Muscles that do the extension: 1. Triceps 2. Anconeus. Movements around the radioulnar joint: 1. Pronation 2. Supination

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2 Lecture 11 Anatomy Upper Limb Movements Flexion Extension are the only movements muscles do Muscles that do the flexion are the muscles in the anterior compartment: 1. Biceps 2. Brachialis 3. Coracobrachilais Muscles that do the extension: 1. Triceps 2. Anconeus Movements around the radioulnar joint: 1. Pronation 2. Supination Pronator muscles: 1. Pronator teres 2. Pronator Quadratus Supinator muscles: 1. Supinator: a muscle that lies deep to anconeus 2. Biceps Movement around the wrist joint: 1. Flexion 2. Extension 3. Abduction 4. Adduction Adduction: 1. Flexor carpi ulnaris (medial) 2. extensor carpi ulnaris (posterior) Abduction: 1. Flexor carpi radialis 2. Extensor carpi radialis longus 3. Extensor carpi radialis brevis

3 Lower Limb Muscles of the gluteal region: a. Gluteus maximus, it s the largest muscle in the body and usually where a needle is injected (it is divided into 4 regions and the needle is injected in the upper lateral part) b. Gluteus medius (can be seen if we remove the gluteus maximus) c. Gluteus minimus(lies deep to the gluteus medius) d. Piriformis (forms the posterior wall of the pelvic cavity) e. Gemellus superior f. Obturator internus (forms the lateral wall of the pelvic cavity and it s tendon is between the gemellus superior and inferior muscles) g. Gemellus inferior h. Quadratus femoris (quadratus means square) These are the small muscles of the gluteal region, Piriformis, Gemellus superior, Gemellus inferior, and between them the tendon of Obturator internus, and the Quadratus femoris (they are all located under the gluteus maximus) The thigh has three compartments, anterior, posterior, and medial The anterior aspect or compartment of the thigh: The anterior compartment is divided into an upper part and a lower part by the Sartorius (خياط و تعني العضلة الخياطية ألن الخياطيه اكثر مه يستعملها Muscle (sartorius means The upper part: 1. Pectineus (a triangular muscle) 2. Psaos major 3. Iliacus *The Psaos major and Iliacus muscles descend from the posterior abdominal wall to the thigh and are called Ilio-psaos The lower part: Includes the quadriceps femoris which consists of four heads: 1. Rectus femoris (lies in the middle) 2. Vastus medialis (lies on the medial side of rectus femoris) 3. Vastus lateralis (lies on the lateral side of rectus femoris) 4. Vastus intermedius (lies deep to rectus femoris) The medial compartment of the thigh muscles: Consists of four muscles: (from the forward backwards) 1. Adductor longus (because it is long it is called longus) 2. Adductor brevis (deep to adductor longus) 3. Adductor magnus (deep to adductor brevis) (because it is huge it is called magnus)

4 4. Gracilis (looks like the sartorius) *The adductor longus can be seen from the anterior aspect *The adductor magnus can be seen from the posterior aspect *The adductor brevis cannot be seen unless the adductor longus is lifted *The medial compartment is sometimes called the adductor compartment because all the muscles are adductors *The anterior compartment (formed by the four heads of the quadriceps) is called the extensor compartment because it produces extension Posterior compartment: Consists of three muscles 1. Bicepts femoris (on the lateral side) 2. semitendinosus (on the medial side and it looks like a tendon) 3. semimembranosus (on the medial side deep to semitendinosus and it looks like a membrane) *They are flexor muscles that produce flexion at the knee joint Sometimes called flexor compartment or hamstring muscle Movement at the hip joint: 1. Flexion : a. Ilio-psaos, it flexes the thigh towards the trunk when the trunk is fixed, and flexes the trunk against the thigh when the thigh is fixed b. Rectus femoris c. Sartorius 2. Extension: The hamstring muscles (posterior compartment or flexor compartment) they are flexor muscles to the knee but they are extensor muscles to the hip and they are helped by gluteus maximus 3. Abduction: gluteus medius and gluteus minimus 4. Adduction: adductor muscles 5. Medial rotation: gluteus medius and minimus 6. Lateral rotation: is formed by the small muscles of the gluteal region (piriformis, obturator internus and externus, superior and inferior gemeli and sometimes called lateral rotator muscles) and quadratus femoris 7. Circumduction: is a combination of flexion, abduction, extension, and adduction Movements around the knee joint: 1. Flexion (by the flexor muscles or posterior muscles which are extensors to the hip joint but flexors to the knee joint) 2. Extension (the quadricepts) Medial rotation is for the thigh (hip joint) and not the leg (knee joint)

5 *medial rotation of flexed leg *lateral rotation of flexed leg The thigh must be flexed to be able to do the rotation movement If the gluteus medius and minimus flex alone, they will not only flex the thigh but rotate it medially as well If the biceps flexes alone, it will produce flexion as well as lateral rotation But if these muscles work together they produce only flexion If the medial muscles (semitendinosus and semimembranosus) flex with the gluteus medius, minimus, they will produce medial rotation If the biceps flexes with the gluteus medius and minimus, it will produce lateral rotation Muscles of the leg: Consists of anterior, posterior, and lateral compartments The anterior compartment consists of three muscles and they are extensors, but we do not call it extension, we call it dorsiflexion (why?) because extension means increasing the angle, but these muscles decrease the angle at the ankle joint thus called dorsiflexion movement 1. Tibialis anterior (anterior to the tibia) 2. Extensor digitorum longus (lies on the lateral side) 3. Extensor hallucis longus (between the tibialis anterior and extensor digitorum longus, and it s tendon goes towards the big toe thus called hallucis) The lateral compartment consists of two muscles and they are called peroneal muscles or the peroneal compartment 1. peroneus longus (it is anterior and has a long tendon) 2. peroneus brevis (it is posterior and has a short tendon) The posterior compartment or flexor compartment Consists of two sets of muscles 1. Superficial muscles 2. Deep muscles The superficial muscles are called muscles of the calf or calf muscles *the calf is the ball shaped muscle on the posterior side of the leg which can be seen (العدائيه) or cross-country runners (الرياضييه) clearly on athletes Superficial muscles consist of: 1. Gastrocnemius (has two heads and is the most superficial muscle of the calf muscles) 2. Soleus (lies deep to the gastrocnemius) 3. Plantaris (it is attached to the tendocalcanus as well, and it is absent at about %40 ) ال يؤثر غيابها على شيء of people, and it s absence does not compromise anything

6 *the gastrocnemius and soleus muscles share one tendon, called tendocalcanus, because inferiorly it is attached to the calcanus, and it is the largest tendon in the body and the strongest tendon in the body *قصة الكريك* The deep muscles 1. Popliteus (because it lies in the popliteal fossa at the back of the knee, or popliteal surface of the femur, and it produces medial rotation of the flexed leg) 2. Tibialis posterior (between flexor digitorum and hallucis) 3. Flexor digitorum longus (on the medial side) 4. Flexor hallucis longus (on the lateral side) *muscles that produce medial rotation are the semitendinosus, semimembranosus, as well as the popliteus muscle *the only muscle that produces lateral rotation is the biceps *the posterior muscles are 7 muscles *the muscles of the foot are not included as the doctor said, he does not want them Movements of the ankle: 1. Dorsiflexion (by the anterior muscles) 2. Plantarflexion (by the posterior muscles except the popliteus) Movements of the foot at subtarsal and transverse tarsal joints: 1. Inversion (to the inside, and produced by tibialis anterior and tibialis posterior muscles) 2. Eversion (to the outside, and produced by peroneus longus and peroneus brevis muscles) *doctor note: some muscles of the same compartment are supplied by nerves different from the other muscles in the compartment, and you must focus on memorizing it *nerve supply of muscle group, also memorize it *most important of the shoulder joint muscles is the deltoid (as doctor says) -By Rashed N. Alomari

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