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Myology

Zhenmei Zhao, MD, Professor


Department of Anatomy
Taishan Medical University
zhenmeizhao@163.com
Introduction of muscle
skeletal
muscle
Muscle can be divided
into three types
according to structure:

smooth muscle
cardiac muscle
skeletal muscle

each muscle is an organ


 The muscle of stomach
wall is smooth muscle
right ventricle
Cardiac muscle

left atrium
 There are more than 600
skeletal muscles all over
the body.
 They make up the
muscular system

 Collectively, the skeletal


muscles account for
approximately 40% of
the body weight
The morphology of skeletal muscle
 Each skeletal muscle consists of two parts
(1) Muscle belly: composed of muscle fibers, be able
to contract.
(2) Tendon: composed of collagen fibers, it is strong
but can’t contract;
The tendon of flat muscle is called aponeurosis
(aponeurosis is flat tendons but strong sheet like
tendon.)

flat long
muscle muscle
Classification of skeletal muscle

 Muscles may be
classified according to
their shape as
long, short, flat (broad)
and orbicular muscles.
The origin, insertion and action of skeletal muscle

 Origin-the fixed attachment is


called the origin, generally the
origin is the more proximal
attachment (arises from or originates
from )
 Insertion-the movable
attachment is called insertion.
Generally the insertion is the more
distal attachment (be inserted into, be
inserted on, inserts at or inserts into)
 Action-agonist, antagonist,
synergist, fixators
action of skeletal muscle

 Biceps brachii=agonist,
 triceps brachii=antagonist,
 brachialis=synergist,
 deltoid=fixators

Flexion of elbow joint


The nomenclature of muscles

Shape :trapezius, deltoid


Location :supraspinatus, infraspinatus
Attachment:sternocleidomastoid
Size :longus,brevis
Orientation of fibers: rectus,transverse,oblique
Relative position:lateral,medial,internal and
external
Function:adductor, flexor, extensor, pronator, and
levator
Accessory structures
fascia
Superficial fascia: ( loose connective tissue)
Deep fascia : dense connective tissue

synovial bursa
synovial sheath of tendon : fibrous layer and synovial layer
sesamoid bones
• Synovial bursa 滑膜囊

Decrease the friction between


tendon and the surface of bone
 Tendinous sheath 腱鞘
 Fibrous layer
 Synovial layer:
Synovial cyst of wrist
Figure 53.19 Radiograph of
adult hand for comparison
(male of 19 years),
dorsopalmar projection.
Note additional ossification
in the sesamoid bones of the
thumb.
blood vessels, lymphatic
vessels, and nerves of muscle
muscular blood supply
muscular lymphatic drainage
muscular innervation
The muscles of head
Facial muscles
 Epicranius
 Frontal belly
 Occipital belly
 Galea aponeurotica
 Orbicularis oculi
 Buccinator
 Orbicularis oris
 Nasalis
Facial muscles
Muscles of facial expression
★Masticatory muscles
 Temporalis
 Masseter
 lateral pterygoid
 Medial pterygoid
★ Masticatory muscles
 Temporalis
 Origin-temporal fossa
 Insertion-coronoid process of
mandible
 Action-elevates and retracts
mandible

 Masseter
 Origin-inferior border and medial
surface of zygomatic arch
 Insertion-lateral surface of ramus
of mandible and angle of mandible
 Action-elevates mandible
★ Masticatory muscles

 Lateral pterygoid

 Medial pterygoid
The muscles of neck
Muscles of the neck
Superficial group
 Platysma
 Sternocleidomastoid
Platysma

 a thin sheet-like muscle of


facial expression, located in
the superficial fascia, arised
inferiorly from the pectoral
and deltoid fascia, and
inserted superiorly to inferior
margin of mandible and
parotideomasseteric fascia
Major muscles of the neck

★ Sternocleidomastoid
 Origin: manubrium and sternal end of
clavicle
 Insertion: mastoid process of temporal
bone
 Action: contraction of one muscle draws
head toward the same side, and turn face
to opposite side; both muscles act together
to draw head backward
Muscles of the neck
Suprahyoid muscles
 Digastric
 Mylohyoid
 Stylohyoid
 Geniohyoid
Elevate (raise) hyoid bone and
depress mandible.
Muscles of the neck

Infrahyoid muscle
 Sternohyoid
 Sternothyroid
 Thyrohyoid
 Omohyoid
Depress hyoid or larynx after elevation
Muscles of the neck

Deep group
 Lateral
 Scalenus anterior
 Scalenus medius
 Scalenus posterior
 Medial
 longus capitis
 longus colli
Flex the head, bends the neck
forward
Major muscles of the neck

Scalenus anterior
 Origin: transverse processes of C3-
C6.
 Insertion: tubercle for scalenus
anterior
 Action: unilateral, bends neck
laterally; bilateral, elevate first rib, an
accessory muscle of inspiration; if rib
is fixed, flex neck anteriorly
Major muscles of the neck

★ Scalene fissure
 Above the first rib, there is a triangular
space between scalenus anterior and
medius.
 The brachial plexus and the subclavian
a. emerge from this space.
Muscles of trunk
The Muscles of Back

Superficial group
 Trapezius
 Levator scapulae
 Rhomboideus
 Latissimus dorsi
 Thoracolumbar fascia
The Muscles of Back

Deep group
 Splenius
 Erector spinae
Major Muscles of Back
Trapezius
 Origin: superior nuchal line, external
occipital protuberance, ligamentum
nuchae and spinous processes of
seventh cervical and all thoracic
vertebrae
 Insertion: lateral third of clavicle,
acromion, and spine of scapular
 Action: upper fibers elevate scapula,
lower fibers depress scapula;
if scapula is fixed, one side acting alone,
draws head toward the same side, and
turn face to opposite side; both sides
together, draw head directly backward
 Nerve supply: accessory nerve (Ⅺ
cranial nerve)
Major Muscles of Back
Latissimus dorsi
 Origin:
 Spinous processes of lower six thoracic
and all lumbar vertebrae
 Median sacral crest

 Posterior part of iliac crest

 Insertion: floor of intertubercular groove of


humerus.
 Action: trunk fixed, extends, adducts and
medially rotates arm ; arm fixed, elevates
trunk.
 Nerve supply: thoracodorsal nerve
Thoracolumbar Fascia

Psoas major
Quadratus
lumborum

Anterior layer

Middle layer
Posterior layer

Quadratus lumborum; Obliquus internus abdominis ,transversus abdominis


Trapezius
Levator scapulae

Deltoid

Ausculatory triangle
Rhomboideus
Latissimus dorsi
Thoracolumbar fascia
Inferior lumbar triangle
Muscles of thorax
Muscles of thorax

Muscles connecting the upper


limb to the thoracic wall
 Pectoralis major

 Pectoralis minor

 Serratus anterior
Muscles of thorax
 Intrinsic muscles
 Intercostales externi
 Intercostales interni
 Intercostales intimi
 Transversus thoracis
Major muscles of thorax

Pectoralis Major
 Origin: medial half of clavicle, sternum,
upper six costal cartilages.
 Insertion: crest of greater tubercle of
humerus
 Action: (1) adducts the arm and rotates
it medially; the clavicular fibers also flex
the arm;
(2) with the arm above the head, raise the
body as in climbing
(3) elevates ribs 1-6,aidding in forced
inspiration.
 Nerve supply: lateral pectoral n.
Major muscles of thorax
Intercostales externi
 Origin: inferior border of rib above
 Insertion: superior border of rib below
 Replaced anteriorly by external intercostal
membrane
 Action: raise ribs adding in forced
inspiration
Major muscles of thorax
Intercostales interni
 Origin: superior border of rib below
 Insertion: inferior border of rib above
 Replaced posteriorly by internal intercostal
membrane.
 Action: depress ribs for forced expiration
Diaphragm
Diaphragm
 Shape and position: dome-shaped
between thorax and abdomen, consists of
a peripheral muscular part and a central
tendon
 Origin
 Sternal part: arising from xiphoid
process
 Costal part: arising from lower six costal
bone and costal cartilages
 Lumbar part: arising by two crura from
upper 2-3 lumbar vertebrae
 Insertion: central tendon
 Weak areas:
 Lumbocostal triangle

 Sternocostal triangle
Diaphragm

Openings in the diaphragm


 Aortic hiatus lies
anterior to the body of the 12th
thoracic vertebra between the crura
and transmits the aorta, thoracic duct
 Esophageal hiatus lies at
level of T10. It transmits esophagus
and vagus nerves
 Vena cava foramen lies at T8 T8
level in the central tendon. It
transmits the inferior vena cava. T10

T12
Diaphragm

Action:
 Contraction: the dome moving
downward, increases the volume of
thoracic cavity which results in
inspiration, at the same time the intra-
abdominal pressure is increased
assists in defecation, vomiting or child
birth.
 Relaxation: the dome returns to the
former position, reduces the volume
of the thoracic cavity, resulting in
expiration.
Muscles of abdomen
Muscles of abdomen

Anterolateral group
 Obliquus externus abdominis
 Obliquus internus abdominis
 Transversus abdominis
 Rectus abdominis
Obliquus externus abdominis

 General direction of fibers:


downward, forward and
medially (run down and inward)
Obliquus externus abdominis

Structures
 Inguinal ligament
 Lacunar ligament
 Superficial inguinal ring
-triangular-shaped defect in
aponeurosis of obliquus externus
abdominis above pubic tubercle
Superficial inguinal ring

Male: spermatic cord; female: round ligament of uterus


Obliquus internus abdominis

 Deep to obliquus externus


abdominis
 General direction of fibers:
upwards, forwards and
medially
Transversus abdominis

 Deep to obliquus internus


abdominis
 General direction of fibers: run
horizontally forward.
Transversus abdominis
 Inguinal falx
 Obliquus internus abdominis
has a lower, free border that
arches over spermatic cord
 Inserted with transversus
abdominis fiber into medial
part of pecten of pubis
 Cremaster
 Derived from the lower fibers
of the obliquus internus
abdominis and transversus
abdominis
 Around the spermatic cord and
testis
Inguinal falx; cremaster; arcuate inferior border
Rectus abdominis
 Position: lies to the side of the midline
 Origin: pubic crest and symphysis
 Insertion: xiphoid process and 5th-7th
costal cartilages
 Tendinous intersections 3-4
 linea semilunaris
Similar functions for
above four pairs of muscles
 Support and compress the abdominal viscera
 Increase intra-abdominal pressure, aid in expulsive
efforts-vomiting, coughing, sneezing, defecation,
urination and childbirth.
 Depress ribs, assist in the act of forced expiration.
 Flex, lateral flex, and rotate vertebral column
Sheath of rectus abdominis
Anterior layer
 Formed by fusion of
aponeurosis of obliquus
externus abdominis and
anterior leaf of aponeurosis of
obliquus internus abdominis
Sheath of rectus abdominis
Posterior layer
 Formed by fusion of posterior leaf of
aponeurosis of obliquus internus
abdominis and aponeurosis of
transversus abdominis
 Absent in about 4-5cm below the
umbilicus, where aponeuroses of all
three muscles form anterior layer ,the
lower free border named arcuate
line
 Below this line rectus abdominis in
contact with transverse fascia
Muscles of abdomen

 Linea alba
-tendinous raphe between
right and left rectus abdominis
from xiphoid process to pubic
symphysis
Landmarks and surface anatomy

 Linea alba
 Rectus abdominis
 Tendinous intersections
 Linea semilunaris
 Umbilicus: at the level of L3 ~ L4
 Inguinal ligament
Muscles of abdomen

Posterior group
 Quadratus lumborum
 Psoas major
Muscles of upper limb
Muscles of shoulder

 Deltoid
 Supraspinatus
 Infraspinatus
 Teres minor
 Teres major
 Subscapularis
Supraspinatus
Infraspinatus
Teres minor
Teres major
Subscapularis (lie in the subscapular fossa)
Major muscles of upper limb

*Deltoid

 Origin: lateral third of clavicle, acromion,


and spine of scapula
 Insertion: deltoid tuberosity of humerus
 Action: abducts the arm,anterior fibers
flex and medially rotate arm; posterior
fibers extend and laterally rotate arm
Major muscles of upper limb
 Teres major
 Origin: dorsal surface of inferior angle
of scapula
 Insertion: crest of lesser tubercle of
humerus
 Action: medially rotates and adducts
arm
Major muscles of upper limb
 Trilateral and quadrilateral foramina
 Between the subscapularis, teres minor and
teres major, there is a long triangular space
whose lateral side is surgical neck of
humerus.
 The long head of triceps brachii subdivides
this space into a medial trilateral foramen
and a lateral quadrilateral foramen.
Muscles of arm
Muscles of arm

 Anterior group
 Biceps brachii
 Coracobrachialis
 Brachialis

 Posterior group
 Triceps brachii
Major muscles of upper limb

Biceps brachii
 Origin: long head, supraglenoid
tubercle; short head, coracoid process
 Insertion: radial tuberosity
 Action: supination of forearm, flexion
of elbow joint, weak flexion of shoulder
joint
 Nerve supply: Musculocutaneous n.
Major muscles of upper limb

Triceps brachii
 Origin: long head, infraglenoid tubercle;
lateral head, above groove for radial n.,
medial head, below groove for radial n.
 Insertion: olecranon of ulna
 Action: extends elbow joint, long head
can extend and adduct shoulder joint
Muscles of forearm
Muscles of forearm
Anterior group (9)
 Superficial layer (5)
 Brachioradialis
 Pronator teres
 Flexor carpi radialis
 Palmaris longus
 Flexor carpi ulnaris
Muscles of forearm
Anterior group (9)
 Second layer (1)
 Flexor digitorum superficialis
 Third layer (2)
 Flexor digitorum profundus
 Flexor pollicis longus
 Fourth layer (1)
 Pronator quadratus

Action: flex radiocarpal joint and


fingers, pronate forearm
Pronator teres
 Origin: medial
epicondyle of humerus
and deep fascia of
forearm
 Insertion: middle of
lateral surface of radius
 Action: pronation of
forearm and flexion of
elbow joint
 flexor pollicis longus
 Actions: Flexes the thumb. It also flexes
the carpometacarpal joints of the thumb
and assists in flexion of the wrist joint.

 flexor digitorum profundus


 Actions: Flexes the distal phalanges and
helps to flex all joints crossed by its
tendons (i.e., the wrist joint, the
carpometacarpal joints, the
metacarpophalangeal joints and the
proximal inter-phalangeal joints).
pronator quadratus
 Actions: pronates the
forearm and holds the
radius and ulnar
together.
Muscles of forearm
Posterior group (10)
 Superficial layer (5)
 Extensor carpi radialis longus
 Extensor carpi radialis brevis
 Extensor digitorum
 Extensor digiti minimi
 Extensor carpi ulnaris
Muscles of forearm
Posterior group (10)
 Deep layer (5)
 Supinator
 Abductor pollicis longus
 Extensor pollicis brevis
 Extensor pollicis longus
 Extensor indicis

 Action: extend radiocapral joint and


fingers, and supinate forearm
Muscles of hand
Muscles of hand
 Lateral group-thenar (4)
 Abductor pollicis brevis
 Flexor pollicis brevis
 Opponens pollicis
 Adductor pollicis
 Action: flex, abduct, adduct and oppose thumb

 Medial group-hypothenar (3)


 Abductor digiti minimi
 Flexor digiti minimi brevis
 Opponens digiti minimi
 Action: flex, abduct , and oppose little finger
Muscles of hand
 Intermedial group
 Lumbricales (4)
flex fingers at MP joints; extend fingers at IP joints
 Palmar interossei (3)
adduct fingers towards middle finger at MP joints
 Dorsal interossei (4)
abduct fingers away from middle finger at MP joints
Muscles of lower limb
Muscles of lower limb

The muscles of lower limb are divided into:


 Muscles of hip
 Muscles of thigh
 Muscles of leg
 Muscles of foot
Muscles of hip

Anterior group
 Iliopsoas
 Iliacus
 Psoas major
 Psoas minor
 Tensor fasciae
latae
Tensor fasciae
latae
Iliotibial tract
Muscles of hip

Iliopsoas
 Origin:
 Psoas major: transverse

processes and lateral surface of


bodies of lumbar vertebrae
 Iliacus: iliac fossa

 Insertion: lesser trochanter of


femur
 Action: flexes thigh on trunk
 Nerve supply: lumbar plexus
Muscles of hip
Posterior group
 Gluteus maximus
 Gluteus medius
 Gluteus minimus
 Piriformis
 Obturator internus
 Obturator externus
 Quadratus femoris
Muscles of hip

Gluteus maximus
 Origin: gluteal surface of ilium and
dorsal aspect of sacrum
 Insertion: gluteal tuberosity of femur
and iliotibial tract
 Action: extends and laterally rotates
thigh at hip joint; raises trunk when
the lower limb is fixed
 Nerve supply: inferior gluteal n.
Muscles of thigh
Muscles of thigh
Anterior group
 Sartorius
 Quadriceps femoris
 Rectus femoris
 Vastus lateralis
 Vastus intermedius
 Vastus medialis
 Blood supply: femoral artery
 Nerve supply: femoral nerve
Muscles of thigh

Sartorius
 Origin: anterior superior iliac spine
 Insertion: upper medial surface of
tibia
 Action: flexes hip and knee joints;
rotates flexed knee medially
 Nerve supply: femoral n.
Muscles of thigh

Quadriceps femoris
Rectus femoris: anterior inferior iliac spine
 Vastus medialis: medial lip of linea aspera
 Vastus lateralis: lateral lip of linea aspera
 Vastus intermedius: anterior surface of
femur
 Insertion: tibial tuberosity via patellar
ligament
 Action: extends leg at knee joint; rectus
femoris also flexes thigh at hip joint
 Nerve supply: femoral n.
Muscles of thigh

Medial group
 Pectineus
 Adductor longus

 Adductor brevis

 Adductor magnus

 Gracilis

Action: adduct thigh at hip joint


Blood supply:
 Deep femoral a.

 Obturator a.

Nerves supply: obturator n.


Muscles of thigh

Posterior group
 Biceps femoris
 Semitendinosus
 Semimembranosus
Action
 Flex the leg at knee joint
 Extend the thigh at hip joint
Muscles of leg
Muscles of leg

Anterior group
 Tibialis anterior
 Extensor hallucis longus
 Extensor digitorum longus
 Peroneus tertius
Blood supply: Anterior tibial a.

Nerve supply: Deep peroneal n.


Muscles of leg

Tibialis anterior
 Origin: lateral surface of tibia
 Insertion: medial cuneiform and
base of 1st metatarsal
 Action: dorsiflexes and inverts foot
 Nerve supply: deep peroneal n.
Muscles of leg

Lateral group
 Peroneus longus
 Peroneus brevis
 Action: plantar flex and evert the
foot
 Blood supply: branches from the
peroneal artery
 Nerve supply: superficial peroneal n.
Muscles of leg

Posterior group
 Superficial layer
 triceps surae
 Gastrocnemius
 Soleus
Muscles of leg

Triceps surae
 Origin:
 Gastrocnemius: medial and lateral

condyles of femur
 Soleus: soleal line of tibia and upper

third of fibula
 Insertion: calcaneum via tendon
calcaneus
 Action: flexes knee joint and plantar
flexes foot at ankle joint; steadies leg on
foot during standing
 Nerve supply: tibial n.
Muscles of leg

Posterior group
 Deep layer
 Popliteus
 Flexor digitorum longus
 Tibialis posterior
 Flexor hallucis longus
 Nerve supply: tibial n.
Muscles of leg

Tibialis posterior
 Origin: posterior surface of tibia and
fibula and interosseous membrane
 Insertion: tuberosity of navicular, all
cuniforms
 Action: plantar flexes and inverts foot
 Nerve supply: tibial n.
Muscles of foot
Muscles of foot

 Muscles on dorsum: extensor


digitorum brevis
 Muscles in sole: medial, lateral
and intermediate groups
See you next class!