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

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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 Lacrimal, frontal, trochlear,
the Sphenoid oculomotor, nasociliary and abducent
nerves; superior ophthalmic vein
Foramen Rotundum Greater wing of the Sphenoid Maxillary Division of the Trigeminal
Nerve
Foramen Ovale Greater wing of the Sphenoid Mandibular division of the Trigeminal
Nerve
Foramen Spinosum Greater wing of the Sphenoid Middle meningeal artery
Foramen Lacerum Between petrous part of temporal Internal carotid artery
and Sphenoid
Posterior Cranial Fossa
Foramen Magnum Occipital Medulla Oblongata, spinal part of
accessory nerve, and right and left
vertebral arteries
Hypoglossal Canal Occipital Hypoglossal nerve
Jugular Foramen Between petrous part of temporal Glossopharyngeal, vagus, and
and condylar part of occipital accessory nerves; sigmoid sinus
becomes internal jugular vein
Internal Acoustic Meatus Petrous part of temporal Vestibulocochlear and facial nerves

Muscles of the Eyeball and Eyelids

Muscle Origin Insertion Innervation Action


Extrinsic Muscles of Eyeball (Striated Skeletal Muscle)
Superior Rectus Tendinous ring on Superior surface of CNIII Raises cornea
posterior wall of eyeball just posterior upward and medially
orbital cavity to corneoscleral
junction
Inferior Rectus Tendinous ring on Inferior surface of CNIII Depresses cornea
posterior wall of eyeball just posterior downward and
orbital cavity to corneoscleral medially
junction
Medial Rectus Tendinous ring on Medial surface of CNIII Rotates eyeball so
posterior wall of eyeball just posterior that cornea looks
orbital cavity to corneoscleral medially
junction
Lateral Rectus Tendinous ring on Lateral surface of CNVI Rotates eyeball so
posterior wall of eyeball just posterior that cornea looks
orbital cavity to corneoscleral laterally
junction
Superior Oblique Posterior wall of Passes through CNIV Rotates eyeball so
orbital cavity pulley and is that cornea looks
attached to superior downward and
surface of eyeball laterally
beneath superior
rectus
Inferior Oblique Floor of orbital cavity Lateral surface of CNIII Rotates eyeball so
eyeball deep to that cornea looks
lateral rectus upward and laterally
Intrinsic Muscles of Eyeball (Smooth Muscle)
Sphincter Pupillae Parasympathetic via Constricts pupil
of Iris CNIII
Dilatory Pupillae of
Iris
Ciliary Muscle
Sympathetic

Parasympathetic via
CNIII
2
Dilates pupil

Controls shape of
lens; in
accommodation,
makes lens more
globular
Muscles of Eyelids
Orbicularis Oculi
ü Palpebral Part Medial palpebral Lateral palpebral Facial nerve Closes eyelids and
ligament raphe dilates lacrimal sac
ü Orbital Part Medial palpebral Loops return to origin Facial nerve Throws skin around
ligament and orbit into folds to
adjoining bone protect eyeball
Levator Palpebrae Back of orbital cavity Anterior surface and Striated muscle Raises upper lid
Superioris upper margin of oculomotor nerve,
superior tarsal plate smooth muscle
Sympathetic

Muscles of the Head

Muscle Origin Insertion Innervation Action


Muscle of Scalp
Occipitofrontalis
ü Occipital belly Highest nuchal line of Epicranial Facial nerve Moves scalp on skull
occipital bone aponeurosis and raises eyebrows
ü Frontal belly Skin and superficial
facia of eyebrows
Muscles of Facial Expression
Orbicularis Oculi
ü Palpebral Part Medial palpebral Lateral palpebral Facial nerve Closes eyelids and
ligament raphe dilates lacrimal sac
ü Orbital Part Medial palpebral Loops return to origin Facial nerve Throws skin around
ligament and orbit into folds to
adjoining bone protect eyeball
Corrugator Superciliary arch Skin of eyebrow Facial nerve Vertical wrinkles of
Supercilii forehead, as in
frowning
Compressor Nasi Frontal process of Aponeurosis of Facial nerve Compresses mobile
maxilla bridge of nose nasal cartilages
Dilator Naris Maxilla Ala of nose Facial nerve Widens nasal
aperture
Procerus Nasal bone Skin between Facial nerve Wrinkles skin of nose
eyebrows
Orbicularis Oris Maxilla, mandible Encircles oral orifice Facial nerve Compresses lips
and skin together
Dilator Muscles of Lips
Levator Labii
Superioris Alaeque
Nasi
Levator Labii
Superioris
Zygomaticus Minor
Zygomaticus Major Arise from bones and fascia around oral
Facial nerve Separate lips
Levator Anguli Oris aperture and insert into substance of lips
Risorius
Depressor Anguli
Oris
Depressor Labii
Inferioris
Mentalis
Buccinator Outer surface of alveolar margins of maxilla, Facial nerve Compresses cheeks
mandible and pterygomandibular ligament and lips against teeth
Platysma

Masseter
Deep fascia over
pectoralis major and
deltoid

Zygomatic arch
Body of mandible
and angle of mouth

Muscles of Mastication
Lateral surface
ramus of mandible
Facial nerve cervical
branch

Mandibular division
of trigeminal nerve
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Depresses mandible
and angle of mouth

Elevates mandible to
occlude teeth
Temporalis Floor of temporal Coronoid process of Mandibular division Anterior and superior
fossa mandible of trigeminal nerve fibers elevate
mandible; posterior
fibers retract
mandible
Lateral Pterygoid Greater wing of Neck of mandible Mandibular division Pulls neck of
(two heads) sphenoid and lateral and articular sac of trigeminal nerve mandible forward
pterygoid plate
Medial Pterygoid Tuberosity of maxilla Medial surface of Mandibular division Elevates mandible
(two heads) and lateral pterygoid angle of mandible of trigeminal nerve
plate

Muscles of Tongue

Muscle Origin Insertion Innervation Action


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

Muscles of the Neck

Muscle Origin Insertion Innervation Action


Platysma Deep fascia over Body of mandible Facial nerve cervical Depresses mandible
pectoralis major and and angle of mouth branch and angle of mouth
deltoid
SCM Manubrium sterni Mastoid process of Spinal part of Two muscles acting
and medial third of temporal bone and accessory nerve and together extend head
the clavicle occipital bone C2 and C3 and flex neck; one
muscle rotates head
to opposite side
Digastric
ü Posterior belly Mastoid process of Intermediate tendon Facial nerve Depresses mandible
temporal bone is held to hyoid by or elevates hyoid
fascial sling bone
ü Anterior belly Body of mandible Nerve to mylohyoid
Stylohyoid Styloid process Body of hyoid bone Facial nerve Elevates hyoid bone
Mylohyoid Mylohyoid line of Body of hyoid bone Inferior alveolar Elevates floor of
body of mandible and fibrous raphe nerve mouth and hyoid
bone or depresses
mandible
Geniohyoid

Sternohyoid

Sternothyroid
Inferior mental spine
of mandible

Manubrium sterni
and clavicle
Manubrium sterni
Body of hyoid bone

Body of Hyoid bone

Oblique line on
First cervical nerve

Ansa cervicalis; C1,


2&3
Ansa cervicalis; C1,
4
Elevates hyoid bone
or depresses
mandible
Depresses hyoid
bone
Depresses larynx
lamina of thyroid 2&3
cartilage
Thyrohyoid Oblique line on Lower border of body First cervical nerve Depresses hyoid
lamina of thyroid of hyoid bone bone or elevates
cartilage larynx
Omohyoid
ü Inferior belly Upper margin of Intermediate tendon Ansa cervicalis; C1, Depresses hyoid
scapula and is held to clavicle and 2&3 bone
suprascapular first rib by fascial
ligament sling
ü Superior belly Lower border of body
of hyoid bone
Scalenius Anterior Transverse First rib C4, 5 & 6 Elevates first rib;
rd th
processes of 3 , 4 laterally flexes and
th th
5 and 6 cervical rotates cervical part
vertebrae of vertebral column
Scalenius Medius Transverse First rib Anterior rami of Elevates first rib;
processes of upper cervical nerves laterally flexes and
six cervical vertebrae rotates cervical part
of vertebral column
Scalenius Posterior Transverse process Second rib Anterior rami of Elevates second rib;
of lower cervical cervical nerves laterally flexes and
vertebrae rotates cervical part
of vertebral column

Cranial Nerves

Nerve Components Function Opening in Skull


Olfactory Sensory Smell Openings in cribriform plate
of ethmoid
Optic Sensory Vision Optic canal
Oculomotor Motor Lifts upper eyelid, turns Superior Orbital Fissure
eyeball upward, downward
and medially; constricts
pupil; accommodates eye
Trochlear Motor Assists in turning eyeball Superior Orbital fissure
downward and laterally
Trigeminal
ü Ophthalmic division Sensory Cornea, skin of forehead, Superior Orbital Fissure
scalp, eyelids and nose;
also mucous membrane of
paranasal sinuses and
nasal cavity
ü Maxillary division Sensory Skin of face over maxilla Foramen Rotundum
and the upper lip; teeth of
upper jaw; mucous
membrane of nose, the
maxillary air sinus, and
palate
ü Mandibular division Motor Muscles of mastication, Foramen Ovale
mylohyoid, anterior belly of
digastrics, tensor veli
palatini and tensor tympani
Sensory Skin of cheek, skin over
mandible, lower lip and
side of head; teeth of lower
jaw and
temporomandibular joint;

Abducent

Facial
Motor

Motor
mucous membrane of
mouth and anterior two
thirds of tongue
Lateral rectus muscle:
turns eyeball laterally
Muscles of face, cheek and
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Superior orbital fissure

Internal acoustic meatus,


scalp; stapedius muscle of facial canal stylomastoid
middle ear; stylohyoid; and foramen
posterior belly of digastrics
Sensory Taste from anterior two
thirds of tongue, floor of
mouth and palate
Secretomotor Submandibular and
parasympathetic sublingual salivary glands,
lacrimal gland and glands
of nose and palate
Vestibulocochlear
ü Vestibular Sensory Position and movement of Internal acoustic meatus
head
ü Cochlear Sensory Hearing
Glossopharyngeal Motor Stylopharyngeus muscle; Jugular Foramen
assists swallowing
Secretomotor Parotid salivary gland
parasympathetic
Sensory General sensation and
taste from posterior third of
tongue and pharynx;
carotid sinus and carotid
body
Vagus Motor Constrictor muscles of Jugular Foramen
phaynx and intrinsic
muscles of larynx;
involuntary muscle of
trachea and bronchi, heart,
alimentary tract from
pharynx to splenix flexure
of colon; liver and pancreas
Sensory Taste from epiglottis and
vallecula and afferent fibers
from structures named
above
Accessory
ü Cranial root Motor Muscles of soft palate, Jugular Foramen
pharynx and larynx
ü Spinal root Motor Sternocleidomastoid and
trapezius muscles
Hypoglossal Motor Muscles of tongue Hypoglossal Canal
controlling its shape and
movement (except
palatoglossus)
Muscles Connecting the Upper Limb to the Thoracic Wall/ Muscles of the Pectoral Region (except Serratus
Anterior)
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Muscle Origin Insertion Innervation Action
Pectoralis Major Clavicle, sternum Lateral lip of the Medial and lateral Adducts arm and
and upper six costal bicipital groove of pectoral nerves form rotates it medially;
cartilages humerus brachial plexus clavicular fibers also
flex arm
rd th th
Pectoralis Minor 3 , 4 and 5 ribs Coracoid process of Medial pectoral nerve Depresses point of
scapula from brachial plexus shoulder; if the
scapula is fixed, it
elevates the ribs of
origin
Subclavius First costal cartilage Clavicle Nerve to subclavius Depresses the
from upper trunk of clavicle and steadies
brachial plexus this bone during
movements of the
shoulder girdle
Serratus Anterior Upper eight ribs Medial border and Long thoracic nerve Draws the scapula
inferior angle of the forward around the
scapula thoracic wall; rotates
the scapula

Muscles Connecting the Upper limb to the Vertebral Column/ Superficial (Appendicular) Group of Back
Muscles

Muscle Origin Insertion Innervation Action


Trapezius Occipital bone, Upper fibers into Spinal part of Upper fibers elevate
ligamentum nuchae, lateral third of accessory nerve the scapula; middle
th
spine of 7 cervical clavicle; middle and (motor) and C3 and fibers pull the
vertebra, spines of all lower fibers into C4 (sensory) scapula medially;
thoracic vertebra acromion and spine lower fibers pull
of the scapula medial border of the
scapula downward
Latissimus Dorsi Iliac crest, lumbar Floor of bicipital Thoracodorsal nerve Extends, adducts
fascia, spines of groove of humerus and medially rotates
lower six thoracic the arm
vertebrae, lower
three or four ribs, and
inferior angle of the
scapula
Levator Scapulae Transverse Medial border of the C3 and C4 and Raises medial border
processes of first four scapula dorsal scapular nerve of the scapula
cervical vertebrae
Rhomboid Minor Ligamentum nuchae Medial border of the Dorsal scapular Raises medial border
th
and spines of 7 scapula nerve of scapula upward
cervical vertebra and and medially
st
1 thoracic vertebra
nd th
Rhomboid Major 2 to 5 thoracic Medial border of Dorsal scapular Raises medial border
spines scapula nerve of scapula upward
and medially

Muscles Connecting the Scapula to the Humerus

Muscle Origin Insertion Innervation Action


Deltoid Lateral third of Middle of lateral Axillary nerve Abducts arm; anterior
clavicle, acromion, surface of shaft of fibers flex and
spine of scapula humerus medially rotate arm;
posterior fibers
extend and laterally

Supraspinatus

Infraspinatus
Supraspinous fossa
of scapula

Infraspinous fossa
Greater tuberosity of
humerus; capsule of
shoulder joint
Greater tuberosity of
humerus; capsule of
Spurascapular nerve

Suprascapular nerve
rotate arm

7
Abducts arm and
stabilizes shoulder
joint
Laterally rotates arm
and stabilizes
shoulder joint shoulder joint
Teres Major Lower third of lateral Medial lip of bicipital Lower subscapular Medially rotates and
border of scapula groove of humerus nerve adducts arm and
stabilizes shoulder
joint
Teres Minor Upper two thirds of Greater tuberosity of Axillary nerve Laterally rotates arm
lateral border of the the humerus; capsule stabilizes shoulder
scapula of shoulder joint joint
Subscapularis Subscapular fossa Lesser tuberosity of Upper and lower Medially rotates arm
humerus subscapular nerves and stabilizes
shoulder joint

Muscles of the Arm

Muscle Origin Insertion Innervation Action


Anterior Compartment
Biceps Brachii
ü Long head Supraglenoid Tuberosity of radius Musculocutaneous Supinator of forearm
tubercle of scapula and bicipital nerve and flexor of elbow
ü Short head Coracoid process of aponeurosis into joint; weak flexor of
scapula deep fascia of shoulder joint
forearm
Coracobrachialis Coracoid process of Medial aspect of Musculocutaneous Flexes arm and also
scapula shaft of humerus nerve weak adductor
Brachialis Front of lower half of Coronoid process of Musculocutaneous Flexor of elbow joint
humerus ulna nerve
Posterior Compartment
Triceps
ü Long head Infraglenoid tubercle
of scapula
ü Lateral head Upper half of
posterior surface of Olecranon process of Extensor of elbow
Radial nerve
shaft of humerus ulna joint
ü Medial head Lower half of
posterior surface of
shaft of humerus

Muscles of the Anterior Fascial Compartment of the Forearm

Muscle Origin Insertion Innervation Action


Pronator Teres
ü Humeral head Medial epicondyle of
humerus
Lateral aspect of the Pronation and flexion
ü Ulnar head Medial border of Median nerve
shaft of radius of forearm
coronoid process of
ulna
nd rd
Flexor Carpi Medial epicondyle of Bases of 2 and 3 Median nerve Flexes and abducts
Radialis humerus metacarpal bones hand at wrist joint
Palmaris Longus Medial epicondyle of Flexor retinaculum Median nerve Flexes hand
humerus and palmar
aponeurosis
Flexor Carpi Ulnaris
ü Humeral head Medial epicondyle of Pisiform bone, hook
humerus of the hamate, base Flexes and adducts
th Ulnar nerve
ü Ulnar head Medial aspect of at 5 metacarpal hand at wrist joint
olecranon process bone
and posterior border

Flexor Digitorum
Superficialis
ü Humeroulnar
head
of ulna

Medial epicondyle of
humerus; medial
border of coronoid
Middle phalanx of
8
Flexes middle
phalanx of fingers
process of ulna Median nerve and assists in flexing
medial four fingers
ü Radial head Oblique line on proximal phalanx and
anterior surface of hand
shaft of radius
Flexor Pollicis Anterior surface of Distal phalanx of Anterior interosseus Flexes distal phalanx
Longus shaft of radius thumb branch of median of thumb
nerve
Flexor Digitorum Anteromedial surface Distal phalanges of Ulnar (medial half) Flexes distal phalanx
Profundus of shaft of ulna medial four fingers and median (lateral of fingers; then
half) nerves assists in flexion of
middle and proximal
phalanges and wrist
Pronator Quadratus Anterior surface of Anterior surface of Anterior interosseus Pronates forearm
shaft of ulna shaft or radius branch of median
nerve

Muscles of the Lateral Fascial Compartment of the Forearm

Muscle Origin Insertion Innervation Action


Brachioradialis Lateral Base of styloid Radial nerve Flexes forearm at
supracondylar ridge process of radius elbow joint; rotates
of humerus forearm to the
midprone position
Extensor Carpi Lateral Posterior surface of Radial nerve Extends and abducts
nd
Radialis Longus supracondylar ridge base of 2 hand at wrist joint
pf the humerus metacarpal bone

Muscles of the Posterior Fascial Compartment of the Forearm

Muscle Origin Insertion Innervation Action


Extensor Carpi Lateral epicondyle of Posterior surface of Deep branch of Extends and abducts
Radialis Brevis humerus base of third radial nerve hand at wrist joint
metacarpal bone
Extensor Digitorum Lateral epicondyle of Middle and distal Deep branch of Extends fingers and
humerus phalanges of medial radial nerve hand
four fingers
Extensor Digiti Lateral epicondyle of Extensor expansion Deep branch of Extends
Minimi humerus of little finger radial nerve metacarpophalangeal
joint of little finger
Extensor Carpi Lateral epicondyle of Base of fifth Deep branch of Extends and adducts
Ulnaris humerus metacarpal bone radial nerve hand at wrist joint
Anconeus Lateral epicondyle of Lateral surface of Radial nerve Extends elbow joint
humerus olecranon process of
ulna
Supinator Lateral epicondyle of Neck and shaft of Deep branch of Supination of forearm
humerus radius radial nerve
Abductor Pollicis Posterior surface of Base of first Deep branch of Extends and abducts
Longus shaft of radius and metacarpal bone radial nerve thumb
ulna
Extensor Pollicis Posterior surface of Base of proximal Deep branch of Extends
Brevis shaft or radius phalanx of thumb radial nerve metacarpophalangeal
joint of thumb
Extensor Pollicis Posterior surface of Base of distal Deep branch of Extends distal phalanx
Longus shaft of ulna phalanx of thumb radial nerve of thumb
Extensor Indicis Posterior surface of Extensor expansion Deep branch of Extends
shaft of ulna of index finger radial nerve metacarpophalangeal
joint of index finger
Small Muscles of the Hand

Muscle
Palmaris Brevis

Lumbricals (4)
Origin
Flexor retinaculum,
palmar aponeurosis
Tendons of flexor
digitorum profundus
Insertion
Skin of palm

Extensor expansion
of medial four
st
Innervation
Superficial branch of
ulnar nerve
nd
1 and 2 (i.e.
lateral two) median
rd th
Action
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Corrugates skin to
improve grip of palm
Flexes
metacarpophalangeal
fingers nerve; 3 and 4 joints and extend
deep branch of ulnar interphalangeal joints of
nerve fingers except thumb
Interossei (8)
ü Palmar (4) First arises from Proximal phalanges Deep branch of Palmar interossei adduct
base of 1st of thumb and index, ulnar nerve fingers toward center of
metacarpal; ring and little fingers third finger
remaining three from and dorsal extensor
anterior surface of expansion of each
nd th
shafts of 2 , 4 and finger
th
5 metacarpals
ü Dorsal (4) Contiguous sidesof Proximal phalanges Deep branch of Dorsal interossei abduct
shafts of metacarpal of index, middle and ulnar nerve fingers from center of
bones ring fingers and third finger; both palmar
dorsal extensor and dorsal flex
expansion metacarpophalangeal
joints and extend
interphalangeal joints
Short Muscles of Thumb (Thenar Muscles; pollicis- thumb)
Abductor Pollicis Scaphoid, Base of proximal Median nerve Abduction of thumb
Brevis trapezium, flexor phalanx of thumb
retinaculum
Flexor Pollicis Flexor retinaculum Base of proximal Median nerve Flexes
Brevis phalanx of thumb metacarpophalangeal
joint of thumb
Opponens Pollicis Flexor retinaculum Shaft of metacarpal Median nerve Pulls thumb medially
bone of thumb and forward across palm
nd
Adductor Pollicis Oblique head; 2 Base of proximal Deep branch of Adduction of thumb
rd
and 3 metacarpal phalanx of thumb ulnar nerve
bones; transverse
rd
head; 3 metacarpal
bone
th
Short Muscles of Little Finger (Hypothenar Muscles; digiti minimi- 5 digit)
Abductor Digiti Pisiform bone Base of proximal Deep branch of Abducts little finger
Minimi phalanx of little ulnar nerve
finger
Flexor Digiti Flexor retinaculum Base of proximal Deep branch of Flexes little finger
Minimi phalanx of little ulnar nerve
finger
th th
Opponens Digiti Flexor retinaculum Medial border of 5 Deep branch of Pulls 5 metacarpal
Minimi metacarpal bone ulnar nerve forward as in cupping
the palm

Summary of the Branches of the Brachial Plexus and their Distribution

Branches Distribution
Roots
Dorsal Scapular Nerve (C5) Rhomboid minor, rhomboid major, levator scapulae
Long Thoracic Nerve (C5, 6, 7) Serratus anterior
Upper Trunk
Suprascapular Nerve (C5, 6) Supraspinatus and infraspinatus
Nerve to Subclavius (C5, 6) Subclavius
Lateral Cord
Lateral Pectoral Nerve (C5, 6, 7) Pectoralis major
Musculocutaneous Nerve (C5, 6, 7) Coracobrachialis, biceps brachii, brachialis; supplies skin
along lateral border of forearm when it becomes the
lateral cutaneous nerve of the forearm
Lateral root of Median Nerve (C5, 6, 7)

Upper Subscapular Nerve (C5, 6)


Thoracodorsal Nerve (C6, 7, 8)
Lower Subscapular Nerve (C5, 6)
Axillary Nerve (C5, 6)
(See medial root of median nerve)
Posterior Cord
Subscapularis
Latissimus dorsi
Subscapularis and teres major
10
Deltoid and teres minor; upper and lateral cutaneous
nerve of arm supplies skin over lower half of deltoid
muscle
Radial Nerve (C5, 6, 7, 8; T1) Triceps, anconeus, part of brachialis, ECRL; via deep
radial nerve branch supplies extensor muscles of
forearm: supinator, ECRB, ECU, ED, EDM, EI, AbPL,
EPL, EPB; skin, lower lateral cutaneous nerve of arm,
posterior cutaneous nerve of arm, and posterior
cutaneous nerve of forearm; skin on lateral side of
dorsum of hand and dorsal surface of lateral three and a
half of fingers; articular branches to elbow, wrist and hand
Medial Cord
Medial Pectoral Nerve (C8; T1) Pectoralis major and pectoralis minor
Medial Cutaneous Nerve of arm joined by intercostals Skin of medial side of arm
brachial nerve from second intercostals nerve (C8;
T1, 2)
Medial Cutaneous Nerve of forearm (C8; T1) Skin of medial side of forearm
rd
Ulnar Nerve (C8; T1) FCU and medial half of FDP, FDM, ODM, AbDM, AdP, 3
th
and 4 lumbricals, interossei, PB, skin of medial half of
dorsum of hand and palm, skin of palmar and dorsal
surfaces of medial one and a half fingers
Medial root of Median Nerve (with lateral root) forms PT, FCR, PL, FDS, AbPB, FPB, OP, first two lumbricals
Median Nerve (C5, 6, 7, 8; T1) (by way of anterior interosseus branch), FPL, FDP (lateral
half), PQ, palmar cutaneous branch to lateral half of palm
and digital branches to palmar surface of lateral three and
a half fingers; articular branches to elbow, wrist and
carpal joints
Muscles of the Gluteal Region
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Muscle Origin Insertion Nerve Supply Action
Gluteus Outer surface of ilium, Iliotibial tract and Inferior gluteal nerve Extends and laterally rotates hip
maximus sacrum, coccyx, gluteal tuberosity of joint; through iliotibial tract, it
sacrotuberous ligament femur extends knee joint
Gluteus Outer surface of ilium Lateral surface of Superior gluteal Abducts thigh at hip joint; tilts
medius greater trochanter of nerve pelvis when walking to permit
femur opposite leg to clear ground
Gluteus Outer surface of ilium Anterior surface of Superior gluteal Abducts thigh at hip joint; tilts
minimus greater trochanter of nerve pelvis when walking to permit
femur opposite leg to clear ground
Tensor fasciae Iliac crest Iliotibial tract Superior gluteal Assists gluteus maximus in
latae nerve extending the knee joint
Piriformis Anterior surface of Upper border of greater First and second Lateral rotator of thigh at hip
sacrum trochanter of femur sacral nerves joint
Obturator Inner surface of Upper border of greater Sacral plexus Lateral rotator of thigh at hip
internus obturator membrane trochanter of femur joint
Gemellus Spine of ischium Upper border of greater Sacral plexus Lateral rotator of thigh at hip
superior trochanter of femur joint
Gemellus Ischial tuberosity Upper border of greater Sacral plexus Lateral rotator of thigh at hip
inferior trochanter of femur joint
Quadratus Lateral border of ischial Quadrate tubercle of Sacral plexus Lateral rotator of thigh at hip
femoris tuberosity femur joint

Muscles of the Anterior Fascial Compartment of the Thigh

Muscle Origin Insertion Nerve Supply Action


Sartorius Anterior superior iliac Upper medial surface of Femoral nerve Flexes, abducts, laterally rotates
spine shaft of tibia thigh at hip joint; flexes and
medially rotates leg at knee joint
Iliacus Iliac fossa of hip bone With psoas into lesser Femoral nerve Flexes thigh on trunk; if thigh is
trochanter of femur fixed, it flexes the trunk on the
thigh as in sitting up from lying
down
Psoas Transverse processes, With iliacus into lesser Lumbar plexus Flexes thigh on trunk; if thigh is
bodies, and trochanter of femur fixed, it flexes the trunk on thigh
intervertebral discs of as in sitting up from lying down
the 12th thoracic and
five lumbar vertebrae
Pectineus Superior ramus of pubis Upper end of linea Femoral nerve Flexes and adducts thigh at hip
aspera of shaft of femur joint
Quadriceps
femoris
Rectus Straight head: anteriorQuadriceps tendon into Femoral nerve Extension of leg at knee joint;
femoris inferior iliac spine patella, then via flexes thigh at hip joint
Reflected head: ilium ligamentum patellae
above acetabulum into tubercle of tibia
Vastus Upper end and shaft of Quadriceps tendon into Femoral nerve Extension of leg at knee joint
lateralis femur patella, then via
ligamentum patellae
into tubercle of tibia
Vastus Upper end and shaft of Quadriceps tendon into Femoral nerve Extension of leg at knee joint;
medialis femur patella, then via stabilizes patella
ligamentum patellae
into tubercle of tibia
Vastus Anterior and lateral Quadriceps tendon into Femoral nerve Extension of leg at knee joint;
intermedius surfaces of shaft of
femur
patella, then via
ligamentum patellae
into tubercle of tibia

Muscles of the Medial Fascial Compartment of the Thigh


synovial membrane
12
articularis genus retracts

Muscle Origin Insertion Nerve Supply Action


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

Muscles of the Posterior Fascial Compartment of the Thigh

Muscle Origin Insertion Nerve Supply Action


Biceps femoris Long head: ischial Head of fibula Long head: tibial Flexes and laterally
tuberosity portion of sciatic rotates leg at knee joint;
nerve long head also extends
thigh at hip joint
Short head: linea Short head:
aspera, lateral common peroneal
supracondylar ridge of portion of sciatic
shaft of femur nerve
Semitendinosus Ischial tuberosity Upper part of medial Tibial portion of Flexes and medially
surface of shaft of tibia sciatic nerve rotates leg at knee joint;
extends thigh at hip joint
Semimembranosus Ischial tuberosity Medial condyle of tibia Tibial portion of Flexes and medially
sciatic nerve rotates leg at knee joint;
extends thigh at hip joint
Adductor magnus Ischial tuberosity Adductor tubercle of Tibial portion of Extends thigh at hip joint
(hamstring portion) femur sciatic nerve

Muscles of the Anterior Fascial Compartment of the Leg

Muscle Origin Insertion Nerve Supply Action


Tibialis Lateral surface of shaft Medial cuneiform and Deep peroneal Extendsb foot at ankle joint;
anterior of tibia and base of first metatarsal nerve inverts foot at subtalar and
interosseous bone transverse tarsal joints; holds
membrane up medial longitudinall arch of
foot
Extensor Anterior surface of shaft Extensor expansion of Deep peroneal Extends toes; extends foot at
digitorum of fibula lateral four toes nerve ankle joint
longus
Peroneus Anterior surface of shaft Base of fifth metatarsal Deep peroneal Extends foot at ankle joint;
tertius of fibula bone nerve everts foot at subtalar and
transverse tarsal joints
Extensor Anterior surface of shaft Base of distal phalanx Deep peroneal Extends big toe; extends foot at
hallucis of fibula of great toe nerve ankle joint; inverts foot at
longus subtalar and transverse tarsal

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

13
Muscles of the Lateral Fascial Compartment of the Leg

Muscle Origin Insertion Nerve Supply Action


Peroneus Lateral surface of shaft Base of first metatarsal Superficial peroneal Plantar flexes foot at ankle
longus of fibula and the medial nerve joint; everts foot at subtalar and
cuneiform transverse tarsal joints;
supports lateral longitudinal
and transverse arches of foot
Peroneus Lateral surface of fibula Base of fifth metatarsal Superficial peroneal Plantar flexes foot at ankle
brevis shaft of bone nerve joint; everts foot at subtalar and
fibula transverse tarsal joint; supports
lateral longitudinal arch of foot

Muscles of the Posterior Fascial Compartment of the Leg

Muscle Origin Insertion Nerve Supply Action


Superficial Group
Gastrocnemius Lateral head from Via tendo calcaneus Tibial nerve Plantar flexes foot at ankle
lateral condyle of femur into posterior surface of joint; flexes knee joint
and medial head from calcaneum
above medial condyle
Plantaris Lateral supracondylar Posterior surface of Tibial nerve Plantar flexes foot at ankle
ridge of femur calcaneum joint; flexes knee joint
Soleus Shafts of tibia and Via tendo calcaneus Tibial nerve Together with gastrocnemius
fibula into posterior surface of and plantaris is powerful
calcaneum plantar flexor of ankle joint;
provides main propulsive force
in walking and running
Deep Group
Popliteus Lateral surface of Posterior surface of Tibial nerve Flexes leg at knee joint;
lateral condyle of femur shaft of tibia above unlocks knee joint by lateral
soleal line rotation of femur on tibia and
slackens ligaments of joint
Flexor Posterior surface of Bases of distal Tibial nerve Flexes distal phalanges of
digitorum shaft of tibia phalanges of lateral lateral four toes; plantar flexes
longus four toes foot at ankle joint; supports
medial and lateral longitudinal
arches of foot
Flexor hallucis Posterior surface of Base of distal phalanx Tibial nerve Flexes distal phalanx of big
longus shaft of fibula of big toe toe; plantar flexes foot at ankle
joint; supports medial
longitudinal arch of foot
Tibialis Posterior surface of Tuberosity of navicular Tibial nerve Plantar flexes foot at ankle
posterior shafts of tibia and fibula bone and other joint; inverts foot at subtalar
and interosseous neighboring bones and transverse tarsal joints;
membrane supports medial longitudinal
arch of foot

Muscles of the Sole of the Foot

Muscle Origin Insertion Nerve Supply Action


First Layer
Abductor Medial tuberosity of Base of proximal Medial plantar nerve Flexes and abducts big toe;
hallucis calcaneum and flexor phalanx of big toe braces medial longitudinal arch

Flexor
digitorum
brevis
retinaculum
Medial tubercle of
calcaneum
Four tendons to four
lateral toes— inserted
into borders of middle
phalanx; tendons
perforated by those of
14
Medial plantar nerve Flexes lateral four toes; braces
medial and lateral longitudinal
arches

flexor digitorum longus


Abductor Medial and lateral Base of proximal Lateral plantar nerve Flexes and abducts fifth toe;
digiti minimi tubercles of calcaneum phalanx of fifth toe braces lateral longitudinal arch
Second Layer
Quadratus Medial and lateral sides Tendon of flexor Lateral plantar nerve Assists flexor digitorum longus
plantae of calcaneum digitorum longus in flexing lateral four toes
Lumbricals (4) Tendons of flexor Dorsal extensor First lumbrical: Extends toes at interphalangeal
digitorum longus expansion; bases of medial plantar joints
proximal phalanges of nerve; remainder:
lateral four toes lateral plantar nerve
Flexor
digitorum
longus tendon
Flexor hallucis
longus tendon
Third Layer
Flexor hallucis Cuboid, lateral Medial tendon into Medial plantar nerve Flexes metatarsophalangeal
brevis cuneiform, tibialis medial side of base of joint of big toe; supports medial
posterior insertion proximal phalanx of big longitudinal arch
toe; lateral tendon into
lateral side of base of
proximal phalanx of big
toe
Adductor Oblique head bases of Lateral side of base of Deep branch lateral Flexes metatarsophalangeal
hallucis second, third, and proximal phalanx of big plantar nerve joint of big toe; holds together
fourth metatarsal toe metatarsal bones
bones; transverse head
from plantar ligaments
Flexor digiti Base of fifth metatarsal Lateral side of base of Lateral plantar nerve Flexes metatarsophalangeal
minimi brevis bone proximal phalanx of joint of little toe
little toe
Fourth Layer
Interossei
Dorsal (4) Adjacent sides of Bases of proximal Lateral plantar nerve Abduction of toes; flexes
metatarsal bones phalanges first: medial metatarsophalangeal joints
side of second toe; and extends interphalangeal
remainder: lateral sides joints
of second, third, and
fourth toes also dorsal
extensor expansion
Plantar (3) Inferior surfaces of Medial side of bases of Lateral plantar nerve Adduction of toes; flexes
third, fourth, and fifth proximal phalanges of metatarsophalangeal joints
metatarsal bones lateral three toes and extends interphalangeal
joints
Peroneus
longus tendon
Tibialis
posterior
tendon

Muscle of the Dorsum of the Foot

Muscle Origin Insertion Nerve Supply Action


Extensor Anterior part of upper By four tendons into the Deep peroneal Extends toes
digitorum surface of the proximal phalanx of big nerve
brevis calcaneum and from
the inferior extensor
retinaculum
toe and long extensor
tendons to second,
third, and fourth toes

Branches of the Sacral Plexus and Their Distribution


15
Branches Distribution
Superior gluteal nerve Gluteus medius, gluteus minimus, and tensor fasciae latae
muscles
Inferior gluteal nerve Gluteus maximus muscle
Nerve to piriformis Piriformis muscle
Nerve to obturator internus Obturator internus and superior gemellus muscles
Nerve to quadratus femoris Quadratus femoris and inferior gemellus muscles
Perforating cutaneous nerve Skin over medial aspect of buttock
Posterior cutaneous nerve of thigh Skin over posterior surface of thigh and popliteal fossa, also over
lower part of buttock, scrotum, or labium majus
Sciatic nerve (L4, 5; S1, 2, 3) Tibial portion Hamstring muscles (semitendinosus, biceps femoris [long head],
adductor magnus [hamstring part]), gastrocnemius, soleus,
plantaris, popliteus, tibialis posterior, flexor digitorum longus, flexor
hallucis longus, and via medial and lateral plantar branches to
muscles of sole of foot; sural branch supplies skin on lateral side of
leg and foot
Common peroneal portion Biceps femoris muscle (short head) and via deep peroneal branch:
tibialis anterior, extensor hallucis longus, extensor digitorum
longus, peroneus tertius, and extensor digitorum brevis muscles;
skin over cleft between first and second toes. The superficial
peroneal branch supplies the peroneus longus and brevis muscles
and skin over lower third of anterior surface of leg and dorsum of
foot
Pudendal nerve Muscles of perineum including the external anal sphincter, mucous
membrane of lower half of anal canal, perianal skin, skin of penis,
scrotum, clitoris, and labia majora and minora

Branches of the Lumbar Plexus and Their Distribution

Branches Distribution
Iliohypogastric nerve External oblique, internal oblique, transversus abdominis muscles
of anterior abdominal wall; skin over lower anterior abdominal wall
and buttock
Ilioinguinal nerve External oblique, internal oblique, transversus abdominis muscles
of anterior abdominal wall; skin of upper medial aspect of thigh;
root of penis and scrotum in the male; mons pubis and labia
majora in the female
Lateral cutaneous nerve of the thigh Skin of anterior and lateral surfaces of the thigh
Genitofemoral nerve (L1, 2) Cremaster muscle in scrotum in male; skin over anterior surface of
thigh; nervous pathway for cremasteric reflex
Femoral nerve (L2, 3, 4) Iliacus, pectineus, sartorius, quadriceps femoris muscles, and
intermediate cutaneous branches to the skin of the anterior surface
of the thigh and by saphenous branch to the skin of the medial side
of the leg and foot; articular branches to hip and knee joints
Obturator nerve (L2, 3, 4) Gracilis, adductor brevis, adductor longus, obturator externus,
pectineus, adductor magnus (adductor portion), and skin on medial
surface of thigh; articular branches to hip and knee joints
Segmental branches Quadratus lumborum and psoas muscles
Back

Muscles Connecting the Upper limb to the Vertebral Column/ Superficial (Appendicular) Group of Back
Muscles
*Trapezius
*Latissimus Dorsi
16
*Levator Scapulae
*Rhomboid Major
*Rhomboid Minor

Intermediate (Respiratory) Group of Back Muscles


Muscle Origin Insertion Innervation Action
Serratus Lower portion of Upper border of Anterior rami of Elevates ribs 2 to
Posterior ligamentum ribs 2 to 5 just upper thoracic 5
Superior nuchae, spinous lateral to their nerves (T2 to T5)
process of C7 to angles
T3 and
supraspinous
ligaments
Serratus Spinous process Lower border of Anterior rami of Depresses ribs 9
Posterior Inferior of T11 to L3 and ribs 9 to 12 just lower thoracic to 12 and may
supraspinous lateral to their nerves (T9 to prevent lower ribs
ligaments angles T12) from being
elevated when
the diaphragm
contracts

Deep Group of Back Muscles

SpinoTransversales Muscles
Muscle Origin Insertion Innervation Action
Splenius Capitis Lower half of Mastoid process, Posterior rami Together- draw
ligamentum skull below lateral middle cervical head backwards
nuchae, spinous 1/3 of superior nerves extending neck;
processes of C7 nuchal line individually- draw
to T4 and rotate head
to one side (turn
face to same
side)
Splenius Cervicis Spinous Transverse Posterior rami Together- extend
processes of T3 processes of C1 middle cervical neck; individually-
to T6 to C3 nerves draw and rotate
head to one side
(turn face to
same side)

Erector Spinae Group of Back Muscles


Muscle Origin Insertion
Iliocostalis Lumborum Sacrum, spinous process of Angles of the lower 6 or 7 ribs
lumbar and lower two thoracic
vertebrae and their
supraspinous ligaments and
the iliac crest
Iliocostalis Thoracis Angles of the lower 6 ribs Angles of the upper 6 ribs and
the transverse process of C7
Iliocostalis Cervicis Angles of ribs 3 to 6 Transverse processes of C4 to
C6
Longissimus Thoracis Blends with iliocostalis in Transverse processes of all
lumbar region and is attached thoracic vertebrae and just
to transverse processes of lateral to the tubercles of the
lumbar vertebrae lower 9 or 10 ribs
Longissimus Cervicis Transverse processes of upper Transverse processes of C2 to
4 or 5 thoracic vertebrae C6
Longissimus Capitis Transverse processes of upper Posterior margin of the mastoid

Spinalis Thoracis

Spinalis Cervicis
4 or 5 thoracic vertebrae and
articular processes of lower
three or four cervical vertebrae
Spinous processes of T10 or
T11 to L2
Lower part of ligamentum
process

Spinous processes of T1 to T8
(varies)
Spinous process of C2 (axis)
17
nuchae and spinous processes
of C7 (sometimes T1 to T2)
Spinalis Capitis Usually blends with With semispinalis capitis
semispinalis capitis

Transversospinales Group of Back Muscles


Muscle Origin Insertion
Semispinalis Thoracis Transverse processes of T2 to Spinous processes of upper 4
T10 thoracic and lower 2 cervical
vertebrae
Semispinalis Cervicis Transverse processes of upper Spinous processes of C2 (axis)
5 or 6 thoracic vertebrae to C5
Semispinalis Capitis Transverse processes of T1 to Medial area between the
T6 (or T7) and C7 and articular superior and inferior nuchal
processes of C4 to C6 lines of occipital bone
Multifidus Sacrum, origin of erector Base of spinous processes of
spinae, PSIS, mammillary all vertebrae from L5 to C2
processes of lumbar vertebrae,
transverse processes of
thoracic vertebrae and articular
processes of lower four cervical
vertebrae
Rotatores Lumborum Mammillary processes of Spinous processes of ;umbar
lumbar vertebrae vertebrae
Rotatores Thoracis Transverse processes of Spinous processes of thoracic
thoracic vertebrae vertebrae
Rotatores Cervicis Articular processes of cervical Spinous processes of cervical
vertebrae vertebrae

Segmental Back Muscles


Muscle Origin Insertion Action
Levatores Costarum Short paired muscles The rib below vertebra Contraction elevates
arising from transverse of origin near tubercle rib
processes of C7 to
T11
Interspinales Short paired muscles
attached to the
spinous process of
contiguous vertebrae,
one on each side of
the interspinous
ligament
Intertransversarii Small muscles
between the
transverse processes
of contiguous
vertebrae

Suboccipital Gorup of Back Muscles


Muscle Origin Insertion Innervation Function
Rectus Capitis Spinous process Lateral portion of Posterior ramus Extension of
Posterior Major of axis (C2) occipital bone of C1 head; rotation of
below inferior face to same side
nuchal line as muscle
Rectus Capitis Posterior tubercle Medial portion of Posterior ramus Extension of head
Posterior Minor of atlas (C1) occipital bone of C1
below inferior
nuchal line
Obliquus Capitis
Superior

Obliquus Capitis
Inferior
Transverse
process of atlas
(C1)

Spinous process
of axis (C2)
Occipital bone
between superior
and inferior
nuchal lines
Transverse
process of atlas
Posterior
of C1

Posterior
of C1
ramus

ramus
Extension of head
and bends it to
same side

Rotation of face
to same side
18
(C1)

Thorax

Muscles Connecting the Upper Limb to the Thoracic Wall/ Muscles of the Pectoral Region (except Serratus
Anterior)
*Pectoralis Major
*Subclavius
*Pectoralis Minor

Muscles of the Thorax/ Thoracic Wall


Muscle Origin Insertion Innervation Function
External Inferior margin of Superior surface f Intercostal Most active
Intercostal rib above rib below nerves; T1-T11 during inspiration;
supports
intercostals
space; moves
ribs superiorly
Internal Lateral edge of Superior surface Intercostal Most active
Intercostal costal groove of of rib below deep nerves; T1-T11 during expiration;
rib above to the attachment supports
of the related intercostals
external space; moves
intercostal ribs inferiorly
Innermost Medial edge of Internal aspect of Intercostal Acts with internal
Intercostal costal groove of superior surface nerves; T1-T11 intercostals
rib above of rib below muscles
Subcostales Internal surface Internal surface of Related May depress ribs
nd rd
(near angle) of 2 to 3 rib intercostal nerves
lower ribs below
Transversus Lower margins Inferior aspect of Related Depresses costal
Thoracis and internal deep surface of intercostals cartilages
surfaces of body of sternum, nerves
cocostal xiphoid process
nd
cartilages of 2 and costal
th
to 6 ribs cartilages ribs 4-7
Diaphragm (most Xiphoid process; Central tendon Phrenic nerve Very important
important muscle lower six costal muscle of
of respiration) cartilages, first inspiration;
three lumbar increases vertical
vertebrae diameter of
thorax by pulling
central tendon
downward;
assists in raising
lower ribs. Also
used in
abdominal
straining and
weight lifting
Levatores Tip of transverse Rib below Posterior rami of Raises ribs and
Costarum (12) process of C7 thoracic spinal therefore
and T1-11 nerves inspiratory
vertebrae muscles
Serratus
Posterior (see Intermediate (Respiratory) Group of Back Muscles)
Superior
Serratus
Posterior Inferior

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