Superficial Muscles of the Back

Muscle Proximal Distal Innervation Action

Trapezius ● Medial third of
superior nuchal line
● External occipital
protuberance
● Nuchal ligament
● Spinous processes of
C7-T12
● Lateral 1/3 of Motor: Spinal Accessory Nerve ● Upper trap:
clavicle CN XI Elevation
● Acromion ● Middle Trap:
● Superior lip of Sensory: VPR C3, C4 Retraction
spine of scapula ● Lower Trap:
Depression
● Upper and Lower
Fibers: Upward Rotation of
glenoid fossa

Latissimus ● Spinous processes of intertubercular sulcus of Thoracodorsal Nerve ● Extends, adducts,

Dorsi T7 – T12
● Posterior layer of
Thoracolumbar fascia
● Iliac Crest
● Ribs 9-12
humerus C6, C7, C8 medially rotates humerus
● Indirect depression
by pulling on humerus
● Indirect downward
rotation of glenoid fossa
● Raises body towards
arms

Rhomboid ● Nuchal Ligament he spine of the scapula Dorsal Scapular Nerve C4, C5
Minor ● Spinous processes of (medial border)
C7-T1

Rhomboid processes of T2-T5 border of scapula from ● Elevation

Major spine to inferior angle ● Retraction
● Downward Rotation
of glenoid fossa

Levator r tubercles of transverse angle of scapula Dorsal Scapular Nerve C4, C5

Scapulae processes of C1-C4 VPR C3, C4

us cervicis has same attachment

Intermediate Muscles of the Back

Muscle Proximal Distal Innervation Action

Serratus posterior
superior Intercostal nerves Inspiration (for respiration)

Serratus posterior
inferior
Deep/Intrinsic Muscles of the Back

Muscle Proximal Distal Innervation Action

Splenius ● Inferior OR
half of the nuchal ● Lateral superior
Capitis ligament nuchal line
● Spinous ● Mastoid Process Unilateral: ipsilaterally rotate and
Processes of C7, Posterior rami of laterally flex neck
T1-T4 spinal nerves
Bilateral: extend head and neck

Spinous processes of Posterior tubercles of

Cervicis T3-T6 the transverse processes
of C1-C4

**Levator scapulae also

attaches here
Erector Spinae
Iliocostalis ● Posterior ● Posterior surface of
tubercles of the Sacrum
Cervicis transverse processes of ● Iliac crest
C4-C6 ● Spinous process of
● Ribs 3-6 T11-L5
● Posterior layer of
Thoracis thoracolumbar fascia
Borders of all ribs ● Posterior sacroiliac
ligament Bilateral:
Lumborum ● Eccentric flexion at Zygapophyseal
and Intervertebral joints
Inferior 6 ribs Posterior Rami of ● Anterior pelvic Tilt – extension of
spinal nerves lumbar vertebrae, increase lumbar
Erector Spinae lordosis
Longissimus Superior: Mastoid
process Unilateral:
Capitis Inferior: TP of T1-T5, AP ● Lateral flexion (ipsilaterally)
of C4-C7 ● Lateral pelvic Tilt

Superior: Posterior
tubercles of transverse *Longissimus Capitis can do ipsilateral
Cervicis processes of C2-C6 rotation of head b/c it has oblique
Inferior: TP of T1-T5 fiber directions

Thoracis

Erector Spinae
Spinalis Spinous Processes

Capitis
Cervicis
Thoracis **Most medial
**Blends with
semispinalis
 Muscle Proximal
Transversospinalis
Between superior and
Semispinalis inferior nuchal lines
(forms roof of Occipital
Captits Triangle)
Cervicis Spinous process of C2-C6
(largest part to C2 for
stabilization)
Thoracis
Spinous processes of
C4-C6
Transversospinalis
Sides of spinous
Multifidus processes from Axis – L5
Deep fibers attached to
joint capsules of facets to
prevent infolding during
Lumbar motion
Thoracic and Cervical
Transversospinalis
transverse processes
Rotatores
Brevis
Longus
Suboccipital Muscles
Rectus Capitis Spinous Process of C2
Posterior Major (Axis)
Rectus Capitis Posterior tubercle of
Posterior Minor posterior arch of C1
(Atlas)
Obliquus Capitis Transverse process of C1
Superior (atlas)
Obliquus Capitis Spinous process of axis
Inferior (C2)
Posterior Triangle of Neck
Distal Innervation Action
● Transverse processes of
C7-T7
● Articular
processes of C4-C7
Transverse processes of
T1-T6
Transverse processes of
T6-T12 Bilateral:
● Extension of head and
vertebral column
● 4 sacral dorsal ● Stabilization/compressive
foramina DPR forces on vertebrae
● PSIS
● Dorsal SI ligament Unilateral:
● L1-L5 Mamillary ● Contralateral Rotation
Processes
● Deep surface of *Rotatores has largest density of
posterior layer of muscle spindles for proprioception –
Thoracolumbar fascia postural control
● Articular processes of
C1-C4
● Transverse processes in
T1-T12 and articular
processes of C1-C4
Spinous processes of more
superior vertebrae in all
regions
Lateral to the Minor’s Rotation, extension
attachment of the inferior
nuchal line
Head Extension
Medial to the Major’s (@ atlanto-occipital joint)
attachment of the inferior Suboccipital Nerve
nuchal line C1
Most lateral of the occipital Head Extension
bone in between the Head Lateral Flexion
superior and inferior nuchal (@ atlanto-occiital joint)
lines
Transverse Process of C1 Ipsilateral Head Rotation
(Atlas) (@ atlanto-axial joint)
 Muscle Proximal Distal Innervation Action
Sternocleidomastoid Unilaterally:
Anterior Surface of Motor: ● Ipsilateral lateral Flexion
Sternal Head manubrium Spinal Accessory CN XI ● Contralateral rotation
**Round tendon Mastoid process, lateral
½ of superior nuchal line Sensory: Bilaterally:
Clavicular Head VPR C2-C3 ● Extends head
**Flat tendon Superior surface of the ● Extends superior cervical
**Deep/lateral to medial 1/3 of the clavicle vertebrae, posterior to axis of
sternal head rotation
put, C1, C2)(“turtle head”)
● Flexes inferior Cervical
vertebrae, anterior to axis of
rotation
w C2) (“chin to chest”)

Omohyoid Superior border of Inferior border of hyoid C1-C3 by a branch from Depresses, retracts and steadies
scapula near bone the ansa cervicalis hyoid
suprascapular notch

Anterior Scalene Anterior Tubercles of Scalene tubercle on C4-C6

Transverse Processes of 1st rib Brachial plexus between Anterior
C3-C6 and Middle scalene

Bilateral: flexion of the head and

Middle Scalene Posterior Tubercles of 1st rib, posterior to VPR C3-C8 neck
Transverse Processes of groove for subclavian
C2-C7 artery Unilateral: lateral flexion

*Accessory muscles of inspiration

Posterior Scalene Posterior Tubercles of 2nd rib VPR C7-C8 (elevate ribs)
Transverse Processes of
C5-C7

Prevertebrals:

Muscle Proximal Distal Innervation Action

Longus Capitis VPR - Deep neck flexors
Longus Colli

**oblique and vertical

Abdominal Wall
Muscle Proximal
External Oblique ● External surface of Ribs
5-12
● Innerdigitates with the
lats and Serratus
anterior
Internal Oblique ● Ribs 10-12
● Middle layer of
thoracolumbar fascia
● Connective tissue deep
to the inguinal ligament
Transverse Abdominis ● Internal surface of
Costal Cartilages of 7-12
● Middle layer of
thoracolumbar fascia
● Connective tissue deep
to inguinal ligament
● Innerdigitates with
diaphragm
Rectus Abdominis ● Pubic symphysis
● Pubic crest
Psoas Major ● Transverse Processes of
L1-L5
● Sides of vertebral bodies
● IV discs
Iliacus Superior 2/3 of iliac fossa,
ala of sacrum, anterior SI
ligament
Quadratus Lumborum ● Iliotransverse:
Transverse Processes
L1-L5
● Iliocostal &
Costotransverse: Rib 12
Distal Innervation Action
● Linea alba Contralateral Rotation
● Pubic tubercle T7-T12
● External lip of iliac crest
● Flexion
● Lateral Flexion
● Posterior Pelvic Tilt
● Linea alba ● Lateral Pelvic Tilt
● Intermediate crest of iliac ● Pelvic Rotation
crest
● Pectin pubis (conjoint T6-T12, L1
tendon with TA)
(L1 splits into Ipsilateral Rotation
Ilioinguinal and
Iliohypogastric
● Linea alba with nerves)
aponeurosis of IO
● Internal lip of iliac crest Compresses and supports
● Pecten pubis tendon abdominal viscera
(conjoint tendon with TA)
● Costal Cartilages of ribs 5-7 T6-T12 ● Flexion
● Xiphoid process ● Posterior Pelvic Tilt
● Iliopsoas- primary hip flexor
Lesser Trochanter of femur ● Some laterally flex lumbar
VPR L1-L3 vertebrae
Lesser Trochanter of Femur Femoral L2-L4 Iliopsoas- primary hip flexor
● Iliotransverse & Iliocostal: ● Extension
Internal lip of iliac crest VPR T12-L1 ● Lateral Flexion
● Costotransverse: TP L1-L5 ● synergist with diaphragm by
● All: Iliolumbar Lig (from fixing 12th rib
iliac crest to TP L4-L5) ● Lateral Pelvic Tilt
Upper Limb
Muscle Proximal
Pectoralis Major
Anterior surface of medial
Clavicular head ½ of clavicle
Anterior surface of
Sternocostal Head sternum, costal cartilages
1-6, aponeurosis of
external oblique
Pectoralis Minor Ribs 3-5 near costal
cartilages [expect
variation]
Subclavius Junction of 1st rib and its
costal cartilage
Serratus Anterior
External surface of
Ribs 1-8
Deltoid
inferior lip of spine of
scapula, acromion, lateral
1/3 of clavicle
Posterior surface of the
Teres Major
inferior angle of the
scapula
**Lat’s little buddy
Supraspinatus Supraspinous fossa of
scapula (goes inferior to
coracoacromial arch)
Infraspinatus
Infraspinous fossa
Teres Minor Middle part of the lateral
border of scapula
Distal
Lateral Lip of Intertubercular
groove/sulcus of humerus
Or
Crest of greater tuberosity
Coracoid process of scapula
Inferior surface of middle 1/3
of clavicle (groove for the
subclavius)
Medial border of anterior
surface of scapula, from the
superior angle to inferior
angle
Deltoid tuberosity of
humerus
(mid shaft, lateral aspect)
Medial lip of the
Intertubercular groove/sulcus
of humerus
Superior facet of the greater
tubercle of the humerus
Middle facet of the greater
tubercle of the humerus
Inferior facet of the greater
tubercle of the humerus
Innervation Action
Lateral Pectoral Nerve Glenohumeral joint:
C5-C7 Adduction, medial rotation,
horizontal flexion
Medial Pectoral nerve SC and AC joints:
C8-T1 protraction, downward
rotation
Clavicular head: flexion (GH
joint)
Sternocostal head:
extension from a flexed
position
Medial pectoral nerve Depression, protraction and
C8-T1 downward rotation
Depresses shoulder girdle,
Nerve to the Subclavius stabilizes the SC joint
C5-C6
● Protraction, upward
Long thoracic nerve rotation (force couple with
C5-C7 trap)
Lateral cutaneous ● superior fibers: elevate
branches of VPR ● lower fibers: depress
● Stabilize scapula against
thoracic wall (along with
rhomboids)
Ant: flexion and medial
Axillary C5-C6 rotation (GH Joint)
Mid: Abduction
Post: Extension and lateral
rotation
**3 Heads work in synergy
when they do abduction
(Ant/Post cancel each other
out)
Lower subscapular Adduction, medial rotation
nerve C5-C7 and extension
Suprascapular nerve
Abduction
C5-C6
Suprascapular nerve
Externally rotates
C5-C6
Axillary C5-C6 Externally rotates

Subscapularis
Subscapular fossa (most
**largest rotator cuff of anterior surface of
scapula)
Biceps Brachii Short head: conjoint
tendon w/coracobrachialis
to coracoid process of
scapula
Long Head: supraglenoid
tubercle of scapula and
superior aspect of labrum
[fibrocartilage disk]
Long head [travels in
intertubercular groove –
held in place by transverse
humeral ligament]
Coracobrachialis Coracoid process of
scapula via conjoint
tendon with biceps brachii
Brachialis Anterior surface of the
distal ½ of the humerus
**Larger cross-sectional
area than biceps
**Brachial artery or
median nerve may run
deep and be
compressed
Triceps Brachii
Infraglenoid tubercle on
Long head scapula
Posterior surface of
Lateral head humerus, superior to
radial groove
Inferolateral to radial
Medial head groove
Posterior Compartment of Forearm – Superficial group
Muscle Proximal
Lesser tubercle of the
humerus
Upper and Lower
Subscapular nerves Medial rotation, adduction
Some fibers of tendon blends
C5-C7
with transverse humeral
ligament
Radial Tuberosity, biccipital Flexes forearm (shoulder
aponeurosis (lacertus and elbow joint)
fibrosis) – attaches to deep
antebrachial fascia Supination (proximal and
distal radioulnar joints)
Impacted by
shoulder/forearm position
Musculocutaneous
nerve
C5-C7
Middle 1/3 of medial surface C6 myotome Shoulder joint: Shoulder
of humerus flexion, adduction
Coronoid process and ulnar
tuberosity Elbow joint: Forearm flexion
**workhorse – not affected
by shoulder/forearm
position
Extension (GH and elbow
Olecranon process of ulna joint)
Long head of triceps:
Radial C8-T1 adduction
Distal Innervation Action
 Proximal 2/3 of lateral
Brachioradialis Lateral surface of the distal
supracondylar ridge of Flexion
radius
humerus

Distal 1/3 of lateral Radial C8-T1

Extensor Carpi Radialis
Supracondylar ridge of nd
Longus Base of 2 metacarpal
humerus distal to
Brachioradialis

Extends and radially deviates

Extensor Carpi Radialis
wrist
Brevis
Base of 3rd metacarpal
Deep Radial

Lateral epicondyle of
humerus via common
Extensor Digitorum extensor tendon Extensor expansion of digits MCP Extension
2-5 IP extension
(Tennis Elbow- usually the
ECRB is involved)
Extensor Digiti Minimi Extensor expansion of 5th 5th MCP extension
digit 5th IP extension

Posterior Interosseous
Extensor Carpi Ulnaris Lateral epicondyle of C7-C8
humerus via common Extension and Ulnar
Base of 5th metacarpal
extensor tendon & deviation
posterior border of ulna

Lateral epicondyle of Lateral surface of the Radial C8-T1 Extension (GH and elbow
Anconeus humerus olecranon and superior part joint)
of ulna
Deep group

Supinator
Lateral epicondyle of
humerus (common
**Arcade of Frohse: can Proximal 1/3 of radius Deep Radial Supination
tendon), supinator fossa &
compress the Deep
supinator crest
radial nerve

Extensor Indicis Surface of posterior and

Extensor expansion of 2nd
distal 1/3 of ulna Extends 2nd digit at MCP, IPs
digit
Interosseus membrane

Abductor Pollicis Longus Posterior surface of Abduction & extension of

Radius & ulna Base of 1st metacarpal thumb @ CMC
Interosseus membrane Radial deviation

Posterior Interosseous
Extensor Pollicis Longus Extends CMC
C7-C8
Posterior surface of Ulna Base of distal phalanx of Extends MCP
Interosseus membrane thumb Extends IP
of thumb

Extensor Pollicis Brevis Extends MCP

Posterior surface of radius Base of proximal phalanx of
Extends CMC
Interosseus membrane thumb
of thumb
Radial deviation
Anterior Compartment of Forearm – Superficial Group
Muscle Proximal Distal Innervation Action
Pronator Teres
Ulnar head
Humeral Head
**Can compress Median
nerve
Flexor Carpi Radialis
**Sits on groove of
Trapezium, surrounded
by flexor retinaculum
Palmaris Longus
Flexor Carpi Ulnaris
Humeral Head
Ulnar Head
**Can compress Ulnar
nerve
Intermediate Group
Flexor Digitorum
Superficialis
Humero-ulnar head
Radial Head
**Sublimis bridge is
between the heads
**Can compress Median
nerve and Ulnar artery
Deep Group
Flexor Digitorum
Profundus
Ulnar Part
Radial Part
Flexor Pollicis Longus
Pronator Quadratus
Coronoid Process
Lateral surface of the radius, Pronate @ Radioulnar
distal to the supinator Weak elbow flexor
Medial Epicondyle of Median Wrist flexor
Base of 2nd metacarpal
humerus via common C6-C8 Radial Deviation
flexor tendon
(golfers elbow)
Palmar fascia/aponeurosis &
flexor retinaculum Very weak wrist flexor
5th metacarpal
Wrist flexor
Hook of Hamate
Ulnar deviation
Pisiform
Weak elbow flexor
Olecranon process & Flexor Retinaculum Ulnar
posterior border of the (stays muscular a long time)
ulna
Medial epicondyle of
humerus via common
flexor tendon
+ coronoid process
Intermediate phalanges of
digits 2-5 Flexion at wrist, MCP, PIP
(tendon splits and attaches to
Median
lateral aspects)
Anterior border of the
radius
Base of distal phalanges 4&5 Flexes distal phalanges 4 & 5
Ulnar
Proximal ¾ of anterior & at wrist, CMC, MCP, IP joints
medial aspect of ulna
Interosseus membrane Base of distal phalanges Flexes distal phalanges 2 & 3
2&3 at wrist, CMC, MCP, IP joints
Flexes thumb at wrist, CMC,
Anterior surface of radius
Distal phalanx of thumb MCP, IP joints
Interosseus membrane
Anterior Interosseous
C8,T1 Pronation
Anterior surface of distal ¼ Anterior surface of distal ¼ of
Dynamically stabilizes distal
of ulna radius
Radioulnar joint
 Intrinsics of the Hand
Thenar Compartment
Muscle Proximal Distal Innervation Action

Opponens Pollicis
Lateral side of shaft of 1st - Opposition
**Deep to metacarpal - Assists w/ medial rotation @ CMC for
abductor poollicis Recurrent branch of pure opposition to take place
brevis median nerve (C8,
- Flexor Retinaculum T1)
- Tubercles on Scaphoid
Abductor Pollicis and Trapezium (after median nerve
Brevis passes through
carpal tunnel) - Abducts @ CMC of thumb
**Radial side of -assists with opposition
flexor pollicis If recurrent branch is
brevis injured, develop Ape
Hand – thumb will
2 sesamoid bones in
Flexor Pollicis Lateral side of base of
tendons at head of 1st
Brevis proximal phalanx of thumb
metacarpal
- Flexes @ CMC & MCP
Superficial head Flexor pollicis longus -Assists with opposition
tendon between sesamoid -Assists in adduction
bones Deep Ulnar Nerve
Deep Head
(C8, T1)

Skin

Palmaris Brevis Superficial Branch of - Wrinkles the skin of the hypothenar

Medial border of palmar Ulnar nerve eminence, aiding grip
aponeurosis and skin on - deepens the hollow of the palm
medial border of hand (only muscle that it - covers and protects ulnar nerve and
innervates) artery

Hypothenar Compartment

Abductor Digiti
Pisiform
Minimi
**Flexor carpi ulnaris Abduction @ MCP
**More medial
stabilizes pisiform Assists w/ flexion @ MCP
proximally so it can move
**Deep ulnar Medial side of base of
its proximal attachment
nerve goes deep Proximal phalanx of 5th digit
to it
Deep Ulnar Nerve
(C8, T1)
Flexor Digiti
Flexes 5th digit @ MCP
Minimi

Hook of the hamate

Opponens Digiti Flexor retinaculum
Opposition @ 5th CMC
Minimi
Medial shaft of the 5th -rotates 5th metacarpal
metacarpal (saddle joint)
**Deepest

Adductor Compartment
Adductor Pollicis Base of 2nd & 3rd
Deep Ulnar Nerve
metacarpal
(C8, T1)
Oblique head Capitate
Adducts thumb @ CMC
Trapezoid
**Radial artery Medial side of base of
Last FULL muscle Assists with flexion of thumb @ MCP
between heads Proximal Phalanx of thumb
rd innervated by deep
Shaft of 3 metacarpal
ulnar nerve
Transverse head

Central Compartment (ALSO tendons of flexor digitorum superficialis and flexor digitorum profundus)

Lumbricals
Attach to Flexor digitorum Median Nerve (C8,
**“worm-like” profundus tendons T1) Primary extensors of PIP/DIP
Flexion @ MCP
1 and 2 1: radial side of 2nd digit
**unipennate 2: radial side of 3rd digit (due to dorsal/ventral attachment into
Radial Side of base of
extensor expansion)
proximal phalanx & extensor
3: ulnar side of 3rd &
expansion
3 and 4 radial side of 4th Called “Lumbrical Position of the
**bipennate Hand” – hold book/cards or patients
4: ulnar side of 4th & radial Deep Ulnar Nerve
side of 5th (C8, T1)

Interossei Compartment

Dorsal Interossei Extensor of PIP/ DIP

Assists flexion @MCP
(Lumbrical position)
**1 - 4 1&2: radial side of bases of
**bipennate proximal phalanges Primary abductor @ MCP
**DAB or 1: 1st & 2nd metacarpals
“Show off your 2: 2nd & 3rd metacarpals 3&4: ulnar side of bases of
ring” 3: 3rd & 4th metacarpals proximal phalanges 1. abduction of index finger
4: 4th & 5th metacarpals 2: acts on middle finger for radial
+ Extensor Expansion deviation
Deep Ulnar Nerve
3: acts on middle finger for ulnar
(C8, T1)
deviation
4: Abduction of ring finger

Point of reference is
Palmar Interossei
nd the middle finger
1: Ulnar side of 2 base of
nd proximal phalange
1: Ulnar side of 2
**1-3 2: Radial side of 4th base of Primary extensor of PIP/DIP
metacarpal
**Unipennate proximal phalange Flexion @ MCP
2: Radial side of 4th
**PAD or 3: Radial side of 5th base of (lumbrical position)
metacarpal
“Asking for proximal phalange
3: Radial side of 5th
change Adduction at MCP
metacarpal
+ Extensor Expansion

Anterior Compartment of the thigh

Muscle Proximal Distal Innervation Action
Iliopsoas
**Floor of fem triangle
Iliacus
**Deep to inguinal
ligament
Psoas Major
**lumbar plexus is within
and deep to it
Tensor Fascia Latae
**Superiormedial to
inferolateral
Sartorius
** “tailor”
**figure 4 position
**lateral boundary of
femoral triangle
**anterior boundary of
adductor canal
Quadriceps Femoris
Rectus Femoris
**Only head that crosses
hip
Quadriceps Femoris
Vastus Lateralis
**Bigger proximally
Quadriceps Femoris
Vastus Medialis
**Bigger distally
**lateral boundary of
adductor canal
**Inferior Fibers: Obliqus
**Superior fibers: Longus
Quadriceps Femoris
Vastus Intermedius
Articularis Genu
**Derivative of vastus
intermedius
Medial Compartment of the thigh
Muscle
Pectineus
** Superficial layer
**Floor of femoral triangle
- Iliac crest
- Superior 2/3 iliac fossa, ala
of sacrum, anterior sacro-iliac
ligaments
Sides of bodies of T12-L5, IV
discs between them, and
Transverse processes of all
lumbar vertebrae
Anterior superior iliac spine
Anterior superior iliac spine,
superior part of notch inferior
to it
Straight head: Anterior
inferior iliac spine
Reflected head: ilium
superior to the acetabulum
Lateral Lip of the Linea Aspera
of the femur, Greater
Trochanter, and Fascia Lata
Intertrochanteric Line &
Medial Lip of the Linea Aspera
of femur
(most medial muscle)
Anterior and lateral surfaces
of the shaft of the femur
Distal part of anterior aspect
of femur
Proximal
Superior ramus of pubis
Tendon of psoas major, lesser
trochanter, femur distal to it L2, L3
Lesser trochanter of femur
Iliotibial Band (encased in
and attaches to; attaches to
Gerdy’s tubercle (lateral
tubercle of tibia)
Anteromedial aspect of
proximal tibia
Pes Anserinus (conjoint
tendon with gracilis and
semitendinosus)
“goose’s foot”
Anserine bursa is deep
Tibial Tuberosity
(Common Quadriceps tendon
to base of patella, and then
Patellar Ligament into the
Tibial Tuberosity)
Femoral Nerve
Lateralis and medialis also
attach to tibia and patella via
aponeuroses
Lateralis attaches into
iliotibial band
*deep to patellar ligament is
Hoffa’s fat pad (infrapatellar)
Synovial membrane of knee
joint; wall of suprapatellar
bursa
Distal
Pectineal Line of femur, just
inferior to the lesser trochanter
Femoral Nerve
Iliacus: anterior pelvic tilt
Primary flexors of the
thigh at the hip joint
Stabilizes the hip joint
VPR L1-L3
Superior Gluteal - Abduct, medially rotates,
Nerve L5, S1 flexes thigh
- keep pelvis level when
ipsilateral leg is weight-bearing
- advance opposite side during
swing phase
- Hip: FABER
Flexion, abduction,
Femoral Nerve external rotation
L2, L3 - Flex leg at knee joint
- medially rotates leg
when knee is flexed
*Rectus femoris
-flexes hip
- anterior pelvic tilt
-steadies hip joint
L2-L4
- Extend Knee
- Pulls synovial membrane
superiorly during leg extension
- prevents folds of membrane to
be compressed between femur
and patella
Innervation Action
Femoral Nerve - Flex + Adduct thigh
L2-L3 - assist with internal
rotation
**Transitional muscle between
anterior/medial compartments

Gracilis Anterior Medial surface of

Body of pubis and proximal tibia Obturator Nerve Adduct thigh
** Superficial layer inferior pubic ramus (Pes Anserinus (conjoint tendon L2-L3 Flexion and medial rotation
**Most medial with sartorius and of leg at the knee
**Only one that crosses knee semitendinosus)
“goose’s foot”
Anserine bursa is deep

Adductor Longus
Adducts thigh
**Superficial layer
Body of pubis inferior to Internal rotation
**Medial boundary and floor Middle 1/3 of Linea Aspera
the pubic crest
of femoral triangle
Flexion/extension?
**Medial boundary of
Adductor Canal

Adductor Brevis Adducts thigh

Can somewhat flex thigh
Body of pubis and Pectineal Line & proximal part of
**Intermediate layer Internal rotation
inferior pubic ramus linea aspera
**Deep to petcineus and
Obturator Nerve
adductor longus Flexion/extension?
L2-L4

Adductor Magnus
Inferior pubic ramus &
**Deep layer ramus of ischium
**Openings for perforating
Linea Aspera, medial Adducts thigh
branches of profunda femoris
supracondylar line & gluteal Internal rotation
artery
tuberosity
**Medial boundary of Adductor
Adductor part: flexes thigh
Canal
from an extended position
Adductor Part
Hamstring Part: extends
thigh from a flexed position
**Adductor hiatus: opening
between 2 parts Ischial Tuberosity Adductor tubercle of the femur Tibial Nerve
Hamstring Part (just proximal to the medial L4
epicondyle)

Obturator Externus
External surface of Trochanteric fossa of femur
**Very deep layer External Rotation
obturator membrane & Obturator Nerve
**Obturator nerve splits into Stabilizes head of femur in
margins of the (Passes posterior to the neck of L3-L4
anterior/posterior branches the acetabulum
obturator foramen the femur)
and goes through this muscle

Posterior Compartment of the thigh

Muscle Proximal Distal Innervation Action
Anterior medial aspect of
Semitendinosus Flex leg at knee
proximal tibia
**Medial Hamstrings Extend thigh at hip
Pes Anserinus (conjoint
**More superficial – Tibial Nerve
tendon with gracilis and
long, slender, round L5-S2 Posterior pelvic tilt
sartorius)
tendon Anterior divisions
“goose’s foot”
Superomedial border of
Anserine bursa is deep
popliteal fossa
 Medial Rotation of leg at
knee only when knee is
flexed

Semimembranosus - Posterior aspect of medial Extend trunk when thigh

tibial condyle and leg are flexed
**Medial Hamstrings -Oblique Popliteal Ligament
**Superomedial border (from muscle tendon; attaches
of popliteal fossa into posterior fibrous capsule During knee flexion,
Ischial Tuberosity of knee joint, goes to lateral semimembranosus assists in
femoral condyle) pulling medial meniscus
-Posterior horn of medial posteriorly
meniscus
-Medial collateral ligament

Biceps Femoris

**Lateral Hamstring
**Superolateral border
Long head:
of popliteal fossa
Extend thigh at hip
Posterior pelvic tilt

BOTH:
Long Head
Lateral side of the head of Flex leg at knee
fibula
(sometimes the fibular Lateral Rotation of leg at
Common Peroneal/
collateral ligament will split knee only when knee is
Fibular Nerve
Lateral supracondylar line the tendon) flexed
Short Head L5-S2
of femur & linea aspera
Posterior divisions
(lateral to the adductor
**Only crosses knee magnus but medial to the
(only muscle that it
Vastus lateralis)
innervates before it
bifurcates)

Muscles of the Gluteal Region

Muscle Proximal Distal Innervation Action
Extend thigh at hip (especially from flexed
Gluteus Maximus Ilium posterior to the
position)
posterior gluteal line, most fibers into the Inferior Gluteal
External rotation
near PSIS, dorsal Iliotibial band + Nerve
Posterior pelvic tilt
surface of the sacrum, other fibers into L5-S2
**Superomedial to coccyx & Gluteal tuberosity
Abduct (superior 1/3)
inferolateral fibers sacrotuberous
Adduct (inferior 2/3)
ligament
Superior Gluteal
Superior lateral
Gluteus Medius Superior ½ of the Nerve Closed chain: Abduct thigh at hip for
surface of the
external surface of the L5-S1 unilateral stance – controls pelvis on fixed
greater trochanter
ilium femur
**Tensor Fascia Latae is Between posterior and
next to medius/minimus anterior gluteal lines
Gluteus Minimus Inferior ½ of the
external surface of the
**Tensor Fascia Latae is ilium Anterior surface of
next to medius/minimus Between anterior and
inferior gluteal lines
keeps pelvis lateral in frontal plane when
ipsilateral limb is weight-bearing (unilateral
stance on one leg)
advance opposite (unsupported) side during
its swing phase
Anterior fibers:
Flexion/ Medial rotation
the greater Middle fibers:
trochanter abduction
Posterior fibers:
Extension/ External rotation
Minimus doesn’t have posterior that much

Piriformis Ventral surface of

sacrum in the pelvic
Nerve to the
**Through Greater cavity; sacrotuberous Superior border of
Piriformis
Sciatic Foramen ligament the greater
S1-S2
**The bed of the sacral trochanter
plexus
**Piriformis Syndrome
Piriformis: Internal Rotation of a super flexed
thigh
Superior Gemellus Ischial Spine

** Part of Triceps Coxae

External Rotation of an extended thigh
Obturator Internus internal surfaces of the Nerve to the
Abduction of a flexed thigh
Obturator membrane Obturator Internus
**Part of Triceps Coxae in pelvic cavity, L5-S1
Trochanteric fossa
**Through Lesser Sciatic surrounding bones of
(medial aspect of Stabilize head of femur in acetabulum
Foramen the ischium and pubis
greater trochanter)
**Greater than 90
degree turn when it
leaves pelvis

Inferior Gemellus Ischial Tuberosity

**Part of Triceps Coxae

Nerve to the
Quadratus Femoris
Quadratus Femoris Lateral border of the Quadrate tubercle
L5-S1
ischial tuberosity on the
intertrochanteric
crest of the femur
External Rotation
and area inferior to
Stabilize head of femur in acetabulum
it
Obturator Externus External surfaces of
Obturator Nerve
the Obturator
Trochanteric fossa L2-L4
**also in the medial membrane & bones of
compartment the ischium & pubis

Anterior Compartment of the Leg (“Pretibials”): deep to superior and inferior extensor retinaculum (V-shaped)
Muscle Proximal Distal Innervation Action

Tibialis Anterior Lateral condyle and Medial and Plantar surface of Primary Dorsiflexion @
superior ½ of lateral medial cuneiform & base of Talocrural
**Most medial in the surface of tibia & 1st metatarsal
compartment interosseus membrane Supination/inversion @
Tendon very prominent Subtalar and Transverse
w/ dorsi + sup tarsal joints
Medial longitudinal arch

Extensor Hallucis Middle part of anterior Dorsum of the base of the Extends IP and MTP of big
Longus surface of fibula distal phalanx of the great toe Deep Peroneal/ Fibular toe
& interosseus membrane & extensor expansion Nerve Assist w/ dorsiflexion
L4-S1 @talocrural
Extensor Digitorum Lateral condyle of tibia &
Longus superior ¾ of medial
surface of fibula
& interosseus membrane
Middle & distal phalanges of Primary Extends toes @
toes 2-5 via extensor MTP (assists with IP)
expansion Assists with Dorsiflexes @
Talocrural
Pronates/Everts @ Subtalar

Peroneus/ Fibularis Inferior 1/3 of anterior Dorsum of the base of the 5th Dorsiflexion @ Talocrural
Tertius surface of fibula metatarsal Pronation/Eversion @
& interosseus membrane subtalar
**Looks like a part of
EDL – same muscle belly
but diff tendon
**very long flat tendon.
**Sometimes absent

Lateral Compartment of the Leg: Longus + Brevis lie in Retromalleolar groove (posterior to Lateral Malleolus). Can sublux out of groove. Held in
place by Superior and Inferior Peroneal Retinaculum
Muscle Proximal Distal Innervation Action

Peroneus/ Fibularis
Longus

**Passes through groove Head and superior 2/3 of Plantar surface of the base of
on cuboid lateral surface of fibula the 1st metatarsal and medial
**deep to long plantar cuneiform
ligament
-LATERAL ankle sprain
(inversion/supination):
**Can sublux out of Pronation/Eversion @
cuboid groove Superficial Peroneal/ Subtalar
**Or can sublux the Fibular Nerve
cuboid from the L4-S1 Weak Plantarflexion @
calcaneus talocrural
**tenderness in sinus
tarsi – interosseous Transverse arch + Lateral
ligament or longitudinal arch
talocalcaneal ligament
can be injured
Inferior 2/3 of lateral
Peroneus/ Fibularis surface of fibula Plantar surface of the
Brevis tuberosity on lateral side of
base of the 5th met
**Deeper
**Longer muscle belly Styloid process – common
**More commonly torn site for fracture
longitudinally – flattens
and envelops the Longus

Posterior Compartment of the Leg

Muscle Proximal Distal Innervation Action

Gastrocnemius Lateral aspect of the lateral Plantarflex @ talocrural

**Smaller CSA than condyle of femur when knee is extended
soleus Supinator/inverter @
**Tearing a head is Subtalar
called Tennis Leg Superior to the medial condyle Weak knee flexion
Lateral head of the femur Calcaneal Tuberosity

Medial head via the Tendocalcaneal/ Calcaneal

**Longer belly Tendon/ Achilles Tendon

Plantaris can have a separate

tendon; the tendon is often called

Soleus
**Doesn’t cross knee
**Tendinous arch
**Tibial Nerve?
**Posterior Tibial artery
+ vein??
Fibula
Tibia
Plantaris
Popliteus
**Deep
**Floor of popliteal fossa
**Inferomedial to
superolateral
**Covered by popliteal
fascia
Flexor Hallucis Longus
**Deep
**Most lateral belly
**Groove between
medial and lateral
tubercles of talus – held
in groove by ligaments
Flexor Digitorum Longus
**Deep
**Most medial belly
**”Profundus of the
foot”
Tibialis Posterior
**Deepest
**Middle muscle belly Posterior surface of the fibula
Interosseus membrane
Tarsal Tunnel: Tom (TP), Dick (FDL), Bloody Nervous (Tibial nerve, posterior tibial vessels), Harry (FHL)
Flexor retinaculum; “Tarsal Tunnel Syndrome” FHL, FDL, TP, Tibial nerve, posterior tibial artery, 2 posterior tibial veins
Intrinsics of the foot:
Muscle
Extensor Digitorum
Brevis
Posterior aspect of head &
superior ¼ of posterior surface
Soleal line & middle 1/3 of
medial border & tendinous arch
Posterior lateral femoral
condyle (proximal to lateral
head of Gastroc)
Oblique popliteal ligament
Anterior part of the groove on
the lateral condyle of femur on
notch, oblique popliteal
ligament, lateral meniscus
(has intra-articular tendon)
- Arcuate popliteal ligament
arches over when it enters knee
joint
Inferior 2/3 of posterior surface
of fibula, inferior part of
Interosseus membrane
-> then inferior to
sustentaculum tali of the
Calcaneus and lies in groove for
tendon of FHL
Medial part of the posterior
surface of the Tibia inferior to
the soleal line; by a broad
tendon to the Fibula
Posterior surface of the tibia
inferior to the soleal line
Proximal
Calcaneus (floor of tarsal
sinus)
Interosseous talocalcaneal
ligament
Inferior extensor
retinaculum
the “fools/freshman nerve” because
it is long and thin Plantarflex @talocrural,
independent of position of
knee
Subcutaneous bursa: Between Supinator/inverter @
tendon and skin Subtalar
Steadies leg on foot
Retrocalcaneal bursa: Between
calcaneus and tendon
Tibial Nerve
L4-S3
Weakly assists gastroc in
plantar flexoion
Weak knee flexion
Posterior surface of tibia, superior Weak knee flexor
to popliteal line (on posterior Open chain: MR of Tibia
surface of body of tibia ) (femur fixed)
Closed Chain: LR of femur
Into tendinous expansion covering (leg fixed)
the surface of the muscle Unlocks the knee (leaving
closed-pack
position)
Plantar surface of the base of the Flexes big toe at MTP and IP
distal phalanx of the great toe
Weak plantar flexion
- Deep to flexor retinaculum and
Kager’s fat pad Supports medial
- Goes between 2 sesamoid bones longitudinal arch of foot
at head of 1st metatarsal
Plantar surface of the base of the Flexes toes 2-5
distal phalanges of toes 2-5 Plantarflexes ankle
- Passes through split in Flex Supination/inversion
Digitorum Brevis tendons
- Proximal attachment of lumbricals Supports longitudinal arch
- Deep to flexor retinaculum
-Quadratus plantae attaches; can
contract and affect the line of pull
Tuberosity of Plantarflexes ankle
Navicular, Cuneiform, Cuboid,
Sustentaculum tali of calcaneus Primary supinator/
Base of 2nd, 3rd, 4th met Inverter
- Crosses FDL near ankle joint, so it’s Medial longitudinal arch +
most medial; closest to medial Transverse arch
malleolus
- Deep to flexor retinaculum
Extensors
Distal Innervation Action
Extensor tendons of digits 2-4 Extension of toes at MTP
Deep Fibular Nerve and IP
L5-S1
Extensor Hallucis Brevis Calcaneus
Abductor Hallucis
Flexor Retinaculumm
**Knot of Henry Medial tubercle on
**Medial and Lateral calcaneal tuberosity
Plantar Nerves are deep Plantar aponeurosis
and can be compressed
Intermuscular Septum
Flexor Digitorum Brevis Medial tubercle on
calcaneal tuberosity
**“Superficialis of the Plantar aponeurosis
foot”
Medial and lateral
Abductor Digiti Minimi tubercles on the calcaneal
tuberosity, plantar
aponeurosis,
intermuscular septum
Also Flexor Hallucis Longus (goes between 2 sesamoid bones at head of 1st metatarsal) and Flexor Digitorum Longus
Medial and lateral plantar
Quadratus Plantae surfaces of the calcaneus
Flexor digitorum longus Medial side of the proximal
Lumbricals tendons
Flexor Digiti Minimi Base of 5th metatarsal
Brevis
Adductor Hallucis Plantar ligaments of MTP
**Shaped like 7 joints
Transverse Head Base of metatarsals 2-4
Oblique Head
Flexor Hallucis Brevis Plantar surface of cuboid
and lateral cuneiform
**Shaped like 11
Plantar aspect of medial
Plantar Interossei (3) side of shaft of
metatarsals 3-5
**unipennate
Dorsal Interossei (4) Adjacent sides of shafts of
metatarsals
**bipennate 1-5
Dorsal aspect of base of
proximal phalanx of great toe
Flexors: First Layer
Medial side of base of
proximal phalanx of 1st toe
Splits and attaches to both
sides of the middle phalanges
of toes 2-5
*Flexor digitorum longus
between tendons
Lateral side of base of
proximal phalanx of
5th toe
Second Layer
Posterolateral margin of
Flexor digitorum longus
tendons
phalanges of toes 2-5 and
extensor expansion
Third Layer
Base of proximal phalanx of
5th toe
Lateral side of the base of
proximal phalanx of 1st toe
Both sides of base of
proximal phalanx of 1st toe
**sesamoid bones within
tendon, FHL goes between
them
Fourth Layer
Medial surface of base of
proximal phalange of toes 3-5
1: medial sides of the 2nd
proximal phalanx
2 – 4: lateral side of the
2nd-4th proximal phalanx
Extends great toe at MTP
Medial plantar
S2-S3 *Medial Longitudinal Arch
Abducts and Flexes 1st toe
Flexes toes 2-5 at PIP
Baxter’s Nerve Abducts and flexes 5th toe
First Branch of the *Lateral Longitudinal Arch
Lateral Plantar Nerve
Inferior Calcaneal Nerve
S2-S3
Lateral plantar Assists the FDL in flexing
S2-S3 toes 2-5
2: Medial Plantar Flex proximal phalanges @
3-5: Lateral Plantar MTP
Extend middle and distal
S2-S3 phalanges @ IPs
Superficial branch of
the lateral plantar nerve Flexes proximal phalanx of
S2-S3 5th toe at MTP
Deep branch of Lateral
plantar nerve Adducts 1st toe
S2-S3 Supports transverse
arch of the foot
Medial Plantar
S2-S3 Flexes proximal
phalanx of 1st toe at MTP
Flex and adducts toes 3-5 at
MTP
Lateral plantar nerve
S2-S3
Flex and abducts toes 2-4 at
MTP