phag/o-, psych/i-, spir/o-, Quick Reference pharyng/o-, pulmon/o, stat/i-, pyel/o-, CORE PRINCIPLES in A&P phleb/o-, systol/i-, phot/o-, py/o-,

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2 phag/o-, eat: autophagy = self eating; condition of a cell digesting itself pharyng/o-, throat: glossopharyngeal = pertaining to the tongue and throat phleb/o-, vein: phlebotomy = incision into a vein phot/o-, light: photophobia = fear or dislike of light phys/i-, function: pathophysiology = study of the altered physiology of disease states pin/o-, drink: pinocytosis = condition of cell drinking plex/u-, network, twisted: nerve plexus = network of nerves pneum/o-, pneumat/o-, air, breath: pneumothorax = air in the thoracic cavity pneumon/o-, lung: pneumonitis = inflammation of the lung pod/o-, foot: podiatrist = medical specialist of the foot and ankle proct/o-, rectum: proctoscope = instrument used to examine the rectum pseud/o-, false: pseudoanemia = pallor of mucous membranes and skin without other signs of true anemia psych/i-, mind: psychopathology = study of diseases of the mind pulmon/o, lung: intrapulmonary = within the lung pyel/o-, pelvis: pyelonephritis = inflammation of the renal pelvis py/o-, pus: pyoderma = condition causing pus to form in the skin pyr/o-, fire: pyrolysis = breakdown of a chemical by elevated temperature ren/i-, kidney: adrenal = pertaining to an area next to the kidney rhin/o-, nose: rhinorrhea = drainage from the nose sarc/o-, flesh, soft tissue: sarcolemmal = pertaining to the outer covering of a muscle fiber (the plasma membrane) scler/o-, hard: scleroderma = hardening of the skin sigm/o-, S-shaped: sigmoidoscopy = examination of the S-shaped portion of the colon sin/u-, cavity: sinusoid = resembling a sinus or cavity son/o-, sound: sonogram = data recorded using sound waves spir/o-, breathe: spirometry = measurement of breathing stat/i-, to stop, standing still: hydrostatic = pertaining to fluids not in motion systol/i-, contract, standing together: systolic pressure = blood pressure during the heart s contraction therm/o-, temperature: thermogenesis = generation of heat thromb/o-, clot: thrombosis = abnormal condition of a blood clot tom/o-, cut, slice: dermatome = instrument that takes slices of skin tox/o-, poison, toxin: neurotoxin = toxin causing damage to the nervous system tympan/o-, drum: tympanoplasty = reconstruction of the eardrum urin/o, urine: oliguria = production of little urine vas/o-, vascul/o, vessel: extravascular = outside a blood vessel vesic/o-, vesicul/o-, bladder, small sac: vesiculotomy = surgical incision of the seminal vesicle viscer/o-, organ: visceral = pertaining to an organ vit/a-, life: vital = pertaining to life

3 9.5 Muscles of the Hip and Lower Limb 367 Table 9.18 Muscles That Move the Thigh and Knee: Posterior Muscles Muscle(s) Action(s) Origin/Insertion/Nerve(s) Concept Figures Gluteus maximus Gluteus medius Gluteus minimus Piriformis Extends the thigh (especially when the thigh is in flexed position); laterally rotates the thigh; abducts the thigh Abducts the thigh; medially rotates the thigh; stabilizes pelvis while walking Abducts the thigh; medially rotates the thigh; stabilizes pelvis while walking Abducts the thigh; laterally rotates the thigh O: Posterior and lateral portions of the ilium, sacrum, and coccyx I: Gluteal tuberosity of femur N: Inferior gluteal nerve O: Between and anterior gluteal lines on the outer surface of ilium I: Greater trochanter of the femur N: Superior gluteal nerve O: Between the anterior and inferior gluteal lines on the outer surface of ilium I: Greater trochanter of the femur N: Superior gluteal nerve O: Anterior/lateral sacrum N: L 5, S 1 S 2 Obturator externus Laterally rotates the thigh O: Edges of and outer surface of obturator foramen and membrane N: Obturator nerve Obturator internus Laterally rotates the thigh O: Edges of and inner surface of obturator foramen and membrane N: L 5, S 1 Gemelli (superior gemellus and inferior gemellus) Laterally rotate the thigh O: Ischial spine and tuberosity N: L 5, S 1 Quadratus femoris Laterally rotates the thigh O: Ischial tuberosity I: Intertrochanteric crest of femur N: L 5, S 1 Biceps femoris* Semitendinosus* Semimembranosus* Extends the thigh; flexes the knee Extends the thigh; flexes the knee Extends the thigh; flexes the knee O: Ischial tuberosity and lower half of femur I: Head of fibula; lateral condyle of tibia N: Sciatic nerve O: Ischial tuberosity I: Upper medial surface of tibia N: Sciatic nerve O: Ischial tuberosity I: Posterior surface of medial condyle of tibia N: Sciatic nerve Biceps femoris Semitendinosus Gluteus muscle group Piriformis Obturator and gemelli Quadratus femoris Semimembranosus *Part of the hamstring muscle group.

4 368 Chapter 9 The Muscular System Muscles That Move the Foot and Toes The movements of this group of are subtle, yet important in helping move the foot correctly for walking, running, dancing, or standing on tiptoe. The anterior and lateral of this group are shown in Figure The tibialis anterior and extensor digitorum are the main of dorsiflexion (movement of the dorsal or upper surface of the foot toward the leg, as when walking on the heels). The extensor digitorum also extends toes 2 5 (digits), as its name implies. The extensor hallucis assists dorsiflexion by pulling up on the great toe (and also extends the great toe, as its name suggests). Far more are involved in plantar flexion, or pushing the front of the foot down (think planting the foot) for actions such as standing on your toes and pushing off when running. The triceps surae group, consisting of the soleus (SO-lee-us) and the two heads of the gastrocnemius (gas -trock-nee-me-us), may be the most familiar producing this action; they are shown in Figure 9.24 with the. Another tip for remembering this action is that in a car you use the gastrocnemius to step on the gas. These form the fleshy calf of the leg and taper down to the calcaneal (Achilles) tendon. See Table 9.19 for more information on that move the foot and toes. Most of the in the lower three-fourths of Table 9.19 share plantar flexion as their action with the gastrocnemius and soleus. Some of the in this group also assist with moving the sole of the foot outward (eversion) or inward (inversion). The fibularis and fibularis are the main of foot eversion. The tibialis and tibialis anterior are the main of foot inversion. The flexor hallucis flexes the big toe, and the flexor digitorum flexes toes 2 5. You use these when you curl your toes. Having already explored the that move the fingers, you will find that many of the small that move the toes Patella anterior Head of fibula anterior digitorum Tibia digitorum hallucis hallucis Superior and inferior extensor retinacula hallucis Superior and inferior extensor retinacula Lateral hallucis digitorum Fibular retinaculum digitorum 5th metatarsal (a) Anterior view (b) Lateral view Figure 9.23 Anterior and lateral that move the ankle and toes. Labels in bold indicate involved in these actions.

5 9.5 Muscles of the Hip and Lower Limb 369 gastrocnemius Medial Lateral Calcaneal (Achilles) tendon Calcaneus Fibula (a) Superficial Flexor hallucis : Lateral head Medial head Head of fibula Flexor digitorum tibialis plantaris tibialis Medial Calcaneal tendon Calcaneus (b) Muscles under the gastrocnemius (c) Deeper under the gastrocnemius and soleus Figure 9.24 Right leg: that move the ankle and toes. Labels in bold indicate involved in these actions.

6 370 Chapter 9 The Muscular System Table 9.19 Muscles That Move the Foot and Toes Muscle(s) Action(s) Origin/Insertion/Nerve(s) Concept Figures anterior Dorsiflexes the foot; inverts the foot digitorum hallucis (peroneus) * Extends the toes; dorsiflexes the foot Extends the great toe; dorsiflexes the foot Everts the foot; plantar flexes the foot Everts the foot; plantar flexes the foot Plantar flexes the foot; assists with flexing knee O: Lateral condyle and upper diaphysis of the tibia I: Cuneiform and first metatarsal N: Deep fibular nerve O: Lateral condyle of the tibia and upper portion of the fibula I: Phalanges and connective tissues of toes 2 5 N: Deep fibular nerve O: Diaphysis of the fibula and interosseous membrane I: Distal phalanx of great toe N: Deep fibular nerve O: Upper lateral fibula I: Cuneiform and first metatarsal N: Superficial fibular nerve O: Lower fibula I: Fifth metatarsal N: Superficial fibular nerve O: Medial and lateral condyles of the femur I: Posterior surface of calcaneus * Plantar flexes the foot O: Head of the fibula, proximal tibia, and interosseous membrane I: Posterior surface of calcaneus Flexor digitorum Plantar flexes the foot; assists with flexing knee (very weak synergist) Inverts the foot; plantar flexes the foot; stabilizes foot Flexes toes; stabilizes foot Flexes the great toe Flexes leg at the knee; rotates leg and other minor movements, depending on which fixators are in use O: Posterior femur near lateral condyle I: Calcaneus and calcaneal tendon O: Upper tibia, fibula, and interosseous membrane I: Metatarsals 2 4 O: Posterior tibia I: Distal phalanges of toes 2 5 O: Posterior fibula and interosseous membrane I: Distal phalanx of great toe O: Lateral condyle of the femur I: Posterior surface of upper tibia *Part of the group of triceps surae that share a common insertion tendon, the calcaneal (Achilles) tendon. anterior Flexor anterior and have similar names (Figure 9.25). The of the foot help support the arches of the foot and allow it to adapt to changing terrain when we walk. Although we often think of hand as more adept with precise movements, the of the feet can also be trained to perform skilled movements, such as drawing or knitting, as shown by individuals with upper limb disabilities. Most of the in this group are named for their actions. For example, the flexor digitorum is a small muscle that flexes toes 2 4. Other in this region are named for their appearance or their placement. The lumbricals are, again, the wormlike that flex the toes and extend the tips of the toes, similar to their actions in the hand. The plantar interossei and dorsal interossei attach between the bones, as do their counterparts in the hand, except that the plantar interossei arise from underneath the metatarsals. See Table 9.20 for more details about that move the toes. Quick Check 3. Name and describe the major of dorsiflexion. 4. Name and describe the of plantar flexion. Apply What You Learned 1. Explain how the rectus femoris can be part of the quadriceps femoris group that mainly extends the knee but also flexes the thigh. 2. Consider the movements of plantar flexion and dorsiflexion. Propose a reason why there are far more (and stronger) involved in plantar flexion.

7 9.5 Muscles of the Hip and Lower Limb 371 Dorsum (top) of foot Plantar aspect (sole) of foot Superior and inferior extensor retinacula hallucis Flexor digiti minimi Abductor digiti minimi flexor hallucis Lumbricals Flexor digitorum digitorum Quadratus plantae Abductor hallucis Plantar aponeurosis (a) Superficial of the dorsum and the plantar aspect Calcaneal tuberosity Plantar aspect Adductor hallucis: Oblique head Transverse head Dorsal aspect Dorsal interossei Plantar aspect Plantar interossei Lumbricals tendon Flexor digitorum (tendon) Flexor digiti minimi Quadratus plantae (b) Deeper of the plantar aspect (c) Muscles between the toes Figure 9.25 Muscles that move the toes. Labels in bold indicate involved in these actions.