MUSCULAR SYSTEM

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Muscular system Myology - the study of muscles
• Muscle is composed of cells which can contract to cause movement
 Produce movement
 Allow us to move, breath, transport materials and circulate our blood etc

 Maintain posture and body position

 By resisting the pull of gravity and preventing unwanted movements

 They hold some articulating bones in place by maintaining tension on the

tendons
 Guard entrance and exits

 Ringlike sphincter muscles around the eyelids, pupils, and mouth control
the admission of light, food, and drink into the body
 Urethral and anal orifices control elimination of waste; and other

sphincters control the movement of food, bile, and other materials

through the body
 Maintain body temperature
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 Skeletal muscles produce as much as 85% of our body heat, which is vital
Muscular system … Types of muscle tissue
Muscle structure
• There are three different types of muscle;
1. Cardiac Muscle (striated, involuntary)
 Makes up the wall of the heart
2. Smooth Muscle (unstriated, involuntary)
 Found in structures which we do not
have control over such as blood vessels,
stomach and intestine, urethra, uterus,
internal muscles of the eye
3. Skeletal Muscle (striated, voluntary)
 This is the muscle attached to our
skeletons and allows us to move our
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bodies
Skeletal muscles …
General anatomy of skeletal muscles
Origin insertion and
belly
• The origin of a muscle is
normally the end attached to
the less movable bone
• The insertion of a muscle is
usually the end that is
attached to the most movable
bone
• Between the origin and
insertion of a muscle there is
thicker middle region called
the belly
• Muscles can have multiple
origins, insertions and bellies
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Shape and architecture of skeletal muscles
• Pennate (L. pennatus, feather)
– Feather-like arrangement of fascicles
(fiber bundles): unipennate,
bipennate, or multipennate
• Fusiform
– Spindle shaped (round, thick belly,
and tapered ends)
• Parallel
– The fascicles lie parallel to the long
axis of the muscle; flat muscles often
have aponeuroses
• Convergent
– Have a broad attachment from which
the fascicles converge to a single
tendon
• Circular 6
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Muscle groups in action
• Muscles can be classified into at least 4 categories by their actions
Agonist
• Primary mover of a muscle, produces most of
the force during a particular joint action
Eg. biceps brachii is main flexor of forearm

Synergists
• Muscles work together, adds extra force to
agonistic movement
– It modifies the direction or reduce
undesirable movement
Fixators
Eg. muscles crossing 2 joints
Antagonists • A muscle that holds bone in
• Oppose agonistic movement or prevent place to provide stable base
overshooting agonistic motion for agonist muscle attached to
it and pull on something else
Eg. triceps brachii is antagonist to biceps 8
brachii Eg. joint stablilizers
Blood and Nerve supply
• Blood vessels and nerves travel
through connective tissues to the
muscle fibres.
Blood vessels
• Provide nutrients and oxygen for
contraction
– Each muscle fibre in contact with
one or more capillaries
Innervation
Motor neurons - Convey impulses for
muscular contraction
• Each motor axon branches to
innervate a number of muscle fibers
at a neuromuscular junction
• A motor neuron and all the muscle 9
Naming
• There are nearly 700 muscles in the body - distinctive
names allow us to tell them apart
 Location: (eg) brachialis = arm
 Shape: (eg) deltoid = triangle
 Relative Size: (eg) minimus, maximus, longus
 Direction of Fascicles: (eg) oblique, rectus
 Location of Attachment: (eg) brachioradialis
 Number of Origins: (eg) biceps, quadriceps
 Action: (eg) flexor, adductor, extensor

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Muscular system …

Classification of Skeletal muscles

• They are classified based on the skeletal position on
which they are attached
– Axial muscles
– Appendicular muscles

Axial muscles
– Muscles of the head
– Muscles of the neck
– Muscles of the trunk
 Muscles of the vertebral column, thorax,
abdomen, and pelvic and perineum

Appendicular muscles
– Muscles of the pectoral girdle and upper limb
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– Muscles of the pelvic girdle and lower limb
Classification of Skeletal muscles …
Axial muscles
• Axial muscles refer to the muscles attached to the axial skeleton
– More than half of all skeletal muscles are axial muscles
• Axial muscles fall into several groups:
Muscles of the head
 Craniofacial muscles (Muscles of the Scalp and Facial expression)
 Muscles that move the eyeball
 Muscles of the mastication (chewing)
 Muscles that move the tongue
Muscles of the trunk
Muscles of the neck  Muscles of the vertebral
 Lateral cervical muscles column /Back
 Anterior cervical muscles  Muscles of the thorax /Respiration
 Suprahyoid muscles  Muscles of the abdomen
 Infrahyoid muscles  Muscles of the pelvic or pelvic
 Poterior cervical muscles floor and perineum 15
Axial Muscles … Muscles of the Head

Muscles of Facial Expression

• They are responsible for
the variety and subtlety of
human facial expression
• Arranged in groups
around the orbit, nose,
mouth and auricles
• They are innervated by
facial nerve
Origin
• They originate on skull
bones or on fascia
Insersion
• They attach to the skin of
the face so that when
they move the expression
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of the face changes
Muscles of the Scalp
Occipitofrontalis
• The occipitofrontalis is a
helmet like strap of muscle
covering the scalp
• It is divided into
– The frontalis of the
forehead and
– The occipitalis at the rear
of the head
– They are connected to each
other by a broad
aponeurosis, the galea
aponeurotica
• The occipitofrontalis moves
the scalp, forehead skin,
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and eyebrows
Facial muscles around the eye
muscles Location Action
Extend froto
Depresses medial
nasal bridge to
eyebrow; wrinkles skin
Procuress the medial part
over the nose (conveying
of the eye
dislike, horror )
brows
Muscle over the Compress and dilate
Nasalis
nose anterior nasal opening

Facial muscles around Location

the eye Action
Selected muscles

Circular muscle
Orbicularis Oculi Closes the eyes
surrounding the eyes
Levator Palpebrae Thin muscle within the
Opens the eyes
Superioris eyelid

Circular, surrounding the

Orbicularis Oris Closes the mouth
mouth and lips

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Axial Muscles … Muscles of the Head
Facial muscles around the mouth
Selected muscles Location Action
From the cheek bone to the corner Pulls the corners of the mouth
Zygomaticus
of the mouth upwards and outwards
Infraorbital margin(E) anterolateral
Labial mm (Elevator sup. & body of mandible(D) to upper(E) & Elevates (upper) & depresses
Depressor inf.) (lower) lip
lower(D) lips
Circular, surrounding the mouth
Orbicularis Oris Closes the mouth
and lips
Buccinator (cheek m) From maxilla and mandible to Compress the cheek against
upper lip, angle, lower lip the gum
Anguli Oris Levator At the side of the chin to the corner
Pulls the mouth corners up &
Depressor of the mouth down
Mentalis From mandible to skin of chin Elevates and protrudes lower
lip
Platysma Above & below clavicle to the base Depresses mandible
of mouth

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Facial muscles around the mouth

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Axial Muscles … Muscles of the Head
Muscles moving the eyeball
• Known as extrinsic eye muscles (six pairs)
– These muscles are fast and precisely controlled
• Originate on skull bones and attach onto
the sclera
• Movements include pulling toward the
muscle origin, and rotation of the eyeball

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Muscles of the Head: Moving the Eyeball
Medial rectus Oculomotor nerve Adducts
Lateral rectus Abdu cent nerve Abducts
Superior Oculomotor nerve Elevates, adducts & rotates medially
rectus
Oculomotor nerve Depresses, adducts & rotates
Inferior rectus laterally
Trochlear nerve
Superior Depresses, abducts & rotates
Oculomotor nerve
oblique medially
Inferior Elevates, abducts & rotates laterally
oblique

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Muscles of the Head: Muscles of Mastication
• The muscles of mastication
are strong muscles which
open & close the mouth for
chewing
• They are innervated by
mandibular nerve
• They move the jaw (mandible)
forwards, backwards and from
side to side at the TMJ
(temporomandibular joint)
Muscles of Mastication Location Action
Temporalis A large triangular muscle on the Closes the jaw.
side of the head.
Masseter Rectangular muscle from the Closes the jaw.
cheek to the outside of the jaw.
Medial and Lateral Two muscles deep inside the jaw; Open and closes the jaw
Pterygoids from the pterygoid plate to the Moves the jaw from side to side and
mandible. forwards and backwards.
Buccinator (???) In the soft tissue of the cheeks. Flattens cheeks to press food under the
molars, and in sucking and blowing. 26
Muscles of the Head: Moving the Tongue

Movement of the tongue is vital during speech, mastication

(chewing), deglutition (swallowing)
Extrinsic tongue muscles move the tongue, while intrinsic tongue
muscles change the shape of the tongue
They are innnervated by hypoglossalnerve
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Muscles of the neck
Lateral cervical muscles
Muscles of Location Action
the Neck
Long thick Both muscles together flex
Sternocleido muscle at the the neck
mastoid side of the An individual muscle will
neck. draw the head to that
shoulder.
scalenus posterior lateral flexion and rotation
anterior border of the of neck
SCM
scalenus Lateral lateral flexion of neck
medius cervical region
scalenus Lateral lateral flexion of neck
posterior cervical region .

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Muscles of the Head: Moving the Tongue

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Anterior cervical muscles
• Two groups of muscles stabilize the
hyoid bone, and allow movements
of the tongue and larynx
Suprahyoid muscles - muscles
superior to the hyoid
• Stylohyoid and posterior belly
digastric innervated by facial n.
• mylohyoidand anterior belly
gigastric – innervated by
mandibular n
• Geniohyoid innervated by C1 n.
Infrahyoid muscles - muscles inferior
to the hyoid
• The omohyoid, sternohyoid,
thyrohyoid, and sternothyroid
• Innervated by ansa cervicalis

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 Muscles of the Back
• Most body weight lies anterior to
the vertebral column, especially
in obese people
• There are two major groups of
muscles in the back
– Extrinsic Muscles of the Back
– Intrinsic Muscles of the Back
• The extrinsic back muscles
control limb movements
• The intrinsic (deep) back muscles
include muscles that specifically
act on the vertebral column,
producing its movements and 31
• The intrinsic or deep muscles of
the back are three layers
1. Superficial (Splenius) group
• Cranial portion - splenius capitis
• Cervical portion- splenius cervicis
2. Intermediate (Erector Spinae) - 3
groups
• Iliocostalis (lateral column)
• Longissimus (intermediate)
• Spinalis (medial column)
3. Deep (Transversospinal) group
 Semispinalis (capitis, thoracis, &cervicis)
 Multifidus (best developed in the lumbar
region)
 Rotatores (developed in thoracic region)
 They are inn.by dorsal cervical nerves
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Muscles of the thorax/Respiration
1. External intercostals
• Are the most superficial
 Obliquely from
posterior to anterior
2. Internal intercostals
• Are b/n the external &
innermost intercostals
Obliquely from parasternal
regions to the angle of ribs
posteriorly
3. innermost intercostal
They are innervated by
intercostal nerves

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Diaphragm
• It is a muscular dome separates
the thoracic and abdominal
cavities
• The outer muscular region
surrounds a central tendon
• Contraction and relaxation alter
pressures in both the thoracic
and abdominal cavities
• It is innervated by frhenic nerve
• Three major openings allow
passage of the aorta, inferior
vena cava, and esophagus

Diaphragm apertures:
Spinal levels
Aortic hiatus = 12 letters = T12
Oesophagus = 10 letters = T10
Vena cava = 8 letters = T8
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 Muscles of the Abdomen
• The anterior and lateral
walls of the abdomen are
reinforced by four pairs of
sheet like muscles
• Actions of these muscles
• Support and protect the
viscera
• Compress the abdomen in
respiration, urination,
defecation, vomiting, and
childbirth
• Flex (anteriorly &
laterally) and rotate the
vertebra
• Stabilize the vertebral
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column during heavy
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 4 major abdominal
muscles

• The Four majors are; " TIRE

around the abdomen"
 Transversus
abdominis
 Internal abdominal
obliq.
 Rectus abdominis
 External abdominal
• The obliq.
2 minors are;
 Pyramidalis
 Cremaster
• They are
innervated by
lower 6 intercostal
nerves
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Muscles of the Abdomen …
1. External oblique
• Are the most superficial
• Originate from external surfaces of 5th-12th ribs to linea alba, pubic tubercle, and
anterior part of iliac crest
 Fibers pass obliquely in an inferomedial direction

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Muscles of the Abdomen …
2. Internal oblique
• Originate from thoracolumbar fascia, anterior part of iliac crest, and
lateral half of inguinal ligament to Inferior borders of 10th-12th ribs,
linea alba, and pecten pubis
Fibers pass in the Superomedial direction
3. Transverse abdominis
• Internal surfaces of 7th-12th costal cartilages, thoracolumbar fascia,
iliac crest, and lateral part of inguinal ligament
– Most of its fibers pass in the transverse direction
4. Rectus abdominis
• It is a paired muscle, separated in the midline by the linea alba
• From pubic symphysis and pubic crest to xiphoid process and 5th-7th
costal cartilages
• Along its course, it is intersected by three or four transverse fibrous
bands or tendinous intersections 40
Pelvis floor muscles
• The floor of the pelvic cavity is
formed by 3 layers of muscles &
fasciae that span the pelvic outlet
– They support the pelvic viscera
and resist forces created by the
viscera and abdominal muscles
• It is penetrated by the anal canal,
urethra & vagina
– They open into a diamond shaped
region b/n the thighs called the
perineum
• The pelvic floor is divided into 3
layers or compartments (from
deep to superficial)
1. Pelvic diaphragm – deepest
2. Urogenital diaphragm – middle
3. Superficial perineal space - just 41
deep to the skin contains 3 muscles
Pelvis floor muscles …

Pelvic Diaphragm
• The deepest
compartment, called
the pelvic diaphragm,
is similar in both sexes
• It consists of two pairs
of muscles - the
levator ani and
coccygeus

Muscle Description Action

• Pubococcygeus - • Supports pelvic viscera
arises from the pubis • Resists intra-abdominal
Levator
Ani • Iliococcygeus - arises pressure
from the obturator • Forms anal and vaginal
fascia sphincters

• Arises from ischial • Supports pelvic viscera

Coccygeus spine and inserts • Resists increased intra- 42
into the coccyx abdominal pressure
• The other two layers
lie in the perineum
• The perineum is a
diamond shaped area
inferior to the pelvic
diaphragm
– It has differences in
males and females
Urogenital diaphram
• The middle
compartment
composed of 3 muscles
• External urethral
sphincter
• External anal sphincter 43
Superficial compartments
• The superficial perineal space lies just
deep to the skin, contains 3 muscles
1. Ischiocavernosus
• It converge like a V from the ischial
tuberosities toward the penis or clitoris
and assist inerection
2. Bulbospongiosus (bulbocavernosus)
• In males, it forms a sheath around the
base (bulb) of the penis
– it expels semen during ejaculation
• In females, it encloses the vagina like a
pair of parentheses and tightens on the
penis during intercourse
• Voluntary contractions of this muscle in It extends from the ischial tuberosities
both sexes also help void the last few to a strong central tendon of the
milliliters of urine perineum
3. Superfi.transverse perineus All of them are innervated by
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pudendal nerve
Appendicular Muscles
• Muscles in this broad group stabilize the pectoral and pelvic girdles,
and/or move the upper and lower limbs
• About 40% of all muscles are appendicular muscles
• Appendicular muscles fall into two major groups:
– Muscles of the pectoral girdle and upper limb
– Muscles of the pelvic girdle and lower limb
• In general, muscles in the pectoral girdle and upper limb have a
greater range of motion.
• Several muscles stabilize the scapula during movements of the
humerus
• Movements of the scapula increase the range of motion at the
shoulder
2. Posterior muscles
1. Anterior muscles
The superficial extrinsic muscles - Trapezius and
– Pectoralis minor
The deep extrinsic muscles - Levator scapulae,
– Subclavius 46
rhomboids major and minor
Muscles that move the pectoral girdle … Anterior muscles
Pectoralis minor
• It lies in the anterior wall of
the axilla, where it is almost
completely covered by the
pectoralis major
• It stabilizes the scapula and is
used when stretching the
upper limb forward to touch
an object that is just out of
reach

• With the coracoid process, the pectoralis minor forms a under

which vessels & nerves pass to the arm
• It is a useful anatomical and surgical landmark for structures in the axilla
(e.g. axillary artery)
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 • Subclavius muscle
• The subclavius lies almost
horizontally when the arm is in
the anatomical position
• This small, round muscle is
located inferior to the clavicle
• Anchors and depresses clavicle
• It affords some protection to
the subclavian vessels and the
superior trunk of the brachial
plexus if the clavicle fractures
• Serratus anterior
• It overlies the lateral part of the thorax and forms the medial wall of
the axilla . It becomes paralyzed if the long thoracic nerve is injured,
a deformation known as a winged scapula When the person leans on
the hand or presses the upper limb against a wall, the medial border
of the scapula pull away from the posterior thoracic wall 48
• 2. Posterior muscles that
move the pectoral girdle
1. Trapezius
2. Levator scapulae
3. Rhomboids

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Muscle Origin Insertion Innervation Function
Trapezius Superior nuchal line, Lateral 1/3 of Motor- Assists in rotating the
external occipital clavicle, accessory scapula during abduction
protuberance, acromion, spine nerve (XI); of humerus above
ligamentum nuchae, of scapula proprioception horizontal; upper fibers
spinous processes of -C3 and C4 elevate, middle fibers
C7to T12 vertebrae adduct, and lower fibers
depress scapula

Latissimu Spinous processes of Floor of Thoracodorsal Extends, adducts, and

s dorsi T7 to L5 and sacrum, intertubercular nerve (C6 to medially rotates humerus
iliac crest , ribs 10 to sulcus of C8)
12 humerus

Levator TP of C1 to C4 Upper portion C3 to C4 and Elevates scapula

scapulae medial border of dorsal scapular
scapula nerve (C4,C5)
Rhomboi SP of T2 to T5 Medial border of Dorsal scapular Retracts (adducts) and
d major scapula between nerve (C4,C5) elevates scapula
spine and inferior
angle
Rhomboi Lower portion of Medial border of Dorsal scapular Retracts (adducts) and
d minor ligamentum nuchae, scapula at the nerve (C4,C5) elevates scapula
SP of C7 and T1 spine of scapula
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Muscles that Move the Humerus
• Muscles with origins on
the axial skeleton
– Pectoralis major
– Latissimus dorsi
• Muscles with origins on
the scapula
– Deltoid Muscle
– Teres Major Muscle
– Rotator cuff muscles (SITS)
• Supraspinatus
• Infraspinatus
• Teres Minor Muscle
• Subscapularis

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Scapulohumeral (intrinsic shoulder) muscles
Deltoid Lateral third of Deltoid tuberosity Axillary nerve flexes and medially rotates arm
clavicle; acromion of humerus (C5, C6) abducts arm
and spine of extends and laterally rotates arm
scapula
Supraspin Supraspinous fossa Superior facet of Suprascapular Initiates and assists deltoid in
atusb of scapula greater tubercle of nerve (C4, C5, abduction of arm and acts with
humerus C6) rotator cuff musclesb
Infraspina Infraspinous fossa Middle facet of Suprascapular
tusb of scapula greater tubercle of nerve (C5, C6)
Laterally rotate arm; help hold
humerus
humeral head in glenoid cavity of
Teres Middle part of Inferior facet of Axillary nerve
scapula
minor b
lateral border of greater tubercle of (C5, C6)
scapula humerus
Teres Posterior surface of Medial lip of Lower Adducts and medially rotates
major inferior angle of intertubercular subscapular arm
scapula groove of humerus nerve (C5, C6)
Subscapul Subscapular fossa Lesser tubercle of Upper and Medially rotates arm.
arisb (most of anterior humerus lower
surface of scapula) subscapular
nerves

Pectora Clavicle, sternum and Lateral lip of Medial and Flexion, adduction, and medial
lis seven costal cartilages; inter-tubercular lateral rotation of arm at gleno-humeral
major aponeurosis of external sulcus of pectoral joint
oblique humerus nerves 56
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Muscles that move the humerus … Scapular origins
Rotator cuff muscles (SITS)
• They are 4 scapulohumeral muscles (referred to as SITS)
– Supraspinatus
– infraspinatus
– teres minor
– subscapularis
• They are named rotator
cuff because they form a
cuff around the
glenohumeral joint
• All except the supraspinatus
are rotators of the humerus
 The supraspinatus,besides
being part of the rotator
cuff, initiates and assists the
deltoid in the first stage of
abduction of the arm 62
Anterior view
 Muscles that Move the Radius and Ulna
• Forearm flexors
– Biceps brachii
– Brachialis
– Coracobrachialis
They have common
innervations by
Musculocutaneous
nerve

• Forearm extensors
– Triceps brachi
– Anconeus

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 anterior arm Muscles that Move the Radius and Ulna
Muscle Origin Insertion Function
Coracobrachialis Apex of coracoid process on mid-shaft of Flexor of the arm at the gleno-
humerus humeral joint
Biceps brachii Long head-supraglenoid Radial Powerful flexor of the forearm
tubercle of scapula; short tuberosity and supinator of the forearm;
head-apex of coracoid process accessory flexor of the arm
Brachialis Anterior aspect of humerus Tuberosity of Powerful flexor of the forearm
the ulna at the elbow joint

Posterior arm muscle Forearm extensors

They are innervated by radial nerve
Triceps brachiiLong head: infra-glenoid Proximal end of Chief extensor of forearm; long
tubercle of scapula olecranon of ulna and head resists dislocation of
Lateral head: humerus, fascia of forearm humerus; during abduction

Medial head: humerus,

Anconeus Lateral epicondyle of olecranon process of extending forearm; stabilizes
humerus ulna elbow joint; may abduct ulna
during pronation

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70
Muscles for Pronation and Supination
• Wrist movements
contribute to our
great flexibility in
our use of our
hands

• Pronators
– Pronator teres
– Pronator
quadratus

• Supinators
– Supinator

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Muscles that Move the Wrist, Hand and Fingers
• The forearm is the location of many muscles, known as extrinsic
hand muscles, that produce a wide variety of movements
– movements of the wrist joint
– flexion of the fingers including the thumb
– pronation
• The anterior forearm muscles function as flexors
• All are innervated by median nerve, exceptFlexor Carpi Ulnaris and
Flexor Digitorum Profundus
• The posterior forearm muscles function as extensors
• All of them are innervated by radial nerve
• Both the anterior and posterior muscle groups are arranged in two
layers - superficial and deep

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 Muscles that Move the Wrist, Hand and Fingers
Anterior forearm muscles/Flexors
• They divided into 3 layers
– Deep, intermediate and
superficial layers
A septum of deep fascia separates
the deep layer from the superficial
& intermediate layers
• The tendons of most flexor
muscles pass across the
anterior surface of the wrist
• These tendons are held in
place by the flexor
retinaculum
– This retinaculum prevents
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bow stringing of the tendons
Muscles that Move the Wrist, Hand and Fingers
Anterior forearm muscles/Flexors
Name Description Action
Flex the wrist and
Flexors Found on the front (palmar side) of the arm.
fingers.
Arises from the common flexor tendon,
Flexor Carpi •Flexes the wrist.
becomes a thin tendon at the wrist and inserts
Radialis •Abducts the hand.
onto the base of the 2nd metacarpal.
Arises from the common flexor tendon,
Flexor Carpi becomes a thin tendon at the wrist and inserts •Flexes the wrist.
Ulnaris onto the 5th metacarpal and the carpal bones •Adducts the wrist.
(pisiform and hamate).
Arises from the common flexor tendon, divides
Flexor Digitorum
into 4 thin tendons each of which inserts onto a •Flexes fingers 2-5.
Superficialis
finger.
Flexor Digitorum Arises from the ulna, divides into 4 thin tendons •Flexes wrist.
Profundus each of which inserts onto to a finger. •Flexes fingers 2-5.
Flexor Pollicis Arises from the ulna, becomes a thin tendon at
Longus the wrist and inserts onto to the thumb. •Flexes the thumb.

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Posterior forearm muscles/Extensors
• They are divided into superficial (6)
& deep (4) groups
– 2 muscles in the suprf. group
(brachioradialis & extensor carpi
radialis longus) are attached to the
lateral supraepicondylar ridge of the
humerus
– The other 4 in the suprf. group (
extensor carpi radialis brevis,
extensor digitorum, extensor digiti
minimi, & extensor carpi ulnaris)
are attached by a common extensor
tendon to the lat. epicondyle of the
humerus
• The long extensor tendons are held in place by a fibrous band, the
extensor retinaculum
It prevents bow stringing of their tendons when the hand is
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hyperextended
Posterior forearm muscles/Extensors
Name Description Action
Extend the wrist
Extensors Found on the back (dorsal side) of the arm
and fingers
Arises from comm. extensor tendon, becomes a flat
Extensor Carpi •Extends the wrist
tendon at the wrist & inserts on the base of the 5th
Ulnaris •Adducts the wrist
metacarpal
Arises from the supracondylar ridge of the humerus,
Extensor Carpi •Extends the wrist
becomes a flat tendon at the wrist & inserts on the 2nd
Radialis Longus •Abducts the wrist
metacarpal
Extensor Carpi Arises from the comm. extensor tendon, becomes a flat •Extends the wrist
Radialis Brevis tendon at the wrist and inserts onto the 3rd metacarpal •Adducts the wrist
Extensor Arises from the common extensor tendon, divides into 4 •Extends the wrist.
Digitorum thin tendons each of which inserts onto a finger •Extends fingers 2-5
Extensor Digiti Arises from the common extensor tendon, becomes a •Extends the little
Minimi thin tendon at the wrist and inserts onto the little finger finger
Extensor Arises from the ulna it becomes a thin tendon at the
Pollicis Longus wrist and inserts onto the first finger •Extends the thumb
Extensor Arises from the radius it becomes a thin tendon at the
Pollicis Brevis wrist and inserts onto the base of the thumb. •Extends the thumb
Arises from the ulna becomes a thin tendon at the wrist •Extends the index
Extensor Indicis
and inserts onto the index finger finger 77
Intrinsic Muscles of the hand
• both originate and insert within
the hand
• They are innervated by branches
of the ulnar and median nerves
• They can be divided into 4
groups:
A. Thenar muscles in the thenar
compartment
B. Hypothenar muscles in the
hypothenar compartment
C. Lumbrical muscles in the central
• Thecompartment
flexibility of the hand is due
to
D. the large number
Interosseous of bones
muscles b/n the
andmetacarpal
joints, as well
bonesas to the
many muscles controlling them 78
Intrinsic Muscles of the Hand

79
Muscles of the hand …

Thenar muscles
• They produce the
thenar eminence
• They are chiefly
responsible for the
movement known as
the opposition of the
thumb
– Opposition - most
important movement of
the thumb
 The tip of the thumb is
brought in contact with
the palmar surface of the
5th digit & opposed to
other digits
80
Muscles of the hand …

Thenar muscles
Name Description Action
Thenar (thumb) Thumb
Muscles of the thumb.
group movements
A triangular muscle with 2 heads; it arises from the
Adductor Pollicis •Adducts thumb.
3rd metacarpal and inserts onto the thumb.
Abductor Pollicis A long thin muscle; it arises from the ulna and
Brevis radius and inserts onto the thumb. •Abducts thumb.
The fleshy part of the thumb; it arises from the
Opponens Pollicis flexor retinaculum and trapezium and inserts onto •Opposes thumb.
the thumb.
A thin muscle, it arises from the flexor retinaculum
Flexor Pollicis
and carpal bones (trapezium, trapezoid and •Flexes thumb.
Brevis
capitate) and inserts onto the thumb.

81
Hypothenar muscles
• These muscles deal with
the movement of the
5th digit
• They lie in the
hypothenar
compartment of the
palm with the
5th metacarpal bone
• The hypothenar muscles
produce the hypothenar
eminence, or ball of the
5th digit
• They are all supplied by
the deep branch of the
ulnar nerve
82
Muscles of the hand …

Hypothenar muscles
Hypothenar (little
Muscles of the little finger. Little finger movements.
finger) Group
A small muscle arising from the flexor
Abductor Digiti
retinaculum and pisiform and inserting •Abducts little finger.
Minimi
onto the little finger.
A small thin muscle arising from the flexor
Flexor Digiti
retinaculum and hamate and inserting •Flexes little finger
Minimi Brevis
onto the little finger.
A small muscle arising from the flexor
Opponens Digiti •Opposes little finger to
retinaculum and hamate and inserting
Minimi thumb.
onto the little finger.

83
Lumbrical muscles
• There are 4 slender lumbrical (L.
lumbricus, earthworm) muscles-
one for each digit
Action
– Flex & extend digits at the
metacarpophalangeal &
interphalangeal joints respectively

84
Muscles of the hand …

Lumbricals and Interosseous (Dorsal & Palmar)

Mid palmar Metacarpal and finger
Muscles of the palm.
Group movements.
Four muscles which originate in the palm •Flex metacarpophalangeal joints
Lumbricals
from the tendons of flexor digitorum of fingers 2-5.
(1-4)
profundus and insert onto the 2nd-5th •Extends interphalangeal joints of
fingers fingers 2-5.
Four muscles which arise from the
Abducts fingers 2-4.
Dorsal adjacent sides of the 1st and 2nd, 2nd and 3rd, •
Interosseous 3rd and 4th and 4th and 5th metacarpal •Flex metacarpophalangeal joints
of fingers 2-4.
(1-4) bones. They insert onto the 2nd-4th fingers
respectively •Extends interphalangeal joint.
Palmar Three muscles which originate from the •Adducts fingers 2, 4 and 5.
interosseous 2 , 4 and 5 metacarpal bones and insert •Flex metacarpophalangeal joints.
nd th th

(1-3) onto the 2nd, 4th and 5th fingers respectively •Extends interphalangeal joint.

85
 Interosseous muscles
• There are 7 interossei muscles located b/n the metacarpal bones
• They are arranged in 2 layers: 3 palmar and 4 dorsal muscles
Action
– The dorsal interossei
abduct the digits
(DAB: Dorsal ABduct)

86
Interosseous muscles…
Palmar interossei 1 to 3
Action
– The palmar interossei adduct the digits
(PAD: Palmar ADduct)
– They also assist the actions of the
lumbrical muscles.
– These are important movements in
typing, writing, and playing the piano

87
 Muscles of the lower limb
• Muscles Acting on the Hip, Knee, andFoot
• Lower limb muscles are larger and stronger - with posture and
stability being more important than range of motion are specialized
for locomotion and balance.
• They include the muscles that move the thigh and leg and those that
control movement of the foot
• Many of these muscles cross two joints and act on both
• Muscles crossing the hip and knee can be grouped into
– Hip flexors (4)
– Anterior compartment (4 knee extensors)
– Gluteal muscles (3)
– Lateral rotators (5)
– Medial compartment (6 adductors)
– Posterior compartment (3 knee flexors)
88
Hip flexors
Psoas Muscles
• Long, thick, powerful
muscle passes from the
abdomen to the thigh
deep to the inguinal
ligament
• Arise from the sides of
lumbar vertebrae to the
lesser trochanter of femur

Iliacus  Other hip flexors

 Sartorius
• Large triangular or fan-  Rectus femori
shaped muscle lies along
the lateral side of the Action of Iliopsoas
• Strongest flexor of the thigh at the hip joint
psoas major in the pelvis 89
Sartorius
• It is the longest muscle in the body, lies superficially in the anterior
compartment
• it arises from the anterior superior iliac spine, travels obliquely in
front of the thigh & attaches to the tibia
• It descends inferiorly as far as the side of the knee and acts across
two joints
• It flexes the hip and participates in flexion of the knee joint
• It also weakly abducts the thigh and laterally rotates it
The actions of both sartorius muscles bring the lower limbs into the
cross-legged sitting position
Quadriceps Muscle
It is the great extensor muscle of the leg, the biggest muscle in the
body
It is divided into 4 parts: Rectus femoris, Vastus lateralis, Vastus
medialis, Vastus intermedius
The names of the parts of the quadriceps m. indicate their form or
location (L. vastus, large) and (L. rectus, straight 90
Thigh muscles ... Anterior compartment
Quadriceps Muscle
• The rectus femoris has deep fibres
that run straight down the thigh
• The vastus intermedius is located
between vastus lateralis and
medialis
– They arise from the femur and attach
via a conjoined tendon to the patella
• The tendons of all of this large
muscle unite to form the quadriceps
tendon
• This broad tendon attaches to and
surrounds the patella and then
continues as the patellar ligament
(ligamentum patellae), which is
attached to the tuberosity of the 91
Thigh muscles … Anterior compartment
Quadriceps Muscle
• All parts of the
quadriceps, acting
through the patella
ligament, extend the leg
at the knee joint
– Through the actions of the
rectus femoris, they flex
the hip joint
• All four parts of this
muscle is used during
climbing, running,
jumping, and rising from
a chair
• They are innervated by
femoral nerve
92
Gluteal muscles
• This is the group of muscles that form the buttocks
• They include gluteal muscles consist of three glutei mm.
– Gluteus maximus
– G. Medius
– G. Minimus
– They all arise from the body of the ilium;
 Maximus also from sacrum and coccyx
• Insert onto the femur;
 Maximus inserts onto the gluteal tuberosity
 Medius and minimus inserted onto the greater trochanter of the femur

G. Maximus A - thigh extension, adduction, abduction, lateral

rotation
G. Medius - A - abducts and flexion and medially rotates thigh
(anterior fibers) lateral rotation by posterior fibers
G. minimus- A - abducts and medially rotates thigh and with gluteus
94
medius prevent tilting of the pelvis
Muscles of the gluteal region
They are Lateral rotators
Piriformis, Quadratus femoris, Obturator internus, the two gemillus

Muscle Origin Insertion Innervation Action

Piriformis Sacrum ant Greater T Brs from Lat rotation
S1&S2 &abduction
Obturator Anterolat Greater T Nerve to obt Lat rotation
internus pelvic wall & externus &abduction
obt memb
Gemellus Iscial spine Greater T Nerve to obt Lat rotation
superior externus &abduction
Gemellus Iscial spine Greater T Nerve to Lat rotation
inferior quadratus F &abduction
Quadratus Ischium lat Qauadrate Nerve to Lat rotation
femoris tubercle of quadratus F &abduction
IT crest
96
97
Medial compartment/Adductors
• These muscles form the inside (medial side) of the
thigh and are innervated by obturator nerve
• They include
– Adductor magnus
– Adductor longus
– Adductor brevis
– Pectineus
– Gracilis
– Obturator externus
Three layers
A. Superficial- pectineus, Gracilis and adductor L
B. Middle- Adductor b
C. Deep- Adductor M & obturator externus Most of
them arise from the body of pubis and inferior
ramus of pubis and ischium insert onto the femur
at different sites
• They are adductors of the femur except obturator
externus which is laterally rotates thigh
 They bring the thighs together, as in grasping a 99
saddle b/n the knees when riding
Thigh Muscles …
Posterior thigh muscles - Hamstring muscles
• Large bulk of 3 muscles on the back of
the thigh
• They arise from the ischial tuberosity
• Insert into the tibia or fibula
Biceps Femoris (2 heads; long & short)
Semitendinosus (has a long thin tendon).
Semimembranosus (it is membranous at
its origin)
They are innervated by sciatic nerve
• Extend hip and flex knee joint
Hamstring Injuries
• Hamstring strains (pulled and/or torn
hamstrings) are common in individuals
who run and/or kick hard (e.g., in
running, jumping, and quick-start sports
such as, basketball, football, and soccer)
101
Muscles of the Thigh …
Femoral triangle
Boundaries-
• Medial- medial boarder of adductor
longus
• Lateral- medial boarder of Sartorius
• Superior- inguinal ligament
• Floor- adductor longus, pectineus,
psoas and iliacus
Contents of the femoral triangle:
• Femoral sheath, femoral artery and its
branch, femoral vein and its
tributaries
• Femoral nerve and its branches
• Deep inguinal lymph nodes
103
•
Muscles of the leg – Anterior Compartment
• Muscles of the anterior
compartment are
innervated by deep fibular
• They pass and insert
anterior to the transversely
oriented axis of the ankle
(talocrural) joint
– Therefore, are
dorsiflexors of the ankle
joint, elevating the
forefoot and depressing
the heel

105
Muscles of the leg – Anterior Compartment
Muscles of the Leg Description Action
Anterior (extensor) Muscles found in the front of the Extends the ankle joint
compartment of the leg leg. (dorsiflexes) and the toes.
It arises from the tibial shaft and
runs down the front of the leg •Dorsiflexes ankle.
Tibialis anterior
becoming tendinous at the ankle to •Inverts foot.
attach to the medial cuneiform.

It arises from the front of the tibia

and fibula and runs down the front •Extends the 4 lateral toes.
Extensor digitorum
of the leg dividing at the ankle into •Assists dorsiflexion of the
Longus
4 tendons which attach to the 4 ankle
lateral toes.
Extensor hallucis It arises from anteriomedial fibula Extends great toe and
longus shaft and interosseous membrane dorsiflexes ankle
To distal phalanx of great toe

Fibularis tertius From the distal surface of fibula Dorsiflexes ankle and aids
and interosseous membrane in inversion of foot
To dorsum of fifth metatarsal

106
Leg Muscles – Lateral/peroneal
compartment
• They are evertor Longus - from upper lateral surface of the fibula to
the base of the 5th toe
compartment, is the smallest
(narrowest) of the leg Brevis – from lower lateral surface of fibula to the
base of 1st metatarsal
compartments
• They are innervated by
superficial fibular
• This group is plantar flexor
and evertor of the foot, fibular
abduction and maintain
transverse arch
– Peroneus longus
– Peroneus brevis
• The compartment ends
inferiorly at the superior
fibular retinaculum, which
spans between the distal tip of 108
Leg Muscles
Muscles that –Move
Posterior compartment
the Foot and Toes
• They are primarily
plantar flexors and flex
the toes
• They are innervated by
sciatic nerve
• Superficial
– Gastrocnemius
– Soleus
– Plantaris
• Deep
– Tibialis posterior
– Flexor digitorum longus
– Flexor hallucis longus
– Popliteus

109
Leg Muscles – Posterior compartment
Name Description Action
Together with soleus it forms the bulk of the calf. It
arises from the femur via two heads, which form the
Gastrocnemius borders of the popliteal fossa. The two heads merge •Flexes knee.
with soleus inferiorly to form tendo calcaneus (Achilles •Plantar flexes ankle.
tendon) which inserts onto the back of the calcaneus
Soleus See above •Plantar flexes ankle
Lies deep in the calf arising from the back of the tibia •Assists plantar
Tibialis flexion (extension) of
and fibula. It becomes tendinous at the back of the
posterior the ankle, Inverts
ankle where it travels into the sole of the foot.
foot
Arising from the back of the tibia it lies deep in the calf.
Flexor •Plantar flexes ankle.
It becomes tendinous at the back of the ankle, travels
Digitorum •Flexes the 4 lateral
into the sole of the foot. In the foot it divides into 4
Longus toes.
tendons which attach to the 4 lateral toes

Arises deep in the calf from the back of the fibula. It •Flexes big toe
Flexor hallucis (hallux).
becomes tendinous at the back of the ankle where it
longus •Assists plantar
enters the sole of the foot to attach to the big toe
flexion of the ankle
Lat. surface of lateral condyle of femur to Posterior
Popliteus Flexes knee
surface of tibia
Plantaris It arises from the lateral supracondylar line of femur •assists gastrocnemius
110
The dorsum of the foot
• There are two closely connected muscles
on the dorsum of the foot
• Extensor digitorum brevis
• Extensor hallucis brevis ( medial slip of
the extensor digitorum brevis )
• These broad thin muscles form a fleshy
mass on the lateral part of the dorsum of
the foot, anterior to the lateral malleolus,
which can be seen in most feet and felt in
all of them
• Actions: the extensor digitorum brevis
extends the second to fourth digits at the
metatarsophalangeal joints, and the
extensor hallucis brevis extends the first
digit or great toe at the
metatarsophalangeal joint.
• These muscles help the long extensor 112
 The sole of the foot
• Plantar aponeurosis- thickened deep fascia, tout when
toes are dorsiflexed (arch of foot increases)
– Attachments- posterior- tubercle of calcaneus; anteriorly divide
in to five slips and again each divide in to two and become
continuous with flexor sheaths of the digits
– Function – protection, keep the longitudinal arch
• There are four muscular layers in the sole of the foot
1. First layer – three muscles
2. Second layer – two muscles and two tendons
3. Third layer - Three muscles
4. Fourth layer - Two muscles and two tendons
• These muscles serve major roles in support of the body and
locomotion
• Flexion of the toes and a role in the longitudinal arch of the foot 113
are
First layer
• Two abductors and one flexor in
b/n the abductors
• Origin – calcaneus
1. Abductor hallucis inserts in to
the proximal phalanx of hallux.
2. Abductor digiti minimi inserts in
the proximal phalanx of toe 5
3. Flexor digitorum brevis inserts in
to the middle phalanges of 2- 5
by splitting in to 2 bands
• These muscles act as a functional
group that acts as an elastic spring
for supporting the arches of the
foot and maintaining the
concavity of the foot.

114
Second layer
• Muscles of the second layer flex,
adduct, and abduct the toes
• Muscles include
– Flexor digitorum accessorius
(quadratus plantae); has to
heads (medial and lateral);
– Four lumbricales- origin form
medial side of the long
tendons of flexor muscles
arranged from 1st to 4th from
medial to lateral. The lateral 2
are innervated by medial nerve
and the 1st by ulnar nerve.
 Tendons – flexor hallucis longus
and flexor digotrum longus

115
Third layer
• This layer has 3 short
muscles of the great and
small digits, which lie in the
anterior half of the sole of
the foot.
• Two act on the great digit
and one on the small digit.
• Includes: flexor hallucis
brevis, adductor hallucis and
flexor digiti minimi.
• A sesamoid bone adheres to
each of the tendons of the
two heads of flexor hallucis 116
Fourth layer

• Tendons of tibialis posterior and

peroneus L
• Muscles
1. Plantar interossei – three
Action - adduct 3rd, 4th, and 5th toes toward 2nd toe
2. Dorsal interossei- 4 , each arise from adjacent
metatarsal (bipennate arrangement)
Action- adduction of 2nd , 3rd &4th digits away from line
of 2nd toe, flex metacarpophalangeal J. and extend
interphalangeal J

117