Oina

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

Openings in the Skull

Bone of the Skull

Structures Transmitted

Anterior Cranial Fossa Perforations in the Cribriform plate

Ethmoid

Olfactory nerves

Middle Cranial Fossa Optic Canal

Lesser wing of the Sphenoid

Optic nerve, ophthalmic artery

Superior Orbital Fissure

Between lesser and greater wings of the Sphenoid

Lacrimal, frontal, trochlear, oculomotor, nasociliary nasociliary and abducent nerves; superior ophthalmic vein

Foramen Rotundum

Greater wing of the Sphenoid

Mai aillary ary !ivision of the "rigemi eminal #erve

Foramen Ovale

Greater wing of the Sphenoid

Mandib dibular div division of the "rigeminal #erve

Foramen Spinosum

Greater wing of the Sphenoid

Middle meningeal artery

Foramen acerum

Between petrous part of temporal and Sphenoid

$nternal carotid artery

Posterior Cranial Fossa Foramen Magnum

Occipital

Medulla Oblongata, spinal part of accessory nerve, and right and left vertebral arteries

!"poglossal !"poglossal Canal

Occipital

%ypoglossal nerve

#ugular Foramen

Between petrous part of temporal and condylar part of occipital

Glossopharyngeal, vagus, and accessory nerves; sigmoid sinus becomes internal &ugular vein

$nternal Acoustic Meatus

'etrous part of temporal

(estibulocochlear and facial nerves

Muscles of the %"eball and %"elids

Muscle

Origin

$nsertion

$nnervation

Action

%&trinsic Muscles of %"eball 'Striated Skeletal Muscle( Superior Rectus

"endinous ring on

Superior surface of

)#$$$

*aises cornea

2

posterior wall of orbital cavity

eyeball &ust posterior to corneoscleral  &unction

upward and medially

$nferior Rectus

"endinous ring on posterior wall of orbital cavity

$nferior surface of eyeball &ust posterior to corneoscleral  &unction

)#$$$

!epresses cornea downward and medially

Medial Rectus

"endinous ring on posterior wall of orbital cavity

Medial surface of eyeball &ust posterior to corneoscleral  &unction

)#$$$

*otates eyeball so that cornea loo+s medially

ateral Rectus

"endinous ring on posterior wall of orbital cavity

Lateral surface of eyeball &ust posterior to corneoscleral  &unction

)#($

*otates eyeball so that cornea loo+s laterally

Superior Obli)ue

'osterior wall of orbital cavity

'asses through pulley and is attached to superior surface of eyeball beneath superior rectus

)#$(

*otates eyeball so that cornea loo+s downward and laterally

$nferior Obli)ue

loo loorr of orb orbit ital al cav cavit ity y

Late Latera rall surf surfac ace e of eyeball deep to lateral rectus

)#$$$

*otates eyeball so that cornea loo+s upward and laterally

$ntrinsic Muscles of %"eball 'Smooth Muscle( Sphincter Pupillae of $ris

'arasympathetic via )#$$$

)onstricts pupil

*ilator" Pupillae of $ris

Sympathetic

!ilates pupil

Ciliar" Muscle

'arasympathetic via )#$$$

)ontrols shape of lens; in accommodation, ma+es lens more globular 

Muscles of %"elids Orbicularis Oculi Palpebral Part

Medial palpebral ligament

Lateral palpebral raphe

acial nerve

)loses eyelids and dilates lacrimal sac

Orbital Part

Medial palpebral ligament and ad&oining bone

Loops return to origin

acial nerve

"hrows s+in around orbit into folds to protect eyeball

Bac+ Bac+ of of orbi orbita tall cav cavit ity y

-nte -nteri rior or sur surfa face ce and and upper margin of

Striated muscle oculomotor nerve,

*aises upper lid

evator Palpebrae Superioris

superior tarsal plate

smooth muscle Sympathetic

Muscles of the !ead Muscle Occipitofrontalis Occipital bell"

Origin

$nsertion Muscle of Scalp

$nnervation

3 Action

%ighest nuchal line of  Epicranial acial nerve occipital bone aponeurosis S+in and superficial facia of eyebrows Muscles of Facial %&pression

Moves scalp on s+ull and raises eyebrows

Medial palpebral ligament Medial palpebral ligament and ad&oining bone Superciliary arch

Lateral palpebral raphe Loops return to origin

acial nerve

S+in of eyebrow

acial nerve

 -poneurosis of bridge of nose -la of nose

acial nerve

*ilator ,aris

rontal process of mailla Mailla

Procerus

#asal bone

acial nerve

Orbicularis Oris

Mailla, mandible and s+in

S+in between eyebrows Encircles oral orifice

)loses eyelids and dilates lacrimal sac "hrows s+in around orbit into folds to protect eyeball (ertical wrin+les of forehead, as in fro+ning )ompresses mobile nasal cartilages .idens nasal aperture .rin+les s+in of nose

Frontal bell"

Orbicularis Oculi Palpebral Part Orbital Part

Corrugator Supercilii Compressor ,asi

acial nerve

acial nerve

acial nerve

)ompresses lips together 

acial nerve

Separate lips

acial nerve

)ompresses chee+s and lips against teeth !epresses mandible and angle of mouth

*ilator Muscles of ips evator abii Superioris Alae)ue ,asi evator abii Superioris -"gomaticus Minor  -"gomaticus Ma.or  evator Anguli Oris Risorius *epressor Anguli Oris *epressor abii $nferioris Mentalis Buccinator  Plat"sma

Masseter  Temporalis

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

Outer surface of alveolar margins of mailla, mandible and pterygomandibular ligament !eep fascia over Body of mandible and pectoralis ma&or and angle of mouth deltoid Muscles of Mastication /ygomatic arch Lateral surface ramus of mandible loor of temporal )oronoid process of fossa mandible

acial nerve cervical branch

Mandibular division of  trigeminal nerve Mandibular division of  trigeminal nerve

Elevates mandible to occlude teeth  -nterior and superior fibers elevate mandible; posterior fibers retract

ateral Pter"goid 't+o heads( Medial Pter"goid 't+o heads(

Greater wing of sphenoid and lateral pterygoid plate "uberosity of mailla and lateral pterygoid plate

4

#ec+ of mandible and articular sac

mandible Mandibular division of  'ulls nec+ of trigeminal nerve mandible forward

Medial surface of angle of mandible

Mandibular division of  Elevates mandible trigeminal nerve

Muscles of Tongue

Muscle ongitudinal

Origin Median septum and submucosa

$nsertion $ntrinsic Muscles Mucous membrane

$nnervation

Action

)#0$$

-lters shape of tongue

)#0$$

'rotrudes ape of tongue through mouth !epresses tongue

Transverse /ertical 0enioglossus

Superior genial spine of mandible

%&trinsic Muscles Blends with other muscles of tongue

!"oglossus

Body of greater cornu of hyoid bone Styloid process of temporal bone

Blends with other muscles of tongue Blends with other muscles of tongue

)#0$$

'alatine aponeurosis

Side of tongue

'haryngeal pleus

St"loglossus

Palatoglossus

)#0$$

!raws tongue upward and bac+ward 'ulls roots of tongue upward and bac+ward, narrows oropharyngeal isthmus

Muscles of the ,eck Muscle Plat"sma

SCM

*igastric Posterior bell"

Origin !eep fascia over pectoralis ma&or and deltoid Manubrium sterni and medial third of the clavicle

$nsertion Body of mandible and angle of mouth

$nnervation acial nerve cervical branch

Action !epresses mandible and angle of mouth

Mastoid process of temporal bone and occipital bone

Spinal part of accessory nerve and )1 and )2

"wo muscles acting together etend head and fle nec+; one muscle rotates head to opposite side

Mastoid process of temporal bone

$ntermediate tendon is held to hyoid by fascial sling

acial nerve

!epresses mandible or elevates hyoid bone

Anterior bell" St"loh"oid M"loh"oid

Body of mandible Styloid process Mylohyoid line of body of mandible

0enioh"oid

$nferior mental spine of mandible

Body of hyoid bone

irst cervical nerve

Sternoh"oid

Manubrium sterni and

Body of %yoid bone

-nsa cervicalis; )3, 1

Body of hyoid bone Body of hyoid bone and fibrous raphe

#erve to mylohyoid acial nerve $nferior alveolar nerve

Elevates hyoid bone Elevates floor of mouth and hyoid bone or depresses mandible Elevates hyoid bone or depresses mandible !epresses hyoid

Sternoth"roid

Th"roh"oid

Omoh"oid $nferior bell"

Superior bell" Scalenius Anterior 

Scalenius Medius

Scalenius Posterior

clavicle Manubrium sterni

Obli5ue line on lamina of thyroid cartilage

Obli5ue line on lamina of thyroid cartilage Lower border of body of hyoid bone

5

42  -nsa cervicalis; )3, 1 42

bone !epresses laryn

irst cervical nerve

!epresses hyoid bone or elevates laryn

6pper margin of scapula and suprascapular ligament Lower border of body of hyoid bone "ransverse processes of 2rd, 7th 8th and 9th cervical vertebrae "ransverse processes of upper si cervical vertebrae

$ntermediate tendon is held to clavicle and first rib by fascial sling

 -nsa cervicalis; )3, 1 42

!epresses hyoid bone

irst rib

)7, 8 4 9

irst rib

-nterior rami of cervical nerves

"ransverse process of lower cervical vertebrae

Second rib

-nterior rami of cervical nerves

Elevates first rib; laterally flees and rotates cervical part of vertebral column Elevates first rib; laterally flees and rotates cervical part of vertebral column Elevates second rib; laterally flees and rotates cervical part of vertebral column

Cranial ,erves

Olfactor"

,erve

Components Sensory

Optic Oculomotor 

Sensory Motor

Trochlear 

Motor

Trigeminal Ophthalmic division

Sensory

Ma&illar" division

Sensory

Mandibular division

Motor

Sensory

Function Smell (ision Lifts upper eyelid, turns eyeball upward, downward and medially; constricts pupil; accommodates eye -ssists in turning eyeball downward and laterally )ornea, s+in of forehead, scalp, eyelids and nose; also mucous membrane of paranasal sinuses and nasal cavity S+in of face over mailla and the upper lip; teeth of upper &aw; mucous membrane of nose, the maillary air sinus, and palate Muscles of mastication, mylohyoid, anterior belly of digastrics, tensor veli palatini and tensor tympani S+in of chee+, s+in over mandible, lower lip and side of head; teeth of lower &aw and temporomandibular

Opening in Skull Openings in cribriform plate of ethmoid Optic canal Superior Orbital issure

Superior Orbital fissure

Superior Orbital issure

oramen *otundum

oramen Ovale

Abducent

Motor

Facial

Motor

Sensory

Secretomotor parasympathetic

/estibulocochlear  /estibular 

Sensory

Cochlear  0lossophar"ngeal

Sensory Motor Secretomotor parasympathetic Sensory

/agus

Motor

Sensory

Accessor" Cranial root Spinal root !"poglossal

Motor Motor Motor

 ∮ mucous membrane of mouth and anterior two thirds of tongue Lateral rectus muscle: turns eyeball laterally Muscles of face, chee+ and scalp; stapedius muscle of middle ear; stylohyoid; and posterior belly of digastrics "aste from anterior two thirds of tongue, floor of mouth and palate Submandibular and sublingual salivary glands, lacrimal gland and glands of nose and palate 'osition and movement of head %earing Stylopharyngeus muscle; assists swallowing 'arotid salivary gland General sensation and taste from posterior third of tongue and pharyn; carotid sinus and carotid body )onstrictor muscles of phayn and intrinsic muscles of laryn; involuntary muscle of trachea and bronchi, heart, alimentary tract from pharyn to spleni fleure of colon; liver and pancreas "aste from epiglottis and vallecula and afferent fibers from structures named above Muscles of soft palate, pharyn and laryn Sternocleidomastoid and trape

6

Superior orbital fissure

$nternal acoustic meatus, facial canal stylomastoid foramen

$nternal acoustic meatus

ugular oramen

ugular oramen

ugular oramen

%ypoglossal )anal

7 Muscles Connecting the 1pper imb to the Thoracic 2all3 Muscles of the Pectoral Region 'e&cept Serratus Anterior(

Muscle Pectoralis Ma.or 

Origin )lavicle, sternum and upper si costal cartilages

$nsertion Lateral lip of the bicipital groove of humerus

$nnervation Medial and lateral pectoral nerves form brachial pleus

Action  -dducts arm and rotates it medially; clavicular fibers also fle arm

Pectoralis Minor 

2rd, 7th and 8th ribs

)oracoid process of scapula

Medial pectoral nerve from brachial pleus

!epresses point of shoulder; if the scapula is fied, it elevates the ribs of origin

Subclavius

irst costal cartilage

)lavicle

#erve to subclavius from upper trun+ of brachial pleus

!epresses the clavicle and steadies this bone during movements of the shoulder girdle

Serratus Anterior 

6pper eight ribs

Medial border and inferior angle of the scapula

Long thoracic nerve

!raws the scapula forward around the thoracic wall; rotates the scapula

Muscles Connecting the 1pper limb to the /ertebral Column3 Superficial 'Appendicular( 0roup of Back Muscles

Muscle Trape4ius

Origin Occipital bone, ligamentum nuchae, spine of ?th cervical vertebra, spines of all thoracic vertebra

$nsertion 6pper fibers into lateral third of clavicle; middle and lower fibers into acromion and spine of the scapula

$nnervation Spinal part of accessory nerve =motor> and )2 and )7 =sensory>

Action 6pper fibers elevate the scapula; middle fibers pull the scapula medially; lower fibers pull medial border of the scapula downward

atissimus *orsi

$liac crest, lumbar fascia, spines of lower si thoracic vertebrae, lower three or four ribs, and inferior angle of the scapula

loor of bicipital groove of humerus

"horacodorsal nerve

Etends, adducts and medially rotates the arm

evator Scapulae

"ransverse processes of first four  cervical vertebrae

Medial border of the scapula

)2 and )7 and dorsal scapular nerve

*aises medial border  of the scapula

8

Rhomboid Minor 

Ligamentum nuchae and spines of ?th cervical vertebra and 3st thoracic vertebra

Medial border of the scapula

!orsal scapular nerve

*aises medial border  of scapula upward and medially

Rhomboid Ma.or 

1nd to 8th thoracic spines

Medial border of scapula

!orsal scapular nerve

*aises medial border  of scapula upward and medially

Muscles Connecting the Scapula to the !umerus

Muscle *eltoid

Origin Lateral third of clavicle, acromion, spine of scapula

$nsertion Middle of lateral surface of shaft of humerus

$nnervation  -illary nerve

Action -bducts arm; anterior  fibers fle and medially rotate arm; posterior fibers etend and laterally rotate arm

Supraspinatus

Supraspinous fossa of scapula

Greater tuberosity of humerus; capsule of shoulder &oint

Spurascapular nerve

-bducts arm and stabili
$nfraspinatus

$nfraspinous fossa

Greater tuberosity of humerus; capsule of shoulder &oint

Suprascapular nerve

Teres Ma.or 

Lower third of lateral border of scapula

Medial lip of bicipital groove of humerus

Lower subscapular nerve

Teres Minor 

6pper two thirds of lateral border of the scapula

Greater tuberosity of  -illary nerve the humerus; capsule of shoulder &oint

Subscapularis

Subscapular fossa

Lesser tuberosity of humerus

6pper and lower subscapular nerves

Laterally rotates arm and stabili
Muscles of the Arm

Muscle

Origin

$nsertion Anterior Compartment

$nnervation

Action

Biceps Brachii ong head

Supraglenoid tubercle of scapula

Short head

)oracoid process of scapula

"uberosity of radius and bicipital aponeurosis into deep fascia of forearm

Musculocutaneous nerve

Supinator of forearm and fleor of elbow  ∮ wea+ fleor of shoulder &oint

9

Coracobrachialis

)oracoid process of scapula

Medial aspect of shaft of humerus

Musculocutaneous nerve

lees arm and also wea+ adductor 

Brachialis

ront of lower half of humerus

)oronoid process of ulna

Musculocutaneous nerve

leor of elbow &oint

Posterior Compartment Triceps ong head

$nfraglenoid tubercle of scapula

ateral head

6pper half of posterior surface of shaft of humerus

Medial head

Olecranon process of  ulna

*adial nerve

Etensor of elbow  &oint

Lower half of posterior surface of shaft of humerus

Muscles of the Anterior Fascial Compartment of the Forearm Muscle Pronator Teres !umeral head

1lnar head

Origin

$nsertion

$nnervation

Action

Medial epicondyle of humerus Medial border of coronoid process of ulna

Lateral aspect of the shaft of radius

Median nerve

'ronation and fleion of forearm

Fle&or Carpi Radialis

Medial epicondyle of humerus

Bases of 1nd and 2rd metacarpal bones

Median nerve

lees and abducts hand at wrist &oint

Palmaris ongus

Medial epicondyle of humerus

leor retinaculum and palmar aponeurosis

Median nerve

lees hand

'isiform bone, hoo+ of the hamate, base at 8th metacarpal bone

6lnar nerve

lees and adducts hand at wrist &oint

Middle phalan of

Median nerve

lees middle

Fle&or Carpi 1lnaris !umeral head

1lnar head

Medial epicondyle of humerus Medial aspect of olecranon process and posterior border of ulna

Fle&or *igitorum Superficialis !umeroulnar

Medial epicondyle of

head

10

humerus; medial border of coronoid process of ulna

phalan of fingers and assists in fleing proimal phalan and hand

medial four fingers Radial head

Obli5ue line on anterior surface of shaft of radius

Fle&or Pollicis ongus

 -nterior surface of shaft of radius

!istal phalan of thumb

 -nterior interosseus branch of median nerve

lees distal phalan of thumb

Fle&or *igitorum Profundus

 -nteromedial surface of shaft of ulna

!istal phalanges of medial four fingers

6lnar =medial half> and median =lateral half> nerves

lees distal phalan of fingers; then assists in fleion of middle and proimal phalanges and wrist

Pronator 5uadratus

 -nterior surface of shaft of ulna

 -nterior interosseus branch of median nerve

'ronates forearm

 -nterior surface of shaft or radius

Muscles of the ateral Fascial Compartment of the Forearm

Muscle Brachioradialis

Origin $nsertion Lateral supracondylar  Base of styloid ridge of humerus process of radius

$nnervation *adial nerve

Action lees forearm at elbow ∮ rotates forearm to the midprone position

%&tensor Carpi Radialis ongus

Lateral supracondylar  'osterior surface of ridge pf the humerus base of 1nd metacarpal bone

*adial nerve

Etends and abducts hand at wrist &oint

Muscles of the Posterior Fascial Compartment of the Forearm

Muscle %&tensor Carpi Radialis Brevis

Origin Lateral epicondyle of  humerus

$nsertion 'osterior surface of base of third metacarpal bone

$nnervation !eep branch of radial nerve

Action Etends and abducts hand at wrist &oint

%&tensor *igitorum

Lateral epicondyle of  humerus

Middle and distal phalanges of medial four fingers

!eep branch of radial nerve

Etends fingers and hand

%&tensor *igiti Minimi

Lateral epicondyle of  humerus

Etensor epansion of little finger 

!eep branch of radial nerve

Etends metacarpophalangeal  &oint of little finger 

%&tensor Carpi 1lnaris

Lateral epicondyle of  humerus

Base of fifth metacarpal bone

!eep branch of radial nerve

Etends and adducts hand at wrist &oint

Anconeus

Lateral epicondyle of  humerus

Lateral surface of *adial nerve olecranon process of 

Etends elbow &oint

ulna

11

Supinator 

Lateral epicondyle of  humerus

#ec+ and shaft of radius

!eep branch of radial nerve

Supination of forearm

Abductor Pollicis ongus

'osterior surface of shaft of radius and ulna

Base of first metacarpal bone

!eep branch of radial nerve

Etends and abducts thumb

%&tensor Pollicis Brevis

'osterior surface of shaft or radius

Base of proimal phalan of thumb

!eep branch of radial nerve

Etends metacarpophalangeal  &oint of thumb

%&tensor Pollicis ongus

'osterior surface of shaft of ulna

Base of distal phalan of thumb

!eep branch of radial nerve

Etends distal phalan of thumb

%&tensor $ndicis

'osterior surface of shaft of ulna

Etensor epansion of inde finger 

!eep branch of radial nerve

Etends metacarpophalangeal  &oint of inde finger 

Small Muscles of the !and Muscle Palmaris Brevis

Origin leor retinaculum, palmar aponeurosis

$nsertion S+in of palm

$nnervation Action Superficial branch of   )orrugates s+in to ulnar nerve improve grip of palm

umbricals '6(

"endons of fleor digitorum profundus

Etensor epansion of medial four fingers

3st and 1nd =i@e@ lees lateral two> median metacarpophalangeal rd th nerve; 2  and 7  &oints and etend deep branch of ulnar  interphalangeal &oints of nerve fingers ecept thumb

Palmar '6(

irst arises from base of 3st metacarpal; remaining three from anterior surface of shafts of 1nd, 7th and 8th metacarpals

'roimal phalanges of thumb and inde, ring and little fingers and dorsal etensor epansion of each finger 

!eep branch of ulnar  'almar interossei adduct nerve fingers toward center of third finger

*orsal '6(

)ontiguous sidesof shafts of metacarpal bones

'roimal phalanges of inde, middle and ring fingers and dorsal etensor epansion

!eep branch of ulnar  !orsal interossei abduct nerve fingers from center of third finger; both palmar and dorsal fle metacarpophalangeal  &oints and etend interphalangeal &oints

$nterossei '7(

Short Muscles of Thumb 'Thenar Muscles; pollicis- thumb( Abductor Pollicis Brevis

Scaphoid, trape
Base of proimal phalan of thumb

Median nerve

-bduction of thumb

12

Fle&or Pollicis Brevis

leor retinaculum

Base of proimal phalan of thumb

Median nerve

lees metacarpophalangeal  &oint of thumb

Opponens Pollicis

leor retinaculum

Shaft of metacarpal bone of thumb

Median nerve

'ulls thumb medially and forward across palm

Adductor Pollicis

Obli5ue head; 1nd and 2rd metacarpal bones; transverse head; 2rd metacarpal bone

Base of proimal phalan of thumb

!eep branch of ulnar   -dduction of thumb nerve

Short Muscles of ittle Finger ' Hypothenar Muscles; digiti minimi- 5 th digit ( Abductor *igiti Minimi

'isiform bone

Base of proimal phalan of little finger 

!eep branch of ulnar   -bducts little finger  nerve

Fle&or *igiti Minimi

leor retinaculum

Base of proimal phalan of little finger 

!eep branch of ulnar  lees little finger  nerve

Opponens *igiti Minimi

leor retinaculum

Medial border of 8th metacarpal bone

!eep branch of ulnar  'ulls 8th metacarpal nerve forward as in cupping the palm

Summar" of the Branches of the Brachial Ple&us and their *istribution

Branches

*istribution Roots

*orsal Scapular ,erve 'C8(

*homboid minor, rhomboid ma&or, levator scapulae

ong Thoracic ,erve 'C89 :9 ;(

 Serratus anterior  1pper Trunk

Suprascapular ,erve 'C89 :(

Supraspinatus and infraspinatus

,erve to Subclavius 'C89 :(

Subclavius ateral Cord

ateral Pectoral ,erve 'C89 :9 ;(

'ectoralis ma&or

Musculocutaneous ,erve 'C89 :9 ;(

)oracobrachialis, biceps brachii, brachialis; supplies s+in along lateral border of forearm when it becomes the lateral cutaneous nerve of the forearm

ateral root of Median ,erve 'C89 :9 ;(

=See medial root of median nerve> Posterior Cord

13

1pper Subscapular ,erve 'C89 :(

Subscapularis

Thoracodorsal ,erve 'C:9 ;9 7(

Latissimus dorsi

o+er Subscapular ,erve 'C89 :(

Subscapularis and teres ma&or 

A&illar" ,erve 'C89 :(

!eltoid and teres minor; upper and lateral cutaneous nerve of arm supplies s+in over lower half of deltoid muscle

Radial ,erve 'C89 :9 ;9 7< T=(

"riceps, anconeus, part of brachialis, E)*L; via deep radial nerve branch supplies etensor muscles of forearm: supinator, E)*B, E)6, E!, E!M, E$, -b'L, E'L, E'B; s+in, lower lateral cutaneous nerve of arm, po sterior cutaneous nerve of arm, and posterior cutaneous nerve of  forearm; s+in on lateral side of dorsum of hand and dorsal surface of lateral three and a half of fingers; articular branches to elbow, wrist and hand Medial Cord

Medial Pectoral ,erve 'C7< T=(

'ectoralis ma&or and pectoralis minor 

Medial Cutaneous ,erve of arm .oined b" intercostals brachial nerve from second intercostals nerve 'C7< T=9 >(

S+in of medial side of arm

Medial Cutaneous ,erve of forearm 'C7< T=(

S+in of medial side of forearm

1lnar ,erve 'C7< T=(

)6 and medial half of !', !M, O!M, -b!M, -d', 2 rd and 7th lumbricals, interossei, 'B, s+in of medial half of dorsum of hand and palm, s+in of palmar and dorsal surfaces of medial one and a half fingers

Medial root of Median ,erve '+ith lateral root( forms Median ,erve 'C89 :9 ;9 7< T=(

'", )*, 'L, !S, -b'B, 'B, O', first two lumbricals =by way of anterior interosseus branch>, 'L, !' =lateral half>, 'A, palmar cutaneous branch to lateral half of palm and digital branches to palmar surface of lateral three and a half fingers; articular branches to elbow, wrist and carpal  &oints

Muscles of the 0luteal Region Muscle 0luteus ma&imus

Origin $nsertion ,erve Suppl" Action Outer surface of ilium, $liotibial tract and gluteal $nferior gluteal nerve Etends and laterally rotates hip sacrum, coccy, tuberosity of femur   ∮ through iliotibial tract, it sacrotuberous ligament etends +nee &oint

0luteus medius

Outer surface of ilium

0luteus minimus

Outer surface of ilium

Tensor fasciae $liac crest latae Piriformis  -nterior surface of sacrum Obturator $nner surface of internus obturator membrane 0emellus Spine of ischium superior  0emellus $schial tuberosity inferior  5uadratus Lateral border of ischial femoris tuberosity

Lateral surface of greater trochanter of femur  -nterior surface of greater trochanter of femur  $liotibial tract

Superior gluteal nerve Superior gluteal nerve

Superior gluteal nerve 6pper border of greater irst and second trochanter of femur  sacral nerves 6pper border of greater Sacral pleus trochanter of femur  6pper border of greater Sacral pleus trochanter of femur  6pper border of greater Sacral pleus trochanter of femur  Auadrate tubercle of Sacral pleus femur 

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 -bducts thigh at hip ∮ tilts pelvis when wal+ing to permit opposite leg to clear ground  -bducts thigh at hip ∮ tilts pelvis when wal+ing to permit opposite leg to clear ground  -ssists gluteus maimus in etending the +nee &oint Lateral rotator of thigh at hip  &oint Lateral rotator of thigh at hip  &oint Lateral rotator of thigh at hip  &oint Lateral rotator of thigh at hip  &oint Lateral rotator of thigh at hip  &oint

Muscles of the Anterior Fascial Compartment of the Thigh Muscle Sartorius

Origin  -nterior superior iliac spine

$nsertion ,erve Suppl" 6pper medial surface of emoral nerve shaft of tibia

$liacus

$liac fossa of hip bone

.ith psoas into lesser trochanter of femur 

Psoas

"ransverse processes, .ith iliacus into lesser Lumbar pleus bodies, and trochanter of femur  intervertebral discs of the 31th thoracic and five lumbar vertebrae Superior ramus of pubis 6pper end of linea emoral nerve aspera of shaft of femur 

Pectineus 5uadriceps femoris   Rectus femoris

  /astus lateralis

  /astus medialis

  /astus intermedius

Straight head: anterior inferior iliac spine *eflected head: ilium above acetabulum 6pper end and shaft of femur 

Auadriceps tendon into patella, then via ligamentum patellae into tubercle of tibia Auadriceps tendon into patella, then via ligamentum patellae into tubercle of tibia 6pper end and shaft of Auadriceps tendon into femur  patella, then via ligamentum patellae into tubercle of tibia  -nterior and lateral Auadriceps tendon into surfaces of shaft of patella, then via femur  ligamentum patellae into tubercle of tibia

emoral nerve

Action lees, abducts, laterally rotates thigh at hip ∮ flees and medially rotates leg at +nee &oint lees thigh on trun+; if thigh is fied, it flees the trun+ on the thigh as in sitting up from lying down lees thigh on trun+; if thigh is fied, it flees the trun+ on thigh as in sitting up from lying down

lees and adducts thigh at hip  &oint

emoral nerve

Etension of leg at +nee ∮ flees thigh at hip &oint

emoral nerve

Etension of leg at +nee &oint

emoral nerve

Etension of leg at +nee ∮ stabili
emoral nerve

Etension of leg at +nee ∮ articularis genus retracts synovial membrane

Muscles of the Medial Fascial Compartment of the Thigh Muscle

Origin

$nsertion

,erve Suppl"

Action

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0racilis

$nferior ramus of pubis, 6pper part of shaft of Obturator nerve -dducts thigh at hip ∮ flees leg ramus of ischium tibia on medial surface at +nee &oint Body of pubis, medial to 'osterior surface of Obturator nerve -dducts thigh at hip &oint and pubic tubercle shaft of femur =linea assists in lateral rotation aspera> $nferior ramus of pubis 'osterior surface of Obturator nerve -dducts thigh at hip &oint and shaft of femur =linea assists in lateral rotation aspera> $nferior ramus of pubis, 'osterior surface of  -dductor portion:  -dducts thigh at hip &oint and ramus of ischium, shaft of femur, adductor obturator nerve assists in lateral rotation; hamstring ischial tuberosity tubercle of femur  %amstring portion: portion etends thigh at hip &oint sciatic nerve Outer surface of Medial surface of Obturator nerve Laterally rotates thigh at hip &oint obturator membrane greater trochanter  and pubic and ischial rami

Adductor longus Adductor brevis Adductor magnus

Obturator e&ternus

Muscles of the Posterior Fascial Compartment of the Thigh Muscle Biceps femoris

Semitendinosus

Origin Long head: ischial tuberosity

$nsertion %ead of fibula

,erve Suppl" Action Long head: tibial lees and laterally rotates leg portion of sciatic at +nee ∮ long head also nerve etends thigh at hip &oint Short head: common peroneal portion of sciatic nerve

Short head: linea aspera, lateral supracondylar ridge of shaft of femur  $schial tuberosity 6pper part of medial "ibial portion of surface of shaft of tibia sciatic nerve

Semimembranosus $schial tuberosity

Medial condyle of tibia "ibial portion of sciatic nerve

Adductor magnus $schial tuberosity 'hamstring portion(

-dductor tubercle of femur 

"ibial portion of sciatic nerve

lees and medially rotates leg at +nee ∮ etends thigh at hip &oint lees and medially rotates leg at +nee ∮ etends thigh at hip &oint Etends thigh at hip &oint

Muscles of the Anterior Fascial Compartment of the eg Muscle Tibialis anterior 

%&tensor digitorum longus Peroneus tertius %&tensor hallucis longus %&tensor digitorum brevis

Origin $nsertion ,erve Suppl" Action Lateral surface of shaft Medial cuneiform and !eep peroneal nerveEtendsb foot at an+le ∮ inverts of tibia and base of first metatarsal foot at subtalar and transverse interosseous membrane bone tarsal &oints; holds up medial longitudinall arch of foot  -nterior surface of shaft Etensor epansion of !eep peroneal nerveEtends toes; etends foot at an+le of fibula lateral four toes  &oint  -nterior surface of shaft Base of fifth metatarsal !eep peroneal nerveEtends foot at an+le ∮ everts of fibula bone foot at subtalar and transverse tarsal &oints  -nterior surface of shaft Base of distal phalan !eep peroneal nerveEtends big toe; etends foot at of fibula of great toe an+le ∮ inverts foot at subtalar and transverse tarsal &oints )alcaneum By four tendons into the !eep peroneal nerve proimal phalan of big toe and long etensor tendons to second, third, and fourth toes

Muscles of the ateral Fascial Compartment of the eg Muscle Peroneus longus

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Origin $nsertion ,erve Suppl" Action Lateral surface of shaft Base of first metatarsal Superficial peroneal 'lantar flees foot at an+le ∮ of fibula and the medial nerve everts foot at subtalar and cuneiform transverse tarsal &oints; supports lateral longitudinal and transverse arches of foot Peroneus Lateral surface of fibula Base of fifth metatarsal Superficial peroneal 'lantar flees foot at an+le ∮ brevis shaft of bone nerve everts foot at subtalar and fibula transverse tarsal ∮ supports lateral longitudinal arch of foot

Muscles of the Posterior Fascial Compartment of the eg Muscle

$nsertion ,erve Suppl" Superficial 0roup 0astrocnemius Lateral head from (ia tendo calcaneus "ibial nerve lateral condyle of femur into posterior surface of and medial head from calcaneum above medial condyle Plantaris Lateral supracondylar 'osterior surface of "ibial nerve ridge of femur  calcaneum Soleus Shafts of tibia and fibula (ia tendo calcaneus "ibial nerve into posterior surface of calcaneum

Popliteus

Fle&or digitorum longus

Origin

*eep 0roup Lateral surface of lateral 'osterior surface of "ibial nerve condyle of femur  shaft of tibia above soleal line 'osterior surface of shaft of tibia

Fle&or hallucis 'osterior surface of longus shaft of fibula

Tibialis posterior 

Bases of distal "ibial nerve phalanges of lateral four  toes

Base of distal phalan of big toe

"ibial nerve

'osterior surface of "uberosity of navicular "ibial nerve shafts of tibia and fibula bone and other and interosseous neighboring bones membrane

Action 'lantar flees foot at an+le  ∮ flees +nee &oint

'lantar flees foot at an+le  ∮ flees +nee &oint "ogether with gastrocnemius and plantaris is powerful plantar fleor of an+le ∮ provides main propulsive force in wal+ing and running lees leg at +nee ∮ unloc+s +nee &oint by lateral rotation of femur on tibia and slac+ens ligaments of &oint lees distal phalanges of lateral four toes; plantar flees foot at an+le ∮ supports medial and lateral longitudinal arches of foot lees distal phalan of big toe; plantar flees foot at an+le ∮ supports medial longitudinal arch of foot 'lantar flees foot at an+le  ∮ inverts foot at subtalar and transverse tarsal &oints; supports medial longitudinal arch of foot

Muscles of the Sole of the Foot Muscle Abductor hallucis Fle&or digitorum brevis

Origin Medial tuberosity of calcaneum and fleor retinaculum Medial tubercle of calcaneum

$nsertion ,erve Suppl" Action First a"er  Base of proimal Medial plantar nerve lees and abducts big toe; phalan of big toe braces medial longitudinal arch our tendons to four Medial plantar nerve lees lateral four toes; braces lateral toesCD inserted medial and lateral longitudinal into borders of middle arches

17

phalan; tendons perforated by those of fleor digitorum longus Abductor digiti Medial and lateral Base of proimal Lateral plantar nerve lees and abducts fifth toe; minimi tubercles of calcaneum phalan of fifth toe braces lateral longitudinal arch Second a"er  5uadratus Medial and lateral sides "endon of fleor Lateral plantar nerve -ssists fleor digitorum longus plantae of calcaneum digitorum longus in fleing lateral four toes umbricals '6( "endons of fleor !orsal etensor irst lumbrical: Etends toes at interphalangeal digitorum longus epansion; bases of medial plantar nerve; &oints proimal phalanges of remainder: lateral lateral four toes plantar nerve Fle&or digitorum longus tendon Fle&or hallucis longus tendon Third a"er  Fle&or hallucis )uboid, lateral Medial tendon into Medial plantar nerve lees metatarsophalangeal brevis cuneiform, tibialis medial side of base of  &oint of big toe; supports medial posterior insertion proimal phalan of big longitudinal arch toe; lateral tendon into lateral side of base of proimal phalan of big toe Adductor Obli5ue head bases of Lateral side of base of !eep branch lateral lees metatarsophalangeal hallucis second, third, and fourth proimal phalan of big plantar nerve  &oint of big toe; holds together metatarsal bones; toe metatarsal bones transverse head from plantar ligaments Fle&or digiti Base of fifth metatarsal Lateral side of base of Lateral plantar nerve lees metatarsophalangeal minimi brevis bone proimal phalan of little  &oint of little toe toe Fourth a"er  $nterossei *orsal '6(

Plantar '?(

 -d&acent sides of metatarsal bones

Bases of proimal Lateral plantar nerve -bduction of toes; flees phalanges first: medial metatarsophalangeal &oints and side of second toe; etends interphalangeal &oints remainder: lateral sides of second, third, and fourth toes also dorsal etensor epansion $nferior surfaces of third, Medial side of bases of Lateral plantar nerve -dduction of toes; flees fourth, and fifth proimal phalanges of metatarsophalangeal &oints and metatarsal bones lateral three toes etends interphalangeal &oints

Peroneus longus tendon Tibialis posterior tendon Muscle of the *orsum of the Foot Muscle %&tensor digitorum brevis

Origin $nsertion ,erve Suppl" Action  -nterior part of upper By four tendons into the !eep peroneal nerveEtends toes surface of the proimal phalan of big calcaneum and from the toe and long etensor inferior etensor tendons to second,

retinaculum

third, and fourth toes

Branches of the Sacral Ple&us a nd Their *istribution Branches Superior gluteal nerve $nferior gluteal nerve ,erve to piriformis ,erve to obturator internus ,erve to )uadratus femoris Perforating cutaneous nerve Posterior cutaneous nerve of thigh Sciatic nerve '69 8< S=9 >9 ?( Tibial portion

Common peroneal portion

Pudendal nerve

18

*istribution Gluteus medius, gluteus minimus, and tensor fasciae latae muscles Gluteus maimus muscle 'iriformis muscle Obturator internus and superior gemellus muscles Auadratus femoris and inferior gemellus muscles S+in over medial aspect of buttoc+ S+in over posterior surface of thigh and popliteal fossa, also over lower part of buttoc+, scrotum, or labium ma&us %amstring muscles =semitendinosus, biceps femoris long headF, adductor magnus hamstring partF>, gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, fleor digitorum longus, fleor hallucis longus, and via medial and lateral plantar branches to muscles of sole of foot; sural branch supplies s+in on lateral side of  leg and foot Biceps femoris muscle =short head> and via deep peroneal branch: tibialis anterior, etensor hallucis longus, etensor digitorum longus, peroneus tertius, and etensor digitorum brevis muscles; s+in over cleft between first and second toes@ "he superficial peroneal branch supplies the peroneus longus and brevis muscles and s+in over lower third of anterior surface of leg and dorsum of foot Muscles of perineum including the eternal anal sphincter, mucous membrane of lower half of anal canal, perianal s+in, s+in of penis, scrotum, clitoris, and labia ma&ora and minora

Branches of the umbar Ple&us and Their *istribution Branches $liohypogastric nerve

$lioinguinal nerve

Lateral cutaneous nerve of the thigh Genitofemoral nerve =L3, 1> emoral nerve =L1, 2, 7>

Obturator nerve =L1, 2, 7>

Segmental branches

*istribution Eternal obli5ue, internal obli5ue, transversus abdominis muscles of anterior abdominal wall; s+in over lower anterior abdominal wall and buttoc+ Eternal obli5ue, internal obli5ue, transversus abdominis muscles of anterior abdominal wall; s+in of upper medial aspect of thigh; root of penis and scrotum in the male; mons pubis and labia ma&ora in the female S+in of anterior and lateral surfaces of the thigh )remaster muscle in scrotum in male; s+in over anterior surface of thigh; nervous pathway for cremasteric refle $liacus, pectineus, sartorius, 5uadriceps femoris muscles, and intermediate cutaneous branches to the s+in of the anterior surface of the thigh and by saphenous branch to the s+in of the medial side of the leg and foot; articular branches to hip and +nee &oints Gracilis, adductor brevis, adductor longus, obturator eternus, pectineus, adductor magnus =adductor portion>, and s+in on medial surface of thigh; articular branches to hip and +nee &oints Auadratus lumborum and psoas muscles

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Back

Muscles Connecting the 1pper limb to the /ertebral Column3 Superficial 'Appendicular( 0roup of Back Muscles "rape
Origin Lower portion of ligamentum nuchae, spinous process of )? to "2 and supraspinous ligaments

$nsertion 6pper border of ribs 1 to 8 &ust lateral to their angles

$nnervation  -nterior rami of upper thoracic nerves ="1 to "8>

Action Elevates ribs 1 to 8

Serratus 'osterior $nferior 

Spinous process of "33 to L2 and supraspinous ligaments

Lower border of ribs H to 31 &ust lateral to their angles

 -nterior rami of lower thoracic nerves ="H to "31>

!epresses ribs H to 31 and may prevent lower ribs from being elevated when the diaphragm contracts

*eep 0roup of Back Muscles SpinoTransversales Muscles Muscle Splenius )apitis

Origin Lower half of ligamentum nuchae, spinous processes of )? to "7

$nsertion Mastoid process, s+ull below lateral 3I2 of superior nuchal line

$nnervation 'osterior rami middle cervical nerves

Action "ogetherJ draw head bac+wards etending nec+; individuallyJ draw and rotate head to one side =turn face to same side>

Splenius )ervicis

Spinous processes of "2 to "9

"ransverse processes of )3 to )2

'osterior rami middle cervical nerves

"ogetherJ etend nec+; individuallyJ draw and rotate head to one side =turn face to same side>

%rector Spinae 0roup of Back Muscles Muscle $liocostalis Lumborum

Origin Sacrum, spinous process of lumbar and lower two thoracic vertebrae and their

$nsertion  -ngles of the lower 9 or ? ribs

supraspinous ligaments and the iliac crest $liocostalis "horacis

-ngles of the lower 9 ribs

-ngles of the upper 9 ribs and the transverse process of )?

$liocostalis )ervicis

-ngles of ribs 2 to 9

"ransverse processes of )7 to )9

Longissimus "horacis

Blends with iliocostalis in lumbar region and is attached to transverse processes of lumbar vertebrae

"ransverse processes of all thoracic vertebrae and &ust lateral to the tubercles of the lower H or 3K ribs

Longissimus )ervicis

"ransverse processes of upper 7 or 8 thoracic vertebrae

"ransverse processes of )1 to )9

Longissimus )apitis

"ransverse processes of upper 7 or 8 thoracic vertebrae and articular processes of lower three or four cervical vertebrae

'osterior margin of the mastoid process

Spinalis "horacis

Spinous processes of "3K or "33 to L1

Spinous processes of "3 to " =varies>

Spinalis )ervicis

Lower part of ligamentum nuchae and spinous processes of )? =sometimes "3 to "1>

Spinous process of )1 =ais>

Spinalis )apitis

6sually blends with semispinalis capitis

.ith semispinalis capitis

Transversospinales 0roup of Back Muscles Muscle

Origin

$nsertion

Semispinalis "horacis

"ransverse processes of "1 to "3K

Spinous processes of upper 7 thoracic and lower 1 cervical vertebrae

Semispinalis )ervicis

"ransverse processes of upper 8 or 9 thoracic vertebrae

Spinous processes of )1 =ais> to )8

Semispinalis )apitis

"ransverse processes of "3 to "9 =or "?> and )? and articular processes of )7 to )9

Medial area between the superior and inferior nuchal lines of occipital bone

Multifidus

Sacrum, origin of erector spinae, 'S$S, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae and articular processes of lower four cervical vertebrae

Base of spinous processes of all vertebrae from L8 to )1

*otatores Lumborum

Mammillary processes of

Spinous processes of ;umbar

20

lumbar vertebrae

vertebrae

*otatores "horacis

"ransverse processes of thoracic vertebrae

Spinous processes of thoracic vertebrae

*otatores )ervicis

-rticular processes of cervical vertebrae

Spinous processes of cervical vertebrae

Segmental Back Muscles Muscle

Origin

$nsertion

Action

Levatores )ostarum

Short paired muscles arising from transverse processes of )? to "33

"he rib below vertebra of origin near tubercle

$nterspinales

Short paired muscles attached to the spinous process of contiguous vertebrae, one on each side of the interspinous ligament

$ntertransversarii

Small muscles between the transverse processes of contiguous vertebrae

)ontraction elevates rib

Suboccipital 0orup of Back Muscles Muscle

Origin

$nsertion

$nnervation

Function

*ectus )apitis 'osterior Ma&or 

Spinous process of ais =)1>

Lateral portion of occipital bone below inferior nuchal line

'osterior ramus of )3

Etension of head; rotation of face to same side as muscle

*ectus )apitis 'osterior Minor 

'osterior tubercle of atlas =)3>

Medial portion of occipital bone below inferior nuchal line

'osterior of )3

ramus

Etension of head

Obli5uus )apitis Superior

"ransverse process of atlas =)3>

Occipital bone between superior and inferior nuchal lines

'osterior of )3

ramus

Etension of head and bends it to same side

Obli5uus )apitis $nferior 

Spinous process of ais =)1>

"ransverse process of atlas =)3>

'osterior of )3

ramus

*otation of face to same side

Thora&

21

22

Muscles Connecting the 1pper imb to the Thoracic 2all3 Muscles of the Pectoral Region 'e&cept Serratus Anterior( 'ectoralis Ma&or  Subclavius 'ectoralis Minor  Muscles of the Thora&3 Thoracic 2all Muscle

Origin

$nsertion

$nnervation

Function

Eternal $ntercostal

$nferior margin of rib above

Superior surface f  $ntercostal rib below nerves; "3J"33

Most active during inspiration; supports intercostals space; moves ribs superiorly

$nternal $ntercostal

Lateral edge of costal groove of rib above

Superior surface of rib below deep to the attachment of the related eternal intercostal

$ntercostal nerves; "3J"33

Most active during epiration; supports intercostals space; moves ribs inferiorly

$nnermost $ntercostal

Medial edge of costal groove of rib above

$nternal aspect of superior surface of rib below

$ntercostal nerves; "3J"33

 -cts with internal intercostals muscles

Subcostales

$nternal surface =near angle> of lower ribs

$nternal surface of 1nd to 2rd rib below

*elated intercostal nerves

May depress ribs

"ransversus "horacis

Lower margins and internal surfaces of cocostal cartilages of 1nd to 9th ribs

$nferior aspect of deep surface of body of sternum, iphoid process and costal cartilages ribs 7J?

*elated intercostals nerves

!epresses costal cartilages

!iaphragm =most important muscle of respiration>

0iphoid process; lower si costal cartilages, first three lumbar vertebrae

)entral tendon

'hrenic nerve

(ery important muscle of inspiration; increases vertical diameter of thora by pulling central tendon downward; assists in raising lower ribs@ -lso used in abdominal straining and weight lifting

Levatores )ostarum =31>

"ip of transverse process of )? and "3J33 vertebrae

*ib below

'osterior rami of thoracic spinal

*aises ribs and therefore inspiratory muscles

nerves Serratus 'osterior Superior  Serratus 'osterior $nferior 

=see Intermediate (Respiratory) Group of ac! Muscles>

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