Anatomy notes

? Week 1- Introduction & Nervous System pt.1 Anatomical position  Superior (cranial): toward the head end or upper part of a structure or the body; above o ex: the head is superior to the abdomen  Inferior (caudal) : away from the head end or toward the lower part of a structure or the body; below o ex: the navel is inferior to the chin  Anterior (ventral) : toward or at the front of the body; in front of o ex: the breastbone is anterior to the spine  Posterior (dorsal) : toward the back of the body; behind o ex: the heart is posterior to the breastbone  Medial: toward or at the midline of the body; on the inner side of o ex: the heart is medial to the arm  Lateral: away from the middle of the body; on the outer side of o ex: the arms are lateral to the chest  Proximal : closer to the origin of the body part or the point of attachment of a limb to the body trunk o ex: the elbow is proximal to the wrist  Distal: farther from the origin of a body part or the point of attachment of a limb to the body trunk o ex: the knee is distal to the thigh  Superficial: toward or at the body surface  Deep (internal): away from the body surface; more internal  Ipsilateral: on the same side  Contralateral: on opposite sides Planes of section through body  Sagittal (median): front middle  Frontal (coronal): side middle  Transverse: dividing upper and lower body Body movements  Flexion: decreasing the angle of a joint  extension: increasing the angle of a joint  Abduction: movement away from the midline  Adduction: movement toward the midline  Lateral/ medial rotation Division of the nervous system: Central nervous system peripheral nervous system sensory (afferent) division, motor (efferent) division Somatic nervous system Autonomic nervous system Sympathetic division, parasympathetic division What is a spinal nerve?  Part of the peripheral nervous system  Mixed nerve carrying motor and sensory information between the spinal cord and body

 31 pairs of spinal nerves Bony framework:  Vertebrae surround spinal cord  Spinal nerves exit between the vertebrae at the intervertebral foraman o Foraman between two vertebrae  During fetal growth the spinal column grows at a faster rate than the spinal cord Sections of the spine and number of vertebrae in each  cervical: 7  thoracic: 12  lumbar: 5  Sacral: 5  coccygeal: 1 Sections of the spinal cord and number of nerves in each  cervical: 8  thoracic: 12  lumbar: 5  Sacral: 5  Coccygeal: 1 How far does the spinal cord go  about to L1 then it is just nerves Where do nerves exit  cervical: EXIT ABOVE VERETBRAE  lumbar, thoracic, sacral: exit below Spinal cord to spinal nerve flow spinal cord - dorsal rootlets - dorsal root - spinal nerve - ventral rootlets - ventral root- spinal nerve divides into dorsal ramus and ventral ramus  ventral root and rootlets: MOTOR  dorsal root and rootlets: SENSORY  the motor nerves stop at muscle and then the sensory ones continue onto the skin Dermatomes  area of skin innervated by a single spinal nerve  Important for diagnosing spinal injuries and shingles (varicella-zoster virus) Motor function:  Each terminal branch applies a group of muscles within the upper limb Terminal branch Muscle group Muscle example musculocutaneous Arm flexors Biceps brachii median Forearm and hand flexors Flexor digitorum radialis ulnar Forearm and hand flexors Flexor digitorum ulnaris radial Arm and forearm extensors Triceps brachii axillary shoulder deltoid Brachial plexus

o acromial end - attaches to acromium process of scapula  function of clavicle o provides muscle attachment o acts as brace for the scapula and arms o transmits compression force  fracture of clavicle o occurs in center o side with the fracture will collapse medially and droop - very easy to see its "braceing" function Scapula  located on dorsal rib cage between ribs 2 and 7  3 borders and angles of scapula o superior, medial (next to spinal column) o lateral (ends in glenoid fossa where humerus connects)  lateral (glenoid fossa)  superior (superior and medial meet)  inferior (medial and lateral meet) Other features of scapula  subscapular fossa (front)  infraspinous fossa  supraspinous fossa  acromium  spine (on posterior)  coracoid process Prime mover  major action (agonist)  antagonist: muscle that opposes action  synergist: muscle that assists a prime mover Movements of the scapula  Elevation/Depression (shrugging)  Retraction/Protraction (punching)  Upward rotation/Downward rotation (arms overhead) Muscles of posterior thorax 1. trapezius 2. levator scapulae 3. rhomboids (major and minor) Trapezius  origin: medial third of superior nuchal line, nuchal ligament, occipital protuberance, spinal processes C7-T12  insertion: lateral third of clavicle, acromium, spine of scapula  action: elevate (superior fibers), retract (medial fibers), rotate scapula, inferior depress scapula  innervation - accessory nerve (CN XI) Levator scapulae  origin: transverse processes of vertebrae c1-c4  insertion: top of medial scapula  Action: elevate and rotate scapula inferiorly  innervation: dorsal scapular (c5) and cervical nerves (c3-c4) Rhomboids  origin:

o minor - nuchal ligament and spinous processes c7-T1 o major - spinous processes t2-t5  insertion: medial border of scapula  action: retract and rotate scapula, attaches scapula to thoracic wall  innervation - dorsal scapular nerve Muscles of anterior thorax: 1. pectoralis minor 2. serratus anterior 3. subclavius Pectoralis minor  origin: ribs 3-5  insertion: coracoid process of scapula  action: lifts scapula anteriorly and inferiorly  innervation: medial pectoral nerve Serratus anterior  Origin: fleshy slips from upper ribs  Insertion: bottom part of medial margin of the scapula  innervation: long thoracic nerve  Actions: protracts and stabilizes scapula, assists in upward rotation Subclavius  stabilizes and depresses pectoral girdle Rotator cuf 4 muscles that originate on scapula and CROSS SHOULDER JOINT to insert on humerus 1. subscapularis 2. supraspinatus 3. infraspinatus 4. teres minor Subscapularis  this guys on the front  Insertion: LESSER tubercle  Action: medial (internal rotation)  Innervation: subscapular nerve Supraspinatus  Action: abducts arm and prevents downward dislocation  Innervation: suprascapular nerve Infraspinatus  Action: lateral rotation  Innervation: suprascapular nerve Teres minor  Action: lateral rotation (outward)  Innervation: axillary nerve which muscles of rotator cuf rotate? 1. Subscapularis 2. Infraspinatus 3. teres minor which muscle of rotator cuf abducts? 1. supraspinatus Humerus

Deltoid  composed of 3 sets of fibers: anterior, medial and posterior  origin: lateral 1/3 of clavicle, acromium and spine of scapula  insertion: deltoid tuberocity  action: o anterior - flex and medially rotate o medial: abducts o posterior -extends and laterally rotates  innervation: axillary Upper crossed syndrome TIGHT: Upper Traps, levator scap, TIGHT: pectorals WEAK: deep neck flexors, lower traps and serratus anterior an example of needing balance in the body: strengthen your lower tramps, rhomboids and stretch the tight muscles Postural Changes:  Forward Head Posture o increased cervical lordosis o increased thoracic kyphosis o fwd & protracted shoulders o rotation and abduction or winging of scapulae o compartments of the limbs o dense fibrous connective tissue divide the muscles of the limbs into compartments each compartment muscles are innervated by the same nerve and have similar actions opposite compartments = agonists/antagonists for each other compartment syndrome  Increased pressure within a compartment = insufficient blood supply to the tissue within that space  fascia does not allow for expansion  can lead to loss of myoneural function and necrosis  amputation may be necessary  occurs in both upper and lower limbs  anterior and posterior compartments of the arm  cross the elbow and regulate movement o pronation/supination o flexion/extension Anterior Compartment of the arm 1. biceps brachii 2. Brachialis 3. coracobrachialis the FLEXORS biceps brachii  Origin o Short head: coracoid process of the scapula. o Long head: supraglenoid tubercle  Insertion: Radial tuberosity and bicipital aponeurosis of forearm  innervation: Musculocutaneous nerve

 Action: Flexes elbow, supinates forearm Brachialis  origin: distal portion of anterior humerus  insertion: coronoid process and tuberocity of ulna  action: flexor of forearm  innervation: musculocutaneous (and radial) Posterior compartment of arm EXTENSORS 1. triceps brachii 2. Anconeus triceps brachii  Origin: o Long head- infraglenoid tubercle of scapula o lateral head- posterior humerus (below grove) o medial head- posterior humerus (above grove)  Insertion: proximal end of Olecranon of ulna and forearm fascia  Action: Powerful forearm extensor, long head steadys abducted humerus head  innervation: radial nerve ? Week 3- Forearm (extenders) & Hand carpal bones some lovers try positions they cant handle 1. scaphoid 2. Lunate 3. Triquetrum 4. Pisiform 5. Trapezium 6. trapezoid 7. Capitate 8. hamate bones of the hand  carpals, metacarpals, proximal, intermediate and distal phalanges  thumb has no intermediate phalange

o digits 2 and 3 - median nerve  Action: assists with flexion of hand and flexes distal phalanges at interphalangeal joints (2-5) flexor pollicis longus  Origin: anterior of radius and the adjacent interosseus membrane.  Insertion: The base of the distal phalanx of the thumb  Innervation: Anterior interosseous nerve (from median nerve)  Action: Flexion of the thumb. pronator quadratus  Origin - distal 1/4 of front of ulna  Insertion - distal 1/4 of front of radius  Innervation: anterior interosseous nerve (from median nerve)  Action: pronates the forearm, fibres bind the radius and ulna together Brachioradialis  Origin: proximal 2/3 of lateral supracondylar ridge of humerus  Insertion: lateral surface of bottom of radius  Action: forearm flexion  innervation: radial nerve o lateral 1/2 is innervated by the median nerve o technically a posterior compartment muscle hangboard training  deep holes = superficial muscles  shallow - recruit deeper muscles golf elbow  MEDIAL epicondylitis , Wrist FLEXOR injury, repetitive injury carpal tunnel syndrome  compression of the median nerve as it passes between the ligament and the bones and tendons of the wrist cutaneous innervation of hand 1. Radial nerve- most of the back of the hand, including the thumb 2. Medial nerve- most of the palm of the hand, including the thumb 3. Ulnar nerve- the pinky and half the ring finger, both sides Hand of Benediction  damage to MEDIAN nerve resulting in loss of flexion of digits 2 and 3  wrist drop radial nerve injury  common with fracture of humerus claw hand  ulnar nerve injury  no tight grip superficial muscles of posterior forearm 1. extensor carpi radialis longus 2. extensor carpi radialis brevis 3. extensor digitorum (digiti minimi) 4. extensor carpi ulnaris extensor carpi radialis longus  Origin: lateral supracondylar ridge of humerus  Insertion: base of 2nd metacarpal  Innervation: radial nerve  Action: extensor at the wrist joint, abducts the hand at the wrist

extensor carpi radialis brevis  Origin: Lateral epicondyle of humerus  Insertion: Base of third metacarpal bone  Action: Extension and abduction at wrist  innervation: deep branch of radial nerve extensor digitorum  origin: lateral epicondyle of humerus  insertion: extensor expansions of digits 2-5  action: extends digits 2-5 at metacarpophalangeal joints and extends hand at the wrist joint  innervation:: posterior interosseaus nevre (from radial nerve) extensor carpi ulnaris  Origin: Lateral epicondyle of the humerus  Insertion: base of 5th metacarpal  Action: Extends and adducts the hand at wrist joint  innervation: posterior interosseus nerve (radial nerve) Deep muscles of the posterior forearm 1. Supinator 2. abductor pollicis longus 3. extensor pollicis brevis 4. extensor pollicis longus 5. extensor indicis supinator  Origin: Lateral epicondyle of humerus, supinator fossa, radial ligaments, crest of ulna  Insertion: Radius  Action: Supinates forearm  innervation: deep branch of radial nerve abductor pollicis longus  Origin: Posterior surface of middle of radius, ulna, and interosseous membrane  Insertion: Base of 1st metacarpal bone  Action: Abduction and extension of thumb at CMC and radial deviation of wrist  Innervation: posterior interosseus nerve (Radial Nerve) extensor pollicis longus  Origin: Posterior surface of middle of ulna and interosseous membrane  Insertion: Base of distal phalanx of thumb  Action: Extension of thumb at CMC and IP joints  Innervation: posterior interosseus nerve - Radial Nerve extensor pollicis brevis  Origin: Posterior surface of middle of radius and interosseous membrane  Insertion: Base of 1st proximal phalanx  Action: Extension of proximal phalanx of thumb at CMC joint  Innervation: Radial Nerve (posterior interosseus nerve) Extensor Indicis  Origin: Posterior surface of ulna + interosseus membrane  Insertion: Extensor expansion of 2nd digit (index finger(  Action: Extension of index finger + helps extend hand  Innervation: posterior interosseus nerve - Radial Nerve

o Oblique head: bases of the second and the third metacarpals and the capitate bones  Insertion: medial side of the base of the proximal phalanx of the thumb  innervation: deep branch of the ulnar nerve  Action: adducts the thumb hypothenar muscles 1. abductor digiti minimi 2. flexor digiti minimi brevis 3. opponens digiti minimi abductor digiti minimi  Origin: (pisiform)  Insertion: Proximal phalanx of little finger  action: abducts pinky  innervation: ulnar nerve Flexor digiti minimi brevis  Origin: Flexor retinaculum and hook of hamate  Insertion: Medial side of proximal phalanx of 5th finger  Action: Flexion of proximal phalanx of pinky  Innervation: Ulnar Nerve Opponenes digiti minimi  Origin- Hook of hamate and flexor retinaculum  Insertion- medial border of pinky  Innervation- Ulnar nerve  Main Action- bringing pinky into opposition with thumb palmar muscles 1. Lumbricals 2. Palmar Interossei 3. Dorsal Interossei Palmar Interossei  Origin: metacarpals  Insertion: proximal phalanx  Innervation: Ulnar nerve  Action: ADDUCTION Dorsal Interossei  Origin: Metacarpals  Insertion: Proximal phalanx  Innervation: ulnar nerve  Action: Abduct finger lumbricals  Origin: tendon of flexor digitorum profundus  Insertion: extensor expansion on posterior  Innervation: o 1, 2, = median o 3,4, = ulnar  Action: flex metacarpophalangeal joints, extend interphalangeal joints innervation of the hand 1/2 LOAF = median (4,3 of lumbricals, opponenes pollicis, adductor pollicis brevis, flexor pollicis brevis ) everything else = ulnar

? Week 4- Lower Limb, Thigh & Glute 3 compartments of the thigh  anterior - 7  medial - 5  posterior - 3 glute, 6 lateral roatator and 3 hamstring pelvic girdle  the hip bones (2), sacrum, and coccyx  Connects the lower limbs to the axial skeleton + spine  Less range of movement than shoulder and far more stable childhood hip development  3 hip bones (ileum, pubis, and ischium) which later fuse in adulthood  Hip bones fuse anteriorly to each other  Fuse posteriorly at sacrum + vertebral column Pelvis femur anatomy:  protruding part of hip that you feel  anterior superior iliac spine  if you break a hip where does it ususally occur  neck of the femur Joint: the point where two bones come together  vary greatly in structure and function:  the structure of the joint determines the degree, range and direction of movement 3 types of joints 1. Fibrous 2. Cartilaginous 3. Synovial fibrous joints  immovable (synathroses) o connected by fibrous tissue o i.e. tibiofibular joint cartilaginous joints  slightly movable (amphiarthroses)  hylaine cartilage or fibrocartilage o i.e. intervertebral discs synovial joints  freely movable (diarthroses) appendicular skeleton components of synovial joints:  articular cartilage (lines the bones)  joint cavity w synovial fluid in it  articular cavity (outer fibrous + inner synovial membrane)  reinforcing ligaments  nerves and vessels

a. a compound muscle composed of psoas and iliacus psoas and iliacus  Origin: o psoas: transverse processes of T12 - L5 vertebrae o iliacus: iliac fossa and ala of sacrum  Insertion: lesser trochanter via iliopsoas tendon  Action: thigh and trunk flexion  innervation: femoral nerve Sartorius  Origin: Anterior superior iliac spine  Insertion: medial aspect of knee and medial aspect of tibia  Innervation: femoral nerve  Action: Flexion, abduction, and lateral rotation of the hip, weak flexion of the knee  longest muscle of the body, crosses both hip and knee rectus femoris  Origin: anterior inferior iliac spine, superior margin of acetabulum  Insertion: patella and tibial tuberosity via patellar tendon  Innervation: femoral nerve  Action: knee extension; hip flexion vastus lateralis  Origin: Greater trochanter, Intertrochanteric line, and Linea aspera of the Femur  Insertion: patella and tibial tuberoscity via patellar tendon  Innervation: femoral nerve  Action: Extends knee vastus medialis  Origin: inea aspera, supracondylar line, intertrochanteric line  Insertion: patella and tibial tuberoscity via patellar tendon  Action: extends knee and stabilizes patella  innervation: femoral nerve vastus intermedius  Origin: antero/ lateral femur  Insertion: patella and tibial tuberoscity via patellar tendon  Innervation: femoral nerve  Action: Extension of knee joint medial thigh superficial muscles 1. pectinueus 2. adductor longus 3. gracilis Pectineus  Origin: pectineal line of pubis  insertion: lesser trochanter to linea aspera on posterior femur  action: adduct, flex and medially rotates thigh  innervation: femoral (sometimes obturator) adductor longus  Origin: pubis  Insertion: Linea aspera of femur  Action: Adduction, flexion, and medial rotation at hip  innervation: obturator nerve

gracilis  origin: inferior ramus and body of pubis and ischial ramus  insertion: medial surface of tibia  action: adducts thigh; flexes and medially rotates leg  innervation: obturator nerve Deep medial thigh muscles 1. adductor brevis 2. adductor magnus adductor brevis  Origin: inferior ramus and body of pubis  Insertion: linea aspera  Action: adducts and medialy rotates thigh  Innervation: obturator nerve adductor magnus  Origin: ischial and pubic rami, ischial tuberoscity  Insertion: Linea aspera of the femur, supracondylar line, adductor tubercle of femur  Action: o anterior: Adducts, medial rotation and flexion o posterior: thigh extension  innervation: obturator nerve and sciatic nerve sacral plexus  from spinal nerves L4-S4  directly behind the lumbar plexus  1/2 of the branches serve buttocks and lower limb sciatic nerve  largest and most important nerve for the lower limb  divides into tibial and common fibular nerve common fibular nerve  supplies lateral and anterior lower leg tibial nerve  posterior lower leg  divides from sciatic nerve at palpatile fossa (back of knee) into the tibial nerve sciatica  pain tingling and numbness caused by irritation of the nerve routes leading to the sciatic nerve  most common causes: herniated disk or narrowing of spinal canal  symptoms made worse from prolonged standing/sitting  relieved through extension of spinal cord or drugs Muscles of the butt 1. gluteus maximum (superficial) 2. gluteus medius (middle) 3. gluteus minimus (deep) gluteus maximus  Origin: dorsal illium, sacrum and coccyx  Insertion Gluteal tuberosity of the femur and iliotibial tract  Innervation: Inferior gluteal nerve  Action: lateral rotation, extension of the thigh, abducts gluteus medius

 tibia with big toe - medial mallolus  fibula - lateral malleolus  intercondylar iminence  tibial tuberoscity  anterior crest  connected via interosseus membrane components of the foot 1. tarsus 2. Metatarsus 3. phalanges function of the foot  support the weight of the body  act as a lever to propel the body forward during locomotion tarsus  posterior foot comprised of seven bones 1. alcaneus 2. Talus 3. Cuboid 4. Navicular 5. medial lateral and middle cuneiforms ankle joint  tibia and fibula articulate directly with the talus  talus then transmits the weight to the calcaneus (heel) characteristics of a typical synovial joint  articular cartilage  articular capsule (fibrous and synovial)  synovial fluid  articular disc  intracapsular and extracapsular ligaments role of the patella  a sesamoid found in most tetrapods  increases the distance between the quads and the knee joint = increase in moment arm  lower limb uses more rotary torque than the elbow knee joint  modified hinge (femoro-tibial)  plane (patella-femur)  bi-condyloids (4 from tibia and femur)  lateral and medial meniscus role  cartilage that act as a cushion and distribute the weight and support the joint extracapsular knee ligaments  lateral and medial collateral ligaments (LCL, MCL) o prevent side to side movement intracapsular ligaments of knee  anterior cruciate ligament (ACL) o prevent forward movement of tibia  posterior cruciate ligament (PCL)  prevents posterior movement of tibia  ACL and PCL during knee extension become taut and lock the knee ligaments on the patella

top: tendon of quadriceps femoris muscle bottom: patellar ligament flanked on both sides by the lateral and medial patellar retinaculum posterior ligaments of knee popliteal ligaments: oblique and acruate blow to the side of knee injury can seperate femur and tibia medially = damage to tibial collateral ligament, medial meniscus, and ACL superficial muscles of the lower leg 1. gastrocnemius 2. Plantaris 3. soleus Gastrocnemius  Origin: 2 heads from lateral and medial condyles of femur  Insertion: calcaneus (achillies tendon)  Action: plantar flexion, knee extension  innervation: tibial nerve Plantaris: little guy  Origin: posterior femur above lateral condyle  Insertion: calcaneous tendon  Action: Plantar flexes foot and flexes knee  Antagonist Tibialis anterior muscle soleus  Origin: superior tibia, fibula and interosseus membrane  Insertion calcaneous tendon  Innervation: tibial nerve  Action: plantar flexion (MAIN GUY) deep lower leg muscles 1. popliteus 2. flexor digitorum longus (FDL) 3. flexor halllocis longus (FHL) 4. tibialis posterior Popliteus  Origin: lateral condyle of femur and lateral meniscus  Insertion: proximal tibia  Innervation: Tibial nerve  Action: flexes and medially rotates lef to unlock from full extension flexor digitorum longus  Origin: Posterior tibia  Insertion: behind medial malleolus into Distal phalanges of toes 2-5  Action: Flex toes; plantar flexes and inverts foot, grips the ground  innervation: tibial nerve flexor hallucis longus  origin: middle fibula and interosseus membrane  insertion: distal phalanx of big toe  action: flexes big toe, plantar flexion, inverts food, "push off" during walking  innervation: tibial nerve tibialis posterior  Origin: Tibia and fibula