TABLE OF CONTENTS

MUSCLES OF THE UPPER LIMB

MUSCLES OF THE UPPER LIMB
(1) Muscles connecting the shoulder girdle to the axial skeleton ................................
(A) Dorsal muscles: .......................................................................................................................
(B) Ventral muscles: .....................................................................................................................
(2) Muscles running from the axial skeleton to the humerus: ..............................
(3) MUSCLES AROUND THE SCAPULA ...............................................................................................
Rotator cuff muscles: .....................................................................................................................................
MUSCLES OF THE ARM
Muscles acting on the radioulnar joints
Pronation:..............................................................................................................................................................
Supination: ............................................................................................................................................................
Muscles acting on the wrist & carpal joints
Muscles on the anterior aspect of the forearm (flexors):................................................................................
Muscles on the posterior aspect of the forearm (extensors): ........................................................................
MUSCLES ACTING ON THE DIGITS
1) Flexors of the digits: ...............................................................................................................
2) Extensors of the digits: ........................................................................................................
MUSCLES OF THE LOWER LIMB
1) GLUTEAL MUSCLES .........................................................................................................................
2) FLEXORS OF THE HIP ...................................................................................................................
3) Adductors of the hip joint: ...............................................................................................
4) Muscles that move the knee joint: ...............................................................................
5) Flexors of the knee joint : ..........................................................................................................
6) Muscles that move the ankle joint: ......................................................................................
7) Muscles on the posterior aspect of leg are plantar flexors of the ankle joint. .........................................
8) Eversion & inversion of the foot: ..................................................................................
THE DIGESTIVE SYSTEM
THE ALIMENTARY or GASTROINTESTINAL TRACT:
(1) THE ORAL CAVITY ................................................................................................................................
(2) THE PHARYNX ...........................................................................................................................
(3) THE ESOPHAGUS ....................................................................................................................
(4) THE STOMACH ......................................................................................................................................
(5) THE INTESTINES .......................................................................................................................
(6) THE SALIVARY GLANDS .........................................................................................................
(1) Parotid Gland: ..........................................................................................................................
(2) The Sublingual Gland: ..............................................................................................
(3) The Submandibular Gland: .............................................................................................
(7) THE LIVER ..................................................................................................................................
o The Gall Bladder: ...................................................................................................................
(8) THE PANCREAS .........................................................................................................................
(9) THE SPLEEN ..............................................................................................................................
 Table of Figures
Figure 37: Muscles of the Shoulder - Posterior View 28
Figure 38: Muscles of the Shoulder - Anterior View
Figure 39: Muscles around Scapula - Anterior View
Figure 40: Muscles around Scapula - Posterior View
Figure 41: Muscles of the Front of Arm - Superficial Layer
Figure 42: Muscles of Pronotion
Figure 43: Muscles of Supination
Figure 44: Muscles of the Front of Forearm (Flexors)
Figure 45: Muscles of the Back of Forearm (Extensors) – Superficial Layer
Figure 46: Muscles of the Back of Forearm (Extensors) – Deep Layer
Figure 47: Gluteal Muscles & Muscles Flexing KneeJoint
Figure 48: Flexors of the Hip
Figure 49: Anterior Muscles of the Leg
Figure 50: Lateral Muscles of the Leg
Figure 51: Muscles of the Back of the Leg (Superficial Layer)
Figure 52: Muscles of the Back of the Leg (Deep Layer)
Figure 53: Oral Cavity, Pharynx & Esophagus
Figure 54: Stomach
Figure 55: Salivary Glands
Figure 56: Liver - Anterior Surface
Figure 57: Liver - Visceral Surface
Figure 58: Extra-hepatic Billiary Passages
Figure 59: Pancreas
Figure 60: Spleen
 MUSCLES OF THE UPPER LIMB

Figure 37: Muscles of the Shoulder - Posterior View

Figure 1: Muscles of the Shoulder - Anterior View

 1) Muscles connecting the shoulder girdle to the axial skeleton.
2) Muscles running from the axial skeleton to the humerus.
a) Muscles around the scapula.
b) Muscles of the arm.
c) Muscles acting on the radioulnar joints (producing pronation &
supination)
d) Muscles acting on the wrist &carpal joints.
e) Muscles acting on the digits.
Muscles connecting the shoulder girdle to the axial skeleton
(A) Dorsal group (B) Ventral group
1- Trapezius 1- Pectoralis minor
2- Levator scapulae. 2- Serratus anterior.
3- Rhomboides minor 3- Subclavius.
4- Rhomboides major

Dorsal muscles:

1) Nerve supply:
a) Trapezius accessory nerve (cranial XI)
b) Levator scapulae, rhomboids minor & major nerve to rhomboids.

2) Action:
a) Trapezius helps deltoid & serratus anterior to rotate the scapula, as
in raising the arm above the head.
b) Levator scapulae &rhomboids rotate the scapula to depress the
shoulder.

Ventral muscles:
1) Nerve supply:
a) Pectoralis minor pectoral nerves.
b) Serratus anterior nerve to serratus anterior.
c) Subclavius nerve to subclavius.

(1) Muscles running from the axial skeleton to the humerus:

a) Dorsal Muscle: Latissimus Dorsi.
b) Ventral Muscle: Pectoralis Major.
i) Nerve supply:
∗ Latissimus dorsi nerve to latissimus dorsi.
∗ Pectoralis major pectoral nerves.
ii) Actions:
∗ Latissimus dorsi extends, adducts & medially rotates arm.
∗ Pectoralis major flexes, adducts& medially rotates arm.

Figure 2: Muscles around Scapula - Anterior View

Figure 3: Muscles around Scapula - Posterior View

 (2) MUSCLES AROUND THE SCAPULA
a) Rotator cuff muscles.
b) Deltoid muscle.
c) Teres major muscle.

Rotator cuff muscles:

1) These are 4 muscles which arise from the scapula & insert into the
humerus.
2) They are:
a. Subscapularis. c. Infraspinatus.
b. Supraspinatus. d. Teres minor.
3) Tendons of these muscles surround the shoulder joint on all sides,
except inferiorly.
4) They help to keep the large humeral head well fitted (applied) to the
shallow glenoid cavity.
Nerve
Muscle Origin Insertion Action
supply
Subscapularis Anterior Lesser Upper & lower Adduction&
surface of tuberosity of subscapular medial rotation of
scapula humerus nerves shoulder
Supraspinatus Supraspinus Greater Suprascapular Abduction of
fossa of tuberosity of nerve shoulder
scapula humerus
Infraspinatus Infraspinus Greater Suprascapular Lateral rotation of
fossa of tuberosity of nerve shoulder
scapula humerus
Teres minor Lateral Greater Axillary nerve Extension of
border of tuberosity of shoulder
scapula humerus
Teres major Lateral Bicipital Lower Adducts &
border of groove of subscapular medially rotates
scapula humerus nerve arm
Deltoid Clavicle + Deltoid Axillary nerve Abducts, flexes,
acromion tuberosity of extends, laterally
process & humerus & medially rotates
spine of arm
scapula.
 MUSCLES OF THE ARM
1) These muscles act mainly on the elbow joint.

2) They are arranged into 2 groups:

a) Dorsal muscles of arm
i) Triceps ii) Anconeus
b) Ventral muscles of arm:
i) Coracob iii) Biceps v) Brachialis
ii) achialis iv) brachii
3) Triceps & anconeus
a) Extend the elbow.
b) Both are supplied by the radial nerve.
4) Coracobrachialis, biceps & brachialis are flexors of the elbow.
5) Biceps is the supinator of the forearm.
6) Coracobrachialis, biceps & brachialis are all supplied by the
musculocutaneus nerve.

Figure 4: Muscles of the Front of Arm - Superficial Layer

 Muscles acting on the radioulnar joints
(muscles producing pronation & supination)

1) The movements of pronation & supination occur at the radioulnar joints

2) During these movements, the ulna is stationary & the radius is mobile.

Pronation:
1) It's a medial rotation of the forearm which brings the palm of hand to face
posteriorly.
2) Muscles producing pronation are:
a) Pronator teres.
b) Pronator quadratus.
c) Both are supplied by the median nerve.

Supination:
1) It's a lateral rotation of the pronated forearm which brings the palm of the
hand to face anteriorly.
2) Muscles producing supination are:
a) Biceps brachii supplied by musculocutaneous nerve.
b) Supinator supplied by radial nerve.

Figure 5: Muscles of Pronotion

 Figure 6: Muscles of Supination

Muscles acting on the wrist & carpal joints

Muscles on the anterior aspect of the forearm (flexors):

1) Superficial group.
2) Deep group.
3) Flexors are supplied by median & ulnar nerves.

Muscles on the posterior aspect of the forearm (extensors):

1) Superficial group.
2) Deep group.
3) Extensors are supplied by radial nerve.
4) ACTIONS:
a) Flexors produce flexion of the wrist.
b) Extensors produce extension of the wrist.
c) Flexors & extensors which lie on the radial (lateral) side of the
forearm abduction of the hand at the wrist.
d) Flexors & extensors which lie on the ulnar (medial) side of the
forearm adduction of the hand at the wrist.
 Figure 7: Muscles of the Front of Forearm (Flexors)

Figure 8: Muscles of the Back of Forearm (Extensors) – Superficial Layer

 Figure 9: Muscles of the Back of Forearm (Extensors) – Deep Layer

MUSCLES ACTING ON THE DIGITS

Movements produced by the digits (fingers) include:
1) Flexion.
2) Extension.
3) Adduction.
4) Abduction.

1) Flexors of the digits:

a) Flexor digitorum superficialis.
b) Flexor digitorum profundus.
c) Flexor pollicis longus flexes the thumb.
i) Nerve supply:
∗ Flexor digitorum superficialis, flexor pollicis longus & lateral 1/2 of
flexor digitorum profundus are supplied by the median nerve.
∗ The medial 1/2 of flexor digitorum profundus by ulnar nerve.
2) Extensors of the digits:
a) Extensor digitorum.
b) Extensor digiti minimi (extends little finger).
c) Extensor pollicis longus extends thumb
d) Extensor pollicis brevis extends thumb
i) Nerve supply:
∗ All extensors are supplied by the radial nerve.
3) There are small muscles in the hands called the lumbricals & interossei.
4) There are: 4 lumbricals, 4 palmar interossei & 4 dorsal interossei.
5) ALL LUMBRICALS & ALL INTEROSSEI PUT THE FINGERS IN THE
WRITING POSITION.
6) The writing position is flexion of the metacarpophalangeal joints &
extension of the interphalangeal joints.
a) Palmar interossei (PAD) Adduct the fingers.
b) Dorsal interossei (DAP) abduct the fingers.

7) Nerve supply:
a) Lumbricals 1st & 2nd by median nerve.
3rd & 4th by ulnar nerve.
b) All interossei by ulnar nerve.
 MUSCLES OF THE LOWER LIMB

Figure 10: Gluteal Muscles & Muscles Flexing KneeJoint

1) GLUTEAL MUSCLES
3)These are 3 muscles which lie posterior & lateral to the hip joint.
4)They are: gluteus maximus, gluteus medius & gluteus minimus.
5)They are most commonly used for giving intramuscular injections.

6)ACTIONS :
a) Gluteus maximus extends & laterally rotates hip.
b) Gluteus medius & minimus abduct & medially rotate hip.

7)NERVE SUPPLY :
a) Gluteus maximus by inferior gluteal nerve.
b) Gluteus medius & minimus by superior gluteal nerve.

8)APPLIED ANATOMY (very important)

a) The important nerves & vessels of the lower limb are found
under the medial part of gluteus maximus.
 b) Care should be taken when giving intramuscular injection in
the buttock, so as not to injure the important nerves
&vessels of the lower limb.
c) The safest area for giving intramuscular injection in the
buttock is the upper lateral quadrant.

Figure 11: Flexors of the Hip

2) FLEXORS OF THE HIP

9)They lie anterior to the hip joint.
10)They include:
1. Psoas major. 3. Pectineus.
2. Iliacus. 4. Sartorius.

11)ACTIONS :
a) The 4 muscles flex the hip joint.
b) Iliacus & psoas medially rotate the hip.
c) Pectineus adducts the thigh.
d) Sartorius laterally rotates the thigh.
12)NERVE SUPPLY:
a) Psoas major directly from lumbar plexus.
b) All others from femoral nerve.

3) Adductors of the hip joint:

13)They lie medial to the hip joint.
14)They are arranged in 2 layers:
1. Anterior layer adductor longus
gracilis
2. Posterior layer adductor brevis
adductor magnus
obturator externus

15)Nerve Supply :
a) They are all supplied by the obturator nerve.

4) Muscles that move the knee joint:

16)Extensors of the knee joint Lie on the anterior aspect of the
thigh.
17)They are the quadriceps femoris which include 4 muscles:
a) Rectus femoris (in the middle )
b) Vastus lateralis (on the lateral side )
c) Vastus medialis (on the medial side )
d) Vastus intermedius (deep to rectus femoris )

18)Nerve supply FEMORAL NERVE.

5) Flexors of the knee joint :

19)They are 3 muscles on the back of the thigh.
20)They are called the Hamstrings.
21)They include:
a) Biceps femoris.
b) Semitendinosis.
c) Semimembranosus.
22)Nerve Supply Sciatic nerve.
Figure 12: Anterior Muscles of the Leg

Figure 13: Lateral Muscles of the Leg

 6) Muscles that move the ankle joint:
23)Muscles on the anterior aspect of the leg are dorsiflexors of the
ankle joint.
24)They include:
1- Tibialis anterior.
2- Extensor digitorum longus.
3- Extensor hallucis.
25)Nerve supply deep peroneal nerve.

Figure 14: Muscles of the Back of the Leg (Superficial Layer)

Figure 15: Muscles of the Back of the Leg (Deep Layer)

 7) Muscles on the posterior aspect of leg are plantar
flexors of the ankle joint.
26)They include:
(A) Superficial group : (B) Deep group:
i. Gastrocnemius. i. Flexor digitorum longus.
ii. Soleus. ii. Flexor hallucis longus.
iii. Plantaris. iii. Tibialis posterior.

27)Nerve supply Tibial nerve.

8) Eversion & inversion of the foot:

28)2 muscles evert the foot. They lie on the lateral side of the leg.
a) They are peroneus longus & peroneus brevis.
b) They are supplied by the superficial peroneal nerve.

29)2 muscles invert the foot :

a) They are tibialis anterior & tibialis posterior.
 THE DIGESTIVE SYSTEM
1) The digestive system is concerned with nutrition, which involves
ingestion, digestion, absorption & assimilation of food.
a) Ingestion of food requires opening the mouth & closing it by muscles
of mastication; aided by facial muscles which control the lips.
b) Digestion of food requires its chewing by the help of the teeth through
movements of muscles of mastication & chemical digestion by
digestive enzymes.
c) Absorption of food from the small intestines into the blood stream.
d) Assimilation of food which is utilization of the absorbed food for the
metabolic process of the living cells.

THE ALIMENTARY or GASTROINTESTINAL TRACT

1) It is a continuous long tube, about 9 meters long; most of it coiled up in

the abdominal cavity. It is formed of:
a) The oral cavity.
b) The pharynx.
c) The esophagus
d) The stomach.
e) The small intestines.
f) The large intestines.
 Figure 16: Oral Cavity, Pharynx & Esophagus

(1) THE ORAL CAVITY

a) The oral cavity is supported by the jaws, inside which the teeth lie in
sockets.
b) The jaws separate the vestibule, which is the space between the lips
& cheeks and the teeth & gums, from the oral cavity proper, which
contains the tongue.
c) The tongue lies on the floor of the oral cavity; partially held down by
an under-tongue fold called the frenulum.
d) The oral cavity is separated from the nasal cavities by the palate.
e) The palate is divided into 2 parts:
i) Anterior part hard palate.
ii) Posterior part soft palate.

(2) THE PHARYNX

a) The pharynx is divided into:
i) Nasopharynx at the back of the nose &
 ii) Oropharynx at the back of the oral cavity.
b) The oropharynx is continuous below with the esophagus.
c) The epiglottis is a leaf like cartilage which closes the opening into the
larynx; to prevent the passage of food into the respiratory tract during
swallowing.
d) The tonsils are special large patches of lymphoid tissue; which lie at the
sides of the pharynx.

(3) THE ESOPHAGUS

a) It is a long straight tube, 25 cm. long.
b) In the neck, it descends behind the trachea.
c) It passes through the esophageal opening in the diaphragm, to join the
stomach.

(4) THE STOMACH

Figure 17: Stomach

a) It lies under the diaphragm to the left of the liver.

b) It is formed of the following parts:
i) Fundus
ii) Body
iii) Pylorus
 iv) Lesser curvature
v) Greater curvature.
c) Important relations to the stomach:
i) Anteriorly: Left lobe of liver + Diaphragm which separates it
from apex of heart + Anterior abdominal wall.
ii) Posteriorly: Pancreas, spleen & splenic artery
d) Blood Supply of Stomach Coeliac trunk of ABDOMINAL AORTA.

(5) THE INTESTINES

a) The Small Intestines
b) Length: About 6 meters.
c) It forms coiled loops which fill the abdominal cavity.
d) It is formed of the following parts:
i) Duodenum: 25 cms & is C- shaped.
ii) Jejunum: 2.5 meters.
iii) Ileum: 3.5 meters.
e) The duodenum receives the opening of :
i) Bile duct &
ii) Pancreatic duct.
f) The Large Intestines
g) Length: 1.5 meters.
h) Divisions:
i) The caecum:
∗ Where the terminal part of ileum ends.
ii) The Appendix:
∗ A blind worm like tube, attached to the caecum.
∗ 8-10 cms in length.
∗ Inflammation of the appendix Appendicitis this requires
surgical removal appendicectomy.
iii) The colon:
∗ It is formed of the following parts:
a. The Ascending Colon:
It extends up to the lower border of the liver, where it
forms the right colic flexure.
 b. The Transverse Colon:
It lies horizontal in position below the liver and stomach
& above the small intestines. It becomes continuous
with the descending colon at the left colic flexure.

c. The Sigmoid Colon:

Lower part of the descending colon.
It lies below the left iliac crest.
It describes an S-shaped curve.

d. The rectum:
It’s the downward continuation of the sigmoid colon.
It lies in the concavity of the sacrum.
It’s about 12 cms in length.

e. The Anal Canal

It’s the terminal part of the large intestines(4 cms).
It ends at the anus (anal orifice).
The anus is guarded by the internal & external anal
sphincters.

e) Blood Supply of the Intestines:

iv) Superior Mesenteric Artery:
o Supplies all the small intestines (except proximal part of
the duodenum), the caecum, appendix, ascending & right
½ of the transverse colon.

v) Inferior Mesenteric Artery:

o Supplies left ½ of transverse colon, descending colon,
sigmoid colon & most of rectum.
(6) THE SALIVARY GLANDS

a) There are 3 pairs of large salivary glands.

Figure 18: Salivary Glands

i) Parotid Gland:
∗ Lies in front of the ear, below the zygomatic arch & over the angle
of the mandible.
∗ The parotid duct pierces the buccinator muscle & opens opposite
then upper 2nd molar tooth.
ii) The Sublingual Gland:
∗ It lies under the tongue.
∗ Sublingual ducts open under the side of the tongue.
iii) The Submandibular Gland:
∗ It lies under the mandible
∗ Submandibular ducts open on the frenulum, under the front of
the tongue.
(7) THE LIVER

Figure 19: Liver - Anterior Surface

Figure 20: Liver - Visceral Surface

a) It is the largest gland in the body.

b) It lies below the diaphragm, to the right of and overlapping the
stomach.
c) The falciform ligament helps in holding the liver in position
(connects the liver to the anterior abdominal wall).
d) Lobes: Liver is formed of right & left lobes & 2 smaller caudate
& quadrate lobes.
e) Each lobe is divided into lobules.
f) Bile Ducts of the liver:
i) Common Hepatic Duct:
∗ Formed by the union of the right & left hepatic ducts from the right
& left lobes of the liver
ii) Cystic Duct
∗ From the gall bladder.
iii) Common Bile Duct
∗ Formed by the union of common hepatic & cystic ducts.
∗ It opens into the duodenum.
g) Blood Supply of the Liver:
i) Hepatic Artery:
∗ Branch of the celiac trunk.
∗ It divides in porta hepatis into right & left terminal branches for the
right & left lobes of the liver.
ii) Portal Vein:
∗ Carries the venous blood from the G.I.T. (gastro-intestinal tract) to
the liver.
∗ It divides into 2 terminal branches in the porta hepatis.
iii) Hepatic Veins:
∗ One vein from each lobe.
∗ They drain venous blood from the liver & open in the Inferior Vena
Cava.
h) The Gall Bladder:

Figure 21: Extra-hepatic Billiary Passages

i) It is a pear- Shaped organ.
ii) Formed of Fundus, body & neck.
iii) Position: It lies on the under-surface of the liver.
iv) Function: It stores bile & concentrates it.
∗ When food is passing from the stomach to the small intestines, the
gall bladder ejects the bile into the duodenum.
v) Blood Supply:
∗ Cystic artery which is a branch from the hepatic artery.
(8) THE PANCREAS

Figure 22: Pancreas

a) It lies behind the stomach in the concavity of the duodenum.

b) It is formed of Head, Body & Tail.
c) Pancreatic duct & bile duct open into the duodenum.
d) Blood Supply: From the Splenic Artery.
(9) THE SPLEEN

Figure 23: Spleen

a) Size: It is about the size of a closed fist.

b) Site: It lies below the diaphragm, behind & to the left of the stomach.
c) It shows impressions on its surface; indicating the organs, with which
it is in contact.
d) Relations of the Spleen:
i) Posteriorly:
∗ The Diaphragm, separating the spleen from the lungs & ribs no. 9,
10 & 11.
ii) Anteriorly:
∗ The stomach (gastric impression)
iii) Inferiorly:
∗ Left colic flexure (colic impression).
iv) Medially:
∗ Left Kidney (Renal impression).
∗ The Hilum of the Spleen: is related to the tail of the pancreas &
through it nerves and vessels enter or leave the spleen.
e) The Blood Supply of the Spleen:
i) Splenic artery.
ii) Splenic Vein.