Copyright Feb 2003 Ted Nissen.BEGIN1 END1
TABLE OF
CONTENTS
1 ABDUCTOR DIGITI MINIMI (FOOT)
2 ABDUCTOR DIGITI MINIMI (HAND)
4 ABDUCTOR POLLICIS BREVIS B4E4
5 ABDUCTOR POLLICIS LONGUS B5E5
13 BICEPS FEMORIS (Lateral
Hamstring) B13E13
17 BULBOCAVERNOSUS
(BULBOSPONGIOSUS) B17E17.
19 COCCYGEUS (ISCHIOCOCCYGEUS)
B19E19
21 CORRUGATOR SUPERCILII B21E21
22 CRICOARYTENOID LATERAL &
POSTERIOR B22E22
32 DIGASTRIC ANT & POST BELLY
(SUPRAHYOID)
36 EXTENSOR CARPI RADIALIS BREVIS
37 EXTENSOR CARPI RADIALIS LONGUS
48 EXTERNAL ABDOMINAL OBLIQUE=ANT
DIV
49 EXTERNAL ABDOMINAL OBLIQUE=LAT
DIV
52 EXTRINSIC AURICULAR MUSCLES
55 FLEXOR DIGITI MINIMI BREVIS
(FOOT)
56 FLEXOR DIGITI MINIMI BREVIS
(HAND)
60 FLEXOR DIGITORUM SUPERFICIALIS
67 GEMELLUS INFERIOR (1 of 6
Deep Lateral Rotators of Femur)
68 GEMELLUS SUPERIOR (1 of 6
Deep Lateral Rotators of Femur)
82 INFERIOR LONGITUDINAL LINGUALIS
84 INFERIOR PHARYNGEAL CONSTRICTOR
86 INFRASPINATUS (Rotator Cuff
Muscle)
87 INTERNAL ABDOMINAL OBLIQUE (Anterior
Division)
88 INTERNAL ABDOMINAL OBLIQUE
(Lateral Division)
92 INTRINSIC AURICULAR MUSCLES
98 LEVATOR ANGULI ORIS(CANINUS)
99 LEVATOR ANI, ILIAC
PART(ILIOCOCCYGEUS)
100 LEVATOR ANI, PUBIC
PART(PUBOCOCCYGEUS)
102 LEVATOR LABII SUPERIORIS ALAEQUE
NASI
103 LEVATOR PALPEBRAE SUPERIORIS
120 MIDDLE PHARYNGEAL CONSTRICTOR
125 NASALIS (COMPRESSOR & DILATOR
NARIS)
126 OBLIQUE ARYTENOID &
ARYEPIGLOTTICUS
129 OBTURATOR EXTERNUS (1 of 6
Deep Lateral Rotators of Femur)
130 OBTURATOR INTERNUS (1 of 6
Deep Lateral Rotators of Femur)
132 OMOHYOID SUPERIOR & INFERIOR
(INFRAHYOID)
137 PALATOGLOSSUS (Palatoglossal
arch; Anterior pillar)
138 PALATOPHARYNGEUS
(Palatopharyngeal arch; Posterior pillar)
143 PECTORALIS MAJOR CLAVICULAR
149 PIRIFORMIS (1 of 6 Deep
Lateral Rotators of Femur)
161 QUADRATUS FEMORIS (1 of 6 Deep
Lateral Rotators of the Femur)
164 RECTUS ABDOMINIS (4 Divisions as
1)
167 RECTUS CAPITIS POSTERIOR MAJOR
168 RECTUS CAPITIS POSTERIOR MINOR
169 RECTUS FEMORIS (Quadriceps
Femoris) (1 of 4 Quadriceps)
180 SEMIMEMBRANOSUS (Medial
Hamstring)
184 SEMITENDINOSUS (Medial
Hamstring)
186 SERRATUS POSTERIOR INFERIOR
187 SERRATUS POSTERIOR SUPERIOR
200 STERNOTHYROID (INFRAHYOID)
205 SUBSCAPULARIS (Rotator Cuff
Muscle)
206 SUPERFICIAL TRANSVERSE PERINEUS
(SUPERFICIALIS)
207 SUPERIOR LONGITUDINAL LINGUALIS
209 SUPERIOR PHARYNGEAL CONSTRICTOR
212 SUPRASPINATUS (Rotator Cuff
Muscle)
218 TERES MINOR (Rotator Cuff Muscle)
219 THYROARYTENOID VOCALIS &
THYROEPIGLOTTICUS
225 TRANSVERSE LINGUALIS (BODY OF
TONGUE)
226 TRANSVERSE PERINEUS (PROFUNDUS)
227 TRAPEZIUS LOWER (Lower Division)
232 VASTUS INTERMEDIUS (QUADRICEPS
FEMORIS) (1 of 4 Quadriceps)
233 VASTUS LATERALIS (Quadriceps
Femoris) (1 of 4 Quadriceps)
234 VASTUS MEDIALIS (Quadriceps
Femoris) (1 of 4 Quadriceps)
235 VERTICAL LINGUALIS (BODY OF
TONGUE)
1
ABDUCTOR DIGITI MINIMI (FOOT)
Back Table of Contents References
1.1 Word Derivation Pronounce
Pronounce
1.1.1 Abductor=Moves
part away from midline
1.1.2 Digit=Finger or
toe
1.1.3 Minimi= Little
finger or toe
1.2 Attachments Illus. (DSL)
1.2.1 Origin
1.2.1.1
Medial and lateral processes of the tuberosity of calcaneus
1.2.2 Insertion
1.2.2.1
Lateral side of the base of the proximal phalanx of the
fifth toe
1.3 Action Illus. (DSL)
1.3.1 Abducts
the fifth toe away from the fourth toe
1.4 Nerve Supply
1.4.1 Nerve
1.4.1.1
Lateral plantar nerve
1.4.2 Roots
1.4.2.1
S2
1.4.2.2
S3
1.5 Synergists
1.5.1 None
1.1 Muscle Tests
1.1.1 Abductor Digiti Minimi
(Foot)
1.2 Trigger Points
1.2.1 ABDUCTOR
DIGITI MINIMI (FOOT)
1.3 Organ Reflexes
1.3.1 None
1.3.2 Illustrations
1.4 Meridian
1.4.1 None
1.5 Discussion (Gray)
1.5.1 The Abductor digiti quinti (Abductor minimi digiti)
(Fig. 443) Discussion lies along the lateral border
of the foot, and is in relation by its medial margin with the lateral plantar
vessels and nerves. It arises, by a broad origin, from the lateral
process of the tuberosity of the calcaneus, from the under surface of the
calcaneus between the two processes of the tuberosity, from the forepart of the
medial process, from the plantar aponeurosis, and from the intermuscular septum
between it and the Flexor digitorum brevis. Its tendon, after gliding over a
smooth facet on the under surface of the base of the fifth metatarsal bone, is inserted,
with the Flexor digiti quinti brevis, into the fibular side of the base of the
first phalanx of the fifth toe.
1.5.2 Variations —Slips of origin from the tuberosity at the base of the
fifth metatarsal Abductor ossis metatarsi quinti, origin external
tubercle of the calcaneus, insertion into tuberosity of the fifth metatarsal
bone in common with or beneath the outer margin of the plantar fascia
1.5.3 Action-the action of the Abductor digiti quinti is twofold, as an
abductor of this toe from the fourth, and as a flexor of its proximal phalanx.
1.5.4 Non Web Based Links
1.5.4.1 Fig443
(Bitmap)
1.5.4.2 Discussion
1.5.5 Discussion
1.5.5.1
http://www.bartleby.com/107/131.html
1.5.6 Illustration
1.5.6.1 http://www.bartleby.com/107/illus443.html
1.6 Category
1.6.1 Intrinsic
Foot Plantar First Superficial Layer (IFP1)
1.7 View (When
Illustrated Individually)
1.7.1 Plantar View
(First Plantar Layer)
1.7.2 Test
1.7.2.1
Illus. (DSL) Illus. (Dial-Up)
2 ABDUCTOR DIGITI
MINIMI (HAND)
Back Table of Contents References
2.1 Word Derivation Pronounce
2.1.1 Abductor=Moves
part away from midline
2.1.2 Digit=Finger or
toe
2.1.3 Minimi= Little
finger or toe
2.2 Attachments Illus. (DSL)
2.2.1 Origin
2.2.1.1
Pisiform bone
2.2.1.2
Tendon of the flexor carpi ulnaris
2.2.2 Insertion
2.2.2.1
Two slips
2.2.2.1.1
Ulnar
side of the base of the proximal phalanx of the little finger
2.2.2.1.2
Ulnar
border of the extensor expansion of the finger
2.3 Action Illus. (DSL)
2.3.1 Abducts the little
finger
2.3.2 Assists in flexing
its proximal phalanx at the Metacarpophalangeal joint
2.4 Nerve Supply
2.4.1 Nerve
2.4.1.1
Ulnar (Deep Branch)
2.4.2 Roots
2.4.2.1
C8
2.4.2.2
T1
2.5 Synergists
2.5.1 Flexor digiti
minimi brevis
2.5.2 Opponens digiti
minimi
2.6 Muscle Tests
2.6.1 ABDUCTOR
DIGITI MINIMI (HAND)
2.7 Trigger Points
2.7.1 ABDUCTOR
DIGITI MINIMI (HAND)
2.8 Organ Reflexes
2.8.1 None
2.8.2 Illustrations
2.9 Meridian
2.9.1 None
2.10 Discussion (Gray)
2.10.1
The Abductor digiti
quinti
(Abductor minimi digiti) (Fig. 427) is situated on the ulnar
border of the palm of the hand. It arises from the pisiform bone and
from the tendon of the Flexor carpi ulnaris, and ends in a flat tendon, which
divides into two slips; one is inserted into the ulnar side of the base
of the first phalanx of the little finger; the other into the ulnar border of
the aponeurosis of the Extensor digiti quinti proprius.
2.10.2
Variations
2.10.2.1
The Abductor digiti quinti may be divided into two or three
slips or united with the Flexor digiti quinti brevis.
2.10.3
Actions —The Abductor
digiti quinti abducts the little finger from the ring finger and assist in
flexing the proximal phalanx.
2.10.4
Nerves-C8 Ulnar
2.11 Category
2.11.1
Intrinsic Hand Hypothenar (IHH)
2.12 View (When
Illustrated Individually)
2.12.1
Anterior
2.12.1.1Illus. (DSL)
3 ABDUCTOR HALLUCIS
Back Table of Contents References
3.1 Word Derivation
3.1.1 Abductor=Moves
part away from midline
3.1.2 Hallucis= Hallux
or Great toe
3.2 Attachments Illus. (DSL)
3.2.1 Origin
3.2.1.1
Medial process of tuberosity of the calcaneus
3.2.1.2
Flexor retinaculum
3.2.1.3
Plantar aponeurosis
3.2.1.4
Intermuscular septum
3.3
Insertion
3.3.1.1
Medial tendon of the flexor hallucis
brevis
3.3.1.2
Medial side of the base of the
proximal phalanx of the big toe
3.4 Action Illus. (DSL)
3.4.1 Abducts
the big toe from the mid line of the foot phalangeal
3.5 Nerve Supply
3.5.1 Nerve
3.5.1.1
Medial plantar
3.5.2 Roots
3.5.2.1
L4
3.5.2.2
L5
3.5.2.3
S1
3.5.2.4
S2
3.5.2.5
S3
3.6 Synergists
3.6.1 None
3.7 Muscle Tests
3.7.1 ABDUCTOR HALLUCIS
3.8 Trigger Points
3.8.1 ABDUCTOR
HALLUCIS
3.9 Organ Reflexes
3.9.1 None
3.9.2 Illustrations
3.10 Meridian
3.10.1
None
3.11 Discussion (Gray)
3.11.1
The Abductor hallucis (Fig. 443) lies along the medial border
of the foot and covers the origins of the plantar vessels and nerves. It arises
from the medial process of the tuberosity of the calcaneus, from the laciniate
ligament, from the plantar aponeurosis, and from the intermuscular septum
between it and the Flexor digitorum brevis. The fibers end in a tendon, which
is inserted, together with the medial tendon of the Flexor hallucis
brevis, into the tibial side of the base of the first phalanx of the great toe.
3.11.2
Variations —Slip to the base
of the first phalanx of the second toe.
3.11.3
Action- The Abductor
hallucis abducts the great toe from the second, and also flexes its proximal
phalanx.
3.11.4
Discussion
3.11.4.1http://www.bartleby.com/107/131.html
3.11.5
Illustration
3.11.5.1http://www.bartleby.com/107/illus443.html
3.12 Category
3.12.1
Intrinsic Foot Plantar First Superficial Layer (IFP1)
3.13 View (When
Illustrated Individually)
3.13.1
Plantar View (First Plantar Layer)
3.13.1.1Illus. (DSL)
4 ABDUCTOR POLLICIS
BREVIS B4E4
Back Table of Contents References
4.1 Word Derivation
4.1.1 Abductor=Moves part
away from midline
4.1.2 Pollex= Thumb
4.1.3 Brevis=Short
4.2 Attachments Illus. (DSL)
4.3
Origin
4.3.1.1
Flexor retinaculum
4.3.1.2
Tubercles of the scaphoid and trapezium
4.4
Insertion
4.4.1.1
Radial side of the base of the proximal phalanx of the thumb
4.5 Action Illus. (DSL)
4.5.1 Abduction of the
proximal phalanx and the metacarpal of the thumb
4.5.2 Medial rotation of
the proximal phalanx and the metacarpal of the thumb
4.6 Nerve Supply
4.6.1 Nerve
4.6.1.1
Median
4.6.2 Roots
4.6.2.1
C8
4.6.2.2
T1
4.7 Synergists
4.7.1 Abductor pollicis
longus
4.7.2 Extensor pollicis
brevis
4.8 Muscle Tests
4.8.1 ABDUCTOR
POLLICIS BREVIS
4.9 Trigger Points
4.9.1 ABDUCTOR
POLLICIS BREVIS
4.10 Organ Reflexes
4.10.1
None
4.10.2
Illustrations
4.11 Meridian
4.11.1
None
4.12 Discussion (Gray)
4.12.1
The Abductor pollicis
brevis
(Abductor pollicis) (Fig. 426) (Fig. 427) is a thin, flat muscle, placed
immediately beneath the integument. It arises from the transverse carpal
ligament, the tuberosity of the navicular, and the ridge of the greater
multiangular, frequently by two distinct slips. Running lateralward and
downward, it is inserted by a thin, flat tendon into the radial side of
the base of the first phalanx of the thumb and the capsule of the
metacarpophalangeal articulation.
4.12.2
Variations —The Abductor
pollicis brevis is often divided into an outer and an inner part; accessory
slips from the tendon of the Abductor pollicis longus or Palmaris longus, more
rarely from the Extensor carpi radialis longus, from the styloid process or
Opponens pollicis or from the skin over the thenar eminence.
4.12.3
Actions —The Abductor
pollicis brevis draws the thumb forward in a plane at right angles to that of
the palm of the hand.
4.13 Category
4.13.1
Intrinsic Hand Thenar (ITT)
4.14 View (When
Illustrated Individually)
4.14.1
Anterior View
4.14.1.1Illus. (DSL)
5 ABDUCTOR POLLICIS
LONGUS B5E5
Back Table of Contents References
5.1 Word Derivation
5.1.1 Abductor=Moves
part away from midline
5.1.2 Pollex= Thumb
5.1.3 Longus=Long
5.2 Attachments Illus. 1 (DSL) Illus. 2 (DSL)
5.3
Origin
5.3.1.1
Posterior surface of middle one third of body of radius
5.3.1.2
Posterior lateral surface of the ulna distal to the origin
of the Supinator
5.3.1.3
Interosseous membrane
5.4
Insertion
5.4.1.1
Base of first metacarpal bone, radial side
5.5 Action Illus. (DSL)
5.5.1 Abducts the
carpometacarpal joint of the thumb
5.5.2 Assists in
extension of the carpometacarpal joint of the thumb
5.6 Nerve Supply
5.6.1 Nerve
5.6.1.1
Posterior interosseous nerve (deep radial nerve)
5.6.2 Roots
5.6.2.1
C7
5.6.2.2
C8
5.7 Synergists
5.7.1 Abductor pollicis
brevis
5.7.2 Extensor pollicis
brevis
5.8 Muscle Tests
5.8.1 ABDUCTOR
POLLICIS LONGUS
5.9 Trigger Points
5.9.1 ABDUCTOR
POLLICIS LONGUS
5.10 Organ Reflexes
5.10.1
None
5.10.2
Illustrations
5.11 Meridian
5.11.1
None
5.12 Discussion (Gray)
5.12.1
The Abductor pollicis
longus
(Extensor oss. metacarpi pollicis) (Fig. 419) lies immediately below the
Supinator and is sometimes united with it. It arises from the lateral
part of the dorsal surface of the body of the ulna below the insertion of the
Anconeus, from the interosseous membrane, and from the middle third of the
dorsal surface of the body of the radius. Passing obliquely downward and
lateralward, it ends in a tendon, which runs through a groove on the lateral
side of the lower end of the radius, accompanied by the tendon of the Extensor
pollicis brevis, and is inserted into the radial side of the base of the
first metacarpal bone. It occasionally gives off two slips near its insertion:
one to the greater multiangular bone and the other to blend with the origin of
the Abductor pollicis brevis.
5.12.2
Variations —More or less
doubling of muscle and tendon with insertion of the extra tendon into the first
metacarpal, the greater multiangular, or into the Abductor pollicis brevis or
Opponens pollicis
5.12.3
Action- The chief action
of the Abductor pollicis longus is to carry the thumb laterally from the palm
of the hand. By its continued action, it helps to extend and abduct the wrist.
5.13 Category
5.13.1
Wrist, Hand, and Fingers Posterior Extensors Deep (WHFPED)
5.14 View (When
Illustrated Individually)
5.14.1
Posterior
5.14.1.1Illus. (DSL)
6 ADDUCTOR BREVIS B6E6
Back Table of Contents References
6.1 Word Derivation
6.1.1 Adductor=Moves
part towards the midline
6.1.2 Brevis=Short
6.2 Attachments Illus. 1 (DSL) Illus. 2 (DSL)
6.3
Origin
6.3.1.1
Outer surface of body and inferior ramus of pubis
6.4
Insertion
6.4.1.1
On a line extending from lesser trochanter to upper part of
linea aspera
6.5 Action Illus. (DSL)
6.5.1 Hip adduction
6.5.2 Hip flexion
6.5.3 Hip medial
rotation
6.6 Nerve Supply
6.6.1 Nerve
6.6.1.1
Obturator
6.6.2 Roots
6.6.2.1
L2
6.6.2.2
L3
6.6.2.3
L4
6.7 Synergists
6.7.1 Adductor magnus
6.7.2 Adductor longus
6.7.3 Gracilis
6.7.4 Pectineus
6.8 Muscle Tests
6.8.1 ADDUCTOR
BREVIS
6.9 Trigger Points
6.9.1 ADDUCTOR
BREVIS
6.10 Organ Reflexes
6.10.1
CLIMACTERIC
6.10.2
Illustrations
6.11 Meridian
6.11.1
Pericardium
6.12 Discussion (Gray)
6.12.1
The Adductor brevis (Fig. 433) is situated immediately behind
the two preceding muscles. It is triangular in form, and arises by a narrow
origin from the outer surfaces of the superior and inferior rami of the pubis,
between the Gracilis and Obturator externus. Its fibers, passing backward,
lateralward, and downward, are inserted, by an aponeurosis, into the
line leading from the lesser trochanter to the linea aspera and into the upper
part of the linea aspera, immediately behind the Pectineus and upper part of
the Adductor longus
6.12.2
Variations- the Adductor brevis may be divided into
two or three parts, or it may be united to the Adductor magnus.
6.12.3
Action- the Pectineus and three Adductores adduct the thigh
powerfully; they are especially used in horse exercise, the sides of the saddle
being grasped between the knees by the contraction of these muscles. In
consequence of the obliquity of their insertions into the linea aspera, they
rotate the thigh outward, assisting the external Rotators, and when the limb
has been abducted, they draw it medialward, carrying the thigh across that of
the opposite side. The Pectineus and Adductores brevis and longus assist the
Psoas major and Iliacus in flexing the thigh upon the pelvis. In progression,
all these muscles assist in drawing forward the lower limb.
6.13 Category
6.13.1
Thigh Adductor Compartment (TAD)
6.14 View (When Illustrated
Individually)
6.14.1
Anterior
6.14.1.1Illus. (DSL)
7 ADDUCTOR HALLUCIS B7E7
Back Table of Contents References
7.1 Word Derivation
7.1.1 Adductor=Moves
part towards the midline
7.1.2 Hallucis= Hallux
or Great toe
7.2 Attachments Illus. (DSL)
7.2.1 Origin
7.2.1.1
Oblique head
7.2.1.1.1
Bases
of the 2nd, 3rd and
4th metatarsals
7.2.1.1.2
Sheath
of tendon of Peroneus Longus
7.2.1.2
Transverse head
7.2.1.2.1
Plantar
Metatarsophalangeal ligaments of the 3rd, 4th and 5th toes
7.2.1.2.2
Deep
transverse metatarsal ligaments
7.2.2 Insertion
7.2.2.1
Lateral side of base of proximal phalanx of big toe
7.3 Action Illus. (DSL)
7.3.1 Adduction
(big toe towards the 2nd toe)
7.3.2 Flexion
(big toe towards plantar surface)
7.4 Joints
7.4.1 Metatarsophalangeal
joint of big toe
7.5 Nerve Supply
7.5.1 Nerve
7.5.1.1
Lateral plantar nerve
7.5.2 Roots
7.5.2.1
S2
7.5.2.2
S3
7.6 Synergists
7.6.1
7.7 Muscle Tests
7.7.1 ADDUCTOR
HALLUCIS
7.8 Trigger Points
7.8.1 ADDUCTOR
HALLUCIS
7.9 Organ Reflexes
7.9.1 None
7.9.2 Illustrations
7.10 Meridian
7.10.1
None
7.11 Discussion (Grays)
7.11.1
The Adductor hallucis (Adductor obliquus
hallucis) (Fig. 445) arises
by two heads—oblique and transverse. The oblique
head
is a large, thick, fleshy mass, crossing the foot obliquely and occupying the
hollow space under the first second, third, and fourth metatarsal bones. It arises
from the bases of the second, third, and fourth metatarsal bones, and from the
sheath of the tendon of the Peroneus longus, and is inserted, together
with the lateral portion of the Flexor hallucis brevis, into the lateral side
of the base of the first phalanx of the great toe. The transverse head (Transversus pedis) is a narrow, flat fasciculus
which arises from the plantar metatarsophalangeal ligaments of the
third, fourth, and fifth toes (sometimes only from the third and fourth), and
from the transverse ligament of the metatarsus. It is inserted into the
lateral side of the base of the first phalanx of the great toe, its fibers
blending with the tendon of insertion of the oblique head.
7.11.2
Variations
7.11.2.1
Slips to the base of the first phalanx of the second toe Opponens
hallucis, occasional slips from the adductor to the metatarsal bone of the
great toe
7.11.2.2
The Abductor, Flexor brevis, and Adductor of the great toe,
like the similar muscles of the thumb, give off, at their insertions, fibrous
expansions to blend with the tendons of the Extensor digitorum longus.
7.11.3
Action- the Abductor hallucis abducts the great toe from the
second, and flexes its proximal phalanx.
7.11.4
Discussion
7.11.4.1http://www.bartleby.com/107/131.html
7.11.5
Illustration
7.11.5.1http://www.bartleby.com/107/illus445.html
7.12 Category
7.12.1
Intrinsic Foot Plantar Third Layer (IFP3)
7.13 View (When
Illustrated Individually)
7.13.1
Plantar
7.13.1.1.1
Illus. (DSL)
8 ADDUCTOR LONGUS B8E8
Back Table of Contents References
8.1 Word Derivation
8.1.1 Adductor=Moves
part towards the midline
8.1.2 Longus=Long
8.2 Attachments Illus. 1 (DSL) Illus. 2 (DSL)
8.2.1 Origin
8.2.1.1
Anterior pubis in angle between crest and symphysis
8.2.2 Insertion
8.2.2.1
Middle 1/3 of medial lip of linea
aspera
8.3 Joints
8.3.1 Hip
8.4 Action Illus. (DSL)
8.4.1 Adduction
8.4.2 Flexion
8.4.3 Medial
rotation
8.5 Nerve Supply
8.5.1 Nerve
8.5.1.1
Obturator
8.5.2 Roots
8.5.2.1
L2
8.5.2.2
L3
8.5.2.3
L4
8.6 Synergists
8.6.1 Gracilis
8.6.2 Adductor
magnus
8.6.3 Pectineus
8.6.4 Adductor
brevis
8.7 Muscle Tests
8.7.1 ADDUCTOR
LONGUS
8.8 Trigger Points
8.8.1 ADDUCTOR
LONGUS
8.9 Organ Reflexes
8.9.1 CLIMACTERIC
8.9.2 Illustrations
8.10 Meridian
8.10.1
Pericardium
8.11 Discussion (Gray)
8.11.1
The Adductor longus (Fig 432) (Fig. 433), the most superficial
of the three Adductores, is a triangular muscle, lying in the same plane as the
Pectineus. It arises by a flat, narrow tendon, from the front of the
pubis, at the angle of junction of the crest with the symphysis; and soon
expands into a broad fleshy belly. This passes downward, backward, and
lateralward, and is inserted, by an aponeurosis, into the linea aspera,
between the Vastus medialis and the Adductor magnus, with both of which it is
usually blended.
8.11.2
Variations-The Adductor longus may be double, may
extend to the knee, or be more or less united with the Pectineus.
8.11.3
Action-The Pectineus and three Adductores adduct the thigh
powerfully; they are especially used in horse exercise, the sides of the saddle
being grasped between the knees by the contraction of these muscles. In
consequence of the obliquity of their insertions into the linea aspera, they
rotate the thigh outward, assisting the external Rotators, and when the limb
has been abducted, they draw it medialward, carrying the thigh across that of
the opposite side. The Pectineus and Adductores brevis and longus assist the
Psoas major and Iliacus in flexing the thigh upon the pelvis. In progression,
all these muscles assist in drawing forward the lower limb.
8.12 Category
8.12.1
Thigh Adductor Compartment (TAD)
8.13 View (When
Illustrated Individually)
8.13.1
Anterior
8.13.1.1Illus. (DSL)
9 ADDUCTOR MAGNUS B9E9
Back Table of Contents References
9.1 Word Derivation
9.1.1 Adductor=Moves
part towards the midline
9.1.2 Magnus=Large
9.2 Attachments Illus. 1 (DSL) Illus. 2 (DSL)
9.2.1 Origin
9.2.1.1
POSTERIOR FIBERS
9.2.1.1.1
Ischial
tuberosity
9.2.1.2
ANTERIOR FIBERS
9.2.1.2.1
Ramus
of ischium
9.2.1.2.2
Inferior
pubic ramus
9.2.2 Insertion
9.2.2.1
Line extending from the greater
trochanter along the linea aspera
9.2.2.2
Medial supracondylar line
9.2.2.3
Adductor tubercle on medial condyle
of femur
9.3 Joints
9.3.1 Hip
9.4 Action Illus. (DSL)
9.4.1 Adduction
9.4.2 Extension
9.4.2.1
. Note
9.4.2.1.1
Fibers arising from ischium and ramus of ischium primarily
insert distally and aid in hip extension
9.4.3 Flexion
9.4.3.1
Note
9.4.3.1.1 Fibers
arising from ramus of pubis insert proximally and aid in hip flexion.
9.4.4 Medial
rotation
9.5 Nerve Supply
9.5.1 Posterior
fibers
9.5.1.1
Nerve
9.5.1.1.1 Tibial
portion of sciatic
9.5.1.2
Roots
9.5.1.2.1 L4
9.5.1.2.2 L5
9.5.1.2.3 S1
9.5.2 Anterior
fibers
9.5.2.1
Nerve
9.5.2.1.1 Obturator
9.5.2.2
Roots
9.5.2.2.1 L2
9.5.2.2.2 L3
9.5.2.2.3 L4
9.6 Synergists
9.6.1 Adductor
brevis
9.6.2 Adductor
longus
9.6.3 Pectineus
9.6.4 Gracilis
9.7 Muscle Tests
9.7.1 ADDUCTOR
MAGNUS
9.8 Trigger Points
9.8.1 ADDUCTOR
MAGNUS
9.9 Organ Reflexes
9.9.1 CLIMACTERIC
9.9.2 Illustrations
9.10 Meridian
9.10.1
Pericardium
9.11 Discussion (Gray)
9.11.1
The Adductor magnus Fig 432 (Fig. 433) is a large triangular muscle, situated on the
medial side of the thigh. It arises from a small part of the inferior
ramus of the pubis, from the inferior ramus of the ischium, and from the outer
margin of the inferior part of the tuberosity of the ischium. Those fibers
which arise from the ramus of the pubis are short, horizontal in direction, and
are inserted into the rough line leading from the greater trochanter to the
linea aspera, medial to the Glutæus maximus; those from the ramus of the
ischium are directed downward and lateralward with different degrees of
obliquity, to be inserted, by means of a broad aponeurosis, into the
linea aspera and the upper part of its medial prolongation below. The medial
portion of the muscle, composed principally of the fibers arising from the
tuberosity of the ischium, forms a thick fleshy mass consisting of coarse
bundles which descend almost vertically, and end about the lower third of the
thigh in a rounded tendon which is inserted into the adductor tubercle on the
medial condyle of the femur, and is connected by a fibrous expansion to the
line leading upward from the tubercle to the linea aspera. At the insertion
of the muscle, there is a series of osseoaponeurotic openings, formed by
tendinous arches attached to the bone. The upper four openings are small, and
give passage to the perforating branches of the profunda femoris artery. The
lowest is of large size, and transmits the femoral vessels to the popliteal fossa.
9.11.2
Variations-The Adductor magnus may be more or less
segmented; the anterior and superior portion is often described as a separate
muscle, the Adductor minimus. The muscle may be fused with the Quadratus
femoris.
9.11.3
Action-The Pectineus and three Adductores adduct the thigh
powerfully; they are especially used in horse exercise, the sides of the saddle
being grasped between the knees by the contraction of these muscles. In
consequence of the obliquity of their insertions into the linea aspera, they
rotate the thigh outward, assisting the external Rotators, and when the limb
has been abducted, they draw it medialward, carrying the thigh across that of
the opposite side.
9.12 Category
9.12.1
Thigh Adductor Compartment (TAD)
9.13 View (When
Illustrated Individually)
9.13.1
Anterior
9.13.1.1Illus. (DSL)
10 ADDUCTOR POLLICIS B10E10
Back Table of Contents References
10.1 Word Derivation
10.1.1
Adductor=Moves part towards the midline
10.1.2
Pollex= Thumb
10.2 Attachments Illus. (DSL)
10.2.1
Origin
10.2.1.1OBLIQUE HEAD
10.2.1.1.1
Capitate
bone
10.2.1.1.2
Bases
of the 2nd and 3rd metacarpal bones
10.2.1.1.3
Intercarpal
ligaments
10.2.1.1.4
Sheath
of the tendon of the Flexor carpi radialis
10.2.1.2TRANSVERSE HEAD
10.2.1.2.1
Distal
2/3 of the palmar surface of the 3rd metacarpal bone
10.2.2
Insertion
10.2.2.1Two heads
converge to insert on the ulnar side of the base of the proximal phalanx of the
thumb
10.3 Joints
10.3.1
Carpometacarpal (CMJ)
10.3.2
Metacarpophalangeal (MPJ)
10.4 Action Illus. (DSL)
10.4.1
Adduction (1st CMJ)
(Thumb)
10.4.2
Adduction (1st MPJ)
(Thumb)
10.4.3
Flexion (1st MPJ) (Thumb)
10.5 Nerve Supply
10.5.1
Nerve
10.5.1.1
Ulnar (Deep branch)
10.5.2
Roots
10.5.2.1
C8
10.5.2.2
T1
10.6 Synergists
10.6.1
Flexor pollicis brevis
10.6.2
Flexor pollicis longus
10.6.3
Opponens pollicis
10.7 Muscle Tests
10.7.1
ADDUCTOR POLLICIS
10.8 Trigger Points
10.8.1
ADDUCTOR POLLICIS
10.9 Organ Reflexes
10.9.1
None
10.9.2
Illustrations
10.10
Meridian
10.10.1
None
10.11
Discussion (Gray)
10.11.1
The Adductor pollicis (obliquus) (Adductor obliquus pollicis) (Fig. 426) arises by several slips from the capitate
bone, the bases of the second and third metacarpals, the intercarpal ligaments,
and the sheath of the tendon of the Flexor carpi radialis. From this origin the
greater number of fibers pass obliquely downward and converge to a tendon,
which, uniting with the tendons of the medial portion of the Flexor pollicis
brevis and the transverse part of the Adductor, is inserted into the
ulnar side of the base of the first phalanx of the thumb, a sesamoid bone being
present in the tendon. A considerable fasciculus, however, passes more
obliquely beneath the tendon of the Flexor pollicis longus to join the lateral
portion of the Flexor brevis and the Abductor pollicis brevis.
10.11.2
The Adductor pollicis (transversus) (Adductor transversus pollicis) (Fig. 426) Fig 427 is the most deeply seated of this group of muscles.
It is of a triangular form arising by a broad base from the lower two-thirds of
the volar surface of the third metacarpal bone; the fibers converge, to be inserted
with the medial part of the Flexor pollicis brevis and the Adductor pollicis
(obliquus) into the ulnar side of the base of the first phalanx of the thumb
10.11.3
Variations-The two adductors
vary in their relative extent and in the closeness of their connection. The
Adductor obliquus may receive a slip from the transverse metacarpal ligament.
10.11.4
Actions-The Abductor
pollicis brevis draws the thumb forward in a plane at right angles to that of
the palm of the hand. The Adductor pollicis is the opponent of this muscle, and
approximates the thumb to the palm.
10.12
Category
10.12.1
Intrinsic Hand Thenar (IHT)
10.13
View (When Illustrated Individually)
10.13.1
Anterior
10.13.1.1 Illus. (DSL)
11 ANCONEUS B11E11
Back Table of Contents References
11.1 Word Derivation
11.1.1
Anconeal=Pertaining to elbow
11.2 Attachments Illus.1
(DSL) Illus.2
(DSL)
11.2.1
Origin
11.2.1.1Posterior surface of lateral
Epicondyle of humerus
11.2.2
Insertion
11.2.2.1Lateral
side of Olecranon process
11.2.2.2Upper
1/4th of posterior surface of proximal portion of ulna
11.3 Joints
11.3.1
Elbow
11.3.2
Radioulnar (RU)
11.4 Action Illus. (DSL)
11.4.1
Extension (Elbow)
11.4.2
Pronation (RU)
11.5 Nerve Supply
11.5.1
Nerve
11.5.1.1
Radial
11.5.2
Roots
11.5.2.1
C7
11.5.2.2
C8
11.5.2.3
T1
11.6 Synergists
11.6.1
Triceps Brachii
11.7 Muscle Tests
11.7.1
ANCONEUS
11.8 Trigger Points
11.8.1
ANCONEUS
11.9 Organ Reflexes
11.9.1
Pancreas
11.9.2
Illustrations
11.10
Meridian
11.10.1 Spleen/Pancreas
11.11
Discussion (Gray)
11.11.1
The Anconæus (Fig. 418) is a small triangular muscle, which is placed on the back
of the elbow-joint, and appears to be a continuation of the Triceps brachii. It
arises by a separate tendon from the back part of the lateral epicondyle
of the humerus; its fibers diverge and are inserted into the side of the
olecranon, and upper fourth of the dorsal surface of the body of the ulna.
11.11.2
Actions-The Anconæus assists the Triceps in extending the
forearm.
11.12
Category
11.12.1
Forearm Extensors (FAE)
11.13
View (When Illustrated Individually)
11.13.1
Posterior
11.13.1.1 Illus. (DSL)
12 BICEPS BRACHII B12E12
Back Table of Contents References
12.1 Word Derivation
and Pronunciation
12.2
Pronunciation
12.2.1.1BICEPS BRA·CHII- 'bI-"seps 'brA-kE-"I, -kE-"E 
12.2.1.2Pronunciation Key
12.2.1
Etymology
12.2.1.1Biceps=Two heads of origin
12.2.1.1.1
New
Latin bicipit-, biceps, from Latin, two-headed, from bi- + capit-,
caput head
12.2.1.2Brachion=Upper Arm
12.1 Attachments Illus. 1 Illus. 2
12.1.1
Origin
12.1.1.1Long head
12.1.1.1.1
Supraglenoid
tubercle of the scapula
12.1.1.2Short head
12.1.1.2.1
Apex
of coracoid process of the scapula
12.1.2
Insertion
12.1.2.1Radial
tuberosity
12.1.2.2Bicipital
aponeurosis (lacertus fibrosus) (Continuous with the
deep fascia covering the origins of the Flexor muscles)
12.2 Joints
12.2.1
Glenohumeral (GH)
12.2.2
Elbow
12.2.3
Radioulnar (RU)
12.3 Action Video
12.3.1
Flexion (Elbow)
12.3.2
Supination (RU)
12.3.3
Flexion (GH)
12.3.4
Reversed origin-insertion action
12.3.4.1
Both heads of the biceps brachii are active during flexion
of the arm at the shoulder joint, with the long head being more active.
12.4 Nerve Supply
12.4.1
Nerve
12.4.1.1
Musculocutaneous
12.4.1.1.1
Separate branches to each head
12.4.2
Roots
12.4.2.1
C5
12.4.2.2
C6
12.5 Synergists
12.5.1
Brachialis
12.5.2
Brachioradialis
12.5.3
Supinator
12.1 Muscle Tests
12.1.1
BICEPS BRACHII
12.2 Trigger Points
12.2.1
BICEPS BRACHII
12.3 Organ Reflexes
12.3.1
Stomach
12.3.2
Illustrations
12.4 Acupressure/Acupuncture
Theory
12.4.1
Organs
12.4.1.1Spleen/Stomach
12.4.2
Channels Discussion
12.4.2.1Spleen/Stomach
12.4.3
Channels Illustration All
12.4.3.1Stomach ALL
12.4.4
Channels Illus Command Points
12.4.4.1Stomach
12.5 Musculoskeletal
Pathology
12.5.1
BICEPS TENDINTIS
(Proximal)
12.5.2
BICEPS TENDINTIS (Distal)
12.6 Orthopaedic Tests
12.6.1
Biceps Strength
12.6.2
Bicipital Tendinitis Test
12.6.3
Impingement Syndrome Test
12.6.4
Reflexes (Shoulder)
12.6.5
Yergason's Test
12.7 Musculoskeletal
Examination
12.7.1
Shoulder and Shoulder Girdle
12.7.2
Elbow
12.8 Stretching
12.8.1
Stretching
Concepts
12.8.2
Stretching
Individual Muscle Discussion
12.8.3
Stretching
Muscle Illustration
12.9 Posture
12.9.1
Postural
Assessment
12.9.2
Postural
Illustrations
12.10 Massage Routines
12.10.1
Deep Tissue
12.10.1.1 Deltoid
12.10.1.2 Biceps
Triceps
12.11
Exercise
12.11.1
Biceps Brachii-Resistance Exercise
12.11.2
Biceps Brachii- Biomechanics
12.12
Discussion (Gray)
12.12.1
The Biceps brachii (Biceps;
Biceps flexor cubiti) (Fig. 411) Discussion is a long fusiform muscle,
placed on the front of the arm, and arising by two heads, from which
circumstance it has received its name. The short
head
arises by a thick flattened tendon from the apex of the coracoid
process, in common with the Coracobrachialis. The long
head
arises from the supraglenoid tuberosity at the upper margin of the
glenoid cavity, and is continuous with the glenoidal labrum. This tendon,
enclosed in a special sheath of the synovial membrane of the shoulder-joint,
arches over the head of the humerus; it emerges from the capsule through an
opening close to the humeral attachment of the ligament, and descends in the
intertubercular groove; it is retained in the groove by the transverse humeral
ligament and by a fibrous prolongation from the tendon of the Pectoralis major.
An elongated muscular belly succeeds each tendon, and the two bellies, although
closely applied to each other, can readily be separated until within about 7.5
cm. of the elbow-joint. Here they end in a flattened tendon, which is inserted
into the rough posterior portion of the tuberosity of the radius, a bursa being
interposed between the tendon and the front part of the tuberosity. As the
tendon of the muscle approaches the radius it is twisted upon itself, so that
its anterior surface becomes lateral and is applied to the tuberosity of the
radius at its insertion. Opposite the bend of the elbow the tendon gives off,
from its medial side, a broad aponeurosis, the lacertus
fibrosus
(bicipital fascia) which passes obliquely downward and medialward across
the brachial artery, and is continuous with the deep fascia covering the
origins of the Flexor muscles of the forearm (Fig. 410).
12.12.2
Variations —A third head (10
per cent.) to the Biceps brachii is occasionally found, arising at the upper
and medial part of the Brachialis, with the fibers of which it is continuous, and
inserted into the lacertus fibrosus and medial side of the tendon of the
muscle. In most cases, this additional slip lies behind the brachial artery in
its coarse down the arm. In some instances, the third head consists of two
slips, which pass down, one in front of and the other behind the artery,
concealing the vessel in the lower half of the arm. More rarely a fourth head
occurs arising from the outer side of the humerus, from the intertubercular
groove, or from the greater tubercle. Other heads are occasionally found. Slips
sometimes pass from the inner border of the muscle over the brachial artery to
the medial intermuscular septum or the medial epicondyle or more rarely to the
Pronator teres or Brachialis. The long head may be absent or arise from the
intertubercular groove.
12.12.3
Actions- The Biceps
brachii is a flexor of the elbow and, to a less extent, of the shoulder; it is
also a powerful Supinator, and serves to render tense the deep fascia of the
forearm by means of the lacertus fibrosus given off from its tendon.
12.12.4
Non Web Based
Links
12.12.4.1 Fig. 410
12.12.4.2 Fig. 411
12.12.4.3 Discussion
12.13
Quiz
12.13.1
Test Your Knowledge
12.14
Category
12.14.1
Forearm Flexors (FAF)
12.15
View (When Illustrated Individually)
12.15.1
Anterior
12.15.1.1 Illus. (DSL)
1 BICEPS
FEMORIS (Lateral Hamstring) B13E13
Back Table of Contents References
1.1 Word Derivation
1.1.1 Biceps=Two heads
of origin
1.1.2 Femoris=Femur
1.2 Attachments Illus. (DSL)
1.2.1 Origin
1.2.1.1
Long head
1.2.1.1.1
Ischial
tuberosity (Posterior Lower & Inner Impression)
1.2.1.1.2
Sacrotuberous
ligament
1.2.1.2
Short head
1.2.1.2.1
Lateral
lip of linea aspera
1.2.1.2.2
Proximal
2/3rd of lateral supracondylar line of femur
1.2.1.3 Lateral
intermuscular septum
1.2.2 Insertion
1.2.2.1
Lateral side of the head of the fibula
1.2.2.2
Lateral condyle of the tibia
1.2.2.3
Deep fascia on the lateral side of
the leg
1.3 Joints
1.3.1 Knee
1.3.2 Hip
1.4 Action Illus. (DSL)
1.4.1 Long and Short
Head
1.4.1.1
Flexion (Knee)
1.4.1.2
Lateral rotation (Knee)
1.4.2 Long Head Only
1.4.2.1
Extension (Hip)
1.4.2.2
Adduction (Hip)
1.4.2.3
Lateral Rotation (Hip)
1.4.2.4
Note
1.4.2.4.1
When
the hip is extended the long head of the biceps Femoris is placed at a
mechanical disadvantage in knee extension. The short head of the biceps Femoris
then becomes the primary knee flexor.
1.4.2.5
Reversed origin-insertion action
1.4.2.5.1
The
long head gives posterior stability to the pelvis and extends the pelvis on the
hip.
1.5 Nerve Supply
1.5.1 LONG
HEAD
1.5.1.1
Nerve
1.5.1.1.1
Sciatic (Tibial Portion)
1.5.1.2
Roots
1.5.1.2.1
L5
1.5.1.2.2
S1
1.5.1.2.3 S2
1.5.2 Short
head
1.5.2.1 Nerve
1.5.2.1.1 Sciatic
(Common peroneal portion)
1.5.2.2
Roots
1.5.2.2.1 L5
1.5.2.2.2 S1
1.5.2.2.3 S2
1.6 Synergists
1.6.1 Semimembranosus
1.6.2 Semitendinosus
1.6.3 Gracilis
1.6.4 Sartorius
1.6.5 Gastrocnemius
1.7 Muscle Tests
1.7.1 BICEPS
FEMORIS
1.8 Trigger Points
1.8.1 BICEPS FEMORIS
1.9 Organ Reflexes
1.9.1 Rectum
1.9.2 Illustrations
1.10 Meridian
1.10.1
Large Intestine
1.11 Discussion (Gray)
1.11.1
The Biceps femoris (Biceps) (Fig. 434) is situated on the posterior and lateral aspect
of the thigh. It has two heads of origin; one, the long
head,
arises from the lower and inner impression on the back part of the
tuberosity of the ischium, by a tendon common to it and the Semitendinosus, and
from the lower part of the sacrotuberous ligament; the other, the short head, arises from the lateral lip of the linea aspera,
between the Adductor magnus and Vastus lateralis, extending up almost as high
as the insertion of the Gluteus maximus; from the lateral prolongation of the
linea aspera to within 5 cm. of the lateral condyle; and from the lateral
intermuscular septum. The fibers of the long head form a fusiform belly, which
passes obliquely downward and lateralward across the sciatic nerve to end in an
aponeurosis which covers the posterior surface of the muscle, and receives the
fibers of the short head; this aponeurosis becomes gradually contracted into a
tendon, which is inserted into the lateral side of the head of the
fibula, and by a small slip into the lateral condyle of the tibia. At its
insertion, the tendon divides into two portions, which embrace the fibular
collateral ligament of the knee-joint. From the posterior border of the tendon,
a thin expansion is given off to the fascia of the leg. The tendon of insertion
of this muscle forms the lateral hamstring; the common peroneal nerve descends
along its medial border
1.11.2
Variations —The short head
may be absent; additional heads may arise from the ischial tuberosity, the
linea aspera, and the medial supracondylar ridge of the femur or from various
other parts. A slip may pass to the Gastrocnemius.
1.11.3
Actions —The hamstring
muscles flex the leg upon the thigh. When the knee is semiflexed, the Biceps
femoris in consequence of its oblique direction rotates the leg outward; and
the Semitendinosus, and to a slight extent the Semimembranosus, rotate the leg
inward, assisting the Popliteus. Taking their fixed point from below, these
muscles serve to support the pelvis upon the head of the femur, and to draw the
trunk directly backward, as in raising it from the stooping position or in
feats of strength, when the body is thrown backward in the form of an arch. As
already indicated on page 285, complete flexion of the hip cannot be affected
unless the knee-joint is also flexed, because of the shortness of the hamstring
muscles.
1.12 Category
1.12.1
Leg Posterior Flexor Compartment (LPF)
1.13 View (When
Illustrated Individually)
1.13.1
Posterior
1.13.1.1Illus. (DSL)
2 BRACHIALIS B14E14
Back Table of Contents References
2.1 Word Derivation
2.1.1 Brachion=Arm
2.2 Attachments Illus. 1
(DSL) Illus. 2
(DSL)
2.2.1 Origin
2.2.1.1
Deltoid tuberosity (embraces by two
angular processes)
2.2.1.2
Humerus (Lower ½) (Anterior) (To
within 2.5 cm of articular margin)
2.2.1.3
Intermuscular Septa (More Medial than Lateral)
2.2.2 Insertion
2.2.2.1
Tuberosity of the ulna
2.2.2.2
Coronoid process of the ulna (Rough depression on
the anterior surface)
2.3 Joints
2.3.1 Elbow
2.4 Action Illus. (DSL)
2.4.1 Flexion
2.5 Nerve Supply
2.5.1 Nerve
2.5.1.1
Musculocutaneous
2.5.1.2 Radial
2.5.2 Roots
2.5.2.1 C5
(Musculocutaneous)
2.5.2.2 C6
(Musculocutaneous)
2.5.2.3
C7 (Radial)
2.6 Synergists
2.6.1 Brachioradialis
2.6.2 Biceps
brachii
2.7 Muscle Tests
2.7.1 BRACHIALIS
2.8 Trigger Points
2.8.1 BRACHIALIS
2.9 Organ Reflexes
2.9.1 Stomach
2.9.2 Illustrations
2.10 Meridian
2.10.1
Stomach
2.11 Discussion (Gray)
2.11.1
The Brachialis (Brachialis
anticus) (Fig. 411) covers the front of the
elbow-joint and the lower half of the humerus. It arises from the lower
half of the front of the humerus, commencing above at the insertion of the
Deltoideus, which it embraces by two angular processes. Its origin extends
below to within 2.5 cm. of the margin of the articular surface. It also arises
from the intermuscular septa, but more extensively from the medial than the
lateral; it is separated from the lateral below by the Brachioradialis and
Extensor carpi radialis longus. Its fibers converge to a thick tendon, which is
inserted into the tuberosity of the ulna and the rough depression on the
anterior surface of the coronoid process.
2.11.2
Variations —Occasionally
doubled; additional slips to the Supinator, Pronator teres, Biceps, lacertus
fibrosus, or radius are more rarely found.
2.11.3
Actions- the Brachialis is a flexor of the forearm, and
forms an important defence to the elbow-joint. When the forearm is fixed, the
Biceps brachii and Brachialis flex the arm upon the forearm, as in efforts of
climbing.
2.12 Category
2.12.1
Forearm Flexors (FAF)
2.13 View
2.13.1
Anterior
2.13.1.1Illus. (DSL)
3 BRACHIORADIALIS B15E15
Back Table of Contents References
3.1 Word Derivation
3.1.1 Brachion=Arm
3.1.2 Radialis=Radius
3.2 Attachments Illus.1
(DSL) Illus.2
(DSL)
3.2.1 Origin
3.2.1.1
Humerus (Lateral supracondylar
ridge) (Proximal 2/3)
3.2.1.2
Intermuscular septum (Lateral)
3.2.2 Insertion
3.2.2.1
Radius (Styloid Process-Base-Lateral
Side)
3.3 Joints
3.3.1 Elbow
3.3.2 Radioulnar (RU)
Distal
3.4 Action Illus. (DSL)
3.4.1 Flexion
3.4.2 Pronation
(To midposition when joint is supinated) (RU) Distal
3.4.3 Supination
(To midposition when joint is Pronated) (RU) Distal
3.5 Nerve Supply
3.5.1 Nerve
3.5.1.1
Radial
3.5.2 Roots
3.5.2.1
C5
3.5.2.2
C6
3.5.2.3
C7
3.6 Synergists
3.6.1 Brachialis
3.6.2 Biceps
brachii
3.7 Muscle Tests
3.7.1 BRACHIORADIALIS
3.8 Trigger Points
3.8.1 BRACHIORADIALIS
3.9 Organ Reflexes
3.9.1 Stomach
3.9.2 Illustrations
3.10 Meridian
3.10.1
Stomach
3.11 Discussion (Gray)
3.11.1
The Brachioradialis (Supinator
longus) (Fig. 414) (Fig. 417) (Fig. 418) is the most superficial
muscle on the radial side of the forearm. It arises from the upper
two-thirds of the lateral supracondylar ridge of the humerus, and from the
lateral intermuscular septum, being limited above by the groove for the radial
nerve. Interposed between it and the Brachialis are the radial nerve and the
anastomosis between the anterior branch of the profunda artery and the radial
recurrent. The fibers end above the middle of the forearm in a flat tendon,
which is inserted into the lateral side of the base of the styloid
process of the radius. The tendon is crossed near its insertion by the tendons
of the Abductor pollicis longus and Extensor pollicis brevis; on its ulnar,
side is the radial artery.
3.11.2
Variations —Fusion with the
Brachialis; tendon of insertion may be divided into two or three slips;
insertion partial or complete into the middle of the radius, fasciculi to the
tendon of the Biceps, the tuberosity or oblique line of the radius; slips to
the Extensor carpi radialis longus or Abductor pollicis longus; absence; rarely
doubled.
3.11.3
Actions-The
Brachioradialis is a flexor of the elbow-joint, but only acts as such when the
Biceps brachii and Brachialis have initiated the movement of flexion.
3.12 Category
3.12.1
Forearm Flexors (FAF)
3.13 View
3.13.1
Anterior
3.13.1.1Illus. (DSL)
4 BUCCINATOR B16E16
Back Table of Contents References
4.1 Word Derivation
4.1.1 Bucc=Cheek
4.1.2 Buccina=a trumpet
4.2 Attachments
4.2.1 Origin
4.2.1.1
Upper attachment
4.2.1.1.1
Maxilla
(External surfaces of the alveolar process) (Corresponding to the three molar
teeth) (Crossing the maxillary tuberosity to the pterygold hamulus)
4.2.1.2
Middle attachment
4.2.1.2.1
Pterygomandibular
raphe (Anterior border)
4.2.1.3
Inferior attachment
4.2.1.3.1
Mandible
(External surfaces of the alveolar processes) (Corresponding to the three molar
teeth) (Crossing the junction of the ramus and body to the posterior end of the
mylohyoid line)
4.2.1.3.2
Mandible
(Buccinator Ridge)
4.2.2 Insertion
4.2.2.1
Upper fibers
4.2.2.1.1
Orbicularis
Oris (Blend with upper fibers)
4.2.2.2
Middle fibers
4.2.2.2.1
Orbicularis
Oris (Decussate (cross) so that lower and upper ones continue into upper and
lower parts of the Orbicularis Oris)
4.2.2.3
Lower fibers
4.2.2.3.1
Blend
with lower fibers of orbicularis oris
4.3 Action Illus. (DSL)
4.3.1 Compresses
the cheeks against the teeth
4.3.2 Draws
angle of the mouth laterally.
4.4 Nerve Supply
4.4.1 Facial
(VII)
4.4.2 Inferior
buccal branch
4.5 Arterial supply
4.5.1 Buccal
(Maxillary)
4.5.2 Facial
4.5.3 Transverse
facial
4.6 Synergists
4.6.1 Risorius
4.7 Antagonists
4.7.1 Orbicularis
oris
4.8 Muscle Tests
4.8.1 BUCCINATOR
4.9 Trigger Points
4.9.1 BUCCINATOR
4.10 Organ Reflexes
4.10.1
None
4.10.2
Illustrations
4.11 Meridian
4.11.1
None
4.12 Discussion (Gray)
4.12.1
The Buccinator (Fig. 380) (Fig. 381) is a thin quadrilateral muscle, occupying the
interval between the maxilla and the mandible at the side of the face. It arises
from the outer surfaces of the alveolar processes of the maxilla and mandible,
corresponding to the three molar teeth; and behind, from the anterior border of
the pterygomandibular raphé which separates it from the Constrictor pharyngis
superior. The fibers converge toward the angle of the mouth, where the central
fibers intersect each other, those from below being continuous with the upper
segment of the Orbicularis oris, and those from above with the lower segment;
the upper and lower fibers are continued forward into the corresponding lip
without decussation.
4.12.2
Relations —The Buccinator
is covered by the buccopharyngeal fascia, and is in relation by its superficial
surface, behind, with a large mass of fat, which separates it from the
ramus of the mandible, the Masseter, and a small portion of the Temporalis;
this fat has been named the suctorial pad, because it is supposed to
assist in the act of sucking. The parotid duct pierces the Buccinator opposite
the second molar tooth of the maxilla. The deep surface is in relation
with the buccal glands and mucous membrane of the mouth.
4.12.3
Actions- The Buccinators
compress the cheeks, so that, during the process of mastication, the food is
kept under the immediate pressure of the teeth. When the cheeks have been
previously distended with air, the Buccinator muscles expel it from between the
lips, as in blowing a trumpet; hence the name (buccina, a trumpet).
4.13 Category
4.13.1
Facial Expression (FE)
4.14 View
4.14.1
Anterior
4.14.1.1Illus. (DSL)
5 BULBOCAVERNOSUS
(BULBOSPONGIOSUS) B17E17
Back Table of Contents References
5.1 Word Derivation
5.1.1 Bulbus=Bulb
5.1.2 Caverna=Hollow
5.2 Attachments
5.2.1 Origin
5.2.1.1
Central tendon of perineum
5.2.2 Insertion
5.2.2.1
Inferior fascia of urogenital diaphragm
5.2.2.2
Corpus spongiosum of penis
5.2.2.3
Deep fascia on dorsum of penis in male
5.2.2.4
Pubic arch (Female)
5.2.2.5
Root and dorsum of clitoris (Female)
5.3 Action Illus. (DSL)
5.3.1 Helps expel last
drops of urine during micturition
5.3.2 Propel semen along
urethra
5.3.3 Assist in erection
of the penis in male
5.3.4 Decreases vaginal
orifice and assists in erection of clitoris in female
5.4 Nerve Supply
5.4.1 Perineal branch of
pudendal nerve
5.5 Synergists
5.5.1
5.6 Muscle Tests
5.6.1 BULBOCAVERNOSUS
5.7 Trigger Points
5.7.1 BULBOCAVERNOSUS
5.8 Organ Reflexes
5.8.1 None
5.8.2 Illustrations
5.9 Meridian
5.9.1 None
5.10 Discussion (Gray)
5.10.1
The Bulbocavernosus (Ejaculator
urinæ; Accelerator urinæ) (Fig. 406) is placed in the middle line of the perineum, in front of
the anus. It consists of two symmetrical parts, united along the median line by
a tendinous raphé. It arises from the central tendinous point of the
perineum and from the median raphé in front. Its fibers diverge like the barbs
of a quill-pen; the most posterior form a thin layer, which is lost on the
inferior fascia of the urogenital diaphragm; the middle fibers encircle the
bulb and adjacent parts, of the corpus cavernosum urethræ, and join with the
fibers of the opposite side, on the upper part of the corpus cavernosum
urethræ, in a strong aponeurosis; the anterior fibers, spread out over the side
of the corpus cavernosum penis, to be inserted partly into that body, anterior
to the Ischiocavernosus, occasionally extending to the pubis, and partly ending
in a tendinous expansion which covers the dorsal vessels of the penis. Dividing
the muscle longitudinally, and reflecting it from the surface of the corpus
cavernosum urethræ best see the latter fibers.
5.10.2
Actions—This muscle
serves to empty the canal of the urethra, after the bladder has expelled its
contents; during the greater part of the act of micturition its fibers are
relaxed, and it only comes into action at the end of the process. The middle
fibers are supposed by Krause to assist in the erection of the corpus
cavernosum urethræ, by compressing the erectile tissue of the bulb. The
anterior fibers, according to Tyrrel, also contribute to the erection of the
penis by compressing the deep dorsal vein of the penis, as they are inserted
into, and continuous with, the fascia of the penis.
5.11 Category
5.11.1
Perineum (PRN)
5.12 View
5.12.1
Ventral
5.12.1.1Illus. (DSL)
6 CILIARY MUSCLE B18E18
Back Table of Contents References
6.1 Attachments
6.1.1 Origin
6.1.1.1
Scleral spur (posterior margin)
6.1.2 Insertion
6.1.2.1
Stroma of the choroid
6.1.2.2
Ciliary processes
6.1.2.3
Orbiculus ciliaris
6.2 Action Illus. (DSL)
6.2.1 Modify
the shape of the lens to adjust for near (lens thickening) or distant Vision
(lens thinning)
6.3 Nerve Supply
6.3.1 Near
vision
6.3.1.1
Parasympathetic fibers through the Oculomotor
nerve (III), from Edinger-Westphal nucleus
6.3.2 Distant vision
6.3.2.1
Sympathetic fibers from the superior cervical ganglion
passing into the eye as the long ciliary nerves
6.4 Arterial supply
6.4.1 Long
posterior and anterior ciliary rami from the ophthalmic and lacrimal branches
of the internal carotid artery
6.5 Synergists
6.5.1 None
6.6 Muscle Tests
6.6.1 CILIARY
6.7 Trigger Points
6.7.1 CILIARY
6.8 Organ Reflexes
6.8.1 None
6.8.2 Illustrations
6.9 Meridian
6.9.1 None
6.10 Antagonists
6.10.1
Parasympathetic and Sympathetic
fibers produce antagonistic effects
6.10.2
Parasympathetic fibers
6.10.2.1
Contract the ciliary muscle thereby relaxing the zonal
fibers which suspend the lens at its periphery
6.10.2.2
The relaxed lens thickens
6.10.3
Sympathetic fibers
6.10.3.1
Act upon arteries in ciliary body
6.10.3.2
Vasomotor activity increases tension
in lens zonal fibers and produces a thinning of the lens
6.11 Discussion (Gray)
6.11.1
The Ciliaris muscle (m. ciliaris;
Bowman’s muscle) consists of unstriped fibers: it forms a grayish,
semitransparent, circular band, about 3 mm. broad, on the outer surface of the
forepart of the choroid. It is thickest in front, and consists of two sets of
fibers, meridional and circular. The meridional fibers, much the more numerous, arise from
the posterior margin of the scleral spur (page 1007); they run backward, and
are attached to the ciliary processes (Fig. 875) and orbiculus ciliaris (Fig. 875). One
bundle, according to Waldeyer, is inserted into the sclera. The circular fibers
are internal to the meridional ones, and in a meridional section appear as a
triangular zone behind the filtration angle and close to the circumference of
the iris. They are well developed in hypermetropic, but are rudimentary or
absent in myopic eyes. The Ciliaris muscle is the chief agent in accommodation,
i.e., in adjusting the eye to the vision of near objects. When it
contracts it, draws forward the ciliary processes, relaxes the suspensory
ligament of the lens, and thus allows the lens to become more convex.
6.11.2
Definitions
6.11.2.1
The Ciliary Body (corpus
ciliare)
—The ciliary body comprises the orbiculus
ciliaris,
and the Ciliaris muscle
6.11.2.2
The orbiculus ciliaris is a zone of
about 4 mm. in width, directly continuous with the anterior part of the
choroid; it presents numerous ridges arranged in a radial manner), the ciliary processes.
6.11.2.3
The ciliary processes (processus
ciliares) are formed by the inward folding of the various layers of the
choroid, i.e., the choroid proper and the lamina basalis, and are
received between corresponding foldings of the suspensory ligament of the lens.
6.11.2.4
Stroma of the choroid Interspersed
between the vessels are dark star-shaped pigment cells, the processes of which,
communicating with those of neighbouring cells, form a delicate net-work or
stroma, which toward the inner surface of the choroid loses its pigmentary
character. The inner layer (lamina
choriocapillaris) consists of an exceedingly fine capillary plexus, formed
by the short ciliary vessels; the network is closer and finer in the posterior
than in the anterior part of the choroid. About 1.25 cm. behind the cornea its
meshes become larger, and are continuous with those of the ciliary processes.
This lamina is connected by a stratum
intermedium
consisting of fine elastic fibers. On the inner surface of the lamina
choriocapillaris is a very thin, structureless, or faintly fibrous membrane,
called the lamina basalis; it is closely
connected with the stroma of the choroid, and separates it from the pigmentary
layer of the retina.
6.11.2.5
The Sclera —The sclera has
received its name from its extreme density and hardness; it is a firm,
unyielding membrane, serving to maintain the form of the bulb. It is much
thicker behind than in front; the thickness of its posterior part is 1 mm.
6.11.2.6
The Cornea —The cornea is
the projecting transparent part of the external tunic, and forms the anterior
sixth of the surface of the bulb.
6.11.2.7
The Iris —The iris has
received its name from its various colors in different individuals. It is a
thin, circular, contractile disk, suspended in the aqueous humour between the
cornea and lens, and perforated a little to the nasal side of its center by a
circular aperture, the pupil.
6.11.3
Additional Illustrations
6.11.3.1
(Fig. 869)
6.11.3.2
(Fig. 870)
6.11.3.3
(Fig. 872)
6.11.3.4
(Fig. 873)
6.11.3.5
(Fig. 874)
6.11.3.6
(Fig. 875)
6.11.3.7
(Fig.876)
6.12 Category
6.12.1
Eye Ball (EB)
6.13 View
6.13.1
(Note: Lower two s are enlarged horizontal
sections.)
6.13.1.1Illus. (DSL)
7 COCCYGEUS
(ISCHIOCOCCYGEUS) B19E19
Back Table of Contents References
7.1 Word Derivation
7.1.1 Coccygeus=Coccyx
7.2 Attachments Illus. 1 (DSL) Illus. 2 (DSL)
7.2.1 Origin
7.2.1.1
Ischial Spine
7.2.2 Insertion
7.2.2.1
Lower Sacrum
7.2.2.2
Upper Coccyx
7.3 Action Illus. (DSL)
7.3.1 Supports and
slightly raises pelvic floor
7.3.2 Resists
intraabdominal pressure
7.3.3 Pulls coccyx
forward following defecation or parturition
7.4 Nerve Supply
7.4.1 Nerve
7.4.1.1
Sacral
7.4.2 Roots
7.4.2.1
S3
7.4.2.2
S4
7.5 Synergists
7.5.1
7.6 Muscle Tests
7.6.1 COCCYGEUS
7.7 Trigger Points
7.7.1 COCCYGEUS
7.8 Organ Reflexes
7.8.1 None
7.8.2 Illustrations
7.9 Meridian
7.9.1 None
7.10 Discussion (Gray)
7.10.1
The Coccygeus (Fig. 404) is situated behind the preceding. It is a
triangular plane of muscular and tendinous fibers, arising by its apex
from the spine of the ischium and sacrospinous ligament, and inserted by
its base into the margin of the coccyx and into the side of the lowest piece of
the sacrum. It assists the Levator Ani and Piriformis in closing in the back
part of the outlet of the pelvis.
7.10.2
Nerve Supply —a branch from
the fourth and fifth sacral nerves supplies The Coccygeus.
7.10.3
Actions—The Coccygei pull
forward and support the coccyx, after it has been pressed backward during
defecation or parturition.
7.11 Category
7.11.1
Pelvic Floor (PF)
7.12 View
7.12.1
Ventral
7.12.1.1Illus. (DSL)
8 CORACOBRACHIALIS B20E20
Back Table of Contents References
8.1 Word Derivation
8.1.1 Coraco=Coracoid
process
8.2 Attachments Illus. (DSL)
8.2.1 Origin
8.2.1.1
Tip of coracoid process of scapula
8.2.2 Insertion
8.2.2.1
Middle of medial border of humerus,
opposite deltoid tuberosity
8.3 Joints
8.3.1 Glenohumeral
8.4 Action Illus. (DSL)
8.4.1 Horizontal
flexion
8.4.2 Adduction
8.5 Nerve Supply
8.5.1 Nerve
8.5.1.1
Musculocutaneous
8.5.2 Roots
8.5.2.1
C5
8.5.2.2
C6
8.5.2.3
C7
8.6 Synergists
8.6.1 Pectoralis
major
8.6.2 Biceps
brachii
8.6.3 Anterior
deltoid
8.7 Muscle Tests
8.7.1 CORACOBRACHIALIS
8.8 Trigger Points
8.8.1 CORACOBRACHIALIS
8.9 Organ Reflexes
8.9.1 Lung
8.9.2 Illustrations
8.10 Meridian
8.10.1
Lung
8.11 Discussion (Gray)
8.11.1
The Coracobrachialis (Fig. 411) the smallest of the three muscles in this region
is situated at the upper and medial part of the arm. It arises from the
apex of the coracoid process, in common with the short head of the Biceps
brachii, and from the intermuscular septum between the two muscles; it is inserted
by means of a flat tendon into an impression at the middle of the medial
surface and border of the body of the humerus between the origins of the
Triceps brachii and Brachialis. It is perforated by the musculocutaneous nerve
8.11.2
Variations —A bony head may
reach the medial epicondyle; a short head more rarely found may insert into the
lesser tubercle.
8.11.3
Actions —The
Coracobrachialis draws the humerus forward and medialward, and at the same time
assists in retaining the head of the bone in contact with the glenoid cavity.
8.12 Category
8.12.1
Arm Scapular (AS)
8.13 View
8.13.1
Anterior
8.13.1.1Illus. (DSL)
9 CORRUGATOR
SUPERCILII B21E21
Back Table of Contents References
9.1 Word Derivation
9.1.1 Corrugo=Wrinkle
9.1.2 Supercilium=Eyebrow
9.2 Attachments
9.3
Origin
9.3.1.1
Medial end of the superciliary arch of
the frontal bone
9.4
Insertion
9.4.1.1
Deep surface of the skin above the
midpart of the orbital arch
9.5 Action Illus. (DSL)
9.5.1 :
Draws eyebrows medially and down (Frowning muscle)
9.6 Nerve Supply
9.6.1 Temporal
branches of the facial nerve (VII)
9.7 Artery supply
9.7.1 Supratrochlear
(Branch of ophthalmic)
9.7.2 Supraorbital
(Branch of ophthalmic)
9.8 Synergists
9.8.1 Orbicularis
oculi
9.8.2 Procerus
9.9 Antagonist
9.9.1 Frontalis
9.10 Muscle Tests
9.10.1
CORRUGATOR SUPERCILII
9.11 Trigger Points
9.11.1
CORRUGATOR SUPERCILII
9.12 Organ Reflexes
9.12.1
None
9.12.2
Illustrations
9.13 Meridian
9.13.1
None
9.14 Discussion (Gray)
9.14.1
The Corrugator (Corrugator
supercilii) (Fig. 379) is a small, narrow,
pyramidal muscle, placed at the medial end of the eyebrow, beneath the
Frontalis and Orbicularis oculi. It arises from the medial end of the
superciliary arch; and its fibers pass upward and lateralward, between the
palpebral and orbital portions of the Orbicularis oculi, and is inserted
into the deep surface of the skin, above the middle of the orbital arch.
9.14.2
Note 79 The
corrugator is not recognized as a separate muscle in the Basle Nomenclature.
9.14.3
Actions- The Corrugator
draws the eyebrow downward and medialward, producing the vertical wrinkles of
the forehead. It is the “frowning” muscle, and may be regarded as the principal
muscle in the expression of suffering.
9.15 Category
9.15.1
Facial Expression (FE)
9.16 View
9.16.1
Anterior
9.16.1.1Illus. (DSL)
10 CRICOARYTENOID
LATERAL & POSTERIOR B22E22
Back Table of Contents References
10.1 Attachments Illus. (DSL)
10.1.1
Origin
10.1.1.1Cricoarytenoid Lateral
10.1.1.1.1
Upper
border of arch of cricoid cartilage
10.1.1.2Cricoarytenoid Posterior
10.1.1.2.1
Posterior
surface of lamina of cricoid cartilage
10.1.2
Insertion
10.1.2.1Cricoarytenoid Lateral
10.1.2.1.1
Muscular
process of arytenoids cartilage
10.1.2.2Cricoarytenoid Posterior
10.1.2.2.1
Muscular
process of arytenoid cartilage
10.2 Action Illus. (DSL)
10.2.1
Cricoarytenoid Lateral
10.2.1.1
Adducts and medially rotates arytenoid cartilage assisting
in closing glottis
10.2.2
Cricoarytenoid Posterior
10.2.2.1
Abducts arytenoid cartilage widening glottis
10.3 Nerve Supply
10.3.1
Vagus (X)
10.3.2
Accessory (XI)
10.4 Synergists
10.4.1
10.5 Muscle Tests
10.5.1
CRICOARYTENOID
10.6 Trigger Points
10.6.1
CRICOARYTENOID
10.7 Organ Reflexes
10.7.1
None
10.7.2
Illustrations
10.8 Meridian
10.8.1
None
10.9 Discussion (Gray)
10.9.1
The Cricoarytænoideus
posterior
(posterior cricoarytenoid) (Fig. 958) arises from the broad depression on the
corresponding half of the posterior surface of the lamina of the cricoid cartilage;
its fibers run upward and lateralward, and converge to be inserted into
the back of the muscular process of the arytenoid cartilage. The uppermost
fibers are nearly horizontal, the middle oblique, and the lowest almost
vertical.
10.9.2
Actions-The Cricoarytœnoidei posteriores separate the
vocal folds, and, consequently, open the glottis, by rotating the arytenoid
cartilages outward around a vertical axis passing through the cricoarytenoid
joints; so that their vocal processes and the vocal folds attached to them
become widely separated.
10.9.3
The Cricoarytænoideus
lateralis
(lateral cricoarytenoid) (Fig. 959) is smaller than the preceding, and of an oblong
form. It arises from the upper border of the arch of the cricoid
cartilage, and, passing obliquely upward and backward, is inserted into the
front of the muscular process of the arytenoid cartilage.
10.9.4
Actions-The Cricoarytœnoidei laterales close the
glottis by rotating the arytenoid cartilages inward, to approximate their vocal
processes.
10.10
Category
10.10.1
Larynx Intrinsic (LXI)
10.11
View
10.11.1
LATERAL AND POSTERIOR VIEW
10.11.1.1 Illus. (DSL)
11 CRICOPHARYNGEUS B23E23
Back Table of Contents References
11.1 Attachments
11.1.1
Origin
11.1.1.1Arch of cricoid cartilage
11.1.2
Insertion
11.1.2.1Arch of cricoid cartilage
11.2 Action Illus. (DSL)
11.2.1
Acts as sphincter to prevent air entering esophagus
11.2.2
Relaxes during swallowing
11.3 Nerve Supply
11.3.1
Nerve Plexus
11.3.1.1
Pharyngeal plexus
11.3.2
Roots
11.3.2.1
CN (IX)
11.3.2.2
CN (X)
11.3.2.3
CN (XI)
11.4 Synergists
11.4.1
11.5 Muscle Tests
11.5.1
CRICOPHARYNGEUS
11.6 Trigger Points
11.6.1
CRICOPHARYNGEUS
11.7 Organ Reflexes
11.7.1
None
11.7.2
Illustrations
11.8 Meridian
11.8.1
None
11.9 Discussion (Gray)
11.9.1
None
11.10
Category
11.10.1
Pharynx longitudinal layer (PXL)
11.11
View
11.11.1
Posterior
11.11.1.1 Illus. (DSL)
12 CRICOTHYROID B24E24
Back Table of Contents References
12.1 Word Derivation
12.1.1
Crico=Cricoid cartilage of larynx
12.1.2
Thyro=Thyroid gland
12.2 Attachments
12.2.1
Origin
12.2.1.1Anterolateral,
external aspect of the cricoid cartilage
12.2.2
Insertion
12.2.2.1Inferior
part
12.2.2.1.1
Anterior
border of the inferior cornu of thyroid
12.2.2.2Superior
Part
12.2.2.2.1
Posterior
part of the lower border of the thyroid lamina
12.3 Action Illus. (DSL)
12.3.1
Elevation of cricoid arch and
tilting, back its lamina
12.3.2
Closes anterior interval between the
cricoid and thyroid cartilages, thereby, tightening the vocal cords
12.4 Nerve Supply
12.4.1
External branch of the superior
laryngeal nerve from the vagus nerve (X)
12.5 Arterial
supply
12.5.1
Cricothyroid branch and rami of the
superior thyroid artery
12.5.2
Rami from the inferior thyroid artery
12.6 Synergists
12.6.1
Posterior Arytenoids
12.7 Antagonists
12.7.1
Vocalis
12.7.2
Thyroarytenoid
12.8 Muscle Tests
12.8.1
CRICOTHYROID
12.9 Trigger Points
12.9.1
CRICOTHYROID
12.10
Organ Reflexes
12.10.1
None
12.10.2
Illustrations
12.11
Meridian
12.11.1
None
12.12
Discussion (Gray)
12.12.1
The Cricothyreoideus (Cricothyroid)
(Fig. 957), triangular in form, arises from the front
and lateral part of the cricoid cartilage; its fibers diverge, and are arranged
in two groups. The lower fibers constitute a pars
obliqua,
slant backward, and lateralward to the anterior border of the inferior cornu;
the anterior fibers, forming pars recta, run upward,
backward, and lateralward to the posterior part of the lower border of the
lamina of the thyroid cartilage. The medial borders of the two muscles are
separated by a triangular interval, occupied by the middle cricothyroid
ligament.
12.12.2
The medial borders of the two muscles are separated by a
triangular interval, occupied by the middle cricothyroid ligament.
12.12.3
The Cricothyreoideus produce tension and elongation
of the vocal folds by drawing up the arch of the cricoid cartilage and tilting
back the upper border of its lamina; the distance between the vocal processes
and the angle of the thyroid is thus increased, and the folds are consequently
elongated.
12.12.4
Actions-
12.12.4.1 The
Cricoarytœnoidei posteriores separate the vocal folds, and, consequently, open
the glottis, by rotating the arytenoid cartilages outward around a vertical
axis passing through the cricoarytenoid joints; so that their vocal processes
and the vocal folds attached to them become widely separated.
12.12.4.2 The Cricoarytœnoidei
laterales close the glottis by rotating the arytenoid cartilages inward, to
approximate their vocal processes.
12.13
Category
12.13.1
Larynx Intrinsic (LXI)
12.14
View
12.14.1
Posterior
12.14.1.1 Illus. (DSL)
13 DELTOID ANTERIOR
B25E25
Back Table of Contents References
13.1 Word Derivation
13.1.1
Delta=Triangular
13.1.2
Supercilium=Eyebrow
13.2 Attachments Illus.
(DSL)
13.2.1
Origin
13.2.1.1 Anterosuperior
border of the lateral 1/3 of the clavicle
13.2.2
Insertion
13.2.2.1 Deltoid
tuberosity of the humerus on the anterolateral surface just above is midshaft
13.3 Joints
13.3.1
Glenohumeral
13.4 Action Illus.
(DSL)
13.4.1
Abduction
13.4.2
Horizontal flexion
13.4.3
Medial rotation
13.5 Nerve Supply
13.5.1
Nerve
13.5.1.1
Axillary
13.5.2
Roots
13.5.2.1
C5
13.5.2.2
C6
13.6 Synergists
13.6.1
Middle Deltoid
13.6.2
Posterior Deltoid
13.6.3
Supraspinatus
13.6.4
Pectoralis Major Clavicular
13.7 Muscle Tests
13.7.1
DELTOID ANTERIOR
13.8 Trigger Points
13.8.1
DELTOID ANTERIOR
13.9 Organ Reflexes
13.9.1
Lung
13.9.2
Illustrations
13.10
Meridian
13.10.1 Lung
13.11
Discussion (Gray)
13.11.1 The Deltoideus (Deltoid muscle) (Fig. 410) is a large, thick, triangular muscle, which covers the
shoulder-joint in front, behind, and laterally. It arises from the
anterior border and upper surface of the lateral third of the clavicle, from
the lateral margin and upper surface of the acromion, and from the lower lip of
the posterior border of the spine of the scapula, as far back as the triangular
surface at its medial end. From this extensive origin the fibers converge
toward their insertion, the middle passing vertically, the anterior obliquely backward
and lateralward, the posterior obliquely forward and lateralward; they unite in
a thick tendon, which is inserted into the deltoid prominence on the middle of
the lateral side of the body of the humerus. At its insertion, the
muscle gives off an expansion to the deep fascia of the arm. This muscle is
remarkably coarse in texture, and the arrangement of its fibers is somewhat
peculiar; the central portion of the muscle—that is to say, the part arising
from the acromion—consists of oblique fibers; these arise in a bipenniform
manner from the sides of the tendinous intersections, generally four in number,
which are attached above to the acromion and pass downward parallel to one
another in the substance of the muscle. The oblique fibers thus formed are inserted
into similar tendinous intersections, generally three in number, which pass
upward from the insertion of the muscle and alternate with the descending
septa. The portions of the muscle arising from the clavicle and spine of the
scapula are not arranged in this manner, but are inserted into the margins of
the inferior tendon.
13.11.2 Variations —Large variations
uncommon. More or less splitting common. Continuation into the Trapezius;
fusion with the Pectoralis major; additional slips from the vertebral border of
the scapula, infraspinous fascia and axillary border of scapula not uncommon.
Insertion varies in extent or rarely is prolonged to origin of Brachioradialis.
13.11.3 Nerves —The Deltoideus
is supplied by the fifth and sixth cervical through the axillary nerve.
13.11.4 Actions —The Deltoideus
raises the arm from the side, to bring it at right angles with the trunk. Its
anterior fibers, assisted by the Pectoralis major, draw the arm forward; and
its posterior fibers, aided by the Teres major and Latissimus dorsi, draw it
backward.
13.11.5 Illustration-None
13.12
Category
13.12.1 Arm
Scapular (AS)
13.13
View
13.13.1 Anterior
13.13.1.1 Illus. (DSL)
14 DELTOID MIDDLE
Back Table of Contents References
14.1 Origin
14.1.1
Superior surface of the Acromion
process
14.2 Insertion
14.2.1
Deltoid tuberosity of humerus
14.3 Joints
14.3.1
Glenohumeral
14.4 Action
14.4.1
Abduction
14.5 Nerve Supply
14.5.1
Nerve
14.5.1.1Axillary
14.5.2
Roots
14.5.2.1C5
14.5.2.2C6
14.6 Synergists
14.6.1
Anterior Deltoid
14.6.2
Posterior Deltoid
14.6.3
Supraspinatus
14.7 Category
14.7.1
Arm Scapular (AS)
15 DELTOID POSTERIOR
Back Table of Contents References
15.1 Origin
15.1.1
Inferior margin of spine of scapula
15.2 Insertion
15.2.1
Deltoid tuberosity of humerus
15.3 Joints
15.3.1
Glenohumeral
15.4 Action
15.4.1
Abduction
15.4.2
Horizontal Extension
15.4.3
Lateral Rotation
15.5 Nerve Supply
15.5.1
Nerve
15.5.1.1Axillary
15.5.2
Roots
15.5.2.1C5
15.5.2.2C6
15.6 Synergists
15.6.1
Anterior Deltoid
15.6.2
Middle Deltoid
15.6.3
Supraspinatus
15.7 Category
15.7.1
Arm Scapular (AS)
16 DEPRESSOR ANGULI
ORIS
Back Table of Contents References
16.1 Origin
16.1.1
The
oblique line of the mandible, below and lateral to the depressor labii
inferioris
16.2 Insertion
16.2.1
The
angle of the mouth, mingling with the levator anguli oris, zygomatIcus major,
and muscular bands of the orbicularis Oris
16.3 Action
16.3.1
Depresses
the modiolus and angle of mouth
16.4 Nerve Supply
16.4.1
Mandibular
marginal branch of the facial nerve (VII)
16.5 Arterial supply
16.5.1
Inferior
labial branch from the facial artery
16.5.2
Mental
branch from the inferior alveolar artery
16.6 Synergists
16.6.1
Platysma
(Pars Modiolus)
16.6.2
Depressor
Labii Inferioris
16.7 Antagonists
16.7.1
For
direct modiolar deviation
16.7.1.1Levator Anguli Oris
16.7.1.2Zygomaticus Major
16.7.2
For
angle of mouth deviation
16.7.2.1Lateral Slip of the Levator Labii
Superioris
16.7.2.2Alaeque Nasi
16.7.2.3Levator Labii Superioris
16.7.2.4Zygomaticus Minor
16.8 Category
16.8.1
Facial Expression (FE)
16.9 Note
16.9.1
(Denotes
Modiolus)
17 DEPRESSOR LABII
INFERIORIS
17.1 Origin
17.1.1
The
oblique line of mandible, between symphysis menti and the mental foramen
17.2 Insertion
17.2.1
The
skin of the lower lip, blending and intersecting with its other and with
orbicularis oris
17.2.2
Note
17.2.2.1It
is
continuous below and laterally with the labial part of the platysma).
17.3 Action
17.3.1
Depresses
the lower lip laterally and assists in eversion
17.4 Nerve Supply
17.4.1
Mandibular
marginal branch of the facial nerve (VII)
17.5 Arterial supply
17.5.1
Inferior
labial branch of the facial artery
17.5.2
Mental
branch of the inferior alveolar artery
17.6 Synergists
17.6.1
Platysma
(Pars Labialis)
17.6.2
Depressor
Anguli Oris
17.7 Antagonist
17.7.1
Orbicularis
Oris
17.8 Category
17.8.1
Facial Expression (FE)
18 DEPRESSOR SEPTI
18.1 Origin
18.1.1
From
the incisive fossa of the maxilla
18.2 Insertion
18.2.1
The
mobile part of the nasal septum, deep to the superior labial mucous membrane
18.3 Action
18.3.1
Draws
ala of nose downwards and thereby constricts the aperture of naris.
18.4 Nerve Supply
18.4.1
Superior
buccal branches of the facial nerve (VII)
18.5 Arterial supply
18.5.1
Septal
and alar branches from the superior labial artery
18.6 Synergists
18.6.1
Nasalis
18.7 Antagonist
18.7.1
Dilator
Naris
18.8 Category
18.8.1
Facial Expression (FE)
19 DIAPHRAGM
19.1 Word
Derivation/Pronunciation ect
19.1.1
http://www.m-w.com/dictionary/DIAPHRAGM
19.2 Origin
19.2.1
An approximately circular line
passing entirely around the inner surface of the body wall
19.2.2
STERNAL PORTION
19.2.2.1Two
slips from the back of the xiphoid process
19.2.3
COSTAL PORTION
19.2.3.1The
inner surfaces of the cartilages and adjacent portions of the lower 6 ribs on
either side, interdigitating with the transverses abdominis
19.2.4
LUMBAR PORTION
19.2.4.1Medial
(Medial Lumbocostal Arch) and lateral arcuate (Lateral Lumbocostal Arch) ligaments
and right and left crura from the anterolateral surfaces of the bodies and
discs of the upper three lumbar vertebrae
19.3 Insertion
19.3.1
The central tendon, which is an
oblong sheet forming the summit of the dome
19.4 Action
19.4.1
Principal muscle of respiration
19.4.2
Draws the central tendon downward,
during quiet inspiration, pressing against the abdominal visera
19.5 Nerve Supply
19.5.1
Nerve
19.5.1.1Phrenic
(Cervical Plexus)
19.5.2
Roots
19.5.2.1C3
19.5.2.2C4
19.5.2.3C5
19.6 Synergists
19.6.1
External Intercostals
19.6.2
Internal Intercostals
19.6.3
Serratus Posterior Superior
19.6.4
Scalenus Anterior
19.6.5
Scalenus Medius
19.6.6
Scalenus Posterior
19.6.7
Levatores Costarum
19.7 Discussion (Gray)
19.7.1
The Diaphragm (Fig. 391) is a dome-shaped musculofibrous septum which separates
the thoracic from the abdominal cavity, its convex upper surface forming the
floor of the former, and its concave under surface the roof of the latter. Its
peripheral part consists of muscular fibers which take origin from the
circumference of the thoracic outlet and converge to be inserted into a central
tendon. 15
19.7.2
The muscular fibers
may be grouped according to their origins into three parts—sternal, costal, and
lumbar. The sternal part arises by two fleshy slips from the back of the
xiphoid process; the costal part from the inner surfaces of the cartilages and
adjacent portions of the lower six ribs on either side, interdigitating with
the Transversus abdominis; and the lumbar part from aponeurotic arches, named
the lumbocostal arches, and from the lumbar vertebræ by two pillars or crura.
There are two lumbocostal arches, a medial and a lateral, on either side. 16
19.7.3
The Medial
Lumbocostal Arch (arcus lumbocostalis medialis [Halleri]; internal arcuate
ligament) is a tendinous arch in the fascia covering the upper part of the
Psoas major; medially, it is continuous with the lateral tendinous margin of
the corresponding crus, and is attached to the side of the body of the first or
second lumbar vertebra; laterally, it is fixed to the front of the transverse
process of the first and, sometimes also, to that of the second lumbar
vertebra. 17
19.7.4
The Lateral
Lumbocostal Arch (arcus lumbocostalis lateralis [Halleri]; external arcuate
ligament) arches across the upper part of the Quadratus lumborum, and is
attached, medially, to the front of the transverse process of the first lumbar
vertebra, and, laterally, to the tip and lower margin of the twelfth rib. 18
19.7.5
The Crura.—At their origins the crura are tendinous in
structure, and blend with the anterior longitudinal ligament of the vertebral
column. The right crus, larger and longer than the left, arises from the
anterior surfaces of the bodies and intervertebral fibrocartilages of the upper
three lumbar vertebræ, while the left crus arises from the corresponding parts
of the upper two only. The medial tendinous margins of the crura pass forward
and medialward, and meet in the middle line to form an arch across the front of
the aorta; this arch is often poorly defined.
19
19.7.6
From this series of
origins the fibers of the diaphragm converge to be inserted into the central
tendon. The fibers arising from the xiphoid process are very short, and
occasionally aponeurotic; those from the medial and lateral lumbocostal arches,
and more especially those from the ribs and their cartilages, are longer, and
describe marked curves as they ascend and converge to their insertion. The
fibers of the crura diverge as they ascend, the most lateral being directed
upward and lateralward to the central tendon. The medial fibers of the right
crus ascend on the left side of the esophageal hiatus, and occasionally a
fasciculus of the left crus crosses the aorta and runs obliquely through the
fibers of the right crus toward the vena caval foramen (Low 82).
20
19.7.7
The Central Tendon.—The central tendon of the diaphragm is a
thin but strong aponeurosis situated near the center of the vault formed by the
muscle, but somewhat closer to the front than to the back of the thorax, so
that the posterior muscular fibers are the longer. It is situated immediately
below the pericardium, with which it is partially blended. It is shaped
somewhat like a trefoil leaf, consisting
of three divisions or leaflets separated from one another by slight
indentations. The right leaflet is the largest, the middle, directed toward the
xiphoid process, the next in size, and the left the smallest. In structure the
tendon is composed of several planes of fibers, which intersect one another at
various angles and unite into straight or curved bundles—an arrangement which
gives it additional strength. 21
19.7.8
Openings in the Diaphragm.—The diaphragm is pierced by a
series of apertures to permit of the passage of structures between the thorax
and abdomen. Three large openings—the aortic, the esophageal, and the vena
caval—and a series of smaller ones are described. 22
19.7.9
The aortic hiatus is
the lowest and most posterior of the large apertures; it lies at the level of
the twelfth thoracic vertebra. Strictly speaking, it is not an aperture in the
diaphragm but an osseoaponeurotic opening between it and the vertebral column,
and therefore behind the diaphragm; occasionally some tendinous fibers
prolonged across the bodies of the vertebræ from the medial parts of the lower
ends of the crura pass behind the aorta, and thus convert the hiatus into a
fibrous ring. The hiatus is situated slightly to the left of the middle line,
and is bounded in front by the crura, and behind by the body of the first
lumbar vertebra. Through it pass the aorta, the azygos vein, and the thoracic
duct; occasionally the azygos vein is transmitted through the right crus. 23
19.7.10 The esophageal hiatus is situated in the
muscular part of the diaphragm at the level of the tenth thoracic vertebra, and
is elliptical in shape. It is placed above, in front, and a little to the left
of the aortic hiatus, and transmits the esophagus, the vagus nerves, and some
small esophageal arteries. 24
19.7.11 The vena caval foramen is the highest of the
three, and is situated about the level of the fibrocartilage between the eighth
and ninth thoracic vertebræ. It is quadrilateral in form, and is placed at the
junction of the right and middle leaflets of the central tendon, so that its
margins are tendinous. It transmits the inferior vena cava, the wall of which
is adherent to the margins of the opening, and some branches of the right
phrenic nerve. 25
19.7.12 Of the lesser apertures, two in the right
crus transmit the greater and lesser right splanchnic nerves; three in the left
crus give passage to the greater and lesser left splanchnic nerves and the
hemiazygos vein. The gangliated trunks of the sympathetic usually enter the
abdominal cavity behind the diaphragm, under the medial lumbocostal
arches. 26
19.7.13 On either side two small intervals exist at
which the muscular fibers of the diaphragm are deficient and are replaced by
areolar tissue. One between the sternal and costal parts transmits the superior
epigastric branch of the internal mammary artery and some lymphatics from the
abdominal wall and convex surface of the liver. The other, between the fibers
springing from the medial and lateral lumbocostal arches, is less constant;
when this interval exists, the upper and back part of the kidney is separated
from the pleura by areolar tissue only.
27
19.7.14 Variations.—The
sternal portion of the muscle is sometimes wanting and more rarely defects
occur in the lateral part of the central tendon or adjoining muscle
fibers. 28
19.7.15 Nerves.—The
diaphragm is supplied by the phrenic and lower intercostal nerves. 29
19.7.16 Actions.—The
diaphragm is the principal muscle of inspiration, and presents the form of a
dome concave toward the abdomen. The central part of the dome is tendinous, and
the pericardium is attached to its upper surface; the circumference is
muscular. During inspiration the lowest ribs are fixed, and from these and the
crura the muscular fibers contract and draw downward and forward the central
tendon with the attached pericardium. In this movement the curvature of the
diaphragm is scarcely altered, the dome moving downward nearly parallel to its
original position and pushing before it the abdominal viscera. The descent of
the abdominal viscera is permitted by the elasticity of the abdominal wall, but
the limit of this is soon reached. The central tendon applied to the abdominal
viscera then becomes a fixed point for the action of the diaphragm, the effect
of which is to elevate the lower ribs and through them to push forward the body
of the sternum and the upper ribs. The right cupola of the diaphragm, lying on
the liver, has a greater resistance to overcome than the left, which lies over
the stomach, but to compensate for this the right crus and the fibers of the
right side generally are stronger than those of the left. 30
19.7.17 In all expulsive acts the diaphragm is called
into action to give additional power to each expulsive effort. Thus, before
sneezing, coughing, laughing, crying, or vomiting, and previous to the
expulsion of urine or feces, or of the fetus from the uterus, a deep
inspiration takes place. The height of the diaphragm is constantly varying
during respiration; it also varies with the degree of distension of the stomach
and intestines and with the size of the liver. After a forced expiration the
right cupola is on a level in front with the fourth costal cartilage, at the
side with the fifth, sixth, and seventh ribs, and behind with the eighth rib;
the left cupola is a little lower than the right. Halls Dally 83 states that the absolute range of movement
between deep inspiration and deep expiration averages in the male and female 30
mm. on the right side and 28 mm. on the left; in quiet respiration the average
movement is 12.5 mm. on the right side and 12 mm. on the left. 31
19.7.18 Skiagraphy shows that the height of the
diaphragm in the thorax varies considerably with the position of the body. It
stands highest when the body is horizontal and the patient on his back, and in
this position it performs the largest respiratory excursions with normal
breathing. When the body is erect the dome of the diaphragm falls, and its
respiratory movements become smaller. The dome falls still lower when the
sitting posture is assumed, and in this position its respiratory excursions are
smallest. These facts may, perhaps, explain why it is that patients suffering
from severe dyspnœa are most comfortable and least short of breath when they
sit up. When the body is horizontal and the patient on his side, the two halves
of the diaphragm do not behave alike. The uppermost half sinks to a level lower
even than when the patient sits, and moves little with respiration; the lower
half rises higher in the thorax than it does when the patient is supine, and
its respiratory excursions are much increased. In unilateral disease of the
pleura or lungs analogous interference with the position or movement of the
diaphragm can generally be observed skiagraphically. 32
19.7.19 It appears that the position of the diaphragm
in the thorax depends upon three main factors, viz.: (1) the elastic retraction
of the lung tissue, tending to pull it upward; (2) the pressure exerted on its
under surface by the viscera; this naturally tends to be a negative pressure,
or downward suction, when the patient sits or stands, and positive, or an
upward pressure, when he lies; (3) the intra-abdominal tension due to the abdominal
muscles. These are in a state of contraction in the standing position and not
in the sitting; hence the diaphragm, when the patient stands, is pushed up
higher than when he sits. 33
19.7.20 The Intercostales interni and externi have
probably no action in moving the ribs. They contract simultaneously and form
strong elastic supports which prevent the intercostal spaces being pushed out
or drawn in during respiration. The anterior portions of the Intercostales
interni probably have an additional function in keeping the sternocostal and
interchondral joint surfaces in apposition, the posterior parts of the
Intercostales externi performing a similar function for the costovertebral
articulations. The Levatores costarum being inserted near the fulcra of the ribs
can have little action on the ribs; they act as rotators and lateral flexors of
the vertebral column. The Transversus thoracis draws down the costal
cartilages, and is therefore a muscle of expiration. 34
19.7.21 The Serrati are respiratory muscles. The Serratus
posterior superior elevates the ribs and is therefore an inspiratory muscle.
The Serratus posterior inferior draws the lower ribs downward and backward, and
thus elongates the thorax; it also fixes the lower ribs, thus assisting the
inspiratory action of the diaphragm and resisting the tendency it has to draw
the lower ribs upward and forward. It must therefore be regarded as a muscle of
inspiration. 35
19.7.22 Mechanism of
Respiration.—The respiratory movements must be examined during (a) quiet respiration,
and (b) deep respiration. 36
19.7.23 Quiet Respiration.—The first and second pairs
of ribs are fixed by the resistance of the cervical structures; the last pair,
and through it the eleventh, by the Quadratus lumborum. The other ribs are
elevated, so that the first two intercostal spaces are diminished while the
others are increased in width. It has already been shown (p. 304) that
elevation of the third, fourth, fifth, and sixth ribs leads to an increase in
the antero-posterior and transverse diameters of the thorax; the vertical
diameter is increased by the descent of the diaphragmatic dome so that the
lungs are expanded in all directions except backward and upward. Elevation of
the eighth, ninth, and tenth ribs is accompanied by a lateral and backward
movement, leading to an increase in the transverse diameter of the upper part
of the abdomen; the elasticity of the anterior abdominal wall allows a slight
increase in the antero-posterior diameter of this part, and in this way the
decrease in the vertical diameter of the abdomen is compensated and space
provided for its displaced viscera. Expiration is effected by the elastic
recoil of its walls and by the action of the abdominal muscles, which push back
the viscera displaced downward by the diaphragm. 37
19.7.24 Deep Respiration.—All the movements of quiet
respiration are here carried out, but to a greater extent. In deep inspiration
the shoulders and the vertebral borders of the scapulæ are fixed and the limb
muscles, Trapezius, Serratus anterior, Pectorales, and Latissimus dorsi, are
called into play. The Scaleni are in strong action, and the
Sternocleidomastoidei also assist when the head is fixed by drawing up the
sternum and by fixing the clavicles. The first rib is therefore no longer
stationary, but, with the sternum, is raised; with it all the other ribs except
the last are raised to a higher level. In conjunction with the increased
descent of the diaphragm this provides for a considerable augmentation of all
the thoracic diameters. The anterior abdominal muscles come into action so that
the umbilicus is drawn upward and backward, but this allows the diaphragm to
exert a more powerful influence on the lower ribs; the transverse diameter of
the upper part of the abdomen is greatly increased and the subcostal angle
opened out. The deeper muscles of the back, e.g., the Serrati posteriores
superiores and the Sacrospinales and their continuations, are also brought into
action; the thoracic curve of the vertebral column is partially straightened,
and the whole column, above the lower lumbar vertebræ, drawn backward. This
increases the antero-posterior diameters of the thorax and upper part of the
abdomen and widens the intercostal spaces. Deep expiration is effected by the
recoil of the walls and by the contraction of the antero-lateral muscles of the
abdominal wall, and the Serrati posteriores inferiores and Transversus
thoracis. 38
19.7.25 Halls Dally (op. cit.) gives the following
figures as representing the average changes which occur during deepest possible
respiration. The manubrium sterni moves 30 mm. in an upward and 14 mm. in a
forward direction; the width of the subcostal angle, at a level of 30 mm. below
the articulation between the body of the sternum and the xiphoid process, is
increased by 26 mm.; the umbilicus is retracted and drawn upward for a distance
of 13 mm.
19.8 Category
19.8.1
Breathing (B)
19.9 Iluustration
19.9.1
Grays
19.9.1.1http://www.bartleby.com/107/illus391.html
20 DIGASTRIC ANT
& POST BELLY (SUPRAHYOID)
20.1 Origin
20.1.1
Anterior
belly
20.1.1.1Digastric fossa of mandible
20.1.2
Posterior
belly
20.1.2.1Mastoid notch of temporal bone
20.2 Insertion
20.2.1
Intermediate
tendon attached to the hyoid via a fibrous loop
20.3 Action
20.3.1
Mandibular
depression and hyoid elevation
20.3.2
Note
20.3.2.1Both bellies act together during
swallowing and chewing
20.4 Nerve Supply
20.4.1
Anterior
belly
20.4.1.1Mylohyoid rami from the inferior
alveolar branch of the trIgeminal nerve (V3)
20.4.2
Posterior
belly
20.4.2.1Digastric branch facial nerve (VII)
20.5 Arterial supply
20.5.1
Anterior
belly
20.5.1.1Mylohyoid branch of inferior alveolar
artery
20.5.1.2Submandibular branch of the facial
artery
20.5.2
Posterior
belly
20.5.2.1Posterior auricular artery and muscular
branches of the occipital artery
20.6 Synergists
20.6.1
Mandibular
Depression
20.6.1.1Mylohyoid
20.6.1.2Geniohyoid
20.6.1.3Lateral Pterygoid
20.6.1.4Platysma
20.6.2
Hyoid
Elevation
20.6.2.1Stylohyoid
20.6.2.2Mylohyoid
20.6.2.3Geniohyoid
20.7 Antagonists
20.7.1
Mandibular
Depression
20.7.1.1Masseter
20.7.1.2Temporalis
20.7.1.3Medial Pterygoid
20.7.2
Hyoid
Elevation
20.7.2.1Sternohyoid
20.7.2.2Thyrohyoid
20.7.2.3Omohyoid
20.8 Category
20.8.1
ORAL CAVITY FLOOR (OCF)
21 DILATOR PUPILLAE
21.1 Origin
21.1.1
The
mesodermal stroma in the periphery of the iris
21.2 Insertion
21.2.1
The
iris among the outer parts of the sphincter pupillae fibers
21.3 Action
21.3.1
Dilation
of the pupil to adjust for distant vision or diminished light
21.4 Nerve Supply
21.4.1
Sympathetic
fibers from the superior cervical ganglion passing as long ciliary nerves to
the globe
21.5 Arterial supply
21.5.1
Long
posterior and anterior ciliary rami from the ophthalmic and lacrimal branches
of the internal carotid artery
21.6 Synergists
21.6.1
None
21.7 Antagonist
21.7.1
Sphincter
pupillae
21.8 Category
21.8.1
Eye Ball (EB)
21.9 View
21.9.1
Note
21.9.1.1Lower 2 s are enlarged horizontal
sections
22 DORSAL INTEROSSEI
(FOOT)
Back Table of Contents References
22.1 Attachments
22.1.1
Origin
22.1.1.1 There
are four dorsal Interossei each by two heads from adjacent sides of the
metatarsals
22.1.2
Insertion
22.1.2.1Bases
of the proximal phalanges
22.1.2.2Extensor
expansion of the tendons of the extensor digitorum longus
22.1.2.3The
1st dorsal interosseous (arising from the 1st and 2nd metatarsals) inserts into
the medial side of the 2nd toe
22.1.2.4The
2nd-4th dorsal Interossei insert into the lateral sides of the 2nd 3rd and 4th
toes
22.2 Action
22.2.1
Abducts the 2nd, 3rd and 4th toes
away from the longitudinal axis of the 2nd toe
22.2.2
Assists in flexing the proximal
phalanx
22.2.3
Extends the middle and distal
phalanges
22.3 Nerve Supply
22.3.1
Nerve
22.3.1.1Lateral
Plantar
22.3.2
Roots
22.3.2.1S2
22.3.2.2S3
22.4 Synergists
22.4.1
Plantar Interossei
22.5 Muscle
Tests
22.5.1
22.6 Trigger Points
22.6.1
22.7 Discussion (Gray)
22.7.1
Interossei—The Interossei in the foot are similar to those in
the hand, with this exception, that they are grouped around the middle line of
the second digit, instead of that of the third. They are seven in number, and
consist of two groups, dorsal and plantar.
29
22.7.2
The Interossei
dorsales (Dorsal interossei) (Fig. 446), four in number, are situated between
the metatarsal bones. They are bipenniform muscles, each arising by two heads
from the adjacent sides of the metatarsal bones between which it is placed;
their tendons are inserted into the bases of the first phalanges, and into the
aponeurosis of the tendons of the Extensor digitorum longus. In the angular
interval left between the heads of each of the three lateral muscles, one of
the perforating arteries passes to the dorsum of the foot; through the space between
the heads of the first muscle the deep plantar branch of the dorsalis pedis
artery enters the sole of the foot. The first is inserted into the medial side
of the second toe; the other three are inserted into the lateral sides of the
second, third, and fourth toes.
22.7.3
Discussion
22.7.3.1http://www.bartleby.com/107/131.html
22.7.4
Illustration
22.7.4.1http://www.bartleby.com/107/illus446.html
22.8 Category
22.8.1
Intrinsic
Foot (Plantar 4th Deep Layer)
23 DORSAL INTEROSSEI
(HAND)
23.1 Origin
23.1.1
Each from the 2 metacarpal bones
between which it inserts
23.2 Insertion
23.2.1
Bases of the proximal phalanges of
the 2nd, 3rd and 4th digits and the extensor expansion
23.3 Action
23.3.1
Abduct index, middle and ring
fingers from an axis through the middle finger
23.3.2
All assist in flexing the proximal
phalanges of the index, middle and ring fingers at the metacarpophalangeal
joints
23.3.3
Extending middle and distal
phalanges
23.4 Nerve Supply
23.4.1
Nerve
23.4.1.1Ulnar
(Deep Branch)
23.4.2
Roots
23.4.2.1C8
23.4.2.2T1
23.5 Synergists
23.5.1
Lumbricals
23.5.2
Palmar Interossei
23.5.3
Flexor Digitorum Profundus
23.5.4
Flexor Digitorum Superficialis
23.6 Category
23.6.1
Intrinsic Hand Intermediate (Midpalmar) (IHI)
24 EXTENSOR CARPI
RADIALIS BREVIS
24.1 Origin
24.1.1
Common extensor tendon from lateral
epicondyle of humerus
24.2 Insertion
24.2.1
Posterior surface of base of 3rd
metacarpal
24.3 Joints
24.3.1
Wrist
24.4 Action
24.4.1
Extension
24.4.2
Radial Deviation
24.5 Nerve Supply
24.5.1
Nerve
24.5.1.1Posterior
interosseous (deep radial)
24.5.2
Roots
24.5.2.1C7
24.5.2.2C8
24.6 Synergists
24.6.1
Extensor Carpi Radialis Longus
24.6.2
Extensor Carpi Ulnaris (Extension)
24.6.3
Extensor Carpi Radialis Longus
24.6.4
Flexor Carpi Radialis (Radial
Deviation)
24.7 Category
24.7.1
Wrist, Hand, and Fingers Posterior Extensors Deep (WHFPED)
25 EXTENSOR CARPI
RADIALIS LONGUS
25.1 Origin
25.1.1
Lower 1/3 of lateral supracondylar
ridge
25.1.2
Lateral epicondyle (few fibers from)
25.2 Insertion
25.2.1
Posterior surface of base of second
metacarpal
25.3 Joint
25.3.1
Wrist
25.4 Action
25.4.1
Extension
25.4.2
Radial Deviation
25.5 Nerve Supply
25.5.1
Nerve
25.5.1.1Radial
25.5.2
Roots
25.5.2.1C6
25.5.2.2C7
25.6 Synergists
25.6.1
Extensor Carpi Radialis Brevis
25.6.2
Extensor Carpi Ulnaris (Extension)
25.6.3
Flexor Carpi Radialis (Radial
Deviation)
25.7 Category
25.7.1
Wrist, Hand, and Fingers Posterior Extensors Superficial
(WHFPES)
26 EXTENSOR CARPI
ULNARIS
26.1 Origin
26.1.1
By two heads from lateral epicondyle
of humerus and middle 1/3 of posterior ridge of ulna
26.2 Insertion
26.2.1
Posterior surface of base of 5th
metacarpal
26.3 Joint
26.3.1
Wrist
26.4 Action
26.4.1
Extension
26.4.2
Ulnar Deviation
26.5 Nerve Supply
26.5.1
Nerve
26.5.1.1Posterior
interosseous (deep radial)
26.5.2
Roots
26.5.2.1C7
26.5.2.2C8
26.6 Synergists
26.6.1
Extensor Carpi Radialis Longus
26.6.2
Extensor Carpi Radialis Brevis
(Extension)
26.6.3
Flexor Carpi Ulnaris (Ulnar Deviation)
26.7 Category
26.7.1
Wrist, Hand, and Fingers Posterior Extensors Superficial
(WHFPES)
27 EXTENSOR DIGITI
MINIMI
27.1 Origin
27.1.1
The common tendon of the extensor
digitorum
27.2 Insertion
27.2.1
The tendon of the extensor digitorum
at the proximal phalanx of the little finger and into the dorsal expansion of
the finger extensor tendons
27.3 Joints
27.3.1
Metacarpophalangeal (MCP)
27.3.2
Interphalangeal (IP)
27.3.3
Wrist
27.4 Action
27.4.1
Extension (Proximal Phalanx Of The
Little Finger) (MCP)
27.4.2
Extension (Wrist)
27.4.3
Extension (Middle And Distal
Phalanges Especially When The Proximal Phalanx Is Held In Flexion) (IP)
27.5 Nerve Supply
27.5.1
27.5.1.1Posterior
interosseous (deep radial)
27.5.2
27.5.2.1C7
27.5.2.2C8
27.5.3
NOTE
27.5.3.1The
posterior interosseous nerve is a direct continuation of the deep radial nerve
after it has passed through the supinator .
27.6 Synergists
27.6.1
Extensor digitorum.
27.7 Category
27.7.1
28 EXTENSOR DIGITORUM
28.1 Origin
28.1.1
Common extensor tendon from lateral
epicondyle of humerus.
28.2 Insertion
28.2.1
By 4tendons, 1 to each finger, each
tendon dividing into 3 slips, the middle one attaching to the dorsal surface of
middle phalanx and the other 2 uniting to attach to dorsal surface of base of
distal phalanx.
28.3 Action
28.3.1
Extends phalanges at the
interphalangeal joints, con- tinued action extends the metacarpophalangeal and
car- pometacarpal articulations. Assists in extending wrist.
28.4 Nerve Supply
28.4.1
Posterior interosseous, (deep
radial) C7, 8.
28.5 Synergists
28.5.1
Extensor indicis, extensor digiti
minimi, lumbri- cales.
28.6 Category
28.6.1
29 EXTENSOR DIGITORUM
BREVIS
Back Table of Contents References
29.1 Word Derivation
and Pronunciation
29.2 Pronunciation
29.2.1.1Extensor Digitorum Brevis= eks-tenser, -sr brev
is
29.2.1.2Pronunciation Key
29.2.2
Etymology
29.2.2.1Extensor=increases
angle at joint
29.2.2.2Digitorum=Finger
or Toe
29.2.2.3Brevis= Brief,
short
29.2.2.4Extensor= Latin
one who stretches, from ex-tendo, to stretch out
29.3 Attachments
29.3.1
Origin
29.3.1.1 Forepart
of the supralateral surface of the calcaneus
29.3.1.1.1
Distal and lateral surfaces of the
calcaneus
29.3.1.1.1.1
Distal part of superior and lateral
surfaces of calcaneus
29.3.1.2Lateral
talocalcaneal ligament
29.3.1.3Distal
to the groove for the peroneus brevis
29.3.1.4 Inferior
extensor retinaculum
29.3.1.4.1
Cruciate crural ligament
29.3.1.4.2
Apex
of the inferior extensor retinaculum
29.3.2
Insertion
29.3.2.1 Branches
into 3 tendons that insert into the lateral sides of the tendons of the
extensor digitorum longus of the 2nd, 3rd and 4th toes.
29.4 Joints
29.5Metatarsal/Tarsal
29.6Metatarsophalangeal
29.7Interphalangeal
29.8 Action
29.8.1
Extends the proximal phalanges of
the 2rid, 3rd and 4th toes
29.9 Nerve Supply
29.9.1
Nerve
29.9.1.1
Deep peroneal
29.9.2
Roots
29.9.2.1L4
29.9.2.2L5
29.9.2.3S1
29.9.2.4S2
29.10
Synergists
29.10.1 Extensor
digitorum longus
29.11
Muscle Tests
29.11.1 EXTENSOR DIGITORUM LONGUS
& BREVIS
29.12
Trigger Points
29.12.1
EXTENSOR DIGITORUM BREVIS
& EXTENSOR HALLUCIS BREVIS
29.13 Organ Reflexes
29.13.1 None
29.14
Acupressure/Acupuncture Theory
29.14.1 None
29.15
Nutritional
29.15.1 None
29.16
Discussion (Gray)
29.16.1 Extensor digitorum
brevis—The fascia on the dorsum of the foot is a thin membranous layer,
continuous above with the transverse and cruciate crural ligaments; on either
side it blends with the plantar aponeurosis; anteriorly it forms a sheath for
the tendons on the dorsum of the foot.
1
29.16.2 The Extensor
digitorum brevis (Fig. 441) is a broad, thin muscle, which arises from the
forepart of the upper and lateral surfaces of the calcaneus, in front of the
groove for the Peronæus brevis; from the lateral talocalcanean ligament; and
from the common limb of the cruciate crural ligament. It passes obliquely
across the dorsum of the foot, and ends in four tendons. The most medial, which
is the largest, is inserted into the dorsal surface of the base of the first
phalanx of the great toe, crossing the dorsalis pedis artery; it is frequently
described as a separate muscle—the Extensor hallucis brevis. The other three
are inserted into the lateral sides of the tendons of the Extensor digitorum
longus of the second, third, and fourth toes.
2
29.16.3 Variations.—Accessory
slips of origin from the talus and navicular, or from the external cunei-form
and third metatarsal bones to the second slip of the muscle, and one from the
cuboid to the third slip have been observed. The tendons vary in number and
position; they may be reduced to two, or one of them may be doubled, or an
additional slip may pass to the little toe. A supernumerary slip ending on one
of the metatarsophalangeal articulations, or joining a dorsal interosseous
muscle is not uncommon. Deep slips between this muscle and the Dorsal
interossei occur. 3
29.16.4 Nerves.—It is
supplied by the deep peroneal nerve. 4
29.16.5 Actions.—The
Extensor digitorum brevis extends the phalanges of the four toes into which it
is inserted, but in the great toe acts only on the first phalanx. The obliquity
of its direction counteracts the oblique movement given to the toes by the long
Extensor, so that when both muscles act, the toes are evenly extended.
29.16.6 Discussion
29.16.6.1 http://www.bartleby.com/107/131.html
29.16.7 Illustration
29.16.7.1 http://www.bartleby.com/107/illus441.html
29.17
Category
29.17.1 Intrinsic Foot (Dorsal
Muscles)
30 EXTENSOR DIGITORUM
LONGUS
Back Table of Contents References
30.1 Word Derivation
and Pronunciation
30.2 Pronunciation
30.2.1.1Extensor Digitorum Longus= eks-tenser, -sr
30.2.1.2Pronunciation Key
30.2.2
Etymology
30.2.2.1Extensor=increases
angle at joint
30.2.2.2Digitorum=Finger
or Toe
30.2.2.3Longus=Long
30.2.2.4Extensor= Latin one
who stretches, from ex-tendo, to stretch out
30.3 Attachments
30.3.1
Origin
30.3.1.1 Lateral
condyle of the tibia
30.3.1.2 Head
and proximal 3/4 of the anterior surface on the body of the fibula
30.3.1.3 Proximal
portion of the interosseus membrane
30.3.1.4 Deep
fascia
30.3.1.5 Adjacent
intermuscular septa
30.3.2
Insertion
30.3.2.1Divides into four
tendons after passing under the extensor retinaculum, to insert on to the
dorsal surfaces of the bases of the middle and distal phalanges of the 2nd -5th
toes
30.3.2.2Each tendon forms
an expansion on the dorsal surface of the toe, and divides into an intermediate
slip attached to the base of the middle phalanx and into two lateral slips
attached to base of the distal phalanx
30.4 Joints
30.5Ankle (Talocrural)
30.6Tibiofibular
(Distal)
30.7Metatarsal/Tarsal
30.8Metatarsophalangeal
30.9Interphalangeal
30.10
Action
30.10.1 Extends
the lateral 4 toes
30.10.1.1 Extends the
metatarsophalangeal joints and assists in extending the interphalangeal joints
of the 2nd through 5th digits.
30.10.2 Dorsiflexes
and everts foot at the ankle.
30.10.2.1 Assists in the
dorsiflexion of the ankle joint and eversion (Pronation) of the foot.
30.11
Nerve Supply
30.11.1 Nerve
30.11.1.1 Deep
peroneal
30.11.2
Roots
30.11.2.1 L4
30.11.2.2
L5
30.11.2.3
S1
30.12
Synergists
30.12.1 Extensor
digitorum brevis
30.13
Muscle Tests
30.13.1
EXTENSOR
DIGITORUM LONGUS & BREVIS
30.14
Trigger Points
30.14.1 Extensor Digitorum Hallucis
Longus
30.15 Organ Reflexes
30.15.1 None
30.16
Acupressure/Acupuncture Theory
30.16.1 None
30.17
Nutritional
30.17.1 None
30.18
Discussion (Gray)
30.18.1 The Extensor
digitorum longus is a penniform muscle, situated at the lateral part of the
front of the leg. It arises from the lateral condyle of the tibia; from the
upper three-fourths of the anterior surface of the body of the fibula; from the
upper part of the interosseous membrane; from the deep surface of the fascia;
and from the intermuscular septa between it and the Tibialis anterior on the medial,
and the Peronæi on the lateral side. Between it and the Tibialis anterior are
the upper portions of the anterior tibial vessels and deep peroneal nerve. The
tendon passes under the transverse and cruciate crural ligaments in company
with the Peronæus tertius, and divides into four slips, which run forward on
the dorsum of the foot, and are inserted into the second and third phalanges of
the four lesser toes. The tendons to the second, third, and fourth toes are
each joined, opposite the metatarsophalangeal articulation, on the lateral side
by a tendon of the Extensor digitorum brevis. The tendons are inserted in the
following manner: each receives a fibrous expansion from the Interossei and
Lumbricalis, and then spreads out into a broad aponeurosis, which covers the
dorsal surface of the first phalanx: this aponeurosis, at the articulation of
the first with the second phalanx, divides into three slips—an intermediate,
which is inserted into the base of the second phalanx; and two collateral
slips, which, after uniting on the dorsal surface of the second phalanx, are
continued onward, to be inserted into the base of the third phalanx. 7
30.18.2 Variations.—This
muscle varies considerably in the modes of origin and the arrangement of its
various tendons. The tendons to the second and fifth toes may be found doubled,
or extra slips are given off from one or more tendons to their corresponding
metatarsal bones, or to the short extensor, or to one of the interosseous
muscles. A slip to the great toe from the innermost tendon has been found.
30.18.3 Discussion
30.18.3.1 http://www.bartleby.com/107/129.html
30.18.4 Illustration
30.18.4.1 http://www.bartleby.com/107/illus437.html
30.18.4.2 http://www.bartleby.com/107/illus440.html
30.19
Category
30.19.1 Foot & Toes (Anterior
Compartment)
31 EXTENSOR HALLUCIS
BREVIS
Back Table of Contents References
31.1 Word Derivation
and Pronunciation
31.2 Pronunciation
31.2.1.1Extensor Hallucis
Brevis
31.2.1.1.1 Extensor=ik-'sten(t)-s&r
31.2.1.1.2
Hallux=ha-l&ks
31.2.1.1.3
Halluces= 'ha-l&-"sEz,
'hal-y&-/
31.2.1.2Pronunciation Key
31.2.2
Etymology
31.2.2.1Extensor=increases
angle at joint
31.2.2.2Hallucis=Hallux or
great toe
31.2.2.2.1
New
Latin, from Latin hallus, hallux
: the innermost digit (as the
big toe) of a hind or lower limb
31.2.2.3Brevis= Short or
Brief
31.3 Attachments
31.3.1
Origin
31.3.1.1Calcaneus
(Forepart medial aspect)
31.3.1.1.1
Anterior superior medial aspect of
calcaneus
31.3.1.1.2
Distal part of superior and
relatively lateral surfaces of calcaneus
31.3.1.2Lateral
talocalcaneal ligament
31.3.1.3 Inferior
extensor retinaculum
31.3.1.3.1
Cruciate
crural ligament
31.3.1.3.2
Apex
of the inferior extensor retinaculum
31.3.2
Insertion
31.3.2.1Dorsal
surface of the base of proximal phalanx of hallux
31.4 Joints
31.51st
Metatarsal/Tarsal
31.61st
Metatarsophalangeal
31.7 Action
31.7.1
Extends proximal phalanx of hallux
(big toe).
31.7.1.1Extends
the metatarsophalangeal joint of the great toe
31.7.1.2The extensor hallucis
brevis is the medial section (Slip) of the extensor digitorum brevis, which
extends the proximal phalanges of the 2nd- 4th toes.
31.8 Nerve Supply
31.8.1
Nerve
31.8.1.1Deep
peroneal
31.8.2
Roots
31.8.2.1L4
31.8.2.2L5
31.8.2.3S1
31.8.2.4S2
31.9 Synergists
31.9.1
Extensor hallucis longus
31.10
Muscle Tests
31.10.1
EXTENSOR
HALLUCIS LONGUS & BREVIS
31.11
Trigger Points
31.11.1 EXTENSOR DIGITORUM BREVIS
& EXTENSOR HALLUCIS BREVIS
31.12 Organ Reflexes
31.12.1 None
31.12.2 Illustrations
31.13
Acupressure/Acupuncture Theory
31.13.1 None
31.14
Nutritional
31.14.1 None
31.15
Discussion (Gray)
31.15.1 Extensor digitorum
brevis—The fascia on the dorsum of the foot is a thin membranous layer,
continuous above with the transverse and cruciate crural ligaments; on either side
it blends with the plantar aponeurosis; anteriorly it forms a sheath for the
tendons on the dorsum of the foot. 1
31.15.2 The Extensor
digitorum brevis (Fig. 441) is a broad, thin muscle, which arises from the
forepart of the upper and lateral surfaces of the calcaneus, in front of the
groove for the Peronæus brevis; from the lateral talocalcanean ligament; and
from the common limb of the cruciate crural ligament. It passes obliquely
across the dorsum of the foot, and ends in four tendons. The most medial, which
is the largest, is inserted into the dorsal surface of the base of the first
phalanx of the great toe, crossing the dorsalis pedis artery; it is frequently
described as a separate muscle—the Extensor hallucis brevis. The other three
are inserted into the lateral sides of the tendons of the Extensor digitorum
longus of the second, third, and fourth toes.
2
31.15.3 Variations.—Accessory
slips of origin from the talus and navicular, or from the external cunei-form
and third metatarsal bones to the second slip of the muscle, and one from the
cuboid to the third slip have been observed. The tendons vary in number and
position; they may be reduced to two, or one of them may be doubled, or an
additional slip may pass to the little toe. A supernumerary slip ending on one
of the metatarsophalangeal articulations, or joining a dorsal interosseous
muscle is not uncommon. Deep slips between this muscle and the Dorsal
interossei occur. 3
31.15.4 Nerves.—It is
supplied by the deep peroneal nerve. 4
31.15.5 Actions.—The
Extensor digitorum brevis extends the phalanges of the four toes into which it
is inserted, but in the great toe acts only on the first phalanx. The obliquity
of its direction counteracts the oblique movement given to the toes by the long
Extensor, so that when both muscles act, the toes are evenly extended.
31.15.6 Discussion
31.15.6.1 http://www.bartleby.com/107/131.html
31.15.7 Illustration
31.15.7.1 http://www.bartleby.com/107/illus441.html
31.16
Category
31.16.1 Intrinsic Foot (Dorsal
Muscles)
31.17
Note
31.17.1 (Note:
The extensor hallucis brevis is the medial section of the extensor
digitorum brevis.)
32 EXTENSOR HALLUCIS
LONGUS
Back Table of Contents References
32.1 Word Derivation
and Pronunciation
32.2 Pronunciation
32.2.1.1Extensor Hallucis
Longus
32.2.1.1.1 Extensor=ik-'sten(t)-s&r
32.2.1.1.2
Hallux=ha-l&ks
32.2.1.1.3
Halluces= 'ha-l&-"sEz,
'hal-y&-/
32.2.1.2Pronunciation Key
32.2.2
Etymology
32.2.2.1Extensor=increases
angle at joint
32.2.2.2Hallucis=Hallux or
great toe
32.2.2.2.1
New
Latin, from Latin hallus, hallux
: the innermost digit (as the
big toe) of a hind or lower limb
32.2.2.3Longus= long
32.3 Attachments
32.3.1
Origin
32.3.1.1 Middle
1/2 ( 2/4) of the anterior surface of the fibula
32.3.1.2 Adjacent
interosseous membrane
32.3.2
Insertion
32.3.2.1 Dorsal
surface of base of distal phalanx of hallux (big toe)
32.4 Joints
32.5Ankle (Talocrural)
32.6Tibiofibular
(Distal)
32.71st
Metatarsal/Tarsal
32.81st
Metatarsophalangeal
32.91st Interphalangeal
32.10
Action
32.10.1 Extends
the distal phalanx of the big toe.
32.10.2 Continued
action extends proximal phalanx
32.10.2.1 Metatarsophalangeal
and interphalangeal joints
32.10.3 Dorsiflexes
and inverts (Supinates) the foot at the ankle.
32.11
Nerve Supply
32.11.1 Nerve
32.11.1.1 Deep
peroneal
32.11.2
Roots
32.11.2.1 L4
32.11.2.2 L5
32.11.2.3 S1
32.12
Synergists
32.12.1 Extensor
Hallucis Brevis
32.13
Muscle Tests
32.13.1 EXTENSOR HALLUCIS LONGUS
& BREVIS
32.14
Trigger Points
32.14.1
EXTENSOR DIGITORUM LONGUS
& EXTENSOR HALLUCIS LONGUS
32.15 Organ Reflexes
32.15.1 None
32.15.2 Illustrations
32.16
Acupressure/Acupuncture Theory
32.16.1 None
32.17
Nutritional
32.17.1 None
32.18
Discussion (Gray)
32.18.1 The Extensor
hallucis longus (Extensor proprius hallucis) is a thin muscle, situated between
the Tibialis anterior and the Extensor digitorum longus. It arises from the
anterior surface of the fibula for about the middle two-fourths of its extent,
medial to the origin of the Extensor digitorum longus; it also arises from the
interosseous membrane to a similar extent. The anterior tibial vessels and deep
peroneal nerve lie between it and the Tibialis anterior. The fibers pass
downward, and end in a tendon, which occupies the anterior border of the
muscle, passes through a distinct compartment in the cruciate crural ligament,
crosses from the lateral to the medial side of the anterior tibial vessels near
the bend of the ankle, and is inserted into the base of the distal phalanx of
the great toe. Opposite the metatarsophalangeal articulation, the tendon gives
off a thin prolongation on either side, to cover the surface of the joint. An
expansion from the medial side of the tendon is usually inserted into the base
of the proximal phalanx. 5
32.18.2
32.18.3 Variations.—Occasionally
united at its origin with the Extensor digitorum longus. Extensor ossis
metatarsi hallucis, a small muscle, sometimes found as a slip from the Extensor
hallucis longus, or from the Tibialis anterior, or from the Extensor digitorum
longus, or as a distinct muscle; it traverses the same compartment of the transverse
ligament with the Extensor hallucis longus.
32.18.4 Discussion
32.18.4.1 http://www.bartleby.com/107/129.html
32.18.5 Illustration
32.18.5.1 http://www.bartleby.com/107/illus437.html
32.18.5.2 http://www.bartleby.com/107/illus440.html
32.19
Category
32.19.1 Foot & Toes (Anterior
Compartment)
33 EXTENSOR INDICIS
33.1 Origin
33.1.1
Dorsal surface of distal half of
ulna.
33.2 Insertion
33.2.1
Index finger extensor digitorum
tendon.
33.3 Action
33.3.1
Extension of all phalanges of index
finger. Assists in wrist extension.
33.4 Nerve Supply
33.4.1
Posterior Interosseous, (deep
radial), C7,8.
33.5 Synergists
33.5.1
Extensor digitorum.
33.6 Category
33.6.1
34 EXTENSOR POLLICIS
BREVIS
34.1 Origin
34.1.1
The posterior surface of the distal
end of the body of the ulna near the middle and the adjacent interosseous
membrane.
34.2 Insertion
34.2.1
The posterior surface of the base of
the proximal phalanx of the thumb.
34.3 Action
34.3.1
Extends the proximal phalanx of the
thumb. Continued action extends and assists abduction of the 1 st metacarpal.
34.4 Nerve Supply
34.4.1
Posterior interosseous nerve (deep
radial nerve), C6,7.
34.5 Synergists
34.5.1
Abductor pollicis longus, extensor
pollicis longus.
34.6 Category
34.6.1
35 EXTENSOR POLLICIS
LONGUS
35.1 Origin
35.1.1
Posterior surface of the middle 1/3
of the ulna and the interosseous membrane.
35.2 Insertion
35.2.1
The posterior surface of the base of
the distal phalanx of the thumb.
35.3 Action
35.3.1
Extends the distal phalanx of the
thumb. Continued action, extends proximal phalanx and metacarpal, and adducts
the 1st metacarpal.
35.4 Nerve Supply
35.4.1
Posterior interosseous nerve (deep
radial nerve) C7,8.
35.5 Synergists
35.5.1
Extensor pollicis brevis.
35.6 Category
35.6.1
36 EXTERNAL ABDOMINAL
OBLIQUE=ANT DIV
36.1 Origin
36.1.1
External surfaces and inferior
borders of the Sth -12th ribs by tendinous slips that interdigitate with those
of serratus anterior and latissimus dorsi.
36.2 Insertion
36.2.1
Linea alba by means of the broad
abdominal aponeurosis from ribs to crest of pubis, inquinalligament and the
anterior half of the iliac crest along the outer lip.
36.3 Action
36.3.1
Acting unilaterally, rotates the
trunk to the opposite side, and flexes it laterally on the side of muscle
contraction. If rotation is only activity, the opposite internal oblique is synergist.
Acting bilaterally, flexes the trunk anteriorly, supports and compresses the
abdominal viscera, giving anterior support to the spinal column. Gives anterior
stabilization to pelvis, decreasing lordosis. Assists in forced expiration.
36.4 Nerve Supply
36.4.1
Branches of the 7th .12th
intercostal nerves.
36.5 Synergists
36.5.1
Rectus abdominis, internal oblique
and external oblique abdominals of opposite side. Psoas on lumbar spine in
total trunk flexion.
36.6 Category
36.6.1
37 EXTERNAL ABDOMINAL
OBLIQUE=LAT DIV
37.1 Origin
37.1.1
37.2 Insertion
37.2.1
37.3 Action
37.3.1
37.4 Nerve Supply
37.4.1
37.5 Synergists
37.5.1
37.6 Category
37.6.1
38 EXTERNAL ANAL
SPHINCTER
38.1 Origin
38.1.1
38.2 Insertion
38.2.1
38.3 Action
38.3.1
38.4 Nerve Supply
38.4.1
38.5 Synergists
38.5.1
38.6 Category
38.6.1
39 EXTERNAL
INTERCOSTALS
39.1 Origin
39.1.1
Inferior border of rib above.
39.2 Insertion
39.2.1
Superior border of rib below
39.3 Action
39.3.1
Elevate ribs during inspiration.
39.4 Nerve Supply
39.4.1
Branches from corresponding
intercostal nerves.
39.5 Synergists
39.5.1
Serratus posterior superior,
levatores costarum. Scaleni group.
39.6 Category
39.6.1
40 EXTRINSIC
AURICULAR MUSCLES
40.1 Origin
40.1.1
Auriculari~
anterior: Lateral edge of the epicranial aponeurosis.
40.1.2
Auricularis
superior: EQicranial aponeurosis. Auricularis posterior: Mastoid part of the
temporal bone.
40.2 Insertion
40.2.1
Auricularis
anterior: The spine of the helix.
40.2.2
Auricularis
superior: The upper part of the cranial surface of the auricle.
40.2.3
Auricularis
posterior: By two or three fasciculi into the ponticulus on the eminentia
conchae.
40.3 Action
40.3.1
Minimal
action in man.
40.3.2
Auricularis
anterior: Draws auricle forwards and up.
40.3.3
Auricularis
superior: Elevates the auricle.
40.3.4
Auricularis
posterior: Draws the auricle back.
40.4 Nerve Supply
40.4.1
Auricularis
anterior and superior: Temporal bral}ches 9f the fa~ial nerve (VII).
40.4.2
AuriCularis
posterior: PosterIor aurIcular branch of the facial nerve (VII).
40.5 Arterial supply
40.5.1
Auricular
rami from the posterior auricular branch of the external carotid artery, the
anterior auricular branches of the superficial temporal artery, and the
auricular branch of the occipital artery.
40.6 Synergists
40.6.1
Frontalis
and occipitalis, indirectly.
40.7 Antagonist
40.7.1
None
40.8 Category
40.8.1
41 FLEXOR CARPI
RADIALIS
41.1 Origin
41.1.1
Common flexor tendon from medial
epicondyle of humerus.
41.2 Insertion
41.2.1
Anterior surfaces of bases of 2nd
and 3rd metacar- pals.
41.3 Action
41.3.1
Flexes and radially deviates the
hand at the wrist.
41.4 Nerve Supply
41.4.1
Median nerve, C6, 7.
41.5 Synergists
41.5.1
Flexor carpi ulnaris and palmaris
longus for flexion. Extension carpi radialis longus and brevis for radial
deviation.
41.6 Category
41.6.1
42 FLEXOR CARPI
ULNARIS
42.1 Origin
42.1.1
By 2 heads from medial epicondyle of
humerus and medial border of olecranon process of ulna.
42.2 Insertion
42.2.1
Palmar surface of pisiform and
hamate carpal bones and base of Sth metacarpal.
42.3 Action
42.3.1
Flexes and ulnarly deviates the hand
at the wrist.
42.4 Nerve Supply
42.4.1
Ulnar, C7, 8.
42.5 Synergists
42.5.1
Flexor carpi radials and palmaris
longus for flexion. Extensor carpi ulnaris for ulnar deviation.
42.6 Category
42.6.1
43 FLEXOR DIGITI
MINIMI BREVIS (FOOT)
Back Table of Contents References
43.1 Attachments
43.1.1
Origin
43.1.1.1 Base
of the 5th metatarsal bone
43.1.2
Insertion
43.1.2.1 Lateral
side of the base of the proximal phalanx of the little toe
43.2 Action
43.2.1
Flexes the proximal phalanx of the
5th toe.
43.3 Nerve Supply
43.3.1
Nerve
43.3.1.1Lateral
plantar nerve
43.3.2
Roots
43.3.2.1S2
43.3.2.2S3
43.4 Synergists
43.4.1
Flexor digitorum brevis
43.4.2
Flexor digitorum longus
43.4.3
Quadratus plantae
43.5 Muscle
Tests
43.5.1
43.6 Trigger Points
43.6.1
43.7 Discussion (Gray)
43.7.1
The Flexor digiti quinti brevis (Flexor brevis minimi
digiti) lies under the metatarsal bone of the little toe, and resembles one of
the Interossei. It arises from the base of the fifth metatarsal bone, and from
the sheath of the Peronæus longus; its tendon is inserted into the lateral side
of the base of the first phalanx of the fifth toe. Occasionally a few of the
deeper fibers are inserted into the lateral part of the distal half of the
fifth metatarsal bone; these are described by some as a distinct muscle, the
Opponens digiti quinti.
43.7.2
Discussion
43.7.2.1http://www.bartleby.com/107/131.html
43.7.3
Illustration
43.7.3.1http://www.bartleby.com/107/illus445.html
43.8 Category
43.8.1
Intrinsic
Foot (Plantar 3rd Layer)
44 FLEXOR DIGITI
MINIMI BREVIS (HAND)
44.1 Origin
44.1.1
Hamulus or hook of the hamate bone
and flexor retinaculum.
44.2 Insertion
44.2.1
Ulnar side of the base of the
proximal phalanx of the Sth finger.
44.3 Action
44.3.1
Flexes the Sth digit at the
metacarpophalangeal articula- tion.
44.4 Nerve Supply
44.4.1
Deep branch of ulnar nerve, C8, T1.
44.5 Synergists
44.5.1
Flexor digitorum superficialis,
flexor digitorum profundus, opponens digiti minimi, interossei.
44.6 Category
44.6.1
45 FLEXOR DIGITORUM
BREVIS
Back Table of Contents References
45.1 Attachments
45.1.1
Origin
45.1.1.1Medial
process of tuberosity of the calcaneus
45.1.1.2Central
part of the plantar aponeurosis (The entire muscle belly is firmly united with
the plantar aponeurosis)
45.1.1.3 Intermuscular
septa
45.1.2
Insertion
45.1.2.1Divides
into 4 tendons that insert into the middle phalanges of the 2nd -5th toes
45.2 Action
45.2.1
Plantar flexes the middle phalanges
on the proximal phalanges
45.2.2
Continued action flexes the proximal
phalanges on the metatarsals.
45.3 Nerve Supply
45.3.1
Nerve
45.3.1.1Medial Plantar (Tibial)
45.3.2
Roots
45.3.2.1L4
45.3.2.2L5
45.3.2.3S1
45.3.2.4S2
45.3.2.5S3
45.4 Synergists
45.4.1
Flexor digitorum longus
45.5 Muscle
Tests
45.5.1
45.6 Trigger Points
45.6.1
45.7 Discussion (Gray)
45.7.1
The Flexor digitorum brevis lies in the middle of the sole
of the foot, immediately above the central part of the plantar aponeurosis, with
which it is firmly united. Its deep surface is separated from the lateral
plantar vessels and nerves by a thin layer of fascia. It arises by a narrow
tendon, from the medial process of the tuberosity of the calcaneus, from the
central part of the plantar aponeurosis, and from the intermuscular septa
between it and the adjacent muscles. It passes forward, and divides into four
tendons, one for each of the four lesser toes. Opposite the bases of the first
phalanges, each tendon divides into two slips, to allow of the passage of the
corresponding tendon of the Flexor digitorum longus; the two portions of the
tendon then unite and form a grooved channel for the reception of the
accompanying long Flexor tendon. Finally, it divides a second time, and is inserted
into the sides of the second phalanx about its middle. The mode of division of
the tendons of the Flexor digitorum brevis, and of their insertion into the
phalanges, is analogous to that of the tendons of the Flexor digitorum sublimis
in the hand. 14
45.7.2
Variations.—Slip to the little toe frequently wanting, 23
per cent.; or it may be replaced by a small fusiform muscle arising from the
long flexor tendon or from the Quadratus plantæ. 15
45.7.3
Fibrous Sheaths of the Flexor Tendons.—The terminal portions
of the tendons of the long and short Flexor muscles are contained in
osseoaponeurotic canals similar in their arrangement to those in the fingers.
These canals are formed above by the phalanges and below by fibrous bands,
which arch across the tendons, and are attached on either side to the margins
of the phalanges. Opposite the bodies of the proximal and second phalanges the
fibrous bands are strong, and the fibers are transverse; but opposite the
joints they are much thinner, and the fibers are directed obliquely. Each canal
contains a mucous sheath, which is reflected on the contained tendons.
45.7.4
Discussion
45.7.4.1http://www.bartleby.com/107/131.html
45.7.5
Illustration
45.7.5.1http://www.bartleby.com/107/illus443.html
45.8 Category
45.8.1
Intrinsic
Foot Plantar First Superficial Layer (IFP1)
46 FLEXOR DIGITORUM
LONGUS
Back Table of Contents References
46.1 Word Derivation
and Pronunciation
46.2 Pronunciation
46.2.1.1Flexor Digitorum
Longus
46.2.1.1.1
Flexor=flek-s&r,
-"sor
46.2.1.2Pronunciation Key
46.2.2
Etymology
46.2.2.1Flexor=decreases
angle at joint
46.2.2.2Digitorum=Finger
or Toe
46.2.2.3Longus= Long
46.3 Attachments
46.3.1
Origin
46.3.1.1Posterior
surface of middle 3/5th of tibia
46.3.1.2Posterior
Tibialis Fascia
46.3.2
Insertion
46.3.2.1Divides
into 4 tendons that insert on the plantar surfaces of bases of distal phalanges
of the 2nd -5th toes
46.4 Joints
46.5Ankle (Talocrural)
46.6Tibiofibular
(Distal)
46.7Metatarsal/Tarsal
46.8Metatarsophalangeal
46.9Interphalangeal
46.10
Action
46.10.1 Flexes
proximal and distal phalanges at all interphalangeal and metatarsophalangeal
articulations of 2nd -5th toes.
46.10.2 Plantar
flexion (Foot-Ankle)
46.10.3 Inversion
(Foot-Ankle)
46.10.4 Medial
ankle stabilization
46.11
Nerve Supply
46.11.1 Nerve
46.11.1.1 Tibial
46.11.2 Roots
46.11.2.1 L5
46.11.2.2 S1
46.11.2.3 S2
46.11.2.4 S3
46.12
Synergists
46.12.1 Tibialis
Posterior
46.12.2 Flexor
Hallucis Longus
46.12.3 Flexor
Digitorum Brevis
46.13
Muscle Tests
46.13.1
FLEXOR
DIGITORUM LONGUS & QUADRATUS PLANTAE
46.14
Trigger Points
46.14.1 FLEXOR DIGITORUM LONGUS &
FLEXOR HALLUCIS LONGUS
46.15 Organ Reflexes
46.15.1 None
46.15.2 Illustrations
46.16
Acupressure/Acupuncture Theory
46.16.1 None
46.17
Nutritional
46.17.1 None
46.18
Discussion (Gray)
46.18.1 The Flexor
digitorum longus is situated on the tibial side of the leg. At its origin it is
thin and pointed, but it gradually increases in size as it descends. It arises
from the posterior surface of the body of the tibia, from immediately below the
popliteal line to within 7 or 8 cm. of its lower extremity, medial to the
tibial origin of the Tibialis posterior; it also arises from the fascia
covering the Tibialis posterior. The fibers end in a tendon, which runs nearly
the whole length of the posterior surface of the muscle. This tendon passes
behind the medial malleolus, in a groove, common to it and the Tibialis
posterior, but separated from the latter by a fibrous septum, each tendon being
contained in a special compartment lined by a separate mucous sheath. It passes
obliquely forward and lateralward, superficial to the deltoid ligament of the
ankle-joint, into the sole of the foot (Fig. 444), where it crosses below the
tendon of the Flexor hallucis longus, and receives from it a strong tendinous
slip. It then expands and is joined by the Quadratus plantæ, and finally
divides into four tendons, which are inserted into the bases of the last
phalanges of the second, third, fourth, and fifth toes, each tendon passing through
an opening in the corresponding tendon of the Flexor digitorum brevis opposite
the base of the first phalanx. 27
46.18.2
46.18.3 Variations.—Flexor
accessorius longus digitorum, not infrequent, origin from fibula, or tibia, or
the deep fascia and ending in a tendon which, after passing beneath the
laciniate ligament, joins the tendon of the long flexor or the Quadratus
plantæ.
46.18.4 Discussion
46.18.4.1 http://www.bartleby.com/107/129.html
46.18.5 Illustration
46.18.5.1 http://www.bartleby.com/107/illus439.html
46.18.5.2 http://www.bartleby.com/107/illus440.html
46.19
Category
46.19.1 Foot & Toes (Posterior
Deep Compartment)
46.20
Individual Muscle Illustration
46.20.1 Posterior
and Plantar View
47 FLEXOR DIGITORUM
PROFUNDUS
47.1 Origin
47.1.1
Upper :}f4 of the anterior
and medial surfaces of the ulna, interosseous membrane and deep fascia of the
forearm.
47.2 Insertion
47.2.1
4 tendons (1 to each finger) to
palmar surface of base of distal phalanx, after passing through tendon of
flexor digitorum superficialis.
47.3 Action
47.3.1
A exes the distal phalanges of the
four fingers. Assists in flexing metacarpophalangeal, carpometacapal and wrist
joints.
47.4 Nerve Supply
47.4.1
Nerve to portion of muscle which
correlates with index and middle fingers, anterior interosseous branch of the
median, C8, T1 ; nerve to portion of muscle which correlates with ring and
little fingers, ulnar, C8, T1.
47.5 Synergists
47.5.1
Aexor digitorum superficialis.
47.6 Category
47.6.1
47.7 View
47.7.1
Anterior View
48 FLEXOR DIGITORUM
SUPERFICIALIS
48.1 Origin
48.1.1
HUMERO-ULNAR HEAD: Medial epicondyle
of the humerus by the common flexor tendon, ulnar collateral ligament of the
elbow and the coronoid process of ulna.
48.1.2
RADIAL: Oblique line of the radius
extending from the radial tuberosity to the insertion of the pronator teres.
48.2 Insertion
48.2.1
4 tendons (1 for each finger) divide
for the passage of the tendons of flexor digitorum profundus then insert as 2
slips on the sides of the shaft of the middle phalanx.
48.3 Action
48.3.1
Flexes the phalanx of each finger on
the proximal phalanx. Continued action, flexes the proximal phalanx at the
hand, flexes the hand at the wrist.
48.4 Nerve Supply
48.4.1
Median C7, 8, T1.
48.5 Synergists
48.5.1
Flexor digitorum profundus.
48.6 Category
48.6.1
48.7 View
48.7.1
- Anterior View
49 FLEXOR HALLUCIS
BREVIS
Back Table of Contents References
49.1 Attachments
49.1.1
Origin
49.1.1.1 Medial
portion of the plantar surface of the cuboid bone
49.1.1.2 Adjacent
portion of the lateral cuneiform bone
49.1.1.3 Prolongation
of the tendon of the tibialis posterior
49.1.2
Insertion
49.1.2.1 Medial
and lateral sides of base of proximal phalanx of the big toe
49.2 Action
49.2.1
Flexes metatarsophalangeal
articulation of big toe
49.3 Nerve Supply
49.3.1
Nerve
49.3.1.1Medial
plantar
49.3.2
Roots
49.3.2.1L4
49.3.2.2L5
49.3.2.3S1
49.3.2.4S2
49.3.2.5S3
49.4 Synergists
49.4.1
Flexor hallucis longus
49.5 Muscle
Tests
49.5.1
49.6 Trigger Points
49.6.1
49.7 Discussion (Gray)
49.7.1
The Flexor hallucis brevis arises, by a pointed tendinous
process, from the medial part of the under surface of the cuboid bone, from the
contiguous portion of the third cuneiform, and from the prolongation of the
tendon of the Tibialis posterior which is attached to that bone. It divides in
front into two portions, which are inserted into the medial and lateral sides
of the base of the first phalanx of the great toe, a sesamoid bone being
present in each tendon at its insertion. The medial portion is blended with the
Abductor hallucis previous to its insertion; the lateral portion with the
Adductor hallucis; the tendon of the Flexor hallucis longus lies in a groove
between them; the lateral portion is sometimes described as the first
Interosseous plantaris. 23
49.7.2
Variations.—Origin subject to considerable variation; it
often receives fibers from the calcaneus or long plantar ligament. Attachment
to the cuboid sometimes wanting. Slip to first phalanx of the second toe.
49.7.3
Discussion
49.7.3.1http://www.bartleby.com/107/131.html
49.7.4
Illustration
49.7.4.1http://www.bartleby.com/107/illus445.html
49.8 Category
49.8.1
Intrinsic
Foot (Plantar 3rd Layer)
49.9 View
49.9.1
Plantar View (3rd Plantar Layer)
50 FLEXOR HALLUCIS
LONGUS
Back Table of Contents References
50.1 Word Derivation
and Pronunciation
50.2 Pronunciation
50.2.1.1Flexor Hallucis
Brevis
50.2.1.1.1
Flexor=flek-s&r,
-"sor
50.2.1.1.2
Hallux=ha-l&ks
50.2.1.1.3
Halluces= 'ha-l&-"sEz,
'hal-y&-/
50.2.1.2Pronunciation Key
50.2.2
Etymology
50.2.2.1Flexor=decreases
angle at joint
50.2.2.2Hallucis=Hallux or
great toe
50.2.2.2.1
New
Latin, from Latin hallus, hallux
: the innermost digit (as the
big toe) of a hind or lower limb
50.2.2.3Longus= long
50.3 Attachments
50.3.1
Origin
50.3.1.1Distal
(Lower) 2l3 of posterior surface of fibula
50.3.1.2Interosseous
membrane
50.3.1.3Adjacent
intermuscular septa and fascia
50.3.2
Insertion
50.3.2.1Plantar
surface of the base of distal phalanx of the hallux (big (great) toe)
50.3.3
Note
50.3.3.1The flexor
hallucis longus is connected to the flexor digitorum longus by a strong
tendinous slip
50.4 Joints
50.5Ankle (Talocrural)
50.6Tibiofibular
(Distal)
50.71st
Metatarsal/Tarsal
50.81st
Metatarsophalangeal
50.91st
Interphalangeal
50.10
Action
50.10.1 Flexion
(big toe)
50.10.1.1 Flexes the
interphalangeal joint of the great toe
50.10.1.2 Assists in the flexion
of the metatarsophalangeal joint
50.10.2 Plantar
flexion (Foot-Ankle)
50.10.2.1 Continued action
aids in plantar flexing the foot
50.10.3 Inversion
(Foot-Ankle)
50.10.4 Medial
ankle stabilization
50.11
Nerve Supply
50.11.1 Nerve
50.11.1.1 Tibial
50.11.2 Roots
50.11.2.1 L5
50.11.2.2 S1
50.11.2.3 S2
50.11.2.4 S3
50.12
Synergists
50.12.1 Flexor
Hallucis Brevis
50.13
Muscle Tests
50.13.1 FLEXOR HALLUCIS LONGUS
50.14
Trigger Points
50.14.1
FLEXOR DIGITORUM LONGUS &
FLEXOR HALLUCIS LONGUS
50.15 Organ Reflexes
50.15.1
Sex Glands
50.15.2 Illustrations
50.16
Acupressure/Acupuncture Theory
50.16.1 Organs
50.16.1.1 Pericardium and Triple Burner
50.16.2 Channels
Discussion
50.16.2.1 Pericardium (Circulation Sex)
50.16.3 Channel
50.16.3.1 Pericardium (Circulation Sex)
Illustration
50.16.4 Command Points
50.16.4.1 Pericardium (Circulation Sex)
50.17
Nutritional
50.17.1 Raw bone
concentrate correlating with tarsal tunnel syndrome or other subluxations of
the foot.
50.18
Discussion (Gray)
50.18.1 The Flexor
hallucis longus is situated on the fibular side of the leg. It arises from the
inferior two-thirds of the posterior surface of the body of the fibula, with
the exception of 2.5 cm. at its lowest part; from the lower part of the
interosseous membrane; from an intermuscular septum between it and the Peronæi,
laterally, and from the fascia covering the Tibialis posterior, medially. The
fibers pass obliquely downward and backward, and end in a tendon which occupies
nearly the whole length of the posterior surface of the muscle. This tendon
lies in a groove which crosses the posterior surface of the lower end of the
tibia, the posterior surface of the talus, and the under surface of the
sustentaculum tali of the calcaneus; in the sole of the foot it runs forward
between the two heads of the Flexor hallucis brevis, and is inserted into the
base of the last phalanx of the great toe. The grooves on the talus and
calcaneus, which contain the tendon of the muscle, are converted by tendinous
fibers into distinct canals, lined by a mucous sheath. As the tendon passes
forward in the sole of the foot, it is situated above, and crosses from the
lateral to the medial side of the tendon of the Flexor digitorum longus, to
which it is connected by a fibrous slip.
25
50.18.2 Variations.—Usually
a slip runs to the Flexor digitorum and frequently an additional slip runs from
the Flexor digitorum to the Flexor hallucis. Peroneocalcaneus internus, rare,
origin below or outside the Flexor hallucis from the back of the fibula, passes
over the sustentaculum tali with the Flexor hallucis and is inserted into the
calcaneum.
50.18.3 Discussion
50.18.3.1 http://www.bartleby.com/107/129.html
50.18.4 Illustration
50.18.4.1 http://www.bartleby.com/107/illus439.html
50.18.4.2 http://www.bartleby.com/107/illus440.html
50.19
Category
50.19.1 Foot & Toes (Posterior
Deep Compartment)
50.20
View
50.20.1
Posterior and Plantar View
51 FLEXOR POLLICIS
BREVIS
51.1 Origin
51.1.1
SUPERFICIAL HEAD: Distal border of
the flexor retinaculum and tubercle of the trapezium bone.
51.1.2
DEEP HEAD: Trapezoid and capitate
bones.
51.2 Insertion
51.2.1
Radial side of the base of the
proximal phalanx of the thumb.
51.3 Action
51.3.1
Flexes proximal phalanx of the
thumb. Continued action, flexes the 1st metacarpal and rotates it medially.
51.4 Nerve Supply
51.4.1
SUPERFICIAL HEAD: Median, C6, 7;
mostly cs and T1.
51.4.2
DEEP HEAD: Ulnar, C8, T1.
51.5 Synergists
51.5.1
Flexor pollicis longus, adductor
pollicis.
51.6 Category
51.6.1
51.7 View
51.7.1
Anterior View
52 FLEXOR POLLICIS
LONGUS
52.1 Origin
52.1.1
Anterior surface of middle 1/2 of
radius. Adjacent interos- seous membrane and a slip from the coronoid process
of the ulna or medial epicondyle of humerus.
52.2 Insertion
52.2.1
Palmar surface of the base of the
distal phalanx of the thumb.
52.3 Action
52.3.1
Flexes the interphalangeal joint of
the thumb. Continued action, flexes the metacarpophalangeal and carpometacarpal
ar- ticulations.
52.4 Nerve Supply
52.4.1
Anterior interosseous branch of the
median, C8, T1.
52.5 Synergists
52.5.1
Flexor pollicis brevis, adductor
pollicis.
52.6 Category
52.6.1
52.7 View
52.7.1
Anterior View
53 FRONTALIS
(EPICRANIUS)
53.1 Origin
53.1.1
No
bony origin, but arises from the epicranial aponeurosis (galea aponeurilica),
anterior to the coronal suture.
53.2 Insertion
53.2.1
Fib~rs
ale coqtinuous with procerus, corrugiltor supercllil and orblculans oculi below
and the galea aponeuntlca above.
53.3 Action
53.3.1
Elevates
the eyebrows and nasal skin while simultaneously protracting the scalp.
53.4 Nerve Supply
53.4.1
Temporal
branches of the facial nerve (VII).
53.5 Arterial supply
53.5.1
SuRraorbital
and supratrochlear branches of the Qpl,1thalmic artery. The frontal (anterior)
branch of the supertlclal temporal artery.
53.6 Synergists
53.6.1
Occipitalis.
53.7 Antagonists
53.7.1
Procerus,
corrugator supercilii, and orbicularis oculi.
53.8 Category
53.8.1
54 GASTROCNEMIUS
Back Table of Contents References
54.1 Word Derivation
and Pronunciation
54.2 Pronunciation
54.2.1.1GASTROCNEMIUS -
"gas-(")träk-'nE-mE-&s, -tr&k-
54.2.1.2Pronunciation Key
54.2.2
Etymology
54.2.2.1gaster=belly
54.2.2.2kneme=leg
54.2.2.3New Latin, from
Greek gastroknEmE calf of the leg, from gastr- + knEmE shank
54.3 Attachments
54.3.1
Origin
54.3.1.1 Lateral
Head
54.3.1.1.1
Lateral condyle and posterior
surface of femur (knee joint)
54.3.1.1.2
Capsule of knee joint
54.3.1.2 Medial
Head
54.3.1.2.1
Proximal and posterior part of
Medial condyle and adjacent part of femur
54.3.1.2.2
Capsule of knee joint
54.3.2
Insertion
54.3.2.1 Middle
part of posterior surface of calcaneus by means of tendo calcaneus (Achilles
tendon)
54.4 Joints
54.5Ankle (Talocrural)
54.6Knee
(Tibiofemoral)
54.7Tibiofibular
54.8 Action
54.8.1
Plantar flexion (Foot)
54.8.2
Inversion (Foot)
54.8.3
Reversed Origin-Insertion Action
54.8.3.1Flexes
leg at the knee
54.8.3.2Dorsiflexion
of foot increases knee flexion capability.
54.8.4
Note
54.8.4.1Since the
gastrocnemius originates above the knee and the soleus below the knee, the
differentiating factor in testing the two muscles is the knee position during
the test.
54.9 Nerve Supply
54.9.1
Nerve
54.9.1.1Tibial
54.9.2
Roots
54.9.2.1S1
54.9.2.2S2
54.10
Synergists
54.10.1 Soleus
54.10.2 Plantaris
54.10.3 Tibialis
posterior
54.10.4 Peroneus
longus
54.10.5 Peroneus
brevis
54.10.6 Flexor
hallucis longus
54.10.7 Flexor
digitorum longus
54.11
Muscle Tests
54.11.1 GASTROCNEMIUS
54.12
Trigger Points
54.12.1 GASTROCNEMIUS
54.13 Organ Reflexes
54.13.1 Adrenal
54.13.2 Illustrations
54.14
Acupressure/Acupuncture Theory
54.14.1
Organs
54.14.1.1 Pericardium
and Triple Burner
54.14.2 Channels
Discussion
54.14.2.1 Pericardium
(Circulation Sex)
54.14.3 Channel
54.14.3.1 Pericardium
(Circulation Sex) Illustration
54.14.4 Command Points
54.14.4.1 Pericardium
(Circulation Sex)
54.15
Nutritional
54.15.1 Adrenal
concentrate
54.15.2 Nucleoprotein
Extract
54.16
Discussion (Gray)
54.16.1 The Gastrocnemius
is the most superficial muscle, and forms the greater part of the calf. It
arises by two heads, which are connected to the condyles of the femur by
strong, flat tendons. The medial and larger head takes its origin from a
depression at the upper and back part of the medial condyle and from the
adjacent part of the femur. The lateral head arises from an impression on the
side of the lateral condyle and from the posterior surface of the femur
immediately above the lateral part of the condyle. Both heads, also, arise from
the subjacent part of the capsule of the knee. Each tendon spreads out into an
aponeurosis, which covers the posterior surface of that portion of the muscle
to which it belongs. From the anterior surfaces of these tendinous expansions,
muscular fibers are given off; those of the medial head being thicker and
extending lower than those of the lateral. The fibers unite at an angle in the
middle line of the muscle in a tendinous raphé, which expands into a broad
aponeurosis on the anterior surface of the muscle, and into this the remaining
fibers are inserted. The aponeurosis, gradually contracting, unites with the
tendon of the Soleus, and forms with it the tendo calcaneus. 13
54.16.2
54.16.3 Variations.—Absence
of the outer head or of the entire muscle. Extra slips from the popliteal
surface of the femur.
54.16.4 Discussion
54.16.4.1 http://www.bartleby.com/107/129.html
54.16.5 Illustration
54.16.5.1 http://www.bartleby.com/107/illus438.html
54.16.5.2 http://www.bartleby.com/107/illus440.html
54.17
Category
54.17.1 Foot & Toes (Posterior
Superficial Compartment)
54.18
View
54.18.1
Posterior View
55 GEMELLUS INFERIOR (1
of 6 Deep Lateral Rotators of Femur)
55.1 Origin
55.1.1
Superior aspect of the ischial
tuberosity.
55.2 Insertion
55.2.1
With the tendon of obturator intern
us into the medial surface of the greater trochanter of the femur.
55.3 Action
55.3.1
Laterally rotates the extended thigh
at the hip, can also produce horizontal extension. Abducts the flexed thigh.
55.4 Nerve Supply
55.4.1
Sacral plexus, L4, 5, S1.
55.5 Synergists
55.5.1
Piriformis, obturator externus,
obturator internus, quadratus femoris, gemellus superior .
55.6 Category
55.6.1
55.7 View
55.7.1
Posterior View
56 GEMELLUS SUPERIOR (1
of 6 Deep Lateral Rotators of Femur)
56.1 Origin
56.1.1
The outer surface of the ischial
spine.
56.2 Insertion
56.2.1
With the tendon of obturator
internus into the medial surface of the greater trochanter of the femur.
56.3 Action
56.3.1
Laterally rotates the extended thigh
at the hip, can also produce horizontal extension. Abducts the flexed thigh.
56.4 Nerve Supply
56.4.1
Sacral plexus, L5, S1, 2.
56.5 Synergists
56.5.1
Piriformis, obturator externus,
obturator internus, quadratus femoris, gemellus inferior .
56.6 Category
56.6.1
56.7 View
56.7.1
Posterior View
57 GENIOGLOSSUS
57.1 Origin
57.1.1
The
superior mental spines behind the mandibular symphysis, above the origin of
geniohyoid.
57.2 Insertion
57.2.1
Inferior
fibers: By thin aponeurosis, to the upper anterior surface of the hyoid body near
the midline, a few fibers passing between hyoglossus and chondroglossus to
blend with the pharyngeal middle constrictor.
57.2.2
Middle
fibers: The hyodlossal membrane, which is the continuation of the lingual
septum that connects the lingual root to the hyoid bone.
57.2.3
Superior
fibers: The whole length of the ventral surface of the tongue, from root to
apex, intermingling with the intrinsic lingual muscles.
57.3 Action
57.3.1
Forward
traction of the tongue to protrude its apex from the mouth. Acting bilaterally,
depresses the medial part of the tongue, making it concave from side to side.
57.4 Nerve Supply
57.4.1
Hypoglossal
nerve {XII).
57.5 Arterial Supply
57.5.1
Lingual
artery and its branches; dorsal lingual and sublingual rami, tonsillar rami of
the facial artery.
57.6 Synergists
57.6.1
Hyoglossus
and chondroglossus.
57.7 Antagonists
57.7.1
Styloglossus
and palatoglossus.
57.8 Category
57.8.1
58 GENIOHYOID
(SUPRAHYOID)
58.1 Origin
58.1.1
Inferior
mental spine behind mandibular symphysis.
58.2 Insertion
58.2.1
Anterior
aspect of the hyoid bone.
58.3 Action
58.3.1
Elevation
and anterior movement of the hyoid bone. When the hyoid is fixed by contraction
of infrahyoid muscles, it depresses tlie mandible.
58.4 Nerve Supply
58.4.1
Branches
of Cl traveling with the hypoglossal nerve.
58.5 Arterial Supply
58.5.1
Submental
branch of the facial artery, the sublingual branch of the lingual artery.
58.6 Synergists
58.6.1
For
elevation of hyoid: Digastric, mylohyoid and stylohyoid.
58.6.2
For
mandibular depression: Digastric and mylohyoid.
58.7 Antagonists
58.7.1
For
elevation of hyoid: Sternohyoid, omohyoid and thyrohyoid.
58.7.2
For
mandibular depression: Temporalis, masseter and medial pterygoid.
58.7.3
For
hyoid protrusion: Stylohyoid.
58.8 Category
58.8.1
59 GLUTEUS MAXIMUS
59.1 Origin
59.1.1
Posterior gluteal line of ilium,
aponeurosis of erector spinae, dorsal surface of sacrum, coccyx and
sacrotuberous liga- ment.
59.2 Insertion
59.2.1
Gluteal tuberosity of femur and
iliotibial tract of fascia lata.
59.3 Action
59.3.1
Extends thigh at the hip, assists in
laterally rotating the thigh. The upper ':?/3 of the muscle are abductors and
the lower 1/3 is inactive as an abductor or an adductor in the standing
position.
59.3.2
REVERSED ORIGIN-INSERTION ACTION:
When the leg is fixed as in standing, the gluteus maximus is an extensor of the
pelvis on the thigh. In this case, it is a synergist to the abdominal muscles.
59.4 Nerve Supply
59.4.1
Inferior gluteal, L5, 51, 2.
59.5 Synergists
59.5.1
Hamstrings which are placed at a
disadvantage by knee flexion.
59.6 Category
59.6.1
59.7 View
59.7.1
Posterior View
60 GLUTEUS MEDIUS
60.1 Origin
60.1.1
Outer surface of ilium from iliac
crest and posterior gluteal line above to the anterior gluteal line below,
gluteal aponeurosis.
60.2 Insertion
60.2.1
Lateral surface of greater
trochanter.
60.3 Action
60.3.1
Abducts femur at the hip and rotates
it medially. Possible lateral rotation. With gluteus minimus is major lateral
pelvic stabi- lizer. Aids in early activity of hip flexion.
60.4 Nerve Supply
60.4.1
Superior gluteal, L5, 51.
60.5 Synergists
60.5.1
Gluteus minimus, tensor fasciae
latae, upper '2/3 of gluteus maximus.
60.6 Category
60.6.1
60.7 View
60.7.1
Lateral View
61 GLUTEUS MINIMUS
ANT & POST
61.1 Origin
61.1.1
Outer surface of ilium between
anterior and inferior gluteal lines and margin of greater sciatic notch.
61.2 Insertion
61.2.1
Anterior border of greater
trochanter.
61.3 Action
61.3.1
Abducts femur at the hip and rotates
it medially. Lateral pelvic stabilizer. Aids in early activity of hip flexion
61.4 Nerve Supply
61.4.1
Superior gluteal, L5, S1.
61.5 Synergists
61.5.1
Gluteus medius, tensor fasciae
latae, upper ';/3 of gluteus maximus.
61.6 Category
61.6.1
61.7 View
61.7.1
Lateral View
62 GRACILIS
62.1 Origin
62.1.1
Anterior aspect of lower 1/2 of symphysis
pubis and medial margin of inferior ramus of pubis.
62.2 Insertion
62.2.1
Anterior and medial surface of the
shaft of the tibia just below the condyle.
62.3 Action
62.3.1
Adducts and medially rotates thigh.
Flexes and medially rotates leg.
62.3.2
REVERSED
ORIGIN-INSERTION ACTION: When
the thigh is fixed, flexes the pelvis at hip.
62.4 Nerve Supply
62.4.1
Obturator, L2, 3.
62.5 Synergists
62.5.1
Adductor brevis, adductor longus,
adductor mag- nus, pectineus.
62.6 Category
62.6.1
62.7 View
62.7.1
Anterior View
63 HYOGLOSSUS
63.1 Origin
63.1.1
The
whole length of the greater cornu and the front of the body of the hyoid bone.
63.2 Insertion
63.2.1
The
side of the tongue between the styloglossus laterally and the inferior
lingualis muscle medially.
63.3 Action
63.3.1
Depresses
the tongue.
63.4 Nerve Supply
63.4.1
Hypoglossal
nerve (XII).
63.5 Arterial Supply
63.5.1
Lingual
artery and it's dorsal lingual rami.
63.5.2
Tonsillar
rami of the facial-artery.
63.6 Synergists
63.6.1
Chondroglossus.
Also the genioglossus when it contracts bilaterally.
63.7 Antagonists
63.7.1
Styloglossus
and palatoglossus.
63.8 Category
63.8.1
63.9 View
63.9.1
(Note: Styloid process and mastoid portion of
temporal bone are superimposed.)
64 ILIACUS
64.1 Origin
64.1.1
Superior ;?/3 of the iliac fossa,
internal border (inner lip) of iliac crest, anterior sacroiliac, lumbosacral
and iliolumbar liga- ments, ala of sacrum.
64.2 Insertion
64.2.1
Lesser trochanter of femur and for a
short distance below along medial border of shaft.
64.3 Action
64.3.1
Flexes thigh at the hip, minimal
action in lateral rotation of the thigh.
64.3.2
REVERSED ORIGIN-INSERTION ACTION:
When the thigh is fixed, the iliacus muscle flexes the pelvis on the thigh, as
in rising to a sitting position from the supine position (sit up).
64.4 Nerve Supply
64.4.1
Femoral, L2, 3.
64.5 Synergists
64.5.1
Psoas major, adductor longus, adductor
brevis, adductor magnus, rectus femoris.
64.6 Category
64.6.1
64.7 View
64.7.1
Anterior View
65 ILIOCOSTALIS
CERVICIS
65.1 Origin
65.1.1
Superior borders of the angles of the
3rd -6th ribs.
65.2 Insertion
65.2.1
The posterior tubercles of the
transverse processes of the 4th, 5th and 6th cervical vertebrae.
65.3 Action
65.3.1
Acting bilaterally, extension of the
spine. Acting unilaterally, laterally flexes the vertebral column.
65.4 Nerve Supply
65.4.1
Dorsal rami of the spinal nerves,
C6, 7, 8.
65.5 Synergists
65.5.1
Splenius cervicis, semispinalis
cervicis, longis- simus cervicis.
65.6 Category
65.6.1
65.7 View
65.7.1
Posterior View
66 ILIOCOSTALIS
LUMBORUM
66.1 Origin
66.1.1
Anterior surface of a broad and
thick tendon which originates from the sacrum, spinous processes of the lumbar
and 11th and 12th thoracic vertebrae, and from the medial lip of the iliac
crest.
66.2 Insertion
66.2.1
Inferior borders of the angles of
the lower 6 or 7 ribs.
66.3 Action
66.3.1
Acting bilaterally, extension of the
spine, Acting unilaterally, laterally flexes the spine.
66.4 Nerve Supply
66.4.1
Dorsal rami of the spinal nerves.
66.5 Synergists
66.5.1
Longissimus thoracis, quadratus
lumborum.
66.6 Category
66.6.1
66.7 View
66.7.1
Posterior View
67 ILIOCOSTALIS
THORACIS
67.1 Origin
67.1.1
Superior borders of the angles of
lower 6 ribs medial to the tendons of insertion of the iliocostalis lumborum.
67.2 Insertion
67.2.1
Into the angles of the upper 6 or 7
ribs and into the transverse process of the 7th cervical vertebra.
67.3 Action
67.3.1
Acting bilaterally, extension of the
spine. Acting unilaterally, laterally flexes the spine.
67.4 Nerve Supply
67.4.1
Dorsal rami of the spinal nerves.
67.5 Synergists
67.5.1
Iliocostalis lumborum, longissimus
thoracis, spinalis thoracis, semispinalis thoracis.
67.6 Category
67.6.1
67.7 View
67.7.1
Posterior View
68 INCISIVUS LABII
INFERIORIS
68.1 Origin
68.1.1
The
floor of the mandibles incisive fossa, late;ral to the mentalis muscle and
below the emmence of the lateral mclsor tooth.
68.2 Insertion
68.2.1
To
the orbicularis oris; suRerficial fibers reach the !lPex.and body of the
modiolus while deep fibers reach the base and lrlfenor cornu.
68.3 Action
68.3.1
J;\ssis~s
orpicularis o.ris (par~ peripheralis inferior and par margmalis mfenor) m
protrudmg the lips.
68.4 Nerve Supply
68.4.1
Inferior
buccal branches of the facial nerve (VII).
68.5 Arterial Supply
68.5.1
Inferior
labial branch of the facial artery and mental branch from the inferior alveolar
artery.
68.6 Synergists
68.6.1
Orbicularis
oris, pars peripheralis inferior and pars margmalis mfenor
68.7 Antagonist
68.7.1
Buccinator,
.depr~ssor anguli oris, risorius zygomaticus major and zygomaticus mmor.
68.8 Category
68.8.1
68.9 Note
68.9.1
( .denotes modiolus)
69 INCISIVUS LABII
SUPERIORIS
69.1 Origin
69.1.1
Maxilla's
incisive fossa superior to the eminence of the lateral incisor tooth.
69.2 Insertion
69.2.1
To
the orbicularis oris; superficial fibers partly blend with levator ang1l;li
oris and to the intermediate and apical modiolar zones. The deep fibers pass to
the superior cornu and oasis moduli.
69.3 Action
69.3.1
Assists
orbicularis oris (oars peripheralis superior and par marginalis superior)
protrude the lips.
69.4 Nerve Supply
69.4.1
Superior
buccal branches of the facial nerve (VII).
69.5 Arterial Supply
69.5.1
Superior
labial branch of the facial artery.
69.6 Synergists
69.6.1
9rbicularis
oris; pars peripheralis superior and par margmalts superIor.
69.7 Antagonists
69.7.1
Buccinator,
zygomaticus major and minor, risorius, and depressor anguli oris.
69.8 Category
69.8.1
69.9 Note
69.9.1
( .denotes modiolus)