Kinesiology.pdf

Kinesiology Chapter 21 Copyright © 2020 by Elsevier Inc. All rights reserved. 1 Learning Objectives Lesson 21.1: Bones of the Upper Extremity, Lower Extremity, and Axial Skeleton 1. Define kinesiology and bony markings, and identify bones and relevant bony markings of the upper extremity, the l...

Kinesiology Chapter 21 Copyright © 2020 by Elsevier Inc. All rights reserved. 1 Learning Objectives Lesson 21.1: Bones of the Upper Extremity, Lower Extremity, and Axial Skeleton 1. Define kinesiology and bony markings, and identify bones and relevant bony markings of the upper extremity, the lower extremity, and the axial skeleton. Copyright © 2020 by Elsevier Inc. All rights reserved. 2 Introduction   Kinesiology: study of human motion Muscles attach to bones and cross joints   Muscles shorten or lengthen, pull on bones, and change their relative positions, creating movement This chapter is divided into 12 lessons:   3 lessons on bones/joints 9 lessons on muscles Copyright © 2020 by Elsevier Inc. All rights reserved. 3 Twelve Lessons (Slide 1 of 2)       Lesson one: bones of the upper extremity Lesson two: bones of the lower extremity Lesson three: bones of the axial skeleton Lesson four: muscles of scapular movement Lesson five: muscles of shoulder joint movement Lesson six: muscles of elbow and radioulnar joint movement Copyright © 2020 by Elsevier Inc. All rights reserved. 4 Twelve Lessons (Slide 2 of 2)       Lesson seven: muscles of wrist and hand movement Lesson eight: muscles of hip and knee movement Lesson nine: muscles of ankle and foot movement Lesson ten: muscles of neck and facial movement Lesson eleven: muscles of trunk and vertebral column movement Lesson twelve: muscles of respiration Copyright © 2020 by Elsevier Inc. All rights reserved. 5 Bones  Contain bony markings (places where muscles, tendons, and ligaments attach and where nerves and blood vessels pass)     Also called surface markings or bony landmarks Muscle attachment sites called origins and insertions Usually easy to locate by palpation Not all bones, bony markings, joints, or muscles are featured in this chapter  Focus on those important to massage practice Copyright © 2020 by Elsevier Inc. All rights reserved. 6 Bony Markings: Projections and Processes         Angle Border Condyle Crest Epicondyle Head Line Process        Protuberance Ramus Ridge Spine Trochanter Tubercle Tuberosity Copyright © 2020 by Elsevier Inc. All rights reserved. 7 Bony Markings: Depressions and Openings  Foramen  Facet Fossa Groove Notch Sinus     Copyright © 2020 by Elsevier Inc. All rights reserved. 8 Bones of Axial and Appendicular Regions (From Patton, K., & Thibodeau, G. [2014]. The human body in health and disease [6th ed.]. St. Louis, MO: Mosby.) Copyright © 2020 by Elsevier Inc. All rights reserved. 9 Lesson One: Bones of the Upper Extremity       Clavicle Scapula Humerus Ulna Radius Carpals, metacarpals, and phalanges Copyright © 2020 by Elsevier Inc. All rights reserved. 10 Bones of Right Upper Extremity (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 11 Clavicle: Bony Markings   Medial (sternal) end Lateral (acromial) end (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 12 Clavicle: Notes    Most commonly fractured bone Sternoclavicular joint (SC) joint: sternum and clavicle articulate Acromioclavicular (AC) joint: acromion (scapula) and clavicle articulate   Where upper extremity joins axial skeleton Shoulder (pectoral) girdle: clavicle and scapula Copyright © 2020 by Elsevier Inc. All rights reserved. 13 Scapula: Bony Markings         Medial and lateral borders Superior and inferior angles Scapular scapula Root of spine Acromion and coracoid processes Glenoid cavity Supraspinous, infraspinous, and subscapular fossae Supraglenoid and infraglenoid tubercles Copyright © 2020 by Elsevier Inc. All rights reserved. 14 Scapula (Slide 1 of 2) (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 15 Scapula (Slide 2 of 2) (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 16 Scapula: Notes   Acromioclavicular (AC) joint: acromion and clavicle articulate Glenohumeral (shoulder) joint: glenoid cavity and humerus articulate   Mobile joint; sacrifices some stability Prone to shoulder separation and dislocation Copyright © 2020 by Elsevier Inc. All rights reserved. 17 Humerus: Bony Markings         Humeral head and neck Greater and lesser tubercles Intertubercular groove Deltoid tuberosity Radial, olecranon, and coronoid fossae Capitulum and trochlea Medial and lateral epicondyles Supracondylar ridge Copyright © 2020 by Elsevier Inc. All rights reserved. 18 Humerus (From Patton, K. T., & Thibodeau, G. A. [2010]. Anatomy & physiology [7th ed.]. St. Louis, MO: Mosby.) Copyright © 2020 by Elsevier Inc. All rights reserved. 19 Humerus: Notes   Glenohumeral (shoulder) joint: glenoid cavity and humerus articulate Elbow joint: formed by humeroradial joint (humerus and radius articulate) and humeroulnar joint (humerus and ulna articulate) Copyright © 2020 by Elsevier Inc. All rights reserved. 20 Ulna: Bony Markings     Olecranon Trochlear and radial notches Ulnar tuberosity Coronoid and styloid processes (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 21 Radius: Bony Markings     Radial head and neck Radial tuberosity Ulnar notch Styloid process (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 22 Interosseous Membrane (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 23 Ulna and Radius: Notes       Ulna = medial forearm bone Radius = lateral forearm bone Humeroulnar joint: humerus and ulna articulate (at elbow joint) Humeroradial joint: humerus and radius articulate (at elbow joint) Radioulnar joints: radius and ulna articulate (at proximal and distal ends) Radiocarpal (wrist) joint: radius and carpal bones articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 24 Carpals         Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate Copyright © 2020 by Elsevier Inc. All rights reserved. 25 Right Hand (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 26 Carpals: Notes  Carpal bones = wrist bones    8 in each wrist Radiocarpal (wrist) joint: radius and carpals articulate Carpometacarpal (CMC) joints: carpals and metacarpals articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 27 Carpal Tunnel (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 28 Carpal Tunnel: Notes  Carpal tunnel: passageway surrounded on three sides by carpal bones and one side by transverse carpal ligament   Contains median nerve and flexor tendons Transverse carpal ligament (flexor retinaculum)   Fibrous band on anterior (palmar) side Forms roof of carpal tunnel Copyright © 2020 by Elsevier Inc. All rights reserved. 29 Metacarpals: Notes  Metacarpals = hand bones  Numbered I-V • •   Thumb is metacarpal I Little finger is metacarpal V Carpometacarpal (CMC) joints: carpals and metacarpals articulate Metacarpophalangeal (MCP) joints: metacarpals and phalanges articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 30 Phalanges: Notes  Phalanges (digits) = fingers and thumb  14 in each hand • •    Fingers have 3 (proximal, middle, distal) Thumb has 2 (proximal, distal) Metacarpophalangeal (MCP) joints: metacarpals and phalanges articulate Proximal interphalangeal (PIP) joints: proximal and middle phalanges articulate Distal interphalangeal (DIP) joints: distal and middle phalanges articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 31 Lesson Two: Bones of the Lower Extremity       Pelvic bone Femur Patella Tibia Fibula Tarsals, metatarsals, and phalanges Copyright © 2020 by Elsevier Inc. All rights reserved. 32 Bones of Lower Extremity (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 33 Pelvic Bones (Slide 1 of 2) (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 34 Pelvic Bones (Slide 2 of 2) (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 35 Pelvic Bones: Notes (Slide 1 of 2)  Three fused bones     Pelvic girdle: right and left pelvic bones   Ilium Ischium Pubis Also known as os coxa, coxal bones, or hip bones Pelvis: both pelvic bones and pelvic spine (sacrum and coccyx) Copyright © 2020 by Elsevier Inc. All rights reserved. 36 Pelvic Bones: Notes (Slide 2 of 2)  Acetabulum (acetabular cavity): hip socket   Acetabulofemoral (hip) joint: acetabulum and femur articulate   Made from portions of all three pelvic bones Stable joint; sacrifices some mobility Obturator foramen: inferior to acetabulum Copyright © 2020 by Elsevier Inc. All rights reserved. 37 Pelvic Tilts (From Fritz, S. [2017]. Mosby’s essential sciences for therapeutic massage [5th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 38 Pelvic Tilt: Notes    Anterior tilt: pelvis tilts forward Posterior tilt: pelvis tilts backward Pelvis neutral: pelvis balanced between exaggerated anterior and posterior tilts    ASIS/PSIS level in transverse/horizontal plane Right tilt: pelvis tilts right Left tilt: pelvis tilts left Copyright © 2020 by Elsevier Inc. All rights reserved. 39 Ilium: Bony Markings and Notes       Iliac crest and iliac fossa Anterior superior iliac spine (ASIS) and anterior inferior iliac spine (AIIS) Posterior superior iliac spine (PSIS) and posterior inferior iliac spine (PIIS) Anterior, posterior, and inferior gluteal lines Greater sciatic notch Sacroiliac (SI) joints: sacrum and ilium articulate  Where lower extremity joins axial skeleton Copyright © 2020 by Elsevier Inc. All rights reserved. 40 Ischium: Bony Markings and Notes      Ischial tuberosity Ischial spine Ischial ramus Sitz bone: another term for ischium Sacrotuberous ligament: extends from ischial tuberosity to sacrum Copyright © 2020 by Elsevier Inc. All rights reserved. 41 Pubis: Bony Markings and Notes      Superior and inferior pubic rami Pubic tubercle Pubic crest Pectineal line Pubic symphysis: pubic bones articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 42 Femur: Bony Markings          Femoral head and neck Greater and lesser trochanters Intertrochanteric line and crest Linea aspera Gluteal tuberosity Adductor tubercle Medial and lateral condyles Intercondylar fossa Medial and lateral epicondyles Copyright © 2020 by Elsevier Inc. All rights reserved. 43 Femur (From Patton, K. T., & Thibodeau, G. A. [2010]. Anatomy & physiology [7th ed.]. St. Louis, MO: Mosby.) Copyright © 2020 by Elsevier Inc. All rights reserved. 44 Femur: Notes     Femur = thigh bone Acetabulofemoral (hip) joint: acetabulum and femur articulate Tibiofemoral (knee) joint: tibia and femur articulate Patellofemoral joint: patella and femur articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 45 Knee (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 46 Knee: Notes     Medial/lateral menisci: half-ringed fibrocartilage disks Anterior cruciate ligament (ACL) Posterior cruciate ligament (PCL) Tibial collateral ligament (TCL)   Fibular collateral ligament (FCL)   Also called medial collateral ligament (MCL) Also called lateral collateral ligament (LCL) Patellar ligament: connects patella to tibial tuberosity Copyright © 2020 by Elsevier Inc. All rights reserved. 47 Patella: Notes     Largest sesamoid bone Embedded in quadriceps tendon Function: assist extension by increasing leverage in quadriceps tendon Patellofemoral joint: patella and femur articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 48 Tibia: Bony Markings       Medial and lateral condyles Tibial tuberosity Gerdy tubercle Crest (anterior border) Soleal line Medial malleolus Copyright © 2020 by Elsevier Inc. All rights reserved. 49 Fibula: Bony Markings   Fibular head Lateral malleolus Copyright © 2020 by Elsevier Inc. All rights reserved. 50 Tibia and Fibula (From Patton, K., & Thibodeau, G. [2014]. The human body in health and disease [6th ed.]. St. Louis, MO: Mosby.) Copyright © 2020 by Elsevier Inc. All rights reserved. 51 Tibia and Fibula: Notes      Tibia = medial leg bone Fibula = lateral leg bone Tibiofemoral (knee) joint: tibia and femur articulate Tibiofibular joints: tibia and fibula articulate (proximal and distal ends) Talocrural (ankle) joint: talus, tibia, and fibula articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 52 Tarsals   Talus Cuneiforms       Medial Intermediate Lateral Navicular Cuboid Calcaneus Copyright © 2020 by Elsevier Inc. All rights reserved. 53 Right Foot (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 54 Tarsals: Notes  Tarsals = foot bones     7 in each foot Talocrural (ankle) joint: talus, tibia, and fibula articulate Tarsometatarsal (TMT) joints: tarsals and metatarsals articulate Three regions of the foot:    Hindfoot (rearfoot): talus and calcaneus Midfoot: navicular, cuboid, and cuneiforms Forefoot: metatarsal and phalanges Copyright © 2020 by Elsevier Inc. All rights reserved. 55 Right Foot Arches (From Patton, K., & Thibodeau, G. [2014]. The human body in health and disease [6th ed.]. St. Louis, MO: Mosby.) Copyright © 2020 by Elsevier Inc. All rights reserved. 56 Foot Arches  Formed by bones, ligaments, and tendons   Resemble a geodesic dome Functions: help foot bear weight, absorb shock, and assist in propulsion movements  Medial longitudinal arch: inner edge •   Prominent in people with high arches Lateral longitudinal arch: outer edge Transverse (metatarsal) arch: across foot Copyright © 2020 by Elsevier Inc. All rights reserved. 57 Metatarsals: Notes  Numbered I-V     Great toe is metatarsal I Little toe is metatarsal V Tarsometatarsal (TMT) joints: tarsals and metatarsals articulate Metatarsophalangeal (MTP) joints: metatarsals and phalanges articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 58 Phalanges: Notes  Phalanges (digits) = toes  14 in each foot • •    Each toe has 3 (proximal, middle, distal) Great toe has 2 (proximal, distal) Metatarsophalangeal (MTP) joints: metatarsals and phalanges articulate Proximal interphalangeal (PIP) joints: proximal and middle phalanges articulate Distal interphalangeal (DIP) joints: distal and middle phalanges articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 59 Lesson Three: Bones of the Axial Skeleton     Skull Ribcage Sternum Vertebral column Copyright © 2020 by Elsevier Inc. All rights reserved. 60 Cranial Bones       Frontal bone Parietal bones Temporal bones Ethmoid bone Sphenoid bone Occipital bone Copyright © 2020 by Elsevier Inc. All rights reserved. 61 Cranial Bones: Bony Markings  Temporal bone   Sphenoid bone    Styloid, mastoid, and zygomatic process Sella turcica Medial and lateral pterygoid plates Occipital bone     Foramen magnum Superior and inferior nuchal lines External occipital protuberance Occipital condyles Copyright © 2020 by Elsevier Inc. All rights reserved. 62 Skull (Slide 1 of 2) (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 63 Skull (Slide 2 of 2) (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 64 Skull: Notes (Slide 1 of 2)     Skull = cranial/facial bones, and hyoid Temporomandibular (TMJ) joint: temporal bone and mandible articulate Atlantooccipital (yes-yes) joint: C1 and occipital bone articulate Paranasal sinuses: frontal, sphenoidal, ethmoidal, and maxillary bones Copyright © 2020 by Elsevier Inc. All rights reserved. 65 Skull: Notes (Slide 2 of 2)  Sutures: fibrous joints between cranial bones      Sagittal suture: between parietal bones Coronal suture: between frontal and parietal bones Lambdoidal (lambdoid) suture: between parietal and occipital bones Squamosal suture: between parietal and temporal bones Sutural (Wormian) bones: irregular bones within sutures Copyright © 2020 by Elsevier Inc. All rights reserved. 66 Facial Bones         Nasal bones Vomer bone Zygomatic bones Lacrimal bones Inferior nasal concha Palatine bones Maxillae Mandible Copyright © 2020 by Elsevier Inc. All rights reserved. 67 Facial Bones: Bony Markings and Notes  Zygomatic bones   Mandible     Temporal process Mandibular ramus Mandibular angle Coronoid and condylar processes Zygomatic arch (cheekbone): bony arch at outer border of eye sockets Copyright © 2020 by Elsevier Inc. All rights reserved. 68 Hyoid (From Patton, K. T., & Thibodeau, G. A. [2010]. Anatomy & physiology [7th ed.]. St. Louis, MO: Mosby.) Copyright © 2020 by Elsevier Inc. All rights reserved. 69 Hyoid: Notes     Does not articulate directly other bones Suspended by ligaments from temporal styloid processes Location: level of mandible; anterior to C3 Shape: miniature mandible with two canine teeth (called lesser horns) Copyright © 2020 by Elsevier Inc. All rights reserved. 70 Ribcage and Sternum (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 71 Ribcage: Notes (Slide 1 of 2)   Ribcage: ribs, sternum, and thoracic vertebrae Ribs: 24 individual bones (12 pairs)     Intercostal space: gap between ribs Costal margin: lower cartilages of ribs 7-10 True ribs: connect to sternum; 7 pairs False ribs: do not connect directly; 5 pairs • • Ribs 8-10: connect by cartilage Ribs 11-12: do not connect at all (called floating ribs) Copyright © 2020 by Elsevier Inc. All rights reserved. 72 Ribcage: Notes (Slide 2 of 2)    Costovertebral joints: ribs and thoracic vertebrae articulate Sternocostal joints: sternum and true ribs articulate Costochondral joints: ribs and their costal cartilages articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 73 Sternum: Bony Markings and Notes      Manubrium Sternal body Xiphoid process Sternoclavicular (SC) joint: sternum and clavicle articulate Sternocostal joints: sternum and true ribs articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 74 Vertebral Column: Notes (Slide 1 of 2)   Vertebral column: approximately 26 bones; extends from skull to pelvis Vertebral regions:     Cervical Thoracic Lumbar Sacrococcygeal (Modified from Leonard, P. C. [2009]. Building a medical vocabulary [7th ed.]. St. Louis, MO: Saunders.) Copyright © 2020 by Elsevier Inc. All rights reserved. 75 Vertebral Column: Notes (Slide 2 of 2)  Individual vertebrae are referred to by their region and placement in the region from top to bottom  Ex: first vertebra in cervical region is called C1 Copyright © 2020 by Elsevier Inc. All rights reserved. 76 Vertebral Ligaments (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 77 Typical Vertebra (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 78 Vertebra: Notes (Slide 1 of 3)  Vertebrae: individual vertebral bones   Vertebral body: anterior weight-bearing portion   Consist of vertebral body and vertebral arch Gradually increase in size from cervical to lumbar regions Intervertebral disks: between vertebral bodies; two regions   Annulus fibrosus: tough outer ring Nucleus pulposus: gel-like center Copyright © 2020 by Elsevier Inc. All rights reserved. 79 Intervertebral Disk (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 80 Vertebra: Notes (Slide 2 of 3)  Vertebral arch: extends from vertebral body      Pedicles: anchor arch to body Spinous process: projects posteriorly Transverse processes: projects laterally Laminae: extend from spinous to transverse processes Superior/inferior articular processes: junction of pedicles and lamina • • • Articular facet: articular surface on processes Facet joint: joint between vertebral articular processes Also called zygapophyseal (Z) joint or apophyseal joint Copyright © 2020 by Elsevier Inc. All rights reserved. 81 Vertebra: Notes (Slide 3 of 3)   Vertebral canal: hole encasing spinal cord Intervertebral foramen: between adjacent vertebrae   Allow passage of spinal nerves and blood vessels Laminar groove: sides of spinous processes  Contains spinal muscles and ligaments Copyright © 2020 by Elsevier Inc. All rights reserved. 82 Atypical Vertebra: Atlas (C1) and Axis (C2) (Modified from Drake, R. L., Vogl, A. W., & Mitchell, A. W. M. [2010]. Gray’s anatomy for students [2nd ed.]. Philadelphia, PA: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 83 Atypical Vertebrae: Sacrum and Coccyx Copyright © 2020 by Elsevier Inc. All rights reserved. 84 Atypical Vertebrae: Notes (Slide 1 of 2)   C1 (atlas): no vertebral body or pedicles C2 (axis): contains dens (odontoid process)   C7 (vertebra prominens): long spinous process; projects posteriorly   Palpable at base of neck Transverse foramen: hole in most cervical transverse processes   Bony protrusion projects superiorly Allows for passage of blood vessels Atlantoaxial (no-no) joint: atlas and axis articulate Copyright © 2020 by Elsevier Inc. All rights reserved. 85 Atypical Vertebrae: Notes (Slide 2 of 2)     Sacrum: triangle-shaped vertebrae Lumbosacral joint: L5 and sacrum articulate Sacroiliac (SI) joints: sacrum and pelvic bones articulate Coccyx (tailbone): small triangle-shaped vertebra  Base of vertebral column Copyright © 2020 by Elsevier Inc. All rights reserved. 86 Learning Objectives Lesson 21.2: Muscles of Scapular Movement, Shoulder Joint Movement, and Muscles of the Elbow, Radioulnar Joint, Wrist, and Hand 2. Identify skeletal muscles and their origins, insertions, and actions of the scapula, shoulders, elbows, radioulnar joints, wrists, and hands. Copyright © 2020 by Elsevier Inc. All rights reserved. 87 Skeletal Muscles  Attach to bones; also attach to ligaments, fascia, membranes, and other structures   Can produce movement at joints To understand these movements or “actions,” learn their attachments and joints they cross  Insertion (I) moves toward its origin (O) Copyright © 2020 by Elsevier Inc. All rights reserved. 88 Muscles: General Rules (Slide 1 of 2)      Origins generally are medial/proximal to insertions Muscles on anterior side of trunk and upper extremity generally flex Muscles on posterior side of lower extremity generally flex Muscles on posterior side of trunk and upper extremity generally extend Muscles on anterior side of lower extremity extend generally extend Copyright © 2020 by Elsevier Inc. All rights reserved. 89 Muscles: General Rules (Slide 2 of 2)        Muscles on medial side generally adduct Muscles on lateral side generally abduct Muscles running superior to inferior generally flex or extend Muscles running obliquely generally rotate If muscle crosses two joints, it acts on both Most muscles have at least two actions Prime movers and antagonists are generally located opposite each other Copyright © 2020 by Elsevier Inc. All rights reserved. 90 Naming Muscles  Muscles are named by:       Origins and insertions Number of origins Relative shape and size Location and/or direction of fibers Actions or functions Combinations Copyright © 2020 by Elsevier Inc. All rights reserved. 91 Skeletal Muscles (Slide 1 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 92 Skeletal Muscles (Slide 2 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 93 Lesson Four: Muscles of Scapular Movement      Trapezius Levator scapulae Rhomboids Serratus anterior Pectoralis minor Copyright © 2020 by Elsevier Inc. All rights reserved. 94 Muscles of Scapular Movement (Slide 1 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 95 Muscles of Scapular Movement (Slide 2 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 96 Trapezius: O’s and I’s   O: external occipital protuberance, superior nuchal line, nuchal ligament, spinous processes of C7-T12 I: lateral third of clavicle, acromion process, scapular spine (From Drake, R., Vogel, A. W., & Mitchell, A. [2015]. Gray’s anatomy for students [3rd ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 97 Trapezius: Notes  Coat hanger muscle   Clothes hang from it like a coat hanger Functions like 3 muscles   Upper, middle, lower fibers perform different actions Can be antagonist to itself (From Drake, R., Vogel, A. W., & Mitchell, A. [2015]. Gray’s anatomy for students [3rd ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 98 Levator Scapulae: O’s and I’s   O: transverse processes of C1-C4 I: medial border of scapula  From superior angle to root of spine (From Drake, R., Vogel, A. W., & Mitchell, A. [2015]. Gray’s anatomy for students [3rd ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 99 Rhomboid Major/Minor: O’s and I’s   O: spinous processes C7-T5 I: medial border of scapula  From superior to inferior angle (From Drake, R., Vogel, A. W., & Mitchell, A. [2015]. Gray’s anatomy for students [3rd ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 100 Rhomboids: Notes   Rhomboids: collective term for rhomboid major and minor Christmas tree muscle: oblique fiber direction  Resembles Christmas tree branches Copyright © 2020 by Elsevier Inc. All rights reserved. 101 Serratus Anterior: O’s and I’s   O: ribs 1-8 or 9 I: anterior medial border of scapula (From Myers, T. W. [2015]. Anatomy trains [3rd ed.]. Edinburgh, Scotland: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 102 Serratus Anterior: Notes  Boxer’s muscle: protracts scapula to deliver a punch  Triceps is also the boxer’s muscle •  Extends elbow Winged scapula: serratus anterior paralysis Copyright © 2020 by Elsevier Inc. All rights reserved. 103 Pectoralis Minor: Os, Is, and Notes    O: ribs 3-5 I: coracoid process of scapula Neurovascular entrapper: can entrap brachial plexus and axillary artery  Can lead to signs and symptoms of thoracic outlet syndrome (From Herring, J. A. [2014]. Tachdjian’s pediatric orthopaedics: From the Texas Scottish Rite Hospital for Children [5th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 104 Lesson Four Review Copyright © 2020 by Elsevier Inc. All rights reserved. 105 Lesson Five: Muscles of Shoulder Joint Movement         Latissimus dorsi Teres major and minor Supraspinatus Infraspinatus Subscapularis Deltoid Pectoralis major Coracobrachialis Copyright © 2020 by Elsevier Inc. All rights reserved. 106 Muscles of Shoulder Joint Movement (Slide 1 of 3) (From Jenkins, D. B. [1991]. Hollinshead’s functional anatomy of the limbs and back [6th ed.]. Philadelphia, PA: Saunders.) Copyright © 2020 by Elsevier Inc. All rights reserved. 107 Muscles of Shoulder Joint Movement (Slide 2 of 3) (From Jenkins, D. B. [1991]. Hollinshead’s functional anatomy of the limbs and back [6th ed.]. Philadelphia, PA: Saunders.) Copyright © 2020 by Elsevier Inc. All rights reserved. 108 Muscles of Shoulder Joint Movement (Slide 3 of 3) (From Jenkins, D. B. [1991]. Hollinshead’s functional anatomy of the limbs and back [6th ed.]. Philadelphia, PA: Saunders.) Copyright © 2020 by Elsevier Inc. All rights reserved. 109 Latissimus Dorsi: O’s and I’s   O: spinous processes T7-L5, ribs 9-12, posterior iliac crest, posterior sacrum I: intertubercular groove of humerus (Modified from Soames, R., & Palastanga, N. [2019]. Anatomy and human movement: Structure and function [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 110 Latissimus Dorsi: Notes    Swimmers muscle: many of its actions are involved in swimming Widest muscle of the body Form posterior axillary folds  Pecs form anterior axillary folds Copyright © 2020 by Elsevier Inc. All rights reserved. 111 Teres Major: Os, Is, and Notes    O: inferior third of lateral border of scapula I: intertubercular groove of humerus Lats’ twin: these two muscles are synergists (From Miller, M., Hart, J., & MacKnight, J. [2010]. Essential orhopaedics. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 112 Rotator Cuff (From Marx, J., Hockberger, R., & Walls, R. [2014]. Rosen’s emergency medicine: Concepts and clinical practice, 2 vols [8th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 113 Rotator Cuff: Notes   Rotator cuff: four muscles enabling rotation SItS:  Supraspinatus •    Does not cause rotation Infraspinatus Teres minor Subscapularis Copyright © 2020 by Elsevier Inc. All rights reserved. 114 Supraspinatus: O’s and I’s   O: supraspinous fossa of scapula I: greater tubercle of humerus (Modified from Soames, R., & Palastanga, N. [2019]. Anatomy and human movement: Structure and function [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 115 Infraspinatus: O’s and I’s   O: infraspinous fossa of scapula I: greater tubercle of humerus (From Myers, T. W. [2015]. Anatomy trains [3rd ed.]. Edinburgh, Scotland: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 116 Teres Minor: O’s and I’s   O: superior two thirds of lateral border of scapula I: greater tubercle of humerus (From Pope, T. L., Bloem, H. L., Beltran, J., Morrison, W. B., & Wilson, D. J. [2014]. Musculoskeletal imaging [2nd ed.]. Philadelphia, PA: Saunders.) Copyright © 2020 by Elsevier Inc. All rights reserved. 117 Subscapularis: O’s, I’s, and Notes    O: subscapular fossa of scapula I: lesser tubercle of humerus Frozen shoulder muscle: trigger points may lead to shoulder immobility (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 118 Deltoid: O’s and I’s   O: lateral third of clavicle, acromion process, scapular spine I: deltoid tuberosity (Modified from Soames, R., & Palastanga, N. [2019]. Anatomy and human movement: Structure and function [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 119 Pectoralis Major: O’s, I’s, and Notes    O: medial half of clavicle, edge of sternal body, ribs 1-7 I: intertubercular groove of humerus Form anterior axillary folds  Lats form posterior axillary folds (From Herring, J. A. [2014]. Tachdjian’s pediatric orthopaedics: From the Texas Scottish Rite Hospital for Children [5th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 120 Coracobrachialis: O’s and I’s   O: coracoid process of scapula I: medial humeral shaft (Modified from Soames, R., & Palastanga, N. [2019]. Anatomy and human movement: Structure and function [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 121 Lesson Five Review Copyright © 2020 by Elsevier Inc. All rights reserved. 122 Lesson 6: Muscles of Elbow and Radioulnar Joint Movement         Biceps brachii Brachialis Brachioradialis Triceps brachii Anconeus Pronator teres Pronator quadratus Supinator Copyright © 2020 by Elsevier Inc. All rights reserved. 123 Muscles of Elbow and Radioulnar Joint Movement (Slide 1 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 124 Muscles of Elbow and Radioulnar Joint Movement (Slide 2 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 125 Biceps Brachii: O’s, I’s, and Notes    O: supraglenoid tubercle of scapula (long head); coracoid process of scapula (short head) I: radial tuberosity, bicipital aponeurosis Corkscrew muscle: supination/flexion used to uncork a bottle (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 126 Brachialis: O’s, I’s, and Notes    O: distal half of anterior humeral shaft I: ulnar tuberosity, coronoid process Workhorse elbow flexor: due to its mechanical advantage (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 127 Brachioradialis: O’s and I’s   O: lateral supracondylar ridge of humerus I: styloid process of radius (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 128 Triceps Brachii: O’s, I’s, and Notes    O: infraglenoid tubercle of scapula, posterior proximal and posterior distal humeral shaft I: olecranon process Boxer’s muscle: extends elbow to deliver a punch  Triceps is also the boxer’s muscle • Protracts scapula (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 129 Anconeus: O’s and I’s   O: lateral epicondyle of humerus I: olecranon process, superior eighth of posterior ulnar shaft Copyright © 2020 by Elsevier Inc. All rights reserved. 130 Pronator Teres: O’s and I’s   O: medial epicondyle of humerus via common flexor tendon, coronoid process of ulna I: midlateral radial shaft (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 131 Pronator Quadratus: O’s and I’s   O: anterior distal quarter of ulnar shaft I: anterior distal quarter of radial shaft (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 132 Supinator: O’s and I’s   O: lateral epicondyle of humerus, proximal eighth of ulnar shaft, radial collateral ligament, annular ligament I: proximal lateral radial shaft (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 133 Lesson Six Review Copyright © 2020 by Elsevier Inc. All rights reserved. 134 Lesson Seven: Muscles of Wrist and Hand Movement (Slide 1 of 2)         Flexor carpi radialis and ulnaris Palmaris longus Flexor digitorum superficialis and profundus Extensor carpi radialis longus and brevis Extensor carpi ulnaris Extensor digitorum Extensor digiti minimi Extensor indicis Copyright © 2020 by Elsevier Inc. All rights reserved. 135 Lesson Seven: Muscles of Wrist and Hand Movement (Slide 2 of 2)        Extensor pollicis longus and brevis Flexor pollicis longus and brevis Opponens pollicis Abductor pollicis longus and brevis Flexor digiti minimi Abductor digiti minimi Opponens digiti minimi Copyright © 2020 by Elsevier Inc. All rights reserved. 136 Muscles of Wrist and Hand Movement (From Roberts, J. [2014]. Roberts and Hedges’ clinical procedures in emergency medicine [6th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 137 Flexor Carpi Radialis: O’s and I’s   O: medial epicondyle of humerus via common flexor tendon I: bases of metacarpals II-III (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 138 Flexor Carpi Ulnaris: O’s and I’s   O: medial epicondyle of humerus via common flexor tendon, medial olecranon, posterior proximal two thirds of ulna I: base of metacarpal V, pisiform, hook of hamate (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 139 Palmaris Longus: O’s, I’s, and Notes    O: medial epicondyle of humerus via common flexor tendon I: palmar aponeurosis Palmar aponeurosis: triangular-shaped structure in central palm (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 140 Flexor Digitorum Superficialis: O’s and I’s   O: medial epicondyle of humerus via common flexor tendon, anterior proximal radial shaft, coronoid process of ulna I: middle phalanges of digits II-V (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 141 Flexor Digitorum Profundus: O’s and I’s   O: anterior proximal three fourths of ulnar shaft, interosseous membrane I: distal phalanges of digits II-V (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 142 Extensor Carpi Radialis Longus: O’s, I’s, and Notes    O: lateral supracondylar ridge of humerus I: posterior base of metacarpal II Extensor retinaculum: fibrous band on posterior wrist (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 143 Extensor Carpi Radialis Brevis: O’s and I’s   O: lateral epicondyle of humerus via common extensor tendon I: posterior base of metacarpal III (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 144 Extensor Carpi Ulnaris: O’s and I’s   O: lateral epicondyle of humerus via common extensor tendon I: metacarpal V (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 145 Extensor Digitorum: O’s and I’s   O: lateral epicondyle of humerus via common extensor tendon I: middle and distal phalanges of digits II-V (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 146 Extensor Digiti Minimi: O’s and I’s   O: lateral epicondyle of humerus via common extensor tendon I: posterior middle and distal phalanges of digit V via tendon of extensor digitorum (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 147 Extensor Indicis: O’s and I’s   O: posterior distal ulnar shaft, interosseous membrane I: middle and distal phalanges of index finger (digit II) (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 148 Extensor Pollicis Longus and Brevis: O’s and I’s   O: posterior ulnar shaft (longus); posterior radial shaft (brevis); interosseous membrane I: posterior distal phalanx of thumb (longus); posterolateral proximal phalanx of thumb (brevis) (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 149 Extensor Pollicis Longus and Brevis: Notes  Anatomic snuffbox: triangular depression on dorsum of hand at base of thumb    Formed by tendons of extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus Visible with wrist adduction, thumb extension, and abduction Used as placement for snuff (powdered tobacco) before inhaled Copyright © 2020 by Elsevier Inc. All rights reserved. 150 Flexor Pollicis Longus and Brevis: O’s, I’s, and Notes    O: anterior radial shaft, interosseous membrane (longus); trapezium, transverse carpal ligament (brevis) I: anterior distal phalanx of thumb (longus); proximal phalanx of thumb (brevis) Thenar eminence: thumb pad on lateral side of palm  Formed by flexor pollicis brevis, opponens pollicis, abductor pollicis Copyright © 2020 by Elsevier Inc. All rights reserved. 151 Flexor Pollicis Longus and Brevis Copyright © 2020 by Elsevier Inc. All rights reserved. 152 Opponens Pollicis: O’s and I’s   O: trapezium, transverse carpal ligament I: anterior metacarpal I (Modified from Soames, R., & Palastanga, N. [2019]. Anatomy and human movement: Structure and function [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 153 Abductor Pollicis Longus and Brevis: O’s and I’s   O: posterior ulnar/radial shaft, interosseus membrane (longus); trapezium, scaphoid, transverse carpal ligament (brevis) I: lateral metacarpal I (longus); lateral proximal phalanx of thumb (brevis) Copyright © 2020 by Elsevier Inc. All rights reserved. 154 Abductor Pollicis Longus and Brevis (Modified from Soames, R., & Palastanga, N. [2019]. Anatomy and human movement: Structure and function [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 155 Flexor Digiti Minimi: O’s, I’s, and Notes    O: hook of hamate, transverse carpal ligament I: proximal phalanx of digit V Hypothenar eminence: medial side of palm  Formed by flexor digiti minimi, abductor digiti minimi, opponens digiti minimi Copyright © 2020 by Elsevier Inc. All rights reserved. 156 Abductor Digiti Minimi: O’s and I’s   O: pisiform, tendon of flexor carpi ulnaris I: proximal phalanx of digit V Copyright © 2020 by Elsevier Inc. All rights reserved. 157 Opponens Digiti Minimi: O’s and I’s   O: hamate, transverse carpal ligament I: metacarpal V Copyright © 2020 by Elsevier Inc. All rights reserved. 158 Lesson Seven Review Copyright © 2020 by Elsevier Inc. All rights reserved. 159 Learning Objectives Lesson 21.3: Muscles of the Hip, Knee, Ankle, and Foot 3. Identify muscles and their origins, insertions, and actions of the hips, knees, ankles, and feet. Copyright © 2020 by Elsevier Inc. All rights reserved. 160 Lesson Eight: Muscles of Hip and Knee Movement (Slide 1 of 2)           Psoas major Iliacus Piriformis Gemellus superior and inferior Obturator internus and externus Quadratus femoris Gluteus maximus, medius, and minimus Tensor fascia lata Rectus femoris Vastus intermedius, medialis, and lateralis Copyright © 2020 by Elsevier Inc. All rights reserved. 161 Lesson Eight: Muscles of Hip and Knee Movement (Slide 2 of 2)          Sartorius Semimembranosus Semitendinosus Biceps femoris Gracilis Adductor magnus, longus, brevis Pectineus Gastrocnemius and plantaris Popliteus Copyright © 2020 by Elsevier Inc. All rights reserved. 162 Muscles of Hip and Knee (Slide 1 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 163 Muscles of Hip and Knee (Slide 2 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 164 Iliopsoas: Notes   Psoas major and iliacus Attach to lesser trochanter (Modified from Muscolino, J. [2010]. Muscular system manual: The skeletal muscles of the human body [3rd ed.]. St. Louis, MO: Mosby.) Copyright © 2020 by Elsevier Inc. All rights reserved. 165 Psoas Major: O’s and I’s   O: transverse processes of T12-L5, vertebral bodies of T12-L5, intervertebral disks of lumbar vertebrae I: lesser trochanter Copyright © 2020 by Elsevier Inc. All rights reserved. 166 Iliacus: O’s and I’s   O: iliac fossa I: lesser trochanter Copyright © 2020 by Elsevier Inc. All rights reserved. 167 Lateral Rotators of the Hip (From Berry, D., & Lieberman J. [2011]. Surgery of the hip. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 168 Lateral (External) Hip Rotators: Notes  Group of six individual muscles        Piriformis Gemellus superior and inferior Obturator internus and externus Quadratus femoris Located deep to gluteus maximus Most attach on greater trochanter Lateral hip rotation is their primary action Copyright © 2020 by Elsevier Inc. All rights reserved. 169 Piriformis: O’s, I’s, and Notes     O: anterior sacrum I: greater trochanter Largest lateral hip rotator 15% of population has part or all of the sciatic nerve running through this muscle (From Hagen-Ansert, S. L. [2018]. Textbook of diagnostic sonography [8th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 170 Gemellus Superior: O’s and I’s   O: ischial spine I: greater trochanter (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 171 Gemellus Inferior: O’s and I’s   O: superior ischial tuberosity I: greater trochanter Copyright © 2020 by Elsevier Inc. All rights reserved. 172 Obturator Internus: O’s and I’s   O: obturator membrane, obturator margin I: greater trochanter Copyright © 2020 by Elsevier Inc. All rights reserved. 173 Obturator Externus: O’s and I’s   O: obturator membrane, superior/inferior pubic rami, ischial ramus I: greater trochanter Copyright © 2020 by Elsevier Inc. All rights reserved. 174 Quadratus Femoris: O’s and I’s   O: lateral ischial tuberosity I: intertrochanteric crest Copyright © 2020 by Elsevier Inc. All rights reserved. 175 Gluteals: Notes  Group of three buttocks muscles     Gluteus maximus Gluteus medius Gluteus minimus These muscles can be antagonists to each other (From Drake, R., Vogel, A. W., & Mitchell, A. [2015]. Gray’s anatomy for students [3rd ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 176 Gluteus Maximus: O’s and I’s   O: posterior sacrum, coccyx, iliac crest, external ilium to posterior gluteal line I: gluteal tuberosity (25% of fibers), iliotibial band (75% of fibers) Copyright © 2020 by Elsevier Inc. All rights reserved. 177 Gluteus Maximus: Notes    Strongest hip extensor One of strongest muscles in the body Iliotibial band (ITB): thickened band of the fascia lata    Located on the lateral thigh Helps stabilize the hip and knee Fascia lata: surrounds thigh like a tight stocking Copyright © 2020 by Elsevier Inc. All rights reserved. 178 Gluteus Medius: O’s and I’s   O: external ilium between anterior/posterior gluteal lines I: greater trochanter Copyright © 2020 by Elsevier Inc. All rights reserved. 179 Gluteus Minimus: O’s and I’s   O: external ilium between anterior/inferior gluteal lines I: greater trochanter Copyright © 2020 by Elsevier Inc. All rights reserved. 180 Tensor Fasciae Latae: O’s and I’s   O: anterior iliac crest, ASIS I: ITB Copyright © 2020 by Elsevier Inc. All rights reserved. 181 Adductors: Notes  Group of five muscles      Gracilis Adductor magnus, longus, and brevis Pectineus All adduct the hip Originate on pubis and ischium  Insert primarily on linea aspera (From Frontera, W. R., Silver, J. K., & Rizzo Jr., T. D. [2019]. Essentials of physical medicine and rehabilitation. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 182 Gracilis: O’s, I’s, and Notes    O: inferior pubic ramus I: medial proximal tibial shaft (at pes anserinus) Pes anserinus: conjoined tendons of gracilis, semitendinosus, and sartorius Copyright © 2020 by Elsevier Inc. All rights reserved. 183 Adductor Magnus: O’s and I’s   O: ischial tuberosity, inferior pubic ramus, ischial ramus I: linea aspera, adductor tubercle of femur Copyright © 2020 by Elsevier Inc. All rights reserved. 184 Adductor Longus: O’s and I’s   O: anterior pubic body I: middle third of linea aspera Copyright © 2020 by Elsevier Inc. All rights reserved. 185 Adductor Brevis: O’s and I’s   O: inferior pubic ramus I: proximal third of linea aspera Copyright © 2020 by Elsevier Inc. All rights reserved. 186 Pectineus: O’s and I’s   O: superior pubic ramus, pectineal line on pubis I: posterior proximal femoral shaft Copyright © 2020 by Elsevier Inc. All rights reserved. 187 Quadriceps Femoris (From Sud, A., & Ranjan, R. [2019]. Textbook of orthopaedics. India: Elsevier India.) Copyright © 2020 by Elsevier Inc. All rights reserved. 188 Quadriceps Femoris: Notes  Group of four muscles        Rectus femoris Vastus lateralis Vastus intermedius Vastus medialis Located on anterolateral thigh Primary actions are knee extension Inserts on tibial tuberosity via the patella Copyright © 2020 by Elsevier Inc. All rights reserved. 189 Rectus Femoris: O’s, I’s, and Notes    O: AIIS, external ilium superior to acetabulum I: tibial tuberosity Only quad crossing two joints  Hip and knee Copyright © 2020 by Elsevier Inc. All rights reserved. 190 Vastus Intermedius: O’s and I’s   O: anterior lateral femoral shaft I: tibial tuberosity Copyright © 2020 by Elsevier Inc. All rights reserved. 191 Vastus Medialis: O’s, I’s, and Notes     O: linea aspera, intertrochanteric line I: tibial tuberosity Teardrop muscle: because of its shape Vastus medialis oblique (VMO): part of muscle with oblique fiber arrangement Copyright © 2020 by Elsevier Inc. All rights reserved. 192 Vastus Lateralis: O’s and I’s   O: linea aspera, gluteal tuberosity I: tibial tuberosity Copyright © 2020 by Elsevier Inc. All rights reserved. 193 Sartorius: O’s, I’s, and Notes      O: ASIS I: medial proximal tibial shaft (at pes anserinus) Tailor’s muscle: actions allow legs to cross, position tailors sat to sew Longest muscle in body Pes anserinus: conjoined tendons of sartorius, semitendinosus, and gracilis Copyright © 2020 by Elsevier Inc. All rights reserved. 194 Popliteus: O’s, I’s, and Notes    O: lateral condyle of femur I: posterior proximal tibial shaft Key that unlocks the knee: unlocks an extended knee  Begins first few degrees of flexion Copyright © 2020 by Elsevier Inc. All rights reserved. 195 Hamstrings (From Liebgott, B. [2018]. The anatomical basis of dentistry [4th ed.]. St. Louis, MO: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 196 Hamstrings: Notes  Group of three posterior thigh muscles       Biceps femoris Semimembranosus Semitendinosus Attach to ischial tuberosity Primary actions are knee flexion and hip extension Contains four heads that lie the medial or lateral side of the thigh Copyright © 2020 by Elsevier Inc. All rights reserved. 197 Semimembranosus: O’s and I’s   O: ischial tuberosity I: medial condyle of tibia Copyright © 2020 by Elsevier Inc. All rights reserved. 198 Semitendinosus: O’s, I’s, and Notes    O: ischial tuberosity I: medial proximal tibial shaft (at pes anserinus) Pes anserinus: conjoined tendons of semitendinosus, gracilis, and sartorius Copyright © 2020 by Elsevier Inc. All rights reserved. 199 Biceps Femoris: O’s and I’s   O: ischial tuberosity, sacrotuberous ligament (long head); linea aspera (short head) I: fibular head Copyright © 2020 by Elsevier Inc. All rights reserved. 200 Pes Anserinus  Three conjoined tendons on the medial proximal tibial shaft (From Donatelli, R. A. [2010]. Orthopedic physical therapy [4th ed.]. St. Louis, MO: Churchill Livingstone.) Copyright © 2020 by Elsevier Inc. All rights reserved. 201 Lesson Eight Review (Slide 1 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 202 Lesson Eight Review (Slide 2 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 203 Lesson Nine: Muscles of Ankle and Foot Movement (Slide 1 of 2)     Tibialis anterior Extensor digitorum longus and brevis Extensor hallucis longus Fibularis longus, brevis, and tertius Copyright © 2020 by Elsevier Inc. All rights reserved. 204 Lesson Nine: Muscles of Ankle and Foot Movement (Slide 2 of 2)       Gastrocnemius Plantaris Soleus Tibialis posterior Flexor digitorum longus Flexor hallucis longus Copyright © 2020 by Elsevier Inc. All rights reserved. 205 Muscles of Ankle and Foot (Slide 1 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 206 Muscles of Ankle and Foot (Slide 2 of 2) Copyright © 2020 by Elsevier Inc. All rights reserved. 207 Tibialis Anterior: O’s, I’s, and Notes    O: proximal half of lateral tibial shaft, interosseous membrane I: metatarsal I, medial cuneiform Stirrup muscle: tendons of this and fibularis longus attach to metatarsal I and medial cuneiform under foot Copyright © 2020 by Elsevier Inc. All rights reserved. 208 Extensor Digitorum Longus and Brevis: O’s and I’s   O: fibular head, proximal two thirds of anterior fibular shaft, lateral condyle of tibia, anterior surface of interosseous membrane (longus); calcaneus (brevis) I: middle/distal phalanges of digits II-V (longus); tendons of extensor digitorum longus to digits II-IV (brevis) Copyright © 2020 by Elsevier Inc. All rights reserved. 209 Extensor Digitorum Longus and Brevis Copyright © 2020 by Elsevier Inc. All rights reserved. 210 Extensor Hallucis Longus: O’s and I’s   O: anterior fibular shaft, interosseous membrane I: distal phalanx of great toe Copyright © 2020 by Elsevier Inc. All rights reserved. 211 Fibularis Longus: O’s, I’s, and Notes    O: fibular head, lateral proximal half of fibular shaft I: metatarsal I, medial cuneiform Stirrup muscle: tendons of this and tibialis anterior attach to metatarsal I and medial cuneiform under foot (From Soames, R. W. [2019]. Anatomy and human movement [7th ed.]. Philadelphia, PA: Elsevier.) Copyright © 2020 by Elsevier Inc. All rights reserved. 212 Fibularis Brevis: O’s and I’s   O: lateral distal half of fibular shaft I: metatarsal V Copyright © 2020 by Elsevier Inc. All rights reserved. 213 Fibularis Tertius: O’s and I’s   O: lateral distal third of fibular shaft, interosseous membrane I: metatarsal V Copyright © 2020 by Elsevier Inc. All rights reserved. 214 Gastrocnemius: O’s, I’s, and Notes     O: medial/lateral epicondyle of femur I: calcaneus via Achilles tendon Achilles tendon: tough fibrous band attaching to calcaneus Toe dancer’s muscle: helps ballet dancers stand on pointe Copyright © 2020 by Elsevier Inc. All rights reserved. 215 Plantaris: O’s and I’s   O: lateral epicondyle of femur I: calcaneus via Achilles tendon Copyright © 2020 by Elsevier Inc. All rights reserved. 216 Soleus: O’s and I’s   O: superior posterior third of fibular shaft, soleal line of tibia I: calcaneus via Achilles tendon Copyright © 2020 by Elsevier Inc. All rights reserved. 217 Tibialis Posterior: O’s and I’s   O: posterior tibial/fibular shafts, interosseous membrane I: plantar surfaces of most tarsals (navicular, cuneiforms, cuboid, calcaneus), bases of metatarsals II-IV Copyright © 2020 by Elsevier Inc. All rights reserved. 218 Flexor Digitorum Longus: O’s and I’s   O: posterior tibial shaft I: distal phalanges of digits II-V Copyright © 2020 by Elsevier Inc.