like
muscle
 Obturator externus: a deeply
placed fan-shaped
sisay A sisay A
165 166
muscles Proximal Distal innervation action
Gracilis
attachment
the body and
attachment
Medial surface of Obturator nerve Adducts thigh at hip
THE POSTERIOR COMPARTMENT
inferior pubic ramus, proximal shaft of the joint and
tibia flexes leg at knee
joint
 Three muscles in the posterior
aspect of the thigh are hamstrings
Adductor magnus Adductor part- Posterior surface of Obturator nerve Adducts and
ischiopubic ramus proximal femur, linea medially rotates  Semitendinosus
aspera, medial thigh at hip joint
supracondylar line  Semimembranosus
Adductor longus External surface of Linea aspera on Obturator nerve Adducts and  Biceps femoris (long head)
body of pubis middle one-third of (anterior division) medially rotates
shaft of femur thigh at hip joint o Arise from the ischial tuberosity
o Are innervated by the tibial division
Adductor brevis body and inferior Pectineal line Obturator nerve Adducts thigh at hip of the sciatic nerve.
pubic ramus proximal part of joint
linea aspera
Obturator externus External surface of Trochanteric fossa Obturator nerve Laterally rotates
obturator membrane (posterior division) thigh, steadies head
and adjacent bone of femur in
sisay A acetabulum sisay A
167 168
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 Biceps femoris
Hamstring Muscles
 Origion--Long head-Ischial
muscles Proximal Distal innervation action
attachment attachment
tuberosity;
Biceps femoris Long head- Head of fibula Sciatic nerve flex leg, rotate
--short head-lateral lip of
Ischial it laterally ;
linea aspera
tuberosity; when knee is  Insertion--Head of fibula
short head- flexed extends  Action --flex leg, rotate it laterally ;
lateral lip of thigh when knee is flexed extends thigh
linea aspera
 Semitendinosus
Semitendinosus ischial Medial surface Sciatic nerve
tuberosity of proximal tibia
 Origion --ischial tuberosity
 Insertion--Medial surface of
Semimembranos ischial medial and Sciatic nerve Extend thigh & proximal tibia
us tuberosity posterior surface flex leg, rotate it  Action --Extend thigh & flex leg, rotate it
of tibial condyle medially; when medially; when thigh & leg are flexed can
thigh & leg are extends trunk
flexed can  Semimembranosus
extends trunk
 Origion--ischial tuberosity
 Insertion--medial and posterior
169 sisay A 170
surface
sisay A of tibial condyle
THE FEMORAL TRIANGLE

Contents
Boundary femoral sheath
 Medial - lateral boarder of femoral artery and its
adductor longus
 Lateral - medial boarder of
branch
sartorius femoral vein and its
 Superior - inguinal ligament tributaries
 Floor - iliopsoas laterally and femoral nerve and its
pectineus medially branches
 Roof - fascia lata, cribriform deep inguinal
fascia, subcutaneous tissue, lymph nodes
and skin
profunda femoris artery
and vein and their
circumflex branches
The adductor canal

 Also termed as (subsartorial canal, Hunter
canal)
 Extends from the apex of the femoral triangle
 BOUNDARY
 anteriorly and laterally by the vastus
medialis
 posteriorly by the adductor longus and
adductor magnus
 medially by the sartorius
 Contents
• Femoral artery and vein, the
saphenous nerve, and the nerve to
vastus medialis
29
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Nerves of Gluteal Region and Posterior Thigh THE POPLITEAL FOSSA

 Is a mostly fat-filled diamond-shaped
 Sciatic nerve (L4-S3) space posterior to the knee
 the largest nerve in the body The popliteal fossa is bound
 the continuation of the main part of the  Superolateral - biceps femoris
sacral plexus  Superomedially - semimembranosus,
 is really two nerves loosely bound  Inferolateral and inferomedially
together in the same connective tissue by the lateral and medial heads
of the gastrocnemius,
sheath: the tibial nerve, and the common
ROOF: Posteriorly by skin and
fibular nerve
popliteal fascia
 Terminate in the middle of the thigh by
FLOOR: Anteriorly by the popliteal
dividing into tibial and common fibular surface of the femur, posterior
nerves capsule of the knee joint, and the
 Supplies no structures in the gluteal region popliteus fascia covering the
 It supplies the posterior thigh muscles, all
popliteus muscle .
leg and foot muscles, and the skin of
175
posterior
sisay A thigh, most of the leg and the foot 176 sisay A
THE POPLITEAL FOSSA

The contents
 Termination of the small
saphenous vein.
 Popliteal artery and vein and
their branches and tributaries.
 Tibial and common fibular
nerves
 Posterior cutaneous nerve of the
thigh.
 Popliteal lymph nodes and
lymphatic vessels.
THE LEG
 The leg is divided into
three compartments by
intermuscular septa
interosseous membrane
and two leg bones
Anterior
Lateral
Posterior
30
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THE LEG Anterior Compartment of Leg

 Are Dorsiflexor (extensor)
compartment) and located
anterior to the interosseous
membrane
 Four muscles in the anterior
compartment
1. Tibialis anterior
2. Extensor digitorum longus
3. Extensor hallucis longus
4. Fibularis tertius
Anterior Compartment of Leg

Neurovasculature in the ant. Comp.
Muscle Proximal Distal Innervation action
attachment attachment
 Nerves
Tibialis Lateral surface of medial cuneiform Deep fibular Dorsiflexion of  The deep fibular
nerve foot at ankle joint;
anterior tibia and base of
inversion of foot nerve, one of the two
metatarsal I
terminal branches of the
Extensor Middle one-half of base of distal Deep fibular Extension of great
common fibular nerve, is
medial surface of phalanx of great nerve toe and
hallucis
longus fibula toe
dorsiflexion of
foot
the nerve of the anterior
compartment.
Extensor Proximal one-half bases of distal Deep fibular Extension of
digitorum of medial surface and middle nerve lateral four toes
longus of fibula and phalanges of and
lateral tibial dorsiflexion of
lateral four toes
condyle foot
Fibularis Distal part of base of metatarsal Deep fibular Dorsiflexion and
medial surface of V nerve eversion of foot
tertius
sisay A
fibula sisay A
183 184
Lateral compartment of Leg Lateral compartment of Leg

The lateral compartment Muscle Proximal Distal action
attachmen attachment
Is evertor compartment, t
contains two muscles: Fibularis Upper medial Eversion
1. The fibularis longus and longus 2/3 of cuneiform and
lateral and base of plantarfle
2. The fibularis brevis
surface of metatarsal xion of
fibula I foot
 Innervated by Superficial
Fibularis Lower Lateral Eversion
fibular nerve brevis two-thirds tubercle at of foot
of lateral base of
surface of metatarsal
fibula V
31
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Posterior Compartment of Leg The superficial group

 Is Plantar flexor compartment  Includs the gastrocnemius,
 is the largest of the three leg compartments
Soleus, and plantaris, and
forms a powerful muscular
 divided into superficial and deep sub compartments/muscle groups
mass in the calf.
 The two-headed of
gastrocnemius and the Soleus
(ankle joint) share a common
tendon, the calcaneal
tendon
 Action - plantar flexes
foot, flexes knee
 Nerve supply: tibial nerve

THE DEEP GROUP

 Four muscles make up the
deep group in the
posterior compartment
1. Popliteus.
2. Flexor digitorum longus.
3. Flexor hallucis longus.
4. Tibialis posterior.
Innervated by tibial nerve
THE DEEP GROUP Flexor retinaculum

Muscle Proximal Distal attachment Innervation action  From Medial malleolus to
attachment
calcaneus
Popliteus Lateral femoral Posterior surface Tibial nerve Unlocks knee joint
 Content – from medial to
condyle of proximal tibia (laterally rotates
femur on fixed lateral
tibia)
 Tendon of tibialis posterior
Flexor hallucis Posterior surface Base of distal Tibial nerve Flexes great toe,
 Tendons of flexor digitorum
of fibula phalanx of great plantar flex ankle
longus longus
toe
 Termination of posterior tibial
Flexor Medial side of bases of distal Tibial nerve Flexes lateral four artery and beginning of lateral
digitorum posterior surface phalanges of the toes, plantar flex
and medial plantar arteries
of the tibia lateral four toes ankle
longus  Termination of posterior tibial
Tibialis Posterior surfaces Primarily Tibial nerve Inversion and nerve and beginning of medial
posterior of interosseous Navicular and also plantarflexion of and lateral plantar nerves
membrane and on cuneiform, foot
adjacent regions of Cuboid, base of 2-  Tendon of flexor hallucis longus
tibia and fibula 4 metatarsal
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Extensor retinaculum Deep fascia of foot

 The deep fascia is thin on the dorsum
 Has superior and of the foot, where it is continuous
inferior portions with the inferior extensor retinaculum
 Prevents the tendons  Over the lateral and posterior aspects,
it is continuous with the plantar fascia,
of peroneus tertius, which has a thick central part (the
extensor hallucis plantar aponeurosis) and weaker
longus and extensor medial and lateral parts
digitorum longus from  The plantar fascia holds parts of
the foot together, helps protect the
bowstringing during sole from injury, and helps support
contraction the longitudinal arches of the foot
 Its intermuscular septum divide the
sole in to three compartment
 Medial
 Central
 Lateral compartment of the sole
MUSCLES IN THE SOLE

INTRINSIC MUSCLES OF THE FOOT
 The muscles in the sole of the foot
Originate and insert in the foot. are organized into four layers
 Intrinsic muscles mainly modify
the actions of the long tendons
and generate fine movements of  The plantar muscles maintain the
the toes. arches of the foot
 There are two intrinsic muscle on
the dorsum of the foot-extensor
 They also refine further the
digitorum brevis & extensor hallucis
brevis. efforts of the long muscles,
 Innervation--Deep fibular nerve producing supination and
 Action--Aid the extensor longus
pronation in enabling the foot to
muscles adjust to uneven ground
FIRST LAYER SECOND LAYER

Quadratus plantae and
 There are three O--Medial and lateral surface of
components in the first calcaneus
layer of muscles I--tendon of flexor digitorum longus
 From medial to lateral, N--Lateral plantar nerve
these muscles are A--Assists flexor digitorum longus
tendon in flexing toes II to V
1. abductor hallucis,
Four lumbrical muscles
2. flexor digitorum brevis, O-- tendon of flexor digitorum longus
and I--extensor expansion of toes II to V
3. abductor digiti minimi. N--First lumbrical-medial plantar nerve
2, 3, 4 -lateral plantar nerve
A--Flexion of metatarsophalangeal joint and
197 sisay A extension
198 sisayof
A interphalangeal joints
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THIRD LAYER FOURTH LAYER

 Three muscles  The dorsal interossei
 Flexor hallucis brevis
• Extend from Sides of
• Arise from cuboid and lateral
cuneiform and insert in to base of adjacent metatarsals to
proximal phalanx of the great toe bases of proximal
 Adductor hallucis phalanges of toes II to IV
• Extend from metatarsals bones 2-4 to • Are abductor and flexor
base of proximal phalanx of great toe
of 2-4 toes
 Flexor digiti minimi brevis
 Are innervated by
• Extend from metatarsals bone 5th to
base of proximal phalanx of little toe Lateral plantar nerve
• All are innervated by Lateral
plantar nerve except
FHB(m.plantar)
• They are adductor and flexor of
the respective digits
FOURTH LAYER cont… NERVES OF THE FOOT

Plantar interossei-3 The foot is supplied
 Extend from medial Sides of adjacent
by the
3-5 metatarsals to bases of proximal 1. Tibial
phalanges of 3-5 toes 2. Deep fibular
• Are adductor and flexor of 3-5 3. Superficial fibular
toes 4. Sural ( origin
 Are innervated by Lateral from tibial and
plantar nerve common
peroneal)and
5. Saphenous
nerves(origin
from femoral)
203 sisay A
34

Muscular System: by Sisay A

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8/2/2021

Connective Tissue Wrappings

Connective Tissue Wrappings

Skeletal Muscle Fiber

 Motor axons innervate skeletal muscle fibers at junctions called

Nerve Stimulus of Skeletal Muscle

Synergist Naming Skeletal Muscles

 Arrangement of fascicles within a muscle vary

Division of skeletal muscles The Principal Skeletal Muscles

 Superiorly – the  Rich in sebaceous and sweat glands

Muscles of the eyelids and eyebrow

Muscles around nose

Dilator naris Maxilla Ala of nose Muscles around mouth

Nerve supply – buccal branch of facial nerve

Muscles of mastication  Lateral Pterygoid

Muscles in posterior triangle  Origin – transverse process of C1 to C4

Anterior triangle of the neck

Subdivisions of the anterior triangle

 Muscles of the back – 4 layers  Splenius

 Longissimus capitis  Sub-occipital muscles

Suboccipital triangle of the neck

Axioappendicular Muscles Pectoralis major

Paralysis of serratus anterior Subclavius

Posterior Axioappendicular Muscles Trapezius

Latissimus dorsi Scapulohumeral Muscles

Rotator cuff muscles

Axilla: content Brachial plexus

Position Muscles of arm

Biceps brachii Brachialis

Coracobrachialis Triceps brachii

Anconeus Nerves of arm

109 sisay A 110 sisay A

Cubital fossa  Contents

113 sisay A 114 sisay A

Superficial (first) layer muscles

 Palmaris longus Intermediate (second) layer muscles

Deep (third) layer muscles  Flexor pollicis longus

Extensor muscles of the forearm

121 sisay A 122 sisay A

Anatomical snuff box

123 sisay A 124 sisay A

 Extensor carpi radialis longus

 Extensor digitorum  Extensor digiti minimi

127 sisay A 128 sisay A

 Extensor carpi ulnaris Deep layer

Outcropping muscles of deep layer  Extensor pollicis

 Extensor pollicis  Extensor indicis

135 sisay A 136 sisay A

Nerves of the forearm Hand

141 sisay A 142 sisay A

Short muscles Dorsal interossei, 1st

Palmar interossei, 1st to

THE GLUTEAL REGION Muscles of the gluteal region

149 sisay A 150 sisay A

Gluteus maximus Gluteus medius

151 sisay A 152 sisay A

153 sisay A sisay A 154

THE THIGH ANTERIOR COMPARTMENT OF THIGH

159 sisay A 160 sisay A

Muscles in the anterior compartment of the thigh

Pectineus Superior Pectineal line of Femoral Adducts and

163 sisay A 164 sisay A