MSK Flashcards
Bone embryo
Axial/appendicular: mesoderm
Skull: ectoderm, neural crest
Joint embryo
mesoderm
Muscle embryo
mesoderm
smooth muscle: ectoderm
Compact Bone microanatomy
dense portion closer to surface of bones
lamellar bone arranged in sheets
osteons contain Haversian canal w/ artery and nerves
concentric layers radiate out from osteons
lacunae contain osteocytes
osteoblast line outside of the osteons
Spongy Bone microanatomy
inner portion of bone
contain trabecula, interconnected cavities, small amount of lamellar bone (sheets of cartilage), long beam like structure with bone marrow in the spaces between
Fibrous joint microanatomy
fibrous connective tissue
wide sheet of connective tissue
Cartilaginous joint microanatomy
hyaline cartilage or fibrocartilage
Synovial joint microanatomy
outer fibrous capsule
inner synovial membrane: synovial fluid and blood vessels
articular cartilage (hyaline)
Skeletal muscle microanatomy
epimysium-> perimysium ->fascicle -> muscle fiber -> endomysium -> myocyte -> long cylinder cells w/ multiple nuclei under sarcolemma contain t-tubules, myofibrils-> sarcomeres (actin, myosin)
Cardiac muscle microanatomy
striated organized into sarcomeres, branched cells w/ 1-2 centrally located nuclei, intercalated disks (connect myocytes)
endomysium, t-tubules, sarcomere, sarcoplasmic reticulum, pacemaker cells
Smooth Muscle microanatomy
thin and thick myofilaments
fusiform, one nucleus, wrapped in endomysium
no t-tubules, less sarcoplasmic reticulum, caveolae
Where is each muscle type found?
skeletal: attach to bones
cardiac; heart
smooth: walls of hollow organs
Skeletal muscle contraction
motor signal from brain -> spinal cord -> motor neuron release Ach -> Ach binds to receptor -> rapid shift of ion across sarcolemma -> t-tubules bring Ca into myocyte -> sarcoplasmic reticulum releases Ca into sarcoplasm -> Ca causes actin and myosin to pull in on each other -> sarcoplasmic reticulum stores ca -> muscle relaxation
Skeletal muscle regulation
how long ca stays in the sarcoplasm, size of muscle, how many are contracting, how close the actin and myosin filament are to each other, how fast the muscle is contracted (slower = more force bc more myosin head can attach), somatic nervous system
Smooth muscle contraction
AP depolarizes membrane -> Ca enters vis L-type Ca channels-> binds to calmodulin -> activates myosin kinase -> phosphorylates myosin heads to form cross-bridges w/ actin -> activates another smooth muscle
no ATP required and maintain low-level contraction for long periods
Cardiac regulation
autorhythmicity, ANS
Cardiac contraction
Ca flows gap junction -> threshold is reached -> na channels open up -> ions move across cell membrane -> ca flows into cell binding to ryanodine receptor on SR -> Ca released into cell -> bind to troponin c -> tropomyosin slide off -> actin and myosin to bind -> ca removed vi ATP or concentration gradient -> no actin and myosin binding
Vertebrae structure
body arch: pedicles, laminae spinous process 2 transverse process 2 inferior articular process 2 superior articular process
Vertebrae Colum structure
body gets bigger as you go down arch: pedicles, laminae spinous process 2 transverse process 2 inferior articular process 2 superior articular process Cervical 7 thoracic 12 Lumbar 5
Vertebrae column function
support weight, protect spinal cord,
Skull bone function
protects brain
Skull viscerocranium structure
mandible, vomer, ethmoid,
2 of each maxilla, inferior nasal concha, zygomatic, nasal, lacrimal, palatine
Skull neurocranium location
house brain, cranial meninges, blood vessels, and cranial nerves
Skull neurocranium structure
frontal, ethmoid, sphenoid, occipital,
2 of each temporal and parietal
Pectoral girdle axioappendicular muscles structure
Anterior: pec major, pec minor, subclavius, serratus anterior
Pectoral girdle function
make upper limb function
Pectoral girdle axioappendicular muscles structure
Anterior: pec major, pec minor, subclavius, serratus anterior
Posterior: trapezius, latissimus dorsi, levator scapulae, rhomboids
Pectoralis Major action
adduction, medial rotation, flexion of arm, extend back from flexed position
Pectoral girdle scapulohumeral muscles structure
teres major, deltoid, supraspinatus, infraspinatus, teres minor, subscapularis (SItS muscles)
Pectoralis Minor O, I, N
O: anterior surface of 3-5 ribs
I: coracoid process of scapula
N: medial pectoral nerve
Pectoralis Major action and artery
adduction, medial rotation, flexion of arm, extend back from flexed position
pectoral artery and deltoid artery
Subclavius O, I, N
O: 1st rib and costal cartilage
I: inferior surface of middle third of clavicle
N: nerve to subclavius (C5, C6)
Pectoralis Minor action and artery
stabilize scapula, deep inhalation, scapula inferior and anterior
pectoral artery
Serratus anterior O, I, N
O: external surface of lateral parts of the upper eight ribs
I: anterior aspect of medial border and inferior angle of scapula
N: long thoracic nerve ( C5-7)
Subclavius action and artery
stabilize acromioclavicular joint, anchoring and depressing clavicle
clavicular artery
Serratus anterior Actions and artery
protract scapula (punching), anchors scapula by holding it close to thoracic wall (push ups), cause scapula to rotate upward (arms above head)
Trapezius O, I, N
O: medial 1/3 of superior nuchal line, EOP, nuchal ligament, spinous processes of C7-T12
I: lateral 1/3 of clavicle, acromion, spine of scapula
N: spinal accessory nerve and anterior rami of C3-4
Trapezius action
elevation of scapula, retracts scapula, pulls scapula down, rotates scapula superiorly
Latissimus Dorsi O, I, N
O: iliac crest, thoracolumbar fascia, inferior 6 thoracic vertebrae, inferior 3-4 ribs
I: floor of intertubercular groove of humerus
N: thoracodorsal nerve
Latissimus Dorsi action
extends and medially rotates humerus, adducts humerus
Levator scapulae O, I, N
O: posterior tubercles of transverse process of C1-C4
I: medial border of scapula, superior to root of scapular spine
N: dorsal scapular nerve, anterior rami of C3-4
Levator scapulae O, I, N
first 4 -2-2-4 RULE
O: posterior tubercles of transverse process of C1-C4
I: medial border of scapula, superior to root of scapular spine
N: dorsal scapular nerve, anterior rami of C3-4
Rhomboids minor O, I, N
4-2-2 C7 &T1 -4 RULE
O: nuchal ligament, spinous process of C7-T1
I: medial border of scapula at spine of scapula
N: dorsal scapular nerve
Rhomboids action
scapular retraction, downward rotation of scapula, assist serratus anterior in holding scapula against thoracic wall
Rhomboids major O, I, N
4-2-2-4 RULE where this is last 4
O: spinous process of T2-5
I: medial border of inferior scapula to spine of scapula
N: dorsal scapular nerve
Deltoid O, I, N
O: spine of scapula, acromion process, and lateral 1/3 of clavicle
I: deltoid tuberosity of humerus
N: axillary nerve
Deltoid action
arm abduction, extension, lateral rotation, abduction, flexion, and medial rotation
Teres major O, I, N
O: posterior surface of inferior angle of scapula
I: medial lip of intertubercular groove of humerus
N: lower subscapular nerve
Teres Major action
adduction and medial rotation
Supraspinatus O, I, N
O: supraspinous fossa of scapula
I: superior facet of the greater tubercle of the humerus
N: suprascapular nerve
Supraspinatus action
abduction
Infraspinatus O, I, N
O: infraspinous fossa of the scapula
I: middle facet of the greater tubercle of the humerus
N: suprascapular nerve
Infraspinatus O, I, N
O: infraspinous fossa of the scapula
I: middle facet of the greater tubercle of the humerus
N: suprascapular nerve
Infraspinatus action
rotates arm laterally
Teres minor O, I, N
O: middle part of lateral border of the scapula
I: inferior facet of the greater tubercle of the humerus
N: axillary nerve
Teres minor action
rotates arm laterally
Subscapularis O, I, N
O: subscapular fossa
I: lesser tubercle of humerus
N: upper and lower subscapular nerve
Subscapularis action
medial rotation
Quadrangular space
boarders: teres minor, teres major, long head of triceps brachii, shaft of humerus
Contents: axillary nerve and posterior circumflex humeral artery
Triangular space
Borders: teres minor, long head of triceps brachii, teres major,
contents: circumflex scapular artery
Upper extremity structure
pectoral girdle: clavicle and scapula arm: humerus forearm: radius ulna Wrist: Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium Hand: 5 metacarpal, 5 dips, and 4 pips
Upper extremity function
move arm, pick up things, walking
Pelvic girdle structure
pelvis (ilium, ischium, pubis)
sacrum
coccyx
Pelvic girdle function
transfer weight when sitting or standing
attachment points for muscles of locomotion and posture
support and protection of abdominopelvic structures
Lower extremity structure
Pelvis, sacrum, coccyx femur tibia fibula patella calcaneus, talus, cuboid, navicular, cuneiform 5 metatarsals 5 proximal, 4 middle, 5 distal
Lower extremity function
locomotion
radiocarpal joint structure
condyloid type of synovial joint, joint capsule
radius, scaphoid, lunate, triquetrum
reinforced by palmar ligaments (distal radius to two rows of carpal bones), dorsal radiocarpal ligaments, ulnar collateral, radial collateral
Muscles: flexor carpi radialis, flexor carpi ulnaris, extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, extensor carpi radialis longus, abductor pollicis longus, and extensor carpi radialis brevis
radiocarpal joint innervation/blood supply
dorsal and palmar carpal arches
median, ulnar, radial nerve
radiocarpal joint function
flex, extend, radially deviate, ulnar deviate
intercarpal joints structure
plane type of synovial joint
carpal bones
intercarpal joints innervation
median, ulnar, radial nerve
intercarpal joints function
augment motion of radiocarpal joint
Carpometacarpal Joints structure
carpal and metacarpal
1st is saddle type
2-5 plane type synovial
Carpometacarpal Joints innervation
median, ulnar, radial nerve
Carpometacarpal Joints function
movement of thumb
Intermetacarpal joints structure
bw two metacarpals
Intermetacarpal joints innervation
median, ulnar, radial nerve
Metacarpophalangeal joints structure
metacarpal and proximal phalanges
condyloid synovial joints surrounded by joint capsule
Metacarpophalangeal joints innervation
median, ulnar, radial nerve
Metacarpophalangeal joints function
adduction, flexion, and extension
Interphalangeal joints function
flexion and extension
Interphalangeal joints structure
proximal and middle phalanges or middle and distal phalanges
hinge type of synovial joint
Interphalangeal joints innervation
median, ulnar, radial nerve
Sternoclavicular joint structure
clavicular notch of the manubrium, medial end of clavicle, and first costal cartilage
saddle synovial and fibrous capsule
surrounded by anterior & posterior sternoclavicular ligament, interclavicular lig, and costoclavicular lig
Sternoclavicular joint innervation
medial supraclavicular nerve and nerve to subclavius
Sternoclavicular joint function
connection between the axial skeleton and the upper limb
Acromioclavicular joints structure
lateral end of clavicle and tip of acromion
plane type joint and fibrous capsule
attached by: acromioclavicular lig, conoid lig, trapezoid lig,
Acromioclavicular joints innervation
articular branches of the suprascapular, axillary, and lateral pectoral nerves
Acromioclavicular joints function
scapula to the clavicle and serves as the main articulation that suspends the upper extremity from the trunk, allow the scapula additional range of rotation on the thorax
Glenohumeral joint structure
ball and socket
humerus and glenoid cavity, glenoid labrum, joint capsule w/ internal synovial lining, sub-acromial bursa and sub-tendinous bursa of the subscapularis
reinforced by: coracohumeral lig, coracoacromial lig, and glenohumeral ligaments
Rotator cuff: supraspinatus, infraspinatus, teres minor, and subscapularis
Glenohumeral joint innervation
N: axillary, suprascapular, lateral pectoral
blood: anterior and posterior circumflex humeral a, suprascapular a
Humero-ulnar joint structure
Hinge type bw trochlea and trochlear notch of ulna, joint capsule, subcutaneous olecranon bursa, subtendinous olecranon bursa, intratendinous olecranon bursa, bicipitoradial bursa
Reinforced by: ulnar collateral lig,
Humero-ulnar function
extends and flexion
Humero-ulnar innervation
musculocutaneous and ulnar
Humero-radial joint structure
hinge type bw capitulum and head of radius
joint capsule, subcutaneous olecranon bursa, subtendinous olecranon bursa, intratendinous olecranon bursa, bicipitoradial bursa
Humero-radial joint function
extends and flexion
Humero-radial joint innervation
musculocutaneous and radial
proximal radioulnar joint structure
pivot type w/ head of radius and radial notch of ulna, annular lig, elbow joint capsule
proximal radioulnar joint function
pronation and supination
distal radioulnar joint structure
pivot type ulnar notch of radius and head of ulna, bound by articular disc, anterior & posterior lig
proximal radioulnar joint innervation
Median, musculocutaneous, radial and ulnar nerves
distal radioulnar joint innervation
Anterior and posterior interosseous nerves
Joint of vertebral bodies structure
symphyses bw articulating surfaces by intervertebral discs
Joint of vertebral bodies function
aid in weight bearing, provided strength, shock absorbers, limited movement
Joint of vertebral bodies structure
symphyses bw articulating surfaces by intervertebral discs maintained by anterior longitudinal lig and posterior longitudinal lig
Zygapophyseal joints structure
synovial joint bw superior and inferior articular processes surrounded by thin joint capsule
attached by: ligamenta flava, interspinous, supraspinous, and intertransverse lig
Zygapophyseal joints function
gliding movements
Altlanto-occipital joint structure
synovial lateral masses of atlas and occipital condyles connected by anterior atlanto-occipital membrane and posterior atlanto-occipital membrane
Altlanto-occipital joint function
extension, flexion, small amount of lateral flexion and rotation
Zygapophyseal joints innervation
medial branch from the spinal nerve above the facet and the nerve below
Atlanto-occipital joint structure
synovial lateral masses of atlas and occipital condyles connected by anterior atlanto-occipital membrane and posterior atlanto-occipital membrane
Atlanto-occipital joint function
extension, flexion, small amount of lateral flexion and rotation
Atlanto-occipital joint innervation
C1 spinal nerve
Atlanto-axial joint Structure
plane type, inferior facets of lateral masses of atlas and superior facets of the axis
pivot joint bw dens and facet on posterior surface of the anterior arch of atlas, transverse ligament of atlas
cruciate lig, alar lig, tectorial membrane
Atlanto-axial joint function
moving head side to side
Atlanto-axial joint innervation
Ventral primary ramus of the second cervical spinal nerve
Superior tibiofibular joint structure
plane joint w/ articular fact of fibular head and articular facet on lateral tibial condyle, joint capsule
Superior tibiofibular joint function
stability ankle joint and weight bearing
Superior tibiofibular joint innervation
common fibular nerve (recurrent branch) and popliteus muscle
Inferior tibiofibular joint structure
fibrous joint bw fibula and fibular notch of tibia held together by deep interosseous tibiofibular ligament, anterior and posterior tibiofibular ligament , inferior transverse ligament
Inferior tibiofibular joint function
stability and weight bearing
Inferior tibiofibular joint innervation
deep fibular and sural nerves
Tibiotalar joint structure
hinge joint bw lateral malleolus of fibula, medial malleolus of tibia, and body/trochlea of talus bounded by anterior talofibular lig, posterior talofibular lig, calcaneofibular lig, medial lig
Tibiotalar joint function
dorsiflexion and plantarflexion
Tibiotalar joint innervation
tibial and deep fibular nerve
Subtalar joint structure
synovial joint bw posterior calcaneal articular surface of talus and posterior articular facet of calcaneus
Subtalar joint function
inversion, eversion
Transverse tarsal joint structure
synovial saddle joint talonavicular (talus and navicular) and calcaneocuboid (calcaneous and cuboid) joint
Transverse tarsal joint function
inversion and eversion
Transverse tarsal joint innervation
Talonavicular joint: deep fibular nerve, medial plantar nerve
Calcaneocuboid joint: deep fibular nerve, sural nerve, lateral plantar nerve
Intertarsal joint structure
Cuboideonavicular joint : cuboid, navicular dorsal, plantar, interosseus ligaments
Naviculocuneiform joint: navicular and cuneiform, dorsal, plantar ligaments
Intercuneiform and cuneocuboid joint: cuneiform, cuboid, dorsal, plantar, interosseus ligaments
Intertarsal joint function
gliding, rotation
Intertarsal joint innervation
Cuboideonavicular joint: deep fibular, medial plantar, lateral plantar nerves
Naviculocuneiform: deep fibular, medial plantar, lateral plantar nerves
Intercuneiform and cuneocuboid: deep fibular, medial plantar, lateral plantar nerves
Tarsometatarsal joints structure
bw tarsal and metatarsal bones, dorsal tarsometatarsal, plantar tarsometatarsal, interosseus cuneometatarsal ligaments
Tarsometatarsal joints function
flexion, extension, abduction, rotation
Tarsometatarsal joints innervation
deep fibular, medial plantar, lateral plantar nerves
Metatarsophalangeal joint structure
bw metatarsal and phalanges, plantar ligaments, deep transverse metatarsophalangeal ligaments, collateral ligaments
Metatarsophalangeal joint innervation
plantar interdigital, medial dorsal cutaneous, deep fibular nerve
interphalangeal joint structure
bw 2 phalanges, collateral ligaments
interphalangeal joint innervation
plantar interdigital nerves
Temporomandibular joint structure
modified synovial hinge joint bw mandibular fossa, articular tubercle, and head of mandible
Lig: lateral temporomandibular, sphenomandibular, stylomandibular
Temporomandibular joint function
protrusion, retrusion, elevation, depression, lateral deviation
Temporomandibular joint innervation
trigeminal nerve
Temporalis O & I
O: temporal fossa, deep surface of temporal fascia
I: coronoid process of mandible anterior border of ramus
Temporalis A & N
A: elevates and retrudes
N: deep temporal nerve
Masseter O & I
O: zygomatic arch, maxillary process of zygomatic bone
I: angle and lateral surface of ramus of mandible
Masseter A & N
A; elevates mandible, protrusion
N: masseteric
Medial pterygoid O & I
O: medial surface of lateral pterygoid plate, pyramidal process of palatine bone, tuberosity of maxilla
I: medial surface of ramus & angle of mandible
Medial pterygoid A & N
A: protrusion, side to side grinding
N: medial pterygoid
Lateral pterygoid O & I
Superior
O: infratemporal surface & crest of greater wing of sphenoid bone
I: joint capsule, articular disc
Inferior:
O: lateral surface of the lateral pterygoid plate
I: pterygoid fovea on neck of mandible
Lateral pterygoid A & N
A; depression, lateral chewing movements
N: lateral pterygoid
Tibiofemoral joint Structure
synovial hinge joint bw lateral and medial condyles of femur, tibial plateaus
lig: patellar ligament, medial and lateral patellar retinacula, tibial (medial) collateral ligament, fibular (lateral) collateral ligament, oblique popliteal ligament, arcuate popliteal ligament, anterolateral ligament (ALL), anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus, lateral meniscus
Tibiofemoral joint Function
flexion and extension
Tibiofemoral joint innervation
Femoral, tibial, common fibular, and posterior division of the obturator
Tibiofemoral joint Structure
synovial hinge joint bw lateral and medial condyles of femur, tibial plateaus
lig: patellar ligament, tibial (medial) collateral ligament, fibular (lateral) collateral ligament, oblique popliteal ligament, arcuate popliteal ligament, anterolateral ligament (ALL), anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus, lateral meniscus
Tibiofemoral joint Structure
synovial hinge joint bw lateral and medial condyles of femur, tibial plateaus
lig: patellar ligament, tibial (medial) collateral ligament, fibular (lateral) collateral ligament, oblique popliteal ligament, arcuate popliteal ligament, anterolateral ligament (ALL), anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus, lateral meniscus
Bursae: infrapatellar bursa, deep infrapatellar bursa, suprapatellar bursae, popliteus bursa, anserine bursa, gastrocnemius bursa
Tibiofemoral joint Function
flexion and extension
Patellofemoral joint innervation
Femoral, tibial, common fibular, and posterior division of the obturator
Patellofemoral joint structure
plane joint bw patellar surface of femur, posterior surface of patella, suprapatellar fat pad
lig: patellar ligament, lateral patellofemoral ligament
bursae: subcutaneous prepatellar bursa, infrapatellar bursa
Patellofemoral joint function
flexion and extension
Hip joint structure
synovial ball and socket bw head of femur covered in articular cartilage and acetabulum of pelvis, acetabular labrum, fibrous capsule, fat pad
lig: ligament of the head of the femur, transverse acetabular, iliofemoral, pubofemoral, ischiofemoral
Hip joint function
flexion, extension, abduction, adduction, medial rotation, lateral rotation, circumduction
Hip joint innervation
femoral, sciatic, obturator, superior gluteal
Ocipitofrontalis O & I
Frontal
O: epicranial aponeurosis
I: on skin superior to eyes
Occipital
O: superior nuchal line
I: epicranial aponeurosis
Ocipitofrontalis O & I
Frontal
O: epicranial aponeurosis
I: on skin superior to eyes
Occipital
O: superior nuchal line
I: epicranial aponeurosis
Orbicularis Oculi O&I
O: medial palperbral ligament and medial orbital margin and medial palpebral ligament
I: lateral palpebral ligament, and skin around orbit
Orbicularis Oculi N & A
N; temporal nerve and zygomatic
A: close eyelids gently and tightly
Orbicularis Oculi N & A
N; temporal nerve and zygomatic
A: close eyelids gently and tightly
Corrugator supercilii O & I
O: medial part of superciliary arch
I: skin of medial half of eyebrow
Corrugator supercilii N & A
N: temporal nerve
A: vertical wrinkles at root of nose
Procerus O & I
O: nasal bone
I: lower part of forehead bw eyebrows
Procerus N & A
N: zygomatic
A: depresses medial ends of eyebrows and creates transverse wrinkles
Levator labii superioris alaeque nasi O & I
O: frontal process of maxilla
I: upper lip and alar cartilage of nose
Levator labii superioris alaeque nasiN & A
N: zygomatic
A: flares nostrils & raise upper lip
Nasalis O & I
O: maxilla
I: midline aponeurosis or alar cartilage
Nasalis N & A
N: zygomatic
A: narrow or flare nostril
Orbicularis oris O & I
O: maxilla, mandible, modiolus
I: mucous membranes of lip
Orbicularis oris N & A
N: buccal
A: close mouth or protrude lips
Risorius O & I
O: parotid fascia & buccal skin
I: modiolus
Risorius N & A
N: zygomatic and buccal
A: retracts corner of mouth
Levator anguli oris O & I
O: infraorbital maxilla
I: modiolus
Levator anguli oris N & A
N: zygomatic and buccal
A: raises corners of mouth
Levator labii superioris O & I
O: infraorbital margin of maxilla
I: skin of upper lip
Levator labii superioris N & A
N: zygomatic and buccal
A: Elevates upper lip, exposes maxillary teeth
Zygomaticus major O & I
O: zygomatic bone
I: modiolus
Zygomaticus major N & A
N: zygomatic and buccal
A: elevates corner of mouth
Zygomaticus minor O & I
O: zygomatic bone
I: skin of upper lip
Zygomaticus minor N & A
N: zygomatic and buccal
A: Elevates upper lip, exposes maxillary teeth
Depressor anguli oris O & I
O: base of mandible
I: modiolus
Depressor anguli oris N & A
N: marginal mandibular
A: pulls corner of mouth downward, dilators of mouth
Depressor labii inferioris O & I
O: anterolateral body of mandible and platysma
I: skin of lower lip
Depressor labii inferioris N & A
N: marginal mandibular
A: pulls lower lip downward, dilators of mouth
Mentalis O & I
O: body of mandible
I: skin of chin
Mentalis N & A
N: marginal mandibular
A: elevates and protrudes lower lip
Platysma O & I
O: suprascapular, intrascapular, subcutaneous tissue
I: base of mandible
Platysma N & A
N: cervical
A: depresses mandible and draws corners of mouth down, tense skin of lower face & neck
Buccinator O & I
O: alveolar processes of maxilla & mandible, pterygomandibular raphe
I: modiolus
Buccinator N & A
N: buccal nerve
A: press cheek against teeth
Osteomalacia def
defective mineralization of osteoid in adults
Osteomalacia cause
deficiency or impaired metabolism of Vit D, phosphate, calcium
intestinal malabsorption, ↓ UV light, medications, liver and kidney disease
Rickets def
defectives mineralization of cartilaginous growth plates in children
Rickets cause
deficiency or impaired metabolism of Vit D, phosphate, calcium
intestinal malabsorption, ↓ UV light, medications, liver and kidney disease
Osteomalacia path
↓ Vit D -> ↓ serum Ca -> ↑ PTH -> ↑ osteoblast activity -> ↓ PO4
Osteomalacia comp
fracture, kidney failure
Osteomalacia clinical
diffuse bone and joint pain, proximal muscle weakness, bone fragility, ↑ fracture risk, muscle spams, numbness
X ray - Osteopenia and Looser zones/ pseudofractures
Rickets path
↓ Vit D -> ↓ serum Ca -> ↑ PTH -> ↑ osteoblast activity -> ↓ PO4
Rickets RF
not enough sunlight, dark skin, premature birth, meds
Rickets comp
fracture, failure to grow, bone deformities
Rickets clinical
diffuse bone and joint pain, proximal muscle weakness, bone fragility, ↑ fracture risk, muscle spams, numbness, craniotabes, delayed closure of fontanelles, genu varum, prominent frontal bone, protruding abdomen, rachitic rosary
X ray - Epiphyseal widening and metaphyseal cupping/fraying
Scurvy def/cause
deficiency of vitamin C
Scurvy path
Lack of vitamin C decreases transcription of pro-collagen
Scurvy comp
depression, recurrent infections, microcytic anemia
Scurvy clinical
swollen gums, bruising, petechiae, hemarthrosis, anemia, poor wound healing, perifollicular and subperiosteal hemorrhages, and corkscrew hair
Ankylosing spondylitis def
chronic inflammatory disease that affects the vertebral joint making the spine stiff
Ankylosing spondylitis cause
Autoimmune, HLA-B27
Ankylosing spondylitis path
MCH class 1 w/ HLA-B27 -> cell sample -> CD8 T cell -> release TNF-a and IL-1 -> inflammation of intervertebral joints and facet joints -> destroy joints -> fibroblast replace joint w/ fibrin -> osteoblast activate
Ankylosing spondylitis RF
< 30, women, smoking , FH, whites,
Ankylosing spondylitis comp
aortic regurgitation, enthesitis, anterior uveitis
Ankylosing spondylitis clinical
weight, loss, fever, fatigue, buttock pain, neck or back pain + stiffness, SOB,
bamboo spine
Bursitis def
Inflammation of bursa
Bursitis cause
overuse, trauma, rheumatoid arthritis, ankylosing spondylitis, scleroderma, SLE, gout, bacterial infx
Bursitis path
inflammation of bursa -> ↑ production of synovial fluid -> enlargement of bursa -> ↑ friction during movement -> symptomatology
Bursitis RF
aging, repetitive motions, injuries to bursa
Bursitis comp
muscle atrophy,
Bursitis clinical
joint pain, stiffness, tenderness, pain, swelling
chronic swelling w/ minimal pain
Fibromyalgia def
chronic condition causing pain
Fibromyalgia cause
genetic, child abuse
Fibromyalgia path
problem w/ pain signals, ↓ serotonin, ↑ substance p and nerve growth factor -> hypersensitivity to pain
Fibromyalgia RF
Females 20-50YO
Fibromyalgia clinical
Chronic widespread MSK pain associated with tender point stiffness, paresthesia, poor sleep, fatigue, cognitive fibro fog
Gout def
urate crystals in joint
Gout cause
hyperuricemia, high purine diet, dehydration, alcohol, chemo, genetics, chronic kidney disease, thiazide diuretics and aspirin
Gout path
monosodium urate crystals deposit in joint -> inflammation
Gout RF
obesity, diabetes
Gout comp
joint damage and deformity, kidney disease, tophi, kidney stones
Dermatomyositis def
inflammatory disorder of skin and muscles
Dermatomyositis cause
autoimmune, HLA-DR3 or HLA-DR5
Dermatomyositis path
immune cells confuse normal muscle and skin proteins w/ foreign antigen, autoantibodies to capillary endothelial cells or soluble antigens from damage skin and muscle deposited in BM-> activation of complement -> damage
Dermatomyositis RF
genetics
Dermatomyositis comp
Respiratory, heart, esophageal disease and cancer
Dermatomyositis clinical
bilateral weakness, muscle atrophy, pain, tenderness of proximal muscles
dysphagia
purple rash on upper eyelids, shoulder, upper chest, and back or malar rash (butterfly on face)
flat, red, scaly papules over back of finger, elbow, knees (Gottron’s sign)
Dermatomyositis clinical
bilateral weakness, muscle atrophy, pain, tenderness of proximal muscles
dysphagia
(Heliotrope rash) purple rash on upper eyelids, shoulder, upper chest, and back or malar rash (butterfly on face)
flat, red, scaly papules over back of finger, elbow, knees (Gottron’s sign)
Polymyositis def
inflammation of many muscles
Polymyositis cause
autoimmune
Polymyositis path
CD8 inappropriately react to normal muscle proteins (look like foreign) tRNA synthases, Mi-2, components of signal recognition particle -> apoptosis
Polymyositis RF
autoimmune conditions
Polymyositis comp
esophagus involvement
Polymyositis clinical
bilateral muscle weakness and wasting, affect large proximal muscles, tender muscles
Polymyalgia Rheumatica (PMR) def
muscle pain and joint stiffness
Polymyalgia Rheumatica (PMR) cause
autoimmune, genetic HLA-DR4
Polymyalgia Rheumatica (PMR) path
inflammation of tendons and bursae
Polymyalgia Rheumatica (PMR) RF
Women >50YOO
Polymyalgia Rheumatica (PMR) comp
giant cell arteritis -> vision loss
Polymyalgia Rheumatica (PMR) clinical
fever, fatigue, weight loss,
pain and stiffness of shoulder or hip starting on one-side progresses to both w/in weeks, worse at night and morning, improve w/ movement,
Reactive Arthritis (Reiter Syndrome) def
inflammation of a joint after STI or gastroenteritis
Reactive Arthritis (Reiter Syndrome) cause
Autoimmune, Chlamydia, Salmonella, Shigella, Yersinia, Campylobacter, E. Coli (gram neg, endotoxin)
HLA-B27
Reactive Arthritis (Reiter Syndrome) RF
genetics, multiple sexual partners, eating contaminated food
Reactive Arthritis (Reiter Syndrome) comp
Reiter syndrome (joint swelling, urethritis, and conjunctivitis), cervicitis, pericarditis, keratoderma blenorrhagicum
Reactive Arthritis (Reiter Syndrome) clinical
pain and swelling of large joint
Tendonitis def
inflammation of tendon
Tendonitis cause
overuse, overload
Tendonitis RF
repetitive movement, trauma, thermal injury to the tendon, use of certain antibiotics (such as levofloxacin and ciprofloxacin), and smoking
Tendonitis comp
rupture, contractures, adhesions, muscle wasting, disability
Tendonitis clinical
pain in the tissues surrounding a joint
Osteopetrosis def
osteoclast dysfunction leading to bone hardening
Osteopetrosis cause
Genetic: autosomal recessive osteopetrosis and autosomal dominant osteopetrosis
Osteopetrosis path
ARO: mutation in CA2 gene encoding carbon anhydrase which osteoclasts fail to reabsorb cone because acidic environment requires -> imbalance bw bone formation and reabsorption -> excess bone formation
ADO: mutation in chloride channel & gene associated w/ renal tubular acidosis -> deficiency of carbonic anhydrase in kidney
Osteopetrosis RF
genetic
Osteopetrosis comp
ARO: death,
ADO: pathologic fractures, osteoarthritis
Osteopetrosis clinical
ARO: failure to thrive, osteomyelitis of mandible, cranial nerve compression, dental abnormalities, hydrocephalus, hepatosplenomegaly, weakness, fatigue, pallor, bruising, hemorrhage, recurrent infections
ADO: asyx, vison loss, hearing loss, cranial nerve compression,
Marfan Syndrome def
defective connective tissue
Marfan Syndrome cause
genetic, autosomal dominant
Marfan Syndrome path
mutation in FBN1 on chromosome 15 -> fibrillin-1 is dysfunctional or less abundant -> fewer functional microfibrils and TGF-B doesn’t get destroyed -> less tissue elasticity and integrity and more tissue growth
Marfan Syndrome RF
FH,
Marfan Syndrome comp
retinal detachment -> lens dislocation (upward)
pneumothorax
aortic valve insufficiency, aortic aneurysm or dissection or rupture, mitral valve prolapse
Muscular Dystrophy def
muscle poorly nourished leading to muscle weakness
Muscular Dystrophy cause
genetic mutation in dystrophin gene
Muscular Dystrophy cause
genetic mutation in dystrophin gene on X chromosome recessive
Muscular Dystrophy path
nonsense or frameshift mutation causing no dystrophin = Duchenne
missense mutation causing misshapen dystrophin = Becker
dystrophin stabilizes sarcolemma -> cell death -> fat
Muscular Dystrophy RF
males, FH,
Muscular Dystrophy comp
short life span
Muscular Dystrophy clinical
waddling gait, calf pseudohypertrophy, Gower’s sign (using hand to get up from ground), immobilization, scoliosis, respiratory failure, dilated cardiomyopathy, arrhythmias
Osteogenesis Imperfecta def
brittle bones prone to fractures
Osteogenesis Imperfecta cause
impaired type I collagen synthesis, autosomal dominant
Osteogenesis Imperfecta path
mutation of COL1A1 or COL1A2 -> misfolding of collagen proteins, loss of function -> bone loss, fragility
Osteogenesis Imperfecta RF
FH,
Osteogenesis Imperfecta comp
type II leads to death
hearing loss
Osteogenesis Imperfecta clinical
pathologic fractures w/ minimal/no trauma, malformations, short stature, scoliosis, skull malformations, blue discoloration/translucency of sclera, exposure of choroidal veins, hearing loss, dentinogenesis imperfecta, easy bruising, hypermobility
Osteoarthritis (OA)/
Degenerative Joint
Disease (DJD) def
inflammation of bone and synovial joints
Osteoarthritis (OA)/
Degenerative Joint
Disease (DJD) cause
loss of articular cartilage
Osteoarthritis (OA)/
Degenerative Joint
Disease (DJD) RF
Age, Female, Obesity, Joint trauma, inflammation,
Osteoarthritis (OA)/
Degenerative Joint
Disease (DJD) comp
bone death, stress fractures
Osteoarthritis (OA)/
Degenerative Joint
Disease (DJD) clinical
Pain in weight-bearing joints after use, improving with rest, morning stiffness, sharp ache, burning, no swelling of joints
Asymmetric joint involvement
HEBERDEN NODES AT DIP
BOUCHARD NODES AT PIP
Osteoarthritis (OA)/
Degenerative Joint
Disease (DJD) path
articular cartilage damage -> chondrocytes make more type II collagen -> switch to type I collagen -> decreased elasticty -> chondrocytes become over worked and die -> leaving debris that type A attempt to remove -> macrophage and lymphocytes recruited -> proinflammatory cytokines causing inflammation -> cracks in bone form
Osteoporosis def
imbalance between bone formation, bone resorption -> decreased bone density, pathologic fractures
Osteoporosis cause
↓ estrogen and old age, Drugs (steroids, alcohol, anticonvulsants, anticoag, thyroid replacement)
Hyperparathyroidism, hyperthyroid, multiple myeloma, malabsorption syndromes, anorexia, turner syndrome, hyperprolactinemia, Klinefelter syndrome, Cushing syndrome, DM
Osteoporosis path
higher breakdown of bone than formation of bone
Osteoporosis RF
genetic, nutrition, estrogen and androgen levels , exercise, age
Osteoporosis comp
Vertebral compression fractures Loss of height Kyphosis Femoral neck fractures Distal radius (colles) fracture
Osteoporosis clinical
asx, pathological fracture of vertebral column (loss of height, kyphosis, sudden back pain, radicular pain, cauda equina) and hips, chronic pain
Paget Disease def
disorder w/ a lot of bone remodeling, excessive bone resorption and growth
Paget Disease cause
Measles, SQSTM1 mutation
Paget Disease path
osteoclast aggressively demineralize bone while rapid, disorganized proliferation of new bone tissue by osteoblasts, collagen deposited unorganized -> osteoblast activity exceeds osteoclast -> weak bone -> osteoblast stop
Paget Disease RF
men, FH, >50
Paget Disease comp
osteosarcoma
Paget Disease clinical
asymptomatic
impinge on nerves causing pain
overgrow of face (leontiasis, hearing loss, vision loss)
kyphosis, lower limb muscle weakness, pelvic asymmetry, bowlegs
Avascular Necrosis def
blood supply to the area has been cut off leading to damage
Avascular Necrosis cause
glucoCorticoids, chronic Alcohol, Sickle cell disease, Trauma, SLE, the Bend (decompression disease), LEgg-Calve-Perthes disease, Gaucher disease, Slipped capital femoral epiphysis
CASTS Bend LEGS
Avascular Necrosis path
femoral
hypoxic -> structural proteins bend out of shape and lysosomal proteins are ineffective at removing affected proteins
Avascular Necrosis RF
Corticosteroids, alcoholism, sickle cell, trauma, SLE
Avascular Necrosis comp
sclerosis, total destruction, nonunion of fracture, and secondary muscle wasting
Avascular Necrosis clinical
pain
Chondrosarcoma def
Tumor of malignant chondrocytes
Chondrosarcoma path
chromosomal mutations in 9p21, 10, 13q14, and 17p13
amplification of MYC and AP-1transcription factors
Chondrosarcoma RF
> 50, PMH of Ollier disease, Maffucci syndrome, Wilms tumor, radiotherapy
Chondrosarcoma comp
bone fractures, metastasis, neurovascular structure impingement
Chondrosarcoma clinical
painful, prgressively enlarging mass, localized swelling, limited ROM, fatigue, weight loss, numbness, weakness, skin discoloration, loss of pulse, claudication
Ewing Sarcoma def
Anaplastic small blue cells of neuroectodermal origin
Ewing Sarcoma cause
mutation
Ewing Sarcoma RF
Caucasians
Boys <15 YO
Ewing Sarcoma comp
Aggressive with early metastases, but responsive to chemo
Ewing Sarcoma clinical
Diaphysis of long bones (esp femur), pelvic flat bones
Osteoid Osteoma def
benign cancer arise from osteoblasts
Osteoid Osteoma comp
scoliosis, enlargement or deformity of bone, stiffness of joint
Osteoid Osteoma clinical
pain, diaphysis of long bones
Osteosarcoma def
cancer of bone tissue, malignant
Osteosarcoma cause
mutation
Osteosarcoma path
mutations in retinoblastoma gene or tumor protein 53 -> cell growth
Osteosarcoma RF
M < 20 YO, genetic, Hereditary retinoblastoma, Paget disease, Li-Fraumeni syndrome,
Osteosarcoma comp
bone marrow repression, cortical bone breakage, adjacent-joint spread
Osteosarcoma clinical
ilium, distal femur, proximal tibia bone pain and tenderness
Rhabdomyosarcoma def
cancer cells arise from skeletal muscle progenitors, malignant
Rhabdomyosarcoma cause
genetic
Rhabdomyosarcoma path
genetic translation determining fusion of two genes which encode two transcription factors FOXO1 & PAX3 -> interferes w/ differentiation-driven gene expression -
Rhabdomyosarcoma RF
Li-Fraumeni syndrome, neurofibromatosis type I, Beckwith-Wiedemann syndrome, Costello syndrome
Rhabdomyosarcoma comp
metastasis
bone marrow involvement
Rhabdomyosarcoma clinical
palpable mass in head/neck, GU tract, limbs, abdomen
hematuria, GU obstruction, sinusitis, headache, cranial nerve alterations, ear discharge, orbital swelling
Septic arthritis def
joint inflammation cause by microbe
Septic arthritis cause
bacteria, Staphylococcus aureus, Streptococcus, mycobacterium tuberculosis, Borrelia species
Septic arthritis path
from preexisting bone infection or from other part of body traveling through blood to joint
toxins from bacteria destroy articular cartilage and then innate immune systems releases cytokines and more cells are recruited to the area -> inflammation and fluid accumulation -> inc pressure -> compress blood vessels -> necrosis
Septic arthritis RF
joint problems, artificial joint, autoimmune conditions
Septic arthritis comp
joint destruction
Septic arthritis clinical
single joint pain, impaired ROM, fever
Gonococcal arthritis RF
sexually active, multiple partners
Gonococcal arthritis comp
meningitis, joint damage, perihepatitis, endocarditis, osteomyelitis
Gonococcal arthritis clinical
multiple joints pain, impaired ROM, fever, skin lesions, and tenosynovitis
Necrotizing Fasciitis def
infection of the subcutaneous fat and muscle fascia
Necrotizing Fasciitis cause
Type I: Bacteroides, Clostridium, Peptostreptococcus, E. coli, Klebsiella, Proteus, Enterobacter,
Type II: group A Streptococcus, other beta-hemolytic streptococci, Staphylococcus aureus
Type II
Necrotizing Fasciitis path
bacteria spared via subcutaneous tissue -> release exotoxins -> tissue destruction spreads along fascial plane
Necrotizing Fasciitis cause
Bacteroides, Clostridium, E. coli, Klebsiella, Proteus, Enterobacter,
group A Streptococcus, other beta-hemolytic streptococci, Staphylococcus aureus
fungal
Necrotizing Fasciitis RF
HIV, diabetes, cirrhosis, corticosteroid use, peripheral vascular disease, trauma, surgery, IV drug abuse, childbirth, exposure of open wound (salt/fresh water, swimming pools, hot tubs), Ludwig’s angina, Lemierre syndrome
Necrotizing Fasciitis comp
death, shock, organ failure
Necrotizing Fasciitis clinical
Skin: warmth, erythema/violet/purple, woody induration, edema, necrosis, bullae (large blisters) w/or w/o serosanguinous fluid, subcutaneous emphysema
pain, fever, tachycardia, pallor, altered LOC, ↓ prefusion, ↓ BP, orthostatic hypotension
Osteomyelitis def
Infection of the bone
Osteomyelitis cause
Staph aureus
Osteomyelitis cause
Staph aureus, Salmonella (SC), Pasteurella multocida (cat scratch)
Osteomyelitis path
trauma, surgery, through blood (most common), or from adjacent area bacteria to bone -> bacteria proliferate -> nearby macrophages and dendritic cells activate -> release cytokines -> bone breakdown -> all bacteria die (acute) or affected bone becomes necrotic and separates (chronic)
Osteomyelitis RF
immunocompromised, DM, IV drugs, hemodialysis, dental extraction of infected tooth, sickle cell
Osteomyelitis comp
abscess in periosteum, infect other joints, muscle, skin, blood vessels (thrombophlebitis)
Osteomyelitis clinical
vertebrae (adults), metaphysis (children)
A: pain, fever, might affect use of bone
C: prolonged fevers, weight loss
Wet Gangrene def
blood supply to an area of the body is interrupted and infection
Wet Gangrene cause
severe burn, frostbite, or injury
Wet Gangrene path
blood supply is cut off -> cell death -> surrounding tissue leaks fluid due to infection
Wet Gangrene RF
diabetes
Wet Gangrene comp
loss of limb
Wet Gangrene clinical
extreme pain, swelling, thin, watery pus can leak out of would, blood filled bullae on skin, fever, tachycardia
Gas Gangrene def
infection of Clostridium perfringens
Gas Gangrene cause
injury, infection, Clostridium perfringens
Gas Gangrene clinical
extreme pain, swelling, thin, watery pus can leak out of would, blood filled bullae on skin, crepitus, fever, tachycardia
Greenstick Fracture
Incomplete fracture extending partway through width of bone following bending stress. Bone fails on the tension side. Compression side intact. Bone is bent like a green twig.
Torus (buckle) Fracture
Axial force apple to immature bone. Cortex buckles on the compression (concave) side, and fractures. Tension (convex) side remains solid.
Arm abduction
supraspinatus, deltoid, trapezius, serratus anterior
Finger Abduction
Dorsal interossei
Finger Adduction
Palmar interossei
Oppose of thumb and pinky
Opponens pollicis
Opponens digiti minimi
Abduct thumb and pinky
Abductor pollicis brevis
Abductor digiti minimi
Flexor of thumb and pinky
Flexor digiti minimi
Flexor pollicis brevis
Hip Abduction
Gluteus medius
Gluteus minimus
Hip Adduction
Adductor magnus
Adductor longus
Adductor brevis
Hip Extension
Gluteus maximus
Semitendinosus
Semimembranosus
Hip Flexion
Iliopsoas Rectus femoris Tensor fascia lata Pectineus Sartorius
Hip Internal Rotation
Gluteus medius
Gluteus minimus
Tensor fascia latae
Hip External Rotation
Iliopsoas
Gluteus maximus
Piriformis
Obturator
Osteoblasts
build bones by secreting collagen and catalyzing mineralization in alkaline environment via alkaline phosphatase
Osteoclast
dissolves bone by secreting H+ and collagenase vis RANK receptors being stimulates by RANKL or osteoprotegerin
Estrogen
inhibits apoptosis in osteoblasts and induces apoptosis in osteoclast
Where dose herniation happen?
C5-C6
C6-C7
L4-L5
L5-S1
What parts of the spine have lordotic?
cervical and lumbar
What parts of spine have kyphotic?
thoracic
Scoliosis cause
idiopathic, congenital, neuromuscular scoliosis
Scoliosis RF
9-15, neuromuscular disorder, FH
Scoliosis comp
heart and lung problem, paralysis
Scoliosis clinical
spinal curvature to one side, uneven hips or shoulders, differences in leg length, tiredness of spine, prominent shoulder blade, rib bump
Rheumatoid Arthritis def
chronic systemic autoimmune disorder
Rheumatoid Arthritis cause
autoimmune
Rheumatoid Arthritis path
antiboidies bind w/ other proteins and tissues -> create immune complexes that cause inflammation -> enzymes cause further joint tissue degradation-> pannus forms -> osteoclasts cause underlying bone to demineralize
Rheumatoid Arthritis clinical
joint swelling, stiffness, warmth, tenderness, pain
joint deformation, fatigue, anorexia, weight loss, weakness, low-grade fever, rheumatoid nodules, pleural effusion, vasculitis, pericarditis, enlarged spleen
Rheumatoid Arthritis antibodies
Rheumatoid factor, anti-cyclic citrullinated peptide
Healing of Fracture
inflammatory stage: hematoma, inflammatory cell degrade debris and bacteria
reparative stage: fibrocartilage formed, soft callus joins fractured bone, hard callus develops, blood vessels form
remodeling stage: lamellar bone replaces woven bone
Compartment syndrome def
edema and swelling cause increased pressure in muscle compament
Compartment syndrome def
edema and swelling cause increased pressure in muscle compartment
Compartment syndrome comp
paralysis, amputation, Volkmann contracture
Adhesive Capsulitis def
acute inflammation of ligaments in shoulder joint capsule
Adhesive Capsulitis clinical
self-imposed immobility of shoulder because of pain, stiffness, loss of motion,
Triceps brachii A & N
A: Elbow joint: extension of the forearm
Shoulder joint: extension and adduction of the arm (long head)
N: Radial nerve
Biceps brachii A & N
Flexion and supination of the forearm at the elbow joint, weak flexor of the arm at the glenohumeral joint
N: Musculocutaneous nerve
Coracobrachialis muscle A & N
Adduction and flexion of the arm at the shoulder joint
N: Musculocutaneous nerve
Coracobrachialis muscle A & N
Adduction and flexion of the arm at the shoulder joint
N: Musculocutaneous nerve
Serratus posterior superior muscle A & N
A: Elevates ribs
N: 2nd-5th Intercostal nerves
Serratus posterior inferior muscle A & N
A: Depresses ribs/ Draws ribs inferoposteriorly
N: Anterior rami of spinal nerves T9-T12
Rectus capitis posterior major muscle A & N
Head extension and Head rotation
Suboccipital nerve
Rectus capitis posterior minor A & N
Head extension
Posterior ramus of spinal nerve C1
Obliquus capitis superior A & N
Head extension and Head lateral flexion
Suboccipital nerve
Obliquus capitis inferior A & N
Head extension and Head rotation
Posterior ramus of spinal nerve C1
brachialis A & N
flexion of the forearm Musculocutaneous nerve (C5,C6); Radial nerve (C7)
pronator teres A & N
Pronation of forearm at the proximal radioulnar joint, flexion of the forearm at the elbow joint Median nerve (C6, C7)
flexor carpi radialis A & N
Wrist flexion, wrist abduction Median nerve (C6, C7)
palmaris longus A & N
Wrist flexion and Tenses palmar aponeurosis
Median nerve
flexor carpi ulnaris A & N
Wrist flexion, wrist adduction
Ulnar nerve
flexor digitorum superficialis A & N
Finger flexion
Median nerve
pronator quadratus A & N
Forearm pronation
Median nerve
extensor digitorum A & N
Finger extension
Posterior interosseous nerve
extensor carpi ulnaris A & N
Hand extension and adduction
Posterior interosseous nerve
extensor carpi radialis longus A & N
Hand extension, hand abduction
Radial nerve
brachioradialis A & N
Forearm flexion
Radial nerve
dorsal interossei muscles of hand A & N
Finger abduction, finger flexion, Finger extension
Deep branch of ulnar nerve
lumbrical muscles hand A & N
Finger flexion and Finger extension
Lumbricals 1-2: Median nerve (C8-T1)
Lumbricals 3-4: Ulnar nerve (C8-T1)
extensor carpi radialis brevis A & N
Hand extension, hand abduction
Radial nerve
dorsal interossei muscles of foot A & N
toe flexion, toe abduction, toe extension
Lateral plantar nerve
lumbrical of foot A & N
Toe flexion, Toes adduction, Toes extension
Lumbrical 1: Medial plantar nerve (S2,S3);
Lumbricals 2-4: Lateral plantar nerve (S2-S3)
Flexor digitorum profundus
Finger flexion
median and ulnar n
Flexor pollicis longus
Thumb flexion
Median nerve
extensor digiti minimi
extension
Radial nerve
Supinator
extension
Radial nerve
abductor pollicis longus
extension
Radial nerve
extensor pollicis brevis a/n
extension
Radial nerve
extensor pollicis longus
extension
Radial nerve
extensor indicis
extension
Radial nerve
Palmar interossei
flexion and extension of fingers 2, 4 & 5
Deep branch of ulnar nerve
Abductor pollicis brevis
Thumb abduction
median nerve
Adductor pollicis
Thumb adduction
ulnar nerve
Flexor pollicis brevis
Thumb flexion
median nerve and ulnar nerve
Opponens pollicis
Thumb opposition
median nerve
Abductor digiti minimi hand
Abduction, flexion and extension of little finger
Ulnar nerve
Flexor digiti minimi
Flexion, lateral rotation and opposition of little finger
Ulnar nerve
Opponens digiti minimi hand
Flexion, lateral rotation and opposition of little finger
Ulnar nerve
Palmaris brevis
tightens palmar aponeurosis, tightens grip
Ulnar nerve
Iliopsoas
Thigh/trunk flexion, Thigh external rotation, lateral flexion
Femoral nerve, Anterior rami of spinal nerves L1-L3
Gluteus maximus
Thigh extension, Thigh external rotation, Thigh abduction (superior part), Thigh adduction (inferior part)
Inferior gluteal nerve
gluteus medius
Hip abduction, Thigh internal rotation (anterior part); Pelvis stabilization
Superior gluteal nerve
gluteus minimus
Hip abduction, Thigh internal rotation (anterior part); Pelvis stabilization
Superior gluteal nerve
tensor fasciae latae A & N
Thigh internal rotation, Leg external rotation, Stabilizes hip & knee joints
Superior gluteal nerve
Piriformis
Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Nerve to piriformis (S1-S2)
obturator internus
Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Nerve to obturator internus (L5-S2)
superior gemellus
Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Nerve to obturator internus (L5-S2)
inferior gemellus
Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Nerve to quadratus femoris (L4-S1)
rectus femoris
Thigh flexion and Leg extension
Femoral nerve
Sartorius
thigh flexion, thigh abduction, thigh external rotation, leg flexion, leg internal rotation
Femoral nerve
vastus lateralis
Leg extension
Femoral nerve
vastus intermedius
Leg extension
Femoral nerve
vastus medialis A/N
Leg extension
Femoral nerve
Pectineus
Thigh flexion, Thigh adduction, Thigh external rotation, Thigh internal rotation; Pelvis stabilization Femoral nerve (L2-L3)
adductor longus
Thigh flexion, Thigh adduction, Thigh external rotation; Pelvis stabilization Obturator nerve (L2-L4)
adductor brevis
Thigh flexion, Thigh adduction, Thigh external rotation; Pelvis stabilization Obturator nerve (L2-L4)
adductor magnus
Thigh flexion, Thigh adduction, Thigh external rotation (adductor part), Thigh extension, Thigh internal rotation (ischiocondylar part); Pelvis stabilization
Obturator nerve (L2-L4) and Tibial division of sciatic nerve (L4)
adductor minimus
Thigh adduction, Thigh external rotation Obturator nerve (L2-L4)
gracilis
Thigh flexion, Thigh adduction; Knee joint: Leg flexion, Leg internal rotation Obturator nerve (L2-L3)
obturator externus
Thigh external rotation, Thigh abduction (from flexed hip), Thigh adduction (secondary function); Stabilizes head of femur in acetabulum Obturator nerve (L3-L4)
Biceps femoris
thigh extension, thigh external rotation, leg flexion, leg external rotation; stabilizes pelvis
tibial division of sciatic nerve and common fibular division of sciatic nerve
semimembranosus
thigh extension, internal rotation, flexion and internal rotation of the leg, Stabilizes pelvis
Tibial division of sciatic nerve
semitendinosus
Thigh extension, thigh internal rotation, stabilizes pelvis, Leg flexion, leg internal rotation
Tibial division of sciatic nerve (L5-S2)
Quadratus femoris
Thigh external rotation; Stabilizes head of femur in acetabulum
Nerve to quadratus femoris (L5-S1)
Flexor digitorum brevis
Toe flexion; Supports longitudinal arch of foot
Medial plantar nerve (S1-S3)
quadratus plantae
Toe flexion
Lateral plantar nerve (S1-S3)
plantar interossei muscles of foot
Toe flexion, Toes adduction, Toes extension
Lateral plantar nerve ( S2-S3)
Abductor digiti minimi foot
toe abduction, Toe flexion; Supports longitudinal arch of foot
Lateral plantar nerve ( S1-S3)
flexor digiti minimi brevis A/N
Toe flexion
Lateral plantar nerve (S2-S3)
opponens digiti minimi foot
Toe abduction, Toe flexion
Lateral plantar nerve (S2-S3)
Abductor hallucis
Toe abduction, Toe flexion; Support of longitudinal arch of foot
Medial plantar nerve (S1-S3)
adductor hallucis
Toe adduction, Toe flexion; Support of longitudinal and transverse arches of foot
Lateral plantar nerve (S2,S3)
flexor hallucis brevis
Toe flexion; Support of longitudinal arch of foot
Medial plantar nerve (S1,S2)
Extensor digitorum brevis
Toe extension
Deep fibular/peroneal nerve (S1, S2)
extensor hallucis brevis
Toe extension
Deep fibular/peroneal nerve (S1, S2)
external oblique
Trunk flexion, compresses abdominal viscera, expiration, Trunk lateral flexion (ipsilateral), trunk rotation
lower intercostal nerves.
internal oblique
Trunk flexion, compresses abdominal viscera, expiration, Trunk lateral flexion (ipsilateral), trunk rotation (ipsilateral)
lower intercostal nerves, iliohypogastric nerve and ilioinguinal nerve
Transversus abdominis
compresses abdominal viscera, expiration, Trunk rotation
lower intercostal nerves, iliohypogastric nerve and ilioinguinal nerve
Rectus abdominis
Trunk flexion, Compresses abdominal viscera, Expiration
Intercostal nerves (T6-T11), Subcostal nerve (T12)
Pyramidalis
Tenses linea alba Subcostal nerve (T12)