Thinking About Muscles
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1 THE MUSCULAR SYSTEM DR. NIHAL APAYDIN
2 Thinking About Muscles Architecture general information fiber tendon, fascia etc. Naming General Principles Function Muscles by region
3 General Information ~700 muscles Muscle fiber: structural unit Motor unit: motor neuron + the muscle fibers it control (1- several 100)
4 General Information Origin Insertion Innervation* Function The forces developed by skeletal muscles are transferred to bones by; Tendon Aponeurosis Fascia
5 Naming Muscles-1 Shape: Location: quadratus, rhomboids subclavius, occipitalis Number of heads: biceps, quadriceps Primary action: flexor digitorum, supinator
6 Naming Muscles-2 Size: gluteus magnus, medius, minimus Course: rectus abdominis, obliquus superior Length: longus,. brevis Origin-insertion: coracobrachialis, sternohyoideus
7 Architecture of Muscles Fibers parallel to tendon short, flat, straplike or fusiform Fibers oblique to tendon pennate, semipennate or multipennate Greater Range of Motion Greater Power
8 The Role of Fascia Protection / Connection / Compartmentalization Superficial Fascia subcutaneous tissue hypodermis Individuality Storage Muscles of facial expression Deep Fascia more fibrous & ordered invests muscles can be site of attachment variable thickness spread of fluid & infection compartmentalizes muscles
9 Attachments & Pull Angles Attachments DYNAMIC cord like (biceps) strap like (lat dorsi) sheet like (bicipital aponeurosis)?? Single pull point?? multiple pull points (fan shaped muscles)?? Why long tendon vs short?? What is the effect of the pull on attachment sites What different leverage systems are created by attachments?
10 Muscles By Region Regions are typically between joints or groups of similar joints. Regions are further divided into muscle groups by similar locations or functions Region back superficial and deep trunk pectoral, intercostal, abdominal arm/forearm flexor & extensor (deep & superficial) hand thenar, hypothenar, central thigh flexor, adductor, extensor leg anterior, posterior, lateral foot layer 1, 2, 3, 4 Groups/Compartments head facial, masticators, orbital
11 MUSCLES OF APPENDICULAR SKELETON
12 MM. OF SHOULDER AND ARM Deltoid Subscapularis Infraspinatus Supraspinatus Teres major Teres minor Biceps brachii Brachialis Coracobrachialis Triceps brachii
13 Deltoid O: 3 parts -clavicular, acromial, spinal I: humerus (deltoid tuberosity) Inn: axillary nerve F: the strongest abductor of the arm*** -clavicular part: add+med. rot. -acromial part: abd********** (15-90 degrees) -spinal: add+lat. rot.
14 Subscapularis O: subscapular fossa I: humerus (greater tuberosity) Inn: subscapular nerve F: med. rot.**
15 Supraspinatus O: supraspinous fossa I: humerus (greater tuberosity) Inn: suprascapular nerve F: abd. (0-15 degrees)*****
16 Infraspinatus O: infraspinous fossa I: humerus (greater tuberosity) In: suprascapular nerve F: lat. rot.
17 Teres minor O: lateral border of the scapula I: humerus (greater tuberosity) Inn: axillary nerve F: lat. rot, add.
18 Teres major O: inferior angle of scapula I: crest of lesser tuberosity Inn: subscapular nerve F: med. rot, add, ext.
19 Rotator Cuff Muscles They form a musculotendinous cuff around the glenohumeral joint. They resist displacement of the head of the humerus from the glenoid cavity.
20 Rotator Cuff Muscles S I T S I T S upraspinatus nfraspinatus eres minor ubscapularis Suprascapular n. Suprascapular n. Axillary n. Upper/lower subscapular n.
21 Posterior Arm = Extensor Muscles of the forearm Triceps Brachii Long Head Medial Head Lateral Head O: Three heads (long, lat, med) I: olecranon F: ext. ****Strongest extensor of the forearm *************** Inn: radial nerve
22 Anterior arm = Flexor muscles of the arm and forearm Biceps brachii Brachialis Coracobrachialis Inn: Musculocutaneous nerve
23 Biceps brachii O: 2 heads - long: supraglenoid tubercle - short: coracoid proc. I: radial tuberosity F: flex, med. rot (supination)
24 Brachialis O: humerus I: ulnar tuberosity F: flex. (only forearm)
25 Coracobrachialis O: coracoid proc. I: humerus F: add, med. rot
26 Muscles of the Forearm Radius, ulna and the interosseous membrane connecting them divide into anterior (flexor-pronator) and posterior (extensor-supinator) compartments
27 Muscles of the Forearm Ant: flex. Inn: median and ulnar nerves
28 Muscles of the Forearm Post.: ext. Inn: radial nerve
29 MUSCLES OF THE LOWER EXTREMITY
30 Gluteal Muscles Gluteus maximus: ext**, lat. rot, abd/add inf. gluteal nerve Gluteus medius: abd**, flex/ext, med/lat. Rot sup. gluteal nerve Gluteus minimus: abd, flex/ext, med/lat rot sup. gluteal nerve
31 External Rotators Piriformis Obturator internus Obturator externus Gemelli sup, and inf Quadratus femoris
32 Muscles of the Anterior Thigh Quadriceps = 4 heads Sartorius Vastus lateralis Rectus femoris Vastus medialis Vastus intermedius
33 Quadriceps femoris O: 4 heads I: patella, tibial tuberosity Inn: femoral nerve F: hip: flex (rectus femoris) knee: extension********
34 Sartorius ~62 cm O: ASIS I: Tibia (pes anserius) Inn: femoral nerve F: Hip: flex+abd+lat. rot Knee: flex+med. rot
35 Deep View Anterior & Medial Thigh pectineus adductor longus (cut) adductor brevis adductor magnus*** gracilis Inn: obturator nerve
36 Hamstring Muscles (Ischiocrural Muscles) Biceps femoris (long and short heads) Semitendinosus Semimembranosus Inn: sciatic nerve (tibial and common fibular divisions)*** F: Hip: ext Knee: flex**
37 Triceps surae Gastrocnemius O: 2 heads, lat and med femural condyles I: calcaneus (tendo calcanei-achilles) Inn: tibial nerve F: plantar flex***, raises heel during walking and flexes leg at knee joint
38 Triceps surae Soleus O: fibula, tibia I: calcaneus Inn: tibial nerve F: plantar flexes ankle and steadies leg on ankle
39 Deep posterior compartment Inn: tibial nerve F: flexion
40 Muscles of the Foot Extensor hallucis brevis Extensor digitorum brevis (medial 4 digits)
41 Muscles of the Foot Muscles in the sole of the foot: 4 layers 17 muscles
42 MUSCLES OF AXIAL SKELETON MM. OF FACE MM. OF MASTICATION NECK MM. MM. OF ABDOMINAL WALL MM. OF BACK
43 MUSCLES OF FACE (FACIAL EXPRESSION MUSCLES) Located in subcutaneous tissue; they move the skin. Surround the orifices of mouth, eyes and nose; act as sphincters or dilators. Change facial expressions to convey mood. *******All are innervated by the facial nerve.
44 MUSCLES OF FACE Orbicularis oculi: closes eyelids. Orbicularis oris: compresses and protrudes lips (whistling, sucking). Buccinator: presses cheek against molat teeth (aid chewing), Expels air from oral cavity (wind instrument), sucking Corrugator supercilii: frowns Levator labii superioris: smiles Levator anguli oris: makes a big smile Levator labii superioris alaeque nasi:???
45 MUSCLES OF FACE Zygomaticus major ve minor: smiles Risorius: grins Depressor labii inferioris: sulks Depressor anguli oris: pouts.
46 MUSCLES OF MASTICATION Temporalis: closes the jaw Masseter: closes the jaw Temporalis Medial pterygoid: closes the jaw Lateral pterygoid: opens the jaw Masseter **************All are innervated by the trigeminal nerve
47 NECK MUSCLES Platysma: muscle of fascial expression, draws corners of mouth inferiorly (fascial nerve) Sternocleidomastoideus: tilts head to one side, flexes neck and rotates it so face is turned superiorly toward opposite side; actinh together, flex the neck (cranial accessory nerve) Infrahyoid muscles Suprahyoid muscles
48 PECTORAL MUSCLES (ANT. THORACOABDOMINAL MUSCLES) Pectoralis major: 3 PARTS: clavicular sternocostal abdominal inserts on humerus add**************** and medial rotation of the arm med. and lat. pectoral nerves
49 PECTORAL MUSCLES (ANT. THORACOABDOMINAL MUSCLES) Pectoralis minor: 3-5 ribs-coracoid process Stabilizes scapula by drawing it inferiorly If insertion is fixed, helps inspiration Inn: med. pectoral nerve
50 ANT. THORACOABDOMINAL MUSCLES Serratus anterior: 1st to 8th ribs-medial border of scapula rotates scapula, holds it against thoracic wall long thoracic nerve Subclavius: Anchors and depresses clavicle
51 Intercostal muscles External intercostal: superficial layer, inferomedial elevates the ribs (inspiration) Internal intercostal: middle layer, inferolateral depress ribs (expiration) Innermost intercostal: deepest layer depress ribs (expiration)
52 MUSCLES OF ANTEROLATERAL ABDOMINAL WALL external oblique: internal oblique: intermediate superficial, inferomedial transverse abdominal: innermost, horizontal rectus abdominis: long, broad, strap-like, tendinous intersections pyramidalis: small triangular muscle
53 MUSCLES OF ANTEROLATERAL ABDOMINAL WALL Actions: Compresses (urination, defecation, vomiting, parturition etc) and support abdominal viscera Flex the trunk. Rotate the trunk. Innervated by the anterior rami of thoracic spinal nerves
54 MUSCLES OF POSTERIOR ABDOMINAL WALL psoas major*/minor: - flexes and externally rotates the thigh - inn : anterior rami of lumbar nerves iliacus: - flexes and externally rotates the thigh - inn : femoral nerve ( psoas + iliacus = iliopsoas: also classified in anterior thigh muscles ) quadratus lumborum: - helps inspiration, laterally rotates the trunk - inn : anterior rami of lumbar nerves
55 PELVIC DIAPHRAGM levator ani: 2 parts pubococygeus iliococygeus cocygeus Actions: resists increases in intra-abdominal pressure helps to support pelvic viscera
56 UROGENITAL DIAPHRAGM superficial/ deep*** transverse perineal muscles external urethral sphincter bulbospongiosus-ischiocavernosus
57 MUSCLES OF THE BACK Two Layers Superficial = extrinsic = migratory Deep = intrinsic Superficial muscles act on upper limb Deep muscles act on vertebral column
58 Superficial Muscles of the Back Trapezius 3 parts: ascending, descending, transverse Functions according to fiber alignment (elevates, retracts and rotates scapula) spinal accessory n./ascending transverse cervical a. Latissimus dorsi Raises the arm to trunk (chin-ups), adducts, medially rotates and extends the arm thoracodorsal n./a. Rhomboid major/minor Abducts the scapula, fixing the scapula during movements of the arm Levator scapulae Elevates scapula dorsal scapular n./descending branch transverse cervical a. Serratus posterior superior Serratus posterior inferior Intercostal nerves/intercostal arteries
59 Deep Muscles of the Back Splenius capitis/cervicis Erector spinae Transversospinalis Minor Deep Group
60 Deep Muscles of the Back Stabilizes spine Extend head, cervical and thoracal regions accordingly, rotate head, cervical and thoracal regions contralaterally Innervated by the post. rami of spinal nerves
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