Myology n Morphology of skeletal muscle Muscle belly

Myology 肌学 n Morphology of skeletal muscle Muscle belly 肌腹 q Tendon 肌腱 aponeurosis 腱膜 Classification q Long muscle 长肌 q Short muscle 短肌 q Broad muscle 阔肌 q Orbicular muscle 轮匝肌 q n

Myology 肌学 n n Origin 起点－the fixed attachment Insertion 止点－ the movable attachment n n Action 作用 q Agonist 原动肌 q Antagonist 拮抗肌 q Synergist 协同肌 q Fixators 固定肌 Nomenclature of mucles 肌的命名: q shape q size q Location q their points of attachment

Myology 肌学 Accessory structures n Fascia 筋膜 q q n Superficial fascia Deep fascia Synovial bursa 滑膜囊

Myology 肌学 n Tendinous sheath 腱鞘 q q Fibrous layer Synovial layer: n n Mesotendon 腱系膜 vincula tendinum 腱纽

Synovial cyst of wrist 腕部腱鞘囊肿

Muscles of head 头肌

Facial muscles 面肌 n Epicranius 颅顶肌 q q q n n Frontal belly 额腹 Occipital belly 枕腹 Galea aponeurotica 帽状腱膜 Orbicularis oculi 眼轮匝肌 Buccinator 颊肌 Orbicularis oris 口轮匝肌 Nasalis 鼻肌

Facial muscles 面肌

n n Temporalis 颞肌 Masseter 咬肌 lateral pterygoid 翼外肌 Medial pterygoid 翼内肌

n Temporalis 颞肌 q q q n Origin－temporal fossa Insertion－coronoid process of mandible Action－elevates and retracts mandible Masseter 咬肌 q q q Origin－inferior border and medial surface of zygomatic arch Insertion－lateral surface of ramus of mandible and angle of mandible Action－elevates mandible

★ Masticatory muscles 咀嚼肌 n Lateral pterygoid 翼外肌 n Medial pterygoid 翼内肌

Muscles of the neck 颈肌

Muscles of the neck Superficial group n n Platysma 颈阔肌 Sternocleidomastoid 胸锁乳突肌

Muscles of the neck Suprahyoid muscles n n Digastric 二腹肌 Mylohyoid 下颌舌骨肌 Stylohyoid 茎突舌骨肌 Geniohyoid 颏舌骨肌 Elevate (raise) hyoid bone and depress mandible.

Muscles of the neck Infrahyoid muscle n Sternohyoid 胸骨舌骨肌 n Sternothyroid 胸骨甲状肌 n Thyrohyoid 甲状舌骨肌 n Omohyoid 肩胛舌骨肌 Depress hyoid or larynx after elevation

Muscles of the neck Deep group n Lateral q q q n Scalenus anterior 前斜角肌 Scalenus medius 中斜角肌 Scalenus posterior 后斜角肌 Medial q q longus capitis 头长肌 longus colli 颈长肌 Flex the head, bends the neck forward

Major muscles of the neck ★ Sternocleidomastoid 胸锁乳突肌 n n n Origin: manubrium and sternal end of clavicle Insertion: mastoid process of temporal bone Action: contraction of one muscle draws head toward the same side, and turn face to opposite side; both muscles act together to draw head backward

Major muscles of the neck Scalenus anterior 前斜角肌 n n n Origin: transverse processes of C 3 C 6. Insertion: tubercle for scalenus anterior Action: unilateral, bends neck laterally; bilateral, elevate first rib, an accessory muscle of inspiration; if rib is fixed, flex neck anteriorly

Major muscles of the neck ★ Scalene fissure 斜角肌间隙 n n Above the first rib, there is a triangular space between scalenus anterior and medius. The brachial plexus and the subclavine a. emerge from this space.

Muscles of trunk 躯干肌

The Muscles of Back Superficial group n Trapezius 斜方肌 n Levator scapulae 肩胛提肌 n Rhomboideus 菱形肌 n Latissimus dorsi 背阔肌 n Thoracolumbar fascia 胸腰筋膜

The Muscles of Back Deep group n Splenius 夹肌 n Erector spinae 竖脊肌

Major Muscles of Back Trapezius 斜方肌 n n Origin: superior nuchal line, external occipital protuberance, ligamentum nuchae and spinous processes of seventh cervical and all thoracic vertebrae Insertion: lateral third of clavicle, acromion, and spine of scapular Acton: upper fibers elevate scapula, lower fibers depress scapula; if scapula is fixed, one side acting along, draws head toward the same side, and turn face to opposite side; both sides together, draw head directly backward Nerve supply: accessory nerve (Ⅺ cranial nerve)

Major Muscles of Back Latissimus dorsi 背阔肌 n n Origin: q Spinous processes of lower six thoracic and all lumbar vertebrae q Median sacral crest q Posterior part of iliac crest Insertion: floor of intertubercular groove of humerus. Action: trunk fixed, extends, adducts and medially rotates arm ; arm fixed, elevates trunk. Nerve supply: thoracodorsal nerve

Thoracolumbar Fascia 胸腰筋膜 Anterior layer Middle layer Posterior layer

Trapezius Levator scapular Deltoid Ausculatory triangle Latissimus dorsi Inferior lumbar triangle Rhomboideus Thoracolumbar fascia

Muscles of thorax Muscles connecting the upper n n n limb to the thoracic wall Pectoralis major 胸大肌 Pectoralis minor 胸小肌 Serratus anterior 前锯肌

Muscles of thorax n Intrinsic muscles q q Intercostales externi 肋间外肌 Intercostales interni 肋间内肌 Intercostales intimi 肋间最内肌 Transverses thoracis 胸横肌

Major muscles of thorax Pectoralis Major n n Origin: medial half of clavicle, sternum, upper six costal cartilages. Insertion: lateral lip of the bicipital groove of humerus Action: adducts the arm and rotates it medially; the clavicular fibers also flex the arm; with the arm above the head, raise the body as in climbing Nerve supply: lateral pectoral n.

Major muscles of thorax Intercostales externi 肋间外肌 n n Origin: inferior border of rib above Insertion: superior border of rib below Replaced anteriorly by external intercostals membrane Action: raise ribs adding in forced inspiration

Major muscles of thorax Intercostales interni 肋间内肌 n n Origin: superior border of rib below Insertion: inferior border of rib above Replaced posteriorly by internal intercostals membrane. Action: depress ribs forced expiration

Diaphragm 膈 n n Shape and position: dome-shaped between thorax and abdomen, consists of a peripheral muscular part and a central tendon Origin q Sternal part: arising from xiphoid process q Costal part: arising from lower six and costal cartilages q Lumbar part: arising by two crura from upper 2 -3 lumbar vertebrae Insertion: central tendon Weak areas: q Lumbocostal triangle q Sternocostal triangle

Diaphragm 膈 Openings in the diaphragm n n n Aortic hiatus 主动脉裂孔 lies anterior to the body of the 12 th thoracic vertebra between the crura and transmits the aorta, thoracic duct Esophageal hiatus 食管裂孔 lies at level of T 10. It transmits esophagus and vagus nerves Vena cava foramen 腔静脉孔 lies at T 8 level in the central tendon. It transmits the inferior vena cava. T 8 T 10 T 12

Diaphragm 膈 Action: n n Contraction: the dome moving downward, increases the volume of thoracic cavity which results in inspiration, at the same time the intraabdominal pressure is increased assists in defecation, vomiting or child birth. Relaxation: the dome returns to the former position, reduces the volume to the thoracic cavity, resulting in expiration.

Muscles of abdomen Anterolateral group n n Obliquus externus abdominis 腹外斜肌 Obliquus internus abdominis 腹内斜肌 Transversus abdominis 腹横肌 Rectus abdominis 腹直肌

Obliquus externus absominis 腹外斜肌 n General direction of fibers: downward, forward and medially (run down and inward)

Obliquus externus absominis 腹外斜肌 Structures n n n Inguinal ligament 腹股沟韧带 Lacunar ligament 腔隙韧带 Superficial inguinal ring 腹股沟管浅环 －triangular-shaped defect in aponeurosis of obliquus externus abdominis above pubic tubercle

Superficial inguinal ring

Obliquus internus abdominis 腹内斜肌 n n Deep to obliquus externus abdominis General direction of fibres: upwards, forwards and medially

Transversus abdominis 腹横肌 n n Deep to obliquus internus General direction of fibers: run horizontally forward.

Transversus abdominis 腹横肌 n Inguinal falx 腹股沟镰 q q n Obliquus internus abdominis has a lower, free border that arches over spermatic cord Inserted with transversus abdominis fiber into medial part of pecten of pubis Cremaster 提睾肌 q q Dirived from the lower fibers of the obliquus internus abdominis and transversus abdominis Around the spermatic cord and testis

Rectus abdominis 腹直肌 n n n Position: lie on to either of midline Origin: pubic crest and symphysis Insertion: xiphoid and 5 th-7 th costal cartilages n n Tendinous intersections 腱划 3 -4 linea semiluaris 半月线

Similar functions for above four pairs of muscles n n Support and compress the abdominal viscera Increase intra-abdominal pressure, aid in expulsive efforts-vomiting, coughing, sneezing, defecation, urination and childbirth. Depress ribs, assist in (the act of force(4)expiration. Flex, lateral flex, and rotate vertebral column

Sheath of rectus abdominis 腹直肌鞘 Anterior layer n Formed by fusion of aponeurosis of obliquus externus abdominis and anterior leaf of aponeurosis of obliquus internus abdominis

Sheath of rectus abdominis 腹直肌鞘 Posterior layer n n Formed by fusion of posterion leaf of aponeurosis of obliquus internus abdominis and aponeurosis of transversus abdominis Absent in about 4 -5 cm below the umbilicus, where aponeuroses of all three muscles form anterior layer the lower free border named arcuate line 弓状线 n Below this line rectus abdominis in contact with transverse fascia

Muscles of abdomen n Linea alba 白线 －tendinous raphe between right and left recti from xiphoid to pubic symphysis

Landmarks and surface anatomy n n n Linea alba Rectus abdominis Tendinous intersections Linea semilunaris Umbilicus: at the level of L 3 ~ L 4 Inguinal ligament

Muscles of abdomen Posterior group n n Quadratus lumborum Psoas major 腰大肌 腰方肌

Muscles of upper limb 上肢肌

Muscles of shoulder n Deltoid 三角肌 n Supraspinatus 冈上肌 n Infraspinatus 冈下肌 n Teres minor 小圆肌 n Teres major 大圆肌 n Subscapularis 肩胛下肌

Muscles of arm n Antererior group q q q n Biceps brachii 肱二头肌 Coracobrachialis 喙肱肌 Brachialis 肱肌 Posterior group q Triceps brachii 肱三头肌

Muscles of forearm Antererior group (9) n Superficial layer (5) q Brachioradialis 肱桡肌 q Pronator teres 旋前圆肌 q Flexor carpi radialis 桡侧腕屈肌 q Palmaris longus 掌长肌 q Flexor carpi ulnaris 尺侧腕屈肌

Antererior group (9) n Second layer (1) q Flexor digitorum superficialis 指浅屈肌 n Third layer (2) q Flexor digitorum profundus 指深屈肌 q n Flexor pollicis longus 拇长屈肌 Fourth layer (1) q Pronator quadratus 旋前方肌 Action: flex radiocarpal joint and fingers, pronate forearm

Muscles of forearm Posterior group (10) n Superficial layer (5) q Extensor carpi radialis longus 桡侧腕长伸肌 q Extensor carpi radialis brevis 桡侧腕短伸肌 q Extensor digitorum 指伸肌 q Extensor digiti minimi 小指伸肌 q Extensor carpi ulnaris 尺侧腕伸肌

Muscles of forearm Posterior group (10) n n Deep layer (5) q Supinator 旋后肌 q Abductor pollicis longus 拇长展肌 q Extensor pollicis brevis 拇短伸肌 q Extensor pollicis longus 拇长伸肌 q Extensor indicis 示指伸肌 Action: extend radiocapral joint and fingers, and supinate forearm

Muscles of hand n Lateral group－thenar 鱼际 (4) q q Abductor pollicis brevis 拇短展肌 Flexor pollicis brevis 拇短屈肌 Opponens pollicis 拇对掌肌 Adductor pollicis 拇收肌 n Action: flex, abduct, adduct and oppose thumb n Medial group－hypothenar 小鱼际（3） q q q n Abductor digiti minimi 小指展肌 Flexor digiti minimi brevis 小指短屈肌 Opponens digiti minimi 小指对掌肌 Action: flex, abduct , and oppose little finger

Muscles of hand n Intermedial group q q q Lumbricales (4) 蚓状肌 flex fingers at MP joints; extend fingers at IP joints Palmar interossei (3) 骨间掌侧肌 adduct fingers towards middle finger at MP joints Dorsal interossei (4) 骨间背侧肌 abduct fingers away from middle finger at MP joints

Major muscles of upper limb Deltoid 三角肌 n n n Origin: lateral third of clavicle, acromion, and spine of scapula Insertion: deltoid tuberosity of humerus Action: abducts the arm，anterior fibers flex and medially rotate arm; posterior fibers extend and laterally rotate arm

Major muscles of upper limb n Teres major 大圆肌 q q q Origin: dorsal surface of inferior angle of scapula Insertion: crest of lesser tubercle of humerus Action: medially rotates and adducts arm

Major muscles of upper limb n Trilateral and quadrilateral foramina 三边孔和四边孔 q Between the subscapularis and teres major, there is a long triangular space whose lateral side is surgical neck of humerus. q The long head of triceps brachii subdivides this space into a medial trilateral foramen and a lateral quadrilateral foramen.

Major muscles of upper limb Biceps brachii 肱二头肌 n n Origin: long head, supraglenoid tubercle; short head, coracoid process Insertion: radical tuberosity Action: supinator of forearm, flexor of elbow joint, weak flexor of should joint Nerve supply: Musculocutaneous n.

Major muscles of upper limb Triceps brachii 肱三头肌 n n n Origin: long head, infraglenoid tubercle; lateral head, above groove for radical n. , medical head, below groove for radical n. Insertion: olecranon of ulna Action: extends elbow joint, long head can extend adduct shoulder joint

Major muscles of upper limb Pronator teres 旋前圆肌 n n Origin: medical epicondyle of humerus and deep fascia of forearm Insertion: middle of lateral surface of radius Action: pronation of forearm and flexion of elbow Nerve supply: median n.

Major muscles of upper limb Supinator 旋后肌 n Origin: lateral epicondyle of humerus and upper part of lateral border of ulna n Insertion: upper third of anterior surface of radius n Action: supination of forearm

Muscles of lower limb 下肢肌

Muscles of lower limb The muscles of lower limb are divided into: n n Muscles of hip Muscles of thigh Muscles of leg Muscles of foot

Muscles of hip Anterior group n Iliopsoas 髂腰肌 q Iliacus 髂肌 q Psoas major 腰大肌 n Psoas minor 腰小肌 n Tensor fasciae latae 阔筋膜张肌

Muscles of hip Posterior group n Gluteus maximus 臀大肌 n Gluteus medius n Gluteus minimus 臀小肌 n Piriformis n Obturator internus n Obturator externus 闭孔外肌 n Quadratus femoris 股方肌 臀中肌 梨状肌 闭孔内肌

Muscles of thigh Anterior group n Sartorius 缝匠肌 n Quadricep 股四头肌 q Rectus femoris 股直肌 q Vastus lateralis 股外侧肌 q Vastus intermedius 股中间肌 q Vastus medialis 股内侧肌 n Blood supply: femoral artery n Nerve supply: femoral nerve

Muscles of thigh Medial group Pectineus 耻骨肌 n Adductor longus 长收肌 n Adductor brevis 短收肌 n Adductor magnus 大收肌 n Gracilis 股薄肌 Action: adduct thigh at hip joint Blood supply: q Deep femoral a. q Obturator a. Nerves supply: obturator n. n

Muscles of thigh Posterior group n Biceps femoris 股二头肌 n Semitendinosus 半腱肌 n Semimembranosus 半膜肌 Action q Flex the leg at knee joint q Extend the thigh at hip joint

Muscles of leg Anterior group n n Tibialis anterior 胫骨前肌 Extensor hallucis longus 拇长伸肌 Extensor digitorum longus 趾长伸肌 Peroneus tertius 第三腓骨肌 Blood supply: Anterior tibial a. Nerve supply: Deep peroneal n.

Muscles of leg Lateral group n Peroneus longus 腓骨长肌 n Peroneus brevis n Action: plantar flex and evert the 腓骨短肌 foot n Blood supply: branches from the peroneal artey n Nerve supply: superficial peroneal n.

Muscles of leg Posterior group n Superficial lager q triceps surae 小腿三头肌 n Gastrocnemius n Soleus 比目鱼肌 腓肠肌

Muscles of leg Posterior group n Deep layer q Popliteus 腘肌 q Flexor digitorum longus 趾长屈肌 q Tibialis posterior 胫骨后肌 Flexor hallucis longus 拇长屈肌 Nerve supply: tibial n. q n

Muscles of foot n n Muscles on dorsum: extensor digitorum brevis Muscles in sole: medial, lateral and intermediate groups

Muscles of hip Iliopsoas 髂腰肌 n n Origin: q Psoas major: transverse processes and lateral surface of bodies of lumbar vertebrae q Iliacus: iliac fossa Insertion: lesser trochanter of femur Action: flexes thigh on trunk Nerve supply: lumbar plexus

Muscles of hip Gluteus maximus 臀大肌 n n Origin: gluteal surface of ilium and dorsal aspect of sacrum Insertion: gluteal tuberosity of femur and iliotibial tract Action: extends and laterally rotates thigh at hip joint; raises trunk when the lower limb is fixed Nerve supply: inferior gluteal n.

Muscles of thigh Sartorius 缝匠肌 n n Origin: anterior superior iliac spine Insertion: upper medial surface of tibia Action: flexes hip and knee joints; rotates flexed knee medially Nerve supply: femoral n.

Muscles of thigh Quadriceps femoris 股四头肌 n Origin: q q n n n Rectus femoris: anterior inferior iliac spine Vastus medialis: medial lip of linea aspera Vastus lateralis: lateral lip of linea aspera Vastus intermedius: anterior surface of femur Insertion: tibial tuberosity via patellar ligament Action: extends leg at knee joint; rectus femoris also flexes thigh at hip joint Nerve supply: femoral n.

Muscles of leg Tibialis anterior 胫骨前肌 n n Origin: lateral surface of tibia Insertion: medial cuneiform and base of 1 st metatarsal Action: dorsiflexes and inverts foot Nerve supply: deep peroneal n.

Muscles of leg Triceps surae 小腿三头肌 n n Origin: q Gastrocnemius: medial and lateral condyles of femur q Soleus: soleal line of tibia and upper third of fibula Insertion: calcaneum via tendo calcaneus Action: flexes knee joint and plantar flexes foot at ankle joint; steadies leg on foot during standing Nerve supply: tibial n.

Muscles of leg Tibialis posterior 胫骨后肌 n n Origin: posterior surface of tibia and fibula and interosseous membrane Insertion: tuberosity of navicular, all cuniforms Action: plantar flexes and inverts foot Nerve supply: tibial n.