1. PowerPoint ® Lecture Slides prepared by Leslie Hendon, University of Alabama, Birmingham HUMAN ANATOMY fifth edition MARIEB | MALLATT | WILHELM 11 Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Body PART 2

2. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Muscles of the Body – Anterior View Figure 11.7a

3. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Muscles of the Body – Posterior View Figure 11.7b

4. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Head – Facial Expression  Muscles of facial expression  Lie in the face and scalp  Thin and variable in shape  Often insert in the skin – not on bones  Innervated by cranial nerve VII – the facial nerve

5. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Head – Facial Expression Figure 11.8

6. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles Mastication and Tongue Movement  Four main pairs of muscles involved in mastication  Innervated by mandibular division of the trigeminal nerve (cranial nerve V)  Prime movers of jaw closure  Masseter and temporalis  Side-to-side movement  Pterygoid muscles  Compression of cheeks  Buccinator muscles

7. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of Mastication and Tongue Movement Figure 11.9a, b

8. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles Mastication and Tongue Movement  Extrinsic muscles of the tongue  Move tongue  Laterally  Anteriorly  Posteriorly  All innervated by cranial nerve XII – the hypoglossal nerve

9. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of Mastication and Tongue Movement Figure 11.9c

10. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Anterior Neck and Throat – Swallowing  The neck is divided into anterior and posterior triangles  Anterior triangle  Divided into suprahyoid and infrahyoid muscles  Participate in swallowing  Pharyngeal constrictors  Squeeze food into the esophagus

11. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Anterior Neck and Throat – Swallowing Figure 11.10a

12. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Anterior Neck and Throat – Swallowing Figure 11.10b

13. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.11a Muscles of the Neck and Vertebral Column  Head movement  Sternocleidomastoid  Splenius capitis and splenius cervicis

14. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Neck and Vertebral Column Figure 11.11b

15. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Neck and Vertebral Column  Trunk extension  Deep muscles of the back  Maintain normal curvatures of the spine  Form a column from sacrum to the skull  Erector spinae group  Largest of the deep back muscles

16. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Neck and Vertebral Column Figure 11.11d

17. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Deep Muscles of the Thorax – Breathing  Deep muscles provide movements for breathing  External intercostal muscles  Lift the ribcage  Internal intercostal muscles  Aid expiration during heavy breathing

18. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Deep Muscles of the Thorax – Breathing  Diaphragm  Most important muscle of respiration  Flattens as it contracts  Increases the volume of the thoracic cavity

19. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Deep Muscles of the Thorax – Breathing Figure 11.12a

20. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Deep Muscles of the Thorax – Breathing Figure 11.12b

21. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Abdominal Wall  Lateral and anterior abdominal wall  Formed from three flat muscle sheets  External oblique  Internal oblique  Transversus abdominis  Fourth muscle pair  Rectus abdominis  Inserts at the linea alba

22. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Abdominal Wall Figure 11.13a

23. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Abdominal Wall Figure 11.13b

24. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Pelvic Floor  Pelvic floor (pelvic diaphragm)  Sheet of two muscles  Both support pelvic organs  Levator ani  Formed from iliococcygeus, puborectalis, and pubococcygeus  Coccygeus

25. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Pelvic Floor Figure 11.14a

26. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Perineum  Inferior to the muscles of the pelvic floor  Urogenital diaphragm formed from  Sphincter urethrae and the deep transverse perineus Figure 11.14b

27. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Perineum  Muscles of the superficial perineal space  Ischiocavernosus  Bulbospongiosus  Superficial transverse perineus

28. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Perineum Figure 11.14c

29. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Muscles of the Anterior Thorax  Movements of the scapula  Pectoralis major  Pectoralis minor  Serratus anterior  Subclavius

30. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Muscles of the Anterior Thorax Figure 11.15a

31. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Muscles of the Posterior Thorax  Movements of the scapula  Trapezius  Levator scapulae  Rhomboid major  Rhomboid minor

32. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Muscles of the Posterior Thorax PLAY Rotator cuff muscles: an overview (b) Figure 11.15b PLAY Rotator cuff muscles: an overview (a)

33. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.16a Muscles Crossing the Shoulder Joint  Movements of the arm  Deltoid  Pectoralis major

34. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings PLAY Movement at the glenohumeral joint: an overview Muscles Crossing the Shoulder Joint  Movements of the arm  Latissimus dorsi  Supraspinatus  Infraspinatus  Teres minor  Teres major  Coracobrachialis  Subscapularis Figure 11.16b

35. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles Crossing the Elbow Joint Figure 11.16a

36. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles Crossing the Elbow Joint  Posterior muscles – extensors of the forearm  Triceps brachii  Anconeus  Anterior muscles – flexors of the forearm  Biceps brachii – also supinates the forearm  Brachialis  Brachioradialis

37. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Forearm  Movements of the wrist, hand, and fingers  Tendons are anchored by  Flexor and extensor retinacula  Most forearm muscles arise from the distal humerus  Movements at the wrist include  Flexion, extension, abduction, and adduction  Wrist and fingers are “operated” by muscles in the forearm

38. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Forearm  Flexors  Anterior flexor compartment  Innervated by median and ulnar nerves  Originate from a common tendon  Medial epicondyle of the humerus

39. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Anterior Muscles of the Forearm  Pronator teres  Flexor carpi radialis  Palmaris longus  Flexor carpi ulnaris  Flexor digitorum superficialis Figure 11.17a

40. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Deep Anterior Muscles of the Forearm  Flexor pollicis longus  Flexor digitorum profundus  Pronator quadratus

41. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Deep Anterior Muscles of the Forearm Figure 11.17b, c

42. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Forearm  Extensors  Posterior compartment of the forearm  Innervated by the radial nerve  Originate at a common tendon  Lateral epicondyle of the humerus

43. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Superficial Posterior Muscles of the Forearm  Brachioradialis – flexes forearm  Extensor carpi radialis longus  Extensor carpi radialis brevis  Extensor digitorum  Extensor carpi ulnaris Figure 11.18a

44. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.18b Deep Posterior Muscles of the Forearm  Supinator  Abductor pollicis longus  Extensor pollicis brevis and longus  Extensor indicus

45. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Hand  Fine movement of the fingers  All located in the palm  Control precise movements  Include muscles of  Adduction, abduction, and opposition

46. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Hand  Thenar muscles – ball of thumb  Abductor pollicis brevis  Flexor pollicis brevis  Opponens pollicis  Adductor pollicis  Hypothenar muscles  Abductor digiti minimi  Flexor digiti minimi  Opponens pollicis PLAY Muscles that act on the wrist and fingers: an overview

47. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Hand Figure 11.19a

48. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.19b Intrinsic Muscles of the Hand  Midpalmar muscles  Lumbricals  Palmar interossei  Dorsal interossei

49. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Hand Figure 11.19c

50. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles Crossing the Hip and Knee Joints  Thigh and leg movements  Anterior muscles  Flex the thigh and extend the leg at the knee  Posterior muscles  Extend the thigh and flex the leg

51. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles Crossing the Hip and Knee Joints  Thigh and leg movements  Adductor muscles – on medial aspect of thigh  Adduct the thigh only  Deep fascia of the thigh  Surrounds and encloses all three groups

52. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles Crossing the Hip and Knee Joints  Movements at the hip joint  Muscles that flex the thigh  Originate on vertebral column or pelvis  Muscles that extend the thigh  Arise posterior to the hip joint  Adductors originate medial to the hip joint  Abductors originate lateral to the hip joint

53. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Anterior and Medial Muscles  Origin on pelvis or vertebral column  Iliacus  Psoas major  Sartorius  Muscles of the medial compartment  Adductor longus  Adductor brevis  Adductor magnus  Pectineus  Gracilis

54. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Anterior and Medial Muscles Figure 11.20a

55. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Anterior Compartment of the Thigh  Quadriceps femoris  Has four separate heads  Has a common insertion at the quadriceps tendon  Powerful knee extensors  Rectus femoris  Vastus lateralis  Vastus medialis  Vastus intermedius  Tensor fasciae latae

56. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Anterior Compartment of the Thigh Figure 11.20a

57. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings PLAY Movement at the hip joint: an overview Posterior Muscles  Origin on pelvis or sacrum  Gluteus maximus  Gluteus medius  Gluteus minimus  Lateral rotators  Piriformis  Obturator externus  Obturator internus  Superior and inferior gemellus  Quadratus femoris

58. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Posterior Muscles Figure 11.21b

59. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.21a Muscles of the Posterior Compartment of the Thigh  Hamstrings  Biceps femoris  Semitendinosus  Semimembranosus

60. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Leg  Fascia lata of the leg surrounds muscles  Tightly binds muscles  Prevents swelling during exercise  Aids venous return  Divides leg into three compartments  Tendons are held in place by  Extensor, fibular, and flexor retinacula  Muscle movement at ankle and intertarsal joints

61. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Anterior Compartment  Tibialis anterior  Extensor digitorum longus  Fibularis (peroneus) tertius  Extensor hallucis longus Figure 11.22a PLAY Muscles of the ankle and foot (b)

62. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.23a Muscles of the Lateral Compartment  Fibularis (peroneus) longus  Fibularis (peroneus) brevis  Flexor hallucis longus  Extensor hallucis longus  Fibularis tertius PLAY Muscles of the ankle and foot (c)

63. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Lateral Compartment Figure 11.23b, c

64. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Posterior Compartment  Superficial muscles  Triceps surae  Gastrocnemius  Soleus  Plantaris PLAY Muscles that act on the ankle and foot: an overview

65. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Posterior Compartment Figure 11.24a, b

66. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Posterior Compartment  Deep muscles  Popliteus  Flexor digitorum longus  Flexor hallucis longus  Tibialis posterior Figure 11.24c PLAY Muscles of the ankle and foot (d) PLAY Muscles of the ankle and foot (a)

67. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Foot  Toe movement and foot support  Help to flex, extend, abduct, and adduct the toes  Support the arches of the foot  Single muscle on dorsal aspect of the foot  Many muscles on the plantar aspect

68. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Foot  Muscle on the dorsum of the foot  Extensor digitorum brevis  Muscles on the sole of the foot  First layer  Flexor digitorum brevis  Abductor hallucis  Abductor digiti minimi Figure 11.25a

69. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.25b Intrinsic Muscles of the Foot  Second layer  Flexor accessorius  Lumbricals

70. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Foot  Third layer  Flexor hallucis brevis  Adductor hallucis  Flexor digiti minimi brevis  Fourth layer  Plantar and dorsal interossei Figure 11.25c

71. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Intrinsic Muscles of the Foot Figure 11.25d, e

72. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Surface Anatomy  Palpation – feeling internal structures through the skin  “Living anatomy” – provides information about  Palpation of arterial pulses  Skeleton, muscles, and blood vessels  Sounds of the heart and lungs  Where to give injections

73. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Head  Cranium – selected structures felt through the skin  Superciliary arches  External occipital protuberance  Mastoid process  Temporalis muscle – at temple region  Frontalis muscle  Feel wrinkling of the forehead when eyebrows are raised

74. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Surface Anatomy of Lateral Aspect of the Head Figure 11.26

75. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Head  Face – selected structures felt through the skin  Lacrimal fossa  Root and bridge of the nose  Auricle of the ear  Zygomatic arch  Masseter muscle  Mandible  Temporomandibular joint

76. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Neck  Skeletal landmarks  Spinous processes of cervical vertebrae  C7 is particularly prominent (vertebra prominens)  Hyoid bone – in the anterior, superior neck  Laryngeal prominence – the “Adam’s Apple”  Cricoid cartilage – inferior to the laryngeal prominence  Jugular notch – depression in the superior part of the sternum

77. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Neck Figure 11.27

78. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Neck  Sternocleidomastoid – most prominent neck muscle  Sternal head  Clavicular head  Deep to the sternocleidomastoid  Common carotid artery  Internal jugular vein  Trapezius – posterior aspect of the neck

79. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Triangles of the Neck  The sternocleidomastoid muscles divide the neck  Anterior triangle  Posterior triangle Figure 11.28a

80. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Triangles of the Neck Figure 11.28b

81. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Trunk  The trunk consists of the  Thorax  Abdomen  Pelvis and perineum

82. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Thorax  Sternum – portions felt through the skin  Manubrium, xiphoid process, and sternal angle  Midaxillary line – line from the center of the axilla onto the lateral thoracic wall  Midclavicular line – vertical line from midpoint of the clavicle to the groin

83. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Thorax  Pectoralis major  Serratus anterior

84. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Anterior Thorax and Abdomen Figure 11.29

85. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Abdomen  Structures felt through the skin  Iliac crest  Anterior superior iliac spine  Inguinal ligament  Runs medially from anterior superior iliac spine to the pubic tubercle  Pubic crest

86. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Inguinal Hernia Figure 11.30

87. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles and other Abdominal Surface Features  Linea alba  The “white line” extending from xiphoid process to the pubic symphysis  Rectus abdominis  Linea semilunaris – lateral margin of rectus abdominis

88. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Pelvis and Perineum  Four bony structures define the perineum  Pubic symphysis  Two ischial tuberosities  Coccyx

89. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Back  Posterior median furrow – vertical groove along the midline  Spinous processes of vertebrae  Spine of the scapula  Medial end is opposite T 3  Medial border of the scapula

90. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Back  Inferior angle of the scapula  Iliac crests  Supracristal line – intersects L 4  Sacrum – superior to cleft in the buttocks  Coccyx – posterior to the anus

91. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Surface Anatomy of the Back Figure 11.31a

92. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Back  Trapezius  Latissimus dorsi  Erector spinae

93. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Surface Anatomy of the Back Figure 11.31b

94. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Upper Limb and Shoulder  The Axilla  Base of the axilla – where armpit hair grows  Deep to the axilla – axillary lymph nodes and blood vessels  Anterior axillary fold – pectoralis major  Posterior axillary fold –latissimus dorsi and teres major

95. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Shoulder and Arm Figure 11.32a, b

96. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Figure 11.33 The Shoulder  Acromion – lateral end of the spine of the scapula  Acromioclavicular joint  Deltoid muscle  Covers the greater tubercle of the humerus

97. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Arm  The region between the shoulder and elbow  Humerus  Palpated through skin along its entire length  Biceps brachii  Medial bicipital groove  The medial boundary of the biceps brachii  Triceps brachii

98. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Arm Figure 11.34

99. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Elbow  Lateral and medial epicondyles of the humerus  Ulnar nerve – “funny bone” runs across medial epicondyle  Olecranon process of the ulna  Cubital fossa – (antecubital fossa)  Forms anterior surface of forearm

100. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Anterior Surface of the Forearm and Fist Figure 11.35a

101. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Forearm  Bones  Ulna – palpate entire length  Styloid process and head – distal end  Radius – partly covered in muscle  Head of the radius – proximal end  Styloid process – distal end

102. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscles of the Forearm  Flexor muscles – anterior forearm  Flexor carpi radialis  Palmaris longus  This muscle is absent in about 30% of people  Extensor muscles – posterior forearm

103. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Other Structures of the Forearm  Anatomical snuff box bordered by  Extensor pollicis brevis  Extensor pollicis longus

104. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Hand  Dorsum of hand  Dorsal venous network  Tendons of extensor digitorum  Palmar surface  Thenar eminence (not labeled on figure 11.35b)  Hypothenar eminence (see figure 11.17a–c )  Pisiform bone

105. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Dorsum of the Hand Figure 11.36

106. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Gluteal Region  Iliac crests  Posterior superior iliac spine  Sacroiliac joint  Prominences of the buttocks  “Cheeks” of the buttocks  Formed from subcutaneous fat and the gluteal muscles

107. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Gluteal Region Figure 11.37

108. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Lower Limb and Gluteal Region  Natal cleft (gluteal cleft)  Vertical midline groove between “cheeks”  Gluteal fold  Horizontal fold below each “cheek”  Ischial tuberosities  Greater trochanter of the femur  Located at the lateral hip

109. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Lower Limb and Gluteal Region Figure 11.38a

110. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Thigh  Medial and lateral condyles of the femur  Patella  Three groups of muscles  Quadriceps femoris – anterior thigh  Vastus lateralis – injection site  Adductors – medial thigh  Hamstrings – posterior thigh

111. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Thigh Figure 11.38b

112. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings The Thigh  The Femoral Triangle  Superior border – inguinal ligament  Inferior borders  Sartorius  Adductor longus  Popliteal fossa  Diamond-shaped hollow on posterior knee  Defined by borders of “hamstring” tendons and gastrocnemius

113. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Leg and Foot  Palpate patella to find the patellar ligament  Structures of the proximal leg  Tibial tuberosity  Lateral and medial condyles of the tibia  Head of the fibula  Structures of the distal leg  Medial malleolus  Lateral malleolus

114. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Leg and Foot Figure 11.40a, c

115. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscle Groups of the Leg  Posterior calf muscles  Gastrocnemius and soleus  Calcaneal tendon – inferior end of the soleus and gastrocnemius  Anterior compartment muscles  Tibialis anterior  Extensor digitorum  Fibularis

116. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Muscle Groups of the Leg Figure 11.41

117. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Foot  Tendons on the dorsal surface of the foot  Extensor digitorum longus tendon  Extensor hallucis longus

118. Copyright © 2008 Pearson Education, Inc., publishing as Benjamin Cummings Foot Figure 11.40d