Anatomy 🫀 Flashcards
what are the muscles of the pectoral region?
- Pectoralis major
- Pectoralis minor
- Subclavius
- Serratus Anterior
what is the origin of Pectoralis major?
(2 heads)
Clavicular head:
- anterior surface of the medial half of the clavicle.
Sternocostal head:
- Anterior surface of the sternum.
- Upper 6 costal cartilages.
- Aponeurosis of external oblique.
what is the insertion of Pectoralis major?
lateral lip of bicipital groove
what is the nerve supply of Pectoralis major?
Medial and lateral pectoral nerves
what is the action of Pectoralis major?
Two heads:
1. Adduction & medial rotation of the arm.
2. Accessory muscle of respiration.
3. In climbing, draws body upwards.
Clavicular head:
- Helps in flexion of the arm.
origin of Pectoralis minor
3rd, 4th and 5th ribs close to their costochondral junction.
insertion of Pectoralis minor
Coracoid process.
nerve supply of Pectoralis minor
Medial pectoral nerve
action of Pectoralis minor
- Protraction of scapula.
- Depression of scapula.
- Accessory muscle of respiration.
origin of Subclavius
Superior surface of the 1st rib.
insertion of Subclavius
Groove on the inferior surface of the intermediate third of the clavicle.
nerve supply of Subclavius
nerve to subclavius.
action of Subclavius
- Steady the clavicle during movement of shoulder girdle.
- Acts as a buffer to protect the great vessels and nerves from the bone.
origin of Serratus Anterior
eight fleshy digitations from the outer surface of the upper 8 ribs
insertion of Serratus Anterior
- Into the medial border of scapula.
- Lower 5 digitations: into the inferior angle.
nerve supply of Serratus Anterior
Long thoracic nerve
action of Serratus Anterior
- The chief muscle to protraction of scapula.
- The lower 5 digitations: upward rotation of the scapula (raise the arm above the head).
- Accessory muscle of respiration
what are the muscles of the back?
Superficial:
- Trapezius
- Latissimus dorsi
Deep:
- Levator scapulae
- Rhomboid minor
- Rhomboid major
From head, Neck & Thorax
origin of Trapezius
- External occipital protuberance (skull)
- Superior nuchal line (medial 1/3)
- Ligamentun nuchae
- Spine of C7
- All thoracic spines & their supraspinous ligaments
insertion of Trapezius
Upper fibers: Lateral 1/3 of clavicle (posterior border)
Middle fibers:
- Medial border of Acromion process
- Upper lip of crest of spine of scapula
Lower fibers: tubercle on lower lip of crest of spine of scapula
nerve supply of Trapezius
- Spinalaccessorynerve
- C3-4 (proprioceptive)
action of Trapezius
Upper fibers: elevation of scapula & shoulder
Lower fibers: depression of scapula & shoulder
Middle fibers: retraction of scapula
Upper and lower fibers: act together in upward rotation of scapula
From Thorax, Abdomen & Pelvis
origin of Latissimus dorsi
- Outer lip of iliac crest (post part)
- Thoraco-lumbar fascia
- Lower 6 thoracic Spines & their supraspinous ligaments
- Lower 3-4 ribs
- Back of inferior angle of scapula
insertion of Latissimus dorsi
floor of bicipital groove of humerus
nerve supply of Latissimus dorsi
Thoracodorsal N (N to latissimus dorsi)
action of Latissimus dorsi
- Extension, adduction & medial rotation
- raises body toward arms during climbing
- Help in violent expiratory movements (cough & sneez)
origin of Levator scapulae
transverse processes of upper 4 cervical vertebrae
insertion of Levator scapulae
back of medial border of scapula (from upper angle to the spine)
origin of Rhomboid minor
- Ligamentum nuchae
- Spines of C7 & T1
insertion of Rhomboid minor
Back of medial border of scapula Opposite the spine
origin of Rhomboid major
Spines of 2nd, 3rd, 4th and 5th thoracic vertebrae
insertion of Rhomboid major
back of medial border of scapula from spine to inferior angle
nerve supply of Levator scapulae, Rhomboid minor & Rhomboid major
Nerve to rhomboids (dorsal scapular N (C5)
action of Levator scapulae, Rhomboid minor & Rhomboid major
- Elevation & Retraction of scapula
- Depression of shoulder (downward rotation of scapula)
- Fixation of scapula to thoracic wall
what are the muscles of the front of the forearm (Flexor group)?
Superficial Group
- Pronator teres
- Flexor carpi radialis
- Palmaris langus
- Flexor carpi ulnaris
Middle Group
- Flexor digitorum superficialis
Deep Group
- Flexor digitorum profundus
- Flexor pollices longus
- Pronator quadratus
Origin, insertion, Nerve supply & action of Pronator teres
Origin
- (common flexor origin) from the Front of medial epicondyle
- Has another head from the ulna (deep head)
Insertion
- Middle of lateral surface of radius.
Nerve Supply
- Median nerve.
Action
- Pronation of the forearm
Origin, insertion, Nerve supply & action of Flexor Carpi Radialis
Origin
- (common flexor origin) from the Front of medial epicondyle
Insertion
- 2nd and 3rd metacarpal bones.
Nerve Supply
- Median nerve
Action
- Flexion and abduction of wrist joint
Origin, insertion, Nerve supply & action of Palmaris Longus
Origin
- (common flexor origin) from the Front of medial epicondyle
Insertion
- flexor retinaculum.
- palmar aponeurosis.
Nerve Supply
- Median nerve
Action
- Flexion of wrist joint.
Origin, insertion, Nerve supply & action of Flexor Carpi Ulnaris
Origin
- (common flexor origin) from the Front of medial epicondyle
- Has another head from the ulna (deep head)
Insertion
- pisiform bone
- hamate
- 5th metacarpal bones.
Nerve Supply
- Ulnar nerve
Action
- Flexion and adduction of wrist joint.
Origin, insertion, Nerve supply & action of Flexor Digitorum Superficialis
Origin
- (common flexor origin) from the Front of medial epicondyle
- Has additional origin from the radius and ulna
a) Humero-ulnar head
b) Radial head
Insertion
- Middle phalanges of medial 4 fingers.
Nerve Supply
- Median nerve
Action
- Flexion of metacarpo-phalangeal and proximal interphalangeal (PIP) joints of medial 4 fingers.
Origin, insertion, Nerve supply & action of Flexor Digitorum Profundus
Origin
- anterior and medial surface of ulna
Insertion
- Distal phalanges of medial four fingers.
Nerve Supply
- Medial 1/2: ulnar nerve
- Lateral 1/2: median nerve
Action
- Flexion of all joints of medial four fingers.
Origin, insertion, Nerve supply & action of Flexor Pollicis Longus
Origin
- anterior surface of radius
Insertion
- distal phalanx of thumb
Nerve Supply
- Median nerve
Action
- Flexion of all joints of thumb.
Origin, insertion, Nerve supply & action of Pronator Quadratus
Origin
- Lower part of the front of ulna.
Insertion
- Lower part of the front of radius
Nerve Supply
- Median nerve
Action
- Pronation of radioulnar joint.
what are the muscles of the back of the forearm (Extensor group)?
Superficial:
- Brachioradialis
- Extensor carpi radialis longus (ECRL)
- Extensor Carpi radialis Brevis (ECRB)
- Extensor Digitorum
- Extensor Digiti Minimi
- Extensor Carpi Ulnaris
- Anconeus
Deep:
- Supinator
- Abductor Pollicis Longus
- Extensor Pollicis Brevis
- Extensor Pollicis Longus
- Extensor indicis
Origin, insertion, Nerve supply & action of Brachioradialis
Origin
- Upper 2/3 of lateral supracondylar ridge.
Insertion
- Lower end of radius just above styloid process.
Nerve Supply
- Radial nerve
Action
1. Brings supinated or pronated forearm into midprone position.
2. Flexion of elbow joint in mid prone position.
Origin, insertion, Nerve supply & action of Extensor carpi radialis longus (ECRL)
Origin
- (common extensor origin) from the Front of lateral epicondyle
- Lower 1/3 of lat. supracondylar ridge.
Insertion
- 2nd metacarpal bone
Nerve Supply
- Radial nerve
Action
- Extension & Abduction of wrist joint.
Origin, insertion, Nerve supply & action of Extensor Carpi radialis Brevis (ECRB)
Origin
- (common extensor origin) from the Front of lateral epicondyle
Insertion
- 3rd metacarpal bone
Nerve Supply
- Radial nerve
Action
- Extension & Abduction of wrist joint.
Origin, insertion, Nerve supply & action of Extensor Digitorum
Origin
- (common extensor origin) from the Front of lateral epicondyle
Insertion
- Middle and distal phalanges of medial 4 fingers through their extensor expansion.
Nerve Supply
- Radial nerve
Action
- Extension of the medial 4 fingers
Origin, insertion, Nerve supply & action of Extensor Digiti Minimi
Origin
- (common extensor origin) from the Front of lateral epicondyle
Insertion
- Extensor expansion of little finger
Nerve Supply
- Radial nerve
Action
- Extension of the little finger.
Origin, insertion, Nerve supply & action of Extensor Carpi Ulnaris
Origin
- (common extensor origin) from the Front of lateral epicondyle
- Posterior border of ulna.
Insertion
- 5th metacarpal bone
Nerve Supply
- Radial nerve
Action
- Extension & adduction of wrist joint.
Origin, insertion, Nerve supply & action of Anconeus
Origin
- Back of the lateral epicondyle.
Insertion
- Olecranon process
Nerve Supply
- Radial nerve
Action
- extension of the elbow joint
Origin, insertion, Nerve supply & action of Supinator muscle
Origin
- Supinator crest.
- Supinator fossa.
- Lateral epicondyle.
- Annular ligament.
Insertion
- Upper third of radius.
Nerve Supply
- Radial nerve
Action
- Supination of the forearm.
Origin, insertion, Nerve supply & action of Abductor Pollicis Longus
Origin
- Posterior surface of ulna & radius.
Insertion
- First metacarpal bone.
Nerve Supply
- Radial nerve
Action
- Abduction of the thumb.
Origin, insertion, Nerve supply & action of Extensor Pollicis Brevis
Origin
- Posterior surface of radius
Insertion
- Proximal phalanx of thumb.
Nerve Supply
- Radial nerve
Action
- Extension of the thumb
Origin, insertion, Nerve supply & action of Extensor Pollicis Longus
Origin
- Posterior surface of ulna
Insertion
- Distal phalanx of thumb.
Nerve Supply
- Radial nerve
Action
- Extension of the thumb
Origin, insertion, Nerve supply & action of Extensor indicis
Origin
- Posterior surface of ulna
Insertion
- Extensor expansion of index finger.
Nerve Supply
- Radial nerve
Action
- Extension of the index.
what is the Site of the axilla?
Space between the upper part of the thorax and the upper part of the arm.
what is the shape and characters of the axilla?
- Pyramidal in shape.
- It has apex, base and 4 walls.
what is the direction of the apex of Axilla?
Directed upwards towards the root of the neck.
what are the boundaries of the apex of Axilla?
- It is triangular bony space (cervico- axillary canal) bounded by:
1) Anteriorly: clavicle.
2) Posteriorly: upper border of scapula.
3) Medially: outer border of 1st rib.
what is the direction and boundaries of the (Base) floor of the axilla?
- Directed downwards.
Formed by:
1. Skin of the armpit
2. Axillary fascia.
what are the walls of the Axilla?
anterior, posterior, medial & lateral
what forms the Anterior wall of the axilla?
1) Pectoralis major.
2) Subclavius and pectoralis minor
3) Clavipectoral fascia.
what forms the posterior Wall of Axilla?
1) Subscapularis above.
2) Teres major
3) latissimus dorsi below
what form is the medial wall of the axilla?
1) Upper 4 or 5 ribs with the intercostal muscles between them.
2) Serratus anterior muscle.
what forms the lateral wall of the axilla?
1) Bicepital groove.
2) Biceps brachii.
3) Coracobrachialis
what are the contents of the axilla?
1) Axillary artery.
2) Axillary vein.
3) Axillary lymph nodes.
4) Axillary tail of the breast.
5) Axillary fat and loose areolar tissue.
6) Cords & branches of brachial plexus.
where is the site of axillary lymph nodes?
They are found in the fibro fatty connective tissue of the axilla.
what are the groups of axillary lymph nodes?
- They are arranged in five principal groups:
1) Apical
2) Pectoral
3) Subscapular
4) Humeral
5) Central
what is the definition of Clavipectoral fascia?
Strong fibrous sheet situated under cover of clavicular head of pectoralis major.
what is the site of Clavipectoral fascia?
Occupies the gap between the clavicle and pectoralis minor.
attachment of Clavipectoral fascia
Above
- Splits to enclose the subclavius muscle then attaches to the clavicle.
Below
- Splits to enclose the pectoralis minor muscle then continues downward as the suspensory ligament of the axilla and joins its fascial floor.
what are the structures of the pierce the Clavipectoral fascia?
- Acromio-thoracic artery
- Cephalic vein
- Lateral pectoral nerve
- Lymphatics
what are examples of intermuscular spaces?
- Quadrangular space
- Upper triangular space
- Lower triangular space
what are the boundaries and the contents of the quadrangular space?
Boundaries
- Superiorly: Subscapularis (anteriorly), Teres minor (posteriorly).
- lnferiorly: Teres major.
- Medially: Long head of triceps.
- Laterally: Surgical neck of humerus.
Contents
- Axillary (circumflex) nerve.
- Posterior circumflex humeral vessels.
what are the boundaries and contents of the upper triangular space?
Boundaries
- Superiorly: Subscapularis and teres minor.
- Inferiorly: Teres major.
- Laterally: Long head of triceps.
Contents
- Circumflex scapular artery
what are the boundaries and the contents of the lower Triangular space?
Boundaries
- Superiorly: Teres major.
- Medially: Long head of triceps.
- Laterally: Shaft of the humerus.
contents
- Radial nerve.
- Profunda brachii vessels.
what is the definition of a cubital fossa?
Hollow Triangular space situated in front of the elbow occupying the upper third of the forearm
what are the boundaries of the cubital fossa?
- Lateral border: medial border of brachioradialis.
- Medial border: lateral border of pronator teres.
- Base: imaginary line between the two humeral epicondyles.
what forms the roof of the cubital fossa?
- Skin.
- Superficial fascia containing:
1. Median cubital vein.
2. cutaneous nerves of forearm - Deep fascia and bicepital aponeurosis
what forms the floor of the cubital fossa?
- Brachialis (medially).
- Supinator (laterally).
what are the contents of the cubital fossa?
From medial to lateral:
1. Median nerve.
2. Termination of brachial artery and its bifurcation into Ulnar and Radial arteries
3. Biceps tendon.
4. Radial nerve and its deep branch.
what are the stages of brachial plexus?
- Roots
- Trunks
- Divisions
- Cords
roots of brachial plexus
These are the anterior primary rami of C5, 6, 7, 8, T1.
Trunks of brachial plexus
3 trunks lie in the posterior triangle of the neck, pass laterally over the 1st rib to enter the axilla.
- Upper trunk: formed by C5, 6 roots.
- Middle trunk: formed by C7 root.
- Lower trunk: formed by C8, T1 roots.
Divisions of brachial plexus
Each trunk is divided into anterior & posterior divisions.
Cords of brachial plexus
3 cords lie in the axilla & are related to 2nd part of axillary artery.
- Lateral cord: formed by the anterior divisions of the upper & middle trunks.
- Medial cord: formed by the anterior division of lower trunk.
- Posterior cord: formed by all the posterior divisions.
what is the position of stages of brachial plexus?
Roots & trunks lie in the neck, divisions lie behind the clavicle, cords& branches lie in the axilla.
what are the branches of the brachial plexus?
- From the Roots
- From the Trunks
- From the Cords
branches from the root of brachial plexus
- Dorsal scapular nerve (C5): Nerve to rhomboid.
- Long thoracic nerve (C5, 6, 7): Nerve to serratus anterior.
branches from the trunks of brachial plexus
(only from the upper trunk (C5 & 6))
- Suprascapular nerve: passes through the suprascapular notch to supply supraspinatus & infraspinatus muscles.
- Nerve to subclavius.
branches from the lateral cord of brachial plexus (C5,6&7)
- Lateral pectoral nerve: supplies pectoralis major.
- Lateral root of median nerve.
- Musculocutaneous nerve (C5, 6, 7).
branches from the Medial cord of brachial plexus (C8&T1)
- Medial pectoral nerve: supplies pectoralis major & minor.
- Medial cutaneous nerves of the arm.
- Medial cutaneous nerves of the forearm.
- Medial root of median nerve.
- Ulnar nerve.
Branches from the posterior cord of brachial plexus (C5,6,7,8&T1)
- Upper subscapular nerve (C5 & 6): supplies subscapularis.
- Lower subscapular nerve (C5 & 6): supplies subscapularis& teres major.
- Nerve to latissimus dorsi (C6, 7 & 8): Thoraco-dorsal nerve.
- Axillary nerve (C5, 6).
- Radial nerve (C5, 6, 7, 8, T1).
what are the lesions of brachial plexus?
- lesion in the upper trunk of brachial plexus C5&6 (Erb’s Paralysis)
- lesion in in the lower trunk of brachial plexus (Klumpk’s Paralysis)
what causes lesion in the upper trunk of brachial plexus C5&6 (Erb’s Paralysis)?
head traction during birth.
what deformity results from legion in upper trunk of brachial plexus?
waiter’s tip position (policeman’s position):
- Adduction of the shoulder, extension & pronation of forearm.
what causes lesion in in the lower trunk of brachial plexus (Klumpk’s Paralysis)?
- Stretch of the upper limb during climbing.
- Difficult breech delivery.
what is the deformity that results from lesion in in the lower trunk of brachial plexus (Klumpk’s Paralysis)?
paralysis of the muscles of the hand and claw hand.
what is the origin of axillary nerve?
from the posterior cord of the brachial plexus (C5, 6).
course of axillary nerve
- Passes backward through the quadrangular space with the posterior circumflex humeral artery.
- It ends by dividing into anterior & posterior divisions.
what does a lesion in the axillary nerve cause?
paralysis of the deltoid muscle
what are the causes of lesions in axillary nerve?
- Dislocation of shoulder.
- Fracture of surgical neck of the humerus.
what are the results of a lesion in the axillary nerve?
Flat shoulder due to paralysis & atrophy of the deltoid muscle.
what is the origin of musculocutaneous nerve?
from the lateral cord of the brachial plexus.
course of musculocutaneous nerve
Pierces the coracobrachialis to descend between brachialis & biceps.
termination of musculocutaneous nerve
continues as lateral cutaneous nerve of the forearm.
- Medial cutenous nerves to the arm & forearm: From the medial cord
- Superior & Inferior Lateral cutenous nerve to the arm: From the axillary and radial respictively (Posterior cord)
- Lateral cutenous nerve to the forearm: From the musculocutenous nerve (lateral cord)
- Posterior cutenous to the arm & forearm: From the radial nerve (Posterior cord)
what are the branches of musculocutaneous nerve?
- Muscular: to biceps brachii, brachialis & coracobrachialis.
- Cutaneous: lateral aspect of the forearm till root of thumb.
Origin of Gluteus maximus
- gluteal surface of the ilium behind the posterior gluteal line.
- sacrum & coccyx.
- sacrotuberous ligament.
Insertion of Gluteus maximus
superficial3/4: into the iliotibial tract.
deep 1/4: into the gluteal tuberosity of the femur.
Nerve supply of Gluteus maximus
Inferior gluteal nerve.
Action of Gluteus maximus
- Main extensor of the hip joint
- Powerful lateral rotator of the hip
- helps in extension of the knee joint
- Steadies the femur on the tibia during standing
Origin of Gluteus medius
gluteal surface of the ilium between the anterior and posterior gluteal line.
Insertion of Gluteus medius
lateral surface of the greater trochanter.
Nerve supply of Gluteus medius
Superior gluteal nerve
Action of Gluteus medius
- Abduction and medial rotation of the hip.
- Stabilize the pelvis during walking (prevent tilting of the pelvis when the opposite limb is raised off the ground).
Origin of Gluteus minimus
gluteal surface of the ilium between the anterior and inferior gluteal lines.
Insertion of Gluteus minimus
anterior surface of the greater trochanter
Nerve supply of Gluteus minimus
Superior gluteal nerve
Action of Gluteus minimus
- Abduction and medial rotation of the hip.
- Stabilize the pelvis during walking (prevent tilting of the pelvis when the opposite limb is raised off the ground).
Origin of Tensor fasciae lata
anterior part of the outer lip of iliac crest
Insertion of Tensor fasciae lata
iliotibial tract
Nerve supply of Tensor fasciae lata
Superior gluteal nerve
Action of Tensor fasciae lata
- Abduction and medial rotation of the hip.
- helps in extension of the knee joint
- Steadies the femur on the tibia during standing
Small lateral rotators of the thigh
what is the definition of iliotibial tract?
it is thickened Lateral part of deep fascia of the thigh
extension of iliotibial tract
from tubercle of iliac crest to the lateral tibial condyle.
what is the function of iliotibial tract?
- It receives insertion of two muscles (tensor fascia lata and gluteus maximus)
- Help in extension of the knee joint.
- maintains the erect posture by:
1. Steadies the pelvis on the femur.
2. Steadies the femur on the tibia.
Origin of Biceps femoris
long head: arises from the ischial tuberosity.
short head: Arises from the lateral lip of the linea aspera and lateral supracondylar line.
Insertion of Biceps femoris
Styloid process of the fibula.
Nerve supply of Biceps femoris
long head: sciatic nerve (tibial part).
short head: sciatic nerve (common peroneal part).
Action of Biceps femoris
- Flexion and lateral rotation of the knee (locking after fully extension).
- Extension of the hip joint.
Origin of Semi-tendinosus
from the ischial tuberosity
Insertion of Semi-tendinosus
upper part of the medial surface of the tibia behind the sartorius and gracilis muscles (SGS)
Nerve supply of Semi-tendinosus
sciatic nerve (tibial part).
Action of Semi-tendinosus
- Flexion and medial rotation of the knee.
- Extension of the hip joint.
Origin of Semi-membranosus
from the ischial tuberosity
Insertion of Semi-membranosus
groove on the back of the medial tibial condyle.
Nerve supply of Semi-membranosus
sciatic nerve (tibial part).
Action of Semi-membranosus
- Flexion and medial rotation of the knee.
- Extension of the hip joint.
what divides the leg into compartments?
The leg is subdivided into three compartments by means of the anterior and the posterior intermuscular septa and the interosseous membrane between the interosseous borders of the tibia and fibula
what are the compartments of the leg?
Anterior compartment: contains the extensor group of muscles.
Lateral compartment: contains the peroneal group of muscles.
Posterior compartment: contains the flexor group of muscles.
what are the contents of the anterior compartment Of the leg?
- Tibialis anterior muscle.
- Extensor digitorum longus muscle.
- Extensor hallucis longus muscle.
- Peroneus tertius muscle.
- Anterior tibial vessels.
- Anterior tibial (deep peroneal) nerve.
what are the contents of the lateral compartment of the leg?
- Peroneus longus muscle.
- Peroneus brevis muscle.
- Superficial peroneal nerve (Musculocutaneous nerve).
Origin, Insertion, Nerve Supply & Action of Tibialis anterior
Origin:
- The upper half of the lateral surface of the tibia.
Insertion:
- Medial cuneiform bone.
- 1st metatarsal bone
Nerve Supply:
- Deep peroneal nerve
- Recurrent genicular nerve
Action:
- Dorsiflexion of the ankle joint
- inversion of the foot at subtalar joints
Origin, Insertion, Nerve Supply & Action of Extensor digitorum longus
Origin:
- The upper 3/4 of the anterior surface of the fibula.
Insertion:
- Middle and distal phalanges of the lateral 4 toes through the extensor expansions.
Nerve Supply:
- Deep peroneal nerve
Action:
- Dorsiflexion of the ankle joint
- inversion of the foot at subtalar joints
- extension of all joints of the lateral four toes
Origin, Insertion, Nerve Supply & Action of Extensor Hallucis longus
Origin:
- The middle 2/4 of the anterior surface of the fibula.
Insertion:
- distal phalanx of big toe
Nerve Supply:
- deep peroneal nerve
Action:
- Dorsiflexion of the ankle joint
- inversion of the foot at subtalar joints
- extension of all joints of the big toe
Origin, Insertion, Nerve Supply & Action of Peroneus tertius
Origin:
- The lower 1/4 of the anterior surface of the fibula
Insertion:
- 5th metatarsal bone.
Nerve Supply:
- Deep peroneal nerve
Action:
- Dorsiflexion of the ankle joint
- Eversion of the foot at the subtalar joints
Origin, Insertion, Nerve Supply & Action of Peroneus longus
Origin:
- The lateral surface of the head of the fibula.
- The upper 2/3 of the lateral surface of the shaft of the fibula.
Insertion:
- Medial cuneiform bone.
- 1st metatarsal bone
Nerve Supply:
- superficial peroneal nerve
Action:
- Eversion of the foot at the subtalar joints
- Planter flexion of the ankle joint.
- Maintains the transverse arch of the foot
Origin, Insertion, Nerve Supply & Action of Peroneus brevis
Origin:
- The lower 2/3 of the lateral surface of the shaft of the fibula
Insertion:
- 5th metatarsal bone.
Nerve Supply:
- superficial peroneal nerve
Action:
- Eversion of the foot at the subtalar joins
- Planter flexion of the ankle joint.
- Maintains the transverse arch of the foot
what are the parts of the posterior compartment of the leg?
It is divided into three layers of muscle by two layers of fasciae:
The superficial layer: consists of the powerful plantar flexors of the ankle; gastrocnemius, soleus with plantaris muscle.
The middle layer: consists of the long flexors of the toes, flexor hallucis longus and flexor digitorum longus muscle.
The deep layer: is formed by tibialis posterior muscle. It lies on the interosseous membrane between the tibia and fibula.
Origin, Insertion, Nerve Supply & Action of Gastrocnemius
Origin:
- Lateral head: lateral surface of the lateral femoral condyle above the lateral epicondyle.
- Medial head: popliteal surface of femur above the medial condyle.
Insertion:
- The tendons of the 3 muscles join each other to form tendocalcaneus
- The tendocalcaneus is inserted into the middle 1/3 of the posterior surface of the calcaneus.
Nerve Supply:
- Tibial nerve
Action:
1. The main and powerful plantar flexor of the ankle joint.
2. Provide the propelling force in walking.
3. They are important elements in the muscle pump, returning venous blood from the lower limbs toward the heart.
4. Gastrocnemius muscle assists in flexion of the knee joint.
Origin, Insertion, Nerve Supply & Action of soleus
Origin:
- The posterior surface of the upper part of fibula.
- The soleal line and middle 1/3 of the medial border of tibia.
- The tendinous arch between the tibia and fibula.
Insertion:
- The tendons of the 3 muscles join each other to form tendocalcaneus
- The tendocalcaneus is inserted into the middle 1/3 of the posterior surface of the calcaneus.
Nerve Supply:
- Tibial Nerve
Action:
1. The main and powerful plantar flexor of the ankle joint.
2. Provide the propelling force in walking.
3. They are important elements in the muscle pump, returning venous blood from the lower limbs toward the heart.
Origin, Insertion, Nerve Supply & Action of Plantaris
Origin:
- Popliteal surface of the femur above lateral condyle of femur.
Insertion:
- Medial to achillis tendon?
Nerve Supply:
- Tibial Nerve
Action:
1. Plantar flexion of the ankle joint.
2. Assists in knee flexion
Origin, Insertion, Neve Supply & Action of Tibialis posterior
Origin:
1. Posterior surface of the tibia.
2. Posterior surface of the interosseous membrane.
3. Posterior surface of the fibula.
Insertion:
- Navicular bone (main insertion).
- All the tarsal bones except the talus.
- Middle three (second, third and fourth) metatarsal bones.
Nerve Supply:
- Tibial nerve
Action:
- Plantar Flexion of the ankle joint
- Inversion of the foot
- Maintains the longitudinal arch of the foot
Origin, Insertion, Neve Supply & Action of Flexor digitorum longus
Origin:
- Posterior surface of the tibia
Insertion:
- Terminal phalanx of the lateral four toes.
Nerve Supply:
- Tibial Nerve
Action:
- Plantar Flexion of the ankle joint
- Inversion of the foot
- Maintains the longitudinal arch of the foot
- Flexion of all joints of the lateral four toes.
Origin, Insertion, Neve Supply & Action of flexor hallucis longus
Origin:
- posterior surface of the fibula
Insertion:
- terminal phalanx of the big toe.
Nerve Supply:
- Tibial nerve
Action:
- Plantar Flexion of the ankle joint
- Inversion of the foot
- Maintains the longitudinal arch of the foot
- Flexion of all joints of the big toe.
Origin, Insertion, Neve Supply & Action of Popliteus
Origin:
- Groove on the lateral surface of the lateral femoral condyle just below the lateral epicondyle.
Insertion:
- Upper part of the posterior surface of tibia above soleal line.
- Into the strong fascia which covering the muscle.
Nerve Supply:
- Tibial Nerve
Action:
- Flexes the knee
- Rotates the leg medially at the beginning of flexion of the fully extended leg (unlocks the knee joint).
Origin, Insertion, Neve Supply & Action of Extensor digitorum brevis muscle (Muscle of the dorsum of the foot)
Origin:
- From the calcaneus and the inferior extensor retinaculum
Insertion:
- it forms four tendons:
❖ The most medial: the extensor hallucis brevis is inserted into the proximal phalanx of the big toe.
❖The remaining three tendons join the long extensor tendons of the second to fourth toes to form extensor expansion.
Nerve Supply:
- lateral branch of deep peroneal nerve.
Action:
- Extension of the medial four toes
what are the muscles of the sole of the foot?
innervation of the muscles of the sole of the foot
All the muscles of the sole are supplied by the lateral plantar nerve except:
1. Abductor halluces
2. Flexor digitorum brevis
3. First lumbrical
4. Flexor halluces brevis
Are supplied by medial plantar
what is the action of lumbricals in the foot?
Flexion of the metatarsophalangeal joints and Extension of the interphalangeal joints of the lateral four toes.
what is the action of planter interossei side of the foot?
adduction of the lateral three toes towards the middle line of the second toe (PAD) + flexion of the metatarsophalangeal joints and extension the interphalangeal joints of the lateral three toes.
what is the action of dorsal interossei of the foot?
abduction of 2nd, 3rd & 4th toes away from the middle line of the second toe (DAP) + flexion of the metatarsophalangeal joints and extension the interphalangeal joints of the lateral three toes.
what is the type of Knee joint?
Synovial, biaxial condylar (or modified hinge) (it allows some rotatory movements beside flexion and extension).
what are the articular surfaces of knee joint?
Articular surface of the femur: An inverted V-shaped articular surface of femoral condyles.
Articular surface of the patella: Large lateral and small medial facets.
Articular surfaces of the tibia: The upper articular surface of the two condyles of the tibia.
articular capsule of knee joint
the capsule is deficient anteriorly and replaced by quadriceps tendon, patella and ligamentum patella.
what are the ligaments of the knee joint?
Extra-capsular:
- Ligamentum patellae
- Fibular collateral (lateral ligament)
- Tibial collateral (medial ligament)
- Posterior oblique ligament
Intra-capsular:
- Menisci (Semilunar cartilages)
- Cruciate ligaments
- Transverse ligament
attachment of Ligamentum patellae
Above: to the apex of the patella.
Below: to the tibial tuberosity.
characters of Ligamentum patellae
continuation of the quadriceps tendon below the patella.
attachment of Fibular collateral (lateral ligament)
Above: lateral epicondyle.
Below: to the head of the fibula. it pierces the tendon of insertion of biceps femoris.
characters of Fibular collateral (lateral ligament)
It is separated from lateral meniscus by the fibrous capsule and the tendon of popliteus.
attachment of Tibial collateral (medial ligament)
Above: medial epicondyle.
Below: The upper part of the medial surface of the tibia behind (S.G.S.).
characters of Tibial collateral (medial ligament)
It is firmly attached to the medial meniscus.
attachment of Posterior oblique ligament
- From the medial condyle of the tibia to the lateral condyle of the femur.
characters of Posterior oblique ligament
- It is an expansion of the tendon of semimembranosus.
what are Menisci?
two C-shaped plates of fibrocartilage on upper surface of tibial condyles
compare between lateral meniscus and medial meniscus according to:
- Shape
- Relation to capsule
- Fixation
- Liability to damage
- Function
what are cruciate ligaments?
two strong fibrous bands, which connect the tibia with the femur forming an X-shaped figure.
compare between anterior cruciate ligament and posterior cruciate ligament in terms of:-
- Tibial attachment
- Femoral attachment
- Direction
- Function
what does the transverse ligament of the knee joined connect?
Connects the anterior horns of both menisci together.
what are the muscles responsible for flexion of the knee joint?
mainly by: biceps femoris, semitendinosus muscles.
Assisted by: sartorius, gracilis and popliteus muscles.
what are the muscles responsible for extension of Knee joint?
mainly by: quadriceps femoris muscle.
Assisted by: tensor fascia lata muscle.
what are the muscles responsible for medial rotation (unlocking) of the knee joint?
mainly by: popliteus muscle.
Assisted by: semitendinosus, semimembranosus, sartorius and gracilis muscles.
what are the muscles Responsible for lateral rotation (locking) of the knee joint?
only done by the biceps femoris muscle
what is the type of Ankle joint?
Synovial uniaxial, of the hinge variety.
what are the articular surfaces of ankle joint?
Below: talus (superior surface - medial surface - lateral surface)
Above: tibia (inferior surface of the lower end and medial malleolus) – fibula (lateral malleolus)
what are the ligaments of the ankle joint?
- The medial (deltoid) ligament
- The lateral ligament
what is the shape of The medial (deltoid) ligament of the ankle?
it is triangular in shape.
attachment of The medial (deltoid) ligament of the ankle
Above (apex): distal border of the medial malleolus.
Below (base): is attached to the following structures
from before backwards:
i. The neck of the talus.
ii. The navicular bone.
iii. The medial edge of the spring ligament.
iv. The sustentaculum tali.
v. The medial side of the body of the talus.
What is the shape of The lateral ligament Of the ankle?
on the lateral aspect of the ankle joint.
what is the site of The lateral ligament Of the ankle?
Is formed of three bands:
1. The anterior talofibular ligament
2. The posterior talofibular ligament
3. The calcaneofibular ligament
What causes dorsiflexion at the ankle joint?
a. Tibialis anterior muscle.
b. Extensor hallucis longus muscle.
c. Extensor digitorum longus muscle.
d. Peroneus tertius muscle.
what causes plantar flexion at the ankle joint?
a. Gastrocnemius muscle (main).
b. Soleus muscle (main).
c. Plantaris.
d. Tibialis posterior muscle.
e. Flexor digitorum longus muscle.
f. Flexor hallucis longus muscle.
g. Peroneus longus.
h. Peroneus brevis.
what is the type of Talocalcanean joint?
Synovial plane.
what are the articular surfaces of the Talocalcanean joint?
a. The lower surface of the body of the talus.
b. The upper surface of the middle of the calcaneus.
what is the type of Talo-calcaneo-navicular joint?
synovial ball and socket.
what are the articular surfaces of Talo-calcaneo-navicular joint?
a. The ball: the head of the talus.
b. The socket: is formed by:
✓ The navicular bone.
✓ The calcaneus.
✓ The spring ligament (plantar calcaneonavicular ligament).
§
what are the articular surfaces of Talo-calcaneo-navicular joint?
eversion and inversion
what causes eversion at subtalar joints?
a) Peroneus longus
b) peroneus brevis
c) peroneus tertius.
what causes inversion at the subtalar joints?
a) Tibialis anterior and posterior.
b) Extensor and flexor hallucis longus.
c) Extensor and flexor digitorum longus.
what does arches of the foot mean?
The skeleton of the foot is built in the form of an arch.
what is the function of the arches of the foot?
a. Supporting the body weight.
b. Transmission of the body weight to the ground.
c. Important in the process of walking.
d. Protection of soft tissue of the sole of the foot.
what are the types of the Arches of the foot?
a. Longitudinal arch:medial and lateral
b. Transverse arch.
what are the bones that form medial longitudinal arch?
i. The key-stone: talus.
ii. The posterior pillar:calcaneus.
iii. The anterior pillar: navicular, three cuneiform and the medial three metatarsal bones.
what are the characters of medial longitudinal arch?
has a greater height
what is the function of medial longitudinal arch?
Important in the process of walking and running
what are the bones forming the Lateral longitudinal arch?
i. The calcaneus.
ii. Thecuboid.
iii. The 4th and 5th metatarsal bones.
what are the characters of the Lateral longitudinal arch?
nearly flat.
what is the function of the Lateral longitudinal arch?
important in support the bod2y. weight
what are the bones forming the Transverse arch?
- cuboid and the three cuneiform.
- The bases of the 5 metatarsal bones.
what are the characters of the Transverse arch?
Its medial end is high while its lateral end reaches the ground.
what is the function of the Transverse arch?
Protection of soft tissue of the sole of foot from the effect of pressure during standing or walking
what are the factors of maintaining the arches of the foot?
Shape of the bones
Long tendons of the foot:
1. Tendon of peroneus longus: maintains both the longitudinal and transverse arch.
2. Tendon of tibialis posterior, flexor hallucis longus and flexor digitorum longus: maintains the longitudinal
arch of the foot.
3. Tendon of tibialis anterior: pull the medial cuneiform upwards and hence it helps the medial longitudinal arch.
4. Short muscles of the foot: their contraction binds the bones of the foot together.
Ligaments of the joints of the foot:
plantar ligaments: They include:
1. Long plantar ligament.
2. Short plantar ligament.
3. Plantar calcaneonavicular ligament (spring ligament).
4. Deltoid ligament.
Planter aponeurosis: is the thickened central part of the deep fascia.
Superficial fascia: distribution of fat in the sole of the foot helps to preserve shape of the arches.
what is the definition of flat foot?
loss of the arches of the foot.
what are the causes of Flat foot?
Congenital:
- Weakness of the muscles of the sole
- Abnormal form of articulated bones.
Acquired:
- Rapid increase in the body weight
- Weakness or paralysis of the muscles of the sole
- Wearing improper arched shoes.
what is the site of Femoral triangle?
it is a triangular space in the upper third of the front of the thigh.
what are the boundaries of Femoral triangle?
Base:
- the inguinal ligament.
Laterally:
- the medial border of the sartorius muscle.
Medially:
- the medial border of the adductor longus muscle.
Apex:
- meeting of medial and lateral borders.
Floor:
- from medial to lateral side:
i. Adductor longus muscle.
ii. Pectineus muscle.
iii. Psoas major muscle.
iv. Iliacus muscle.
what are the contents of Femoral triangle?
- Femoral artery.
- Femoral branch of genitofemoral nerve
- Femoral vein
- Lateral cutaneous nerve of the thigh
- Femoral nerve.
- Deep inguinal lymph nodes and fatty tissue.
- Femoral sheath.
- Sympathetic plexus around the femoral artery.
what is the site of Adductor canal (Subsartorial canal)?
In the middle third of the medial side of the thigh.
extension of Adductor canal (Subsartorial canal)
Extends from the apex of femoral triangle to the opening into the adductor magnus.
what are the boundaries of Adductor canal (Subsartorial canal)?
Anterolateral wall: vastus medialis.
Posterior wall (floor): Adductor longus (above) - Adductor magnus (below)
Anteromedial wall (roof): sartorius muscle
what are the contents of Adductor canal (Subsartorial canal)?
1) Femoral artery.
2) Femoral vein.
3) Saphenous nerve: Crosses in front of the femoral artery from
lateral to medial side.
4) Nerve to vastus medialis.
5) Descending genicular artery: arises from femoral artery
what is the definition of The popliteal fossa?
Hollow space on the back of the knee joint.
what is the shape of The popliteal fossa?
Diamond shape space.
what are the boundaries of The popliteal fossa?
Superior lateral boundary: Biceps femoris muscle.
Superior medial boundary: Semitendinosus & Semimembranosus.
Inferior lateral boundary: by lateral head of gastrocnemius muscle supplemented by plantaris muscle.
Inferior medial boundary: by medial head of gastrocnemius muscle.
what forms the roof of The popliteal fossa?
- skin.
- superficial fascia containing short saphenous vein and branches of the posterior cutaneous nerve of the thigh.
- The deep fascia (popliteal fascia).
what forms the floor of The popliteal fossa?
From above downwards:
- The popliteal surface of the femur (upper part).
- The back of the capsule of the knee joint (middle part).
- Fascia covering the popliteus muscle (lower part)
what are the contents of The popliteal fossa?
- Popliteal artery
- Popliteal vein: is superficial to the artery.
- Tibial nerve: it crosses superficial to the popliteal vessels.
- Common peroneal nerve: Passes downwards and laterally along the medial side of the biceps femoris.
- Posterior cutaneous nerve of the thigh: in the superficial fascia of the roof.
- Short saphenous vein: piercing the deep fascia of the fossa to end in the popliteal vein.
- Genicular branch of posterior division of the obturator nerve.
- Popliteal lymph node: Situated close to the popliteal vein at the site of entrance of the small saphenous vein.
- Sympathetic plexus: around the popliteal artery.
