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Shoulder MRI, CT Scan, and Arthrogram

See also Plate 408

MRI

Acromion

Deltoid muscle

Articular cartilage of humeral head

Greater tubercle

Physeal closure

Surgical neck

Deltoid muscle

 

Bicipital groove

 

with long head

 

Humeral head

Sternal end of clavicle

of biceps tendon

 

 

Glenoid

1st rib

 

 

2nd rib

 

Articular

CT

 

 

 

cartilage of

 

 

 

 

 

 

humeral head

 

 

 

Greater

 

 

 

tuberosity

 

 

 

Contrast within

 

 

 

glenohumeral

 

 

 

joint capsule

 

 

 

Bicipital groove

 

 

Scapula

Contrast within

 

Vertebral border

sheath of biceps

 

Body of T2 of scapula

 

long head

Subscapularis muscle

Surgical neck

Infraspinatus muscle

 

Supraspinatus muscle

Superior glenoid labrum

Suprascapular nerve, artery, vein

Glenoid

Inferior glenoid labrum

Latissimus dorsi muscle

Teres major muscle

Arthrogram: glenohumeral joint

Acromion

Subacromial space

Axillary recess

Subscapular recess

Plate 467

Regional Scans

 

 

 

 

 

 

Muscle Tables

6

 

 

 

 

 

 

 

 

 

 

 

PROXIMAL

DISTAL

 

 

 

MUSCLE

 

 

MUSCLE

ATTACHMENT

ATTACHMENT

INNERVATION

MAIN ACTIONS

BLOOD SUPPLY

 

 

GROUP

 

 

 

(ORIGIN)

(INSERTION)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Abductor digiti

Pisiform bone and

Medial side of base

 

 

 

 

 

 

of proximal

Ulnar nerve (deep

 

Deep palmar branch

 

 

 

tendon of flexor

Abducts little finger

Hand

 

 

minimi

phalanx of little

branch)

of ulnar artery

 

 

carpi ulnaris

 

 

 

 

 

finger (5th digit)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Flexor retinaculum,

Lateral side of base

Median nerve

 

Superficial palmar

 

 

 

Abductor pollicis

tubercles of

of proximal

 

 

 

 

(recurrent

Abducts thumb

branch of radial

Hand

 

 

brevis

scaphoid and

phalanx of

 

 

branch)

 

artery

 

 

 

 

trapezium

thumb

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Posterior surface of

 

Radial nerve

Abducts and extends

Posterior

 

 

 

Abductor pollicis

ulna, radius, and

Base of 1st

Posterior

 

 

(posterior

thumb at

interosseous

 

 

longus

interosseous

metacarpal

forearm

 

 

interosseous)

carpometacarpal joint

artery

 

 

 

membrane

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Oblique head: bases

 

 

 

 

 

 

 

 

of 2nd and 3rd

 

 

 

 

 

 

 

 

metacarpals and

 

 

 

 

 

 

 

 

capitate and

Medial side of base

 

 

 

 

 

 

Adductor pollicis

adjacent bones

of proximal

Ulnar nerve (deep

Adducts thumb

Deep palmar arch

Hand

 

 

 

phalanx of

branch)

 

 

 

Transverse head:

 

 

 

 

 

 

thumb

 

 

 

 

 

 

 

anterior surface

 

 

 

 

 

 

 

 

of 3rd

 

 

 

 

 

 

 

 

metacarpal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Posterior surface

Lateral surface of

 

Assists triceps in

 

 

 

 

Anconeus

of lateral

olecranon and

Radial nerve (C5–T1)

extending elbow,

Deep brachial artery

Arm

 

 

epicondyle of

posterior

abducts ulna in

 

 

 

 

 

 

 

 

 

humerus

proximal ulna

 

pronation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Long head:

 

 

 

 

 

 

 

 

supraglenoid

 

 

 

 

 

 

 

 

tubercle of

Radial tuberosity,

 

 

 

 

 

 

Biceps brachii

scapula

fascia of

Musculocutaneous

Flexes and supinates

Muscular branches

 

 

 

 

forearm via

of brachial

Arm

 

 

Short head: tip of

nerve (C5,C6)

forearm at elbow

 

 

 

bicipital

artery

 

 

 

 

 

 

 

 

 

 

coracoid

aponeurosis

 

 

 

 

 

 

 

process of

 

 

 

 

 

 

 

 

scapula

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distal half of anterior

Coronoid process

Musculocutaneous

 

Radial recurrent

 

 

 

 

 

artery, muscular

 

 

 

Brachialis

surface of

and tuberosity

nerve and radial

Flexes forearm at elbow

Arm

 

 

branches of

 

 

 

humerus

of ulna

nerve (C7)

 

 

 

 

 

 

brachial artery

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Proximal 2/3 of

 

 

 

 

 

 

 

 

lateral

Lateral side of distal

 

Weak flexion of forearm

Radial recurrent

Posterior

 

 

Brachioradialis

supracondylar

Radial nerve

when forearm is

 

 

end of radius

artery

forearm

 

 

 

ridge of

 

midpronated

 

 

 

 

 

 

 

 

 

 

humerus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tip of coracoid

Middle third of

Musculocutaneous

Flexes and adducts arm

Muscular branches

 

 

 

Coracobrachialis

process of

medial surface

of brachial

Arm

 

 

nerve

at shoulder

 

 

 

scapula

of humerus

artery

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clavicular part: flexes and

 

 

 

 

 

 

 

 

medially rotates arm

Posterior circumflex

 

 

 

 

Lateral third of

 

 

Acromial part: abducts

 

 

 

 

 

 

humeral

 

 

 

 

anterior clavicle,

Deltoid tuberosity of

 

 

 

 

 

 

arm beyond initial 15

artery, deltoid

 

 

 

Deltoid

lateral acromion,

Axillary nerve

Shoulder

 

 

humerus

degrees done by

branch of

 

 

 

inferior edge of

 

 

 

 

 

 

 

supraspinatus

thoraco-acromial

 

 

 

 

spine of scapula

 

 

 

 

 

 

 

 

 

artery

 

 

 

 

 

 

 

Spinal part: extends and

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

laterally rotates arm

 

 

 

 

 

 

Base of proximal

 

Abduct digits from axial

 

 

 

 

 

 

 

line of hand (3rd

 

 

 

 

Dorsal interosseous

Adjacent sides of

phalanges,

 

 

 

 

 

Ulnar nerve (deep

digit); flex digits at

 

 

 

 

two metacarpal

extensor

Deep palmar arch

Hand

 

 

muscles

branch)

metacarpophalangeal

 

 

bones

expansion of

 

 

 

 

 

 

joint and extend

 

 

 

 

 

 

digits 2–4

 

 

 

 

 

 

 

 

interphalangeal joints

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dorsal base of 3rd

 

 

 

 

 

 

Extensor carpi

Lateral epicondyle of

metacarpal and

Radial nerve (deep

Extends and abducts

Radial artery, radial

Posterior

 

 

radialis brevis

humerus

slip to 2nd

branch)

hand at wrist

recurrent artery

forearm

 

 

 

 

metacarpal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distal third of lateral

Dorsal base of 2nd

 

 

 

 

 

 

Extensor carpi

supracondylar

metacarpal and

Radial nerve

Extends and abducts

Radial artery, radial

Posterior

 

 

radialis longus

ridge of

slip to 3rd

hand at wrist

recurrent artery

forearm

 

 

 

 

 

 

humerus

metacarpal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Variations in spinal nerve contributions to the innervation of muscles, their arterial supply, their attachments, and their actions are common themes in human anatomy. Therefore, expect differences between texts and realize that anatomical variation is normal.

Muscle Tables

Table 6-1 

Muscle Tables

 

PROXIMAL

DISTAL

 

 

 

MUSCLE

MUSCLE

ATTACHMENT

ATTACHMENT

INNERVATION

MAIN ACTIONS

BLOOD SUPPLY

GROUP

 

(ORIGIN)

(INSERTION)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lateral epicondyle of

 

Radial nerve

 

Posterior

 

Extensor carpi

humerus and

Dorsal base of 5th

Extends and adducts

Posterior

(posterior

interosseous

ulnaris

posterior border

metacarpal

hand at wrist

forearm

interosseous)

artery

 

of ulna

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Extensor digiti

Lateral epicondyle of

Extensor expansion

Radial nerve

 

Posterior

Posterior

(posterior

Extends 5th digit

interosseous

minimi

humerus

of 5th digit

forearm

interosseous)

 

artery

 

 

 

 

 

 

 

 

 

 

 

 

Extensor digitorum

Lateral epicondyle of

Extensor expansions

Radial nerve

Extends medial four

Posterior

Posterior

of medial four

(posterior

digits, assists in wrist

interosseous

humerus

forearm

 

digits

interosseous)

extension

artery

 

 

 

 

 

 

 

 

 

 

 

Posterior surface of

 

Radial nerve

Extends 2nd digit and

Posterior

 

Extensor indicis

ulna and

Extensor expansion

Posterior

(posterior

helps extend hand at

interosseous

interosseous

of 2nd digit

forearm

 

interosseous)

wrist

artery

 

membrane

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Posterior surface of

Dorsal base of

Radial nerve

Extends proximal phalanx

Posterior

 

Extensor pollicis

radius and

proximal

Posterior

(posterior

of thumb at

interosseous

brevis

interosseous

phalanx of

forearm

interosseous)

carpometacarpal joint

artery

 

membrane

thumb

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Posterior surface of

 

 

Extends distal phalanx

 

 

Extensor pollicis

middle third of

Dorsal base of distal

Radial nerve

of thumb at

Posterior

Posterior

ulna,

phalanx of

(posterior

interphalangeal and

interosseous

longus

forearm

interosseous

thumb

interosseous)

metacarpophalangeal

artery

 

 

 

membrane

 

 

joints

 

 

 

 

 

 

 

 

 

Flexor carpi radialis

Medial epicondyle of

Base of 2nd

Median nerve

Flexes and abducts hand

Radial artery

Anterior

humerus

metacarpal

at wrist

forearm

 

 

 

 

 

 

 

 

 

 

 

Humeral head:

 

 

 

 

 

 

medial

 

 

 

 

 

 

epicondyle of

Pisiform bone, hook

 

 

 

 

 

humerus

 

 

 

 

 

of hamate, base

 

Flexes and adducts hand

Posterior ulnar

Anterior

Flexor carpi ulnaris

 

Ulnar nerve

 

of 5th

at wrist

recurrent artery

forearm

 

Ulnar head:

 

 

metacarpal

 

 

 

 

 

olecranon and

 

 

 

 

 

 

 

 

 

 

 

posterior border

 

 

 

 

 

 

of ulna

 

 

 

 

 

 

 

 

 

 

 

 

Flexor digiti minimi

Flexor retinaculum

Medial side of base

 

 

 

 

of proximal

Ulnar nerve (deep

Flexes proximal phalanx

Deep palmar branch

 

and hook of

Hand

brevis

phalanx of little

branch)

of little finger

of ulnar artery

hamate bone

 

 

finger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medial and anterior

 

Medial part: ulnar

 

 

 

 

surface of

Palmar base of

Flexes distal phalanges

Anterior interosseous

 

 

nerve

 

Flexor digitorum

proximal 3/4 of

distal phalanges

of medial four digits,

artery, muscular

Anterior

 

profundus

ulna and

of medial four

Lateral part: median

assists with flexion of

branches of

forearm

 

interosseous

digits

hand at wrist

ulnar artery

 

 

nerve

 

 

membrane

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Humero-ulnar head:

 

 

 

 

 

 

medial

 

 

 

 

 

 

epicondyle of

 

 

 

 

 

 

humerus and

Bodies of middle

 

Flexes middle and

 

 

Flexor digitorum

coronoid

phalanges of

Median nerve

proximal phalanges

Ulnar and radial

Anterior

superficialis

process of ulna

medial four

of medial four digits,

arteries

forearm

 

 

 

digits

 

flexes hand at wrist

 

 

 

Radial head:

 

 

 

 

 

 

superior half of

 

 

 

 

 

 

anterior radius

 

 

 

 

 

 

 

 

 

 

 

 

 

Flexor retinaculum

Lateral side of base

Median nerve

 

Superficial palmar

 

 

of proximal

Flexes proximal phalanx

 

Flexor pollicis brevis

and tubercle of

(recurrent

branch of radial

Hand

phalanx of

of thumb

 

trapezium

branch)

artery

 

 

thumb

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Anterior surface of

Palmar base of

Median nerve

 

 

 

Flexor pollicis longus

radius and

Flexes phalanges of

Anterior interosseous

Anterior

distal phalanx of

(anterior

interosseous

thumb

artery

forearm

 

thumb

interosseous)

 

membrane

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infraspinous fossa of

Middle facet of

Suprascapular nerve

Lateral rotation of arm

Suprascapular artery

Shoulder

Infraspinatus

scapula and

greater tubercle

(with teres minor)

 

deep fascia

of humerus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 6-2 

Muscle Tables

 

 

 

 

 

 

Muscle Tables

6

 

 

 

 

 

 

 

 

 

 

 

PROXIMAL

DISTAL

 

 

 

MUSCLE

 

 

MUSCLE

ATTACHMENT

ATTACHMENT

INNERVATION

MAIN ACTIONS

BLOOD SUPPLY

 

 

GROUP

 

 

 

(ORIGIN)

(INSERTION)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thoracodorsal

 

 

 

 

Spinous processes

 

 

 

artery, dorsal

 

 

 

 

 

 

 

perforating

 

 

 

 

of T7–L5

Intertubercular

 

Extends, adducts, and

branches of 9th,

 

 

 

Latissimus dorsi

vertebrae,

 

10th, and 11th

 

 

 

sulcus of

Thoracodorsal nerve

medially rotates

Shoulder

 

 

thoracolumbar

posterior

 

 

 

humerus

 

humerus at shoulder

 

 

 

 

fascia, iliac

 

intercostal,

 

 

 

 

 

 

 

 

 

 

 

crest, last 3 ribs

 

 

 

subcostal, and

 

 

 

 

 

 

 

 

first three

 

 

 

 

 

 

 

 

lumbar arteries

 

 

 

 

Posterior tubercles

Medial border of

 

 

Dorsal scapular

 

 

 

 

Ventral rami of C3–

Elevates scapula

artery,

 

 

 

Levator scapulae

of transverse

scapula from

transverse

 

 

 

C4 and dorsal

medially, inferiorly

Superficial back

 

 

processes of

superior angle

cervical artery,

 

 

 

scapular nerve

rotates glenoid cavity

 

 

 

 

C1–C4

to spine

ascending

 

 

 

 

 

 

 

 

 

 

 

 

 

 

cervical artery

 

 

 

 

Lateral two tendons

Lateral sides of

 

Extend digits at

 

 

 

 

 

 

interphalangeal

 

 

 

 

Lumbrical, first and

of flexor

extensor

Median nerve (digital

Superficial and deep

 

 

 

joints, flex

Hand

 

 

second

digitorum

expansion of

branches)

palmar arches

 

 

metacarpophalangeal

 

 

 

 

profundus

digits 2 and 3

 

 

 

 

 

 

 

joints

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medial three

Lateral sides of

 

Extend digits at

 

 

 

 

 

 

interphalangeal

 

 

 

 

Lumbrical, third and

tendons of

extensor

Ulnar nerve (deep

Superficial and deep

 

 

 

joints, flex

Hand

 

 

fourth

flexor digitorum

expansion of

branch)

palmar arches

 

 

metacarpophalangeal

 

 

 

 

profundus

digits 4 and 5

 

 

 

 

 

 

 

joints

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Opponens digiti

Flexor retinaculum

Palmar surface of

Ulnar nerve (deep

Draws 5th metacarpal

Deep palmar branch

 

 

 

and hook of

anteriorly and rotates

Hand

 

 

minimi

5th metacarpal

branch)

of ulnar artery

 

 

hamate bone

it to face thumb

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Flexor retinaculum

Lateral side of 1st

Median nerve

Draws 1st metacarpal

Superficial palmar

 

 

 

Opponens pollicis

and tubercle of

(recurrent

forward and rotates it

branch of radial

Hand

 

 

metacarpal

 

 

 

trapezium

branch)

medially

artery

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bases of proximal

 

Adducts digits toward

 

 

 

 

 

 

phalanx and

 

axial line of hand (3rd

 

 

 

 

Palmar interosseous

Sides of metacarpals

extensor

Ulnar nerve (deep

digit); flexes digits at

Deep palmar arch

Hand

 

 

muscles

2, 4, and 5

expansion of

branch)

metacarpophalngeal

 

 

 

 

 

 

 

 

digits 2, 4, and

 

joint and extends

 

 

 

 

 

 

5

 

interphalangeal joints

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Palmar aponeurosis

Skin of medial

Superficial palmar

Deepens hollow of hand,

Superficial palmar

 

 

 

Palmaris brevis

and flexor

branch of ulnar

Hand

 

 

border of palm

assists grip

arch

 

 

 

retinaculum

nerve

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distal half of flexor

 

Flexes hand at wrist and

 

 

 

 

Palmaris longus

Medial epicondyle of

retinaculum

 

Posterior ulnar

Anterior

 

 

Median nerve

tenses palmar

 

 

humerus

and palmar

recurrent artery

forearm

 

 

 

 

aponeurosis

 

 

 

 

aponeurosis

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sternal half of

 

 

 

Pectoral branch

 

 

 

 

clavicle, sternum

 

 

 

 

 

 

 

 

 

 

of thoraco-

 

 

 

 

to 7th rib,

Lateral lip of

 

 

 

 

 

 

 

 

acromial artery,

 

 

 

Pectoralis major

cartilages of true

intertubercular

Medial and lateral

Flexes and adducts arm,

Pectoral region/

 

 

perforating

 

 

ribs,

sulcus of

pectoral nerves

rotates arm medially

axilla

 

 

 

branches of

 

 

 

aponeurosis of

humerus

 

 

 

 

 

 

 

 

internal thoracic

 

 

 

 

external oblique

 

 

 

 

 

 

 

 

 

 

artery

 

 

 

 

muscle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outer surface of

 

 

 

Pectoral branch of

 

 

 

 

Coracoid process of

Medial pectoral

Lowers lateral angle of

thoraco-acromial

Pectoral region/

 

 

Pectoralis minor

upper margin of

scapula and

and intercostal

 

 

scapula

nerve

axilla

 

 

 

ribs 3–5

protracts scapula

lateral thoracic

 

 

 

 

 

 

 

 

 

 

 

 

 

arteries

 

 

 

 

 

 

 

 

 

 

 

 

Pronator quadratus

Distal fourth of

Distal fourth of

Median nerve

 

Anterior interosseous

Anterior

 

 

(anterior

Pronates forearm

 

 

anterior ulna

anterior radius

artery

forearm

 

 

 

interosseous)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Two heads: medial

 

 

 

 

 

 

 

 

epicondyle of

Midway along lateral

 

Pronates forearm and

Anterior ulnar

Anterior

 

 

Pronator teres

humerus and

Median nerve

assists with elbow

 

 

surface of radius

recurrent artery

forearm

 

 

 

coronoid

 

flexion

 

 

 

 

 

 

 

 

 

 

process of ulna

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Muscle Tables

Table 6-3 

Muscle Tables

 

PROXIMAL

DISTAL

 

 

 

MUSCLE

MUSCLE

ATTACHMENT

ATTACHMENT

INNERVATION

MAIN ACTIONS

BLOOD SUPPLY

GROUP

 

(ORIGIN)

(INSERTION)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dorsal scapular OR

 

 

 

 

 

 

deep branch of

 

 

 

 

 

 

transverse

 

 

Spinous processes

Medial border of

 

Fixes scapula to thoracic

cervical artery,

 

 

 

dorsal

 

 

scapula below

Dorsal scapular

wall and retracts and

 

Rhomboid major

of T2–T5

perforating

Superficial back

base of spine of

nerve

rotates it to depress

 

vertebrae

branches of the

 

 

scapula

 

glenoid cavity

 

 

 

 

upper five or six

 

 

 

 

 

 

 

 

 

 

 

 

posterior

 

 

 

 

 

 

intercostal

 

 

 

 

 

 

arteries artery

 

 

 

 

 

 

 

 

 

 

 

 

 

Dorsal scapular

 

 

 

 

 

 

artery OR deep

 

 

 

 

 

 

branch of

 

 

Ligamentum nuchae,

 

 

Fixes scapula to thoracic

transverse

 

 

Medial border of

 

cervical artery,

 

Rhomboid minor

spines of C7

Dorsal scapular

wall and retracts and

dorsal

 

scapula at spine

Superficial back

and T1

nerve

rotates it to depress

perforating

 

of scapula

 

 

vertebrae

 

glenoid cavity

branches of the

 

 

 

 

 

 

 

 

 

 

upper five or six

 

 

 

 

 

 

posterior

 

 

 

 

 

 

intercostal

 

 

 

 

 

 

arteries

 

 

 

 

 

 

 

 

Serratus anterior

Lateral surfaces of

Costal surface of

 

Protracts and rotates

Lateral thoracic

 

medial border of

Long thoracic nerve

scapula and holds it

Shoulder

upper 8–9 ribs

artery

 

scapula

 

against thoracic wall

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Upper border of 1st

Inferior surface of

 

Anchors and depresses

Clavicular branch

 

Subclavius

rib and its

middle third of

Nerve to subclavius

of thoraco-

Shoulder

clavicle

 

cartilage

clavicle

 

acromial artery

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medially rotates arm at

 

 

Subscapularis

Subscapular fossa

Lesser tubercle of

Upper and lower

shoulder and

Subscapular artery,

 

subscapular

adducts it, helps hold

lateral thoracic

Shoulder

humerus

 

 

nerves

humeral head in

artery

 

 

 

 

 

 

 

 

 

glenoid cavity

 

 

 

 

 

 

 

 

 

 

Lateral epicondyle

Lateral, posterior,

 

 

Radial recurrent

 

 

and anterior

 

 

 

Supinator

of humerus,

Radial nerve (deep

 

artery, posterior

Posterior

surfaces of

Supinates forearm

supinator crest

branch)

interosseous

forearm

 

proximal third of

 

 

of ulna

 

 

arteries

 

 

radius

 

 

 

 

 

 

 

 

 

 

Supraspinous fossa

Superior facet of

 

Initiates arm abduction,

 

 

Supraspinatus

of scapula and

greater tubercle

Suprascapular nerve

acts with rotator cuff

Suprascapular artery

Shoulder

 

deep fascia

of humerus

 

muscles

 

 

 

 

 

 

 

 

 

 

Posterior surface of

Medial lip of

 

 

 

 

 

intertubercular

Lower subscapular

Adducts and medially

Circumflex scapular

 

Teres major

inferior angle of

Shoulder

sulcus of

nerve

rotates arm

artery

 

scapula

 

 

humerus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Upper 2/3 of

Inferior facet of

 

 

 

 

Teres minor

posterior surface

 

 

Circumflex scapular

 

greater tubercle

Axillary nerve

Laterally rotates arm

Shoulder

of lateral border

artery

 

of humerus

 

 

 

 

of scapula

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Superior nuchal line,

 

 

 

Transverse cervical

 

 

external

 

 

 

 

 

 

 

 

artery, dorsal

 

 

occipital

Lateral third of

 

Elevates, retracts, and

 

 

 

perforating

 

Trapezius

protuberance,

clavicle,

Accessory nerve

rotates scapula;

 

branches of

Superficial back

nuchal ligament,

acromion, and

(cranial nerve XI)

lower fibers depress

 

posterior

 

 

spinous

spine of scapula

 

scapula

 

 

 

intercostal

 

 

processes of

 

 

 

 

 

 

 

 

arteries

 

 

C7–T12

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Long head:

 

 

 

 

 

 

infraglenoid

 

 

 

 

 

 

tubercle of

 

 

 

 

 

 

scapula

 

 

Extends forearm at

 

 

 

Lateral head: upper

 

 

elbow; long head

 

 

 

Posterior surface of

 

stabilizes head of

Branch of profunda

 

Triceps brachii

half of posterior

olecranon

Radial nerve

abducted humerus

Arm

brachii artery

 

humerus

process of ulna

 

and extends and

 

 

 

 

 

 

 

 

 

adducts arm at

 

 

 

Medial head: distal

 

 

shoulder

 

 

 

2/3 of medial

 

 

 

 

 

 

and posterior

 

 

 

 

 

 

humerus

 

 

 

 

 

 

 

 

 

 

 

 

Table 6-4 

Muscle Tables

Lower Limb 71

 

 

 

 

 

 

 

 

 

 

 

 

 

Section

 

 

 

 

 

7 LOWER LIMB

 

 

 

 

Topographic Anatomy

 

 

 

 

Plate 468

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

468

Lower Limb: Surface Anatomy

 

 

 

 

Cutaneous Anatomy

 

 

 

 

Plates 469–472

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

469

Dermatomes of Lower Limb

 

 

 

 

470

Superficial Nerves and Veins of Lower Limb:

 

 

 

 

 

Anterior View

 

 

 

 

471

Superficial Nerves and Veins of Lower Limb:

 

 

 

 

 

Posterior View

 

 

 

 

472

Lymph Vessels and Nodes of Lower Limb

 

 

 

 

Hip and Thigh

 

 

 

 

Plates 473–492

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

473

Hip (Coxal) Bone

 

 

 

 

474

Hip Joint

 

 

 

 

475

Hip Joint: Anteroposterior Radiograph

 

 

 

 

476

Femur

 

 

 

 

477

Bony Attachments of Muscles of Hip and

 

 

 

 

 

Thigh: Anterior View

 

 

 

 

478

Bony Attachments of Muscles of Hip and

 

 

 

 

 

Thigh: Posterior View

 

 

 

 

479

Muscles of Thigh: Anterior Views

 

 

 

 

480

Muscles of Thigh: Anterior Views (continued)

 

 

 

 

481

Muscles of Hip and Thigh: Lateral View

 

 

 

 

482

Muscles of Hip and Thigh: Posterior Views

 

 

 

 

483

Psoas and Iliacus Muscles

 

 

 

 

 

 

 

 

Atlas of Human Anatomy

Lower Limb

484

Lumbosacral and Coccygeal Plexuses

 

Ankle and Foot

485

Lumbar Plexus

 

Plates 511–524

 

Sacral and Coccygeal Plexuses

 

 

 

486

511

Bones of Foot

487

Arteries and Nerves of Thigh: Anterior Views

512

Bones of Foot (continued)

488

Arteries and Nerves of Thigh: Anterior Views

513

Calcaneus

 

(continued)

514

Ligaments and Tendons of Ankle

 

Arteries and Nerves of Thigh: Posterior View

489

515

Ligaments and Tendons of Foot: Plantar View

 

Nerves of Hip and Buttock

490

516

Tendon Sheaths of Ankle

 

Arteries of Femoral Head and Neck

491

517

Muscles of Dorsum of Foot: Superficial

 

Thigh: Serial Cross Sections

492

 

 

Dissection

 

 

518

Dorsum of Foot: Deep Dissection

Knee

519

Sole of Foot: Superficial Dissection

Plates 493–499

520

Muscles of Sole of Foot: First Layer

 

 

 

 

493

Knee: Medial and Lateral Views

521

Muscles of Sole of Foot: Second Layer

494

Knee: Anterior Views

522

Muscles of Sole of Foot: Third Layer

495

Knee: Interior

523

Interosseous Muscles and Deep Arteries

496

Knee: Cruciate and Collateral Ligaments

 

 

of Foot

497

Knee: Anteroposterior Radiograph and

524

Interosseous Muscles of Foot

 

Posterior View

 

 

 

498

Knee: Posterior and Sagittal Views

 

Neurovasculature

499

Arteries of Thigh and Knee: Schema

 

Plates 525–529

 

 

 

 

 

 

 

525

Femoral Nerve and Lateral Cutaneous Nerve of

Leg

 

 

Thigh

Plates 500–510

526

Obturator Nerve

 

 

527

Sciatic Nerve and Posterior Cutaneous Nerve

500

Tibia and Fibula

501

Tibia and Fibula (continued)

 

 

of Thigh

 

 

Tibial Nerve

502

Attachments of Muscles of Leg

528

 

 

Common Fibular (Peroneal) Nerve

503

Muscles of Leg (Superficial Dissection):

529

 

 

 

 

Posterior View

 

Regional Scans

504

Muscles of Leg (Intermediate Dissection):

 

 

Posterior View

 

Plates 530–531

 

Muscles of Leg (Deep Dissection):

 

 

 

505

530

Hip Radiograph, Arthrogram, and MRI

 

Posterior View

531

Ankle: Radiographs

 

Muscles of Leg: Lateral View

506

 

 

 

507

Muscles of Leg (Superficial Dissection):

 

Muscle Tables

 

Anterior View

 

 

 

 

 

508Muscles of Leg (Deep Dissection): Anterior View

509Arteries of Knee, Leg, and Foot

510Leg: Cross Sections and Fascial Compartments

Atlas of Human Anatomy

Anterior view

Iliac crest

Anterior superior iliac spine

Tensor fasciae latae muscle

Rectus femoris muscle

Vastus lateralis muscle

Iliotibial tract

Fibularis (peroneus) longus muscle

Tibialis anterior muscle

Lateral malleolus

Extensor digitorum longus tendons

Lower Limb: Surface Anatomy 7

See also Plates 470, 471

Iliac crest

Gluteus medius muscle

Inguinal ligament

Sartorius muscle

SemitendiGreat nosus saphenous muscle vein

Adductor magnus muscle

Vastus medialis muscle

 

Gracilis

Rectus femoris

tendon

 

tendon

 

Quadriceps

Great

femoris tendon

saphenous

 

Patella

vein

Patellar ligament

 

Tibial tuberosity

 

Anterior border of tibia

Great

Calcaneal (Achilles)

saphenous

vein

tendon

Medial

 

malleolus

 

 

Medial malleolus

 

Plantar surface

 

of foot

Extensor hallucis

 

longus tendon

 

Posterior view

Gluteus maximus muscle

Greater trochanter of femur

Gluteal fold

Iliotibial tract

Biceps femoris muscle

Long head Short head

Popliteal fossa

Gastrocnemius muscle

Medial head Lateral head

Small saphenous vein

Fibularis (peroneus) longus and brevis tendons

Lateral malleolus

Calcaneal tuberosity

 

 

 

Topographic Anatomy

Plate 468

Dermatomes of Lower Limb

See also Plate 162

Schematic

 

T10

 

L1

T12

 

 

L2

 

demarcation of

 

 

 

L3

 

dermatomes

 

T11

 

L4

 

(according to

 

 

 

L5

 

Keegan and

 

T12

 

S1

 

Garrett) shown as

L1

 

S2

 

 

 

 

distinct segments.

 

 

S3

 

 

S2

 

 

There is actually

 

Autonomous

S4

S2

considerable

 

S3

S5

 

overlap between

L2

sensory zones

Co

 

 

 

any two adjacent

 

 

 

 

 

dermatomes.

 

 

 

 

 

 

L3

 

L3

L1

 

 

 

 

 

 

 

 

 

 

S2

S1

 

 

 

 

L2

 

L4

L4

 

 

L3

L5

L5

L5

L5

 

 

 

 

 

 

 

 

L4

 

 

 

S1

 

S1

 

 

 

 

 

L4

L5 S1 Posterior view

Anterior view

 

 

Segmental innervation

 

of lower limb movements

Knee

 

Extension

Hip

L2, 3

Flexion

L3, 4

S1

L5,

Extension

S1

L5,

Flexion

 

Dorsiflexion

 

 

L4,

5

 

 

 

Inversion

L4, 5

 

Foot

 

Ankle

 

S1,

2

 

 

 

Plantarflexion

S1

L5,

Eversion

Plate 469

Cutaneous Anatomy

Superficial Nerves and Veins of Lower Limb: Anterior View 7

See also Plates 525, 526, 529

Lateral cutaneous branch of subcostal nerve

Inguinal ligament (Poupart’s)

Lateral femoral cutaneous nerve

Superficial circumflex iliac vein

Femoral branches

of genitofemoral nerve

Saphenous opening (fossa ovalis)

Fascia lata

Anterior cutaneous branches of femoral nerve

Patellar nerve plexus

Branches of lateral sural cutaneous nerve (from common fibular [peroneal] nerve)

Deep fascia of leg (crural fascia)

Superficial fibular (peroneal) nerve

Medial dorsal cutaneous branch

Intermediate dorsal cutaneous branch

Small saphenous vein and lateral

dorsal cutaneous nerve (from sural nerve)

Lateral dorsal digital nerve and vein of 5th toe

Dorsal metatarsal veins

Dorsal digital nerves and veins

Superficial epigastric vein

Ilio-inguinal nerve (scrotal branch) (usually passes through superficial inguinal ring)

Genital branch of genitofemoral nerve

Femoral vein

Superficial external pudendal vein

Accessory saphenous vein

Great saphenous vein

Cutaneous branches of obturator nerve

Infrapatellar branch of saphenous nerve

Saphenous nerve (terminal branch of femoral nerve)

Great saphenous vein

Dorsal digital nerves

Dorsal venous arch

Dorsal digital nerve and vein of medial side of great toe

Dorsal digital branch of deep fibular (peroneal) nerve

 

 

 

Cutaneous Anatomy

Plate 470

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