Openings in the Base of the Skull and the structures that pass through them Openings in the Skull

Perforations in the Cribriform plate Optic Canal Superior Orbital Fissure Bone of the Skull Anterior Cranial Fossa Ethmoid Middle Cranial Fossa Lesser wing of the Sphenoid Between lesser and greater wings of the Sphenoid Greater wing of the Sphenoid Greater wing of the Sphenoid Greater wing of the Sphenoid Between petrous part of temporal and Sphenoid Posterior Cranial Fossa Occipital

Structures Transmitted Olfactory nerves Optic nerve, ophthalmic artery Lacrimal, frontal, trochlear, oculomotor, nasociliary and abducent nerves; superior ophthalmic vein Maxillary Division of the Trigeminal Nerve Mandibular division of the Trigeminal Nerve Middle meningeal artery Internal carotid artery

Foramen Rotundum Foramen Ovale Foramen Spinosum Foramen Lacerum

Foramen Magnum

Hypoglossal Canal Jugular Foramen

Occipital Between petrous part of temporal and condylar part of occipital Petrous part of temporal Muscles of the Eyeball and Eyelids

Internal Acoustic Meatus

Medulla Oblongata, spinal part of accessory nerve, and right and left vertebral arteries Hypoglossal nerve Glossopharyngeal, vagus, and accessory nerves; sigmoid sinus becomes internal jugular vein Vestibulocochlear and facial nerves

Muscle Superior Rectus

Inferior Rectus

Medial Rectus

Lateral Rectus

Superior Oblique

Inferior Oblique

Sphincter Pupillae

Origin Insertion Innervation Extrinsic Muscles of Eyeball (Striated Skeletal Muscle) Tendinous ring on Superior surface of CNIII posterior wall of eyeball just posterior orbital cavity to corneoscleral junction Tendinous ring on Inferior surface of CNIII posterior wall of eyeball just posterior orbital cavity to corneoscleral junction Tendinous ring on Medial surface of CNIII posterior wall of eyeball just posterior orbital cavity to corneoscleral junction Tendinous ring on Lateral surface of CNVI posterior wall of eyeball just posterior orbital cavity to corneoscleral junction Posterior wall of Passes through CNIV orbital cavity pulley and is attached to superior surface of eyeball beneath superior rectus Floor of orbital cavity Lateral surface of CNIII eyeball deep to lateral rectus Intrinsic Muscles of Eyeball (Smooth Muscle) Parasympathetic via

Action Raises cornea upward and medially

Depresses cornea downward and medially Rotates eyeball so that cornea looks medially Rotates eyeball so that cornea looks laterally Rotates eyeball so that cornea looks downward and laterally

Rotates eyeball so that cornea looks upward and laterally Constricts pupil

of Iris Dilatory Pupillae of Iris Ciliary Muscle

CNIII Sympathetic Parasympathetic via CNIII

Dilates pupil

Controls shape of lens; in accommodation, makes lens more globular

Muscles of Eyelids Orbicularis Oculi Palpebral Part Orbital Part Medial palpebral ligament Medial palpebral ligament and adjoining bone Back of orbital cavity Lateral palpebral raphe Loops return to origin Facial nerve Facial nerve Closes eyelids and dilates lacrimal sac Throws skin around orbit into folds to protect eyeball Raises upper lid

Levator Palpebrae Superioris

Anterior surface and upper margin of superior tarsal plate

Striated muscle oculomotor nerve, smooth muscle Sympathetic

Muscles of the Head Muscle Occipitofrontalis Occipital belly Frontal belly Origin Insertion Muscle of Scalp Innervation Action

Highest nuchal line of Epicranial Facial nerve occipital bone aponeurosis Skin and superficial facia of eyebrows Muscles of Facial Expression Medial palpebral ligament Medial palpebral ligament and adjoining bone Superciliary arch Lateral palpebral raphe Loops return to origin Facial nerve Facial nerve

Moves scalp on skull and raises eyebrows

Orbicularis Oculi Palpebral Part Orbital Part

Corrugator Supercilii Compressor Nasi Dilator Naris Procerus Orbicularis Oris

Skin of eyebrow

Facial nerve

Frontal process of maxilla Maxilla Nasal bone Maxilla, mandible and skin

Aponeurosis of bridge of nose Ala of nose Skin between eyebrows Encircles oral orifice Dilator Muscles of Lips

Facial nerve Facial nerve Facial nerve Facial nerve

Closes eyelids and dilates lacrimal sac Throws skin around orbit into folds to protect eyeball Vertical wrinkles of forehead, as in frowning Compresses mobile nasal cartilages Widens nasal aperture Wrinkles skin of nose Compresses lips together

Levator Labii Superioris Alaeque Nasi Levator Labii Superioris Zygomaticus Minor Zygomaticus Major Levator Anguli Oris Risorius Depressor Anguli Oris Depressor Labii Inferioris Mentalis Buccinator

Arise from bones and fascia around oral aperture and insert into substance of lips

Facial nerve

Separate lips

Outer surface of alveolar margins of maxilla,

Facial nerve

Compresses cheeks

Platysma

Masseter Temporalis

mandible and pterygomandibular ligament Deep fascia over Body of mandible pectoralis major and and angle of mouth deltoid Muscles of Mastication Zygomatic arch Lateral surface ramus of mandible Floor of temporal Coronoid process of fossa mandible

Facial nerve cervical branch

and lips against teeth Depresses mandible and angle of mouth

Mandibular division of trigeminal nerve Mandibular division of trigeminal nerve

Lateral Pterygoid (two heads) Medial Pterygoid (two heads)

Greater wing of sphenoid and lateral pterygoid plate Tuberosity of maxilla and lateral pterygoid plate

Neck of mandible and articular sac Medial surface of angle of mandible

Mandibular division of trigeminal nerve Mandibular division of trigeminal nerve

Elevates mandible to occlude teeth Anterior and superior fibers elevate mandible; posterior fibers retract mandible Pulls neck of mandible forward Elevates mandible

Muscles of Tongue Muscle Longitudinal Transverse Vertical Genioglossus Superior genial spine of mandible Body of greater cornu of hyoid bone Styloid process of temporal bone Palatine aponeurosis Extrinsic Muscles Blends with other muscles of tongue Blends with other muscles of tongue Blends with other muscles of tongue Side of tongue CNXII Protrudes apex of tongue through mouth Depresses tongue Draws tongue upward and backward Pulls roots of tongue upward and backward, narrows oropharyngeal isthmus Origin Median septum and submucosa Insertion Intrinsic Muscles Mucous membrane Innervation CNXII Action Alters shape of tongue

Hyoglossus Styloglossus

CNXII CNXII

Palatoglossus

Pharyngeal plexus

Muscles of the Neck Muscle Platysma Origin Deep fascia over pectoralis major and deltoid Manubrium sterni and medial third of the clavicle Insertion Body of mandible and angle of mouth Mastoid process of temporal bone and occipital bone Innervation Facial nerve cervical branch Spinal part of accessory nerve and C2 and C3 Action Depresses mandible and angle of mouth Two muscles acting together extend head and flex neck; one muscle rotates head to opposite side Depresses mandible or elevates hyoid bone Elevates hyoid bone Elevates floor of mouth and hyoid bone or depresses

SCM

Digastric Posterior belly Anterior belly Stylohyoid Mylohyoid

Mastoid process of temporal bone Body of mandible Styloid process Mylohyoid line of body of mandible

Intermediate tendon is held to hyoid by fascial sling Body of hyoid bone Body of hyoid bone and fibrous raphe

Facial nerve

Nerve to mylohyoid Facial nerve Inferior alveolar nerve

Geniohyoid

Inferior mental spine of mandible Manubrium sterni and clavicle Manubrium sterni

Body of hyoid bone

First cervical nerve

Sternohyoid Sternothyroid

Body of Hyoid bone Oblique line on lamina of thyroid cartilage Lower border of body of hyoid bone

Ansa cervicalis; C1, 2&3 Ansa cervicalis; C1, 2&3 First cervical nerve

mandible Elevates hyoid bone or depresses mandible Depresses hyoid bone Depresses larynx

Thyrohyoid

Oblique line on lamina of thyroid cartilage Upper margin of scapula and suprascapular ligament Lower border of body of hyoid bone Transverse processes of 3rd, 4th 5th and 6th cervical vertebrae Transverse processes of upper six cervical vertebrae Transverse process of lower cervical vertebrae

Depresses hyoid bone or elevates larynx Depresses hyoid bone

Omohyoid Inferior belly

Intermediate tendon is held to clavicle and first rib by fascial sling

Ansa cervicalis; C1, 2&3

Superior belly

Scalenius Anterior

First rib

C4, 5 & 6

Scalenius Medius

First rib

Anterior rami of cervical nerves

Scalenius Posterior

Second rib

Anterior rami of cervical nerves

Elevates first rib; laterally flexes and rotates cervical part of vertebral column Elevates first rib; laterally flexes and rotates cervical part of vertebral column Elevates second rib; laterally flexes and rotates cervical part of vertebral column

Cranial Nerves Nerve Olfactory Optic Oculomotor Components Sensory Sensory Motor Function Smell Vision Lifts upper eyelid, turns eyeball upward, downward and medially; constricts pupil; accommodates eye Assists in turning eyeball downward and laterally Cornea, skin of forehead, scalp, eyelids and nose; also mucous membrane of paranasal sinuses and nasal cavity Skin of face over maxilla and the upper lip; teeth of upper jaw; mucous membrane of nose, the maxillary air sinus, and palate Muscles of mastication, mylohyoid, anterior belly of digastrics, tensor veli palatini and tensor tympani Skin of cheek, skin over mandible, lower lip and side of head; teeth of lower jaw and Opening in Skull Openings in cribriform plate of ethmoid Optic canal Superior Orbital Fissure

Trochlear Trigeminal Ophthalmic division

Motor

Superior Orbital fissure

Sensory

Superior Orbital Fissure

Maxillary division

Sensory

Foramen Rotundum

Mandibular division

Motor

Foramen Ovale

Sensory

Abducent Facial

Motor Motor

Sensory

Secretomotor parasympathetic

temporomandibular joint; mucous membrane of mouth and anterior two thirds of tongue Lateral rectus muscle: turns eyeball laterally Muscles of face, cheek and scalp; stapedius muscle of middle ear; stylohyoid; and posterior belly of digastrics Taste from anterior two thirds of tongue, floor of mouth and palate Submandibular and sublingual salivary glands, lacrimal gland and glands of nose and palate Position and movement of head Hearing Stylopharyngeus muscle; assists swallowing Parotid salivary gland General sensation and taste from posterior third of tongue and pharynx; carotid sinus and carotid body Constrictor muscles of phaynx and intrinsic muscles of larynx; involuntary muscle of trachea and bronchi, heart, alimentary tract from pharynx to splenix flexure of colon; liver and pancreas Taste from epiglottis and vallecula and afferent fibers from structures named above Muscles of soft palate, pharynx and larynx Sternocleidomastoid and trapezius muscles Muscles of tongue controlling its shape and movement (except palatoglossus)

Superior orbital fissure

Internal acoustic meatus, facial canal stylomastoid foramen

Vestibulocochlear Vestibular Cochlear Glossopharyngeal

Sensory Sensory Motor Secretomotor parasympathetic Sensory

Internal acoustic meatus

Jugular Foramen

Vagus

Motor

Jugular Foramen

Sensory

Accessory Cranial root Spinal root

Motor Motor Motor

Jugular Foramen

Hypoglossal

Hypoglossal Canal

Muscles Connecting the Upper Limb to the Thoracic Wall/ Muscles of the Pectoral Region (except Serratus Anterior) Muscle Pectoralis Major Origin Clavicle, sternum and upper six costal cartilages 3rd, 4th and 5th ribs Insertion Lateral lip of the bicipital groove of humerus Coracoid process of scapula Innervation Medial and lateral pectoral nerves form brachial plexus Medial pectoral nerve from brachial plexus

Pectoralis Minor

Subclavius

First costal cartilage

Clavicle

Nerve to subclavius from upper trunk of brachial plexus

Serratus Anterior

Upper eight ribs

Medial border and inferior angle of the scapula

Long thoracic nerve

Action Adducts arm and rotates it medially; clavicular fibers also flex arm Depresses point of shoulder; if the scapula is fixed, it elevates the ribs of origin Depresses the clavicle and steadies this bone during movements of the shoulder girdle Draws the scapula forward around the thoracic wall; rotates the scapula

Muscles Connecting the Upper limb to the Vertebral Column/ Superficial (Appendicular) Group of Back Muscles Muscle Trapezius Origin Occipital bone, ligamentum nuchae, spine of 7th cervical vertebra, spines of all thoracic vertebra Insertion Upper fibers into lateral third of clavicle; middle and lower fibers into acromion and spine of the scapula Floor of bicipital groove of humerus Innervation Spinal part of accessory nerve (motor) and C3 and C4 (sensory) Action Upper fibers elevate the scapula; middle fibers pull the scapula medially; lower fibers pull medial border of the scapula downward Extends, adducts and medially rotates the arm

Latissimus Dorsi

Levator Scapulae

Rhomboid Minor

Rhomboid Major

Iliac crest, lumbar fascia, spines of lower six thoracic vertebrae, lower three or four ribs, and inferior angle of the scapula Transverse processes of first four cervical vertebrae Ligamentum nuchae and spines of 7th cervical vertebra and 1st thoracic vertebra 2nd to 5th thoracic spines

Thoracodorsal nerve

Medial border of the scapula Medial border of the scapula

C3 and C4 and dorsal scapular nerve Dorsal scapular nerve

Raises medial border of the scapula Raises medial border of scapula upward and medially Raises medial border of scapula upward and medially

Medial border of scapula

Dorsal scapular nerve

Muscles Connecting the Scapula to the Humerus Muscle Deltoid Origin Lateral third of clavicle, acromion, spine of scapula Insertion Middle of lateral surface of shaft of humerus Innervation Axillary nerve Action Abducts arm; anterior fibers flex and medially rotate arm; posterior fibers

Supraspinatus

Supraspinous fossa of scapula Infraspinous fossa

Infraspinatus

Teres Major

Lower third of lateral border of scapula

Greater tuberosity of humerus; capsule of shoulder joint Greater tuberosity of humerus; capsule of shoulder joint Medial lip of bicipital groove of humerus

Spurascapular nerve

Suprascapular nerve

Lower subscapular nerve

Teres Minor

Subscapularis

Upper two thirds of lateral border of the scapula Subscapular fossa

Greater tuberosity of the humerus; capsule of shoulder joint Lesser tuberosity of humerus

Axillary nerve

Upper and lower subscapular nerves

extend and laterally rotate arm Abducts arm and stabilizes shoulder joint Laterally rotates arm and stabilizes shoulder joint Medially rotates and adducts arm and stabilizes shoulder joint Laterally rotates arm stabilizes shoulder joint Medially rotates arm and stabilizes shoulder joint

Muscles of the Arm Muscle Biceps Brachii Long head Short head Origin Insertion Anterior Compartment Innervation Action

Supraglenoid tubercle of scapula Coracoid process of scapula

Coracobrachialis Brachialis

Tuberosity of radius and bicipital aponeurosis into deep fascia of forearm Coracoid process of Medial aspect of scapula shaft of humerus Front of lower half of Coronoid process of humerus ulna Posterior Compartment Infraglenoid tubercle of scapula Upper half of posterior surface of shaft of humerus Lower half of posterior surface of shaft of humerus

Musculocutaneous nerve

Supinator of forearm and flexor of elbow joint; weak flexor of shoulder joint Flexes arm and also weak adductor Flexor of elbow joint

Musculocutaneous nerve Musculocutaneous nerve

Triceps Long head Lateral head

Olecranon process of ulna

Radial nerve

Extensor of elbow joint

Medial head

Muscles of the Anterior Fascial Compartment of the Forearm Muscle Pronator Teres Humeral head Ulnar head Origin Medial epicondyle of humerus Medial border of coronoid process of ulna Medial epicondyle of humerus Medial epicondyle of humerus Insertion Innervation Action

Lateral aspect of the shaft of radius Bases of 2nd and 3rd metacarpal bones Flexor retinaculum and palmar aponeurosis Pisiform bone, hook of the hamate, base at 5th metacarpal bone

Median nerve

Pronation and flexion of forearm Flexes and abducts hand at wrist joint Flexes hand

Flexor Carpi Radialis Palmaris Longus

Median nerve Median nerve

Flexor Carpi Ulnaris Humeral head Ulnar head

Medial epicondyle of humerus Medial aspect of olecranon process

Ulnar nerve

Flexes and adducts hand at wrist joint

and posterior border of ulna Flexor Digitorum Superficialis Humeroulnar head

Radial head

Flexor Pollicis Longus Flexor Digitorum Profundus

Medial epicondyle of humerus; medial border of coronoid process of ulna Oblique line on anterior surface of shaft of radius Anterior surface of shaft of radius Anteromedial surface of shaft of ulna

Middle phalanx of medial four fingers

Median nerve

Flexes middle phalanx of fingers and assists in flexing proximal phalanx and hand Flexes distal phalanx of thumb Flexes distal phalanx of fingers; then assists in flexion of middle and proximal phalanges and wrist Pronates forearm

Distal phalanx of thumb Distal phalanges of medial four fingers

Anterior interosseus branch of median nerve Ulnar (medial half) and median (lateral half) nerves

Pronator Quadratus

Anterior surface of shaft of ulna

Anterior surface of shaft or radius

Anterior interosseus branch of median nerve

Muscles of the Lateral Fascial Compartment of the Forearm Muscle Brachioradialis Origin Lateral supracondylar ridge of humerus Lateral supracondylar ridge pf the humerus Insertion Base of styloid process of radius Innervation Radial nerve Action Flexes forearm at elbow joint; rotates forearm to the midprone position Extends and abducts hand at wrist joint

Extensor Carpi Radialis Longus

Posterior surface of base of 2nd metacarpal bone

Radial nerve

Muscles of the Posterior Fascial Compartment of the Forearm Muscle Extensor Carpi Radialis Brevis Extensor Digitorum Origin Lateral epicondyle of humerus Lateral epicondyle of humerus Lateral epicondyle of humerus Lateral epicondyle of humerus Lateral epicondyle of humerus Lateral epicondyle of humerus Posterior surface of shaft of radius and ulna Posterior surface of shaft or radius Posterior surface of shaft of ulna Posterior surface of shaft of ulna Insertion Posterior surface of base of third metacarpal bone Middle and distal phalanges of medial four fingers Extensor expansion of little finger Base of fifth metacarpal bone Lateral surface of olecranon process of ulna Neck and shaft of radius Base of first metacarpal bone Base of proximal phalanx of thumb Base of distal phalanx of thumb Extensor expansion of index finger Innervation Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve Radial nerve Action Extends and abducts hand at wrist joint Extends fingers and hand Extends metacarpophalangeal joint of little finger Extends and adducts hand at wrist joint Extends elbow joint

Extensor Digiti Minimi Extensor Carpi Ulnaris Anconeus

Supinator Abductor Pollicis Longus Extensor Pollicis Brevis Extensor Pollicis Longus Extensor Indicis

Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve

Supination of forearm Extends and abducts thumb Extends metacarpophalangeal joint of thumb Extends distal phalanx of thumb Extends metacarpophalangeal joint of index finger

Small Muscles of the Hand Muscle Palmaris Brevis Lumbricals (4) Origin Flexor retinaculum, palmar aponeurosis Tendons of flexor digitorum profundus Insertion Skin of palm Extensor expansion of medial four fingers Innervation Superficial branch of ulnar nerve 1st and 2nd (i.e. lateral two) median nerve; 3rd and 4th deep branch of ulnar nerve Deep branch of ulnar nerve

Action Corrugates skin to improve grip of palm Flexes metacarpophalangeal joints and extend interphalangeal joints of fingers except thumb Palmar interossei adduct fingers toward center of third finger

Interossei (8) Palmar (4)

Dorsal (4)

First arises from base of 1st metacarpal; remaining three from anterior surface of shafts of 2nd, 4th and 5th metacarpals Contiguous sidesof shafts of metacarpal bones

Proximal phalanges of thumb and index, ring and little fingers and dorsal extensor expansion of each finger Proximal phalanges of index, middle and ring fingers and dorsal extensor expansion

Deep branch of ulnar nerve

Dorsal interossei abduct fingers from center of third finger; both palmar and dorsal flex metacarpophalangeal joints and extend interphalangeal joints Abduction of thumb

Abductor Pollicis Brevis Flexor Pollicis Brevis Opponens Pollicis Adductor Pollicis

Short Muscles of Thumb (Thenar Muscles; pollicis- thumb) Scaphoid, Base of proximal Median nerve trapezium, flexor phalanx of thumb retinaculum Flexor retinaculum Base of proximal Median nerve phalanx of thumb Flexor retinaculum Shaft of metacarpal bone of thumb Base of proximal phalanx of thumb Median nerve

Oblique head; 2nd Deep branch of and 3rd metacarpal ulnar nerve bones; transverse head; 3rd metacarpal bone th Short Muscles of Little Finger (Hypothenar Muscles; digiti minimi- 5 digit) Abductor Digiti Pisiform bone Base of proximal Deep branch of Abducts little finger Minimi phalanx of little ulnar nerve finger Flexor Digiti Flexor retinaculum Base of proximal Deep branch of Flexes little finger Minimi phalanx of little ulnar nerve finger Opponens Digiti Flexor retinaculum Medial border of 5th Deep branch of Pulls 5th metacarpal Minimi metacarpal bone ulnar nerve forward as in cupping the palm Summary of the Branches of the Brachial Plexus and their Distribution Branches Dorsal Scapular Nerve (C5) Long Thoracic Nerve (C5, 6, 7) Suprascapular Nerve (C5, 6) Nerve to Subclavius (C5, 6) Lateral Pectoral Nerve (C5, 6, 7) Musculocutaneous Nerve (C5, 6, 7)

Flexes metacarpophalangeal joint of thumb Pulls thumb medially and forward across palm Adduction of thumb

Distribution Roots Rhomboid minor, rhomboid major, levator scapulae Serratus anterior Upper Trunk Supraspinatus and infraspinatus Subclavius Lateral Cord Pectoralis major Coracobrachialis, biceps brachii, brachialis; supplies skin along lateral border of forearm when it becomes the

lateral cutaneous nerve of the forearm (See medial root of median nerve) Posterior Cord Upper Subscapular Nerve (C5, 6) Subscapularis Thoracodorsal Nerve (C6, 7, 8) Latissimus dorsi Lower Subscapular Nerve (C5, 6) Subscapularis and teres major Axillary Nerve (C5, 6) Deltoid and teres minor; upper and lateral cutaneous nerve of arm supplies skin over lower half of deltoid muscle Radial Nerve (C5, 6, 7, 8; T1) Triceps, anconeus, part of brachialis, ECRL; via deep radial nerve branch supplies extensor muscles of forearm: supinator, ECRB, ECU, ED, EDM, EI, AbPL, EPL, EPB; skin, lower lateral cutaneous nerve of arm, posterior cutaneous nerve of arm, and posterior cutaneous nerve of forearm; skin on lateral side of dorsum of hand and dorsal surface of lateral three and a half of fingers; articular branches to elbow, wrist and hand Medial Cord Medial Pectoral Nerve (C8; T1) Pectoralis major and pectoralis minor Medial Cutaneous Nerve of arm joined by intercostals Skin of medial side of arm brachial nerve from second intercostals nerve (C8; T1, 2) Medial Cutaneous Nerve of forearm (C8; T1) Skin of medial side of forearm Ulnar Nerve (C8; T1) FCU and medial half of FDP, FDM, ODM, AbDM, AdP, 3 rd and 4th lumbricals, interossei, PB, skin of medial half of dorsum of hand and palm, skin of palmar and dorsal surfaces of medial one and a half fingers Medial root of Median Nerve (with lateral root) forms PT, FCR, PL, FDS, AbPB, FPB, OP, first two lumbricals Median Nerve (C5, 6, 7, 8; T1) (by way of anterior interosseus branch), FPL, FDP (lateral half), PQ, palmar cutaneous branch to lateral half of palm and digital branches to palmar surface of lateral three and a half fingers; articular branches to elbow, wrist and carpal joints Lateral root of Median Nerve (C5, 6, 7)

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Muscles of the Gluteal Region Muscle Gluteus maximus Gluteus medius Gluteus minimus Origin Outer surface of ilium, sacrum, coccyx, sacrotuberous ligament Outer surface of ilium Insertion Iliotibial tract and gluteal tuberosity of femur Lateral surface of greater trochanter of femur Anterior surface of greater trochanter of femur Iliotibial tract Upper border of greater trochanter of femur Upper border of greater trochanter of femur Upper border of greater trochanter of femur Upper border of greater trochanter of femur Quadrate tubercle of femur Nerve Supply Action Inferior gluteal nerve Extends and laterally rotates hip joint; through iliotibial tract, it extends knee joint Superior gluteal Abducts thigh at hip joint; tilts nerve pelvis when walking to permit opposite leg to clear ground Superior gluteal Abducts thigh at hip joint; tilts nerve pelvis when walking to permit opposite leg to clear ground Superior gluteal Assists gluteus maximus in nerve extending the knee joint First and second Lateral rotator of thigh at hip sacral nerves joint Sacral plexus Lateral rotator of thigh at hip joint Sacral plexus Lateral rotator of thigh at hip joint Sacral plexus Lateral rotator of thigh at hip joint Sacral plexus Lateral rotator of thigh at hip joint Outer surface of ilium Tensor fasciae Iliac crest latae Piriformis Anterior surface of sacrum Obturator Inner surface of internus obturator membrane Gemellus Spine of ischium superior Gemellus Ischial tuberosity inferior Quadratus Lateral border of ischial femoris tuberosity

Muscles of the Anterior Fascial Compartment of the Thigh Muscle Sartorius Origin Anterior superior iliac spine Iliac fossa of hip bone Insertion Nerve Supply Upper medial surface of Femoral nerve shaft of tibia With psoas into lesser trochanter of femur Femoral nerve Action Flexes, abducts, laterally rotates thigh at hip joint; flexes and medially rotates leg at knee joint Flexes thigh on trunk; if thigh is fixed, it flexes the trunk on the thigh as in sitting up from lying down Flexes thigh on trunk; if thigh is fixed, it flexes the trunk on thigh as in sitting up from lying down

Iliacus

Psoas

Pectineus Quadriceps femoris Rectus femoris

Transverse processes, With iliacus into lesser Lumbar plexus bodies, and trochanter of femur intervertebral discs of the 12th thoracic and five lumbar vertebrae Superior ramus of pubis Upper end of linea Femoral nerve aspera of shaft of femur

Flexes and adducts thigh at hip joint

Vastus lateralis

Straight head: anterior inferior iliac spine Reflected head: ilium above acetabulum Upper end and shaft of femur

Vastus medialis

Quadriceps tendon into Femoral nerve patella, then via ligamentum patellae into tubercle of tibia Quadriceps tendon into Femoral nerve patella, then via ligamentum patellae into tubercle of tibia Upper end and shaft of Quadriceps tendon into Femoral nerve femur patella, then via ligamentum patellae into tubercle of tibia

Extension of leg at knee joint; flexes thigh at hip joint

Extension of leg at knee joint

Extension of leg at knee joint; stabilizes patella

Vastus intermedius

Anterior and lateral surfaces of shaft of femur

Quadriceps tendon into Femoral nerve patella, then via ligamentum patellae into tubercle of tibia

Extension of leg at knee joint; articularis genus retracts synovial membrane

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Muscles of the Medial Fascial Compartment of the Thigh Muscle Gracilis Adductor longus Adductor brevis Adductor magnus Origin Insertion Nerve Supply Inferior ramus of pubis, Upper part of shaft of Obturator nerve ramus of ischium tibia on medial surface Body of pubis, medial to Posterior surface of Obturator nerve pubic tubercle shaft of femur (linea aspera) Inferior ramus of pubis Posterior surface of Obturator nerve shaft of femur (linea aspera) Inferior ramus of pubis, Posterior surface of Adductor portion: ramus of ischium, shaft of femur, adductor obturator nerve ischial tuberosity tubercle of femur Hamstring portion: sciatic nerve Outer surface of Medial surface of Obturator nerve obturator membrane greater trochanter and pubic and ischial rami Action Adducts thigh at hip joint; flexes leg at knee joint Adducts thigh at hip joint and assists in lateral rotation Adducts thigh at hip joint and assists in lateral rotation Adducts thigh at hip joint and assists in lateral rotation; hamstring portion extends thigh at hip joint Laterally rotates thigh at hip joint

Obturator externus

Muscles of the Posterior Fascial Compartment of the Thigh Muscle Biceps femoris Origin Long head: ischial tuberosity Insertion Head of fibula Nerve Supply Long head: tibial portion of sciatic nerve Short head: common peroneal portion of sciatic nerve Tibial portion of sciatic nerve Action Flexes and laterally rotates leg at knee joint; long head also extends thigh at hip joint

Semitendinosus

Short head: linea aspera, lateral supracondylar ridge of shaft of femur Ischial tuberosity Upper part of medial surface of shaft of tibia

Semimembranosus Ischial tuberosity

Medial condyle of tibia Tibial portion of sciatic nerve Adductor tubercle of femur Tibial portion of sciatic nerve

Adductor magnus Ischial tuberosity (hamstring portion)

Flexes and medially rotates leg at knee joint; extends thigh at hip joint Flexes and medially rotates leg at knee joint; extends thigh at hip joint Extends thigh at hip joint

Muscles of the Anterior Fascial Compartment of the Leg Muscle Tibialis anterior Origin Insertion Nerve Supply Lateral surface of shaft Medial cuneiform and Deep peroneal of tibia and base of first metatarsal nerve interosseous bone membrane Anterior surface of shaft Extensor expansion of Deep peroneal of fibula lateral four toes nerve Anterior surface of shaft Base of fifth metatarsal Deep peroneal of fibula bone nerve Anterior surface of shaft Base of distal phalanx of fibula of great toe Deep peroneal nerve Action Extendsb foot at ankle joint; inverts foot at subtalar and transverse tarsal joints; holds up medial longitudinall arch of foot Extends toes; extends foot at ankle joint Extends foot at ankle joint; everts foot at subtalar and transverse tarsal joints Extends big toe; extends foot at ankle joint; inverts foot at

Extensor digitorum longus Peroneus tertius Extensor hallucis

longus Extensor digitorum brevis Calcaneum By four tendons into the Deep peroneal proximal phalanx of big nerve toe and long extensor tendons to second, third, and fourth toes

subtalar and transverse tarsal joints

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Muscles of the Lateral Fascial Compartment of the Leg Muscle Peroneus longus Origin Insertion Nerve Supply Action Lateral surface of shaft Base of first metatarsal Superficial peroneal Plantar flexes foot at ankle of fibula and the medial nerve joint; everts foot at subtalar and cuneiform transverse tarsal joints; supports lateral longitudinal and transverse arches of foot Peroneus Lateral surface of fibula Base of fifth metatarsal Superficial peroneal Plantar flexes foot at ankle brevis shaft of bone nerve joint; everts foot at subtalar and fibula transverse tarsal joint; supports lateral longitudinal arch of foot Muscles of the Posterior Fascial Compartment of the Leg Insertion Nerve Supply Superficial Group Gastrocnemius Lateral head from Via tendo calcaneus Tibial nerve lateral condyle of femur into posterior surface of and medial head from calcaneum above medial condyle Plantaris Lateral supracondylar Posterior surface of Tibial nerve ridge of femur calcaneum Soleus Shafts of tibia and Via tendo calcaneus Tibial nerve fibula into posterior surface of calcaneum Muscle Origin Action Plantar flexes foot at ankle joint; flexes knee joint

Plantar flexes foot at ankle joint; flexes knee joint Together with gastrocnemius and plantaris is powerful plantar flexor of ankle joint; provides main propulsive force in walking and running Flexes leg at knee joint; unlocks knee joint by lateral rotation of femur on tibia and slackens ligaments of joint Flexes distal phalanges of lateral four toes; plantar flexes foot at ankle joint; supports medial and lateral longitudinal arches of foot Flexes distal phalanx of big toe; plantar flexes foot at ankle joint; supports medial longitudinal arch of foot Plantar flexes foot at ankle joint; inverts foot at subtalar and transverse tarsal joints; supports medial longitudinal arch of foot

Popliteus

Deep Group Lateral surface of Posterior surface of Tibial nerve lateral condyle of femur shaft of tibia above soleal line Posterior surface of shaft of tibia Bases of distal phalanges of lateral four toes Tibial nerve

Flexor digitorum longus

Flexor hallucis Posterior surface of longus shaft of fibula

Base of distal phalanx Tibial nerve of big toe

Tibialis posterior

Posterior surface of Tuberosity of navicular Tibial nerve shafts of tibia and fibula bone and other and interosseous neighboring bones membrane

Muscles of the Sole of the Foot Muscle Abductor Origin Medial tuberosity of Insertion Nerve Supply Action First Layer Base of proximal Medial plantar nerve Flexes and abducts big toe;

hallucis Flexor digitorum brevis

Four tendons to four Medial plantar nerve Flexes lateral four toes; braces lateral toes inserted medial and lateral longitudinal into borders of middle arches phalanx; tendons perforated by those of flexor digitorum longus Abductor Medial and lateral Base of proximal Lateral plantar nerve Flexes and abducts fifth toe; digiti minimi tubercles of calcaneum phalanx of fifth toe braces lateral longitudinal arch Second Layer Quadratus Medial and lateral sides Tendon of flexor Lateral plantar nerve Assists flexor digitorum longus plantae of calcaneum digitorum longus in flexing lateral four toes Lumbricals (4) Tendons of flexor Dorsal extensor First lumbrical: Extends toes at interphalangeal digitorum longus expansion; bases of medial plantar joints proximal phalanges of nerve; remainder: lateral four toes lateral plantar nerve Flexor digitorum longus tendon Flexor hallucis longus tendon Third Layer Flexor hallucis Cuboid, lateral Medial tendon into Medial plantar nerve Flexes metatarsophalangeal brevis cuneiform, tibialis medial side of base of joint of big toe; supports medial posterior insertion proximal phalanx of big longitudinal arch toe; lateral tendon into lateral side of base of proximal phalanx of big toe Adductor Oblique head bases of Lateral side of base of Deep branch lateral Flexes metatarsophalangeal hallucis second, third, and proximal phalanx of big plantar nerve joint of big toe; holds together fourth metatarsal toe metatarsal bones bones; transverse head from plantar ligaments Flexor digiti Base of fifth metatarsal Lateral side of base of Lateral plantar nerve Flexes metatarsophalangeal minimi brevis bone proximal phalanx of joint of little toe little toe Fourth Layer Interossei Dorsal (4) Adjacent sides of metatarsal bones Bases of proximal Lateral plantar nerve Abduction of toes; flexes phalanges first: medial metatarsophalangeal joints side of second toe; and extends interphalangeal remainder: lateral sides joints of second, third, and fourth toes also dorsal extensor expansion Medial side of bases of Lateral plantar nerve Adduction of toes; flexes proximal phalanges of metatarsophalangeal joints lateral three toes and extends interphalangeal joints

calcaneum and flexor retinaculum Medial tubercle of calcaneum

phalanx of big toe

braces medial longitudinal arch

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Plantar (3)

Inferior surfaces of third, fourth, and fifth metatarsal bones

Peroneus longus tendon Tibialis posterior tendon Muscle of the Dorsum of the Foot Muscle Extensor Origin Anterior part of upper Insertion Nerve Supply By four tendons into the Deep peroneal Action Extends toes

digitorum brevis

surface of the calcaneum and from the inferior extensor retinaculum

proximal phalanx of big nerve toe and long extensor tendons to second, third, and fourth toes

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Branches of the Sacral Plexus and Their Distribution Branches Superior gluteal nerve Inferior gluteal nerve Nerve to piriformis Nerve to obturator internus Nerve to quadratus femoris Perforating cutaneous nerve Posterior cutaneous nerve of thigh Sciatic nerve (L4, 5; S1, 2, 3) Tibial portion Distribution Gluteus medius, gluteus minimus, and tensor fasciae latae muscles Gluteus maximus muscle Piriformis muscle Obturator internus and superior gemellus muscles Quadratus femoris and inferior gemellus muscles Skin over medial aspect of buttock Skin over posterior surface of thigh and popliteal fossa, also over lower part of buttock, scrotum, or labium majus Hamstring muscles (semitendinosus, biceps femoris [long head], adductor magnus [hamstring part]), gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus, and via medial and lateral plantar branches to muscles of sole of foot; sural branch supplies skin on lateral side of leg and foot Biceps femoris muscle (short head) and via deep peroneal branch: tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius, and extensor digitorum brevis muscles; skin over cleft between first and second toes. The superficial peroneal branch supplies the peroneus longus and brevis muscles and skin over lower third of anterior surface of leg and dorsum of foot Muscles of perineum including the external anal sphincter, mucous membrane of lower half of anal canal, perianal skin, skin of penis, scrotum, clitoris, and labia majora and minora

Common peroneal portion

Pudendal nerve

Branches of the Lumbar Plexus and Their Distribution Branches Iliohypogastric nerve Distribution External oblique, internal oblique, transversus abdominis muscles of anterior abdominal wall; skin over lower anterior abdominal wall and buttock External oblique, internal oblique, transversus abdominis muscles of anterior abdominal wall; skin of upper medial aspect of thigh; root of penis and scrotum in the male; mons pubis and labia majora in the female Skin of anterior and lateral surfaces of the thigh Cremaster muscle in scrotum in male; skin over anterior surface of thigh; nervous pathway for cremasteric reflex Iliacus, pectineus, sartorius, quadriceps femoris muscles, and intermediate cutaneous branches to the skin of the anterior surface of the thigh and by saphenous branch to the skin of the medial side of the leg and foot; articular branches to hip and knee joints Gracilis, adductor brevis, adductor longus, obturator externus, pectineus, adductor magnus (adductor portion), and skin on medial surface of thigh; articular branches to hip and knee joints Quadratus lumborum and psoas muscles

Ilioinguinal nerve

Lateral cutaneous nerve of the thigh Genitofemoral nerve (L1, 2) Femoral nerve (L2, 3, 4)

Obturator nerve (L2, 3, 4)

Segmental branches

Back

Muscles Connecting the Upper limb to the Vertebral Column/ Superficial (Appendicular) Group of Back Muscles *Trapezius *Latissimus Dorsi *Levator Scapulae *Rhomboid Major *Rhomboid Minor Intermediate (Respiratory) Group of Back Muscles Muscle Origin Insertion Serratus Lower portion of Upper border of Posterior ligamentum ribs 2 to 5 just Superior nuchae, spinous lateral to their process of C7 to angles T3 and supraspinous ligaments Serratus Spinous process Lower border of Posterior Inferior of T11 to L3 and ribs 9 to 12 just supraspinous lateral to their ligaments angles

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Innervation Anterior rami of upper thoracic nerves (T2 to T5)

Action Elevates ribs 2 to 5

Anterior rami of lower thoracic nerves (T9 to T12)

Depresses ribs 9 to 12 and may prevent lower ribs from being elevated when the diaphragm contracts

Deep Group of Back Muscles SpinoTransversales Muscles Muscle Origin Splenius Capitis Lower half of ligamentum nuchae, spinous processes of C7 to T4

Insertion Mastoid process, skull below lateral 1/3 of superior nuchal line

Innervation Posterior rami middle cervical nerves

Splenius Cervicis

Spinous processes of T3 to T6

Transverse processes of C1 to C3

Posterior rami middle cervical nerves

Action Together- draw head backwards extending neck; individually- draw and rotate head to one side (turn face to same side) Together- extend neck; individuallydraw and rotate head to one side (turn face to same side)

Erector Spinae Group of Back Muscles Muscle Origin Iliocostalis Lumborum Sacrum, spinous process of lumbar and lower two thoracic vertebrae and their supraspinous ligaments and the iliac crest Iliocostalis Thoracis Angles of the lower 6 ribs Iliocostalis Cervicis Longissimus Thoracis Angles of ribs 3 to 6 Blends with iliocostalis in lumbar region and is attached to transverse processes of lumbar vertebrae Transverse processes of upper 4 or 5 thoracic vertebrae

Insertion Angles of the lower 6 or 7 ribs

Longissimus Cervicis

Angles of the upper 6 ribs and the transverse process of C7 Transverse processes of C4 to C6 Transverse processes of all thoracic vertebrae and just lateral to the tubercles of the lower 9 or 10 ribs Transverse processes of C2 to C6

Longissimus Capitis

Spinalis Thoracis Spinalis Cervicis

Spinalis Capitis

Transverse processes of upper 4 or 5 thoracic vertebrae and articular processes of lower three or four cervical vertebrae Spinous processes of T10 or T11 to L2 Lower part of ligamentum nuchae and spinous processes of C7 (sometimes T1 to T2) Usually blends with semispinalis capitis

Posterior margin of the mastoid process

Spinous processes of T1 to T8 (varies) Spinous process of C2 (axis)

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With semispinalis capitis

Transversospinales Group of Back Muscles Muscle Origin Semispinalis Thoracis Transverse processes of T2 to T10 Semispinalis Cervicis Semispinalis Capitis Transverse processes of upper 5 or 6 thoracic vertebrae Transverse processes of T1 to T6 (or T7) and C7 and articular processes of C4 to C6 Sacrum, origin of erector spinae, PSIS, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae and articular processes of lower four cervical vertebrae Mammillary processes of lumbar vertebrae Transverse processes of thoracic vertebrae Articular processes of cervical vertebrae

Multifidus

Insertion Spinous processes of upper 4 thoracic and lower 2 cervical vertebrae Spinous processes of C2 (axis) to C5 Medial area between the superior and inferior nuchal lines of occipital bone Base of spinous processes of all vertebrae from L5 to C2

Rotatores Lumborum Rotatores Thoracis Rotatores Cervicis

Spinous processes of ;umbar vertebrae Spinous processes of thoracic vertebrae Spinous processes of cervical vertebrae

Segmental Back Muscles Muscle Origin Levatores Costarum Short paired muscles arising from transverse processes of C7 to T11 Interspinales Short paired muscles attached to the spinous process of contiguous vertebrae, one on each side of the interspinous ligament Intertransversarii Small muscles between the transverse processes of contiguous vertebrae

Insertion The rib below vertebra of origin near tubercle

Action Contraction elevates rib

Suboccipital Gorup of Back Muscles Muscle Origin Insertion Rectus Capitis Spinous process Lateral portion of Posterior Major of axis (C2) occipital bone below inferior nuchal line Rectus Capitis Posterior tubercle Medial portion of Posterior Minor of atlas (C1) occipital bone below inferior

Innervation Posterior ramus of C1

Posterior of C1

ramus

Function Extension of head; rotation of face to same side as muscle Extension of head

Obliquus Capitis Superior

Transverse process of atlas (C1) Spinous process of axis (C2)

Obliquus Capitis Inferior

nuchal line Occipital bone between superior and inferior nuchal lines Transverse process of atlas (C1)

Posterior of C1

ramus

Extension of head and bends it to same side Rotation of face to same side

Posterior of C1

ramus

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Thorax Muscles Connecting the Upper Limb to the Thoracic Wall/ Muscles of the Pectoral Region (except Serratus Anterior) *Pectoralis Major *Subclavius *Pectoralis Minor Muscles of the Thorax/ Thoracic Wall Muscle Origin Insertion External Inferior margin of Superior surface f Intercostal rib above rib below

Innervation Intercostal nerves; T1-T11

Internal Intercostal

Lateral edge of costal groove of rib above

Innermost Intercostal Subcostales

Transversus Thoracis

Diaphragm (most important muscle of respiration)

Medial edge of costal groove of rib above Internal surface (near angle) of lower ribs Lower margins and internal surfaces of cocostal cartilages of 2nd th to 6 ribs Xiphoid process; lower six costal cartilages, first three lumbar vertebrae

Superior surface of rib below deep to the attachment of the related external intercostal Internal aspect of superior surface of rib below Internal surface of 2nd to 3rd rib below Inferior aspect of deep surface of body of sternum, xiphoid process and costal cartilages ribs 4-7 Central tendon

Intercostal nerves; T1-T11

Intercostal nerves; T1-T11 Related intercostal nerves Related intercostals nerves

Function Most active during inspiration; supports intercostals space; moves ribs superiorly Most active during expiration; supports intercostals space; moves ribs inferiorly Acts with internal intercostals muscles May depress ribs

Depresses costal cartilages

Phrenic nerve

Levatores Costarum (12)

Tip of transverse process of C7 and T1-11 vertebrae

Rib below

Posterior rami of thoracic spinal nerves

Very important muscle of inspiration; increases vertical diameter of thorax by pulling central tendon downward; assists in raising lower ribs. Also used in abdominal straining and weight lifting Raises ribs and therefore inspiratory muscles

Serratus Posterior Superior

(see Intermediate (Respiratory) Group of Back Muscles)

Serratus Posterior Inferior

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