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424 Cards in this Set

  • Front
  • Back
Trapezius Upper Origin:
EOP, superior nuchal line, C7 spinous process
Trapezius Upper Insertion
lateral third of clavicle, acromion process
Trapezius Upper Action
elevates the scapula, upward rotation of scapula,
extends head and neck, laterally flexes head and
neck to side of contraction, rotates head and neck
away from side of contraction
Trapezius Middle Origin
spinous processes of T1-5
Trapezius Middle Insertion
spine of the scapula
Trapezius Middle Action
adduction and elevation of scapula
Trapezius Lower Origin
spinous processes of T6-12
Trapezius Lower Insertion
spine of scapula
Trapezius Lower Action
depression, adduction, and upward rotation of
scapula
Trapezius Innervation
spinal accessory, C-11
Levator Scapula Innervation
dorsal scapular nerve
Levator Scapula Origin
transverse processes of C1-5
Levator Scapula Insertion
superior angle of the scapula down along the
superior medial border to the spine of the scapula
Levator Scapula Action
elevation and downward rotation of the scapula,
lateral flexion of the head
Rhomboid Minor Innervation
Innervation: dorsal scapular nerve
Rhomboid Minor Origin
Origin: spinous processes of C7 and T1
Rhomboid Minor Insertion
Insertion: medial border of scapula at scapular spine
Rhomboid Minor Action
Action: adduction and downward rotation of the scapula
Rhomboid Major Innervation
Innervation: dorsal scapular nerve
Rhomboid Major Origin
Origin: spinous processes of T2-5
Rhomboid Major Insertion
Insertion: medial border of scapula inferior to scapular spine
Rhomboid Major Action
Action: adduction and downward rotation of the scapula
Serratus Anterior
Innervation
Innervation: long thoracic nerve
Serratus Anterior Origin
Origin: ribs 1-8 or 9
Serratus Anterior Insertion
Insertion: anterior surface of the medial border and inferior angle of the
scapula
Serratus Anterior Action
Action: abduction and upward rotation of the scapula; when the scapula is
fixed, it elevates the ribs
Pectoralis Minor
Innervation
Innervation: medial pectoral nerve
Pectoralis Minor Origin
Origin: ribs 3-5 at the costal cartilage
Pectoralis Minor Insertion
Insertion: coracoid process of scapula
Pectoralis Minor Action
Action: depression and downward rotation of scapula; stabilizes shoulder
anteriorly; elevates ribs 3-5 during forced inspiration when scapula
is fixed
Pectoralis Major Innervation
Innervation: lateral and medial pectoral nerves
Pectoralis Origin
Origin: medial 2/3 of clavicle, sternum, costal cartilage of ribs 1-6
Pectoralis Insertion
Insertion: bicipital groove and greater tubercle of humerus
Pectoralis Action
Action: flexion, adduction, and medial rotation of the arm
Deltoid Innervation
Axillary Nerve
Deltoid Insertion
Deltoid Tuberosity
Deltoid Anterior Origin
Origin: lateral 1/3 of clavicle
Deltoid Anterior Action
Action: abduction, flexion, medial rotation of the arm
Deltoid Middle Origin
Origin: acromion process
Deltoid Middle Action
Action: abducts the arm
Deltoid Posterior Origin
Origin: spine of scapula
Deltoid Posterior Action
Action: abduction, extension, lateral rotation of the arm
Supraspinatus Innervation
Innervation: suprascapular nerve
Supraspinatus Origin
Origin: supraspinous fossa
Supraspinatus Insertion
Insertion: greater tuberosity of humerus
Supraspinatus Action
Action: initial abduction of the arm
Infraspinatus
Innervation
Innervation: suprascapular nerve
Infraspinatus Origin
Origin: infraspinous fossa
Infraspinatus Insertion
Insertion: greater tuberosity of humerus
Infraspinatus Action
Action: lateral rotation and adduction of the arm
Teres Minor Innervation
Innervation: axillary nerve
Teres Minor Origin
Origin: superior 2/3 of lateral border of scapula
Teres Minor Insertion
Insertion: greater tuberosity of humerus
Teres Minor Action
Action: lateral rotation, adduction, and extension of the arm
Subscapularis Innervation
Innervation: upper and lower subscapular nerves
Subscapularis Origin
Origin: subscapular fossa (anterior or costal surface) of the scapula
Subscapularis Insertion
Insertion: lesser tuberosity of humerus
Subscapularis Action
Action: medial rotation of the arm
Teres Major Innervation
Innervation: lower subscapular nerve
Terres Major Origin
Origin: inferior angle and inferior 1/3 of lateral border of scapula
Terres Major Insertion
Insertion: bicipital groove of humerus
Terres Major Action
Action: adduction, extension, medial rotation of the arm
Latissimus Dorsi
Innervation
Innervation: thoracodorsal nerve
Latissimus Dorsi Origin
Origin: spinous processes of T7-L5, iliac crest, posterior superior surface
of sacrum, all via the thoracolumbar fascia; lower 3-4 ribs
Latissimus Dorsi Insertion
Insertion: bicipital groove of humerus
Latissimus Dorsi Action
Action: adduction, extension, medial rotation of the arm
Triceps Brachii Innervation
Innervation: radial nerve
Triceps Brachii Origin
Origin:
Long Head: infraglenoid tubercle of scapula
Lateral Head: superior 1/2 of posterior lateral humerus
Medial Head: inferior 2/3 of posterior humerus
Triceps Brachii Insertion
nsertion: olecranon process of ulna
Triceps Brachii Action
Action: extension of the forearm; long head also extends and adducts the
arm
Biceps Brachii
Innervation:
musculocutaneous nerve
Biceps Brachii Long Head Origin
Origin: Long Head: supraglenoid tubercle of the scapula
Biceps Brachii Short Head Origin
Short Head: coracoid process of the scapula
Biceps Brachii Insertion:
Insertion: radial tuberosity, bicipital aponeurosis
Biceps Brachii Action:
Action: flexion and supination of the forearm, flexion of arm
Short Head: also adducts arm
Coracobrachialis Innervation:
musculocutaneous nerve
Coracobrachialis Origin:
Origin: coracoid process of scapula
Coracobrachialis Insertion:
Insertion: middle of medial shaft of humerus
Coracobrachialis Action:
Action: flexion and adduction of the arm
Brachialis Innervation:
Innervation: musculocutaneous and radial nerves
Brachialis Origin:
Origin: distal 1/2 of anterior humerus
Brachialis Insertion:
Insertion: ulnar coronoid process and tuberosity
Brachialis Action:
Action: flexion of forearm
Anconeus Innervation
radial nerve
Anconeus Origin:
Origin: lateral humeral epicondyle
Anconeus Insertion:
Insertion: olecranon and posterior proximal ulna
Anconeus Action:
Action: extension of the forearm
Supinator Innervation:
deep radial nerve
Supinator Origin:
Origin: lateral humeral epicondyle, proximal ulna
Supinator Insertion:
Insertion: anterolateral proximal 1/3 of radius
Supinator Action:
Action: supination of the forearm
Brachioradialis Innervation:
radial nerve
Brachioradialis Origin:
Origin: lateral humeral supracondylar ridge
Brachioradialis Insertion:
Insertion: radial styloid process
Brachioradialis Action:
Action: flexion of forearm, half supination and half pronation of forearm
Pronator Teres Innervation:
median nerve
Pronator Teres Origin:
Origin: medial humeral epicondyle, ulnar coronoid process
Pronator Teres Insertion:
Insertion: midlateral radius
Pronator Teres Action:
Action: flexion and pronation of forearm
Flexor Carpi Radialis Innervation:
median nerve
Flexor Carpi Radialis Origin:
Origin: medial humeral epicondyle
Flexor Carpi Radialis Insertion:
Insertion: anterior bases of 2nd and 3rd metacarpals
Flexor Carpi Radialis Action:
Action: flexion and abduction (radial deviation) of the hand
Palmaris Longus
Innervation:
median nerve
Palmaris Longus Origin:
Origin: medial humeral epicondyle
Palmaris Longus Insertion:
Insertion: palmar aponeurosis and flexor retinaculum
Palmaris Longus Action:
Action: flexion of hand
Flexor Digitorum Superficialis
Innervation:
median nerve
Flexor Digitorum Superficialis Origin:
Origin: medial humeral epicondyle, ulnar coronoid process, middle of
anterior radius
Flexor Digitorum Superficialis Insertion:
Insertion: 4 tendons that split to allow passage of flexor digitorum
profundus tendons and insert on the sides of the middle phalanx of
each finger
Flexor Digitorum Superficialis Action:
Action: flexion of the middle phalanx of each finger and flexion of the
proximal phalanges and hand by its continued action
Flexor Carpi Ulnaris
Innervation:
ulnar nerve
Flexor Carpi Ulnaris Origin:
Origin: medial humeral epicondyle, proximal posterior ulna
Flexor Carpi Ulnaris Insertion:
Insertion: pisiform, hamate, anterior base of 5th metacarpa
Flexor Carpi Ulnaris Action:
Action: flexion and adduction (ulnar deviation) of the hand
Extensor Carpi Radialis Longus Innervation:
radial nerve
Extensor Carpi Radialis Longus Origin:
Origin: lateral humeral epicondyle and lateral humeral supracondylar ridge
Extensor Carpi Radialis Longus Insertion:
Insertion: posterior base of 2nd metacarpal
Extensor Carpi Radialis Longus Action:
Action: extension and abduction (radial deviation) of wrist
Extensor Carpi Radialis Brevis
Innervation:
deep radial nerve
Extensor Carpi Radialis Brevis Origin:
Origin: lateral humeral epicondyle
Extensor Carpi Radialis Brevis Insertion:
Insertion: posterior base of 3rd metacarpal
Extensor Carpi Radialis Brevis Action:
Action: extension and abduction (radial deviation) of wrist
Extensor Digitorum
Innervation:
posterior interosseous nerve (radial nerve)
Extensor Digitorum Origin:
Origin: lateral humeral epicondyle
Extensor Digitorum Insertion:
Insertion: posterior 2nd-5th middle and distal phalanges
Extensor Digitorum Action:
Action: extends 2nd-5th middle and distal phalanges and extends 2nd-5th
proximal phalanges and hand by continued action
Extensor Carpi Ulnaris
Innervation:
posterior interosseous nerve (radial nerve)
Extensor Carpi Ulnaris Origin:
Origin: lateral humeral epicondyle and proximal posterior ulna
Extensor Carpi Ulnaris Insertion:
Insertion: posterior base of 5th metacarpal
Extensor Carpi Ulnaris Action:
Action: extension and adduction (ulnar deviation) of the hand
MEDIAL FEMORAL
CONDYLE
Move your thumb that is on the
medial side of the patella superiorly *(also lateral one)
MEDIAL
FEMORAL EPICONDYLE
Palpate to the superior medial bulge of the medial femoral condyle *(also lateral one
ADDUCTOR TUBERCLE
Now palpate to the superior posterior edge of the
epicondyle and you will feel a prominence /// between the vastus medialis and the semimembranosus muscles.
*insertion of the adductor magnus muscle.
ANTERIOR PROMINENCE OF THE LATERAL FEMORAL CONDYLE.
Move your thumb
anteriorly until it is just lateral to the patella. With your partner’s leg relaxed, extend it slightly and palpate the bony prominence just lateral to the patella
TROCHLEAR GROOVE.
With both thumbs next to the patella again, move superiorly along both femoral condyles until you are at the highest point of each edge of the patella. Slightly superior to the patella, palpate toward the midline until you reach a depression
MEDIAL TIBIAL PLATEAU.
Press your thumb that is on the medial side of the patella inferiorly and you
will feel a ledge of bone
MEDIAL TIBIAL CONDYLE.
Continue palpating inferiorly from medial tibial tubercle and you will palpate over a bulge of bone
LATERAL TIBIAL PLATEAU
Press your thumb that is on the lateral side of the patella inferiorly and you will
feel a ledge of bone,
LATERAL TIBIAL TUBERCLE.
Continue palpating inferiorly on the antero-lateral surface of the tibia. Immediately inferior to the plateau is a large prominence
LATERAL TIBIAL CONDYLE
Palpate laterally from lateral tibial tubercle and you will palpate over a bulge of bone
TIBIAL TUBEROSITY, or TUBERCLE
Move your thumbs toward the midline of the patella until the tips of your thumbs
touch. Now move them inferiorly until they palpate over a bulge of bone on the
anterior proximal surface of the tibia
ANTERIOR SUPERIOR TIBIOFIBULAR JOINT, or the PROXIMAL
TIBIOFIBULAR JOINT.
Palpate anteriorly from the head of the fibula
(head of fibula: lateral bulge that is approximately level with the tibial tuberosity)
Quadriceps Femoris muscles are...
rectus femoris, vastus medialis, vastus lateralis, and vastus intermedius.
quadriceps tendon
With your partner sitting on a table with the knee flexed to 90o and the leg hanging freely, palpate just superior to the patella
Rectus Femoris
Innervation: femoral nerve
Origin: AIIS
Insertion: tibial tuberosity
Action: flexion of the thigh, extension of the leg
Vastus Medialis
Innervation: femoral nerve
Origin: linea aspera and distal, medial aspect of the femur
Insertion: tibial tuberosity
Action: extension of the leg
Vastus Lateralis
Innervation: femoral nerve
Origin: greater trochanter and linea aspera of the femur
Insertion: tibial tuberosity
Action: extension of the leg
Vastus Intermedius
Innervation: femoral nerve
Origin: proximal 2/3 of the anterior and lateral femur
Insertion: tibial tuberosity
Action: extension of the leg
Adductor Magnus
Innervation: obturator nerve, sciatic nerve (tibial portion)
Origin: inferior ramus of the pubis and ischium and the ischial tuberosity
Insertion: linea aspera, medial supracondylar ridge, and adductor tubercle of femur
Action: adduction of the thigh; anterior fibers from the inferior ramus of the pubis also flex and medially rotate the thigh; posterior fibers from the ramus of the ischium and the ischial tuberosity extend and laterally rotate the thigh
Adductor Magnus tendon palpation...
Palpate
the medial femoral condyle with its superior prominence, the adductor tubercle.
You can palpate the tendon of the adductor magnus muscle as it inserts onto the
adductor tubercle.
Sartorius
Innervation: femoral nerve
Origin: ASIS
Insertion: proximal, medial tibial shaft just inferior to the medial tibial condyle
Action: flexion, lateral rotation, and abduction of the thigh; flexion and medial rotation of the leg
Sartorius tendon palpation
With your partner’s leg hanging freely, resist further flexion of the leg and palpate just posterior to the medial tibial condyle. You will feel several tendons in this area. The sartorius is the most anterior of these tendons.
Gracilis
Innervation: obturator nerve
Origin: pubic symphysis and arch
Insertion: proximal, medial tibial shaft just inferior to the medial tibial condyle
Action: adduction and medial rotation of the thigh; flexion and medial rotation of the leg
Gracilis tendon palpation
With your partner’s leg hanging freely, resist further flexion of
the leg and palpate just posterior to the medial tibial condyle. Its tendon is just posterior to the sartorius (the most anterior one)
Semitendinosus
Origin: ischial tuberosity (common tendinous origin with the long head of the biceps)
Insertion: proximal, medial tibial shaft just inferior to the medial tibial condyle
Action: extension of the thigh with some adduction and medial rotation;
flexion and medial rotation of the leg
Semitendinosus tendon palpation
It is the most posterior of the tendons that
are palpated posterior to the medial tibial condyle.
Semimembranosus
Innervation: sciatic nerve (tibial portion)
Origin: ischial tuberosity
Insertion: postero-medial aspect of the medial tibial condyle
Action: extension of the thigh with some adduction and medial rotation;
flexion and medial rotation of the leg
Palpation: The semimembranosus is palpated
Semimembranosus tendon palpation
It is palpated by placing your fingers anterior to the semitendinosus muscle (most posterior of tendons) at the level of the superior edge of the medial tibial condyle.
Biceps Femoris
Innervation:
Long head: sciatic nerve (tibial portion)
Short head: sciatic nerve (common peroneal portion)
Origin:
Long head: ischial tuberosity
Short head: middle 1/3 of the linea aspera of the femur
Insertion:
Both heads: head of fibula and lateral condyle of the tibia
Action:
Long head: extension with some lateral rotation of the thigh
Both heads: flexion and lateral rotation of the leg
Biceps Femoris tendon
Palpate just posterior and superior to the head of the fibula and you will feel a thick tendon on the postero-lateral aspect of the knee going to the fibular head
Gastrocnemius innervation
tibial nerve
Gastrocnemius origin
posterior aspect of medial and lateral femoral condyles
Gastrocnemius insertion
calcaneus via the calcaneal, or Achilles, tendon
Gastrocnemius action
plantar flexion of the foot, flexion of the leg
Gastrocnemius palpation
The gastrocnemius is the most superficial of the posterior leg muscles. plantar flex the foot against resistance and you will see the gastrocnemius muscle contract in the posterior leg. Palpate the superior portion of the posterior leg and the posterior portion of the femoral condyles. You will feel the lateral and medial heads of the gastrocnemius as they originate on the posterior femoral condyles
Soleus innervation
tibial nerve
Soleus origin
posterior surface of the head and proximal 1/3 of the shaft of the
fibula; soleal line and middle 1/3 of the postero-medial border of the
tibia
Soleus insertion
calcaneus via the calcaneal, or Achilles, tendon
Soleus action
plantar flexion of the foot
Soleus palpation
The soleus lies deep to the gastrocnemius muscle. In the superior portion of the posterior leg, it is not palpable as a separate muscle. We will return to its palpation when we palpate the leg and ankle. The soleus and gastrocnemius muscles share the calcaneal tendon and together are called the TRICEPS SURAE.
Plantaris innervation
tibial nerve
Plantaris origin
inferior posterior portion of the lateral supracondylar line of the femur
Plantaris insertion
calcaneus, medial to the calcaneal tendon
Plantaris action
plantar flexion of the foot, flexion of the leg
Plantaris palpation
The plantaris is deep to the lateral head of the gastrocnemius
at the posterior lateral femoral condyle. Its tendon goes across the superior
medial edge of the soleus, between the soleus and gastrocnemius muscles, and
along the medial edge of the calcaneal tendon. When you palpate the origin of
the lateral head of the gastrocnemius muscle, you are palpating over the
plantaris muscle belly.
Popliteus innervation
tibial nerve
Popliteus origin
posterior lateral condyle of the femur
Popliteus insertion
postero-medial surface of the tibia superior to the soleal line
Popliteus action
flexion and medial rotation of the leg; brings the knee out of full extension
Popliteus palpation
The popliteus muscle is deep to the gastrocnemius, soleus, and
plantaris muscles and is not palpable.
ADDUCTOR CANAL
femoral vessels pass thru this
*Palpate the
middle 1/3 of the antero-medial thigh. In this area, deep to the sartorius and vastus medialis muscles and superficial to the adductor longus muscle
ADDUCTOR HIATUS
At the distal end of the adductor canal, the vessels pass through an opening in the adductor magnus muscle close to the femur. This hiatus is located approximately 10 cm superior to the knee on the medial side of the femur. When the femoral vessels go from anterior to posterior through the adductor hiatus, they become the popliteal vessels.
SUPRAPATELLAR BURSA
Deep to the quadriceps tendon
PREPATELLAR BURSA
Superficial to the patella
PATELLAR LIGAMENT or INFRAPATELLAR TENDON
goes from the patella to the tibial tuberosity. It is a continuation of the quadriceps tendon
SUPERFICIAL INFRAPATELLAR BURSA.
Superficial to the patellar ligament
DEEP INFRAPATELLAR BURSA
Deep to the patellar ligament
ANTERIOR CRUCIATE LIGAMENT
goes from the anterior portion of the tibial
plateau between the medial and lateral menisci to the medial aspect of the lateral
femoral condyle
POSTERIOR CRUCIATE LIGAMENT
goes from the
posterior portion of the proximal tibia between the tibial condyles and posterior to
the medial and lateral menisci to the lateral aspect of the medial femoral condyle
MEDIAL MENISCUS
cup-shaped cartilaginous structure that is located on the superior edge of the medial tibial plateau. attached to plateau by CORONARY LIGAMENTS (non palpable) Keeping your thumb in the area of the junction of the medial femoral condyle and the medial tibial plateau, use your other hand to medially rotate the leg while you palpate deeply into the superior edge of the medial tibial plateau.On medial rotation of the leg, the medial meniscus will become prominent and you will feel a tightening, or a bulging, against your thumb. On lateral rotation of the leg, the tightening or bulging will disappear
MEDIAL COLLATERAL
LIGAMENT
Beginning with your thumb still in the depression between the medial femoral condyle and the medial tibial plateau, move your thumb medially and posteriorly along the joint line. As you reach the medial aspect of the knee, the joint line will become less distinct... on MCL (This ligament is a broad, fan-shaped structure that goes from the medial femoral epicondyle to the medial inferior edge of the medial tibial condyle)
PES ANSERINE
proximal medial tibial shaft just inferior to the medial tibial condyle... area of insertion of the sartorius (most ant), gracilis (middle), and semitendinosus (most inf and post)
The PES
ANSERINE BURSA
lies between tendons and the tibia (non palpable unless inflamed)
LATERAL MENISCUS
cup-shaped cartilaginous structure that is located on the superior edge of the lateral tibial plateau (attached to plateau by coronary ligaments)
*bring the leg into slight flexion while you palpate deeply into the superior edge of the lateral tibial plateau. The lateral meniscus will become prominent and you will feel a tightening, or a bulging, against your thumb. On full extension of the leg, the tightening or bulging will disappear
LATERAL COLLATERAL LIGAMENT
Have your partner cross the legs so that the ankle rests on the opposite knee... LCL is a tight cord-like structure, that goes from the lateral femoral condyle to the fibular head.
ILIOTIBIAL TRACT
a long thick band of fascia, can be palpated on the antero-lateral aspect of the knee at its insertion onto the lateral tibial tubercle, the lateral tibial condyle, and the fibular head. Have your partner either extend the leg or flex the leg against resistance. The iliotibial tract is most easily palpated just lateral to the superior edge of the patella
ANTERIOR SUPERIOR
TIBIOFIBULAR LIGAMENT, or the ANTERIOR LIGAMENT OF THE HEAD OF
THE FIBULA
between the tibia and the head of the fibula, just anterior and medial to the fibular head
COMMON PERONEAL NERVE
Palpate inferior to the head of the fibula and the insertion of the biceps femoris muscle and you will feel a cord-like structure wrapping around the fibular head (branch of sciatic nerve)
POPLITEAL FOSSA
*biceps femoris tendon forms lateral and superior lateral border of the popliteal fossa
*semitendinosus + semimembranosus form the medial and superior medial border of the popliteal fossa
*medial and lateral heads of the gastrocnemius muscle as they originate on the posterior femoral condyles (inferior border)
Three structures bisect the popliteal fossa vertically
POPLITEAL ARTERY,
the POPLITEAL VEIN, and the TIBIAL NERVE
POPLITEAL ARTERY,
the POPLITEAL VEIN
continuations of the femoral artery and vein, respectively.
*pop artery: enters the popliteal fossa from the superior medial portion and travels down the midline of the popliteal fossa.
*pop vein: Immediately lateral to the popliteal artery
TIBIAL NERVE
one of the two branches of the sciatic nerve (common peroneal is other branch)
*tibal nerve just lateral to poplitial vein (cord-like structure just lateral to the midline of the popliteal fossa)
nerves do ____ at superior portion of popliteal fossa
the sciatic nerve divides into the tibial nerve and the common peroneal nerve
*tibial: continues down the posterior aspect of the popliteal fossa.
*common peroneal: continues inferiorly and laterally deep to the biceps femoris muscle and can be palpated by palpating deep to the medial edge of the biceps femoris muscle and following it inferiorly. It will be palpable as a cord-like structure medial and deep to the biceps tendon as it crosses the knee. You can continue its palpation as it wraps around the head of the fibula
The MEDIAL
LONGITUDINAL ARCH OF THE FOOT
abnormally high (PES CAVUS) or absent (PES
PLANUS)
CALCANEUS
*from achilles, move inferiorly, feel superior portion of bulge of calcaneous - DOME
*medial plantar side - medial tubercle/process
*lateral plantar side - lateral tubercle/process
*posterior bulge: calcaneal tuberosity
SUSTENTACULUM TALI
the medial support of the talus, palpate inf. from medial malleolus about 1-2 finger breadths
PERONEAL TUBERCLE
inf and slightly ant to lateral malleolus (bulge separating tendons of peroneus longus and brevis)
SINUS TARSI
depression just anterior to lateral malleolus
(palpate directly in to feel superior aspect of calcaneus, possibly the CALCANEO CUBOID JOINT - approx 2/3 of way from lat. malleolus to base of 5th metatarsal.
TALUS + MEDIAL TUBERCLE
sup. to calcaneus btwn two malleoli MEDIAL TUBERCLE: inf. and sl. post. to medial malleolus, sml bulge
HEAD OF TALUS
HEAD: sl. inf. and distal to medial malleolus into depression. Evert foot to feel
(approx. 1/2 btwn ant. tip of medial mall and navicular bone
NECK of TALUS
palpate into the sinus tarsi. Invert the foot and palpate more deeply and medially into the sinus tarsi
DOME OF TALUS
With the foot still inverted and your finger still palpating in the sinus tarsi, plantar flex the foot and you may feel the DOME of the talus push against your finger
INFERIOR TIBIOFIBULAR JOINT, or
the DISTAL TIBIOFIBULAR SYNDESMOSIS,
from anterior surface of the lateral malleolus, palpate medially
(btwn tibia and fibula)
NAVICULAR TUBEROSITY
from head of the talus palpate distally and inferiorly
1ST (MEDIAL) CUNEIFORM
just distal to navicular bone, articulates with the navicular bone and the base of the 1st metatarsal.
*at distal end palpate 1ST
METATARSOCUNEIFORM JOINT,
2ND (INTERMEDIATE) CUNEIFORM
just lateral to 1st cuneiform
*articulates with the navicular bone and the base of the 2nd metatarsal
3RD (LATERAL) CUNEIFORM
just lateral to 2nd cuneiform
*It articulates with the navicular bone and the base of the 3rd metatarsal
3 finger trick pointing toward and extending over the medial side of foot
index: over talus
middle: over navicular
ring: over cuneiform bones
CUBOID
slightly distal and laterally to sinus tarsi
*invert foot to see sml. prominence distal and inferior to lateral maleolus (CUBOID TUBERCLE) + immediately inferior to it is CUBOID SULCUS or groove (on lateral and plantar surfaces of cuboid bone formed by tendon of peroneus longs as it travels to plantar surface foot
metatarsals
BASE
SHAFT
HEAD
*base of first metatarsal often highest point on foot
*1/2 inch prox and lateral - base of 2nd
*move horizontal/lateral for rest
TUBEROSITY OF THE BASE OF THE 5TH METATARSAL
sometimes called styloid process of 5th metatarsal. just distal to cuboid (lateral foot)
phalanges
proximal, intermediate, distal
metatarsophalangeal (MP joints)
btwn head of each metatarsal and base of each proximal phalanx
PIP
proximal interphalangeal joint
DIP
distal interphalangeal joint
*great toe only has proximal and distal phalanx: so only has an interphalangeal (IP joint)
SUPERFICIAL POSTERIOR COMPARTMENT muscles are...
+ innervation?
gastrocnemius, soleus, and plantaris
*innervated by the tibial
nerve and all act to plantar flex the foot
DEEP POSTERIOR
COMPARTMENT muscles are... + innervation?
popliteus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus
*innervated by the tibial nerve and all, except the popliteus, plantar flex and invert the foot
ANTERIOR COMPARTMENT muscles are...
+ innervation?
tibialis anterior, extensor hallucis
longus, extensor digitorum longus, and peroneus tertius
* innervated by the deep peroneal nerve and all act to dorsiflex the foot
LATERAL COMPARTMENT muscles are...
+ innervation?
peroneus longus and peroneus
brevis.
*innervated by the superficial peroneal nerve and plantar flex and evert the foot.
dorsal muscles of foot are...
extensor digitorum brevis and extensor hallucis brevis
plantar muscles of the foot are divided into four layers...
abductor hallucis,flexor digitorum brevis, abductor digiti minimi, and the dorsal interossei
Gastrocnemius innervation
tibial nerve
Gastrocnemius origin/insertion
O: posterior aspect of medial and lateral femoral condyles
I: calcaneus via the calcaneal, or Achilles, tendon
Gastrocnemius action
plantar flexion of the foot, flexion of the leg
Soleus innervation
tibal nerve
Soleus origin/insertion
O: posterior surface of the head and proximal 1/3 of the shaft of the fibula; soleal line and middle 1/3 of the postero-medial border of the tibia
I: calcaneus via the calcaneal, or Achilles, tendon
*action: plantar flexion of foot
Soleus action
plantar flexion of the foot
Plantaris innervation
tibial nerve
Plantaris origin/insertion
O: inferior posterior portion of the lateral supracondylar line of the femur
I: calcaneus, medial to the calcaneal tendon
Plantaris action:
plantar flexion of the foot, flexion of the leg
Popliteus
Innervation: tibial nerve
Origin: posterior lateral condyle of the femur
Insertion: postero-medial surface of the tibia superior to the soleal line
Action: flexion and medial rotation of the leg; brings the knee out of full extension
NOT PALPABLE
Tibialis Posterior innervation
tibial nerve
Tibialis Posterior origin/insertion
O: posterior surface of tibia, fibula, and interosseous membrane
I: navicular tuberosity; plantar surfaces of all tarsal bones except the talus; plantar surfaces of the bases of the 2nd, 3rd, and 4th metatarsals
*action: plantar flexion, inversion of foot; support arch
Tibialis Posterior action
plantar flexion, inversion of the foot; supports the arch
Flexor Digitorum Longus innervation
tibial nerve
Flexor Digitorum Longus origin/insertion
O: distal 2/3 of posterior fibula and interosseous membrane
I: plantar surface of base of distal phalanx of great toe
*action: plantar flexion of great toe and foot; inversion foot
Flexor Digitorum Longus action
plantar flexion of great toe and foot; inversion foot
Tibialis Anterior innervation
deep peroneal nerve
Tibialis Anterior origin/insertion
O: lateral condyle of the tibia; proximal 2/3 of lateral surface of the tibia; interosseous membrane
I: plantar surface of the base of the 1st metatarsal; medial plantar surface of 1st cuneiform
*action: dorsiflexion and inversion of the foot
Tibialis Anterior action
dorsiflexion and inversion of the foot
Extensor Hallucis Longus innervation
deep peroneal nerve
Extensor Hallucis Longus origin/insertion
O: middle 1/2 of anterior fibula; interosseous membrane
I: dorsum of base of distal phalanx of the great toe
*action: dorsiflexion, or extension, of the great toe; dorsiflexion and inversion of the foot
Extensor Hallucis Longus action
dorsiflexion, or extension, of the great toe; dorsiflexion and inversion of the foot
Extensor Digitorum Longus innervation
deep peroneal nerve
Extensor Digitorum Longus origin/insertion
O: lateral condyle of tibia; anterior head and shaft of fibula; interosseous membrane
I:dorsum of middle and distal phalanges of lesser toes
*action: dorsiflexion, or extension, of lesser toes; dorsiflexion and eversion of foot
Extensor Digitorum Longus action
dorsiflexion, or extension, of lesser toes; dorsiflexion and eversion of foot
Peroneus Tertius innervation
deep peroneal nerve
Peroneus Tertius origin/insertion
O: distal 1/3 of anterior fibula and interosseous membrane
I:dorsum of base of 5th metatarsal
*action: dorsiflexion and eversion of foot
Peroneus Tertius action
dorsiflexion and eversion of foot
Peroneus Longus innervation
superficial peroneal nerve
Peroneus Longus origin/insertion
O: head and proximal 2/3 of lateral shaft of fibula; lateral condyle of tibia
I: lateral plantar surface of 1st cuneiform and base of 1st
metatarsal
*action: plantar flexion and eversion of the foot
Peroneus Longus action
plantar flexion and eversion of the foot
Peroneus Brevis innervation
superficial peroneal nerve
Peroneus Brevis origin/insertion
O: distal 2/3 of lateral shaft of fibula
I: tuberosity of base of 5th metatarsal
*action: plantar flexion and eversion of the foot
Peroneus Brevis action
plantar flexion and eversion of the foot
Extensor Digitorum Brevis innervation
deep peroneal nerve
Extensor Digitorum Brevis origin/insertion
O:distal lateral surface of the calcaneus
I:lateral sides of the tendons of extensor digitorum longus of the 2nd, 3rd, and 4th toes
*action: dorsiflexion, or extension, of toes 2-4
Extensor Digitorum Brevis action
dorsiflexion, or extension, of toes 2-4
Extensor Hallucis Brevis innervation
deep peroneal nerve
Extensor Hallucis Brevis origin/insertion
O: distal medial surface of the calcaneus
I: dorsum of base of proximal phalanx of the great toe
*action: dorsiflexion, or extension, of the great toe
Extensor Hallucis Brevis action
dorsiflexion, or extension, of the great toe
Abductor Hallucis innervation
medial plantar nerve
Abductor Hallucis origin/insertion
O: medial tuberosity of the calcaneus; plantar aponeurosis
I: medial side of the base of the proximal phalanx of the great toe
*action: abduction of the great toe from the midline of the foot
Abductor Hallucis action
abduction of the great toe from the midline of the foot
Flexor Digitorum Brevis innervation
medial plantar nerve
Flexor Digitorum Brevis origin/insertion
O: medial tuberosity of the calcaneus; plantar aponeurosis
I: plantar surface of middle phalanges of lesser toes
*action: plantar flexes, or flexes, the lesser toes
Flexor Digitorum Brevis action
plantar flexes, or flexes, the lesser toes
Abductor Digiti Minimi innervation
lateral plantar nerve
Abductor Digiti Minimi origin/insertion
O: lateral tuberosity of the calcaneus; plantar aponeurosis
I: lateral side of the base of the proximal phalanx of the 5th toe
*action: abduction of the 5th toe from the midline of the foot
Abductor Digiti Minimi action
abduction of the 5th toe from the midline of the foot
Dorsal Interossei innervation
lateral plantar nerve
Dorsal Interossei origin/insertion
O:adjacent sides of the metatarsals
I: both sides of the proximal phalanges of the 2nd toe; lateral side of the proximal phalanges of the 3rd and 4th toes
*action: abduction of toes
Dorsal Interossei action
abduction of toes
SMALL, or SHORT, SAPHENOUS VEIN
On the midline of the posterior leg, coming from the inferior posterior aspect of the lateral malleolus. At this point, it comes from the dorsal venous arch and at the popliteal crease, it goes deep to join with the popliteal vein
SURAL NERVE
On the lateral side of the small saphenous vein, thin string-like structure, travels w/ sml saphenous vein to post. inf. aspect lateral malleolus. In popliteal fossa tibal nerve branches into server nerves, includes the sural which supplies sensation to post. lat. leg and lateral foot
RETROCALCANEAL BURSA
Between the calcaneus
and the achilles (calcaneal) tendon
CALCANEAL BURSA
Between the achilles tendon and the skin
Structures posterior to medial malleolus
tom, dick AN harry: anterior to posterior
Tibialis posterior, flexor digitorum longus, posterior tibial artery, tibial nerve, flexor hallucis longus (usu. not palpable)
main blood supply to foot
posterior tibial artery
(approx. 5 cm inf. and post. to tibial plateau the popliteal artery divides into anterior tibial artery and posterior tibial artery (then goes into sustentaculum tali and divides into medial and lateral plantar arteries)
DELTOID LIGAMENT
medial collateral ligament of the ankle
*goes from the inferior portion of the medial malleolus anteriorly and inferiorly to the medial portion of the navicular bone, posteriorly and inferiorly to the medial portion of the
sustentaculum tali, and then connects superiorly from the sustentaculum tali to the posterior portion of the medial malleolus
SPRING LIGAMENT
Along with the tibialis posterior tendon,supports the head of the talus. It is palpated from the plantar surface of the navicular to the plantar surface of the sustentaculum tali
GREAT, or LONG, SAPHENOUS VEIN.
Immediately anterior to the medial malleolus,
*Palpate this vein as it comes from the dorsal venous arch, travels anterior to the medial malleolus, posterior to the tibia, posterior to the tibial and femoral condyles, posterior to the sartorius muscle in the thigh, and into the femoral vein through the saphenous opening
SUPERIOR
EXTENSOR RETINACULUM, or TRANSVERSE LIGAMENT OF THE ANKLE and INFERIOR EXTENSOR RETINACULUM, or the CRUCIATE LIGAMENT
OF THE ANKLE
anterior surface of the ankle approximately level with the malleoli, the tendons of the anterior compartment muscles are held down by these ligaments
ANTERIOR TIBIAL ARTERY
popliteal artery divides, ant. tibial artery comes down anteriorly between the tibia and fibula and courses inferiorly down the leg between the tibialis anterior and extensor digitorum longus muscles.
*It may be palpable just superior to the superior extensor retinaculum and lateral to the tibialis anterior tendon.
DORSALIS PEDIS ARTERY
As the anterior
tibial artery passes under the superior and inferior extensor retinacula, it becomes the dorsalis pedis artery
*palpable on dorsal surface of foot btwn tendons of the extensor hallucis longus and extensor digitorum longus
DEEP PLANTAR ARTERY
The dorsalis pedis artery continues between the 1st and 2nd metatarsals where it goes deep into the sole to become
deep plantar artery which joints lateral plantar artery and forms the plantar arch
COMMON PERONEAL NERVE
wraps around head of fibula
Just ant. and inf. to head GB 34, common peroneal divides into deep peroneal nerve and superficial peroneal nerve down the leg
*It continues anterior to the lateral malleolus and supplies most of the dorsum of the foot. Here it has divided into two superficial nerves, the DORSAL
medial cutaneous and dorsal intermediate cutaneous nerves
ANTERIOR INFERIOR
TIBIOFIBULAR LIGAMENT
palpate the inferior tibiofibular joint between the distal tibia and fibula, over the joint is ant. inf. tibiofibular ligament
ANTERIOR TALOFIBULAR LIGAMENT
The anterior talofibular ligament travels from the anterior portion of the lateral
malleolus to the lateral portion of the talar neck. Palpate from the anterior lateral malleolus to the sinus tarsi and you will be palpating over this ligament.
CALCANEOFIBULAR LIGAMENT,
The calcaneofibular ligament travels from the inferior portion of the lateral malleolus inferiorly to the calcaneus slightly posterior to the peroneal tubercle. Palpate inferior to the lateral malleolus and you will be palpating over this ligament.
POSTERIOR TALOFIBULAR
LIGAMENT
The posterior talofibular ligament travels from the posterior portion of the lateral
malleolus to the lateral tubercle on the posterior portion of the talus. Palpate
immediately posterior and inferior to the lateral malleolus and you will be palpating over this ligament.
PLANTAR APONEUROSIS, or PLANTAR FASCIA
sole of foot/plantar surface
*It travels from the medial
tuberosity of the calcaneus to the proximal plantar surface of each toe.
Platysma
OR: subcutaneous tissue over thorax, dwn to 2nd intercost. sp.
IS: mandible
Action: depresses mandible, pullls crnr of mouth downward
IN: facial nerve (crtanial Vii)
Mylohyoid
OR: mandible
IN: hyoid bone
AC: elevates hyoid bone, depresses mandible
IV: mandibular division of trigeminal nerve (c: v)
Sternohyoid
OR: clavicle, manubrium of sternum
IN: hyoid bone
Ac: depresses hyoid
IV: ansa cervicalis
Sternocleidomastoid
OR: clavicle, manubrium of sternum
IN: mastoid process
Ac: bilat: flexion of cervical vertebral column, ant. motion of head, elevation of chin
unilateral: ipsilateral flexion of head, contralateral rotation of head
IV: spinal accessory (cn: XI)
Scalenes
OR: transverse processes of c2-7
IN: 1st & 2nd ribs
Ac: bilat: flexion of the neck, elevation of the 1st & 2nd ribs
unilateral - ipsilateral lateral flexion of neck, contralateral rotation
of neck
Iv: cervical nerves 3-8
Splenius Capitis
Or: lower half of ligamentum nuchae, spinous processes of C7-t4
In: lateral 1/3 of sup. nucal line, mastoid process
ac: bilat: extension of head and neck
Unilat: ipsilateral lateral flexion of neck, ipsilateral rotation of head
Iv: middle cervical nerves
Orbicularis Oculi
Location: encircles eye
Action: closes eye
Corrugator Supercilii
Location: eyebrow
Action: draws eyebrow downward and medially as in frowning
Procerus
Location: root of nose
Action: draws skin of forehead down
Orbicularis Oris
Location: encircles mouth
Action: closes, protrudes, and shapes lips as in kissing and speaking
Levator Labii Superioris
Location: upper lip
Action: raises upper lip
Zygomaticus Major and Minor
Location: infraorbital region
Action: raises corner of mouth and draws it laterally as in smiling and
laughing
Risorius
Location: corner of mouth
Action: draws corner of mouth laterally
Levator Anguli Oris
Location: superior to corner of mouth
Action: draws corner of mouth upward
Depressor Anguli Oris
Location: inferior to corner of mouth
Action: draws corner of mouth downward
Depressor Labii Inferioris
Location: lower lip
Action: draws lower lip downward
Mentalis
Location: chin
Action: pushes lower lip outward as in pouting
Buccinator
Location: cheek
Action: pulls lips and cheeks against teeth
Masseter
Innervation: mandibular branch of trigeminal nerve (cranial nerve V)
Origin: maxilla and zygomatic arch
Insertion: angle and ramus of mandible
Action: elevates and protracts mandible, assists in lateral movement of
mandible
Temporalis
Innervation: mandibular branch of trigeminal nerve (cranial nerve V)
Origin: temporal fossa - portions of the parietal, temporal, sphenoid, and
frontal bones
Insertion: coronoid process of mandible
Action: elevates and retracts mandible, assists in lateral movement of
mandible
Lungs location...
*begins 3 cm superior to the medial 1/3 of the clavicle. Its medial border goes inferiorly almost to the midline at the sternal angle. It then turns laterally away from the midline at the 6th costal cartilage on the right and the 4th costal
cartilage on the left due to the heart.
*The inferior border of the lungs is located level with the 6th rib in the mid-clavicular line, the 8th rib in the mid-axillary line, and the 10th rib posteriorly.
***Focus most likely just on the RIGHT lung
The PLEURAL CAVITY
location is similar to each lung, but its lower border is 2 ribs more inferior than that of the lungs. Therefore, its inferior border is level with the 8th rib in the mid-clavicular line, the 10th rib in the mid-axillary line, and the 12th rib posteriorly.
VENA CAVAL HIATUS,
through which the inferior vena cava passes, is level with T8,
***1 cm to the right and 1-2 cm superior to the xiphisternal joint.
ESOPHAGEAL HIATUS
through which passes the esophagus, is level with T10
*** 2-3 cm to the left of the midline, posterior to the 6th costal cartilage.
AORTIC HIATUS,
through which passes the aorta
* 7-8 cm inferior to the xiphisternal joint.
Rectus Abdominis
Innervation: thoracic nerves 7-12
Origin: symphysis pubis, pubic crest
Insertion: costal cartilages 5-7, xiphoid process
Action: flexes vertebral column, compresses abdomen
External Abdominal Oblique
Innervation: thoracic nerves 7-12, iliohypogastric nerve
Origin: ribs 5-12
Insertion: iliac crest, linea alba; Its inferior fibers fold back on themselves
posteriorly and attach from the ASIS to the pubic tubercle to form
the INGUINAL LIGAMENT.
Action: flexion, ipsilateral lateral flexion, & contralateral rotation of the
vertebral column; compresses abdomen
Internal Abdominal Oblique
Innervation: thoracic nerves 8-12, iliohypogastric, ilioinguinal
Origin: inguinal ligament, iliac crest, thoracolumbar fascia
Insertion: costal cartilage of ribs 8-10, linea alba
Action: flexion, ipsilateral lateral flexion, & ipsilateral rotation of the
vertebral column, compresses abdomen
Transversus Abdominis
Innervation: thoracic nerves 8-12, iliohypogastric, ilioinguinal
Origin: inguinal ligament, iliac crest, thoracolumbar fascia, costal
cartilages of ribs 7-10, bodies of ribs 11-12
Insertion: linea alba, pubic tubercle
Action: compresses abdomen
Rectus Abdominis
Innervation: thoracic nerves 7-12
Origin: symphysis pubis, pubic crest
Insertion: costal cartilages 5-7, xiphoid process
Action: flexes vertebral column, compresses abdomen
INTERNAL, or DEEP, INGUINAL RING
find the midpoint of the inguinal ligament. 2 cm superior to this
EXTERNAL, or SUPERFICIAL, INGUINAL RING
2 cm superior to the pubic tubercle
At, and inferior to, the midinguinal point you can palpate the ______ _____ The
FEMORAL
ARTERY.
9th costal cartilage approx. level with the....
transpyloric plane
TRANSPYLORIC PLANE
midway between the xiphisternal joint and the umbilicus
roughly level w/9th costal cartilage
SUBCOSTAL
PLANE
is level with the lowest point of the 10th costal cartilage. often runs close to or through the umbilicus
SUPRACRISTAL PLANE
connects the iliac crests (highest point of ileum)
TRANSTUBERCULAR, or
INTERTUBERCULAR, PLANE
connects the iliac tubercles. It is level with the spinous process of L5.
INTERSPINOUS PLANE
connects the anterior superior iliac spines, or ASIS. It is level with the posterior superior iliac spines, or PSIS, and S2.
HYPOCHONDRIUM,
is lateral to the midclavicular line, inferior to the level of the xiphisternal joint, and superior to the subcostal plane
Location of the HT
The right border of the heart goes from the 3rd to the 6th costal cartilages, 1 cm lateral to the right sternal margin. At the 6th costal cartilage, the inferior border goes through the xiphisternal joint and continues to the LEFT 5th intercostal space in the mid-clavicular line. (known as the apical beat) The left border goes from the apical beat diagonally to the LEFT 2nd intercostal space, 1 cm lateral to the left sternal margin. The superior border connects the left 2nd intercostal space with the right 3rd costal cartilage.
XIPHISTERNAL JOINT located at the...
fifth costal cartilage
ILIAC TUBERCLE is...
the most lateral bulge of the ilium
inguinal region nerves arteries veins from medial to lateral....f
femoral vein, femoral artery, femoral nerve
HYPOCHONDRIUM
both right and left, is lateral to the midclavicular line, inferior to the level of the xiphisternal joint, and superior to the subcostal plane.
LUMBAR region
both right and left, is lateral to the midclavicular line, inferior to the subcostal plane, and superior to the transtubercular plane
ILIAC region
both right and left, is lateral to the midclavicular line, inferior to the transtubercular plane, and superior to the inguinal ligament.
EPIGASTRIUM
medial to the midclavicular lines, inferior to the xiphisternal joint, and superior to the subcostal plane.
UMBILICAL region
medial to the midclavicular lines, inferior to the subcostal plane, and superior to the transtubercular plane.
HYPOGASTRIUM
medial to the midclavicular lines, inferior to the transtubercular plane, and superior to the pubic bone.
Quadrant division....
midline + horizontal line thru umbilicus. upper quadrants are lateral to midline, inf. to xiphisternal joint, superior to
umbilicus. lower quadrants are superior to inguinal ligament, inf. umbilicus, lat to midline
LIVER
*on RIGHT: LV sup. margin lies just inf. to R dome of diaphragm. It starts @ 4th int. space in midclavicular line + proceeds to 5th costal cartilage @ R sternal margin.
*It crosses xiphisternal joint + proceeds to 6th costal cartilage at the L sternal margin
*From starting pt. @ 4th inter. space/midclav. line, it proceeds to 7th inter. space in R midaxillary line + down to bottom of the costal margin.
*It follows the costal margin on R toward tip of 9th costal cart., crosses epigastrium to tip of 8th costal cart. on L + continues sup. + lat. to end approx. level w/xiphisternal joint (***8-10 cm. to left of midline). This connects to superior border of liver @ 6th costal cart. on L sternal margin.
GALLBLADDER
located posterior to the tip of the 9th costal cartilage.
STOMACH
*CARDIA of ST begins posterior to the 7th costal cartilage, 2-3 cm to the left of the midline.
*the R side or LESSER CURVATURE of ST goes inferiorly + to the right becoming the PYLORUS of ST 1-2 cm to R of midline on the transpyloric plane.
*From Cardia (start pt.) again, the L side goes inf. then curves sharply sup. + to the left to form FUNDUS of ST, reaching the 5th rib in midclav. line.
*From here the GREATER CURVATURE goes inferior and almost to the left midaxillary line, then curves inferior and to the R along the transpyloric plane to meet the Pylorus again, 1-2 cm to right of midline in transpyloric plane.
SMALL INTESTINE (only Duodenum portion)
The Duodenum starts from Pylorus of ST (2-3 cm to R of midline on transpyloric plane). It continues until approx. 5 cm to R of midline, where it turns downwards for 7-8 cm b4 turning @ R angle to L (about level w/costal margin).
*It continues horizontally to cross midline. At 1-2 cm to L of midline it turns superiorly and ends at the duodeno-jejunal junction, about 3 cm to L of midline on the transpyloric plane.
*Jejunum, 2nd portion, located in sup. L portion of abdomen.
*ileum, 3rd portion, located in inf. R portion of abdomen
LARGE INTESTINE
*starts @ the CAECUM, located inf. to transtubercular plane + sup. to lat. half of inguinal ligament
*the Ascending colon goes superiorly up the R flank just lateral to the midclavicular line.
*it ascends to level of 9th intercostal space, * just inf. to transpyloric plane. Here, it bends to L (*HEPATIC FLEXURE). *Transverse colon heads to L, going just lat. to midclavic. line, post. to 8th costal cartilage (just above Transpyloric plane) This turn is called the SPLENIC FLEXURE
*Descending colon goes inf. down L flank just lat. to midclavicular line.
* The SIGMOID colon turns medial and inf. @ level of left ASIS + reaches midline approx. 2-3 cm inf. to ASIS, and connects to the Rectum.
SPLEEN
posterior to the ST. It is located on the LEFT side, between the 9th and 11th ribs between the midaxillary line and the lateral edge of the erector spinae muscles
ABDOMINAL AORTA
* the abdominal aorta enters the abdomen in the midline, 3-4 cm superior to the transpyloric plane.
*** it BIFURCATES inferior to the umbilicus, in the supracristal plane
***INFERIOR VENA CAVA...
is formed from the common iliac veins....
***beginning 2-3 cm to the right of the midline in the transtubercular plane (level w/L5)
***the inferior vena cava courses superiorly to pierce the diaphragm @ vena caval hiatus (level w/T8, 1-2 cm to right + 1-2 cm superior to xiphisternal joint)
Trapezius upper: origin, insertion, action
Origin: EOP, superior nuchal line, C7 spinous process
Insertion: lateral third of clavicle, acromion process
Action: elevates the scapula, upward rotation of scapula,
extends head and neck, laterally flexes head and
neck to side of contraction, rotates head and neck
away from side of contraction
Trapezius middle: origin, insertion, action
Origin: spinous processes of T1-5
Insertion: spine of the scapula
Action: adduction and elevation of scapula
Trapezius lower: origin, insertion, action
Origin: spinous processes of T6-12
Insertion: spine of scapula
Action: depression, adduction, and upward rotation of
scapula
Trapezius innervation
spinal accessory
Levator Scapula
Innervation: dorsal scapular nerve
Origin: transverse processes of C1-5
Insertion: superior angle of the scapula down along the
superior medial border to the spine of the scapula
Action: elevation and downward rotation
Rhomboid Minor
Innervation: dorsal scapular nerve
Origin: spinous processes of C7 and T1
Insertion: medial border of scapula at scapular spine
Action: adduction and downward rotation of the scapula
Rhomboid Major
Innervation: dorsal scapular nerve
Origin: spinous processes of T2-5
Insertion: medial border of scapula inferior to scapular spine
Action: adduction and downward rotation of the scapula
Serratus Anterior
Innervation: long thoracic nerve
Origin: ribs 1-8 or 9
Insertion: anterior surface of the medial border and inferior angle of the
scapula
Action: abduction and upward rotation of the scapula; when the scapula is
fixed, it elevates the ribs
Pectoralis Minor
Innervation: medial pectoral nerve
Origin: ribs 3-5 at the costal cartilage
Insertion: coracoid process of scapula
Action: depression and downward rotation of scapula; stabilizes shoulder
anteriorly; elevates ribs 3-5 during forced inspiration when scapula
is fixed
Pectoralis Major
Innervation: lateral and medial pectoral nerves
Origin: medial 2/3 of clavicle, sternum, costal cartilage of ribs 1-6
Insertion: bicipital groove and greater tubercle of humerus
Action: flexion, adduction, and medial rotation of the arm
Deltoid
Anterior:
Origin: lateral 1/3 of clavicle
Insertion: deltoid tuberosity
Action: abduction, flexion, medial rotation of the arm
Middle:
Origin: acromion process
Insertion: deltoid tuberosity
Action: abducts the arm
Posterior:
Origin: spine of scapula
Insertion: deltoid tuberosity
Action: abduction, extension, lateral rotation of the arm
Supraspinatus
Innervation: suprascapular nerve
Origin: supraspinous fossa
Insertion: greater tuberosity of humerus
Action: initial abduction of the arm
Infraspinatus
Innervation: suprascapular nerve
Origin: infraspinous fossa
Insertion: greater tuberosity of humerus
Action: lateral rotation and adduction of the arm
Teres Minor
Innervation: axillary nerve
Origin: superior 2/3 of lateral border of scapula
Insertion: greater tuberosity of humerus
Action: lateral rotation, adduction, and extension of the arm
Subscapularis
Innervation: upper and lower subscapular nerves
Origin: subscapular fossa (anterior or costal surface) of the scapula
Insertion: lesser tuberosity of humerus
Action: medial rotation of the arm
Teres Major
Innervation: lower subscapular nerve
Origin: inferior angle and inferior 1/3 of lateral border of scapula
Insertion: bicipital groove of humerus
Action: adduction, extension, medial rotation of the arm
Latissimus Dorsi
Innervation: thoracodorsal nerve
Origin: spinous processes of T7-L5, iliac crest, posterior superior surface
of sacrum, all via the thoracolumbar fascia; lower 3-4 ribs
Insertion: bicipital groove of humerus
Action: adduction, extension, medial rotation of the arm
sagittal plane
a vertical plane dividing the body or an organ
into right and left sides
median plane
a vertical plane dividing the body or an organ
into equal right and left halves
coronal plane
a vertical plane dividing the body or an organ
into anterior (front) and posterior (back)
portions; also called frontal plane
horizontal plane
a plane dividing the body or an organ into
superior (top) and inferior (bottom) portions;
sometimes called transverse plane
anterior
nearer to the front of the body; ventral
posterior
nearer to the back of the body; dorsal
superior
toward the head or upper part of a structure
inferior
away from the head or toward the lower part of
a structure
proximal
nearest to the trunk or point of origin
distal
farthest from the trunk or point of origin
medial
nearer to the median plane or midline
lateral
farther from the median plane or midline
intermediate
between two structures
ipsilateral
on the same side of the body
contralateral
on the opposite side of the body
palmar
relating to the palm of the hand
plantar
relating to the sole of the foot
superficial
on or near the surface
deep
farther from the surface
internal
related to the inside; nearer to the center
external
related to the outside; farther from the center
parietal
relating to the wall of a cavity
visceral
relating to the organs
origin
the attachment of a muscle to the more fixed
part of the skeleton
insertion
a decrease in the angle between articulating
bones or parts of the body
extension
an increase in the angle between articulating
bones or parts of the body
lateral flexion
movement of the trunk away from the median
plane of the body
dorsiflexion
upward bending of the foot or toes in the
direction of the dorsal surface
plantar flexion
downward bending of the foot or toes in the
direction of the plantar surface or sole
abduction
movement away from the midline
adduction
movement toward the midline
rotation
movement of a part of the body around its
longitudinal axis
medial rotation
rotation toward the midline
lateral rotation
rotation away from the midline
circumduction
successive movements of flexion, abduction,
extension, and adduction to create a circle
supination
movement of the forearm in which the radius
is rotated laterally so that the palm faces
anteriorly in anatomical position
pronation
movement of the forearm in which the radius
is rotated medially so that the palm faces
posteriorly in anatomical position
inversion
movement of the plantar surface, or sole, of
the foot so that it faces toward the midline
eversion
movement of the plantar surface, or sole, of
the foot so that it faces away from the midline
opposition
movement which brings the thumb pad toward
a finger pad
reposition
movement of the thumb back from opposition
to its anatomical position
protraction
anterior, or forward, movement of the mandible
or scapula and shoulder
retraction
posterior, or backward, movement of the
mandible or scapula and shoulder from a
protracted position
elevation
movement of a body part superiorly
depression
movement of a body part inferiorly