atlas of skeletal muscles 6th edition

Biology

McGraw−Hill Primis

ISBN−10: 0−39−050577−3ISBN−13: 978−0−39−050577−4

Text: Atlas of Skeletal Muscles, Sixth EditionStone−Stone

Atlas of Skeletal Muscles6th Edition

Stone−Stone

McGraw-Hill��

Biology

http://www.primisonline.comCopyright ©2008 by The McGraw−Hill Companies, Inc. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without prior written permission of the publisher. This McGraw−Hill Primis text may include materials submitted to McGraw−Hill for publication by the instructor of this course. The instructor is solely responsible for the editorial content of such materials.

111 BIOLGEN ISBN−10: 0−39−050577−3 ISBN−13: 978−0−39−050577−4

This book was printed on recycled paper.

Biology

Contents

Stone−Stone • Atlas of Skeletal Muscles, Sixth Edition

Front Matter 1

Preface 1

1. The Skeleton 3

Text 3

2. Movements of the Body 29

Text 29

3. Muscles of the Face and Head 35

Text 35

4. Muscles of the Neck 59

Text 59

5. Muscles of the Trunk 81

Text 81

6. Muscles of the Shoulder and Arm 107

Text 107

7. Muscles of the Forearm and Hand 131

Text 131

8. Muscles of the Hip and Thigh 165

Text 165

9. Muscles of the Leg and Foot 195

Text 195

Back Matter 223

Alphabetical Listing of Muscles 223Index 225Notes 228

iii

Stone−Stone: Atlas of Skeletal Muscles, Sixth Edition

Front Matter Preface 1© The McGraw−Hill Companies, 2009

This book is a study guide and reference for theanatomy and actions of human skeletal muscles. It is de-signed for use by students of anatomy, physical educa-tion, and health-related fields. It also serves as a com-pact reference for the practicing professional.

The first chapter presents photographic illustrationsof the major features of the skeleton. These photos havebeen selectively enhanced and combined to emphasizeimportant features. They are thus a hybrid betweendrawings and unretouched photographs. The philoso-phy embraced is that the teacher function as a lens tofocus attention on selected facts and observations. Amaster numbering system is used so that each structureis labeled with the same number in all drawings.

The second chapter describes through illustrationand description the various movements of the body.

In chapters 3 through 9, the origin, insertion, action,and innervation of the skeletal muscles are described,and each muscle is presented on a separate page with aline drawing.

The spinal cord levels of the nerve fibers that inner-vate each muscle are included in parentheses after thename of each nerve.

Labeled drawings of major muscle groups arepresented throughout chapters 3 through 9. Notes andrelationships among muscles have been included onmany pages.

The drawings include the following importantfeatures:

1. Bones and cartilage containing muscle attachmentsare shaded.

2. Adjacent structures are shown.3. Muscle fibers are drawn by direction.4. Muscle fibers are shown on the undersurface of

bone and cartilage as dashed lines.5. Tendons and aponeuroses are shown.6. Labeled muscle groups are included.

These features aid in visual orientation and under-standing of the action of the muscles. We have noticedthat many students find it useful to color the illustrations.

Preface

Notes have been included on many pages to showhow muscles are used. Relationships among many of themuscles have also been indicated where appropriate.

Some users of previous editions have advised thatsome of the smaller muscles should be enlarged andshown with less skeletal background. We have purposelystandardized the skeletal views to allow an appreciationof the relative sizes and positions of the muscles.Skeletal muscles, at the gross level, are relatively simpleanatomical structures, so very little additional informa-tion would be included by enlargement, and many com-parative relationships would be lost.

Our primary objective is to describe the musclesmoving the skeleton, therefore we have not includedthe muscles of the peritoneum, eye, tympanic cavity,tongue, larynx, pharynx, or palate.

We extend our appreciation to Mr. George Boykin,for many years the jolly proprietor of the gross anatomylaboratories at the State University of New York at StonyBrook, for his help and encouragement. We also thankMr. Vincent Verdisco for his technical advice and themany students who have offered valuable suggestionsover the years.

We would also like to thank the many reviewerswho have made helpful suggestions for improving pasteditions of this atlas, as well as Leann Blem, University ofMontana; Christine A. Byrd-Jacobs, Western MichiganUniversity; Pamela B. Fouche, Walters State CommunityCollege; Candice Francis, Palomar College; MichaelHendrix, Missouri State University; Steven L. Keffer,James Madison University; Dennis Landin, LouisianaState University; Malinda McMurry, Morehead StateUniversity; Virginia L. Naples, Northern IllinoisUniversity; Donna Newhouse, Lakehead University;Russell Nordeen, University of Arkansas at Monticello;David Pearson, Ball State University; Mark L. Wagner,CollegeAmerica for their input on the sixth edition.

Robert J. Stone

Judith A. Stone

ix

2 Notes


1. The Skeleton Text 3© The McGraw−Hill Companies, 2009

C H A P T E R O N E

The Skeleton


1. The Skeleton Text4 © The McGraw−Hill Companies, 2009

2 C H A P T E R O N E

1. Frontal bone1c. Superciliary arch1d. Glabella

2. Nasal bone3e-h. Maxilla

3e. Alveolar border3f. Infraorbital foramen3g. Incisive foramen3h. Palatine process

4. Mandible4i. Symphysis5. Zygomatic bone

7a. Perpendicular plate of ethmoid bone8. Sphenoid

8b. Lateral pterygoid plate

SKULL—ANTERIOR VIEW

1

1c

2

8

7a

3

4

4i

3f

3e

1d

12

5

8d. Medial pterygoid plate8e. Foramen ovale

9b-f. Temporal bone9b. Mastoid process (temporal bone)9c. Foramen lacerum9e. Zygomatic process (temporal bone)9f. Carotid canal

11a. Superior nuchal line (occipital bone)11b. Inferior nuchal line (occipital bone)11c. External occipital protuberance (occipital bone)11d. Occipital condyle (occipital bone)11e. External occipital crest (occipital bone)11f. Jugular foramen11g. Foramen magnum

12. Turbinates13. Palatine bone14. Vomer



SKULL—INFERIOR (BASAL) VIEW

T H E S K E L E T O N 3

3h

3g

13

14

8e

11f

9b

11g

5

8b

9e

8d

11d

9c

9f

11b

11a

11c

11e




9a-e. Temporal bone9a. Temporal fossa (squamous part of temporal bone)9b. Mastoid process9d. Styloid process9e. Zygomatic process10. Parietal bone

10a. Superior temporal line10b. Inferior temporal line

11. Occipital bone

Note: The zygomatic arch is formed by the zygomatic process ofthe temporal bone meeting the zygomatic bone.

SKULL—LATERAL VIEW

10

10a10b

9a

11

9b9e

9d4a

4d4c 4b4e

4g4h

8b

3d3c

5

6

3a2

8a

1

1. Frontal bone2. Nasal bone

3a-d. Maxilla3a. Frontal process3c. Incisive process3d. Canine fossa

4a-h. Mandible4a. Neck of condyle4b. Coronoid process4c. Angle4d. Ramus4e. Oblique line4g. Mental foramen4h. Incisive fossa

5. Zygomatic bone6. Lacrimal bone

8a. Greater wing of sphenoid bone8b. Lateral pterygoid plate of sphenoid bone




VERTEBRAL COLUMN—LATERAL VIEW

C1-7. Cervical vertebraeC1. AtlasC2. AxisC7. Seventh cervical vertebra

T1-12. Thoracic vertebraeT1. First thoracic vertebra

T12. Twelfth thoracic vertebraL1-5. Lumbar vertebrae

L1. First lumbar vertebraL5. Fifth lumbar vertebraS. Sacrum

Co. Coccyx

Co

S

L5

L1

T12

T1

C7

C2

C1




Atlas1. Anterior tubercle2. Anterior arch3. Superior articular facet4. Posterior arch5. Posterior tubercle6. Transverse foramen

Axis7. Dens (odontoid process)8. Spinous process9. Transverse process

ATLAS AND AXIS

12 3

4

56

9

7

8




1. Superior articular process2. Transverse process3. Body4. Demifacets (for ribs)5. Disk6. Inferior vertebral notch7. Facet (for rib tubercle)8. Spinous process9. Inferior articular process

THORACIC VERTEBRAE—LATERAL VIEW

1

45

67

8

9

2

3




1. Spinous process2. Mammillary process3. Transverse process4. Lamina5. Vertebral foramen6. Pedicle7. Body (centrum)

LUMBAR VERTEBRA—SUPERIOR VIEW

1

2

3

4

5

6

7




1. Sacral canal2. Superior articular facet3. Sacral tuberosity4. Lateral crest5. Posterior sacral foramen6. Sacral hiatus (opening of sacral canal)7. Auricular surface8. Median crest9. Intermediate crest

10. Coccyx

SACRUM—POSTERIOR VIEW

1 2

3

4

5

6

10

9

8

7




1. Promontory2. Ala5. Sacral foramina

10. Coccyx

SACRUM—PELVIC VIEW

1

2

5

10




ClavicleP = proximal end (sternal)D = distal end (acromial or lateral)Scapula (S)A = acromionSternumM = manubriumSA = sternal angleB = bodyX = xiphoid processThe proximal (sternal) end of the clavicle forms

the sternoclavicular joint with the manubrium of thesternum.

The distal (scapular) end forms the acromioclavicularjoint with the acromion of the scapula. This is the onlybony articulation of the upper limb with the torso.

The second rib cartilage articulates at the sternalangle between the manubrium and the body of thesternum.

The cartilages of ribs 7-10 are fused to form thecostal arch.

STERNUM AND CLAVICLE WITH SCAPULA

M

B

X

SA

P

1

2

34

5

6

7

8

910

Costalcartilages

D

A

S




18a-c. Hyoid bone18a. Greater horn18b. Body18c. Lesser horn

The greater horn of the hyoid bone attaches to thestyloid processes of the temporal bones by the styloidligaments. It attaches to the thyroid cartilage by the thy-rohyoid ligament and supports the upper respiratorytract.

HYOID BONE—SUPERIOR VIEW

18a

18c

18b




The head (H) of a rib articulates with the demifacetsof two adjacent vertebrae. The tubercle (T) joins thefacet of the transverse process of the upper vertebra.The anterior end (A) meets the costal cartilage, whichthen joins the sternum.

RIB ARTICULATIONS

A

H

T




SCAPULA AND HUMERUS—ANTERIOR VIEW

36f36g

36h

36i36j

36k

36l

36e

36d

36c

36b

36a

33d

33p

33j33i 33a

33e

33b

33m33c33h

33o

33a-p. Scapula33a. Superior border33b. Vertebral (medial) border33c. Axillary (lateral) border33d. Acromion33e. Coracoid process33h. Infraglenoid tubercle33i. Supraspinous fossa33j. Crest of spine

33m. Inferior angle33o. Glenoid fossa33p. Supraglenoid tubercle

36a-1. Humerus36a. Greater tubercle36b. Lesser tubercle36c. Intertubercular (bicipital) groove36d. Surgical neck36e. Deltoid tuberosity36f. Lateral supracondylar ridge36g. Lateral epicondyle36h. Capitulum36i. Coronoid fossa36j. Trochlea

36k. Medial epicondyle36l. Medial supracondylar ridge




33b-q. Scapula33b. Vertebral (medial) border33c. Axillary (lateral) border33d. Acromion33i. Supraspinous fossa33j. Crest of spine

33k. Infraspinous fossa33m. Inferior angle33n. Root of spine33q. Suprascapular notch

36g-m. Humerus36g. Lateral epicondyle36k. Medial epicondyle

36m. Olecranon fossa

SCAPULA AND HUMERUS—POSTERIOR VIEW

36k

36m

36g

33c

33d

33m

33k

33b

33n

33j

33i33q




35. Annular ligament36i-l. Humerus

36i. Coronoid fossa36k. Medial epicondyle36l. Medial supracondylar ridge

37a, b. Radius37a. Radial tuberosity37b. Head of radius

38a-d. Ulna38a. Ulnar tuberosity38b. Coronoid process38d. Supinator crest

ELBOW—ANTERIOR VIEW

36

36i

36l

36k

38b

38a

38d

38

37

37a

37b

35




34. Radial (lateral) collateral ligament35. Annular ligament

36k-m. Humerus36k. Medial epicondyle

36m. Olecranon fossa37. Radius

37d. Styloid process of radius38c-e. Ulna

38c. Olecranon38e. Styloid process39. Interosseous membrane

FOREARM—POSTERIOR VIEW

38e 37d

39

38

37

35

34

3636m

36k

38c




40. Scaphoid40a. Tubercle of scaphoid41. Lunate42. Pisiform

43a. Tubercle of trapezium44. Trapezoid45. Capitate

46a. Hook of hamate47. Triquetrum48. Metacarpals

49a. Proximal (first) phalanges49b. Middle (second) phalanges49c. Distal (third) phalanges50. Flexor retinaculum51. Palmar aponeurosis

HAND—PALMAR VIEW

44

43a

40a40

41

47

42

46a

45

48

49a

49b

49c

49c




40. Scaphoid41. Lunate43. Trapezium44. Trapezoid45. Capitate46. Hamate47. Triquetrum48. Metacarpals

49a. Proximal (first) phalanges49b. Middle (second) phalanges49c. Distal (third) phalanges

HAND—DORSAL VIEW

43

4041

47

4645

44

49a

49b

49c

48




52b-i. Ilium52b. Iliac crest52c. Iliac tubercle52e. Anterior superior iliac spine52f. Anterior inferior iliac spine52g. Iliac fossa52h. Arcuate line52i. Iliopectineal eminence53. Ischium

54a-e. Pubis54a. Superior ramus54b. Inferior ramus54c. Pubic crest54d. Pubic symphysis54e. Pubic tubercle

57. Obturator foramen63. Acetabulum

68a-e. Femur68a. Greater trochanter68b. Trochanteric fossa68c. Lesser trochanter68e. Intertrochanteric line

PELVIS—ANTERIOR VIEW

63

52c

52b

52g

52e

52f

52i

53

5754a54b54c

54e

52h

68c

68a

68b

68e

68

54d




52j-n. Ilium52j. Posterior gluteal line

52k. Middle gluteal line52l. Inferior gluteal line

52m. Posterior superior iliac spine52n. Posterior inferior iliac spine

53a-d. Ischium53a. Sacrospinous ligament53b. Ischial tuberosity53c. Ischial spine53d. Lesser sciatic notch (lesser sciatic foramen)*

55. Greater sciatic notch (greater sciatic foramen)*56. Sacrotuberous ligament

68a-h. Femur68a. Greater trochanter68c. Lesser trochanter68d. Intertrochanteric crest68g. Gluteal tuberosity68h. Linea aspera

*Note: These bony notches are converted to foramina by the two ligaments.

PELVIS—THREE QUARTER POSTERIOR VIEW

68h

68g

68d

68a

53c

52l

52k

52j

52n

55

56

53a

53d5353b68c68

52m




68a-n. Femur68a. Greater trochanter68c. Lesser trochanter68d. Intertrochanteric crest68h. Linea aspera68i. Lateral supracondylar ridge68k. Adductor tubercle68l. Popliteal surface

68m. Medial condyle68n. Lateral condyle

FEMUR—POSTERIOR VIEW

68n

68l

68i

68h

68k

68m

68d68c

68a




68i-k. Femur68i. Lateral supracondylar ridge68j. Medial supracondylar ridge

68k. Adductor tubercle70. Patella71. Patellar ligament

74a-c. Tibia74a. Tibial tuberosity74b. Lateral condyle74c. Medial condyle75a. Head of fibula

Note: The quadriceps tendon continues through the patella andbecomes the patellar ligament.

KNEE—ANTERIOR VIEW

75a

74b

68i

74

74a

74c

71

70

68k

68j




74. Tibia74d. Medial malleolus of tibia

75. Fibula76. Interosseous membrane77. Lateral talocalcaneal ligament78. Inferior extensor retinaculum83. Talus84. Calcaneus85. Navicular86. Medial cuneiform87. Intermediate cuneiform88. Lateral cuneiform89. Cuboid

90a-e. Metatarsal bones90a. First metatarsal90b. Second metatarsal90c. Third metatarsal90d. Fourth metatarsal90e. Fifth metatarsal91a. Proximal phalanges91b. Middle phalanges91c. Distal phalanges

ANKLE AND FOOT—ANTEROLATERAL VIEW

91b

91a

90

8886

8785

83

76

74

74d

75

84

89

91c

ed

cb

a

77 78




FOOT—PLANTAR VIEW

84

89

88

90

91b91a

91c

86

85

83

a b c de

79. Flexor retinaculum80. Plantar aponeurosis81. Plantar metatarsophalangeal ligaments82. Transverse metatarsal ligaments83. Talus84. Calcaneus85. Navicular86. Medial cuneiform88. Lateral cuneiform89. Cuboid90. Metatarsal bones

90a. First metatarsal90b. Second metatarsal90c. Third metatarsal90d. Fourth metatarsal90e. Fifth metatarsal91a. Proximal phalanges91b. Middle phalanges91c. Distal phalanges


2. Movements of the Body Text 29© The McGraw−Hill Companies, 2009

C H A P T E R T W O

Movements of the Body


2. Movements of the Body Text30 © The McGraw−Hill Companies, 2009

28 C H A P T E R T W O

Anatomical position—A subject in the anatomical posi-tion is standing erect with the head, eyes, and toes fac-ing forward and the arms hanging straight at the sideswith the palms of the hands facing forward.

F I G U R E 2.1Median or midsagittal plane—Passes vertically throughthe body from anterior (front) to posterior (back). Itdivides the body into right and left sides. Other sagittalplanes are parallel to this plane.

F I G U R E 2.2Coronal (frontal) planes—Pass vertically through thebody from side to side. They divide the body from frontto back.

F I G U R E 2.3Transverse planes (cross sections)—Pass horizontallythrough the body parallel to the ground.



M O V E M E N T S O F T H E B O D Y 29

F I G U R E 2.5Lateral flexion—The torso (or head)bends laterally in the coronal plane.

F I G U R E 2.6Abduction—The right leg moves laterally in the coronal plane.Adduction—The leg is returned medially in the coronal plane.

Note: If the foot is fixed, this motion results in tilting the pelvis upward onthe opposite side.

F I G U R E 2.7Medial rotation—The anterior of the arm(or thigh) is moved toward the medianplane.Lateral rotation—The anterior of the arm(or thigh) is moved away from the medianplane.

F I G U R E 2.4Flexion-extension—Starting from the anatomical position, movementis anterior or posterior in a sagittal plane. In the hinge joints flexionresults in a decrease in the angle made by the bones in the joint, andextension brings the bones toward a 180° angle. Hyperextension ispermitted in the shoulder, wrist, and vertebrae where movementcontinues posterior to anatomical position. In the knee, hip, andelbow, hyperextension is prevented by bone structure or ligaments.




MOVEMENTS OF THE SCAPULA

F I G U R E 2.8Elevation—The rightscapula of this figure isdrawn superiorly againstthe resistance of the rock.

F I G U R E 2.9Depression—The rightscapula of this figure ispushing the arm inferiorly.

F I G U R E 2.10Protraction—The scapula pushes the arm forwardin a sagittal plane.

F I G U R E 2.11Retraction—The scapula is pulled back from protractionin a sagittal plane. The scapula slides around the ribstoward the median plane, so it becomes adduction.

F I G U R E 2.12Rotation—For abduction of the arm to continue abovethe height of the shoulder, the scapula must rotate onits axis so that the glenoid fossa turns upward.



M O V E M E N T S O F T H E B O D Y 31

MOVEMENTS OF THE HAND AND FOREARM

F I G U R E 2.13Pronation—The forearm is rotated away from theanatomical position so that the palm turns medially,then posteriorly. If the forearm is flexed at the elbow,then the palm turns inferiorly.Supination—The forearm is rotated so that the palmturns anteriorly (or superiorly if the forearm is flexed).Also see figure 2.19.

F I G U R E 2.14Abduction—The fingers are moved away from the mid-line of the hand.

F I G U R E 2.15Radial deviation (abduction)—The hand, at the wrist, ismoved laterally toward the radius. In anatomical posi-tion this moves the hand away from the body in thecoronal plane. Ulnar deviation (adduction)—The hand, at the wrist, ismoved medially toward the ulna.

F I G U R E 2.16Adduction—The fingers are moved toward the midlineof the hand.

F I G U R E 2.17Opposition—The saddle joint between the trapeziumand first metacarpal allows the thumb to turn so itsanterior surface can touch the anterior surfaces of thefour fingers when they are partially flexed.




MOVEMENTS OF THE FOOT

F I G U R E 2.18Dorsiflexion—Elevating the foot, decreasing the anglebetween the foot and the leg. Plantar flexion—Depressing the foot, increasing theangle between the foot and the leg.

F I G U R E 2.19Inversion-eversion—During inversion the sole of the foot turnsmedially, and during eversion it returns or turns slightly later-ally. Most of this movement is permitted by the gliding of theintertarsal and tarsometatarsal joints but because the articulat-ing surface of the talus is narrower posteriorly, it permits somelateral movement when the ankle is plantar flexed.


3. Muscles of the Face and Head

Text 35© The McGraw−Hill Companies, 2009

C H A P T E R T H R E E

Muscles of theFace and Head



Text36 © The McGraw−Hill Companies, 2009

34 C H A P T E R T H R E E

Skull—lateral view

EPICRANIUS

Frontal belly (frontalis)

■ OriginGalea aponeurotica

■ InsertionFascia of facial muscles and skin above nose and eyes

■ ActionDraws back scalp, wrinkles forehead, raises eyebrows

■ NerveTemporal branches of facial nerve

Occipital belly (occipitalis)

■ OriginLateral two-thirds of superior nuchal line of occipitalbone, mastoid process of temporal bone

■ InsertionGalea aponeurotica (an intermediate tendon leading tofrontal belly)

■ ActionDraws back scalp, aids frontal belly to wrinkle foreheadand raise eyebrows

■ NervePosterior auricular branch of facial nerve




M U S C L E S O F T H E F A C E A N D H E A D 35

Skull—lateral view■ ActionRaises ears, tightens scalp

■ NerveTemporal branch of facial nerve

■ OriginFascia over ear

■ InsertionLateral border of galea aponeurotica

TEMPOROPARIETALIS






Auricularis anterior

■ OriginFascia in temporal region

■ InsertionAnterior to helix of ear

■ ActionDraws ear forward in some individuals, moves scalp*


Auricularis superior

■ OriginFascia in temporal region

■ InsertionSuperior part of ear

■ ActionDraws ear upward in some individuals, moves scalp*


Auricularis posterior

■ OriginMastoid area of temporal bone

■ InsertionPosterior part of ear

■ ActionDraws ear upward in some individuals*

■ NervePosterior auricular branch of facial nerve

*This muscle is nonfunctional in most people.

AURICULARIS ANTERIOR, SUPERIOR, POSTERIOR





ORBITAL AND PALPEBRAL PARTS LACRIMAL PART

Orbital part

■ OriginFrontal bone, maxilla (medial margin of orbit)

■ InsertionContinues around orbit and returns to origin

■ ActionStrong closure of eyelids

■ NerveTemporal and zygomatic branches of facial nerve

Palpebral part (in eyelids)

■ OriginMedial palpebral ligament

■ InsertionLateral palpebral ligament into zygomatic bone

ORBICULARIS OCULI

Skull—three-quarter anterior view

■ ActionGentle closure of eyelids


Lacrimal part (behind medial palpebralligament and lacrimal sac)

■ OriginLacrimal bone

■ InsertionLateral palpebral raphe

■ ActionDraws lacrimal canals onto surface of eye






LEVATOR PALPEBRAE SUPERIORIS

Skull—three-quarter anteriorview■ OriginInferior surface of lesser wing of sphenoid

■ InsertionSkin of upper eyelid

■ ActionRaises upper eyelid

■ NerveOculomotor nerve






Skull—anterior view■ OriginMedial end of superciliary arch

■ InsertionDeep surface of skin under medial portion of eyebrows

■ ActionDraws eyebrows downward and medially


CORRUGATOR SUPERCILII





Skull—anterior view■ ActionDraws down medial part of eyebrows, wrinkles nose

■ NerveBuccal branches of facial nerve

■ OriginFascia over nasal bone and lateral nasal cartilage

■ InsertionSkin between eyebrows

PROCERUS





Skull—anterior view

Alar part

■ OriginGreater alar cartilage, skin on nose

■ InsertionSkin at point of nose

■ ActionBoth parts maintain opening of external nares duringforceful inspiration


Transverse part

■ OriginMiddle of maxilla

■ InsertionMuscle of opposite side over bridge of nose

NASALIS





Skull—anterior view■ OriginIncisive fossa of maxilla

■ InsertionNasal septum and ala

■ ActionConstricts nares


DEPRESSOR SEPTI





Skull—lateral view■ InsertionBecomes continuous with other muscles at angle ofmouth

■ ActionClosure and protrusion of lips

■ NerveBuccal and mandibular branches of facial nerve

■ OriginLateral band—alveolar border of maxilla

Medial band—septum of nose

Inferior portion—lateral to midline of mandible

ORBICULARIS ORIS






Infraorbital head

■ OriginInfraorbital margin of maxilla

■ InsertionSkin of lateral half of upper lip

■ ActionElevates upper lip, forms nasolabial furrow


Angular head (aleque nasi)

■ OriginFrontal process of maxilla and zygomatic bone

■ InsertionGreater alar cartilage and skin of nose, upper lip

■ ActionElevates upper lip, dilates nares, forms nasolabial furrow


Note: The angular head is frequently referred to as a separatemuscle, levator labii superioris aleque nasi.

LEVATOR LABII SUPERIORIS





Skull—lateral view■ ActionElevates corner (angle) of mouth


■ OriginCanine fossa of maxilla

■ InsertionAngle of mouth

LEVATOR ANGULI ORIS





Skull—lateral view■ ActionDraws angle of mouth upward and backward (laughing)


■ OriginZygomatic bone

■ InsertionAngle of mouth

ZYGOMATICUS MAJOR





Skull—lateral view■ OriginZygomatic bone

■ InsertionUpper lip lateral to levator labii superioris

ZYGOMATICUS MINOR

■ ActionForms nasolabial furrow






Skull—lateral view■ ActionRetracts angle of mouth, as in grinning


RISORIUS

■ OriginFascia over masseter

■ InsertionSkin at angle of mouth





Skull—lateral view■ ActionDraws lower lip downward and laterally

■ NerveMandibular branch of facial nerve

DEPRESSOR LABII INFERIORIS

■ OriginMandible, between symphysis and mental foramen

■ InsertionSkin of lower lip





Skull—lateral view■ ActionDepresses angle of mouth, as in frowning


DEPRESSOR ANGULI ORIS

■ OriginOblique line of the mandible

■ InsertionAngle of the mouth






■ ActionRaises and protrudes lower lip, wrinkles skin of chin


MENTALIS

■ OriginIncisive fossa of mandible

■ InsertionSkin of chin





Skull—lateral view■ ActionCompresses cheek


BUCCINATOR

■ OriginOuter surface of alveolar processes of maxilla andmandible over molars and along pterygomandibularraphe

■ InsertionDeep part of muscles of lips





Skull—lateral view■ ActionElevates, retracts mandible (rotation at tempero-mandibular joint) closing mouth, biting

■ NerveMandibular division of trigeminal nerve

TEMPORALIS

■ OriginTemporal fossa including frontal, parietal, and temporalbones

■ InsertionCoronoid process and anterior border of ramus ofmandible





Skull—lateral view■ ActionElevates mandible (rotation at temperomandibularjoint) closing mouth, biting


Note: Superficial fibers slightly protract jaw (see lateral pterygoid).

MASSETER

■ OriginZygomatic process of maxilla, medial and inferior sur-faces of zygomatic arch

■ InsertionAngle and ramus of mandible, lateral surface of coro-noid process of mandible





Skull—lateral view(Part of mandible cut away)

■ ActionElevates mandible, assists in protruding mandible


MEDIAL PTERYGOID (Pterygoideus Medialis)

■ OriginMedial surface of lateral pterygoid plate of sphenoidbone, palatine bone, and tuberosity of maxilla

■ InsertionMedial surface of ramus and angle of mandible





Skull—lateral view■ ActionOpens jaw, protrudes mandible, moves mandible later-ally for grinding teeth


Note: This sideward movement, aided by superficial fibers ofmasseter, causes chewing movements.

■ OriginSuperior head—lateral surface of greater wing ofsphenoid

Inferior head—lateral surface of lateral pterygoid plate

■ InsertionCondyle of mandible, temporomandibular joint

LATERAL PTERYGOID (Pterygoideus Lateralis)


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Three-quarter frontal view

STERNOCLEIDOMASTOID

■ ActionUnilateral—bends neck laterally, rotates head to oppo-site side

Bilateral—flexes neck, draws head ventrally and elevateschin, draws sternum superiorly in deep inspiration

■ NerveSpinal part of accessory nerve (C2, C3)

■ OriginSternal head—manubrium of sternum

Clavicular head—medial part of clavicle

■ InsertionMastoid process of temporal bone, lateral half ofsuperior nuchal line of occipital bone



M U S C L E S O F T H E N E C K 59

Three-quarter frontal view■ ActionDepresses and draws lower lip laterally, draws up skin ofchest, depresses mandible

■ NerveCervical branch of facial nerve

PLATYSMA

■ OriginSubcutaneous fascia of upper one-fourth of chest justbelow the clavicle

■ InsertionSubcutaneous fascia and muscles of chin and jaw,mandible




Lateral view■ ActionRaises hyoid bone, depresses mandible, moves hyoidforward or backward

■ NervePosterior belly—facial nerve

Anterior belly—mandibular division of trigeminal

Note: The two bellies are joined at an intermediate tendon by afibrous loop at the side of the body and the greater horn of thehyoid bone.

DIGASTRICUS

■ OriginPosterior belly—mastoid notch of temporal bone

Anterior belly—inner side of inferior border of mandiblenear symphysis

■ InsertionIntermediate tendon attached to hyoid bone




Lateral view■ ActionElevates and draws hyoid bone posteriorly, elevatestongue

■ NerveFacial nerve

STYLOHYOID

■ OriginStyloid process of temporal bone

■ InsertionHyoid bone




Lateral view■ ActionElevates hyoid bone, raises floor of mouth and tongue


MYLOHYOID

■ OriginInside surface of mandible from symphysis to molars(mylohyoid line)

■ InsertionHyoid bone




Lateral view■ ActionProtrudes hyoid bone and tongue

■ NerveBranch of C1 through hypoglossal nerve

GENIOHYOID

■ OriginInferior mental spine on interior medial surface ofmandible

■ InsertionBody of hyoid bone




Lateral view

STERNOHYOID

Frontal view■ OriginMedial end of clavicle, manubrium of sternum

■ InsertionBody of hyoid bone

■ ActionDepresses hyoid bone

■ NerveAnsa cervicalis (C1–C3)




Lateral view

Frontal view■ OriginDorsal surface of manubrium of sternum

■ InsertionLamina of thyroid cartilage

■ ActionDepresses thyroid cartilage

■ NerveAnsa cervicalis (C1–C3)

STERNOTHYROID




Lateral view■ ActionDepresses hyoid or raises thyroid

■ NerveC1 through hypoglossal nerve

THYROHYOID

■ OriginLamina of thyroid cartilage

■ InsertionInferior border of body and greater horn of hyoid bone




Lateral view■ ActionDepresses hyoid bone

■ NerveAnsa cervicalis (C2, C3)

OMOHYOID

■ OriginSuperior border of scapula

■ InsertionInferior belly—bound to clavicle by central tendon

Superior belly—continues to body of hyoid bone




Frontal view(Mandible and part of maxilla removed)

Vertical part

■ OriginAnterior surfaces of bodies of upper three thoracic andlower three cervical vertebrae

■ InsertionAnterior surfaces of the second, third, and fourth cervi-cal vertebrae

■ ActionAll three parts flex cervical vertebrae

■ NerveC2–C7

Note: Cervical hyperextension injuries (whiplash) may strain thesemuscles and/or sprain the anterior ligaments of vertebrae.

LONGUS COLLI

Superior oblique part

■ OriginTransverse processes of third, fourth, and fifth cervicalvertebrae

■ InsertionAnterior arch of atlas

Inferior oblique part

■ OriginAnterior surface of bodies of first two or three thoracicvertebrae

■ InsertionTransverse processes of fifth and sixth cervical vertebrae





■ ActionActing together (bilaterally)—flex head

Acting on one side only—rotate head

■ NerveC1–C3

LONGUS CAPITIS

■ OriginAnterior tubercles of transverse processes of thirdthrough sixth cervical vertebrae

■ InsertionOccipital bone anterior to foramen magnum





■ ActionFlexes head

■ NerveC1, C2

RECTUS CAPITIS ANTERIOR

■ OriginAnterior base of transverse process of atlas

■ InsertionOccipital bone anterior to foramen magnum





■ ActionBends head laterally

■ NerveC1, C2

RECTUS CAPITIS LATERALIS

■ OriginTransverse process of atlas

■ InsertionJugular process of occipital bone




Three-quarter frontal view(Mandible and part of maxilla removed)

■ ActionRaises first rib (respiratory inspiration); acting together,they flex neck; acting on one side, they laterally flex,rotate neck

■ NerveVentral rami of cervical nerves (C4–C6)

SCALENUS ANTERIOR

■ OriginTransverse processes of third through sixth cervicalvertebrae

■ InsertionInner border of first rib (scalene tubercle)





■ ActionRaises first rib (respiratory inspiration); acting together,they flex neck; acting on one side, they laterally flex,rotate neck

■ NerveVentral rami of cervical nerves (C3–C8)

SCALENUS MEDIUS

■ OriginTransverse processes of lower six cervical vertebrae(C2–C7)

■ InsertionUpper surface of first rib





■ ActionRaises second rib (respiratory inspiration); actingtogether, they flex neck; acting on one side, theylaterally flex, rotate neck

■ NerveVentral rami of lower three cervical nerves

SCALENUS POSTERIOR

■ OriginTransverse processes of lower two or three cervicalvertebrae (C5–C7)

■ InsertionOuter surface of second rib




Posterior skull and cervical vertebrae■ ActionExtends and rotates head

■ NerveSuboccipital nerve

RECTUS CAPITIS POSTERIOR MAJOR

■ OriginSpinous process of axis

■ InsertionLateral portion of inferior nuchal line of occipital bone




Posterior skull and cervical vertebrae■ ActionExtends head


RECTUS CAPITIS POSTERIOR MINOR

■ OriginPosterior arch of atlas

■ InsertionMedial portion of inferior nuchal line of occipital bone




Posterior skull and cervical vertebrae■ ActionRotates atlas


OBLIQUUS CAPITIS INFERIOR

■ OriginSpinous process of axis

■ InsertionTransverse process of atlas




Posterior skull and cervical vertebrae■ ActionExtends head and flexes head laterally to the same side(ipsilaterally)


OBLIQUUS CAPITIS SUPERIOR

■ OriginTransverse process of atlas

■ InsertionOccipital bone between inferior and superior nuchallines


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Posterior skull, neck, and back

SPLENIUS CAPITIS

■ ActionActing together, they extend, hyperextend head, neck;acting on one side, they laterally flex, rotate head, neck

■ NerveLateral branches of dorsal primary divisions of middleand lower cervical nerves

■ OriginLower part of ligamentum nuchae, spinous processes ofseventh cervical vertebra (C7) and upper three or fourthoracic vertebrae (T1–T4)

■ InsertionMastoid process of temporal bone and lateral part ofsuperior nuchal line



M U S C L E S O F T H E T R U N K 81

Posterior skull, neck, and back■ ActionActing together, they extend, hyperextend head, neck;acting on one side, they laterally flex, rotate head, neck

■ NerveLateral branches of dorsal primary divisions of middleand lower cervical nerves

SPLENIUS CERVICIS

■ OriginSpinous processes of third through sixth thoracicvertebrae (T3–T6)

■ InsertionTransverse processes of upper two or three cervicalvertebrae (C1–C3)




Iliocostalis cervicis

■ OriginAngles of third through sixth ribs

■ InsertionTransverse processes of fourth, fifth, and sixth cervicalvertebrae

■ ActionExtension, lateral flexion of vertebral column

■ NerveDorsal primary divisions of spinal nerves

Iliocostalis thoracis

■ OriginAngles of lower six ribs medial to iliocostalis lumborum

■ InsertionAngles of upper six ribs and transverse process ofseventh cervical vertebra

■ ActionExtension, lateral flexion of vertebral column, rotatesribs for forceful inspiration


Iliocostalis lumborum

■ OriginMedial and lateral sacral crests and medial part of iliaccrests

■ InsertionAngles of lower six ribs



Note: The erector spinae (sacrospinalis) is a complex of three setsof muscles: iliocostalis, longissimus, and spinalis. The origin of thisgroup is the medial and lateral sacral crests, the medial part ofiliac crests, and the spinous processes and supraspinal ligament oflumbar and eleventh and twelfth thoracic vertebrae.

ERECTOR SPINAE

Trunk—dorsal view




Longissimus capitis

■ OriginTransverse processes of upper five thoracic vertebrae(T1–T5), articular processes of lower three cervicalvertebrae (C5–C7)

■ InsertionPosterior part of mastoid process of temporal bone

■ ActionExtends and rotates head

■ NerveDorsal primary divisions of middle and lower cervicalnerves

Longissimus cervicis

■ OriginTransverse processes of upper four or five thoracic verte-brae (T1–T5)

■ InsertionTransverse processes of second through sixth cervicalvertebrae (C2–C6)

■ ActionExtension, lateral flexion of vertebral column


Longissimus thoracis

■ OriginMedial and lateral sacral crests, spinous processes andsupraspinal ligament of lumbar and eleventh andtwelfth thoracic vertebrae, and medial part of iliac crests

■ InsertionTransverse processes of all thoracic vertebrae, betweentubercles and angles of lower nine or ten ribs



ERECTOR SPINAE

Trunk—dorsal view




Spinalis capitis(Medial part of semispinalis capitis)

Spinalis cervicis

■ OriginLigamentum nuchae, spinous process of seventh cervicalvertebra

■ InsertionSpinous process of axis

■ ActionExtends vertebral column


Spinalis thoracis

■ OriginSpinous processes of lower two thoracic (T11, T12) andupper two lumbar (L1, L2) vertebrae

■ InsertionSpinous processes of upper thoracic vertebrae (T1–T8)

■ ActionExtends vertebral column


ERECTOR SPINAE

Trunk—dorsal view




Semispinalis capitis(Medial part is spinalis capitis)

■ OriginArticular processes of cervical vertebrae C4–C6 and transverseprocesses of C7 and upper six or seven thoracic vertebrae(T1–T7)

■ InsertionBetween superior and inferior nuchal lines of occipital bone

■ ActionExtends and rotates head


Semispinalis cervicis

■ OriginTransverse processes of upper five or six thoracic vertebrae(T1–T6)

■ InsertionSpinous processes of second to fifth cervical vertebrae (C2–C5)

■ ActionExtends and rotates vertebral column


Semispinalis thoracis

■ OriginTransverse processes of the sixth through tenth thoracicvertebrae (T6–T10)

■ InsertionSpinous processes of the lower two cervical (C6, C7) and upperfour thoracic (T1–T4) vertebrae

■ ActionExtends and rotates vertebral column


Note: The transversospinalis is composed of groups of small musclesgenerally extending upward from transverse processes to spinousprocesses of higher vertebrae. They are deep to erector spinae. Theyinclude semispinalis, multifidi, and rotatores.

TRANSVERSOSPINALIS

Trunk—dorsal view




Trunk—dorsal view

■ OriginSacral region—along sacral foramina up to posteriorsuperior iliac spine

Lumbar region—mammillary processes† of vertebrae

Thoracic region—transverse processes

Cervical region—articular processes of lower fourvertebrae (C4–C7)

■ InsertionSpinous process two to four vertebrae superior to origin

■ ActionExtend and rotate vertebral column

■ NerveDorsal primary division of spinal nerves

*Part of transversospinalis.

†Posterior border of superior articular process.

MULTIFIDIS*




Trunk—dorsal view

■ OriginTransverse process of each vertebra

■ InsertionBase of spinous process of next vertebra above

■ ActionExtend and rotate vertebral column


*Part of transversospinalis.

ROTATORES*




Trunk—dorsal view

■ OriginCervical region—spinous processes of third to seventhcervical vertebrae (C3–C7)

Thoracic region—spinous processes of first to third(T1–T3) and eleventh and twelfth thoracic vertebrae(T11, T12)

Lumbar region—spinous processes of second to fifthlumbar vertebrae (L2–L5)

■ InsertionSpinous process of next vertebra superior to origin

■ ActionExtend vertebral column


INTERSPINALES (Paired on either side of interspinal ligament)




Cervical region

Intertransversarii anteriores■ Origin Anterior tubercle of transverse processes of

vertebrae from first thoracic to axis■ Insertion Anterior tubercle of next superior

vertebra■ Action Lateral flexion of vertebral column■ Nerve Ventral primary division of spinal nerves

Intertransversarii posteriores■ Origin Posterior tubercle of transverse processes of

vertebrae from first thoracic to axis■ Insertion Posterior tubercle of next superior

vertebra

Thoracic region

■ Origin Transverse processes of first lumbar toeleventh thoracic vertebrae

■ Insertion Transverse processes of next superiorvertebra

Lumbar region

Intertransversarii laterales■ Origin Transverse processes of lumbar vertebrae■ Insertion Transverse process of next superior

vertebra■ Action Lateral flexion of vertebral column■ Nerve Ventral primary division of spinal nerves

Intertransversarii mediales■ Origin Mammillary process* of each lumbar vertebra■ Insertion Accessory process of the next superior

lumbar vertebra■ Action Lateral flexion of vertebral column■ Nerve Dorsal primary division of spinal nerves

*Posterior border of superior articular process.

INTERTRANSVERSARII

Trunk—dorsal view




Trunk—anterior view■ ActionDraw ventral part of ribs upward, increasing the volumeof the thoracic cavity for inspiration

■ NerveIntercostal nerves

EXTERNAL INTERCOSTALS (Intercostales Externi)

■ OriginLower margin of upper eleven ribs

■ InsertionSuperior border of rib below (each muscle fiber runsobliquely and inserts toward the costal cartilage)




Trunk—anterior view■ ActionDraw ventral part of ribs downward, decreasing thevolume of the thoracic cavity for expiration


INTERNAL INTERCOSTALS (Intercostales Interni)

■ OriginFrom the cartilages to the angles of the upper elevenribs

■ InsertionSuperior border of the rib below (each muscle fiber runsobliquely and inserts away from the costal cartilage)




Trunk—dorsal view

■ ActionDraw ventral part of ribs downward, decreasing thevolume of the thoracic cavity for forceful expiration


Note: These muscles are deep to the internal intercostals. Theycontinue distally between single ribs, where they are known asinnermost intercostal muscles.

SUBCOSTALS (Subcostales)

■ OriginInner surface of each rib near its angle

■ InsertionMedially on the inner surface of second or third ribbelow




Trunk—anterior view■ ActionDraws ventral part of ribs downward, decreasing thevolume of the thoracic cavity for forceful expiration


Note: These muscles are deep to the internal intercostal muscles.

TRANSVERSUS THORACIS

■ OriginInner surface of lower portion of sternum and adjacentcostal cartilages

■ InsertionInner surfaces of costal cartilages of the second throughsixth ribs




Trunk—dorsal view

■ ActionRaises ribs; extends, laterally flexes, and rotatesvertebral column


LEVATORES COSTARUM

■ OriginTransverse processes of the seventh cervical and theupper eleven thoracic vertebrae

■ InsertionLaterally to outer surface of next lower rib (lowermuscles may cross over one rib)




Trunk—dorsal view■ ActionRaises ribs in inspiration

■ NerveT1–T4

SERRATUS POSTERIOR SUPERIOR

■ OriginLigamentum nuchae, spinous processes of seventhcervical and first few thoracic vertebrae

■ InsertionUpper borders of the second through fifth ribs lateral totheir angles




Trunk—dorsal view

■ ActionPulls ribs down, resisting pull of diaphragm

■ NerveT9–T12

SERRATUS POSTERIOR INFERIOR

■ OriginSpinous processes of the lower two thoracic and theupper two or three lumbar vertebrae

■ InsertionLower borders of bottom four ribs




Trunk—anterior view(Lower costal cartilages removed)

■ ActionDraws central tendon inferiorly, for inspiration

■ NervePhrenic nerve (C3–C5)

Note: This muscle inserts upon itself. Its action is to change thevolume of the thoracic and abdominal cavities.

*These tendinous structures, also known as the medial and lateralarcuate ligaments, allow the diaphragm to bridge the upper partsof the psoas major and quadratus lumborum muscles.

DIAPHRAGM

■ OriginSternal part—inner part of xiphoid process

Costal part—inner surfaces of lower six ribs and theircartilages

Lumbar part—upper two or three lumbar vertebrae andlateral and medial lumbocostal arches*

■ InsertionFibers converge and meet on a central tendon




Trunk—lateral view■ NerveEighth to twelfth intercostal, iliohypogastric, ilioinguinalnerves

■ RelationshipMost superficial of the three lateral abdominal muscles

Note: Important in forced expiration, coughing, sneezing.

EXTERNAL OBLIQUE (Obliquus Externus Abdominis)

■ OriginLower eight ribs

■ InsertionAnterior part of iliac crest, abdominal aponeurosis(rectus sheath) to linea alba

■ ActionCompresses abdominal contents, laterally flexes androtates vertebral column




Trunk—lateral view■ NerveEighth to twelfth intercostal, iliohypogastric, ilioinguinalnerves

■ RelationshipMiddle layer of the three lateral abdominal muscles


INTERNAL OBLIQUE (Obliquus Internus Abdominis)

■ OriginLateral half of inguinal ligament, iliac crest, thoracolumbar fascia

■ InsertionCartilage of bottom three or four ribs, abdominalaponeurosis (rectus sheath) to linea alba

■ ActionCompresses abdominal contents, laterally flexes androtates vertebral column




Trunk—anterior view■ ActionPulls testes toward body

■ NerveGenital branch of genitofemoral nerve

■ RelationshipThis muscle is continuous with the internal abdominaloblique.

Note: The cremaster regulates the temperature of the testes,important for spermatogenesis.

CREMASTER

■ OriginInguinal ligament

■ InsertionPubic tubercle, crest of pubis, sheath of rectus abdominis




Trunk—lateral view■ NerveSeventh to twelfth intercostal, iliohypogastric,ilioinguinal nerves

■ RelationshipDeepest of the three lateral abdominal muscles


TRANSVERSE ABDOMINAL (Transversus Abdominis)

■ OriginLateral part of inguinal ligament, iliac crest,thoracolumbar fascia, cartilage of lower six ribs

■ InsertionAbdominal aponeurosis (rectus sheath) to linea alba

■ ActionCompresses abdomen




Trunk—anterior view

■ OriginCrest of pubis, pubic symphysis

■ InsertionCartilage of fifth, sixth, and seventh ribs, xiphoid process

■ ActionFlexes vertebral column, compresses abdomen

■ NerveSeventh through twelfth intercostal nerves

*Tendinous bands divide each rectus into three or four bellies. Eachrectus is sheathed in aponeurotic fibers from the lateral abdominalmuscles. These fibers meet centrally to form the linea alba.

Note: The pyramidalis is a small, unimportant muscle that extendsfrom the ventral surface of the pubis to the lower part of the lineaalba. It is frequently absent.

RECTUS ABDOMINIS*




1. External oblique2. Internal oblique3. Transverse abdominal

ABDOMINAL MUSCLES

Trunk—anterior and cross-sectional views

4. Rectus abdominis5. Linea alba

Note: The aponeuroses (broad, flat tendons) of the three lateralabdominal muscles join to form the fascial sheath surrounding therectus abdominis.

The rectus abdominis is separated into four bellies by tendinoussheaths.




QUADRATUS LUMBORUM

Lower trunk—anterior view■ OriginIliolumbar ligament, iliac crest

■ InsertionTwelfth rib, transverse processes of upper four lumbarvertebrae

■ ActionLaterally flexes vertebral column, fixes ribs for forcedexpiration

■ NerveT12, L1

Note: Fixation of the ribs may provide a stable attachment of thediaphragm for voice control in singers.


6. Muscles of the Shoulder and Arm


C H A P T E R S I X

Muscles of theShoulder andArm




106 C H A P T E R S I X

PECTORALIS MAJOR

■ ActionBoth parts adduct, medially rotate arm; clavicular partflexes arm from full extension; sternocostal part extendsthe flexed arm

■ NerveMedial and lateral pectoral nerves (C5–C8, T1)

■ OriginClavicular part—medial half of the clavicle

Sternocostal part—sternum, upper six costal cartilages,aponeurosis of external oblique

■ InsertionLateral lip of intertubercular (bicipital) groove ofhumerus, crest below greater tubercle of the humerus

Anterior view




M U S C L E S O F T H E S H O U L D E R A N D A R M 107

Anterior view

■ NerveMedial pectoral nerve (C8, T1)

■ RelationshipDeep to pectoralis major; medial pectoral nerve piercesthis muscle

*Raising the ribs requires stabilization of the scapula by therhomboids and trapezius.

PECTORALIS MINOR

■ OriginExternal surfaces of the third, fourth, and fifth ribs

■ InsertionCoracoid process of the scapula

■ ActionDraws scapula forward and downward, raises ribs* inforced inspiration





Anterior view■ ActionSteadies clavicle during movements of the shouldergirdle

■ NerveNerve to the subclavius from upper trunk of brachialplexus (C5, C6)

SUBCLAVIUS

■ OriginJunction of the first rib with its costal cartilage

■ InsertionGroove on the inferior (lower) surface of the clavicle





Anterior view■ NerveMusculocutaneous nerve (C6, C7)

■ RelationshipDeep to short head of biceps

Note: The musculocutaneous nerve usually pierces this muscle.

CORACOBRACHIALIS

■ OriginTip (apex) of the coracoid process of scapula

■ InsertionMiddle third of the medial surface and border of thehumerus

■ ActionWeakly adducts arm (flexion unsubstantiated), aids instabilizing humerus





Anterior view■ ActionSupinates forearm, flexes forearm, weakly flexes arm atshoulder

■ NerveMusculocutaneous nerve (C5, C6)

■ RelationshipLong head passes through intertubercular (bicipital)groove, then inside glenohumeral joint capsule

Note: As a two joint muscle, its contribution to shoulder flexionmainly occurs when both joints are extended.

BICEPS BRACHII

■ OriginLong head—supraglenoid tubercle of scapula

Short head—coracoid process of scapula

■ InsertionTuberosity of radius, bicipital aponeurosis into deepfascia on medial part of forearm





Anterior view

■ NerveMusculocutaneous nerve (C5, C6)

■ RelationshipDeep to biceps brachii

BRACHIALIS

■ OriginAnterior of lower half of humerus

■ InsertionCoronoid process of ulna, tuberosity of ulna

■ ActionFlexes forearm





Shoulder—anterior view

4. Biceps brachii5. Brachialis

MUSCLES OF THE ANTERIOR CHEST AND ARM

1. Pectoralis major (cut)2. Pectoralis minor3. Coracobrachialis





Posterior view■ ActionUpper part elevates scapula*, middle part retracts(adducts) scapula, lower part depresses scapula, upperand lower parts together rotate scapula (important inelevating arm)

■ NerveAccessory (eleventh cranial), C3, C4

■ RelationshipMost superficial muscle of back

*Upper part stabilizes scapula against downward rotation, as whenweight is carried in the hand.

TRAPEZIUS

■ OriginMedial third of superior nuchal line, external occipitalprotuberance, ligamentum nuchae, spinous processesand supraspinous ligaments of seventh cervical and allthoracic vertebrae

■ InsertionUpper part—lateral third of clavicle

Middle part—acromion and spine of scapula

Lower part—medial portion of spine of scapula(tubercle)





Posterior view■ ActionExtends, adducts, and medially rotates the arm; drawsthe shoulder downward and backward; keeps inferiorangle of scapula against the chest wall; accessory muscleof respiration

■ NerveThoracodorsal nerve (C6–C8)

Note: This muscle is used for the crawl (freestyle) stroke inswimming.

LATISSIMUS DORSI

■ OriginSpinous processes of lower six thoracic vertebrae,spinous processes of all lumbar and sacral vertebrae(through thoracolumbar fascia), supraspinal ligamentand iliac crest, outer surfaces of lower three or four ribs,inferior angle of scapula

■ InsertionBottom of intertubercular (bicipital) groove





Posterior view

■ ActionElevates medial border of scapula, rotates scapulato lower the lateral angle, acts with trapezius andrhomboids to pull scapula medially and upward,bends neck laterally

■ NerveDorsal scapular nerve (C5)

LEVATOR SCAPULAE

■ OriginPosterior tubercles of the transverse processes of thefirst four cervical vertebrae

■ InsertionVertebral (medial) border of the scapula at and abovethe spine





Posterior view

■ ActionRetracts and stabilizes scapula, elevates the medialborder of the scapula causing downward rotation,assists in adduction of arm


RHOMBOID MAJOR

■ OriginSpines of the second to fifth thoracic vertebrae,supraspinous ligament

■ InsertionMedial border of the scapula below the spine





Posterior view■ ActionRetracts and stabilizes scapula, elevates the medialborder of the scapula, rotates the scapula to depressthe lateral angle (assists in adduction of arm)


RHOMBOID MINOR

■ OriginSpines of the seventh cervical and first thoracicvertebrae, lower part of the ligamentum nuchae

■ InsertionMedial border of the scapula at the root of the spine





Lateral view■ OriginOuter surfaces and superior borders of first eight or nineribs, and fascia covering first intercostal space

■ InsertionAnterior surface (costal surface) of the medial border ofthe scapula

■ ActionRotates scapula for abduction and flexion of arm,protracts scapula

■ NerveLong thoracic nerve (C5–C7)

■ RelationshipsSerratus anterior and rhomboids both insert on themedial border of scapula; they are antagonists causingprotraction and retraction; long thoracic nerve lies onthe superficial surface of this muscle

Note: When the arm is fixed, this muscle can assist in rib movementfor ventilation.

SERRATUS ANTERIOR





Lateral view■ OriginAnterior portion—anterior border and superior surfaceof the lateral third of the clavicle

Middle portion—lateral border of the acromion process

Posterior portion—lower border of the crest of the spineof the scapula

■ InsertionDeltoid tuberosity, on the middle of the lateral surfaceof the shaft of the humerus

■ ActionAnterior portion—flexes and medially rotates arm

Middle portion—abducts arm

Posterior portion—extends and laterally rotates arm

■ NerveAxillary nerve (C5, C6)

DELTOID





Lateral view■ OriginSupraspinous fossa of scapula

■ InsertionUpper part of the greater tuberosity of the humerus,capsule of the shoulder joint

■ ActionAids deltoid in abduction of arm; draws humerus towardglenoid fossa, preventing deltoid from forcing humerusup against acromion

■ NerveSuprascapular nerve (C5)

*Supraspinatus, infraspinatus, teres minor, and subscapularistogether are called the rotator cuff.

Note: The joint capsule and its ligaments cannot provide necessarysupport because of the great range of motion between thehumerus and scapula. The rotator cuff muscles prevent dislocationof the humerus throughout most of the arm’s range of motion.

SUPRASPINATUS (Rotator Cuff*)





Lateral view■ OriginInfraspinous fossa of the scapula

■ InsertionMiddle facet of the greater tuberosity of the humerus,capsule of the shoulder joint

■ ActionDraws humerus toward glenoid fossa, thus resisting pos-terior dislocation of arm, as in crawling; laterally rotates;aids in stabilization of humerus during abduction

■ NerveSuprascapular nerve (C5, C6)

INFRASPINATUS (Rotator Cuff)





Lateral view■ OriginUpper two-thirds of the dorsal surface of the axillaryborder of the scapula

■ InsertionThe capsule of the shoulder joint, the lower facet of thegreater tuberosity of the humerus

■ ActionLaterally rotates arm, weakly adducts arm, drawshumerus toward glenoid fossa

■ NerveAxillary nerve (C5)

TERES MINOR (Rotator Cuff)





Anterior view(Upper ribs cut away)

■ ActionMedially rotates arm, stabilizes glenohumeral joint

■ NerveUpper and lower subscapular nerves (C5, C6)

SUBSCAPULARIS (Rotator Cuff)

■ OriginSubscapular fossa on the anterior surface of scapula

■ InsertionLesser tuberosity (tubercle) of the humerus, ventral partof the capsule of the shoulder joint





Posterior view■ ActionMedially rotates arm, adducts arm, extends arm

■ NerveLower subscapular nerve (C5, C6)

TERES MAJOR

■ OriginLower third of the posterior surface of the lateral borderof the scapula, near the inferior angle

■ InsertionMedial lip of the intertubercular (bicipital) groove of thehumerus





Posterior view■ ActionExtends forearm, long head aids in adduction if arm isabducted

■ NerveRadial nerve (C7, C8)

Note: The radial nerve comes from the axilla (armpit) and passesalong the humerus between the medial and lateral heads. It canbe compressed against the humerus, so it is one of the mostcommonly injured peripheral nerves.

TRICEPS BRACHII

■ OriginLong head—infraglenoid tubercle of the scapula

Lateral head—upper half of the posterior surface of theshaft of the humerus

Medial head—posterior surface of the lower half of theshaft of the humerus

■ InsertionPosterior part of olecranon process of the ulna





Posterior view of arm■ ActionExtends forearm (assists triceps)


ANCONEUS

■ OriginPosterior part of lateral epicondyle of the humerus

■ InsertionLateral surface of the olecranon process and posteriorsurface of ulna





Superficial layer

1. Trapezius2. Latissimus dorsi

Deep layer

3. Levator scapulae4. Rhomboid minor5. Rhomboid major

6. Supraspinatus (rotator cuff)7. Infraspinatus (rotator cuff)8. Teres minor (rotator cuff)9. Teres major

10. Serratus anterior

Posterior arm

11. Triceps brachii

POSTERIOR BACK, SHOULDER, AND ARM MUSCLES

Trunk—posterior view


7. Muscles of the Forearm and Hand


C H A P T E R S E V E N

Muscles of theForearm andHand




130 C H A P T E R S E V E N

Forearm—anterior view

■ OriginHumeral head—medial supracondylar ridge and medialepicondyle of the humerus

Ulnar head—medial border of the coronoid process ofthe ulna

■ InsertionMiddle of lateral surface of the radius (pronatortuberosity)

■ ActionPronates and flexes forearm

■ NerveMedian nerve (C6, C7)

Note: The median nerve passes between the humeral and ulnarheads of this muscle.

PRONATOR TERES (Superficial Group)




M U S C L E S O F T H E F O R E A R M A N D H A N D 131

Forearm—anterior view■ OriginMedial epicondyle of the humerus through the commontendon

■ InsertionFront of the bases of the second and third metacarpalbones

■ ActionFlexes hand, synergist in abduction with extensor carpiradialis longus and brevis


FLEXOR CARPI RADIALIS (Superficial Group)





Forearm—anterior view■ OriginMedial epicondyle of the humerus through the commontendon

■ InsertionFront (central part) of the flexor retinaculum and apexof the palmar aponeurosis

■ ActionFlexes the hand


Note: This muscle is absent in about 14% of limbs.

Reference: Agur, Amr: Grant’s Atlas of Anatomy, 9th ed. Williams &Wilkins, Baltimore, 1991.

PALMARIS LONGUS (Superficial Group)





FLEXOR CARPI ULNARIS (Superficial Group)

Forearm—anterior view■ OriginHumeral head—medial epicondyle of the humerusthrough the common tendon

Ulnar head—medial margin of olecranon process ofulna, dorsal border of shaft of the ulna

■ InsertionPisiform bone, hook of the hamate, and base of the fifthmetacarpal bone

■ ActionFlexes hand, synergist in adduction of hand withextensor carpi ulnaris

■ NerveUlnar nerve (C8, T1)






Muscles

1. Pronator teres2. Flexor carpi radialis3. Palmaris longus4. Flexor carpi ulnaris

Associated structures

5. Flexor retinaculum6. Palmar aponeurosis

SUPERFICIAL MUSCLES OF THE FOREARM





Forearm—anterior view■ OriginHumeroulnar head—medial epicondyle of the humerusthrough common tendon*, medial margin of the coronoid process of ulna

Radial head—anterior surface of shaft of radius

■ InsertionFour tendons divide into two slips each; slips insert intothe sides (margins of the anterior surfaces) of the middlephalanges of four fingers

■ ActionFlexes the middle phalanges of the fingers

■ NerveMedian nerve (C7, C8, T1)

■ RelationshipDeep to superficial flexors

*See superficial flexors.

Note: The tendons of flexor digitorum superficialis split and attachto the middle phalanx. The tendons of flexor digitorum profunduspass through this split and continue to the distal phalanx.

FLEXOR DIGITORUM SUPERFICIALIS






■ OriginUpper three-fourths of anterior and medial surfaces ofshaft of ulna and medial side of the coronoid process,interosseous membrane

■ InsertionFront of base of distal phalanges

■ ActionFlexes distal phalanges

■ NerveUlnar nerve supplies the medial half of the muscle(going to the fourth and fifth fingers)

Anterior interosseous branch of median nerve supplieslateral half (going to index and middle fingers) (C8, T1)

■ RelationshipDeep to flexor digitorum superficialis

Note: Flexor digitorum muscles, flexor pollicis longus, and themedian nerve pass under the flexor retinaculum (p. 134) in thewrist. When irritated, the synovial sheaths of these muscles cancompress the median nerve, causing the sensory and motor deficitsknown as carpal tunnel syndrome.

FLEXOR DIGITORUM PROFUNDUS






■ OriginMiddle of anterior surface of shaft of radius,interosseous membrane, medial epicondyle of humerus,and often coronoid process of ulna

■ InsertionPalmar aspect of base of the distal phalanx of thumb

■ ActionFlexes the thumb

■ NerveAnterior interosseous branch of median nerve (C8, T1)

FLEXOR POLLICIS LONGUS






1. Flexor digitorum superficialis (cut)2. Flexor digitorum profundus3. Flexor pollicis longus

FLEXORS OF THE FINGERS





Forearm—anterior view■ OriginAnterior surface of distal part of shaft of ulna

■ InsertionLower portion of anterior surface of shaft of radius,distal part of lateral border of radius

■ ActionPronates forearm and hand

■ NerveAnterior interosseous branch of median nerve (C8, T1)

■ RelationshipDeepest forearm muscle

PRONATOR QUADRATUS





Forearm—dorsal view■ ActionFlexes forearm


BRACHIORADIALIS

■ OriginUpper two-thirds of lateral supracondylar ridge ofhumerus

■ InsertionBase of styloid process and lateral surface of radius





Forearm—dorsal view■ ActionExtends hand, synergist in abduction of hand with flexorcarpi radialis


EXTENSOR CARPI RADIALIS LONGUS

■ OriginLower third of lateral supracondylar ridge of humerus

■ InsertionDorsal surface of the base of the second metacarpalbone





Forearm—dorsal view■ ActionExtends hand, synergist in abduction of hand with flexorcarpi radialis


EXTENSOR CARPI RADIALIS BREVIS

■ OriginLateral epicondyle of humerus

■ InsertionDorsal surface of third metacarpal bone





Forearm and hand—dorsal view■ NerveDeep branch of radial nerve (C7, C8)

■ RelationshipTends to hyperextend the metacarpophalangeal jointcausing “claw hand”; its action is balanced by thelumbricales and interossei

EXTENSOR DIGITORUM

■ OriginCommon tendon attached to lateral epicondyle ofhumerus

■ InsertionLateral and dorsal surfaces of all the phalanges of thefour fingers

■ ActionExtends the fingers and wrist





Forearm and hand—dorsal view■ ActionExtends fifth finger


EXTENSOR DIGITI MINIMI


■ InsertionDorsal surface of base of first phalanx of fifth finger





Forearm and hand—dorsal view■ ActionExtends hand, synergist in adduction of hand with flexorcarpi ulnaris


EXTENSOR CARPI ULNARIS


■ InsertionDorsal surface of base of fifth metacarpal bone





Forearm and hand—anterior view■ OriginLateral epicondyle of humerus, lateral ligament (radialcollateral) of elbow, annular ligament of superiorradioulnar joint, supinator crest of ulna

■ InsertionDorsal and lateral surfaces of upper third of radius

■ ActionSupinates forearm


SUPINATOR





Forearm and hand—dorsal view■ ActionAbducts, laterally rotates, and extends thumb; abductswrist


ABDUCTOR POLLICIS LONGUS

■ OriginPosterior (dorsal) surface of shaft of radius, ulna,interosseous membrane

■ InsertionDorsal surface of base of first metacarpal bone





Forearm and hand—dorsal view

■ ActionExtends thumb, abducts hand


EXTENSOR POLLICIS BREVIS

■ OriginDorsal surface of radius, adjacent part of interosseousmembrane

■ InsertionBase of proximal phalanx of thumb





Forearm and hand—dorsal view■ ActionExtends thumb


EXTENSOR POLLICIS LONGUS

■ OriginMiddle third of dorsal surface of ulna, interosseousmembrane

■ InsertionBase of distal phalanx of thumb





Forearm—posterior view1. Abductor pollicis longus2. Extensor pollicis brevis3. Extensor pollicis longus

Note: Beginning at the styloid process of the radius, the tendons of the extensor pollicis longus (medially) and the extensor pollicis brevis(laterally) form a hollow depression known as the anatomical snuff box.

EXTENSORS OF THE THUMB





Forearm and hand—dorsal view

■ ActionExtends index finger


EXTENSOR INDICIS

■ OriginPosterior surface of ulna and adjacent part ofinterosseous membrane

■ InsertionExtensor expansion on dorsal surface of proximalphalanx of index finger





Hand—palmar view

■ ActionCorrugates lateral skin of palm


PALMARIS BREVIS

■ OriginFlexor retinaculum, palmar aponeurosis

■ InsertionSkin of the palm





Hand—palmar view■ NerveMedian (C8, T1)

Note: The abductor pollicis brevis, flexor pollicis brevis, and oppo-nens pollicis form the thenar eminence at the base of the thumb.

ABDUCTOR POLLICIS BREVIS (Thenar Eminence)

■ OriginTubercle of scaphoid, tubercle of trapezium, flexorretinaculum


■ ActionAbducts thumb and moves it anteriorly, acts togetherwith other muscles of thenar eminence to opposethumb to other fingers





Hand—palmar view■ ActionFlexes metacarpophalangeal joint of thumb, assists inabduction and rotation of thumb, acts together withother muscles of thenar eminence to oppose thumb toother fingers

■ NerveLateral portion—median nerve (C8, T1)

Medial portion—ulnar nerve (C8, T1)

FLEXOR POLLICIS BREVIS (Thenar Eminence)

■ OriginFlexor retinaculum and trapezium, and first metacarpalbone






Hand—palmar view■ ActionRotates thumb into opposition with fingers, actstogether with other muscles of thenar eminence tooppose thumb to other fingers

■ NerveMedian nerve (C8, T1)

OPPONENS POLLICIS (Thenar Eminence)

■ OriginFlexor retinaculum, tubercle of trapezium

■ InsertionLateral border of first metacarpal bone





Hand—palmar view■ ActionAdducts thumb


ADDUCTOR POLLICIS

■ OriginOblique head—anterior surfaces of second and thirdmetacarpals, capitate, trapezoid

Transverse head—anterior surface of third metacarpalbone

■ InsertionMedial side of base of proximal phalanx of thumb





Hand—palmar view■ NerveUlnar nerve (C8, T1)

Note: The hypothenar eminence is less prominent than the thenareminence, and the fifth finger obviously cannot oppose the otherdigits.

ABDUCTOR DIGITI MINIMI (Hypothenar Eminence)

■ OriginPisiform bone, tendon of flexor carpi ulnaris

■ InsertionMedial side of base of proximal phalanx of fifth finger

■ ActionAbducts fifth finger





Hand—palmar view

■ ActionFlexes fifth finger at metacarpophalangeal joint


FLEXOR DIGITI MINIMI BREVIS (Hypothenar Eminence)

■ OriginAnterior surface of flexor retinaculum, hook of hamate

■ InsertionMedial side of base of proximal phalanx of fifth finger





Hand—palmar view■ ActionRotates fifth metacarpal bone, draws fifth metacarpalbone forward, assists flexor digiti minimi brevis inflexing carpometacarpal joint of fifth finger


OPPONENS DIGITI MINIMI (Hypothenar Eminence)

■ OriginAnterior surface of flexor retinaculum, hook of hamate

■ InsertionWhole length of medial border of fifth metacarpal bone





Hand—palmar view■ NerveLateral lumbricals (first and second)—median nerve(C8, T1)

Medial lumbricals (third and fourth)—ulnar nerve (C8, T1)

■ RelationshipAssist extensor digitorum communis in extending fingerswithout hyperextension at the metacarpophalangealjoints

*Associated with the tendons of flexor digitorum profundus.

LUMBRICALES* (Four Muscles)

■ OriginTendons of flexor digitorum profundus in palm

■ InsertionLateral side of corresponding tendon of extensordigitorum on fingers

■ ActionExtend fingers at interphalangeal joints, weakly flexfingers at metacarpophalangeal joints





Hand—palmar view■ ActionAdduct fingers toward center of third finger at metacarpophalangeal joints, assist in flexion of fingers at metacarpophalangeal joints


Note: The palmar interosseus of the thumb is called the palmarinterosseus of Henle. Most anatomists claim that it is usually absentwhile some argue for its common occurrence.

PALMAR INTEROSSEI

■ OriginFirst—medial side of base of first metacarpal bone

Second, third, and fourth—anterior surfaces of second,fourth, and fifth metacarpal bones

■ InsertionFirst—medial side of base of proximal phalanx of thumb

Second—medial side of base of proximal phalanx ofindex finger

Third and fourth—lateral side of proximal phalanges ofring finger and fifth finger





Hand—palmar viewThird—medial side of base of proximal phalanx ofmiddle finger

Fourth—medial side of base of proximal phalanx of ringfinger

■ ActionAbduct fingers away from center of third finger atmetacarpophalangeal joints, assist in flexion of fingersat metacarpophalangeal joints


DORSAL INTEROSSEI

■ OriginBy two heads from adjacent sides of first and second,second and third, third and fourth, and fourth and fifthmetacarpal bones

■ InsertionFirst—lateral side of base of proximal phalanx of indexfinger

Second—lateral side of base of proximal phalanx ofmiddle finger


8. Muscles of the Hip and Thigh


C H A P T E R E I G H T

Muscles of theHip and Thigh




164 C H A P T E R E I G H T

Lumbar region, hip, and thigh—anterior view

PSOAS MAJOR (Part of Iliopsoas)

■ NerveBranches from lumbar plexus (L2, L3) and sometimesL1 or L4

Note: Some upper fibers insert onto the hip bone from the arcuateline to the iliopectineal eminence to form the psoas minor. Thismuscle has little function and is frequently absent.

■ OriginBases of transverse processes of all lumbar vertebrae,bodies of twelfth thoracic and all lumbar vertebrae,intervertebral disks above each lumbar vertebra

■ InsertionLesser trochanter of femur

■ ActionFlexes thigh*, flexes vertebral column

*See note on p. 188.




M U S C L E S O F T H E H I P A N D T H I G H 165

Lumbar region, hip, and thigh—anterior view■ ActionFlexes thigh*

■ NerveFemoral nerve (L2, L3)

Note: The iliacus brings swinging leg forward in walking orrunning.


ILIACUS (Part of Iliopsoas)

■ OriginUpper two-thirds of iliac fossa, ala of sacrum andadjacent ligaments, anterior inferior iliac spine

■ InsertionOnto tendon of psoas major, which continues into lessertrochanter of femur (together the two muscles form theiliopsoas)





Hip and thigh—anterior view

■ NerveAnterior rami of first and second sacral nerves

Note: The common peroneal part of the sciatic nerve may emergethrough the belly of the piriformis instead of below its inferiorborder along with the tibial part.

PIRIFORMIS

■ OriginInternal surface of sacrum, sacrotuberous ligament

■ InsertionUpper border of greater trochanter

■ ActionLaterally rotates thigh, abducts thigh





Hip—posterior view■ ActionLaterally rotates thigh

■ NerveNerve from sacral plexus (L5, S1)

OBTURATOR INTERNUS

■ OriginPelvic surface of obturator membrane and surroundingbones (ilium, ischium, pubis)

■ InsertionCommon tendon with superior and inferior gemelli tomedial surface of upper border of greater trochanter





Hip—posterior view

■ ActionLaterally rotates thigh

■ NerveBranch of nerve to obturator internus from sacral plexus(L5, S1)

GEMELLUS SUPERIOR

■ OriginSpine of ischium

■ InsertionWith tendon of obturator internus into medial surfaceof upper border of greater trochanter





Hip—posterior view■ ActionLaterally rotates thigh

■ NerveBranch of nerve to quadratus femoris from sacral plexus

GEMELLUS INFERIOR

■ OriginUpper margin of ischial tuberosity

■ InsertionWith tendon of obturator internus into medial surfaceof upper border of greater trochanter





Hip and thigh—anterior view■ NerveObturator nerve (L3, L4)

Note: Part of this muscle can be seen posteriorly by separating thegemellus inferior and quadratus femoris. It is deep within this cleft.

OBTURATOR EXTERNUS

■ OriginOuter surface of superior and inferior rami of pubis andramus of ischium surrounding obturator foramen

■ InsertionTrochanteric fossa of femur

■ ActionLaterally rotates thigh





Hip and thigh—posterior view■ ActionLaterally rotates thigh

■ NerveBranch from sacral plexus (L5, S1)

QUADRATUS FEMORIS

■ OriginLateral border of ischial tuberosity

■ InsertionBelow intertrochanteric crest (quadrate line)





Hip and thigh—lateral view■ ActionUpper part—abducts, laterally rotates thigh

Lower part—extends, laterally rotates thigh, extendstrunk, assists in adduction of thigh

■ NerveInferior gluteal nerve (L5, S1, S2)

Note: This is not a postural muscle; it is not used in walking butonly in forceful extension, as in running, climbing, or rising from aseated position.

GLUTEUS MAXIMUS

■ OriginOuter surface of ilium behind posterior gluteal line,adjacent posterior surface of sacrum and coccyx,sacrotuberous ligament, aponeurosis of erector spinae(sacrospinalis)

■ InsertionIliotibial tract of fascia lata, gluteal tuberosity of femur





Hip and thigh—lateral view■ NerveSuperior gluteal nerve (L4, L5, S1)

Note: In locomotion, this muscle (along with the gluteus minimus)prevents the pelvis from dropping (adduction of thigh) toward theopposite swinging leg.

GLUTEUS MEDIUS

■ OriginOuter surface of ilium inferior to iliac crest

■ InsertionLateral surface of greater trochanter

■ ActionAbducts femur and rotates thigh medially





Hip and thigh—lateral view■ ActionAbducts femur, rotates thigh medially

■ NerveSuperior gluteal nerve (L4, L5, S1)

See note on p. 173.

GLUTEUS MINIMUS

■ OriginOuter surface of ilium between middle (anterior) andinferior gluteal lines

■ InsertionAnterior surface of greater trochanter





Hip—posterior view1. Gluteus maximus (cut)2. Gluteus medius3. Piriformis4. Gemellus superior5. Obturator internus

6. Gemellus inferior7. Obturator externus8. Quadratus femoris9. Sciatic nerve

Note: Gemellus inferior and quadratus femoris have been shownseparated to expose the deeply placed obturator externus.

MUSCLES OF THE HIP





Hip and thigh—lateral view■ OriginOuter edge of iliac crest between anterior superior iliacspine and iliac tubercle

■ InsertionIliotibial tract on upper part of thigh

■ ActionFlexes, abducts thigh

■ NerveSuperior gluteal nerve (L4, L5, S1)

Note: This muscle, along with gluteus maximus, draws the fascialata upward, stabilizing the knee.

TENSOR FASCIAE LATAE





Hip, thigh, and leg—anterior view■ OriginAnterior superior iliac spine and area immediatelybelow it

■ InsertionUpper part of medial surface of shaft of tibia

■ ActionFlexes, abducts, and laterally rotates thigh, flexes andslightly medially rotates leg at knee joint after flexion

■ NerveFemoral nerve (L2, L3)

■ RelationshipInsertions of sartorius, gracilis, and semitendinosus fuseon the medial tibia; these tendons, called the pesanserinus (goose foot), give medial support to the knee

Note: This muscle is used to bring swinging leg forward in walkingand running.

SARTORIUS





Hip, thigh, and leg—anterior view■ OriginAnterior head—anterior inferior iliac spine

Posterior head—ilium above acetabulum

■ InsertionPatella, then by patellar ligament to tuberosity of thetibia

■ ActionExtends leg at knee joint, flexes thigh

■ NerveFemoral nerve (L2–L4)

Note: This muscle is used when thigh flexion and leg extension areneeded together, such as in kicking a football. In walking, thequadriceps prevent the knee from flexing during heel strike andearly support phase.

RECTUS FEMORIS (One of Quadriceps Femoris)





Hip, thigh, and leg—anterior view■ OriginIntertrochanteric line, inferior border of greatertrochanter, gluteal tuberosity, lateral lip of linea asperaof femur

■ InsertionLateral margin of patella, then by patellar ligament totuberosity of tibia

■ ActionExtends leg


VASTUS LATERALIS (One of Quadriceps Femoris)





Hip, thigh, and leg—anterior view■ OriginIntertrochanteric line, medial lip of linea aspera offemur, medial intermuscular septum of adductormagnus and adductor longus, medial supracondylarridge

■ InsertionMedial border of the patella, then by patellar ligamentinto tibial tuberosity, medial condyle of tibia

■ ActionExtends leg, draws patella medially


Note: Although they are not anatomically separate1, the lowerportion of the vastus medialis is referred to as the vastus medialisobiliquus (VMO). Its action is to stabilize the patella and prevent itslateral dislocation.

1Noric, M. M., Mitchell, J., de Klerk, D. (1997) A comparison of theproximal and distal parts of the vastus medialis muscle. AustralianJournal of Physiotherapy, 43(4):277–281.

VASTUS MEDIALIS (One of Quadriceps Femoris)





Hip, thigh, and leg—anterior view■ OriginAnterior and lateral surfaces of upper two-thirds offemur, lateral intermuscular septum, linea aspera, lateralsupracondylar ridge

■ InsertionDeep aspect of quadriceps tendon, then through patellato tibial tuberosity

■ ActionExtends leg


Note: A few bundles of fibers from this muscle insert onto theupper part of the joint capsule of the knee. They probably drawthe capsule superiorly during extension of the leg, preventing itfrom binding in the joint. They are called articularis genus.

VASTUS INTERMEDIUS (One of Quadriceps Femoris)





Hip and thigh—anterior view1. Tensor fasciae latae2. Iliotibial tract3. Vastus lateralis (quadriceps femoris)4. Vastus intermedius (quadriceps femoris)5. Rectus femoris (cut) (quadriceps femoris)6. Sartorius7. Vastus medialis (quadriceps femoris)

MUSCLES OF THE ANTERIOR THIGH





Hip and thigh—posterior view■ NerveLong head—tibial part of sciatic nerve (S1–S3)

Short head—common peroneal part of sciatic nerve(L5, S1, S2)

Note: During walking or running, the hamstrings are used to slowdown the leg at the end of its swing and prevent the trunk fromflexing at the hip. They are susceptible to being strained byresisting the momentum of these body parts.

BICEPS FEMORIS (Part of Hamstrings)

■ OriginLong head—ischial tuberosity, sacrotuberous ligament

Short head—linea aspera, lateral supracondylar ridge,lateral intermuscular septum

■ InsertionLateral side of head of fibula and lateral condyle of tibia

■ ActionFlexes leg, long head also extends thigh





Hip and thigh—posterior view■ NerveTibial portion of sciatic nerve (L5, S1, S2)

See note on p. 183 and Relationship section on p. 177.

SEMITENDINOSUS (Part of Hamstrings)

■ OriginIschial tuberosity

■ InsertionMedial surface of shaft of tibia

■ ActionFlexes and slightly medially rotates leg; after flexion,extends thigh





Hip and thigh—posterior view■ ActionFlexes and slightly medially rotates leg; after flexion,extends thigh

■ NerveTibial portion of sciatic nerve (L5, S1, S2)

See note on p. 183.

SEMIMEMBRANOSUS (Part of Hamstrings)

■ OriginIschial tuberosity

■ InsertionPosterior part of medial condyle of tibia





Hip and thigh—posterior view1. Sciatic nerve2. Quadratus femoris3. Biceps femoris4. Semimembranosus5. Semitendinosus6. Tibial nerve7. Common peroneal nerve

Note: The common peroneal nerve is exposed to compression anddamage as it passes over the head of the fibula. The quadratusfemoris, a lateral rotator, is included for reference.

HAMSTRING MUSCLES





Hip and thigh—anterior view■ OriginLower margin of body and inferior ramus of pubis

■ InsertionUpper part of medial surface of shaft of tibia

■ ActionAdducts thigh at hip joint and flexes leg, with legflexed, assists in medial rotation

■ NerveObturator nerve (L2–L4)

See Relationship section on p. 177.

GRACILIS





Hip and thigh—anterior view■ OriginPectineal line on superior ramus of pubis

■ InsertionFrom lesser trochanter to linea aspera of femur

■ ActionFlexes thigh, assists in adduction when hip is flexed

■ NerveFemoral nerve (L2, L3), (sometimes a branch ofobturator nerve)

Note: The rotational component of thigh muscle action dependsupon the starting position of the hip joint. The pectineus, adductorlongus, adductor brevis, and psoas major probably assist in medialrotation when the thigh is in anatomical position but may shift toassisting in lateral rotation as the thigh flexes and abducts.

The iliacus and adductor tubercle part of adductor magnusprobably assist in medial rotation throughout the range of motionof the hip joint while the linea aspera part of the adductor magnusmay be a slight lateral rotator.

PECTINEUS





Hip and thigh—posterior view■ ActionAdducts, flexes thigh, assists in medial rotation*



ADDUCTOR LONGUS

■ OriginAnterior of body of pubis

■ InsertionMedial lip of linea aspera





Hip and thigh—posterior view■ ActionAdducts thigh, assists in flexion, medial rotation*



ADDUCTOR BREVIS

■ OriginOuter surface of inferior ramus of pubis

■ InsertionFrom below lesser trochanter to linea aspera and intoproximal part of linea aspera





Hip and thigh—posterior view■ ActionAdducts, extends thigh, lower portion (adductortubercle insertion) assists in medial rotation*

■ NerveObturator nerve (L2–L4), sciatic nerve


ADDUCTOR MAGNUS

■ OriginInferior ramus of pubis, ramus and lower part oftuberosity of ischium

■ InsertionLinea aspera, adductor tubercle of femur





Hip and thigh—anterior view1. Psoas major2. Iliacus3. Inguinal ligament4. Femoral nerve, vein, artery5. Pectineus6. Adductor brevis7. Adductor longus (cut)8. Adductor magnus9. Gracilis

HIP FLEXORS AND ADDUCTORS


9. Muscles of the Leg and Foot


C H A P T E R N I N E

Muscles of theLeg and Foot




194 C H A P T E R N I N E

Leg—anterolateral view■ OriginLateral condyle of tibia, upper half of lateral surface oftibia, interosseous membrane

■ InsertionMedial side and plantar surface of medial cuneiformbone, base of first metatarsal bone

■ ActionDorsiflexes foot, inverts (supinates) foot

■ NerveDeep peroneal nerve (L4, L5, S1)

TIBIALIS ANTERIOR




M U S C L E S O F T H E L E G A N D F O O T 195

Leg—anterolateral view■ OriginMiddle half of anterior surface of fibula andinterosseous membrane

■ InsertionBase of distal phalanx of great toe

■ ActionExtends, hyperextends great toe, dorsiflexes and inverts(supinates) foot


EXTENSOR HALLUCIS LONGUS





Foot—anterolateral view■ OriginUpper two-thirds of anterior surface of fibula,interosseous membrane, lateral condyle of tibia

■ InsertionAlong dorsal surface of four lateral toes, and then tobases of middle and distal phalanges

■ ActionExtends toes, dorsiflexes foot, everts foot


Note: The lower lateral part of this muscle makes a separateinsertion onto the dorsal surface of the fifth metatarsal and iscalled peroneus tertius.

EXTENSOR DIGITORUM LONGUS

Leg—anterolateral view





Leg—anterolateral view■ OriginLower third of anterior surface of fibula andinterosseous membrane

■ InsertionDorsal surface of base of fifth metatarsal bone

■ ActionDorsiflexes and everts foot


Note: This muscle is not present in all individuals. It may bedescribed as the fifth tendon of extensor digitorum longus.

FIBULARIS TERTIUS (Peroneus Tertius)





Leg—anterolateral view1. Fibularis longus2. Fibularis brevis3. Fibularis tertius4. Tibialis anterior5. Extensor retinaculum6. Extensor hallucis longus7. Extensor digitorum longus8. Extensor digitorum brevis

ANTERIOR AND LATERAL LEG MUSCLES





Leg—posterior view■ OriginLateral head—lateral condyle and posterior surface offemur

Medial head—popliteal surface of femur above medialcondyle

■ InsertionPosterior surface of the calcaneus

■ ActionPlantar flexes foot, flexes leg when foot is dorsiflexedand knee is extended

■ NerveTibial nerve (S1, S2)

GASTROCNEMIUS (Part of Triceps Surae)





Leg—posterior view■ OriginPosterior surface of the tibia (soleal line), upper third ofposterior surface of fibula, fibrous arch between tibiaand fibula


■ ActionPlantar flexes foot


SOLEUS (Part of Triceps Surae)





Leg—posterior view■ OriginLateral supracondylar ridge of femur, oblique poplitealligament


■ ActionPlantar flexes foot, flexes leg


PLANTARIS





Leg—posterior view1. Soleus2. Plantaris3. Gastrocnemius (cut)

MUSCLES OF THE CALF





Leg—posterior view■ OriginLateral surface of lateral condyle of femur

■ InsertionUpper part of posterior surface of tibia

■ ActionRotates leg medially, flexes leg

■ NerveTibial nerve (L4, L5, S1)

Note: Stern contends that this muscle stabilizes the knee bypreventing lateral rotation of the tibia during medial rotation ofthe thigh while the foot is planted. Knee stabilization allowsstanding without undue fatigue to the quadriceps.

Reference: Stern, J. T. Essentials of Gross Anatomy, F. A. DavisCompany, Philadelphia, 1988.

POPLITEUS





Leg—posterior view■ OriginLower two-thirds of posterior surface of shaft of fibula,posterior intermuscular septum, interosseous membrane

■ InsertionBase of distal phalanx of great toe

■ ActionFlexes distal phalanx of great toe, assists in plantarflexing foot, inverts foot

■ NerveTibial nerve (L5, S1, S2)

Note: This muscle is important in pushing off the surface inwalking, running, jumping.

FLEXOR HALLUCIS LONGUS





Foot—plantar view

■ OriginMedial part of posterior surface of tibia

■ InsertionBases of distal phalanges of second, third, fourth, andfifth toes

■ ActionFlexes distal phalanges of lateral four toes, assists inplantar flexing foot, inverts foot

■ NerveTibial nerve (L5, S1)

FLEXOR DIGITORUM LONGUS

Leg—posterior view





Foot—plantar view■ OriginLateral part of posterior surface of tibia, interosseousmembrane, proximal half of posterior surface of fibula

■ InsertionTuberosity of navicular bone, cuboid, cuneiforms,second, third, and fourth metatarsals, sustentaculumtali of calcaneus

■ ActionPlantar flexes, inverts foot

■ NerveTibial nerve (L5, S1)

Leg—posterior view

TIBIALIS POSTERIOR





Leg—posterior view1. Popliteus2. Tibialis posterior

2a. Tendon of tibialis posterior3. Flexor hallucis longus (cut)4. Flexor digitorum longus (cut)5. Medial malleolus

Note: The order of the three tendons, from anterior to posterior,passing posterior to the medial malleolus can be remembered bythe following mnemonic: Tom (tibialis posterior), Dick (flexordigitorum), Harry (flexor hallucis longus).

DEEP POSTERIOR LEG MUSCLES





Foot—plantar view■ OriginUpper two-thirds of lateral surface of fibula

■ InsertionLateral side of medial cuneiform, base of first metatarsal

■ ActionPlantar flexes, everts foot

■ NerveSuperficial peroneal nerve (L4, L5, S1)

Leg—anterolateral view

FIBULARIS LONGUS (Peroneus Longus)





Leg—anterolateral view■ OriginLower two-thirds of lateral surface of fibula

■ InsertionLateral side of base of fifth metatarsal bone

■ ActionEverts, plantar flexes foot

■ NerveSuperficial peroneal nerve (L5, S1, S2)

FIBULARIS BREVIS (Peroneus Brevis)





Foot—anterolateral view

■ ActionExtends the four toes

■ NerveDeep peroneal nerve (S1, S2)

EXTENSOR DIGITORUM BREVIS

■ OriginAnterior and lateral surfaces of calcaneus, lateraltalocalcaneal ligament, inferior extensor retinaculum

■ InsertionInto base of proximal phalanx of great toe; into lateralsides of tendons of extensor digitorum longus of second,third, and fourth toes





Foot—plantar viewNote: The muscles of the sole of the foot can be divided into fourlayers (from superficial to deep):

First layer—abductor hallucis, flexor digitorum brevis, abductordigiti minimi

Second layer—quadratus plantae, lumbricales (tendons of flexorhallucis longus and flexor digitorum longus pass through this layer)

Third layer—flexor hallucis brevis, adductor hallucis, flexor digitiminimi brevis

Fourth layer—interossei (tendons of tibialis posterior and peroneuslongus pass through this layer)

ABDUCTOR HALLUCIS (First Layer)

■ OriginTuberosity of calcaneus, flexor retinaculum, plantaraponeurosis

■ InsertionMedial side of base of proximal phalanx of great toe

■ ActionStabilizes great toe (with adductor hallucis)

■ NerveMedial plantar nerve (L4, L5)





Foot—plantar view■ ActionFlexes proximal phalanges and extends distal phalangesof second through fifth toes

■ NerveMedial plantar nerve (L4, L5)

FLEXOR DIGITORUM BREVIS (First Layer)

■ OriginTuberosity of calcaneus, plantar aponeurosis

■ InsertionSides of middle phalanges of second to fifth toes





Foot—plantar view

■ ActionAbducts fifth toe

■ NerveLateral plantar nerve (S1, S2)

ABDUCTOR DIGITI MINIMI (First Layer)

■ OriginTuberosity of calcaneus, plantar aponeurosis

■ InsertionLateral side of proximal phalanx of fifth toe





Foot—plantar view

■ ActionFlexes terminal phalanges of second through fifth toes


QUADRATUS PLANTAE (Second Layer)

■ OriginMedial head—medial surface of calcaneus

Lateral head—lateral border of inferior surface ofcalcaneus

■ InsertionLateral margin of tendon of flexor digitorum longus





Foot—plantar view■ NerveFirst lumbricalis—medial plantar nerve (L4, L5)

Second through fifth lumbricales—lateral plantar nerve(S1, S2)

LUMBRICALS (Second Layer)

■ OriginTendons of flexor digitorum longus

■ InsertionDorsal surfaces of proximal phalanges

■ ActionFlex proximal phalanges of second through fifth toes





Foot—plantar view■ ActionFlexes proximal phalanx of great toe

■ NerveMedial plantar nerve (L4, L5, S1)

Note: The tendons of insertion contain sesamoid bones.

FLEXOR HALLUCIS BREVIS (Third Layer)

■ OriginCuboid bone, lateral cuneiform bone

■ InsertionMedial part—medial side of base of proximal phalanxof great toe

Lateral part—lateral side of base of proximal phalanxof great toe





Foot—plantar view■ InsertionLateral side of base of proximal phalanx of great toe

■ ActionStabilizes great toe (with abductor hallucis)


ADDUCTOR HALLUCIS (Third Layer)

■ OriginOblique head—second, third, and fourth metatarsalbones, and sheath of peroneus longus tendon

Transverse head—plantar metatarsophalangealligaments of third, fourth, and fifth toes, and transversemetatarsal ligaments





Foot—plantar view

■ ActionFlexes proximal phalanx of fifth toe


FLEXOR DIGITI MINIMI BREVIS (Third Layer)

■ OriginBase of fifth metatarsal, sheath of peroneus longustendon

■ InsertionLateral side of base of proximal phalanx of fifth toe





Foot—anterolateral view■ ActionAbduct toes, flex proximal phalanges


DORSAL INTEROSSEI (Fourth Layer; Four Muscles)

■ OriginAdjacent sides of metatarsal bones

■ InsertionBases of proximal phalanges

First—medial side of proximal phalanx of second toe

Second, third, fourth—lateral sides of proximalphalanges of second, third, and fourth toes





Foot—plantar view■ ActionAdduct toes, flex proximal phalanges


PLANTAR INTEROSSEI (Fourth Layer; Three Muscles)

■ OriginBases and medial sides of third, fourth, and fifthmetatarsal bones

■ InsertionMedial sides of bases of proximal phalanges of sametoes


Back Matter Alphabetical Listing of Muscles

223© The McGraw−Hill Companies, 2009

AAbductor digiti minimi

of foot, 213of hand, 157

Abductor hallucis, 211Abductor pollicis brevis, 153Abductor pollicis longus, 147Adductor brevis, 190, 192Adductor hallucis, 217Adductor longus, 189, 192Adductor magnus, 191, 192Adductor pollicis, 156Anconeus, 126Auricularis

anterior, superior, posterior, 36

BBiceps brachii, 110, 112Biceps femoris, 183, 186Brachialis, 111, 112Brachioradialis, 140Buccinator, 52

CCoracobrachialis, 109, 112Corrugator supercilii, 39Cremaster, 100

DDeltoid, 119Depressor

anguli oris, 50labii inferioris, 49septi, 42

Diaphragm, 97Digastricus, 60Dorsal interossei

of foot, 219of hand, 162

EEpicranius

frontal belly (frontalis), 34occipital belly (occipitalis), 34

Iliopsoas, 164, 165Infraspinatus, 121, 127Intercostales

externi, 90interni, 91

Interosseiof foot, 219–220of hand, 161–162

Interspinales, 88Intertransversarii, 89

LLatissimus dorsi, 114, 127Levator anguli oris, 45Levator labii superioris, 44Levator palpebrae superioris, 38Levator scapulae, 115, 127Levatores costarum, 94Longissimus

capitis, 83cervicis, 83thoracis, 83

Longuscapitis, 69colli, 68

Lumbricalesof foot, 215of hand, 160

MMasseter, 54Mentalis, 51Multifidis, 86Muscle Groups

abdominal muscles, 103anterior and lateral leg muscles, 198deep posterior leg muscles, 207extensors of the thumb, 150flexors of the fingers, 138hamstring muscles, 186hip flexors and adductors, 192muscles of anterior chest and arm, 112muscles of the anterior thigh, 182muscles of the calf, 202muscles of the hip, 175muscles of the wrist, 134

Erector spinae, 82–84Extensor carpi radialis brevis, 142Extensor carpi radialis longus, 141Extensor carpi ulnaris, 145Extensor digiti minimi, 144Extensor digitorum brevis, 210Extensor digitorum communis, 143Extensor digitorum longus, 196, 198Extensor hallucis longus, 195, 198Extensor indicis, 151Extensor pollicis brevis, 148, 150Extensor pollicis longus, 149, 150

FFlexor carpi radialis, 131, 134Flexor carpi ulnaris, 133, 134Flexor digiti minimi, 157, 213Flexor digiti minimi brevis, 158, 218Flexor digitorum brevis, 212Flexor digitorum longus, 205Flexor digitorum profundus, 136, 138Flexor digitorum superficialis, 135, 138Flexor hallucis brevis, 216Flexor hallucis longus, 204Flexor pollicis brevis, 154Flexor pollicis longus, 137, 138Frontalis. See Epicranius

GGastrocnemius, 199Gemellus

inferior, 169, 175superior, 168, 175

Geniohyoid, 63Gluteus

maximus, 172, 175medius, 173, 175minimus, 174

Gracilis, 187, 192

IIliacus, 165, 192Iliocostalis

cervicis, 82lumborum, 82thoracis, 82

221

AlphabeticalListing of Muscles


Back Matter Alphabetical Listing of Muscles

224 © The McGraw−Hill Companies, 2009

222 A L P H A B E T I C A L L I S T I N G O F M U S C L E S

posterior back, shoulder, and armmuscles, 127

Mylohyoid, 62

NNasalis

alar part, 41transverse part, 41

OObliquus capitis

inferior, 77superior, 78

Obliquus externus abdominis, 98, 103Obliquus internus abdominis, 99, 103Obturator

externus, 170, 175internus, 167, 175

Occipitalis. See EpicraniusOmohyoid, 67Opponens digiti minimi, 159Opponens pollicis, 155Orbicularis oculi, 37Orbicularis oris, 43

PPalmar interossei, 161Palmaris

brevis, 152longus, 132, 134

Pectineus, 188, 192Pectoralis

major, 106, 112minor, 107, 112

Peroneusbrevis, 209longus, 208tertius, 197, 198

Piriformis, 166, 175Plantar interossei, 220Plantaris, 201Platysma, 59Popliteus, 203Procerus, 40Pronator

quadratus, 139teres, 130, 134

Psoasmajor, 164, 192minor, 164

Pterygoideuslateralis, 56medialis, 55

Pyramidalis, 102

QQuadratus

femoris, 171, 175, 182lumborum, 104plantae, 214

Quadriceps femorisrectus femoris, 178vastus intermedius, 181, 182vastus lateralis, 179, 182vastus medialis, 180

RRectus abdominis, 102, 103Rectus capitis

anterior, 70lateralis, 71posterior major, 75posterior minor, 76

Rectus femoris. See Quadriceps femorisRhomboid

major, 116, 127minor, 117, 127

Risorius, 48Rotatores, 87

SSacrospinalis. See Erector spinaeSartorius, 177, 182Scalenus

anterior, 72medius, 73posterior, 74

Semimembranosus, 185Semispinalis

capitis, 85cervicis, 85thoracis, 85

Semitendinosus, 184Serratus

anterior, 118, 127posterior inferior, 96posterior superior, 95

Soleus, 200

Spinaliscapitis, 84cervicis, 84thoracis, 84

Spleniuscapitis, 80cervicis, 81

Sternocleidomastoid, 58Sternohyoid, 64Sternothyroid, 65Stylohyoid, 61Subclavius, 108Subcostales, 92Subscapularis, 123Supinator, 146Supraspinatus, 120, 127

TTemporalis, 53Temporoparietalis, 35Tensor fasciae latae, 176, 182Teres

major, 124, 127minor, 122, 127

Thyrohyoid, 66Tibialis

anterior, 194, 198posterior, 206

Transversospinalis, 85Transversus

abdominis, 101, 103thoracis, 93

Trapezius, 113, 127Triceps brachii, 125, 127

VVastus

intermedius. See Quadriceps femorislateralis. See Quadriceps femorismedialis. See Quadriceps femoris

ZZygomaticus

major, 46minor, 47


Back Matter Index 225© The McGraw−Hill Companies, 2009

Index

intertrochanteric crest, 21, 22, 171intertrochanteric line, 20, 179, 180lesser trochanter, 20–22, 164, 165,

188, 190linea aspera, 21, 22, 179–181, 183,

188–191popliteal surface, 22, 199quadrate line, 171supracondylar ridge line, 180, 183

lateral, 22, 23, 181, 183, 201medial, 23, 180

trochanteric fossa, 20Fibula, 23, 24, 195–197, 200, 204, 206,

208, 209head, 23

Flexion, 29, 31, 32Flexor retinaculum

of foot, 25, 211of hand, 18, 134, 152–155, 158, 159

Foramen magnum, 69, 70Frontal bone, 2, 4, 37, 53

glabella, 2superciliary arch, 2

Frontal (coronal) planes, 28, 29, 31Frontal process of maxilla. See maxilla.

GGalea aponeurotica, 34Genitofemoral nerve, genital branch, 100Glenoid cavity. See scapula.Gluteal nerve

inferior, 172superior, 173, 174, 176

HHamate bone, 18, 19, 158, 159

hook, 18, 133Humerus, 14–17, 109, 111

capitulum, 14coronoid fossa, 14, 16deltoid tuberosity, 14, 119greater tuberosity (tubercle), 14, 106,

120–122intertubercular (bicipital) groove, 14,

106, 110, 114, 124lateral epicondyle, 14, 15, 126,

142–146lateral supracondylar ridge, 14,

140, 141

223

AAbdominal aponeurosis, 98, 99, 101Abduction, 29, 31, 32Accessory nerve (11th cranial)

cranial part, 113spinal part, 58

Acetabulum, 20, 178Acromion. See scapula.Adduction, 29–32Ala

of nose, 42of sacrum, 165

Alar cartilage, 41, 44Alveolar border (process). See maxilla.Anatomical position, 28, 29, 31Annular ligament of radius, 16, 17, 146Ansa cervicalis, 64, 65, 67Arcuate ligament

lateral, 97medial, 97

Atlas, 5, 6anterior arch, 6, 68anterior tubercle, 6posterior arch, 6, 76posterior tubercle, 6superior articular facet, 6transverse foramen, 6transverse process, 6, 70, 71, 77, 78

Axillary nerve, 119, 122Axis, 5, 6

dens, 6spinous process of, 6, 75, 77, 84

BBicipital aponeurosis, 110Bicipital (intertubercular) groove. See

humerus.

CCalcaneus, 24, 25, 199–201, 210, 214

sustinaculum tali, 206tuberosity, 211–213

Canine fossa. See maxilla.Capitate bone, 18, 19, 156Carpometacarpal joint, 159Cervical nerves

dorsal primary divisions, 80–89ventral rami, 72–74

Clavicle, 11, 58, 67, 106, 108, 113, 119

Coccyx, 5, 9, 10, 172Common peroneal nerve, 183, 186Coracoid process. See scapula.Coronal (frontal) planes, 28, 29, 31Costal cartilage, 13, 90, 91, 101, 102,

106, 108Cuboid bone, 24, 25, 206, 216Cuneiform bones, 24, 194, 206, 208

DDeep peroneal nerve, 194–197, 210Deltoid tuberosity. See humerus.Depression of scapula, 30Dorsal scapular nerve, 115–117Dorsiflexion of ankle joint, 32

EEar

helix, 36Elevation of scapula, 30Ethmoid bone, 2

nasal septum, 2, 42, 43Eversion, 32Extension, 29, 32Extensor expansion, 151Extensor retinaculum, 198, 210

inferior, 24External occipital protuberance. See

occipital bone.

FFacial nerve, 60, 61

auricular branch (posterior), 34, 36buccal branches, 40–48, 52cervical branch, 59mandibular branch, 43, 49–51temporal branch, 34–37, 39zygomatic branch, 37

Fascia lata. See illotibial tract.Femoral nerve, 165, 177–181, 188, 192Femur, 20–23

adductor tubercle, 22, 23, 191condyles

lateral, 22, 199, 203medial, 22, 203

gluteal tuberosity, 2, 172, 179greater trochanter, 20–22, 166–169,

173, 174, 179


Back Matter Index226 © The McGraw−Hill Companies, 2009

224 I N D E X

Humerus (Continued)lesser tuberosity (tubercle), 14, 123medial epicondyle, 14–17, 130–133,

135, 137medial supracondylar ridge, 14, 16, 130olecranon fossa, 15, 17surgical neck, 14trochlea, 14

Hyoid bone, 12, 60–64, 66, 67body, 12, 63, 64, 67greater horn, 66

Hyperextension, 29Hypoglossal nerve, 63, 66Hypothenar eminence, 157

IIliohypogastric nerve, 98, 99, 101Ilioinguinal nerves, 98, 99, 101Iliolumbar ligament, 104Iliotibial tract, 172, 176, 182Ilium, 20, 21

arcuate line, 20crest, of, 20, 82, 83, 98, 99, 101fossa of, 20, 165gluteal lines

inferior, 21, 174middle (anterior), 21, 174posterior, 21, 172

iliopectineal eminence, 20, 164spines

anterior inferior iliac, 20, 178anterior superior iliac, 20, 176, 177posterior inferior iliac, 21posterior superior iliac, 21, 86

tubercle, 20, 176Inferior temporal line, 3Inguinal ligament, 99–101, 192Intercostal nerves, 90–94, 98, 99,

101, 102Intercostal space, 91Interosseous membrane

radioulnar, 17, 136, 137, 147–149, 151tibiofibular, 24, 194–197, 204, 206

Intervertebral disks, 164Inversion, 32Ischium, 20, 21

greater sciatic notch, 21lesser sciatic notch, 21ramus, 170, 191spine, 21, 168tuberosity, 21, 169, 171, 183–185

LLacrimal bone, 2, 4, 37Lateral cuneiform bone, 25Ligamentum nuchae, 80, 84, 95, 113, 117

Linea alba, 98, 99, 101, 103Lumbar plexus, 164Lumbar vertebrae. See vertebra.Lumbocostal arch (es), 97Lunate bone, 18, 19

MMammillary process. See vertebra.Mandible, 2, 4, 43, 59, 60, 63

alveolar process (border), 52angle, 3, 54, 55condyle (neck of), 4, 56coronoid process, 3, 53, 54incisive fossa, 3, 51mental foramen, 3, 49mylohyoid line, 62oblique line, 3ramus, 3, 53–55symphysis, 2, 49, 60

Mastoid process, 3Maxilla, 2, 4

alveolar process (border), 2, 43, 52canine fossa, 4, 45frontal process, 4, 44incisive foremen, 2incisive process, 4infraorbital foramen, 2palatine process, 2tuberosity, 55zygomatic process, 54

Medial cuneiform bone, 25Medial malleolus, 24Median (midsagittal plane), 28–30Median nerve, 130–132, 135,

153–155, 160anterior interosseous branch, 136–139

Metacarpal bones, 18, 19, 131, 133, 141,142, 145, 147, 154–156, 159, 161,162

Metacarpophalangeal joint, 143, 154,158, 160–162

Metatarsal bones, 24, 25, 194, 196, 197,206, 208, 209, 217–220

Muscles. See pages 221–222Musculocutaneous nerve, 109–111

NNasal bone, 2, 4Nasal septum (ethmoid bone), 42, 43Nasolabial furrow, 44, 47Navicular bone

tubercle of, 24, 25tuberosity of, 206

OOblique popliteal ligament, 201Obturator foramen, 20, 170

Obturator membrane, 167Obturator nerve, 170, 187, 188–191Occipital bone, 2, 4

external occipital crest, 2external occipital protuberance, 2, 113foramen magnum, 2, 69, 70inferior nuchal line, 2, 75, 76, 78jugular process, 2occipital condyle, 2superior nuchal line, 2, 78, 80, 113

Oculomotor nerve, 38Opposition, 31

PPalatine bone, 2, 55Palmar aponeurosis, 18, 132, 134, 152Palpebral ligament

lateral (raphe), 37medial, 37

Parietal bone, 4inferior temporal line, 4superior temporal line, 4

Patella, 23, 178–181Patellar ligament, 23, 178–180Pectoral nerves

lateral, 106medial, 106, 107

Peroneal nervescommon, 183deep, 194–197, 210superficial, 208, 209

Pes anserinus, 177Phalanges

of foot, 24, 25, 195, 196, 204, 205,210–220

of hand, 18, 19, 135–137, 143, 144,148, 149, 151, 153–155

Phrenic nerve, 97Pisiform bone, 18, 133, 157Plantar aponeurosis, 25, 211, 213Plantar flexion, 32Plantar metatarsophalangeal ligaments,

25, 217Plantar nerves

lateral, 213–215, 217–220medial, 211, 212, 215, 216

Pronation of scapula, 31Protraction of scapula, 30Pterygoidomandibular raphe, 52Pubic symphysis, 20, 102Pubis, 20

crest, 20inferior ramus, 20, 170, 187,

190, 191pectineal line, 188superior ramus, 20, 170tubercle, 20


Back Matter Index 227© The McGraw−Hill Companies, 2009

I N D E X 225

superior border, 14supraglenoid tubercle, 110supraspinous fossa, 14, 15, 120vertebral (medial) border, 14, 15

Sciatic nerve, 175, 186, 191common peroneal part, 183tibial part, 183–185

Sphenoid bone, 2, 4foramen ovale, 2greater wing, 2, 3, 56lesser wing, 2, 38pterygoid plate

lateral, 2, 3, 55, 56medial, 2

Spinal nervesdorsal primary division, 82–89ventral primary division, 89

Sternum, 11, 93, 106body, 11costal arch, 11manubrium, 11, 58, 64, 65sternal angle, 11sternoclavicular joint, 11xiphoid process, 11, 97, 102

Styloid ligaments, 12Suboccipital nerve, 75–78Superficial peroneal nerve, 208, 209Supination 31Superior temporal line, 3Suprascapular nerve, 120, 121Supraspinous ligament, 83, 113, 114, 116

TTalocalcaneal ligament, 24, 210Talus, 24, 25Teeth, 52–55, 62Temporal bone, 2, 4, 53

carotid canal, 2mandibular process, 2mastoid notch, 60mastoid process, 2, 34, 58, 80, 83styloid process, 3temporal fossa, 3zygomatic process, 3

Temporal fossa, 53Temporomandibular joint, 56Testes, 100Thoracic nerves

dorsal, 114long, 118

Thoracic vertebrae. See vertebra.Thoracolumbar (lumbar) fascia, 99,

101, 114Thyrohyoid ligament, 12Thyroid cartilage

lamina, 65, 66

QQuadriceps tendon, 23, 181

RRadial collateral ligament, 17, 146Radial nerve, 125, 126, 140–151

deep branch, 143Radius, 16, 17

scalene tubercle, 72styloid process, 17, 140tuberosity, 16, 130

Retraction of scapula, 30Rib(s)

articulations, 13tubercle, 83

Rotation, 29Rotator cuff, 120–123

SSacral nerves, 166Sacral plexus, 167–171Sacral vertebrae. See vertebra.Sacrotuberous ligament, 21, 166, 172, 183Sacrum, 5, 166, 172

ala, 10, 167auricular surface, 9crests, 82, 83

intermediate, 9lateral, 9medial, 9

foramina, 9, 86posterior sacral foramen, 9promontory, 10sacral canal, 9sacral foramina, 10sacral hiatus, 9sacral tuberosity, 9superior articular facet, 9

Sagittal plane, 28–30Scalp, 34–36Scaphoid bone, 18, 19

tubercle, 18, 153Scapula, 14, 15

acromion, 14, 15, 113, 119, 120angle, inferior, 14, 15, 114, 124axillary (lateral) border, 14, 15coracoid process, 14, 107, 109, 110glenoid cavity (fossa), 14, 120–122inferior angle, 14, 15infraglenoid tubercle, 14, 125infraspinous fossa, 14, 15, 121movements, 30root of spine, 15spine, 14, 15, 113, 115–117, 119subscapular fossa, 15, 123

Tibia, 23, 24condyles, 23, 180, 183, 185, 194, 196tuberosity of, 23, 178–181

Tibial nerve, 186, 199–206Transverse metatarsal ligaments, 25, 217Transverse planes (cross section), 28Trapezium bone, 18, 19, 154

tubercle, 18, 153, 155Trapezoid bone, 18, 19, 156Trigeminal nerve

mandibular division, 53–56, 60, 62Triquetrum bone, 18, 19Turbinate, 2

UUlna, 16, 17

coronoid process, 16, 111, 130,135–137

olecranon process, 17, 125, 126, 133

`styloid process, 17supinator crest, 16tuberosity, 16, 111

Ulnar flexion, 31Ulnar nerve, 133, 136, 152, 154,

156–162

VVertebra

accessory process, 89anterior tubercle, 89articular process, 83, 86body (centrum), 7, 8cervical vertebra, 5disk, 7inferior articular process, 7inferior vertebral notch, 7lamina, 8lumbar vertebra, 5mammillary process, 8, 86, 89pedicles, 8posterior tubercle, 89, 115spinous process, 7, 8, 78, 80, 81, 83–88,

95, 96, 113, 116superior articular process, 7thoracic vertebra, 5

demi facets, 7, 13transverse process, 7, 8, 68, 72–74,

81–89, 94, 104, 164vertebral foramen, 8vomer, 2

ZZygomatic arch, 2, 14, 54Zygomatic bone, 2, 4, 37, 44, 46, 47

atlas of skeletal muscles 6th edition

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