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Exam 1 Anatomy Review Guide With Muscle Actions
Exam 1 Anatomy Review Guide With Muscle Actions
ARM (5)
Grouping Muscle Action Innervation Vasculature
Coracobrachialis flex, ADduct arm
Anterior (3) Biceps brachii flex arm, forearm; Musculocutaneous n. Brachial a. & its
(long, short) supinate forearm branches
Brachialis flex forearm
Triceps brachii extend arm, forearm
Posterior (2) (long, lateral, medial) Radial n. Profunda brachii a.
Anconeus extend forearm
FOREARM (20)
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Grouping Muscle Action Innervation Vasculature
HAND (19)
Grouping Muscle Action Innervation Vasculature
Thenar (3) Abductor pollicis brevis ABduct/oppose thumb Superficial palmar branch
Flexor pollicis brevis flex thumb Recurrent branch of of the radial a.
Opponens pollicis oppose, medially rotate median n.
thumb
Hypothenar (3) Abductor digiti minimi ABduct 5th digit
Flexor digit minimi flex MPC of 5th digit Deep branch of ulnar n. Ulnar a.
brevis
Opponens digiti minimi oppose 5th digit to thumb
Lumbrical 1 + 2 flex MPC joint; Median n. Superficial palmar arch
extend IP joint Deep palmar arch
Short (Palmar – 9) Common palmar digital a
Dorsal digital a.
Lumbrical 3 + 4 “” Deep branch of ulnar n. Superficial palmar arch
Deep palmar arch
Common palmar digital a
Dorsal digital a.
Palmar interossei (1-3) ADduct digits; Dorsal metacarpal a. &
flex MCP joint; palmar metacarpal a.
extend IP joint
Palmaris brevis improves grip Superficial branch of Palmar branches of the
ulnar n. ulnar a.
Adductor pollicis ADduct thumb Deep branch of ulnar n. Deep palmar arterial arch
Short (Dorsal – 4) Dorsal interossei (1-4) ABduct digits; Deep branch of ulnar n. Dorsal metacarpal a. &
flex MCP joint; palmar metacarpal a.
2
extend IP joint
THIGH (16)
Grouping Muscle Action Innervation Vasculature
Iliopsoas flex thigh; flex and laterally Femoral n. (for iliacus) Lumbar branch of
bend lumbar spine & lumbar plexus iliopsoas branch of
(psoas) internal iliac a.
Pectineus flex, ADduct, laterally rotate Femoral n. & obturator Medial circumflex
thigh at hip n. femoral branch of
femoral a. & obturator a.
Sartorius flex, ABduct, laterally rotate hip; Femoral a. branches
Anterior (7) flex, medially rotate knee
Rectus femoris flex hip; extend knee Medial circumflex
(quadriceps) femoral a.
Vastus lateralis extend leg at knee Femoral n. Lateral circumflex
(quadriceps) femoral a.
Vastus medialis “” Femoral a.
(quadriceps) Profunda femoris a.
Superior medial
genicular branch of
popliteal a.
Vastus intermedius “” Lateral circumflex
(quadriceps) femoral a.
Gracilis flex, ADduct, thigh at hip;
flex, medially rotate knee Obturator n.
Medial (5) Obturator externus laterally rotate, ADuct hip; holds Obturator a.
head of femur in acetabulum
Adductor longus flex, ADduct thigh at hip
Adductor brevis flex, extend, ADduct, laterally
rotate thigh at hip
Adductor magnus ADduct thigh; adductor – flex Obturator n. & tibial n.
thigh; hamstring – extend thigh
Semimenbranosus extend thigh;
(hamstrings) flex, medially rotate leg
Posterior (3) Semitendinosus “” Perforating branches of:
(hamstrings) Tibial n. Profunda femoris a.
Biceps femoris extend thigh; Inferior gluteal a.
(long head) flex, laterally rotate leg Superior branches of
(hamstrings) popliteal a.
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femoral a.
LEG (13)
Grouping Muscle Action Innervation Vasculature
Tibialis anterior dorsiflex ankle; invert foot
Extensor hallucis longus dorsiflex ankle; extend 1st digit
Anterior (4) Extensor digitorum longus dorsiflex ankle; extend 2 – 5 digit Deep fibular Anterior tibial a.
Fibularis tertius dorsiflex ankle; n.
evert foot
Lateral (2) Fibularis longus evert foot; weak plantarflexion of ankle Superficial Branches of
Fibularis brevis “” fibular n. fibular a.
Soleus plantarflex ankle; raise heal to walk
Posterior (superficial Gastrocnemius flex leg;
– 3) plantarflex foot
Plantaris “” Tibial n. Posterior tibial a.
Tibialis posterior plantarflex ankle; invert foot
Posterior (deep – 4) Flexor digitorum longus flex digits 2 – 5, plantarflex ankle,
supports long arch
Flexor hallucis longus flex 1st digit; plantarflex ankle; support
med long arch of foot
Popliteus weakly flex knee; rotate femur on fixed
tibia and unlocks leg; medially rotate
tibia of unplanted limb
FOOT (18)
Grouping Muscle Action Innervation Vasculature
Flexor (layer 1) (3) Flexor digitorum brevis flex digits 2 – 5 Medial plantar n. Medial plantar a.
Abductor hallucis ADduct 1st digit; support
transverse arch
Abductor digiti minimi ABduct, flex 5th digit Lateral plantar n. Lateral plantar a.
Flexor (layer 2) (6) Flexor hallucis brevis flex proximal phalanx 1st digit Medial plantar n. Medial plantar a.
Lumbrical 1 flex PIP; extend DIP digit 2 – 4
Lumbrical 2 “”
Lumbrical 3 “” Lateral plantar n. Lateral plantar a.
Lumbrical 4 “”
Quadratus plantae flex digits 2 – 5
Adductor hallucis ADduct 1st digit;
(transverse head) support transverse arch Deep branch of
Adductor hallucis lateral plantar n.
(oblique head) Lateral plantar a.
Flexor (layer 3) (2) Flexor digiti minimi plex proximal phalanx 5th digit Superficial branch of
brevis lateral plantar n.
Flexor (layer 4) (7) Plantar interossei (1-3) ADduct digits 2 – 4; flex MP Lateral plantar n.
Dorsal interossei (1-4) ABduct digits 2 – 4; flex MP
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o Supinator
o Triceps
- Compartmentalization of arm
o Anterior/Posterior divisions made by humerus and medial and lateral intermuscular septa formed by brachial fascia
(continuation of pectoral, axillary, and deep fascia of the latissimus dorsi and deltoids)
o Anterior
Flexors of arm or forearm
Musculocutaneous nerve innervates all structures of the arm (not talking about forearm)
o Posterior
Extensors of arm or forearm
Radial nerve innervates extensors of arm and forearm
Profunda brachii artery
- The median nerve does not innervate any muscles in the arm – it gives off the anterior interosseus nerve in the cubital
fossa
- Musculocutaneous nerve
o Innervates all muscles of anterior compartment of arm
o Pierces supinator
- Ulnar nerve
o Passes through arm but does not supply any muscles in arm (not talking about forearm)
o Passes posterior to humerus at medial epicondyle
o Funnybone – blow to medial epicondyle and hence the ulnar nerve
- Brachial artery
o Continuation of axillary artery distal to inferior border of teres major
o Gives rise to profunda brachii, superior & inferior lateral branches, ulner artery, radial artery, and other muscular
branches
- Profunda brachii artery
o Highest branch of brachial artery
o Travels with radial nerve
o Anastomosis with posterior circumflex humeral artery
- Radial nerve
o Observed also through cubital fossa in plane between brachioradialis and brachialis muscle
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- Branches off femoral artery
o Anterior tibial artery
o Medial/lateral inferior genicular artery
o Medial/lateral superior genicular artery
o Profunda femoris artery
o Popliteal artery
o Posterior tibial artery
- Branches of sciatic nerve
o Common fibular division
Nerve to short head of biceps femoris
Articulate branch
Superficial fibular
Deep fibular
Lateral sural cutaneous
o Tibial division
Nerves to hamstrings (4 separate branches, including one to hamstring portion of adductor magnus)
Branches to posterior compartment muscles
Medial seral cutaneous nerve
Sural nerve formed by lateral and medial sural cutaneous nerves
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- Sciatic nerve divisions and actions: PED TIP
o Peroneal Everts and Dorsiflexes (if injured results in foot drop)
o Tibial Inverts and Plantarflexes (if injured can’t stand on TIPtoes)
- Other structures in leg (see cross section in lab manual)
o Fibula (small “feeble” lateral bone)
o Tibia
o Great saphenous vein
o Saphenous nerve
o Small saphenous vein
o Lateral sural cutaneous nerve
JOINTS
BACK
JOINT & TYPE LOCATION/ASSOC. ARTICULATING SURFACES MOTION
STRUCTURES
Atlanto-occipital Above cervical vertebrae Atlas – superior articulating surfaces for Biaxial motion
Synovial – condyloid between atlas (C1) and occipital epicondal (flexion/extension of
occipital bone Occipital bone head & lateral flexion
away from midline)
YES joint
Atlanto-axial Between atlas (C1) and axis Atlas – articular facet for dens Rotation
Synovial – pivot (C2) (has dens) Axis – anterior articular facet for anterior arch NO joint
of atlas
Symphyses Between vertebral bodies Articulating surfaces connected by IV discs Shock absorption and
Secondary cartilaginous and ligaments weight bearing
joints
Allow movement in
spinal column
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Glenohumeral Features Humeral head Rotation of shoulder
Synovial – ball & Glenoid fossa = ~ 1/3 size of Glenoid fossa
socket humeral head
Noncontractile ligaments and
contractile rotator cuff
enhance stability
Associated structures
Coracoacromial ligament
Superior, middle, & inferior
glenohumeral ligaments
Coracohumeral ligament
Transverse humeral ligament
(doesn’t provide stability to joint but
instead stabilizes biceps tendon
between glenoid and humeral
tuberosities)
Glenoid labrum
(fibrocartilagenous ring that
surrounds glenoid fossa and acts as
rim of cartilage to deepen glenoid
fossa)
Subacromial/subdeltoid
bursa
(between coracoacromial arch and
supraspinatus tendon which also
extends to deltoid muscle; decreases
friction between these 2 structures)
Scapulothoracic Between scapula and thoracic cavity Elevation/depression
Not a true synovial joint (frontal plane motions)
Protraction/retraction
(transverse plane)
downward/upward
rotation of shoulder
girdle
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(does not occur in elbow jt;
occurs in forearm)
Proximal radioulnar Annular ligament of radius Supination – radial head spins on fixed Supination/pronation
Synovial – pivot capitulum of ulna (does not occur in elbow jt;
occurs in forearm)
Strengthens fibrous
capsule (AL & PL)
HAND
Radiocarpal Between distal radius and proximal carpals Wrist flexion/extension
Synovial – condyloid
Wrist
abduction/adduction
Midcarpal Between proximal and distal row of carpal Gliding motions
Synovial – plane bones between carpals
Distal radioulnar joint Between distal end of radius and ulna Supination/pronation of
Synovial – pivot forearm
Carpometacarpal Between carpals and metacarpals Adduction/abduction of
Thumb – saddle thumb
Digits – gliding (perpendicular to plane of
palm)
Flexion/extension of
thumb
(parallel to plane of palm)
Opposition of thumb
Metacarpophalangeal Associated structures Between metacarpals and proximal phalanges Flexion/extension of
Thumb – hinge Collateral ligament digits
Digits – condyloid Palmar ligament (plate)
(provide lateral stability to joint; Flexion/extension of
medial collateral ligament of each
thumb
digit prevents lateral deviation)
AB/Adduction of digits
Proximal Associated structures Between proximal phalanges and middle Flexion/extension of
interphalangeal Collateral ligament phalanges digits
Hinge Palmar ligament (plate)
(provide lateral stability to joint;
medial collateral ligament of each
digit prevents lateral deviation)
Distal interphalangeal Associated structures Between middle phalanges and distal phalanges Flexion/extension of
Hinge Collateral ligament digits
Palmar ligament (plate)
(provide lateral stability to joint;
medial collateral ligament of each
digit prevents lateral deviation)
Ligamentum teres
(originates from acetabular labrum of
the hip bone and inserts into fovea of
femoral head)
Sacroiliac joint Associated structures Between pelvic girdle and axial skeleton Strongest and most
Synovial Sacroiliac ligament stable joint in body
(between sacrum and iliac crest)
Iliolumbar ligament Prevents great upward
(between iliac crest on either side to
movement of inferior
transverse processes of fifth lumbar
vertebra) end of sacrum
Sacrospinous ligament
(ischial spine to sacrum)
Sacrotuberous ligament
(ischial tuberosity to sacrum)
Pubic symphysis Associated structures Between left and right hip bones Holds pubic symphysis
Secondary cartilaginous Superior pupbic ligament Anterior together
joint
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Unhappy triad = MCL,
ACL, medial meniscus
Femoropatellar joint – Associated structures Apex of patella to tibial tuberosity Prepatellar and
knee joint 2 Patellar ligament suprapatella bursa
associated; bursitis of
suprapatella causes
patella to appear to float
over femur
NOTES
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Inguinal ligament – superior border of femoral triangle
OBJECTIVES
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o Lumbar puncture – above or below L4; passes through skin, fascia, interspinous ligament, ligamentum flavum, fatty
tissue, internal vertebral venous plexus, dura mater, and arachnoid mater
- Pathologies of back, vertebral column, and spinal cord
o Herniation of nucleus pulposus – sudden increase in compression load on column; annulus fibrosus ruptures and
nucleus herniates posteriorly into vertebral canal and can press on spinal roots or cord; common in lower lumbar and
lower cervical; disc ruptures laterally to thin PLL where annulus fibrosus is weak
o Spinal cord ischemia – meager blood supply to cord; follows minor damage to arterial supply as a result of regional
anesthesia, pain blockage procedures, or aortic surgery
o Spondylitis – inflammation of 1+ vertebrae; results in additional bone growth at margins of vertebral bodies; ALL
and sacroilioac joins calcify; patients experience joint stiffening (ankylosis)
o Spondylolysis – loosening of firm attachment of contiguous vertebrae; degernation in discs; additional bone growth
at body margins
o Spondylolisthesis – slipping and falling; forward movement of body of lower lumbar vertebra
o Spina bifida – vertebral laminae fail to fuse; lack of spinous process; common in lower lumbar or sacral
Spina bifida occulta – 1+ spinous processes fail to form at lumbar or sacral levels; asymptomatic; tuft of
hair in skin over defect
Spina bifida cystica – cyst through defect in vertebral arch; results in hydrocephalus and neuro defects
Spina bifida cystica with meningocele – protrusion of membranes of cord through column defect; cyst
lined by the meninges and containes CSF
Spina bifida cystica with meningomyelocele – protrusion of membranes and cord through vertebral
column defect; bladder, bowel, lower limb weakness
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Pronator teres (medial)
Brachialis and supinator (floor)
Biceps aponeurosis (roof) is NOT the same thing as biceps tendon
o Contents – TAN
Biceps Tendon
Brachial Artery
Median Nerve
Bicipital aponeurosis
Roof
Cephalic vein
Basilic vein
Median cubital vein
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o Klumpke’s paralysis – lower BP damage – C8, T1
o Winged scapula – damage to long thoracic nerve
o Crutch paralysis – radial nerve palsy – wrist drop (no extension), axillary n affected so no shoulder abduction
o Collateral circulation if axillary artery blocked – scapular anastomosis
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o Sacroiliac joint – strong, immobile between pelvic girdle and axial skeleton
Sacroiliac ligament
Iliolumbar igament
Sacrospinous ligament
Sacrotuberous ligament
Ligaments make this joint the strongest and most stable in body
o Hip joint
Range of motion sacrificed for stability
Ab/Ad
F/E
Rotation
Circumduction not as great as shoulder b/c muscles stabilize shoulder joint whereas ligaments and bones
stabilize hip joint
Capsular ligaments (3)
Iliofemoral ligament – strongest
Pubofemoral ligament
Ischiofemoral ligament – resists posterior dislocation of femoral head
o Ligamentum teres – originates from acetabular labrum and inserts into fovea of femoral head; little role in stability;
but carries artery of ligamentum teres which is important
- Arterial anastomoses source around hip
o Inferior gluteal artery anastomoses with branches of profunda femoris artery
o The two circumflex femoral (med/lat) arteries anastomose with each other and with inferior gluteal artery
- Gluteal region muscles, innervations, actions
- Thigh compartmentalization
o Anterior – flexors – femoral a.
o Medial – abductors – obturator a.
o Posterior – extensors (ex. Glut max) – tibial n.
o Deep gluteal – external (lateral) rotators – piriformis, gemelli
o Internal (medial) rotators – glut med, minimus, tensor fascia latae; weaker than lateral rotators
o Fascia septae divides thigh into anterior and posterior compartments
o Popliteal fossa
Boundaries
Biceps femoris (superolaterally)
Semimembranosus (superomedially)
Gastrocnemius (inferomedially and inferolaterally by medial and lateral heads respectively)
Contents
Termination of small saphenous vein
Popliteal artery
Popliteal vein
Tibial nerve
Common fibular nerve
Posterior cutaneous femoral nerve
Popliteal lymph nodes
Popliteal fat
- Thigh muscles, innervations, blood supply
o Semitendinosus tendon joins pes anserinus with the sartorius and gracilis tendons to insert distal to medial tibial
condyle
o Adductor canal – entered by:
Femoral artery (emerges as popliteal artery)
Femoral vein
Saphenous nerve
Nerve to vastus medialis
- Arterial and venous supply for LE, thigh, gluteal
o Nutrient artery off of profounda femoris artery supplies shaft of femur
o Great saphenous vein penetrates fascia lata in the femoral triangle through the saphenous hiatus
- Pathology and procedures
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o Avascular necrosis of femur head – due to fall b/c medial circumflex femoral artery (main source of blood supply
around head and neck) is disrupted
o Fracture of femur – due to fall
o Occlusion of femoral artery
o Hip dislocation – fracture acetabulum; hip joint least stable in flexed position b/c fibrous capsule ligaments are
slack
Posterior dislocation – sciatic nerve damage
Articular capsule torn could damage blood supply to femoral head
o Trendelenburg gait – superior gluteal nerve damage – hip drop; when contralateral foot raised, can’t keep pelvis
level; hip drop on foot in the air so use a cane on that side; on the hip drop side, abduction not occurring (glut med
and min b/c of superior gluteal n. damage)
o Intragluteal injection – upper lateral quadrant to avoid sciatic nerve
Superior glut neurovascular bundle, piriformis, inferior gluteal neurovascular bundle, sciatic nerve, internal
pudendal vessels, and pudendal nerve leave deep pelvis through greater sciatic notch
o Inferior gluteal n. damage – weak hip extension (glut max affected)
- Cross section of thigh
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