Articulations

JOINT CLASSIFICATIONS Synarthrosis: immovable Amphiarthrosis: slightly movable joint Diarthrosis: freely movable joint

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Fibrous: neighboring bones are jointed together by a solid mass of dense irregular connective tissue o Sutures: fibrous joint composed of a thin layer of dense irregular connective tissue -> only in the skull o Syndesmosis: greater distance between the articulating surfaces and more dense irregular connective tissue than in a suture o Interosseous membranes: substantial sheet of dense irregular connective tissue that binds neighboring long bones and permits slight movement -> radius/ulna, tib/fib Cartilaginous: solid connective tissue that allows little or no movement. Tightly connected by hyaline cartilage or by fibrocartilage o Sunchondroses: immovable cartilaginous joint in which connecting material is hyaline cartilage. -> epiphyseal plate (growing bone) o Symphyses: ends of articulating bones are covered in hyaline cartilage All in the midline of the body Pubic symphysis Synovial: presence of a space called a synovial cavity, surrounded by connective tissue capsule that attaches the articulating bones o Slightly movable to the most movable o Carpal bones, shoulder, etc. Bursae: saclike structures strategically situated to alleviate friction around some joints (shoulder/knee) o Resemble synovial capsules o Located between the skin and the bone, muscle and bones, ligaments and bones Tendon sheaths: tubelike bursae that wrap around tendons experiencing considerable friction on all sides as they pass through

fibro-osseous tunnels (tunnels formed by connective tissue bands and bone) o Protects all sides of the tendon from friction within the tunnel o Wrists, ankles JOINTS OF THE AXIAL SKELETON Joint Suture Atlanto-occipital Articular Components b/w skull bones Movements Slight

b/w superior articular Flexion/extention of head facets of atlas and occipital and slight lateral flexion condyles of occipital bone 1. B/w dens of axis and anterior arch of atlas 2.Between lateral masses of atlas and axis 1. b/w vertebral bodies 2. b/w vertebral arches 1. b/w facets of heads of ribs and facets of bodies of adjacent thoracic vertebrae and intervertebral discs b/w them 2. b/w articular part of tubercles of ribs and facets of transverse processes of thoracic vertebra Between sternum and first 7 pairs of ribs Rotation of head

Atlanto-axial

Intervertebral

Flexion, extension, lateral flexion, rotation of vertebral column Slight gliding

Vertebrocostal

Sternocostal

None b/w sternum and first pair of ribs, slight gliding b/w sternum and 2nd-7th pair

Lumbrosacral

1. b/w body of 5th lumbar Flexion, extension, lateral vertebra and base of flexion, rotation of vertebral sacrum 2 between inferior articular facets of 5th lumbar and superior articular facets of 1st sacral

JOINTS OF THE APPENDICULAR SKELETON Joint Sternoclavicular Articular components b/w sternal ends of clavicle, manubrium of sternum and first costal cartilage b/w acromion of scapula and acromial end of clavicle Proximal radioulnar joint b/w head of radius and radial notch of ulna. Distal radioulnar joint b/w ulnar notch of radius and head of ulna b/w distal end of radius and scaphoid, lunate, and triquetrum of carpus b/w proximal row of carpal bones and b/w both rows of carpal bones Movements Gliding with limited movements in nearly every direction Glidint and rotation of scapula on clavicle Rotation of forearm

Acromioclavicular

Radioulnar

Wrist (radiocarpal)

Flexion, extension, abduction, adduction, circumduction, and slight hyperextension of wrist Gliding plus flexion, extension, abduction, adduction and slight rotation at midcarpal joints

Intercarpal

Carpometacarpal

Joint of thumb between trapezium and 1st metacarpal, between carpals and 2nd-5th metacarpals b/w heads of metacarpals and bases of proximal phalanges B/ heads of phalanges and bases of more distal phalanges

Flexion, extension, adduction, abduction, circumduction at thumb and gliding at remaining digits Flexion, extension, adduction, abduction, and circumduction of phalanges Flexion and extension of phalanges Slight gliding (even more so during pregnancy) Slight movements (even more during pregnancy) Slight gliding at proximal joint, and slight rotation of fibular during dorsiflexion of foot

Metacarpopha langeal Interphalangeal

Sacroiliac

b/w auricular surfaces of sacrum and ilia of hip bones b/w anterior surfaces of hip bones Proximal tibiofibular joint b/w lateral condyle of tibia and head of fibula, distal tibiofibular joint b/w distal end of fibula and fibular notch of tibia Subtalar joint b.w talus and calcaneus of tarsus, talocalcaneonavicular joint b/w talus and calcaneus and navicular of tarsus, calcaneocuboid joint bw calcaneus and cuboid of tarsus b/w 3 cuneiforms of tarsus and bases of five metatarsal bones

Pubic symphysis Tibiofibular

Intertarsal

Inversion and eversion of foot

Tarsometatarsal

Slight gliding

SHOULDER

Ball-and-socket joint Head of humerus engages in shallow socket (formed by glenoid cavity) on scapula -> very shallow and has small contact area Ring of fibrocartilage (glenoid labrum) encircles edge of glenoid cavity -> increases contact area slightly Capsule surrounding joint lined with synovial fluid -> releases to reduce friction Bridged and protected by coracoacromial arch -> acromion posteriorly and coracoid process anteriorly w/ coracoacromial ligament passing b/w them

ELBOW

HIP

KNEE Tibiofemoral joint Modified hinge joint Laterally: lateral condyle of the femur, lateral meniscus, lateral condyle of the tibia (weight bearing bone of the lower leg) Medially: between medial condyle of the femur, medial meniscus, medial condyle of the tibia Intermediate: patellofemoral joint b/w pateall and patellar surface of the femur

ANKLE

Skull sutures with fibrous connective tissue base: Atlas (C1) = flex & extend Mandible: temporalmandibular joint -> condyloid synovial joint Orbital Cavity formed by sutures with fibrous connective tissue Ear Auditory ossicles join to each other by synovial joints Articulates cause transmission of sound waves Auditory Ossicles Head of malleus -> incus Base of the long process of incus -> stapes Connection with the tympanic membrane triggers it Vertebrae With one another through intervertebral disks 3 separate joints with vertebra above/below pair of facet joints, single anterior intervertebral joint 10 of thoracic vertebrae -> rib pairs 1-10 atlas: (C1) forms 2 joints -> atlanto-occipital joints (w/ base of skull) axis: (C2) dens -> w/ midline of atlas cervical: articular processes project up and down from left and right sides of the vertebral arch -> facet joints with articular processes of adjacent vertebrae thoracic: facet joints b/w 12th thoracic vertebrae + connected ribs o articular processes -> facet -> articular processes Lumbar: anterior intervertebral joints occur b/w the bodies of adjacent vertebrae Sacrum: articulates with the 5th lumbar vertebra (L5) o Sacrococcygeal joint -> sacrum + coccyx o Sacroiliac joint -> where ilium and sacrum meet (front = synovial, back = fibrous) Intervertebral disks Form joints b/w bodies of the vertebrae -> unite adjacent vertebrae and permit movement between them

 Ribs

Reinforced front and behind by ligaments (pass along length of vertebral column

Sternoclavicular joint:manubrium + clavicles Sternocostal joint: costal cartilage + sternum Costochondral joint: costal cartilage + rib Posteriorly w/ corresponding thoracic vertebrae Anteriorly 1-7 with sternum Clavicles Acromioclavicular: acromion of scapula + distal end of clavicle o Supported by capsule of ligaments -> pass own from the undersurface of the clavicle to the coracoid process Coracoidclavicular ligament: part of capsule that supports acromioclavicular joint Sternoclavicular joint: clavicle + manubrium o Held by ligaments Upper Limbs Elbow: humerus +ulna and radius o b/w humerus and ulna = synovial hinge joint wrist: ulna and radius + carpals Radius: w/ shaft of ulna = pivot joint o Distal ends w/ carpal bones Ulna: firmly bound to radius along length by a fibrous membrane o Not involved in the wrist joint Radioulnar joint: b/w radius and articular disk of the joint o Ellipsoidal joint Carpal bones: articulate with one another on gliding joints -> ellipsoidal joint o Hamate, capitate, trapezoid, trapezium articulate with metacarpal bones Metacarpophalanges joints (MCP): metacarpal + proximal phalanges Joint b/w trapezium + metacarpal bone of the thumb = saddle joint o Interphalangeal joints: b/w each ket -> head of the femur meets acetabulum of the hip bone Sacroiliac joint: sacrum and iliac

o Synovial at the front and fibrous at the back Sacroccygeal joint: sacrum and coccyx Lower Limbs Hip: femur head and acetabulum Knee: femur base + patella + tibia o Hinge Ankle: tib + fib + talus o Synovial hinge Foot: tarsals separated by joints o Metatarsals from behind with tarsus ad with phalanges

Muscles
MUSCLE NAMING Name Rectus Oblique Meaning Name

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Meaning Perpendicular to midline

Direction: Orientation of muscle fascicles relative to bodys midline Parallel to midline Transverse Oblique Diagonal to midline Largest Long Widest Large Smaller Triangular Saw-toothed Circular Pear-shaped Square, 4-sided Decreases joint angle Moves a bone away from the midline Raises or elevates a body part Turns palm anteriorly Decreases the size of an opening Rotates a bone around its Minimus Brevis Longissimus Major Vastus Trapezius Rhomboid Pectinate Platys Gracillis Extensor Adductor Smallest Short Longest Larger Huge Trapezoid Diamond-shaped Comblike Flat Slender Increases a joint angle Moves a bone closer to the midline Lowers or depresses a body part Turns palm posteriorly Makes a body part rigid

Size: relative size of the muscle Maximus Longus Latissimus Magnus Minor Deltoid Serratus Orbicularis Piriformis Quadratus Flexor Abductor

Shape: Relative shape of the muscle

Action: Principle action of the muscle

Levator

Depressor

Supinator Sphincter

Pronator Tensor

Rotatory

longitudinal axis Number of Origins: Number of tendons of origin Biceps Quadriceps 2 origins 4 origins Triceps 3 origins

HEAD AND NECK Name Occipitalis Origin Superior nuchal line Galea aponeurotica Zygomatic bone Insertion Galea aponeurotic a Eyebrows and bridge of nose Orbicularis oris, levator labii superioris Orbicularis oris Nerve Facial Action Draw scalp backwards Raise eyebrows Pull corners of the mouth upward and outward Pull corner of the mouth downward Compresse s the cheeks Orbicularis oculi Procerus Medial margin of the orbit Fascia Skin around the eyelids Skin of forehead Facial Facial Closes eyelids Draws eyebrows down at bridge of nose Lowers bottom lip

Frontalis

Facial

Zygomaticus

Facial

Depressor anguli oris

Mandible

Facial

Buccinators

Maxilla, mandible

Orbicularis oris

Facial

Depressor labii inferioris

Mandible

Skin of lower lip

Facial

Orbicularis oris

Maxilla, mandible Maxilla, alar cartilage

Orbicularis oris

Facial

Closes and purses the lips Flares nostrils

Nasalis

Nasal Facial cartilage at bridge of the nose Sclera

Inferior rectus

Dural sheath around optic nerve

Oculomotor Moves the (CNIII) eye laterally, upward, sideward Oculomotor Moves the eye laterally, upward, sideward Oculomotor Moves the eye laterally, upward, sideward Abducens (CNVI) Moves the eye laterally, upward, sideward Moves eye downward and sideward

Medial rectus

Dural sheath around optic nerve

Sclera

Superior rectus

Dural sheath around optic nerve

Sclera

Lateral rectus

Moves the eye laterally, upward, sideward Sphenoid bone

Sclera

Superior oblique

Sclera

Trochlear (CNIV)

Inferior oblique

Maxillary

Sclera

Oculomotor Moves eye upward and sideward Posterior Moves head

Splenius capitis

Spinous

Mastoid

processes of C7-T4, lower part of nuchal ligament Levator scapulae Transverse process of cervical vertebrae C1C4 Transverse processes of cervical vertebrae C1C7 Trapezius Occipital bone, spinous processes from lowest cervical vertebra to lowest thoracic vertebra C7T12 Transverse processes of cervical vertebrae C3C7 Transvese process of cervical vertebrae C1C7 Manubrium

process, skill below superior nuchal line Medial border of scapula

rami of middle cervical nerves Cervical spinal nerves C3 and C4 Cervical spinal nerves

backwards

Raise and rotate scapula with trapezius Raise ribs and flex neck

Scalenus posterior

2nd rib

Clavicle, acromion, spine of scapula

Spinal accessory nerve (CNXI)

Works with levator scapulae to raise and rotate the scapula

Scalenus anterior

Scalene tubercle of 1st rib

Cervical spinal nerves

Raise ribs and flex neck

Scalenus medius

Superior surface of 1st rib

Cervical spinal nerves

Raise ribs and flex neck

Sternocleidomasto

Mastoid

Spinal

Rotate the

id

and midsection of the clavicle

process, occipital bone

accessory nerve + cervical spinal nerves C2 and C3 Mandibular branch of the trigeminal nerve (CNV) Mandibular branch of the trigeminal nerve (CNV) Mandibular branch of the trigeminal nerve (CNV)

head

Temporalis

Temporal fossa, temporal fascia

Coronoid process of the mandible

Close the jaw by working with the masseter Close the jaw by working with the temporalis Raise the mandible (close the jaw) 1 protrudes the jaw, jaw grinding Lower the mandible, side to side movement of the mandible

Masseter

Inferior border of the zygomatic arch

Ramus and coronoid process of the mandible Medial surface of the mandibular ramus, angle of the mandible Temporoma ndibular joint, neck of the mandible

Medial pterygoid

Lateral pterygoid plate, tuberorisity of the maxilla

Lateral pterygoid

Lateral pterygoid plate, infratemporal surface of the greater wing of the sphenoid bone and pterygoid

Mandibular branch of the trigeminal nerve (CNV)

ridge Superior constrictor Pterygoid Median plate of the raphe of the sphenoid bone pharynx Horns of the hyoid bone Median raphe of the pharynx Median raphe of the pharynx Thyroid cartilage of the larynx Thyroid cartilage of the larynx Thyroid cartilage of the larynx Pharyngeal plexus and its branches Pharyngeal plexus and its branches Pharyngeal plexus and its branches Pharyngeal plexus and its branches Pharyngeal plexus and its branches Pharyngeal plexus and its branches Hypoglossa l (XII) nerve Hypoglossa l Constrict pharynx

Middle constrictor

Constrict pharynx

Inferior constrictor

Cricoid and thyroid cartilages of the larynx Styloid process

Constrict pharynx

Stylopharyngeus

Raise the larynx

Salpingopharynge us

Cartilage of the auditory tube Hard palate in the oral cavity

Raise the larynx

Palatopharyngeus

Raise the larynx

Tongue Muscles Genioglossus Mandible Undersurfac e of tongue and hyoid bone Depresses tongue and thrusts it anteriorly Elevates and draws it posteriorly Depresses

Styloglossus

Styloid Side and process of undersurfac temporal bone e of tongue Greater horn Side of

Hpoglossus

Hypoglossa

and body of hyoid bone Palatoglossus Anterior surface of soft palate

tongue

tongue and draws down its sides Elevates posterior portion of tongue and draws soft palate down on tongue Elevates hyoid bone, Depresses mandible as in opening the mouth

Side of tongue

Pharyngeal plexus

Suprahyoid Digastric Anterior belly from inner side of inferior border of mandible, posterior belly from temporal bone Body of hyoid bone via an intermediate tendon Mandibular division of trigeminal (V) nerve, facial (VII) nerve

Stylohyoid

Styloid Body of process of hyoid bone temporal bone

Facial nerve (VII)

Elevates hyoid bone and draws it posteriorly Elevates hyoid bone and floor of mouth and depresses mandible Elevates hyoid bone, draws hyoid bone and

Mylohyoid

Inner surface of mandible

Body of hyoid bone

Mandibular division of trigeminal nerve

Geniohyoid

Inner surface of mandible

Body of hyoid bone

1st cervical spinal nerve C1

tongue anteriorly and depresses mandible Infrahyoid muscles Omohyoid Superior border of scapular and superior transverse ligament Sternohyoid Medial end of clavicle and manubrium of sternum Manubrium of sternum Body of hyoid bone Branches Depresses of spinal hyoid bone nerves C1C3 Branches Depresses of spinal thyroid nerves C1- cartilage C3 Branches Elevates of spinal thyroid nerves C1- cartilage C2, descendin g hypogloss al (XII) nerve Body of hyoid Branches Depresses of spinal hyoid bone nerves C1C3

Sternothyroid

Thyroid cartilage of larynx Greater horn of hyoid bone

Thyrohyoid

Thyroid cartilage of larynx

BACK Name Latissimus dorsi Origin Insertion Innervation Thoracodorsal nerves C6- C8 Action Movement of the shoulder Thoracolumbar Humerus fasci, spines of the lumbar

vertebrae External abdominal oblique Lower eight pairs of ribs (5-12) Linea alba Thoracic nerves

region and humerus Movement of the spine, bending and flexing Head movement

Semispinalis capitis

Lowest Occipital cervical and bone upper thoracic vertebrae (C7T3) Inferior border of each rib Superior border of the rib below the point of origin Inferior borders of ribs 9-12

Cervical spinal nerves

External intercostal muscles

Intercostal nerves

Elevating the rib cage part of the breathing process Pulls down the ribs

Serratus Spinous posterior inferior processes, supraspinous ligaments of T11-L3 Serratus posterior superior Ligamentum nuchae, spinous processes, supraspinous ligaments of C7-T3

Anterior rami of T9- T12

Superior borders of ribs 2-5

Anterior rami of T2- T5 thoracic nerves

Elevating the ribs

Internal abdominal oblique

Thoracolumbar Lower ribs, fascia, iliac xiphoid crest process, linea alba

Subcostal, iliohypogastric, ilioinguinal nerves

Bending flexing, rotating spinal column, rib

movement CHEST AND ABDOMEN Name Pectoralis Major Origin Clavicle, sternum, costal cartilage Anterior surface of the upper 8 pairs of ribs (1-8) External abdominal oblique Pectoralis minor Lower 8 ribs (5-12) Insertion Innervation Action Movements of the humerus Interubercular Medial and groove of the lateral humerus pectoral nerves (C5T1) Near the vertebral border of the scapula Midline of the thoracolumba r fascia (linea alba) Coracoid process of the scapula Superior border of the ribs below their origin Costal cartilages of the lower ribs, xiphoid process, linea alba Thoracic nerves Thoracic nerves

Serratus anterior

Shoulder movements , moving ribs in inhalation Compress the abdomen Moves shoulder and humerus Depress the ribs

Rib pairs 2-5

Medial pectoral nerves Intercostal nerves

Internal intercostals

Inferior border of each rib Iliac crest of the pelvis, thoracolumba r fascia

Internal abdominal oblique

Subcostal, iliohypogastric , iliinguinal nerves

Compress abdomen and help move vertebral column Compress abdomen and help

Transversus abdominus

Costal Linea alba cartilages of and pubis the lower ribs,

Subcostal, iliohypogastric ilioinguinal

iliac crest, thoracolumba r fascia Rectus abdominis Pubic crest, pubic symphysis Xiphoid process, costal cartilage 5-7

nerves

move vertebral column Compress abdomen and help move vertebral column Inspiration. Descends during inspiration and ascends during relaxation

Lower thoracic nerves (T7T12)

Diaphragm

Vertebral column, ribs 7-12 along the side of the chest, xiphoid process

Central tendon of diaphragm

Phrenic nerve

Coccygeus

Ischial spine

Lateral and inferior borders of the sacrum

Branches of the sacral nerves S4-S5 Sacral nerve S4, pudendal nerve

Support pelvic viscera and flex coccyx Support the pelvic organs and provide resistance to increases in intraabdominal pressure Rotate outward Rotate outward

Levator ani

Body of pubis, Coccyx, ischial spine anococcygeal ligament

Infraspinatus

Scapula

Greater tubercle of the humerus Greater tubercle of

Suprascapular nerve Axillary nerve

Teres minor

Scapula

humerus Supraspinatu s Scapula Greater tubercle of humerus Lesser tubercle of humerus Deltoid tuberosity of the humerus Medial border of scapula Suprascapular nerve Assists deltoid muscle in raising arm Rotates the front of the arm inward Most shoulder movements Downward rotation of the scapula

Subscapularis

Scapula

Subscapular nerve Axillary nerve

Deltoid

Clavicle, acromion, spine of scapula Spinous processes of thoracic vertebrae T2T5 Spinous processes of last cervical vertebra and first thoracic vertebra C7T1

Rhomboid major

Dorsal scapular nerve

Rhomboid minor

Medial border of the scapula

Dorsal scapular nerve

Downward rotation of the scapula

UPPER LIMB Name Forearm Flexors Biceps Brachii Long head: tubercle above glenoid cavity of scapula Short head: Radial tuberosirt of radius and bicipital aponeurosis Musclocuteneo us nerve Flexes forearm, at elbow joint, supinates forearm at radioulnar joints and Origin Insertion Innervation Action

coracoid process of scapula Brachialis Distal, anterior surface of humerus Ulnar tuberosity and coronoid process of ulna Superior to styloid process of radius Musculocutane ous and radial nerves

flexes arm at shoulder joint Flexes forearm at elbow joint

Brachioradialis Lateral border of distal end of humerus

Radial nerve

Flexes forearm at elbow joint, supinates and pronates forearm at radioulnar joints to neutral position

Forearm extensors Triceps brachii Long head: infraglenoid tubercle Lateral head: lateral and posterior surface of humerus Medial head: entire posterior surface of humerus inferior to a groove for Olecranon of ulna Radial nerve Extends forearms at elbow joint and extends arm at shoulder joint

the radial nerve Anconeus Lateral epicondyle of humerus Olecranon and superior portion of shaft of ulna Midlateral surface of radius Radial nerve Extends forearm at elbow joint

Forearm pronators Pronator teres Medial epicondyle of humerus and coronoid process of ulna Distal portion of shaft of ulna Median nerve Pronates forearm at radioulnar joints and weakly flexes forearm at elbow joint Pronates forearm at radioulnar joints Supinates forearm at radioulnar joint

Pronator quadratus

Distal portion of shaft of radius

Median nerve

Forearm supinator supinator Lateral epicondyle of humerus and ridge near radial notch of ulna Lateral surface of proximal 1/3 of radius Deep radial nerve

HAND Name Dorsal interosseus muscles (4) Origin One head of each muscle from each neighboring metacarpal Lateral Insertion Innervation Action Abduct the fingers Extensor Ulnar nerve tendons, base of proximal phalanges of 2nd and 4th fingers Proximal Deep branch

Extensor

Straightening

digiti minimi Extensor digitorum Extensor carpi radialis brevis Abductor pollicis longus Extensor pollicis brevis

epicondyle of humerus Lateral epicondyle of humerus Lateral epicondyle of humerus Posterior of proximal end of radius and ulna Posterior of radius

phalanges of 5th finger Extensor expansions of 2nd- 5th finger Base of 2nd metacarpal bone Base of 1st metacarpal bone Base of proximal phalanx of thumb Base of distal phalanx of thumb Base of 2nd metacarpal bone

of radial nerve Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve Deep branch of radial nerve Radial nerve

the fingers Straightening the fingers Straightening the fingers Abducts the thumb

Straightening the fingers

Extensor pollicis longus Extensor carpi radialis longus

Posterior of ulna, interosseous membrane Lateral supracondylar ridge of humerus

Straightening the fingers

Straightening the fingers

WRIST Name Flexor digitorium superficialis Origin Medial epicondyle of humerus, coronoid process of ulna, anterior surface of radius Insertion Middle phalanx of index, middle, ring, and little fingers Innervation Median nerve Action Flexes middle phalanx of the index, middle, ring, and little fingers

Flexor carpi radialis

Medial epicondyle of humerus, coronoid process of ulna, anterior surface of radius

Base of 2nd and 3rd metacarpal bones

Median nerve

Flexes and abducts wrist

LOWER LIMB Name Iliopsoas Origin Transverse processes and bodies of lumbar vertebrae, iliac fossa and sacrum Insertion With iliacus into lesser trochanter of femur With psoas major into lesser trochanter of femur Illiotibial tract of fascia lata and superior lateral part of linea aspera under greater trochanter of femur Greater torchanter of femur Innervation Lumbar spinal nerves L2-L3, femoral nerve Action Flex thigh at hip, rotate thigh laterally, flex trunk at hip as in sitting from supine

Gluteus maximus

Iliac crest, sacrum, coccyx, aponeurosis of sacrospinalis

Inferior gluteal nerve

Extends thigh at hip joint and laterally rotates thigh

Gluteus medius

Illium

Superior gluteal nerve

Abducts thigh at hip joint and medially rotates thigh

Gluteus minimus

Ilium

Greater trochanter of femur Tibia by way of the iliotibial tract Superior border of greater trochanter of femur

Superior gluteal nerve

Abduct thigh at hip joint and medially rotates thigh Flexes and abducts thigh at hip joint Laterally rotates and abducts thigh at hip joint Laterally rotates abduct thigh at hip joint Laterally rotates and abducts thigh at hip joint Laterally rotates and abducts thigh at hip joint Laterally rotates and abducts thigh at hip joint Laterally

Tensor fasciae Iliac crest latae

Superior gluteal nerve

Piriformis

Anterior sacrum

Sacral spinal nerves S1/S2, mainly S1 Nerve to obtuator internus

Obturator internus

Inner surface of obturator foramen, pubis, ischium Outer surface of obturator membrane

Medial surface of greater trochanter of femur Deep depression inferior to greater trochanter of femur Medial surface of greater trochanter of femur Medial surface of greater trochanter of femur Elevation

Obturator externus

Obturator nerve

Superior gemellus

Ischial spine

Nerve to obturator infernus

Inferior gemellus

Ischial tuberosity

Nerve to quadratus femoris

Quadratus

Ischial

Nerve to

femoris

tuberosity

superior to mid portion of intertrochant eric crest on posterior femur Linea aspera of femur

quadratus femoris

rotates and stabilizes hip joint

Medial (adductor) compartment of the thigh Adductor longus Pubic crest and pubic symphysis Obturator nerve Adducts and flexes thigh at hip joint and rotates thigh Adductor brevis Inferior ramus of pubis Superior half of linea aspera Obturartor nerve Adducts and flexes thigh at hip joint and rotates thigh Adducts thigh at hip joint and rotates thigh, anteriror part flexes thigh at hip joint and posterior part extends thigh at hip joint Flexes and adducts thigh at hip joint

Adductor magnus

Inferior ramus of pubis and ischium to ischial tuberosity

Linea aspera of femur

Obturartor nerve, sciatic nerve

Pectineus

Superior ramus of pubis

Pineal line of femur, between lesse

Femoral nerve

trochanter and linea aspera Gracillis Body and inferior ramus of pubis Medial surface of body of tibia Adducts thigh Obturator at hip joint, neve medially rotates thigh, and flexes leg at knee joint Femoral nerve extend leg at knee joint, rectus femoris muscle acting alone also flexes thigh at hip joint extend leg at knee joint, rectus femoris muscle acting alone also flexes thigh at hip joint extend leg at knee joint, rectus femoris muscle acting alone

Anterior (extensor) compartment of the thigh Rectus femoris (quads) Anterior inferior iliac spine Patealla via quadricepts tendon and then tibial tuberosity via patellar ligament

Vastus lateralis (quads)

Greater trochanter and linea aspera of femur

Patella via quadriceps tendon and then tibial tuberosity via patellar ligament

Femoral nerve

Vastus medialis (quads)

Linea aspera of femur

Patella via quadriceps tendon and then tibial tuberosity via patella

Femoral nerve

ligament

also flexes thigh at hip joint Femoral nerve extend leg at knee joint, rectus femoris muscle acting alone also flexes thigh at hip joint Weakly flexes leg at knee joint, weakly flexes, abducts, and laterally rotates thigh at hip joint Flexes leg at knee joint and extends thigh at hip joint

Vastus intermedius (quads)

Anterior and lateral surfaces of body of femur

Patella via quadriceps tendon and then tibial tuberosity via patella ligament

sartorius

Anterior superior iliac spine

Medial surface of body of tibia

Femoral nerve

Posterior (flexor) compartment of the thigh Biceps femoris Long head arises from ischial tuberosity: short head arises from linea aspera of femur Ischial tuberosity Head of fibula and lateral condyle of tibia Tibial and common fibular nerves from the sciatic nerve

Semitendinos us

Proximal part of medial surface of shaft of tibia

Tibial nerve from the sciatic nerve

Flexes leg at knee joint and extends thigh at hip joint

Semimembra nosus

Ischial tuberosity

Medial condyle of tibia

Tibial nerve from sciatic nerve

Flexes leg at knee joint and extends thigh at hip joint Dorsiflexion foot at ankle joint and inverts at intertarsal joints Dorsiflexes foot at ankle joint and extends proximal phalanx of great toe at metatarsopha langeal joint Dorsiflexes foot at ankle joint and extends distal and middle phalanges of each toe at interphalange al joints and proximal phalanx of each toe at metatarsopha langeal joint

Anterior compartment of the leg Tibialis anterior Lateral condyle and body of tibia and interosseus membrane Extensor hallucis longus Anterior surface and fibular and interosseous membrane Distal phalanx of great toe Deep fibular nerve First metatarsal and first cuneiform Deep fibular nerve

Extensor digitorum longus

Lateral condyle of tibia, anterior surface of fibula, and interosseous membrane

Middle and distal phalanges of toes 2-5

Deep fibular nerve

Lateral compartment of the leg Fibularis longus Head and body of fibular First metatarsal and first cuneiform Superficial fibular nerve Plantar flexes foot at ankle joint and everts foot at intertarsal joints Plantar flexes foot at ankle joint and everts foot at intertarsal joints Superficial posterior compartment Gastrocnemiu s Lateral and medial condyles of femur and capsule of knee Head of fibular and medial border of tibia Femur superior to lateral condyle Calcaneus by way of achilles tendon Tibial nerve Plantar flexes foot at ankle joint and flexes leg at knee joint Plantar flexes foot at ankle joint Plantar flexes foot at ankle joint and flexes leg at knee joint Flexes leg at knee joint and medially rotates tibia to unlock the

Fibularis brevis

Body of fibular

Base of 5th metatarsal

Superficial fibular nerve

Soleus

Calcaneus by way of Achilles tendon Calcaneus by way of achilles tendon

Tibial nerve

Plantaris

Tibial nerve

Deep posterior compartment of the leg Popliteus Lateral condyle of femur Proximal tibia Tibial nerve

extended knee Tibialis posterior Tibia, fibula, interosseous membran 2nd,3rd, 4th, metatarsals, navicular, all 3 cuneiforms, cuboid Distal phalanges of toes 2-5 Tibial nerve Plantar flexes foot at ankle joint and inverts foot at intertarsal joints Plantar flexes foot at ankle joint, flexes distal and middle phalanges of each toe at interphalange al joints and proximal phalanx of each toe at metatarsophl angeal joint Flexor hallucis longus Inferior 2/3 of fibula Distal phalanx of great toe Tibial nerve Plantar flexes foot at ankle joint, flexes distal and middle phalanges of each toe at interphalange al joints and proximal phalanx of each toe at metatarsophl

Flexor digitorum longus

Posteror surface of tibia

Tibial nerve

angeal joint FOOT Name Fibularis longus Origin Lateral condyle of tibia, head of fibula Interosseous membrane, fibula Extensor digitorum brevis Extensor digitorum longus Calcaneous Phalanges of toes 1-4 Phalanges of toes 2-5 Deep fibular nerve Deep fibular nerve Extend the toes Insertion Medial cuneiform, base of 1st metatarsal bone Base of 5th metatarsal Innervation Action Superficial Plantar flexion, fibular nerve eversion of the foot, abduction of the foot Superficial Plantar flexion, fibular nerve eversion of foot

Fibularis tertius

Lateral condyle of tibia, anterior surface of fibula Anterior surface of fibula Posterior surface of fibula Tibia, fibula, interosseous membrane Posterior surface of tibia Lateral condyle of tibia, head of

Extend the toes

Extensor hallucis longus Flexor hallucis longus Tibialis posterior Flexor digitorum Longus Fibularis longus

Base of distal phalanx of big toe Base of distal phalanx of big toe Tarsal and metatarsal bones 2-4 Distal phalanges of toes 2-5 Base of 1st metatarsal bone, medial

Deep fibular nerve Tibial nerve

Extend the toes

Flexes big toe

Tibial nerve

Plantarflexion

Tibial nerve

Flexes remaining toes

Superficial Plantarflexion, fibular nerve everts and abducts the

fibula Flexor digitorum brevis Abductor hallucis Calcaneous

cuneiform Middle phalanges of 2nd 5th toes Medial side of proximal phalanx of big toe Medial plantar nerve Medial plantar nerve

foot Flex the toes

Calcaneous

Flexes and abducts the big toe Abducts the little 5th toe

Abductor digiti minimi

calcaneous

Lateral side of Lateral base of plantar proximal nerve th phalanx of 5 toe Medial side of base of proximal phalanges of 2nd-5th toes Medial and lateral plantar nerves

Lumbricals

Flexor digitorum longus tendons

Joint movement between the metatarsal bones and phalanges of the toes Assists the flexor muscles

Quadratus plantae

Calcaneous

Flexor digitorum longus tendons Base of proximal phalanx of the big toe

Lateral plantar nerve Medial plantar nerve (S1S2)

Flexor hallucis brevis

Cuboid and lateral cuneiform bones

Flexes the big toe and supports the medial longitudinal arch Adducts the big toe and supports the transverse arch

Adductor hallucis (oblique)

Base of metatarsal bones 2-4

Proximal phalanx of the big toe

Deep branch of the lateral plantar nerve (S2-

S3) Adductor hallucis (transverse) Metatar sophalangeal joint Proximal phalanx of the big toe Deep branch Adducts the big of the toe lateral planter nerve (S2S3) Superficial branch of the lateral planter nerve (S2S3) Dorsal interossei Adjacent sides of metatarsal bones 1st interosseous: muscle inserts into the medial side of proximal phalanx of 2nd toe rest of them: Lateral side of the 2nd-4th toes Medial side of the base of the proximal phalanx of the 3rd, 4th, and little toes Lateral planter nerve (S2S3) Abduct toes and flex meta tarsophalangeal joints Flexes little toe

Flexor digiti minimi

Base of metatarsal bone 5

Base of the proximal phalanx of the little toe

Plantar interossei

Base and medial side of metatarsal bones 3-5

Lateral planter nerve (S2S3)

Adduct the toes and flex the metatarso phalangeal joints

Nerves

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CENTRAL NERVOUS SYSTEM Brain and spinal cord Processes incoming sensory information Source of thoughts, emotions, memories Most nerve impulses that stimulate muscles to contract and glands to secret originate in the CNS PERIPHERAL NERVOUS SYSTEM All nervous structures outside the CNS Cranial nerves and their branches, spinal nerves and their branches, ganglia, enteric plexuses, and sensory receptors Link all parts of the body to the CNS 31 pairs of spinal nerves ganglia: small masses of nervous tissue, consisting primarily of neuron cell bodies located outside the brain and spinal cord o closely associated with cranial and spinal nerves enteric plexuses: help regulate digestive system sensory receptors: structures that monitor changes in the internal and external environment (receptors in the skin that detect touch sensation) functional organization o 1. Sensory function: afferent neurons o 2. Integrative function: interneurons o 3. Motor function: efferent neurons SOMATIC NERVOUS SYSTEM Part of the PNS Consists of sensory neurons called somatic sensory neurons that convey information to the CNS from sensory receptors in the skin, skeletal muscles and joints and front the receptors for the special sense INPUT of information to the CNS for integration Somatic motor neurons: convey info from CNS to skeletal muscles only voluntary AUTONOMIC NERVOUS SYSTEM Autonomic sensory neurons: convey info to the CNS from autonomic sensory receptors located primarily in the visceral organs

Autonomic motor neurons: convey info from the CNS to smooth muscle, cardiac muscle and glands Involuntary Sympathetic division Parasympathetic division ENTERIC NERVOUS SYSTEM Of the PNS brain of the gut throughout most of the gastrointestinal tract both sensory and motor components and can operate independently from the CNS sensory neurons: monitor chemical changes in the GI tract as well as stretching of its walls motor neurons: ability to propel food through GI tract and control secretions involuntary

BRACHIAL PLEXUS

Nerve Dorsal scapular

Origin C5

Distribution Levator scapulae, rhomboid major, rhomboid minor Serratus anterior muscle Subclavius muscle Supraspinatus and infrapsinatus muscles Coracobrachialis, biceps brachii, brachialis muscles Pectoralis major muscle Subscapularis muscle

Long thoracic Nerve to subclavius Suprascapular Muscolocutaneous

C5-C7 C5-C6 C5-C6 C5-C7

Lateral pectoral Upper subscapular

C5-C7 C5-C6

Thoracodorsal Lower subscapular Axillary

C6-C8 C5-C6 C5-C6

Latissimus dorsi Subscapularis and teres major Deltoid and teres minor muscles, skin over deltoid and superior posterior aspect of arm Flexors of forearm except flexor carpi ulnaris Triceps brachii, anconeus, and extensor muscles

Median

C5-T1

Radial

Medial pectoral Medial cutaneous nerve of arm Medial cutaneous nerve of forearm Ulnar

C8-T1 C8-T1

Pectoralis major and pectoralis minor Skin of medial and posterior aspects of distal 1/3 of arm Skin of medial and posterior aspects of forearm Flexor carpi ulnaris, ulnar half of flexor digitorum profundus and most muscles of the hand

C8-T1

C8-T1

Cranial Olfactory (I) o smell Optic (II) o Visual impulses from the retina of the eye to the brain Oculomotor (III) o Control movements of the eyeball and eyelids Trochlear (IV)

o Control movements of the eyeball and eyelids Trigeminal (V) o 3 sections: ophthalmic, maxillary, mandibular o forehead, skin of cheek, muscles used for chewing Abducens (VI) o Control movements of the eyeball and eyelids Facial (VII) o Motor fibers for facial expression, taste at the front of the tongue Vestibulocochlear (VIII) o Hearing and balance

Glossopharyngeal (IX) o Carotid sinus and taste at the back of the tongue and soft palate, reflex control of the heart Vagus (X) o Swallowing speaking, secretions from the glands of the stomach, sensation of hunger Spinal accessory (XI) o Movement of muscles of the shoulders, head, neck, larynx, pharynx Hypoglossal (XII) o Controls movement of the tongue 12 nerves that lead directly from the brain and brainstem to muscles and sensory structures of the head and neck some distribute to organs of the chest and upper 2/3 of the gastrointestinal tract Spinal Cord Aortic Arch Sympathetic Ganglia o -> sympathetic nerves servicing the viscera in the abdomen from in front of the abdominal aorta o principle: celiac, superior mesenteric, aorticorenal, inferior mesenteric ganglia o celiac plexus branches to organs supplied by celiac trunk o superior mesenteric ganglion supply blood vessels to the small intestine and part of the large intestine

o inferior mesenteric ganglion supply blood vessels to the large intestine Spinal Cord Peripheral nerve Head and Neck Zygomatic branch Upper buccal branch Lower buccal branch Mandibular branch Cervical branch Trunk Posterior auricular Temporal branch Facial nerves supply muscles in the face and supply salivary glands in the mouth and lacrimal glands in the eye, carry taste from the front 2/3 of the tongue Emerge from brainstem and pass through temporal bone in the skull and exit through the stylomastoid foramen and then fan out over each side of the face anterior to the ears Auricular nerve supplies area around the ear Auriculotemporal nerve supplies the parotid gland (part of the scalp close to the ear) and the eardrum Upper limb Ulnar o Runs down inner side of the arm, winding aroud the back of the elbow joint, then continues down the inner side of the forearm to enter the hand on the little finger side o Innervates flexor carpi ulnaris, half of the flexor digitorum profundus, small muscles of the hand o Sensation to the skin on the palm side of the little finger side of the hand Median o Between ulnar and radial from the shoulder to the hand o Innervates most of the flexor muscles of the forearm, some of the muscles of the thumb, some of the skin on the front of the hand

WRIST

Common palmar digitial nerves Radial o Runs down the outer side of the arm to the foream and hand o Innervates extensor muscles in the back of the arm and supplies skin over the back of the arm, forearm, hand on thumb side Muscolocutaneous o Innervates flexor muscles of the arm Axillary o Innervates the deltoid muscle at the shoulder Arise from brachial plexus in the shoulder region Superficial branch of ulnar nerve Flexor retinaculum Median nerve o Flexor muscles of the hand and skin between that innervated by the ulnar and radial nerves Ulnar nerve o Little finger side Superficial branch of radial nerve o Thumb side Common palmar digital branches of median nerve LIMB Lateral femoral cutaneous nerve Femoral* o Major branch saphenous nerve o Supply muscles at the front of the thigh, joints of the hip and knee, skin of the thigh, leg, foot Sciatic* o Supply hamstring muscles and all muscles of the leg and foot Common fibular Superficial fibular Deep fibular Posterior fibular Posterior tibial Obtuator*

LOWER

o Gracilis muscles and adductor muscles of the thigh, skin on medial part of the thigh

Arteries
HEART

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atria: receiving chambers o receiving from veins ventricles: pumping chambers o eject into arteries pulmonary pump: right atrium and right ventricle o weaker o moves deoxygenated blood through the blood vessels of the lungs systemic pump: left atrium and left ventricle o pumps oxygenated blood to all the systems of the body auricle: wrinkled pouchlike structure on the anterior surface o increases the capacity of an atrium slightly so that it an hold a greater volume of blood sulci: on the surface of the heart, series of grooves o contain coronary blood vessels and a variable amount of fat o each sulcus marks the external boundary between two chambers of the heart o deep coronary: encircles most of the heart and marks the external boundary between the superior artria and inferior ventricles o anterior interventricular sulcus: shallow grove on the anterior surface of the heart that marks the external boundary between right and left ventricles o continues around the heart as the poster interventricular sulcus

Right o o o o

Right

marks the external boundary between the ventricles on the posterior aspect of the heart atrium Receives blood from superior vena cava, inferior vena cava, coronary sinus Pectinate mucles line the atrial wall Interatrial septum: between right and left -> thin partition Fossa ovalis: remnant of the foramen ovale Transport: right atrium -> right ventricle through tricuspid valve (right atrioventricular valve) ventricle

o Contains a serioes of ridges formed by raised bundles of cardiac musce fibers traberculae carneae -> some contain part of the conduction system of the heart o Chordae tendineae are connected to cone-shaped trabeculae carneae = papillary muscles o Right and left ventricle separated by interventricular septum o Pulmonary valve -> pulmonary trunk -> divides into right and left pulmonary arteries -> carry blood to the lungs Left atrium o Most of the base of the heart o Receives blood from the lungs through 4 pulmonary veins o Blood passes from left atrium into left ventricle though bicuspid valve (mitral) valve looks like a bishops hat (left atrioventricular valve) left ventricle o thickest part of the heart o apex of the heart o trabeculae carneae and chordae tendineae that anchor the cusps of the bicuspid valve to papillary muscles o -> aortic valve -> ascending aorta -> some to coronary arteries -> remainder into the arch of the aorta and descending aorta atria thin walled because they deliver blood under less pressure into the adjacent ventricles

ventricles pump blood under higher pressure over greater distances, they have thicker walls right less pressure, left more pressure but the same flow rate semilunar valves: aortic and pulmonary valves o made up of 3 crescent moon-shaped cusps o allow ejection of blood from the heart into arteries but prevent backflow into the ventricles

CIRCULATION OF BLOOD

systemic and pulmonary circulation o output of one becomes the input of the other o left side: systemic circulation oxygenated blood from lungs -> left ventricle -> aorta -> systemic arteries -> arterioles -> systemic capillaries -> systemic venule -> deoxygenated blood away from tissues -> systemic veins -> right atrium o right side: pulmonary circulation -> deoxygenated blood from systemic circulation -> right ventricle -> pulmonary trunk -> pulmonary arteries -> right and left lungs -> fresh oxygenated blood -> pulmonary veins -> left atrium coronary circulation o wall of the heart has its own blood supply o blood vessels pierce the myocardium o arteries encircle the heart like a crown o coronary arteries -> branch from ascending aorta o little oxygenated blood during contraction o aorta pressure pumps blood during relaxation into the coronary arteries -> capillaries -> coronary veins

HEART BEAT Autorhythmic cells act as a pacemaker and set the rhythm for contraction of the entire heart o Cardiac conductions system o Delivers AP throughout the heart muscle o Ensure cardiac chambers are stimulated to contract in a coordinated manner and make the heart an effective pump 1. Sinatrial node (SA node) located in the right atrial wall just inferior and lateral to the opening for the superior vena cava o each AP from the SA node conducts through conduction cells to the contractile cardiac muscle cells of both atria via gap junctions in the intercalated discs of the fibers o arrival of AP = 2 atria contract at the same time 2. AP reaches the atrioventricular node (AV node) by conducting along modified atrial muscle fibers (internodal fibers) o in interatrial septum just anteriror to the opening of the coronary sinus o at AV node, AP slows considerably as a result of various differences in cell structure in the AV node o delay provides time for the atria to empty their blood into the ventricles 3. AP enters atrioventricular bundle (AV bundle) (bundle of His) o only site where AP can conduct from the atria to the ventricles 4. AP enters both the right and left bundle branches arising from the AV bundle o course through the interventricular septum towards the apex of the heart 5. Purkinje fibers leave their insulating connective tissue sheaths near the apex of the heart and relay the AP to the contractile cells of the ventricular myocardium o as the wave of ventricular contraction moves upward from the apex, blood is pushed toward the semilunar valves and ventricular contraction occurs about 0.2 seconds after atrial contraction

electrocariogram o P-wave: spread of depolarization from the SA node through the 2 atria o QRS wave: spread of depolarization through the ventricles Shortly after AP reached and ventricles contract o T wave: indicates ventricular repolarization Corresponds to the relocation of ventricular muscle fibers o No wave to show atrial repolarizaion because the strong QRS wave masks this event o Normal sinus rhythm: usual rhythm of heartbeats established by the SA node o Arrhythmia: abnormal rhythm as a result of a defect in the conduction system of the heart Too quickly or too slowly Chest pain, shortness of breath, lightheadedness, dizziness, fainting May be caused by stress, caffeine, or other stimulants, congenital defect, coronary artery disease, myocardial infarction, hypertension, defective heart valves, rheumatic heart disease, hyperthyroidism, potassium deficiency Categorized by their speed, rhythm and origination of the problem o Bradycardia: slow heart rate (below 50 bpm)

o Tachycardia: rapid rate (100 bpm+) o Fibrillation: rapid, uncoordinated heartbeats Cardiac cylce o Systole: phase of contraction of a chamber of the heart o Diastole: phase of relaxation o 1. relaxation: at the end of the cardiac cycle when the ventricles start to relax, all 4 chambers are in diastole Beginning of relaxation period As ventricles relax, pressure within the chambers drops and blood starts to flow from the pulmonary trunk and aorta back toward the ventricles Blood becomes trapped in the semilunar cusps and semilunar valves close Pressure falls more and space inside expands When the ventricular pressure drops below atrial pressure the AV valves open and ventricular filling begins 75% of ventricular filling occurs just after the AV valves open (without atrial systole) o 2. Atrial systole (contraction): marks end of relaxation period and accounts for the remaining 25% of the blood that fills the ventricles AV valves still open Semilunar valves still closed o 3. Ventricular systole (contraction): pushes blood up against AV valves forcing them shut for a brief period, all 4 valves are closed again pressure rises sharply in the chambers left ventricular pressure rises above the pressure of the arteries = both semilunar valves open and eject of blood from heart begins lasts until ventricles start to relax semilunar valves close and another relaxation period begins

ARTERIES

Division and branches Ascending aorta Right and left coronary arteries Arch of the aorta Brachiocephalic trunk Right common carotid artery Right subclavian artery Left common carotid artery Left subclavian artery Thoracic aorta Pericardial arteries Bronchial arteries Esophageal arteries Mediastinal arteries Posterior intercostal arteries Subcostal arteries Superior phrenic arteries Abdominal aorta Inferior phrenic arteries Celiac trunk Common hepatic artery Left gastric artery Splenic artery Superior mesenteric artery Suprarenal arteries Renal arteries Gonadal arteries Testricular arteries Ovarian arteries Inferior mesenteric artery Common iliac arteries External iliac arteries

Region supplied Heart

Right side of head and neck right upper limb Left side of head and neck Left upper limb Pericardium Bronchi of lungs Esophagus Structures in medistinum Intercostal and chest muscles Same as posterior intercostals Superior and posterior surfaces of diaphragm Inferior surface of diaphragm Liver, stomach, duodenum, pancreas Stomach and esophagus Spleen, pancreas, and stomach Small intestine, cecum, ascending and transverse colons, and pancreas Adrenal glands Kidneys Testes Ovaries Transverse, descending, and sigmoid colons, rectum Lower limbs

Internal iliac arteries

Uterus, prostate, muscles of buttocks, urinary bladder

MAJOR VEINS External jugular vein Internal jugular vein Axillary Cephalic Azygos Brachial Basilic Median cubital Common iliac Femoral Obturator Dorsal venous Plantar venous Great saphenous Small saphenous Popliteal External iliac Internal iliac Palmar venous Ulnar Radial Inferior vena cava Renal Superior vena cava Subclavian Brachiocephalic

MAJOR ARTERIES Common carotid Heart Brachial Renal

Common iliac External iliac Internal iliac Obturator Popliteal Arcuate Plantar arch Posterior tibial Anterior tibial Fibular Femoral Palmar arches Ulnar Radial Abdominal aorta Arch of aorta Axillary facial

Function

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Temporalmandibular Joint Condyloid synovial Elevated and depressed Protruded, retracted Moved side to side Ear The joints work in unison to transmit sound waves to the cochlea Act as amplifier by magnifying the movement of the eardrum Eardrum vibrates = malleus vibrates in incus -> vibrates the stapes Base of stapes covers the oval window (membrane that passes vibrations into the spiral of the cochlea) Triggered by auditory ossicles by the tympanic membrane Vertebrae Flexion Lateral flexion Extension rotation Circumduction combination of all movements Cervical and lumbar have most amount of movement Thoracic not as much movement because of ribs Only move a few degrees between each vertebra Acts as a single unit Large movements = sum of many small movements Atlas: nodding action from atlanto-occipital joints Axis: pivoting movement o 45o of rotation of neck occurs at these joints alone orientation of joint surfaces affects the direction of movement between vertebrae o adjacent cartilage-covered surfaces are able to glide on each other during movements of the vertebral column Clavicles acromioclavicular joint allows small amount of gliding movement to occur b/w the two bones in conjunction with movements of the arm coracoclavicular ligament helps support the weight of the arm movement of shoulder part of sternoclavicular joint Upper Limbs

shoulder: shape of joint gives mobility to upper limb o movements always accompanied by movements of the pectoral girdle (clavicle + scapula) o deltoid, pectoralis major, latissimus dorsi, teres major and minor elbow: humerus + ulna -> allows arm to flex + bend o flexion: biceps brachii and brachialis, brachioradialis o extensor: triceps brachii o supination: biceps brachii wrist: range of movements radius: pivot joint w/ ulna allowing rotational movement ulna: hinge joint with humerus -> flexion + extension o rotational movement of radius around ulna wrist and hand: Some Lovers Try Positions That They Cant Handle o Proximal row -> distal row o Scaphoid, lunate, triquetrium, pisiform, trapezium, trapezoid, capate, hamate o TrapeziUM is by the thUMB, TrapeziOID is inSIDE o Saddle joint of trapezium and metacarpal of the thumb allows movement in 2 directions o Long tendons of the extensor muscles (extension of fingers and thumb) pass across back of the wrist o WRIST -> long flexor tendons to the fingers and thumb pass over the front of the wrist through tendon sheaths protect tendons and reduce friction as they pass over the carpal bone Muscles of the forearm converge at the wrist and their tendons extend over the wrist area Forearm -> most powerful muscles for gripping an object lie in the inside (front) of the forearm o Extensors: on back of arm straightening fingers and extending wrist Deep muscles contribute to overall mobility of the limb Hip: joint enclosed in fibrous capsule that is loose enough to permit free movement but strong enough to permit free movement

Pelvis

o Capability of rotation limited only by flexibility of its supporting ligaments Lower Limbs Knee: flexion and extension -> main movements o Backwards and forwards gliding also occurs o Small amount of rotation at the end of extension and at beginning of flexion -> Lock and unlock the knee joint Ankle: plantarflexion -> pointing toes o Dorsiflexion -> lifting foot up Superficial muscles = locomotion Thigh has 2 distinct muscle compartments which are separates by connective tissue (Deep fascia) Upper 2/3 femur o Quadriceps femoris: major muscle mass of the front and outer side of the thigh Rectus remoris, vastus lateralis, vastus medialis, vastus intermedius Extend/straighten knee Flexes thigh on the pelvis Knee-jerk action o Distal tendons blend together to form a single tendon that is attached to the upper surface of the patella (extends as the patellar ligament attached to tubercle of the tibia) o Covers most of the front and sides of the femur leg in 3 compartments o anterior: muscles that move the foot upward o lateral: fibularis longus and fibularis brevis turns sole of foot outwards o posterior: calf superficial/deep superficial: gastrocnemius and soleus deep: pass behind the ankle joint and attaches to bones of the foot flexor hallucis longus pushng off from the big toe during walking gluteal: maximus (largest muscle in the body) extends the thigh when running or climbing

hamstring: posterior compartment of the thigh o semitendinosus, long head of biceps femoris, semimembranosus o split in the middle so that the biceps femoris tendon passes behind the outside of the knee to reach the fibula o semimembranosus and smitendonosus tendons pass behind the inside of the knee to read the tibia o extend the hip joint and flex the knee joint medial compartment of the thigh: adductor muscles (pulls leg towards midline) o counterbalancing the action of the gluteus madeius and gluteus minimus muscles when walking Deep muscles of the thigh: adductor muscles (magnus, longus, brevis) medial to quadriceps femoris o Rotate, flex, adduct the thigh Deep muscles of the leg: Extensor muscles: hallucis longus, digitorum longus o Extend the foot at the ankle and toes (plantarflex) Dorsiflexion: main muscles of the foot arise at the front of the leg Plantarflexion: main muscles at the back of the leg Interosseous muscles between toes adduct/abduct toes Ankle: muscles of the leg converge at the ankle think into tendons o Extend across the front, back, sides of ankle o Tendon sheaths protect tendons s they pass across the ankle joint o Achilles tendon at back of the ankle Long tendons extend along the sole of the foot (also contains a number of small muscles) 4 layers o 1st: sole of the foot dominated by flexor digitorum brevis, abductor hallucis, abductor digiti minimi o 2nd: Lumbricals, Quadratus plantae o 3rd: flexor hallucis brevis, adductor hallucis (oblique), adductor hallucis (transvese) flexor digiti minimi movement of big/little toe and support the arches

Foot

o 4th:dorsal interossei (4), plantar interossei (3) deepest layer o Tall Californian Navy Medcial Interns Lay Cuties": In order (right foot, superior to inferior, medial to lateral): Talus Calcanous Navicular Medial cuneiform Intermediate cuneiform Lateral cuneifrom Heart 2 halves, separated by septum (thick muscular wall) receives blood from coronary arteries which branch from the aorta cardiac muscle network of muscle fibers that do not contract voluntarily and not under the control of the central nervous system contraction originates with electrical impulse in the sinuatrial node (SA node) natural pacemaker o SA node and electrical conduction system that run through the muscle control the heart rate Heart supplied with nerves from the autonomic nervous system, but these nerves speed or slow the heart rate, not create the contractions Contraction/relaxation of the papillary muscles in conjunction with the chordae tendineae open and close atrioventricular valves of the heart Valves o Tricuspid valve b/w right atrium and right ventricle o Mitral valve b/w left atrium and left ventricle o Aortic valve separates ascending aorta and descending aorta Cuboid

Cells

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Tissues Epithelial o Covers body surfaces and lines holly organs o Interact with internal and external environment o Classification: Layers: simple, pseudostratified, stratified Cell shape: squamous, cuboidal, columnar, transitional (cells change shape from squamous to cuboidal and back) Combine the 2 o Simple squamous: cardiovascular and lymphatic system, serous membranes/processes of filtration, not in areas subject to mechanical stress o Simple cuboidal: ovary, lines anterior surface of capsule of the lens of the eye, pigmented epithlium at the posterior surface of the retina of the eye, lines kidney tubules and smaller ducts of many glands, secretory portion of some glands (thyroid/pancreas)/secretion and absorption o Nonciliated simple columnar: gastrointestinal tract, ducts of glands, gallbladder/secretion and absorption o Ciliated simple columnar: lines some bronchioles of respiratory tract, uterine, uterus, some paranasal sinuses, central canal of spinal cord, ventricles of the brain/cilia movement o Pseudostratified columnar o Stratified squamous o Stratified cuboidal o Stratified columnar o Transitional Connective o Most abundant and widely distributed tissues in the body. o Binds together, supports and strengthens other body tissues o Protects and insulates internal organs o Compartmentalizes structure such as skeletal muscles o Blood, a fluid connective tissue, serves as a major transport system within the body

o Classification: Merocrine secretion Apocrine secretion Holocrine secretion o Dense regular connective o Dense irregular connective o Elastic connective o Hyaline cartilage o Fibrocartilage o Elastic cartilage o Bone o Blood Muscular o Skeletal: long, cylindrical, striated fibers. Vary in length. Cylindrical shape. Multinucleated cell with the nuclei located at the cells periphery Voluntary Attached to bones by tendons Motion, posture, heat production, protection o Cardiac: branched, usually have one located nucleus (some have 2). Attach end to end by transverse thickenings of plasma membrane (intercalated discs) Contains desmosomes and gap junctions Strengthen the fibers during vigorous contractions Gap junctions provide a route for quick concution of electrical signals (AP throughout the heart) Involuntary o Smooth: nonstriated. Small spindle-shaped cell that is thickest in the middle and tapers at each end. Contains single centrally located nucleus Involuntary Gap junctions connect many individual fibers Intestines: powerful contractions b/c many muscle fibers contract together

Eye: contract individually because gap junctions are absent Iris of the eyes, walls of hollow internal structures (blood vessels, airways, stomach intestines, gallbladder, urinary bladder, uterus) Motion constriction of blood vessels, propulsion of foods through gastrointestinal tract, contraction of urinary bladder and gallbladder

Nervous o Neurons Broad category of unusually shaped cell types with one common structural feature Dendrites/axons project from the main cell body > vary in number and length Within the CNS (98% of the tissue is in the CNS) Highly excitable cells with the ability to initiate and propagate electrical signals nerve action potentials (nerve impulses) When AP reaches end of the axon the neuron releases a neurotransmitter o Neuroganglia Do not generate or conduct nerve impulses Support neurons both physically and metabolically, without neuroganglia, neurons couldnt survive and function 5:1 ratio of neuroganglia to neurons specialized

SKIN (deep to surface) Stratum basale o Deepest layer Stratum spinosum o Consists of numerous keratinocytes produced by stem cells in the basal layer arraged in 8-10 layers o Occasional merkel cell o Strength and flexibility to the skin

Stratum granulosum o Middle of the epidermis o Keratinocyes undergoing apoptosis o Transition where they start to die Stratum lucidum o In thick skin (like fingertips, palms, and soles) o Additional layer of toughness Stratum corneum o Cells dead and no longer contain nuclei or any internal organelles o Final product of the differentiation process of the keratinocytes

Bones
SURFACE MARKINGS Name Description Name

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description

Depressions and openings: sites allowing the passage of soft tissue or formation of joints Fissure Narrow slit between adjacent parts of bones where vessels or nerves pass Shallow depression Foramen Opening through which blood vessels, nerves, or ligaments pass Furrow along the bone surface that accommodates a blood vessel, nerve, or tendon

Fossa

Sulcus

Meatus

Tubelike opening

Processes: projections or outgrowths on bone that form joints or attachment points for connective tissues (ligaments and tendons) Condyle (joints) Large, round protuberance with a smooth articular surface at the end of a bone Usually rounded articular projection supported on the neck of a bone Typically roughened projection above a condyle Sharp, slender projection Facet (joints) Smooth, flat concave or convex articular surface

Head (joints)

Crest (attachment)

Prominent ridge or elongated projection

Epicondyle (attachment)

Line (attachment) Long, narrow ridge or border

Spinous process (attachment)

Trochanter (attachment)

Very large projection

Tubercle (attachment)

Variable sized rounded projection

Tuberosity (attachment)

Variable sized projection that has a rough bumpy surface

AXIAL SKELTON

black eye: not usually due to an injury of the eye but trauma to the face. Blood and other fluids accumulate in the space around the eye causing the swelling and discoloration

PRINCIPLE FORAMINA OF THE SKULL Foramen Carotid Location Petrous portion of temporal bone Superior to base of occipital condyle Structures passing though Internal carotid artery and sympathetic nerves for eyes Cranial nerve XII and branch of ascending pharyngeal artery

Hypoglossal (under tongue) Incisive (below)

Posterior to incisor teeth Branches of greater in maxilla palatine blood vessels and nasopalatine nerve Posterior to carotid canal between petrous portion of temporal bone and occipital bone Bounded anteriorly by sphenoid bone, posteriorly by petrous portion of temporal bone, medially by the sphenoid bone and occipital bone Internal jugular vein, CN IX (glossopharyngeal), X (vagus), XI (accessory) Branch of ascending pharyngeal artery in palatine bone

Jugular (throat)

Lacerum (lacerated)

Magnum

Occipital bone

Medulla oblongata and its membranes, CNXI (accessory) and vertebral and spinal arteries Inferior alveolar nerve and blood vessels Emissary vein to transverse sinus and branch of occipital artery to dura mater Mental nerve and vessels CN I (olfactory)

Mandibular Mastoid

Medial surface of ramus of mandible Posterior border of mastoid process of temporal bone Inferior to second premolar tooth in mandible Cribiform plate of ethmoid bone

Mental

Olfactory Optic

Between superior and CN II (optic) and inferior portions of small ophthalmic artery wing of sphenoid bone Greater wing of sphenoid bone Junction of anterior and medial parts of sphenoid bone Posterior angle of sphenoid bone Between styloid and mastoid processes of temporal bone Supraorbital margin of orbit in frontal bone Mandibular branch of CN V (trigeminal) Maxillary branch of CN V (trigeminal) Middle meningeal blood vessels CN VII (facial) and stylomastoid artery Supraorbital nerve and artery

Ovale Rotundum

Spinosum Stylomastoid

Supraorbital

Hyoid bone: does not articulate with any other bone

Suspended from the styloid processes of the temporal bones by ligaments and muscles Between the mandible and the larynx Supports the tongue and attachment for tongue muscles and muscles of neck and pharynx

VERTEBRAL COLUMN 7 Cervical 12 Thoracic 5 Lumbar 1 Sacrum 1 Coccyx normal curves o cervical and lumbar: convex (bulging out) o thoracic and sacral: concave (cupping in) primary curves o increase its strength and help maintain balance o protects vertebrae from fracture intervertebral discs: from 2nd cervical to sacrum o found between the bodies of adjacent vertebrae o 25% of vertebral column height abnormal curves o scoliosis: lateral bending of the vertebral column, usually in the thoracic region congenitally malformed vertebrae, chronic sciatica, paralysis of muscles on one side of the vertebral column, poor posture, one leg shorter than other o kyphosis: increase in thoracic curve of the vertebral column in elderly: degeneration of the intervertebral discs lead to kyphosis rickets, poor posture, advanced osteoporosis o lordosis: (hollow or sway back) increase in the lumbar curve of the vertebral column TYPICAL VERTEBRA increased weight of the abdomen, poor posture, rickets, osteoporosis, tuberculosis of the spine

Characteristic Overall structure

Cervical

Thoracic

Lumbar

Size Foramina Spinous process

Small 1 vertebral 2 transverse

Large 1 vertebral

Largest 1 vertebral Short and blunt (project posteriorly) Large and blunt Absent Sup: medial Inf: lateral massive

Slender and often Long and fairly bifid (C2-C6) thick (project inferiorly) Small Absent Fairly large Present

Transverse process Articular facets of ribs Direction of articular facets Size of intervertebral discs

Sup: Sup: posterosuperior posterolateral Inf: anteroinferior Inf: anteromedial Thick relative to size of vertebral body Thin relative to vertebral bodies

SACRUM

STERNUM Enclose and protect organs in the thoracic cavity and upper abdominal cavity

RIBS 1-12 from superior to inferior articulates posteriorly with its corresponding thoracic vertebra

APPENDICULAR SKELETON UPPER LIMB 32 bones clavicle, scapula, humerus, radius, ulna, carpals, metacarpals, phalanges SCAPULA

RADIUS AND ULNA

HAND

LOWER LIMB 30 bones

 FEMUR

ramus: branch (rami)

fovea capitis: in the middle of the head of the femur where the ligament passes through TIBIA AND FIBULA

FOOT