113264016 Anatomia Omului

8/13/2019 113264016 Anatomia Omului

http://slidepdf.com/reader/full/113264016-anatomia-omului 1/298

B O D Y

O R G A N I Z A T I O N

Anatomical position and terms of direction

aA

Ib



1. Anatomical position and terms of direction

a. Sup erior or cranial . Proximal

b. Inferior or caud al . Distal

c . Lateral . Poste rior (do rsal)

d . M edial . An terior (ventral)

The p osit ion of structures within the body, and mo vemen t of body

parts, is described by th is set of term s and always refers to the p osition

of the structure if the individual were standing in the p osit ion shown

here. The head area is designated by th e term cranial, referring to aterm for the bon es of the skull, while the opp osite en d o f the bod y is

caudal, referring to th e tail. Cranial and caud al are synonym ous w ith

the term s superior and Inferior, respectively, indicating th at a structure

is higher or lower. M edial is toward th e vertical midline o f the bod y,

wh ile lateral is away from the m idline. In the limbs, structures near

the tru nk are proximal, while those further from the tru nk are d istal.An terior den otes the front of the body (in the direction of travel)

wh ile po sterior is op posite. In hum ans, ven tral (tow ard th e belly) is

equ ivalent t o anter ior, wh ile do rsal is the same as posterior. Not show n

in the il lustration, super ficial is near the bo dy surface w hile deep refers

to structures away from the bod y surface.



2natomical planes of the body

KAPLAN) MEDICAL".....



3. Anterior regions of the body

a. Head

b. Neck (cervical)

c. Deltoid

d . Sternal

e. Pecto ral (chest)

1. Brachial (arm)

g. Cubital

h. Abdominal

I. An tebrachial (forearm)

j. Trochanteric

k. Palmar

L D igital (fingers)

m . Inguinal and p ubic

n . Pen is (genital)

o. F emoral (thigh)

p . Knee

q. Lig

r. Do rsal foot

The head is connected to the trun k through th e cervical or neck region.

Th e trunk includ es the chest and sternal regions, the abdom en, and the

inguin al/pu bic and gen ital region s (the p en is, of cou rse, is an or gan

that is only foun d in the m ale). The u pp er lim bs may be divided into

the d eltoid (shou lder), brachial (up per arm ), cubital (fron t of elbow),antebrach ial (lower arm ), palmar (hand ) and d igital (fingers) regions,

wh ile the lower limbs include trochanteric (hip), femoral (upp er leg),

knee, leg and foot. It may be helpful to rem em ber that some region s

are correlated w ith the nam es of underlying structures: the d eltoid and

pecto ral regions are nam ed for the m uscles in th at area, while sternal

and troc hanteric regions refer to skeletal structur es under neath.




Po sterior regions o f the b ody

II

m

KAPLAN) MEDICAL



4. Posterior regions of the body

a. Head

b. Neck cervical)

c. Scapular (shoulder blade)

d. Brachial arm)

e. Vertebral

f. Olecranon elbow)

g. Lumbar

h. Antebrachial forearm)

I. Gluteal

j. Femoral thigh)

k. Popliteal

I. Surat calf)

m. Calcaneal

From the posterior aspect, one can see areas not visible from the

anterior view, such as scapular (shoulder blade), vertebral, lumbar

(lower back) and gluteal (buttocks) regions in the trunk. The upper

limbs include the olecranon or elbow region, while the lower limbs

include popliteal (back of knee), sural (calf) and calcaneal (heel)

regions. The olecranon and calcaneus are bone structures in their

respective regions.



5ody cavities

Dorsal bodycavity:

a

b

1 1 4 7 — T— d

e

f

g

Abdominopelviccavity:

Thoracic cavity:

V

KAPLAN) MEDICAL

•



O R G N I Z TIO N

keletal and visceral structures of the head and neck

KAPLAN MEDIC L



6. Sk eletal and visceral structures o f the hea d an d n eck

a. Extern al occipital

protuberance

b. Styloid pro cessc. C4 - Fou rth cervical vertebra

d . Carotid tubercle of C6

e. Vertebra prom inens

f. First rib

g. Esophagus

h. Acro mion process

I. Coracoid process

j. Scapula

k. Sternum

I. Clavicle

m . Thyroid gland

n . Thyroid cartilage

o . H yoid bone

p . Mandible

q. Nasal bon e

r. Zygom atic bone

s. F rontal bone

A n ove rview of head and n eck structures shows skeletal elemen ts

surroun ding and p rotecting the brain and spinal cord. The cranium

exten ds from th e frontal bone ante riorly to the occipital bone

posteriorly. A small bum p o n its inferior surface is the ex ternal occipital

protu berance. The facial bones includ e the nasal and zygomatic

bones, which help to form th e bridge of the nose and the orbit of the

eye, respectively. The m andible is the lower jaw. In the neck region,

the e sophagus is part of th e d igestive tract and , anterior to i t , the

trachea is part of the respiratory system . A t the junction o f the head

and n eck is the sm all hyoid bone, held in place by ligamen ts from the

styloid p rocess of the tem poral bone (form ing the lateral surfaces of

the cranium ); the hyo id suppor ts the larynx wh ich is protec ted by the

thyroid cartilage. Inferior to the larynx is the thyroid gland , which

secretes the hor mo ne thyrox in. The n eck joins the trunk at the pectoral

girdle— including the clavicle and scapula— that supp orts the upper

l im bs. The clavicles also prov ide a con nect ion w ith the axial skeleton

whe re they articulate with the sternu m. The coracoid and acrom ion

proc esses of the scapula prov ide an attachm ent po int for num erou s

m uscles and l igamen ts.



ab

Thoracic, abdominal and pelvic viscera, anterior view

KAPLAN) MEDICAL



7. Thoracic, abdominal and pelvic viscera, anterior view

a. Thyroid cartilage

b. Thyroid gland

c. Clavicle

d. Arch of aorta

(behind sternum)

e. Third rib

f. Outline of heart

g. Left lung

h. Spleen

1 Stomach

j. Transverse colon

k. Small intestine

1 Outline of descending colon

(behind small intestine)

m . Sigmoid colonn. Ou tline of rectum

o. Urinary bladder

p. Ascending colon

q. Gall bladder

r. Liver

s. Right lung

t. Superior vena cava

(behind sternum)

u. Hyo id bone

Organs of several body systems share the space within the cavities

of the trunk. The superior part of these cavities is protected by the

ribs, sternum and vertebral column of the axial skeleton, while the

inferior portion is supported by the pelvic girdle. The thoracic cavity

contains the lungs which surround the pericardial cavity containing

the heart. Venous blood enters the heart through the vena cava and

is pumped from the heart to the body through the aorta; this critical

area is well protected behind the sternum. In the abdominal cavity, the

digestive tract includes the stomach, small intestine, colon (ascending,

transverse, descending and sigmoid), and rectum. Accessory glands of

the digestive system include the liver, gall bladder and pancreas. The

spleen is an organ of the circulatory, lymphatic and immune systems.

The urinary bladder is located in the lower part of the abdominal cavity.



Thoracic, abdominal and pelvic viscera, posterior view

KAPLAN) MEDICAL



8. Thoracic, abdominal and pelvic viscera, posterior view

a. Atlas

b. Pharynx

c. Thyroid gland

d. Trachea

e. Right lung

1 . Right adrenal gland

g. Liver

h. Pancreas

I . Right kidney

j. Small intestine

k. Ascending colon

L Iliac crest

m . Pelvic girdle

n. Seminal vesicle

o. Sacrum

p. Descending colon

q. Left ureter

r. Left kidney

s. Spleen

t. Outline of pancreas

u. Diaphragm

v. Esophagus

w. Left lung

x. First thoracic vertebra

The posterior view clearly shows the position of the vertebral column,

extending from the atlas that articulates with the cranium to the fused

vertebrae that form the sacrum, which articulates with the pelvic girdle.

The wide pharynx at the rear of the nose and mouth divides into two

passageways—the posterior esophagus leading to the stomach and

the anterior trachea or windpipe. The rear of the thoracic cav ity is filled

with the lungs. The diaphragm is a thin sheet of muscle that marks the

boundary between the thoracic and abdominal cavities, and functionsin breathing. Accessory digestive organs include a large liver and the

deep, mostly hidden pancreas, while the small intestine and parts of

the colon are also visible from this view. The excretory system includes

the dorsal, paired kidneys that form urine, and the ureters that carry

the urine to the bladder. Superior to the kidney lie paired adrenal

gland s, part o f the endocrine system. The only reproductive structures

in view are the sem inal vesicles, fou nd on ly in th e m ale.




Thoracic, abdominal and pelvic viscera,

right lateral view

KAPLAN) MEDICAL



9 . Thoracic, abdominal and pelvic viscera, right lateral view

a. Horizontal fissure of lung . Rectum

b. Gall bladd er . Ureter

c. Stomach Right kidney

d . Transverse colon . L i vertebra

e. Ascending colon . Liver

1. Small intestine . Oblique fissure of lung

g. Ovary . Right lung

h. Urinary bladd er . C7 vertebraI. Uterus

The right lung is divided into three lobes by the horizontal and oblique

fissures. In the abdominal cavity, the digestive tract occupies the largest

part of the space, including the stomach, small intestine, colon and

rectum. The small intestine terminates on the right side, leading into

the ascending colon and then to the transverse colon. The gall bladder,

an accessory organ of the digestive system, is found on the posterior

surface of the right lobe of the liver. The kidneys lie near the posterior

wall of the abdominal cavity, with the right kidney being positioned

slightly inferior compared with the left. The kidneys and ascending

colon are retroperitoneal, while the small intestine and transverse colon

are peritoneal. Ureters lead from the kidneys down to the inferior and

anterior position of the bladder. The female reproductive structures, the

ovary and uterus may be found between the bones that form the pelvis.



=Thoracic, abdominal and pelvic viscera, 0

left lateral view

KAPLAN) MEDICAL



10. Thoracic, abdominal and pelvic viscera, left lateral view

a. C7 v ertebra

b. O blique fissure of lung

c. L eft dome of d iaphragm

d. Spleen

e. L 1 vertebra

1. Prostate gland

j. Urinary bladde r

k. D escending colon

1. Small intestine

m. Transverse colon

1. Left kidney . Stomach

g. Ureter . Liver

h. Rectum . Left lung

The left lung is divided in to two lobes by an oblique fissure. The

diaphragm is located betwee n the thoracic and abdom inal cavit ies,

and forms a d om e shape w hen relaxed. Usually lying left and ventral

to the lobes of the l iver is the stomach , which th en leads to the small

intest ine, colon, and rectu m . O n the right side, the transverse colon

leads to the d escending colon, before und igested m aterials em pty into

the rectum for com paction and el imination. Posterior to the stom ach

is the left kidney, with the u reter fun neling urine to th e bladd er.

A lthough many m ale reprod uctive structures are located outside the

abdom inope lvic cavity, the pr ostate gland is found near the bladde r.



I N T E G U M E N T A R Y

S Y S T E M

Layers o f the sk in and ass ociated structures 1



11. L ayers of the skin

a. Sweat gland

b. Meissner's corpuscle

c. Haird. Epidermis

e. Dermis

1 . Hypodermis

and associated structu res

g. Papillary layer

h. Reticular layer

I . Hair follicle

j. Sebaceous gland

k. Pacinian corpuscle

I . Arrector pili m uscle

The integumentary system includes the largest organ of the body—

the skin. It functions to protect underlying body parts from water loss,

chemical insult, and physical harm. Specialized structures detect

pressure, pain or temperature stimuli; Meissner's corpuscles sense

light touch while Pacinian corpuscles sense deep pressure. Sebaceous

glands secrete lipids that inhibit bacteria and lubricate the hair shaft.

Sweat glands secrete water, waste products and electrolytes, in part to

cool the skin and reduce body temperature. A cross-section of humanskin reveals layers of the skin; the interface between the layers is often

indistinct as one layer merges into the next. The epidermis consists of

stratified squamous epithelium that provides mechanical protection

against invasion by microorganisms. The dermis has a superficial

papillary layer of areolar tissue, with capillaries and sensory neurons

that supply the epidermis; and a deeper, thicker reticular layer withdense, irregular connective tissue and networks of blood vessels,

lymph vessels, and nerve fibers. Many of the accessory organs such as

hair follicles and sweat glands are embedded in the reticular layer. The

subcutaneous layer, or hypodermis, consists of areolar and adipose

tissue; distribution of body fat in this layer varies between the sexes or

at different times in life (such as the presence of "baby fat").



Epidermis

—a

:,......,..44...,

— b. ., .1 .. ...

• 0 ••° "••.. . •'• •

. .- •

• ao 0 0

0

0 ,.., 00 •0, NZ a0 d..

--a

a 0 ••••..., a6

O• • 0 90•

• .' •• •

or •

-o0s 0•

0

—

• • •

•

•

KAPLAN MEDICAL



S Y S T E M

1 .APLA) MEDICAL



13. Hair

a. H air follicle

b. Hair root

c . H air shaft

d . Matrix

e. Papilla

1 . Sebaceous gland

g. Arrector pili muscle

h. Bulb

W hile hum ans possess less hair than m ost m amm als, hair fol lic les

are found on m ost areas of the skin excep t for parts of the hand s

and feet. Only 2-3% of a hum an's hairs are found on th e head. The

hair shaft is com po sed of dead , keratinized c ells arranged in sever allayers. The hair follicle arises from the h air bulb, usually foun d in th e

subcutaneous or h ypod erm is layer; the fol lic le continu es through the

derm is, and the hair shaft that is prod uced p rotrud es through the

epid erm is. A t the base of the fo llicle is the co nn ective tissue papilla,

con taining capillaries and n erves. Arou nd the p apilla is the m atrix,

con sisting of epith elial cells that d ivide to form the ce lls of the hair

root. As cells continu e to be prod uced in the matrix, they are pushed

up ward in the foll icle, becom e keratinized, die, and hard en to form the

hair shaft. A ssociated arr ecto r pill m uscles contr ol the angle of hair

position, pulling the hair toward a ver tical position whe n stimulated;

the muscles also squeeze on sebaceous glands and push lipid

secretion s into the fo llicle to lubricate the h air shaft.



I N T E G U M E N T A R Y

S Y S T E M

Fingernail

\_



14. Fingernail

a. F ree edge

b. Hyponychium

c . Nail plated . D istal ph alanx

e. Nail bed

1. Ep onychium

g. Germinal m atrix

h . Nail roo t

Nails form on the d orsal surfaces of the tips of th e fingers and to es.

They p rotect the expo sed ends of the f ingers and toes when they are

subjected to m echan ical stress, for exam ple, wh en grasping or run ning.

A t the base of th e nail, an ep idermal fold called the epon ychium allowsthe n ail root to rem ain sequestered below the skin surface, near the

distal ph alanx bon e. New nail is pro du ced at the germ inal m atrix, near

the n ail root. The nail plate covers an area of epithelium called t he n ail

bed that is continuou s with the germ inal matrix on its proximal side;

the n ail bed c on tains blood vessels and ne rves. As the n ail plate is

prod uced, i t streams along the surface of th e nail bed and is attachedto i t through grooves on the un derside o f the nail plate. The free edge

of the n ail covers the hypo nychium , an area where th e nail bed m eets

the ad joining ep iderm is. The n ail itself consists of hard , t ightly packed ,

dehyd rated cells that are packed w ith keratin. The keratin protein

forms an extrem ely strong and hard p rotein m atrix that is not readily

soluble in w ater.



Skeleton, anterior view 15

KAPLAN) MEDICAL

S Y S T E M



15. Skeleton, anterior view

a. F rontal bone

b. Maxilla

c. Mandible

d . Clavicle

e. Humerus

1. Co stal carti lage

g. Tho racic vertebra

h . Ulna

i. H ip bone (os coxae)

j. Sacrum

k. Phalanges

I. Patella

m. Fibula

n . Metatarsals

o. Phalanges

p . Tarsals

q. Tibia

r. Femur

s. Metacarpals

t . Carpals

u . L umbar vertebra

v. Radius

w . Ribs

x. Sternum

y. Cerv ical vertebra

z. Zygom atic bone

The axial skeleton h as 8o bones, includ ing the skull and associated

bones, the rib cage, and the vertebral column. L ooking at the axial

skeleton from the anterior aspect beginning w ith the head , one sees

the fron tal bone wh ich is part of the cranium , the m axilla, zygomatic

and m andible wh ich are all facial bones, the cerv ical, thoracic, and

lumbar vertebrae, the sacrum and co ccyx, as well as the ribs which are

conn ected to th e sternum th rough th e costal cartilage. The craniumand vertebral colum n p rotect the brain and spinal cord; the rib cage

protec ts internal organs and facilitates breathing. The append icular

skeleton con sists of 126 bon es, includ ing the pe lvic and pect oral

girdles and the limbs. Parts of the append icular skeleton o bserved

anteriorly include the c lavicle of the p ectoral girdle, the hu mer us, ulna,

radius, carpals, m etacarpals, and ph alanges of the up per lim bs, the

hip bo ne o f the p elvic gird le, the fem ur , patella, tibia, fibula, tarsals,

metatarsals and phalanges of the low er limb. The p ectoral and p elvic

girdles conn ect the l imbs to th e axial skeleton; it is the app end icular

skeleton that al lows on e to m ove about in the en vironmen t.



Ske leton , po sterior view

KAPLAN MEDICAL

S Y S T E M



S K E L E T A L

S Y S T E M

17Anterior view of the skull

1



S Y S T E M

Skull, lateral view 8

KAPLAN) MEDICAL.....



18. Sku ll, lateral view

a. Coronal suture . Zygomatic bone

b. Parietal bone . Nasal bone

c. Zygomatic process . Lacrimal bone

d . Temporal bone . Sphenoid bone

e. Squamous suture . Frontal bone

1 . Lambdoid suture . Coronoid process

g. External occ ipital . Mandibular foramen

protuberance . Mandibular notch

h . Occipital bone . Mandibular condyle

I. Mastoid process . Ramus of mandible

j. External acoustic meatus . Angle of mandible

k. Styloid process . Body of mandible

L Mandible . Mental foramen

m . Maxilla

Observed from the lateral aspect, one can identify the large

braincase formed by the cranial bones, including a single frontal,

two parietal , two temp oral, one occipi tal, one sphen oid and one

ethm oid wh ich is not seen in this view. The tem poral bone has

several pro cesses that articulate with bones or pro vide attachm ent

sites for mu scles and l igamen ts, and t he exte rnal acoustic meatu sor extern al ear. The tem po ral bone articulates with the parietal

bone at an imm ovable joint, the squamous suture. The m andible

form s the lower jaw; it articulates with the te m po ral bon e at the

mand ibular co ndyle. The strong temp oralis mu scle that closes the

jaw attaches at the corono id pro cess. Op enings in th e m andible

include the m ental foramen for n erves and the mand ibular foramenfor blood vessels and ne rves. Oth er facial bones visible from this

aspect includ e th e m axilla, zygom atic, nasal and lacrim al bones.



S Y S T E M

Skull, superior view 9

KAPLA) MEDICAL....



19. Sku ll, sup erior view

a. Frontal bone . Sagittal suture

b. Corona( suture . Lambdoid suture

c. Parietal bones . Occipital bone

Sutures are immovable joints between cranial bones where the

bones are held together securely by dense fibrous tissue. The

two parietal bones articulate at the sagittal suture. The frontal

bone articulates with the two parietal bones at the corona

suture. The parietal bones meet the occipital bone at the lambdoid

suture. However, at birth, an infant's skull is still growing and

the bones do not completely meet; they are connected only by

relatively large areas of fibrous tissue called fontanels. Most of

the fontanels disappear within a few months after birth, although

the largest may take a year or two before it closes completely.



External surface o f the base of the sku ll 20

KAPLA) MEDICAL



20. External su rface of the b ase of the sk ull

a. Palatine p rocess of m axilla

b. Vomer

c. Greater wing of

sphenoid bone

d . M edial pterygoid plate

of sphenoid bone

e. M and ibular fossa

f. Carotid canal

g. Jugular foramen

h. F oramen magnum

i. External occipital

protuberance

j. Occipital condyle

k. M astoid process

1 Styloid process

m . F oramen lacerum

n . F oramen ovate

o . Zygomatic arch

p . L ateral plate of

sphenoid bone

q. Palatine bone

r. Inc isive fo ssa

The h ard palate is form ed by th e palatine p rocess of the m axillae

anteriorly and th e palatine bo nes po steriorly; the incisive fossa forms

a passageway for nerv es and arteries. The v om er form s the bony

part of the n asal septu m . The p terygoid plates are extensions of the

sphenoid bone that form attachm ent s i tes for muscles that mo ve the

lower jaw. The foram en m agnum is the large hole in the o ccipital bone

throu gh wh ich the spinal cord p asses; on either side , the occ ipital

condyles articulate w ith the first vertebra of the n eck. Between th e

foramen m agnum and th e external occipital protuberance, a bonycrest m arks attachm ent sites for ligam ents stabilizing the ve rtebrae

of the neck. The m astoid pr ocess of the tem poral bone provides an

attachmen t site for m uscles rotating the head ; muscles attached t o

the styloid p rocess contro l the hyoid, the p harynx and th e tongu e.

H oles for passage of blood vessels and nerv es includ e the carotid

canal and foramen lacerum in the tem poral bone, the foramenovate in the sphenoid bon e, and the jugular foramen form ed at the

junction of the t emp oral and occipital bones. A d epression in the

tem poral bone, the m andibular fossa, articulates with th e m andible.



S Y S T E M

Right tem poral and sph enoid bon es 2

Right temporal bone,

lateral view

Sphenoid bone,

superior view

Ki. . 3 . . . . . N MEDICAL



22. Right temporal and sphenoid bones

Temporal bone:

a. Squamous part

b. Zygomatic process

c. Mandibular fossa

d . External acoustic meatus

e. Styloid process

f. Mastoid process

Sphenoid bone:g. Hypophysial fossa sella

turcica, pituitary fossa

h. O ptic canal

i. Lesser wing

I . Superior orbital fissurek. Greater wing

I Foramen spinosum

m . Pterygoid hamulus

n . Dorsum sellae

o. F oramen ovate

P. Foramen rotundum

q• Anterior clinoid process

The large, flat surface of the temporal bone is the squamous

region. The mandibular fossa is a depression that articulates

with the mandible. The zygomatic process articulates with the

zygomatic bone to form the cheekbone, while the mastoid process

is an attachment site for muscles, and the styloid process is an

attachment site for muscles and ligaments supporting the hyoid

bone. The external acoustic meatus provides the opening for the

auditory canal. The sphenoid bone is a butterfly-shaped bone that

articulates with both cranial and facial bones and provides cross-

bracing that serves to strengthen the skull. The central region or

body is composed of the dorsum setae and the sella turcica, which

contains a depression where the pituitary gland is located, the

hypophysial fossa. The lesser wing of the sphenoid is located anterior

to the sella turcica; it is penetrated by the optic canal carrying the

optic nerve from the rear of the orbit toward the brain. The greater

wing is lateral to the body. The superior orbital fissure, foramen

spinosum, foramen ovate, and foramen rotundum are passages

that carry blood vessels and nerves to the face, jaws or eye region.



S Y S T E M

Hyoid bone 3

KAPLAN MEDICAL



23. Hyoid bone

a. L esser horn

b. Greater horn

c. Body

The small hyoid bone is located at th e base of the to ngue

and im med iately superior to the larynx. It is crucial to hu man

speech as i t braces the ton gue and larynx to allow a wide range

of mo vem ents. The bod y of the hyoid is an attachm ent s i te for

mu scles of the ph arynx, larynx and tongue. The greater horn s

support the larynx and provide attachmen t s ites for mu scles

mo ving the tongue. The lesser horns are suspended from the

styloid p roce sses of the tem po ral bon es via l igame nts.



Vertebral column lateral view 4

KAPLAN MEDICALS



24. V ertebral colum n, lateral view

a. Cervical vertebrae . Lumbar vertebrae

cervical curvature) lumbar curvature)

b. Thoracic vertebrae Sacrum pelvic curvature)

thoracic curvature) . Coccyx

The vertebral column is the part of the axial skeleton that surrounds

and protects the spinal cord, while bearing the weight of the head, neck

and trunk. The vertebral column is not straight, as can be seen in this

lateral view; its curves accommodate the thoracic and abdominopelvicviscera as well as balance the weight of the trunk and head over the

lower limbs. Regions of the vertebral column and their corresponding

curves include 7 cervical vertebrae the cervical curve is concave on

the posterior surface), 12 thoracic vertebrae (the thoracic curve is

convex on the posterior surface), 5 lumbar vertebrae (the lumbar curve

is concave), a sacrum pelvic or sacral curve is convex ), and a coccyx.



S Y S T E M

Po sterior view o f the vertebrae 5

KAPLA5) MEDICAL



25. Posterior view of the vertebrae

a. Cervical vertebrae . Sacrum

b. Thoracic vertebrae . Coccyx

c. Lumbar vertebrae

The adult human vertebral column consists of 26 bones-7 cervical

vertebrae C1•C7, including the atlas[Ci] and axis[C2D form the

neck, 12 thoracic vertebrae (Ti-T12) support the upper back and

articulate with ribs, 5 lumbar vertebrae (11-15) sup port the lower

back, a sacrum consisting of 5 fused vertebrae articulates with

the pelvis, and a coccyx resulting from the fusion of the final 4-6

vertebrae. Generally, one spinal nerve emerges at each vertebra;

however, although there are only 7 cervical vertebrae, there are

8 cervical nerves. Each individual vertebra consists of a vertebral

body or centrum that transfers weight to the next lower vertebra, a

vertebral arch forming the posterior margin of the vertebral canal,

and variable types of processes that either provide attachment

points for muscles or articulate with ribs. The 5 sacral vertebrae

begin fusing after puberty and are usually completely fused by age

25-30. The coccyx is not completely fused until late in adulthood.



Atlas (Ci) and axis (C2), superior view 6

a

Atlasi

e

Atlas and Axis

KAPLAN) MEDICAL



26. Atlas Ci) and axis C2), superior view

a. Posterior tubercle . Posterior arch

b. Vertebral foramen . Facet for odontoid

c. Lateral mass rocess of axis

d. Transverse foramen . Bifid spinous process

e. Superior articular . Body of axis

process (facet) . Odontoid process (dens)

f. Anterior tubercle . Arch of axis lamina)

g. Anterior arch . Axis

h. Transverse process . Atlas

I. Groove for vertebral artery

The first cervical vertebra is called the atlas; its superior articular

processes have facets that articulate with the occipital condyles of

the skull in a type of joint that permits forward•backward motion of

the head. The body of the second cervical vertebra, the axis, has aprominent odontoid process that extends superiorly and articulates

with a facet on the atlas, providing a pivot point to allow rotational

movement of the head. The facet of the superior articular process of

the axis articulates with a similar flat surface on an inferior articular

process of the atlas. Like other individual vertebrae, the axis has

a prominent dorsal spinous process, which is notched as it is in

cervical vertebrae 3-6 and is referred to as bind ; the atlas has a

smaller dorsal process know n as the posterior tu bercle. L aterally, a

transverse process provides attachm ent sites for mu scles, wh ile the

tran sverse foram en allows passage of verte bral arteries and v eins.



Superior view

S Y S T E M

Cervical vertebra, superior and lateral views 7

I(APLA) MEDICAL



27. Cervical vertebra, superior and lateral views

a. Bifid spinous process . Transverse process

b. Vertebral foramen . Body

c. Lam ina of vertebral arch . Uncus of vertebral bodyd. Pedicle of vertebral arch . Transverse foramen

e. Superior articular process . Inferior articular process

Cervical vertebrae have a relatively large vertebral foramen, since

the spinal cord still includes most of the axons that exit the brain,

and the vertebral bod y only needs to support the weight of thehead. The vertebral foramen is bounded by the body anteriorly, the

pedicles laterally, and the laminae posteriorly. Where the lamina

meet is a posteriorly projecting protrusion called the spinous process,

which is notched, or bifid, for C2-C6. Articular processes lie at the

junction between the pedicles and laminae; each has a relatively

flat surface, the facet, which articulates with the articular process of

the neighboring vertebra. The superior articular process articulates

with the vertebra above, and the inferior articular process articulates

with the vertebra below. The uncus is a ridge of bone around the

superior edge of the body in cervical vertebrae, increasing the

stability of the joint with the vertebra above it. Laterally, transverse

processes provide attachment sites for neck muscles; a hole, the

transverse foramen, allows passage of vertebral arteries and veins.



Superior view

h

Lateral view

Tho racic ve rtebra, superior and lateral views 8

KAPLAN) MEDICAL



Lum bar vertebra, supe rior an d lateral views 9

Superior view r /

f

Lateral view

e

I(APLA) MEDICAL,••



30. Sacrum and coccyx anterior v iew

a. Sacral pro m ontory Transverse l ines

b. Sup erior a rticular p rocess . A nte rior sacral foramina

c. L ateral m ass (ala) Coccyx

F ive sacral vertebrae fuse to form the sacrum , wh ile 3.5 coccygeal

vertebrae fuse to form the co ccyx. These vertebrae begin fusing after

pu berty; the sacrum is usually comp letely fused by the m id•twen ties,

wh ile the coccyx is not co m pletely fused until late in adu lthood . The

coccyx is a vestigial rem nant of the tail of evo lutionary ancestors,

but in hum ans, has no vertebral foramen and does not surroun d

a part of the spinal cord. The regions of the sacrum include the

sacral pro mon tory that articulates with the last lumbar vertebra

(L 5), the tw o broad lateral masses (ala) on either side, and the

central sacral bod y, correspond ing to the fu sed vertebral bodies;

the transverse l ines mark the p osition of the interv ertebral discs

between the bod ies of the fused vertebrae. The anterior sacral

foram ina pro vide p assageways for sacral nerves as well as arteries.



31. Sacrum and coccyx, posterior view

a. Superior articular process . Median sacral crest

b. Auricular surface . Posterior sacral foramina

c. Lateral sacral crest . Coccyx

The posterior surface of the sacrum is convex, allowing room within

the pelvic region for internal organs and providing many surfaces for

attachment of muscles and ligaments. Laterally, the auricular surfaces

articulate with the pelvis at the iliac joints. The median sacral crest

is a bumpy ridge produced from the fused spinal processes of the

sacral vertebrae; deep to this ridge is the sacral canal which is the

continuation of the vertebral canal. The lateral sacral crest represents

the fused transverse processes of the sacral vertebrae. Between the

two ridges are the posterior sacral foramina, passageways for sacral

nerves as well as arteries. Sexual differences exist—in the female,

the sacrum is shorter and wider than in the male, with most of the

curvature in the lower half, but it is more evenly distributed in the male.



S K E L E T A L

S Y S T E M

Sternum , anterior view 3

MEDICAL



33. Sternum anterior view

a. Sup rasternal notch

b. Clavicular notch

c. Manubriumd . Stern al angle

e. Co stal notches

1. Body

g. Xiphoid process

The sternum , part of the axial skeleton, functions to p rotect and

support the internal organs of the th oracic cavity, and to form an

attachmen t point for ribs. It has three main po rtions—the superior

section is the triangular manu brium that articulates with the clavicles,

the m ain bod y, and th e small xipho id proc ess located inferior to

the body. The superior edge of the m anubrium has two points of

attachmen t for the clavicles, located laterally on either side of th e

med ial depression kn own as the suprastemal notch. At the po int of

attachmen t between the manubrium and body of the sternum is the

sternal angle, a conven ient m arker located at the level of the secon d

rib. The anterior en ds of ribs 1-7 articulate with the sternum ; the first

rib articulates with the m anubrium at sites inferior to the clavicular

notch es, and ribs 2.7 h ave cart ilage conn ect ions to the bod y of the

sternum at the co stal notch es. R ibs 8.10 are attached by carti lage

to the carti lage conn ections of rib 7. The x iphoid p rocess forms an

attachmen t po int for som e m uscles, including th e d iaphragm.



34ib and vertebra, articulated, superior view;

rib, posterior view

S K E L E T A L

S Y S T E M



34. R ib and vertebra, articulated, sup erior view;rib, po sterior view

a. Tho racic vertebra . Angle of rib

b. Head of rib . Costal groovec. Neck of rib . Sternal extremity

d. Tubercle of rib

The ribs function to protect the organs of the thoracic cavity and

to provide a flexible cavity for breathing. The thoracic vertebrae

articulate with the ribs; the head of the rib attaches at the costal

facets near the body of the vertebrae while the tubercle of the rib

is positioned at the costal facet of the transverse process. The

shaft of the rib curves anteriorly at the angle of the rib. Along

the inferior border of the internal surface of the rib lies a costal

groove which marks the site where nerves and blood vessels

pass. Cartilage connected to ribs 17 at the sternal extremity

articulate with the sternum at the costal notches. Cartilage

attached to ribs 8•io, in turn, attaches to the cartilage from rib 7.



S Y S T M

Rib cage anterior view 5

KAPLA MEDICAL



35. R ib cage, anterior view

a. 1st thoracic vert ebra

b. Clavicle

c . Scapula

d . Co stal cartilage

e . 12th th oracic vertebra

f. 1st lum bar vertebra

g. 12th rib

h. nth rib

I. Sternum

j. 1st rib

The rib cage consists of the sternum and the 12 p airs of ribs, wh ich

are attached po steriorly to the thoracic vertebrae. R ibs 1-7 articulate

with th e sternu m thro ugh the co stal cartilage; for ribs 8.io the costalcartilage articulates only indirectly with t he sternum since it fuses

to th e cartilage of rib 7 for sup po rt. Ribs 11-12 do n ot attach to the

sternum at all; they are conn ected w ith other skeletal elem ents only

at the v ertebral end. The articulation between the axial skeleton and

the pector al girdle occurs where th e clavicle, or collarbone, attaches

to the sternum at the m anubrium; in turn , the clavicle articulateswith the scapu la or shoulder blade. The fun ction of the rib cage is

to p rotect the heart, lun gs and other th oracic organs as well as to

serve as an attachm ent po int for mu scles involved in m ovem ents

of the p ectoral girdle and u pp er lim bs, adjustmen ts to the po sition

of the vertebral colum n, and m ost impo rtantly, breathing.



36. Pectoral girdle and upper limb, anterior view

a. Clavicle

b. Acromion process

c. Coracoid process

d. Humerus

e. Radius

1 . Sternum

g. Scapula

h. Ulna

i. Carpals

j. Metacarpals

k. Phalanges

The pectoral girdle is composed of four bones, two clavicles and two

scapulae. The acromion and coracoid processes of the scapulaeare points of attachment for numerous ligaments and muscles. The

clavicle articulates with the sternum of the axial skeleton medially,

and with the scapula laterally. The primary function of the pectoral

girdle is to provide an anchor for movements of the arm. Each upper

limb consists of a humerus in the (upper) arm, an ulna and a radius

in the forearm, eight carpal bones in the wrist, five metacarpal

bones in the hand, and u; phalanges or finger bones. At the

shoulder, the humerus articulates with the scapula to produce a

wide range of arm movements; at the elbow, the humerus articulates

with the radius and ulna to flex the forearm, while articulation

between the radius and ulna allows pronation of the forearm. The

complex wrist joint provides for a wide range of movements while

the finger joints allow flexion and extension of the fingers.



S Y S T E M

Scapula, anterior and lateral views 7

e

d

f

Anterior view

b

Lateral view

MEDICAL



37. Scapula, anterior and lateral views

a. Acrom ion process . Subscapular fossa

b. Sup erior border . L ateral border

c. Coracoid process . M edial borde rd . Gleno id fossa . In ferior angle

Viewed from t he anterior per spective, the scapula has an obvious

large, triangular surface that is roughly con cave, forming th e

subscapu lar fossa; its ed ges are, observ ed in a clockw ise direc tion

from this aspect , the sup erior border, medial border, inferior angle,

and lateral bord er. Betw een th e superior and lateral bord ers, the

scapula articulates with the h um erus at the shou lder joint. The

glenoid fossa is the con cave 'socket ' within which th e rou nded head

of the h um erus rotates. Tw o pro cesses also originate in this area and

extend superiorly; the m ore anterior is the coracoid p rocess which

is an attachme nt p oint for l igamen ts and tend ons; posterior to this

is the larger acrom ion p rocess, which articulates with the clavicle

as well as being the attachm ent p oint for add ition al l igamen ts and

tend ons of th e shoulde r joint. The lateral view clearly shows that

these two processes project from the thin p lane o f the scapula; the

roun ded nature of the glenoid fossa also becom es more o bvious.



Scapula, posterior view 8

KAPLAI9 MEDICAL



Clavicle and related bones, superior view;

clavicle, inferior view

Superior view



39. Clavicle and related bones, superior view;

clavicle, inferior view

a. First thoracic vertebra (Ti) . Conoid tubercle

b. First rib . Sternal end of claviclec. Scapula . Sternum

d. Acrom ial end of clavicle

Looking down from above the head and shoulders reveals the

superior aspect of the pectoral girdle including both the clavicle

and scapula. The girdle is anchored to the axial skeleton by a

single articulation anteriorly, and is held in position posteriorly

by many small muscles attached to the scapula; this provides

mobility but limited strength to the shoulders as they provide the

anchor for arm motions. The S-shaped clavicle articulates medially

with the manubrium of the sternu m just above the first rib, and

laterally with the acrom ial proc ess of the scapula. The acrom ial

end of the clavicle is broader th an the sternal end; at the po sterior

margin of the inferior surface near the acrom ial end is the cono id

tubercle which is an attachmen t point for the co noid l igame nt

that also attaches to the co racoid p rocess of the scapula.



40um erus, anterior and posterior view s

Anterior view osterior view

S Y S T E M

KAPLA :1) MEDICAL



40. H umerus anterior and posterior views

a. Greater tubercle

b. L esser tubercle

c . Intertu bercular sulcusd . Head

e. An atomical neck

1 Surgical neck

g. Deltoid tu berosity

h . Su pracond ylar ridges

i. L ateral epicond yle

j. Co rono id fossak. O lecranon fossa

1 M edial epicondyle

m . Capitulum

n . Trochlea

The roun ded h ead of the hum erus moves wi thin the cup-shapedglenoid fossa of the scapula. A djacent to the head are two project ions

on th e lateral surface of the hum erus— the greater tubercle is the

mo st lateral point of th e bod y at shoulder level and the lesser

tuberc le lies on th e anterior, me dial surface and is separated

from the greater tubercle by a shallow groove, the In tertubercular

sulcus. M uscles attach to both tu bercles while a large tend on

passes along the length o f the sulcus. Th e edge o f the joint cap sule

is called the anatom ical neck, while the n arrower surgical neck

m arks the m etaphysic of the growing bone. The deltoid m uscle

attaches to the shaft at the de ltoid tubero sity. A t the d istal end of

the hu me rus, the capitulum and th e trochlea articulate with the

radius and ulna, respectively. The radial , corono id and olecranon

fossae are depressions that accom m od ate the radial head, ulnar

coron oid pro cess and ulnar olecranon as they move . L aterally,

the h um erus widens o ut in the m edial and lateral epicondyles;

supracond ylar ridges pro vide attachmen t si tes for m uscles.



S Y S T E M

Ulna and radius, lateral and anterior views 41

b

d

e

g

k.

Ulna, lateral view lna and radius, anterior view

KAPLAN MEDICAL



41. Ulna and radius, lateral and anterior views

a. Olecranon process

b. Trochlear notch

c. Coronoid process

d. Rad ial notch

e. Tuberosity of the ulna

f. Head of radius

g. Radial tuberosity

h. Interosseous margin

I . U lnar notch

j. Styloid process of ulna

k. Head of ulna

I. Styloid process of radius

The bones of the forearm are the ulna and radius. The more medial and

longer ulna articulates with the trochlea of the humerus at the trochlearnotch. The superior edge of the trochlear notch is the olecranon process

which fits into the olecranon fossa of the humerus when the forearm is

extended, and the inferior edge of the trochlear notch is the coronoid

process which fits into the coronoid fossa of the humerus when the

forearm is flexed. Lateral to the coronoid process, the radial notch of

the ulna articulates with the head of the radius. Distal to the radialhead, the radial tuberosity forms an attachment site for muscles. A

fibrous sheet called the interosseous membrane connects the radius

and ulna along the interosseous margins, and serves as a site for

muscle attachment. At their distal ends, the ulna and radius articulate

with each other, and the radius articulates with bones of the wrist. The

lateral surface of the ulnar head articulates with the ulnar notch of

the radius. A stytoid process extends distally from each of the bones,

providing many attachment sites for ligaments and muscles of the wrist.



S Y S T E M

Han d, pos terior (dorsal) view 2

KAPLAN) MEDICAL......



42. H and, posterior (dorsal) view

a. Phalanges . Triquetrum

b. Head of m etacarpal . Lunate

c. Shaft of m etacarpal Metacarpal

d. Base of m etacarpal . T rapezoid

e. Hamate . Trapezium

f. Capitate Scaphoid

Eight carpal bones m ake u p the flexible wrist, articulating at

individual joints that allow lim ited, gliding m otion between the

bone surfaces. The proxim al row of carpals includes the scaphoid

bone, lun ate bone, triquetrum , and p isiform bone; the distal row

consists of the trapezium , trapezoid bon e, capitate bone, and the

ham ate bone. Articulating w ith the distal carpal bones are the five

m etacarpal bones, form ing the hand . T he m etacarpals are identified

by rom an nu m erals; m etacarpal I is m ost lateral, form ing the base ofthe thum b, and articulates with the trapezium . The proxim al base of

each m etacarpal articulates with the carpals. T he m etacarpal heads

articulate distally with phalanges, or finger bones. The thum b has

two p halanges; each of the other fingers has three, m aking a total of

14 phalanges on each hand. The joint between m etacarpal I and the

trapezium at the base of the thum b is a saddle joint, allow ing m orerange of m otion than foun d w ith the other m etacarpals, and leading

to the abilities associated w ith having an opp osable thum b.



S Y S T E M

Hand, anterior (palmar) view 3

KAI. . . . . _21 AN MEDICAL



S Y S T E M

44ip bone, lateral view

Adult hip bone

pHip bone of a child

KAPLAN) MEDICAL

•



44. H ip bone, lateral view

a. Iliac crest

b. Posterior superior iliac spine

c. Posterior inferior iliac spine

d. G reater sciatic notch

e. Ischia' spine

f. L esser sciatic notch

g. Ischia' tuberosity

h. Ischial ram us

i. Acetabulum

I.

k.

I.

m .

n.

o.

p.

q .

O bturator foramen

Inferior pubic ramu s

Superior pubic ram us

Anterior inferior iliac spine

Anterior superior iliac spine

Ilium

Ischium

Pubis

T he hip bone, or os coxae, is form ed from the fusion of three

bones— the ilium , ischium , and p ubis. T he fusion lines are visible

in the child's hip bone im age, showing how the three bones m eet

to form the acetabulum which is seen clearly in the lateral view and

articulates with the head of the fem ur. An terior to the acetabulumare the superior and inferior ram i of the pubis; posterior to the

acetabulum is the ischium , extending from the Ischia( spine on the

superior edge to the ischial ram us w hich m eets the inferior pu bic

ram us. The Ischia' tuberosity is the rounded p rotrusion that bears

one's weight when seated. The space im m ediately inferior to the

acetabulum is the obdura tor foram en w hich is filled by a sheet ofcollagen fibers that provide sites for attachm ent of m uscles. Superior

to the acetabulum is the large broad ilium , which suppo rts the weight

of the internal organs of the trunk; m uscles, tendons and ligam ents

attach at sites includ ing the iliac crest and variou s iliac spines. The

greater sciatic notch allow s passage of the sciatic nerve to the low er



45. Pelvis, anterior view

a. Iliac crest

b. Sacroiliac joint

c. Greater sciatic notch

d. Anterior superior iliac spine

e. An terior inferior iliac spine

1 Acetabulum

g. Obturator foramen

h. Symphysis pubis

I False pelvis

j. True pelvis

The pelvis is formed from the two ossa coxae of the appendicular

skeleton and the sacrum and coccyx of the axial skeleton. Because

it supports the weight of the upper body and mediates the stresses

of locomotion, the bones are larger and heavier than those of the

pectoral girdle. The ilium of the ox coxae articulates with the sacrum

at the sturdy sacroiliac joint. T he iliac crest form s the sup erior,

posterior edge of the pelvis, w hile the anterior su perior iliac spines

m ark the lateral edges. The anterior an d inferior lim it of the pelvis

is comp osed of the pubis bones, med ial to the obdurator foram en;

the pubis bones a re conn ected by fibrocartilage at the sym physis

pu bis. T he true pelvis (or lesser pe lvis) is the cavity po sterior to

the pubic sym physis, anterior to the sacrum and coccyx, and

boun ded by the m edial surfaces of the ilia near the greater sciatic

notch. The fa lse pelvis (or greater pelvis) is the larger, mo re sup erior

cavity bou nded latera lly by the anterior sup erior iliac spines.



46 Differences between male and female pelvis

a. W ing ala) of ilium . Subpubic angle,

b. Subpubic angle, emale wider)

male narrower) . True pelvis female

c. True pelvis, m ale wider, oval)

(narrower, heart-shaped)

Males and females show gender-related differences in the pelvis,

due partly to the larger size and muscle mass of males, and partly to

adaptations in females for childbearing. Generally, the female pelvis

has lighter bones with smoother surfaces; it is broader and has less

depth than the male pelvis. The broad surface of the ilium, known as

the ala or wing, projects further laterally in females, but the iliac crest

is not located as far superior from the level of the sacrum. The subpubic

angle formed between the two pubis bones at the pubic symphysis islarger in females. The sacrum and coccyx are less curved in females

at the inferior, anterior side, leading to a larger and more circular

opening at the inferior side of the cavity known as the true pelvis.

Overall the true pelvis is wider and more oval in females to allow for

childbirth, while it is narrower and somewhat heart-shaped in males.



ower limb anterior view 7

pl AN MEDICAL



47. Lower limb, anterior view

a. Femur . Tarsals

b. Patella Metatarsals

c. Tibia . Phalanges

d. Fibula

T he lower lim b m ust withstand the stresses of locom otion and bearing

the body's weight; for this reason, the bones are m ore m assive

than the bones of the upp er lim bs. The low er lim bs are supported

by the pelvis. The bones of the lower limbs include the fem ur, whicharticulates proxim ally w ith the pelvis at the acetabulum of the hip bone

and distally w ith the tibia and patella. L ateral to the tibia is the fibula,

but on ly the tibia articulates w ith the tarsals, the ank le bones. At the

ankle, the foot turns 9o° com pared w ith the leg bones, to provide

stability as the body's weight is transferred to the grou nd . T he bones

of the foot includ e the m etatarsals and the phalan ges, or toe bon es.



S Y S T E M

Femur and patella, anterior and posterior views 8

Anterior view Posterior view

KAPLArs) MEDICAL



48. Femur and patella, anterior and posterior views

a. Greater trochanter

b. Head of femur

c. Neck of femurd. Intertrochanteric line

e. Intertrochanteric ridge

f. L esser trochanter

g. Linea aspera

h. Lateral epicondykle

I. Medial epicondyle

j. Lateral condylek. Medial condyle

L Base of patella

m . Apex of patella

The femur, or thigh bone, is the largest and strongest bone in thehuman body. The head of the femur articulates with the pelvis at

the acetabulum; the head is joined to the shaft of the femur through

the neck at an angle of about125°. The rim of the articular capsule

is marked anteriorly by the Intertrochanteric line and posteriorly by

the intertrochanteric ridge. Adjacent to the neck are the superior

greater trochanter and the inferior lesser trochanter, both sites

where large tendons attach. The Linea aspera is a ridge running

along the posterior side of the femur where strong hip muscles

attach. At the distal end, the femur widens out, forming the lateral

and medial epicondyles. Inferior to the epicondyles are the lateral

and medial condyles, the surfaces that articulate with the tibia at

the knee. A deep groove, the intercondylar fossa, extends between

the condyles on the posterior side. Between the condyles anteriorly,

there is a smooth surface over which the patella can glide. The

patella has an inferior apex connected to the tibia by a ligament;

a broad, superior base; a smooth, convex anterior surface; and

posterior facets for articulating with the condyles of the femur.



r

Anterior view Posterior view

q

S Y S T E M

Tibia and fibula anterior and posterior views 9

KAPLAN) MEDICAL



49. Tibia and fibula, anterior and posterior views

a. L ateral tibial condyle . La teral surface of tibial shaft

b. Intercondylar em inence Posterior surface of tibia

c. Medial tibial condyle . Medial surface of tibial shaftd. Ap ex of fibula Interosseous borders

e. Hea d of fibula . M alleolar groove

1. T ibial tubero sity . M edial m alleolus

g. Soleal line . L ateral m alleolus

h. M edial crest of fibula . Inferior articular su rface

I. An terior border of fibula f tibia

I. Anterior border (crest)

of tibia

T he tibia, or shinbone, articulates with the lateral and m edial condyles

of the femu r at the lateral and m edial tibial condyles. Betw een

the cond yles, the intercondylar em inence provides attachm entfor cru ciate ligam ents. Anteriorly, the tibial tuberosity is a site of

attachm ent for the patellar ligam ent. The d istal end o f the tibia has

an In ferior articular surface that articulates with a prox imal tarsal

bone. Ad jacent to this is the m edial m alleolus, a large process that

lends stability to the ank le joint; the m alleolar groove is a tendon

passagew ay. The fibula, or calf bone, is a long, slender bone. The

head of the fibula articulates w ith the lateral tibial condyle, w hile the

inferior end of the tibia also articulates with a flat region on the side

of the fibula. T he lateral m alleolus is a fibular process that continues

inferiorly beyond the articulation with the tibia, providing lateral

supp ort for the ankle joint. Alon g the shaft of both bones, prom inent

crests, borders, and lines ma rk the attachm ent sites for m uscles

or the interosseous m em brane that helps stabilize the positions of

the two bones and provides additional m uscle attachm ent sites.



50. Bones of the foot, dorsal view

1. Phalanges . F irst (m edial) cuneiform

2. Metatarsals . Second (interm ediate)

3. Tarsals uneiform

a. Distal phalanges . Third (lateral) cuneiform

b. M iddle phalanges . Cuboid

c. Proxim al phalanges . Navicular

d. Head of m etatarsal Talus

e. Shaft of m etatarsal. C alcaneus

f. Base of m etatarsal

T he bones of the foot include seven tarsal or an kle bones, five

m etatarsal or foot bones, and 14 p halanges or toe bones. The toes

each have d istal, m iddle and p roxim al phalanges, with the exception

of the m ost m edial great toe, which only has two phalanges

(like the thum b)—the distal and proxim al. Each m etatarsal has a

head that articulates with the proxim al phalanges, a shaft, and a

base that articulates w ith the tarsals. T he talus is a large tarsal

that articulates w ith the tibia at a process that also articulates w ith

the lateral m alleolus of the fibula. T he calcaneu s or heel bone is

the largest tarsal. T he navicu lar bone is anterior to the talus and

articulates with the m edial, interm ediate and lateral cuneiformbones, that in turn articulate with m etatarsal bones I— III. Anterior

to the calcaneou s and lateral to the navicular and cu neiform s is

the cuboid bone, which articulates with m etatarsals IV and V.



S Y S T E M

B on es of the foot, lateral view 1

KAPLAN) MEDICAL. . . .



51. Bones of the foot, lateral view

a. F irst (m edial) cuneiform . M iddle phalanx

b. Second (intermediate) . Proxim al phalanx

cuneiform . H ead of m etatarsalc. Third (lateral) cuneiform . Shaft of metatarsal

d. Navicular . Base of m etatarsal

e. Talus Cuboid

1. Distal pha lanx . C alcaneus

The large tarsu s called the talus articulates w ith the tibia to distributethe weight of the body evenly, both toward the d istal end of the

m etatarsals and also toward the heel. An teriorly, the talus articulates

with the navicular bon e, which in turn articulates w ith the m edial,

interm ediate and lateral cuneiform bones. These tarsals then articulate

with m etatarsals I, II and III . Ad ditionally, the talus articulates with

the calcaneus or heel bone. Anteriorly, the calcaneu s articulates w ith

the cuboid bone, which then articulates with m etatarsals IV an d V .

L igam ents and tendons attach to tarsals and m etatarsals to m aintain

an a rched p osition that lifts the m edial bones so that blood vessels,

nerves and m uscles are not squeezed between the bones and the

grou nd . T he elasticity of the arch also helps to cushion the shocks

that arise as the weight shifts during w alking or run ning. The head s of

the m etatarsals articulate with the proxim al phalanxes of each toe.



52. Go m phosis peg suture)

a Tooth

b Alveolar socket

c Enamel

d Dentin

e Pulp

f Gingiva

g Alveolar ridge

h Periodontal ligaments

A gomphosis is a fibrous synarthrotic (immovable) joint holding a tooth

in its alveolar socket in the maxilla or mandible. The bulk of the tooth iscomposed of dentin, a mineralized matrix secreted by cells found in the

pulp cavity. The exposed portion of the tooth is covered by a crystalline

calcium phosphate layer called enamel—the hardest substance in the

human body. The root of the tooth is bound in place by the periodontal

l igament; it is composed of collagen fibers extending from the dentin

of the tooth to the bone surrounding the root of the tooth. A bony

alveolar ridge forms the deep socket or alveolus where the peg-like

root of the tooth is inserted. Superficial to the bone is the gingiva,

mucosal tissue tightly bound to the bone surrounding the teeth; it

provides a smooth surface to reduce friction with food.



R T I C U L T I O N S

Suture3

KAPLAN MEDICAL



53. Suture

a. Sagittal suture

A suture is a fibrous synarthrotic (immovable) joint located between

the bones of the skull, in order to form a protective case for the brain

and sensory organs of the head. Cranial sutures include the sagittat

suture shown here, which connects the two parietal bones and extends

between the anterior coronal suture and the posterior lambdoid

suture. Further attachment between bones at the suture is provided

by collagen fibers that bind the bones in a firm but slightly flexible

manner. The bone edges at the sutures are interlocking in adults,

although they are slightly separated and are only connected by fibrous

connective tissue during development to allow both more flexibility

of the skull during birth and room for growth as the brain increases in

size during the early postnatal period.



54. Syndesm osis, posterior view

a Tibia . Posterior tibiofibular

b Fibula igament

c Interosseous membrane Transverse tibiofibular

d Interosseous ligament igament

A syndesmosis is a fibrous amphiarthrotic (slightly moveable) joint

where the articulation between the bones is strengthened considerably

by a ligament or network of collagen fibers that connects them. The

syndesmosis between the tibia and fibula permits a small amount of

movement between them. The interosseous membrane is composed

of collagen fibers that connect the interosseous borders along most of

the length of the tibia and fibula; it is continuous with the interosseousligament, composed of fibers which connect the rough surfaces where

the tibia and fibula meet. The anterior, posterior and the deeper

transverse tibiofibular ligaments are strong bands of collagen that

extend from the distal end of the tibia to the lateral malleolus of the

fibula. The strength of the tibiofibular articulation is critical for the

strength of the ankle joint.



Synchondrosis 55

KAPLAN) MEDICAL,...

A R T I C U L A T I O N S



55. Synchondrosis

a Sternum: manubrium

b First costal cartilage

c First rib

A synchondrosisis a fibrous synarthrotic (immovable) joint where

the two articulating bones are joined by cartilage. While there are

many examples of synchondroses in the developing skeleton, such as

growth plates in the long bones that become completely ossified in the

adult, the sternocostal joint between the first rib and the manubrium

of the sternum remains a synchondrosis throughout adult life. The

costal cartilage of rib i is hyaline cartilage that is continuous with the

rib laterally and with the sternum medially. For other ribs, the costalcartilage is continuous with the rib laterally, but either fits into a

depression on the sternum (ribs 2-7), connects with the costal cartilage

on other ribs (ribs 8-so), or ends in the body wall (ribs 11-12).



Symphysis 56

1


a

c

KAPLAN MEDICAL



56. Symphysis

a Intervertebral disc

b Lumbar vertebra

c Sacrum

A symphysis is a cartilaginous amphiarthrotic (slightly moveable) joint

where a pad of fibrocartilage separates the two bones. Intervertebral

discs are found between the bodies of adjacent cervical (except Ci

and C2), thoracic, and lumbar vertebrae, and between the fifth lumbar

vertebra and the sacrum. The intervertebral disc includes a tough outer

layer called the annulus fibrosis composed of layers of collagen fibers

oriented at various angles and attached to the bone of the vertebrae,

and an inner layer called the nucleus pulposus that is more hydratedand consists of a gel-like material that resists compression. Movement

of the vertebral column displaces the nucleus pulposus in the opposite

direction, permitting smooth, gliding motion while retaining the

appropriate alignment of the vertebrae. The force exerted on the discs

as the vertebrae support the weight of the body precludes the presence

of blood vessels in the disc cartilage; nutrients must diffuse in from

surrounding tissues.




Synovial joint, diagrammatic sagittal section 7

KAPLA MEDICAL. . . . .



57. Synovial joint, diagrammatic sagittal section

a Bone Meniscus

b Joint capsule . Articular cartilage

c Synovial cavity

(synovial fluid)

Synovial joints are diarthrotic (freely moveable) joints where the

bone ends are enclosed within a joint capsule, that is lined by an

articular membrane. Within the synovial cavity, lubricating synovial

fluid is secreted by the areolar tissue of the synovial membrane.

The articulating surfaces of the bones are covered by a thin layer

of articular cartilage which provides a smooth surface that, when

lubricated by synovial fluid, reduces friction and allows ready

movement of the joint. In some synovial joints such as the knee, a

fibrocartilage pad, the meniscus, further separates the opposing bones

of the joint, or adapts the cavity shape to the specific shapes of the

bones of the joint. In addition to its role in lubrication, synovial fluid

functions in distributing nutrients to cartilage cells and absorbing the

shock of pressure changes during movement.



Tendon sheath

58


b

c

—dCC)

e

f



f.

g .

58. Tendon sheath

a Distal phalanx

b Tendon insertion, flexor

digitorum profundus muscle

c Tendon, flexor digitorum

profundus muscle

d Middle phalanx

e Fibrous digital sheath,

cruciate part

Proximal phalanx

Fibrous digital sheath,

annular part

h synovial sheath

i Tendon, flexor digitorumsuperficialis muscle

A tendon sheath is a tubular pocket lined with syno vial sheath and

filled with synovial fluid, that may surround tendons where they run

along a bony surface. The synovial fluid reduces friction and acts asa shock absorber. Tendon sheaths in the fingers surround the long

tendons of the f lexor d igitorum profundus and the flexor digitorum

superficialis that insert upon and flex the distal and middle phalanges,

respectively; the origins of these muscles are near the elbow. As its

name implies, the flexor digitorum superficialis is closer to the surface

as it crosses the palm but, since it inserts on the middle phalanx, the

fibers split, allowing the flexor digitorum profundus to pass from

deeper to more superficial, on its way to the distal phalanx. The tendon

sheath is thicker along the shaft of the phalanges, and thinner and

more flexible at the interphalangeal joints. Thickenings of the sheath

capsule are termed annular where the fibers are parallel and go

around the sheath, and cruciate where the fibers cross over each other.

The arrangement of these fibers ensures that the sheath will not be

pinched during flexion of the fingers.



Bursa 59


Sagittal section view

Lateral view

KAPLA MEDICAL



ARTICULATIONS

Gliding joint 0



60. Gliding joint

a Superior articular process

b Vertebrae

c Inferior articular process

A gliding joint is a synovial joint where the two opposing surfaces

glide past one another. The movement is usually slight, and rotation

is prevented by the shape of the capsule and/or the arrangement of

ligaments. Articulations between the superior and inferior articular

processes of adjacent vertebrae are gliding joints. The articulating

surfaces of these processes are covered with cartilage. When the back

is flexed or rotated, small movements occur at these joints but not

between the bodies of the vertebrae. As one moves the torso to the

right or left, the superior articular process glides smoothly along the

lateral surface of the inferior articular process of the adjacent vertebra

to the superior side. The process on the left moves in an oppositedirection to that on the right. Infraspinous and supraspinous ligaments

prevent rotation, while the anterior and posterior longitudinal

ligaments hold the vertebral bodies stable relative to one another. This

also prevents the occurrence of larger movements that could injure the

spinal cord.



CAPLAN) MEDICAL


Hinge joint 61



KAPLAN MEDICAL

--


Rotating joint 2



62. Rotating joint

a Ulna

b Radius

A rotating joint is a synovial joint that rotates one bone in relation to

another. At the articulation between the proximal ends of the ulna and

radius, movement of the bones is limited to the rotation of the radialshaft; this allows the distal end of the radius to roll across the anterior

surface of the ulna. Pronation refers to this movement of the hand

from the anatomical position with the palm facing front to the opposite

orientation with palm facing back; supination is the opposite motion.

Similarly, movement of the hand from the palm up position to the

opposite orientation with the palm facing down is also pronation; the

opposite motion is also supination.



R T IC U L T I O N S

all and socket joint



63. Ball and socket joint

a lium

b Femur

A ball and socket joint is a synovial joint where the rounded head of

one bone moves within a cup-shaped depression in the other. This

permits a wide range of motion, including both angular and rotational

movements, at this type of joint. In the hip joint, the "ball" is therounded head of the femur, which is offset about 125° from the shaft of

the femur. The head of the femur rests within the acetabulum, which is

the depression located at the junction between the ilium, ischium and

pubis bones. The joint capsule extends from the lateral and inferior

surfaces of the pelvis and joins the femur at the intertrochanteric line

and intertrochanteric crest; thus the entire head and neck of the femur

are enclosed within the capsule. The hip joint is extremely strong and

stable because of the extent of the socket, the strong articular capsule,

strong supporting ligaments, and the bulk of the surrounding muscles.



RT ICUL T IONS

ondyloid join t

KAPLAJ MEDIC L



64. Condyloid joint

a Radius . Lunate

b Scaphoid Triquetrum

A condyloid joint is a synovial joint in which an oval or ellipsoidal

articular face of one bone rests within a slight depression on the

opposing surface. This permits movement at the joint to occur in

either of two planes. At the wrist, the articular surface at the distalend of the radius is a broad shallow depression. The articular surfaces

of the scaphoid and lunate bones are more convex and shaped to

fit the depression in the radius. This allows not only for the flexion

or extension of the hand at the wrist, but also for moving the hand

toward the body (adduction) or away from the body (abduction) when

considering the anatomical position of the hand. Movement at the wrist

also involves the ulna and the triquetrum bone, which do not articulate

with each other, but with a fibrocartilage pad between them. The wrist

is stabilized laterally and medially by the styloid processes of the

radius and ulna, respectively.



65. Saddle joint

a Trapezium

b First metacarpal

A saddle joint is a synovial joint where opposing articular faces are

convex along one axis and concave along the other. This allows angular

motion in a variety of directions, but prevents rotation. A saddle joint

exists in the carpometacarpal joint at the base of the thumb, at the

articulation between the trapezium and metacarpal. The range of

movements allowed at this joint include flexion and extension in the

plane of the palm, abduction and adduction in a plane at a right angle

to the palm, circumduction and opposition. It is the latter motion that

is important in the concept of the "opposable thumb," the evolution of

which is thought to have allowed humans to develop fine motor skillsand tool making capability.




Temporomandibular joint, sagittai section 6



66. Temporomandibular joint, sagittal section

a Zygomatic process of Articular disc

temporal bone Articular capsule

b Articular surface, mandibular . Head of mandible

fossa of temporal bone Mandible

The temporomandibular joint is a synovial joint with the unusualcharacteristic of having an articular disk dividing the articular capsule

into two parts. The lower joint compartment is formed between

the head of the mandible and the articular disk; movements are

rotational—opening and closing the jaw. As the jaw closes, the coronoid

process of the mandible slides into a cavity medial to the zygomatic

process of the temporal bone. The upper joint compartment is formed

between the mandibular fossa of the temporal bone and the articular

disk; movements here are translational—moving the jaw forwards and

backwards or side-to-side. The great mobility of the mandible enables

flexibility while chewing or talking, but also results in a joint that can

be easily dislocated by forceful forward or lateral displacement of the

mandible.




Shoulder joint, frontal section 7



68

Isl MEDC L


Shoulder ligaments, anterior view



68. Shoulder ligaments, anterior view

a Acromion

b Acromioclavicular ligament

c Coracoacromial ligament

d Coracoclavicular ligment,

trapezoid ligamente Coracoclavicular ligament,

conoid ligament

f Clavicle

g Coracohumeral ligament

h Transverse humeral ligament

i Humerus

j Articular capsulek Coracoid process of scapula

L Scapula

The shoulder joint is partly stabilized by the bones of the pectoral

girdle—particularly where the acromion and coracoid process of the

scapula extend laterally, superior to the head of the humerus. Another

measure of stability for the shoulder comes from ligaments. The

acromioclavicular, coracoacromial and coracoclavicular ligaments

connect the two processes of the scapula with the clavicle. The

coracohumoral ligament arises on the coracoid process and passes

across the joint to the greater tubercle of the humerus. The transverse

humoral ligament passes between the greater and lesser tubercles

of the humerus, forming a canal along the intertubercular groove

for the passage of the tendon of the biceps brachii. But by far, the

majority of the stability of the shoulder joint comes from the muscles

that move the humerus—especially the muscles collectively known as

the "rotator cuff", including the supraspinatus, the infraspinatus, the

subscapularis, and the teres minor.




Elbow joint, sagittal section 9



69. Elbow joint, sagittal section

a Triceps muscle

b Body of humerus

c Brachialis muscle

d Biceps brachii muscle

e Trochlea of humerus

f Joint cavity

g Ulna

h Ulnar artery

The strongest part of the complex elbow joint can be seen in a

sagittal section through the humeroulnar joint when the forearm

is extended. This hinge joint is capable of flexing or extending the

forearm. The trochlea of the humerus fits into the trochlear notch of

the ulna. Muscles that flex the forearm include the brachialis that

inserts on the coronoid process of the ulna, and to a lesser extent,

the biceps brachii that inserts on the radius. Extension of the forearm

is accomplished by contraction of the triceps muscle which inserts on

the olecranon of the ulna.



KAPLA

R T IC U L T IO N S

Elbow ligaments anterior view 7



70. Elbow ligaments, anterior view

a Humerus . Interosseous membraeb Medial epicondyle . Radius

c Ulnar collateral ligament Radial tuberosity

d Trochlea of humerus Radial annular ligament

e Ulnar tuberosity Radial collateral ligament

f Oblique cord Capitulum of humerus

g Ulna Lateral epicondyle

The elbow joint is very stable for several reasons: the humerus and

ulna interlock, the articular capsule is very thick, and several strong

ligaments reinforce the joint. The ulnar collateral ligament extends

from the medial epicondyle of the humerus anteriorly to the coronoid

processes of the ulna and posteriorly to the olecranon. The annular

ligament binds the head of the radius with the radial notch of the ulna.The radial collateral ligament extends from the lateral epicondyle

of the humerus to the annular ligament. Although the radioulnar

articulation allows rotational movement of the radius around the ulna,

the interosseous membrane allows only limited movement between

the two bones. The fibers of the oblique cord pass obliquely between

the bones just inferior to the ulnar and radial tuberosities.



71ip joint, frontal section




71. Hip joint, frontal section

a Coxal bone Zona orbicularis of capsule

b Articular cartilage . Articular capsule

c Acetabular labrum Femur

The hip joint is a sturdy synovial joint (ball and socket joint) between

the globular head of the femur and the cup-like acetabulum of the

coxal bone. A thin layer of articular cartilage covers both bone surfaces

to reduce friction. A fibrocartilage lip called the acetabular labrum

extends the edge of the acetabulum to increase its depth; it is located

slightly beyond the widest diameter of the femoral head to hold it

firmly in place. The articular capsule is strong and dense; it completely

encloses the head and neck of the femur, and extends beyond the

edge of the acetabulum. The capsule includes longitudinal bands of

fibers that stretch between the hip bone and the femur to strengthen

the joint; the zona orbicularis of the capsule includes deep circular

fibers that form a collar to hold the head of the femur tightly in the

socket. The joint permits a range of movements: flexion and extension,

adduction and abduction, circumduction and rotation.




Pelvic ligaments, posterior view 2

KAPLA MEDICAL



72. Pelvic ligaments, posterior view

a Iliac crest . Femur

b Posterior superior iliac spine . Sacrospinous ligament

c Iliolumbar ligament Superficial dorsal

d Fifth lumbar vertebra acrococcygeal ligament

e Supraspinous ligament Sacrotuberous ligament

f Short dorsal sacroiliac Articular capsule of the

ligaments ip joint

g Long dorsal sacroiliac

ligament

Strong ligaments are necessary to stabilize the pelvis. The

supraspinous ligament that runs along the edges of the vertebral

dorsal spinous processes continues along the median sacral crest. In

addition, the iliolumbar ligament connects the fifth lumbar vertebra

both to the sacrum and the iliac crest. The sacroiliac joint is stabilized

by the horizontal short dorsal sacroiliac ligament between the sacrum

and the tuberosity of the ilium and by the oblique long dorsal sacroiliac

ligament connecting the sacrum to the posterior superior iliac spine.

The sacrotuberous ligament is connected at one end to the posterior

inferior iliac spine, the lower part of the sacrum, and the coccyx; the

other end attaches to the tuberosity and ramus of the ischium. Nearby,

the sacrospinous ligament extends from the sacrum and coccyx to the

spine of the ischium. The sacrococcygeal joint is stabilized by several

ligaments, including the superficial dorsal sacrococcygeal ligament.

At the hip joint, strong ligaments reinforce the articular capsule that

encloses the head and much of the neck of the femur.




Knee joint, anterior view 3



73. Kne e joint, anterior view

a Femur

b Patella

c Fibular collateral ligament

(lateral collateral ligament)

d Lateral meniscus

e Lateral condyle of tibia

f Fibula

g Tibia

h Tibial collateral ligament

(medial collateral ligament)

i Medial condyle of tibia

j Medial meniscus

k Patellar ligament

The articulation between the femur and tibia at the knee joint performs

a simple hinge function, primarily facilitating flexion and extension of

the lower leg. However, a small amount of medial and lateral rotation

(10° and 3o° respectively) is also possible. The medial and lateralcondyles of the femur articulate with the medial and lateral condyles

of the tibia; the medial and lateral menisci are fibrocartilage pads

that cushion and separate the bones within the joint. The patella is

held in place anterior to the distal portion of the femur by the patellar

ligament distally and the quadriceps muscle tendon proximally; it not

only protects the knee joint but also provides increased leverage for

the quadriceps muscle during knee extension. The patella resides at

its most superior location during full extension of the knee, and moves

as much as 7 cm inferiorly during flexion, until it is located between

the distal ends of the femoral condyles. To the side, the knee joint is

stabilized by the tibial medial) collateral ligament and the fibular

lateral) collateral ligament.



KAPLAN MEDICAL

i

i

h


Bent knee joint, anterior view with patella removed 4 7



74. Bent knee joint, anterior view with patella removed

a Femur

b Articular cartilage

c Anterior cruciate ligament

d Lateral meniscus

e Lateral condyle of tibia

1 Fibula

g Tibia

h Tibial collateral ligament

i Medial condyle of tibia

j Medial meniscus

k Posterior cruciate ligament

With the knee bent and the patella removed, the interior of the synovial

joint is revealed. The articular cartilage protecting the articular

surface of the femur extends superiorly behind the position of the

patella, as part of the femoropatellar joint. The two femoral condyles

are separated from the two tibial condyles by the medial and lateral

menisci. These pads of fibrocartilage fill in the space between the

convex surface of the femoral condyle and the flatter surface of the

tibial condyle; they act as durable shock absorbers and contributeto both stability and lubrication in the joint. Ligaments stabilize the

joint; the anterior cruciate ligament (ACL) extends between the lateral

condyle of the femur posteriorly and the intercondylar region of the

tibia anteriorly; the posterior cruciate ligament (PCL) connects the

posterior intercondylar region of the tibia with the medial condyle of

the femur anteriorly. The ACL resists forces pushing the tibia forward,

while the PCL resists forces pushing the tibia posteriorly relative to the

femur. Excessive abduction or adduction motion at the knee joint is

limited by the fibular (lateral) and tibial medial) collateral ligaments.




Knee joint, sagittal section 5

h



75. Knee joint, sagittal section

a Femur . Lateral meniscus, anterior

b Lateral menniscus, orn

posterior horn . Infrapatellar fat pad

c Fibula Patella

d Tibia . Articular cartilage

e Patellar ligament

A sagittal section through the lateral condyles of the femur and tibia

reveals the anterior-posterior relationships of the fully-extended

knee joint. Articular cartilage covers the convex articular surface

of the femur and the flatter articular surface of the tibia. Between

the two articular cartilages lies the C-shaped lateral meniscus, with

posterior and anterior horns positioned to fill the area between the

curving articular surfaces. Popliteal ligaments strengthen the back

of the synovial articular capsule. The fibula articulates with the tibial

epicondyle laterally and posteriorly; a collateral ligament extends

from the fibula to the lateral epicondyle of the femur to strengthen the

joint. Anteriorly, the patella moves along the femoral articular surface

when the quadriceps muscle flexes the knee; the articular cartilage

of the patella is one of the thickest due to the intense stresses of this

movement. The quadriceps muscle tendon attaches on the superior

surface and is continuous with the inferior patellar ligament. The

infrapatellar fat pad absorbs shocks and fills in the space below and

behind the patella.



I


k

i

Ankle joint, posterior view 6

KAPLAN MEDICAL. ...



76. Ankle joint, posterior view

a Fibula

b Posterior tibiofibular

ligament

c Transverse tibiofibular

ligament

d Posterior talofibular

ligament

e Posterior talocalcaneal

ligament

f Calcaneofibular ligament

g Calcaneal (Achilles) tendon

h Calcaneus

i Medial talocalcaneal

ligament

I Talus

k Deltoid ligament,

tibiocalcaneal part

I Deltoid ligament, tibiotalar

part

m Tibia

The posterior view of the ankle joint shows several ligaments that

stabilize the articulations between the leg and ankle bones. The

largest tendon in the human body is the calcaneal tendon (also known

as the Achilles tendon) that connects three lower leg muscles—the

gastrocnemius, the soleus, and the plantaris—with their insertion on

the calcaneus, the largest of the tarsal bones. Above the ankle, the

distal articulation of the tibia and fibula are stabilized by the posteriorand transverse tibiofibular ligaments. Laterally, the ankle joint is

stabilized by connections between the lateral malleolus of the fibula

and the tarsal bones, including the talofibular and calcaneofibular

ligaments. On the medial side, the ankle is stabilized by ligaments

connecting the medial malleolus of the tibia with tarsal bones such as

the calcaneus and the talus, including the tibiocalcaneal and tibiotalar

parts of the deltoid ligament. Articulations between the tarsal bones

are also stabilized by ligaments, such as the medial and posterior

talocalcaneal ligaments connecting the talus and calcaneus.



c

d

e


Ankle joint, frontal section 7

KAPLAN MEDICAL



77. Ankle joint, frontal section

a Tibia

b Articular cartilage

c Medial malleolus of tibia

d Deltoid ligament, posterior

tibiotalar part

e Deltoid ligament,

tibiocalcaneal part

f Calcaneus

g Calcaneofibular ligament

h Lateral malleolus of fibula

i Talus

j Tibiofibular syndesmosis

k Fibula

A frontal section through the talus shows its articulations with the tibia,

fibula, and calcaneus. The talus rests on the calcaneus and supports

the tibia; the ankle is stabilized on either side by the lateral malleolus

of the fibula and the medial malleolus of the tibia. The articular sufaces

of all these bones are covered with articular cartilage. On the medial

side, the deltoid ligament attaches to the medial malleolus of the tibia

and parts of it connect to the tarsal bones in four places, including theposterior tibiotalar part (to the talus) and the tibiocalcaneal part (to

the calcaneus). Laterally, the fibula is connected to the calcaneus by

the calcanealfibular ligament. Further stability of the ankle is provided

by the sturdy connection between the tibia and fibula along much of

their shafts, the tibiofibular syndesmosis.



Superficial muscles of the body, anterior view



Superficial muscles of the body posterior view 9

KAPLA MEDICAL



79. Superficial muscles of the body, posterior view

a. Sternocleidomastoid . Soleus

b. Trapezius . Semitendinosus

c. Teres Major . Semimembranosus

d. Brachioradialis . Iliotibial tract

e. Extensor carpi radialis longus q . Gluteus maximus

f. Flexor carpi ulnaris . Gluteus medius

g. Extensor carpi ulnaris . Extensor digitorum

h. Gracilis . Extensor carpi radialis brevis

I Adductor magnus . External abdominal oblique

j. Biceps femoris . Latissimus dorsi

k. Gastrocnemius . Triceps

L Calcaneal tendon . Deltoid

More than 600 muscles carry out the actions of moving body parts;

in many cases, their names are descriptive regarding the location,

origin, insertion, action, shape, etc. Thus, the two trapezius muscles

together form a trapezoid shape between the neck, shoulders, and

thoracic vertebrae; they act to shrug the shoulders and to pull the

shoulder blades toward the vertebrae. The flexor carpi ulnaris and

extensor carpi u lnaris are two muscles that act to flex or extend

the wrist (carpus); they originate on the ulna. The triceps muscle isnamed because it has three heads that originate on either the scapula

or the humerus; the muscle has a single tendon that inserts on the

olecranon of the ulna so that it acts to extend the forearm. The gluteal

muscles in the butt are named for their size—the gluteus maximus

is larger than the gluteus medius or the deeper gluteus minimus.



M uscle forms : fusiform an d flat sheet 0

d

KAPLAN) MEDICAL



80. M uscle form s: fusiform an d f lat sheet

Fusiform: road, flat sheet:

a. Basic fusiform, Palm aris . Latissimus dorsi

longus

b. Bicipital, Biceps fem oris

c. Tricipital, Triceps surae

(gastrocnemius and soleus)

d. Quadriceps femoris

Fusiform muscles are wide in the middle and taper at both ends. The

patmaris longus is a slender, fusiform muscle that originates on

the humerus and ends in a long tendon that inserts on the palmar

fascia. A bicipital muscle has two heads or origins, as the biceps

femoris with the long head originating on the ischium and the shorthead on the femur; the muscle inserts at the knee and both heads

act to flex the knee. The triceps surae is a tricipital muscle with

three heads; this composite muscle consists of the gastrocnemius

with two heads originating on the femur and the soleus which

originates on the tibia; the triceps surae inserts on the calcaneus

and acts in plantar flexion of the foot. The quadriceps femoris is a

quadricipital muscle with four heads originating on the ilium and

femur; the muscle inserts on the patella and extends the knee. Other

muscles occur in broad, flat sheets, such as the latissimus dorsi

which is a triangular, flat muscle that originates along the thoracic

and lumbar vertebrae as well as the sacrum and ilium; it inserts on

the humerus and acts to extend, adduct and rotate the shoulder.



Muscle forms: pennate, circular, and multicaudal 1

a b c

d e

KAPLAN MEDICAL



81. Muscle forms: pennate, circular, and multicaudal

Pennate:

a. Unipennate,

semimembranosus

b. Bipennate, tibialis anterior

c. Multipennate, deltoid

Circular:

d. External sphincter

ani, deep portion

Multicaudal:

e. Flexor digitorum profundus

In pennate muscles, the contracting fibers attach to the tendon at an

oblique angle; they provide more stability and force, but the tendon

is not moved as far as when the fibers are parallel to the tendon. All

the muscle fibers are on the same side of the tendon in unipennate

muscles, such as the semimembranosus muscle which extends

between the ischium and the tibia. Bipennate muscles are more

common and have muscle fibers on both sides of the tendon, including

the tibialis anterior which is a shin muscle that flexes the foot. In

multipennate muscles, the fibers attach on both sides of the tendon,

and the tendon branches within the muscle; an example is the deltoid

muscle that forms the rounded shape of the shoulder. Circular, or

sphincter, muscles are arranged concentrically around an opening; a

good example is the deep portion of the external sphincter ani muscle

which closes off the anal canal at its orifice. Multicaudal musclesattach at multiple sites; the flexor digitorum profundus is a single

muscle that inserts on the phalanges of the four fingers to flex them.



S Y S T E M

Muscle forms: cylindrical, triangular, 2quadrilateral, biventral, multiventral

a

d

KAPLAN) MEDICAL



82. Muscle forms: cylindrical, triangular, quadrilateral,

biventral, m ultiven tral

a. Cylindrical teres major . Biventral, digastric

b. Triangular deltoid . Multiventral, rectus

c. Quadrilateral, pronator bdominis

quadratus

Named from the Latin word for round or cylindrical the teres major

muscle extends between the scapula and humerus; it adducts

and rotates the arm. The triangular deltoid muscle covers the

shoulder joint, extending from the clavicle and scapula to the

humerus; different parts of the muscle act to flex, extend or rotate

the humerus. The pronator quadratus muscle is a square, or

quadrilateral, muscle that extends between the ulna and radius at

their distal end; it acts to pronate the forearm. The digastric muscleconsists of two bellies with different origins that unite in a single

tendon that inserts on the hyoid bone; the longer, posterior belly

originates on the mastoid process of the temporal bone, while the

anterior belly arises on the mandible. The rectus abdominis muscle

has multiple insertions; it arises on the pubis bone and three

portions of the muscle insert on the fifth, sixth and seventh ribs.



M uscles of facial expression anterior view



83. Muscles of facial expression, anterior view

a. Frontalis . Levator anguli oris

b.Procerus . Orbicularis oris

c. Orbicularis oculi . Risorius

d. Levator labii superioris . Depressor anguli oris

alaeque nasi Platysma

e. Levator labii superioris . Depressor labii inferioris

f. Zygomaticus minor . Mentalis

g. Zygomaticus major

Facial expressions result from muscular contractions that move

the skin in particular facial regions. The frontalis muscle raises the

eyebrows and wrinkles the brow. The procerus muscle wrinkles the

skin at the top of the nose and flares the nostrils. The orbicularis

oculi muscle closes the eye. The upper lip can be made to snarl

by the levator [Ail superioris alaeque nasi muscle or to be raised

by the levator [Ail superioris muscle. The muscles known as

the zygomaticus minor and major, and levator anguli oris, draw

the corners of the mouth superiorly and are used in smiling. The

orbicularis oris is a sphincter muscle around the mouth that aids

in pursing the lips. The risorius muscle draws the corner of the

mouth laterally in a grimace and the depressor anguli oris muscledraws the corner of the mouth downwards in a frown. The depressor

labii inferioris muscle pulls the lower lip down, while the mentalis

muscle is involved in wrinkling the chin. The platysma draws

the corners of the mouth down in expression of fright as well as

drawing the skin of the neck upward when the teeth are clenched.



Muscles of facial expression, lateral view 4

KAPLAN) MEDICAL



84. Muscles of facial expression, lateral view

a. Frontalis part,

occipitofrontalis

b. Orbicularis oculi

c. Procerus

d. Nasalis

e Levator labii superioris

alaeque nasi

1. Levator labii superioris

g. Orbicularis oris

h. Depressor labii inferioris

i. Depressor anguli oris

j. Risorius

k. Platysma

1. Zygomaticus major

m . Zygomaticus minor

n. Zygomatic arch

Muscles controlling facial expression often originate on bones

and insert on the skin of the face. The frontalis portion of the

occipitofrontalis muscle covers the forehead from above the hairline

to the eyebrows. The orbicularis oculi muscle arises on the frontal

bone and circles the eye to the temple and the cheek. The procerusmuscle extends from the nasal bone to the skin of the medial

forehead, while the nasalis muscle extends from the maxilla to the

nasal bone and compresses the nasal cartilage. The levator labii

superioris alaeque nasi extends from the maxilla to the upper lip

and the levator labii superioris muscle arises on the margin of the



85. Superficial muscles of mastication, lateral view

a. Temporalis . Buccinator

b. Zygomatic arch Mandible

c. O rbicularis oris . Masseter

M astication, or chewing, involves the jaw open ing and closing,

accom plished by m uscles that m ove the m andible at the

tem perom andibular joint. The tem poralis m uscle originates on the

tem poral bone, passes m edial to the zygom atic arch and inserts

on the m andible on the anterior and m edial aspects of the coronoidprocess. T he m asseter m uscle arises on the zygom atic arch, passes

lateral to the broad surface of the m andible, and inserts along the

angle and lower part of the ramu s of the man dible. T he temp oralis

and m asseter both elevate and retract the m andible. T he buccinator

m uscle is a qu adrilateral facial m uscle located between the m axilla

and m andible. It inserts on the orbicularis oris m uscle and a cts to

flatten the cheek against the teeth, acting as an auxiliary m astication

m uscle holding the food betw een the teeth during m astication.



Deep muscles of mastication, lateral view 6

-

KAPLAN) MEDICAL



86. Deep muscles of mastication, lateral view

a. Buccinator muscle Zygomatic arch (cut)

b. Mandible . Lateral pterygoid musclec. Medial pterygoid muscle

The deep muscles of mastication are attached on the medial aspect

of the mandible. During mastication, the jaw is opened by action of

the lateral pterygoid muscle. The lateral pterygoid originates on the

sphenoid bone and inserts on the coronoid process of the mandible

and on the articular disc of the temperomandibular joint. The lateral

pterygoids act both to lower the mandible and to bring it forward.

Closing of the jaw during chewing involves elevation of the mandible

by actions of the masseter, temporalis, and medial pterygoid muscles.

The medial pterygoid has two heads, one originating on the sphenoid

bone and the other from the palatine bone. The muscle inserts on the

medial side of the ramus of the mandible to elevate it. The medial

pterygoid and masseter work together, respectively, on the medial and

lateral aspects of the mandible to raise it. Both the medial and lateral

pterygoid muscles can also act to move the mandible side-to-side.



M uscles of the neck anterior view 7

KAPLAN MEDIC L



87. Muscles of the neck, anterior view

a. Hyoid bone

b. Superior belly of omohyoid

muscle

c. Inferior belly of om ohyoid

muscle

d. Scapula

e. Manubrium of sternum

f. Clavicle

g. Sternocleidomastoid muscle

h. Sternohyoid muscle

i. Mastoid process of temporal

bone

Muscles in the neck control the position of the larynx, contribute

to mastication and respiration, and support activities of the tongueand pharynx. The inferior belly of the omohyoid muscle arises on

the scapula, runs parallel to the clavicle while being held in position

by connective tissue, and the tendon then turns superiorly where it

becomes the superior belly. The superior belly of the omohyoid inserts

on the hyoid bone and acts to depress the larynx. The stemohyoid

muscle also acts to depress the larynx; it originates on the manubriumof the sternum and inserts on the hyoid. The two heads of the

stemocleidomastoid muscle arise on the sternum and clavicle and

manubrium of the sternum; the muscle inserts on the mastoid process

of the temporal bone. Acting separately, the sternocleidomastoids

on each side rotate the head; acting together, they flex the neck

and assist in respiration along with the scalene muscles.



88uprahyoid and infrahyoid m usclesof the nec k anterior view

KAPLA MEDICAL••



88. Suprahyoid and infrahyoid muscles of the neck,

anterior v iew

a. Mylohyoid muscle . Sternohyoid muscleb. Mastoid process of temporal . Superior belly of omohyoid

bone uscle

c. Thyroid cartilage . Stylohyoid

d. Sternothyroid muscle . Posterior belly of digastric

e. Scapula uscle

1 Sternum Mandibleg. Inferior belly of omohyoid . Anterior belly of digastric

muscle uscle

Suprahyoid muscles are located above (superior to) the hyoid bone.

The mylohyoid muscle is flat and triangular; it arises along the

mandible and inserts on the hyoid bone. The mylohyoid forms the floor

of the oral cavity and acts to raise the hyoid and lower the mandible.

The digastric muscle opens the jaw (when the masseter and temporalis

are relaxed); it inserts on the hyoid bone; the posterior belly originates

on the mastoid process of the temporal bone, the anterior belly arises

on the mandible. The stylohyoid muscle arises on the styloid process

of the temporal bone, inserts on the hyoid bone and acts to elevate

the larynx and aid in swallowing. The infrahyoid muscles include the

omohyoid, stemohyoid, and stemothyroid, all of which insert on the

hyoid and depress the larynx. The sternothyroid muscle arises on the

posterior aspect of the sternum and inserts on the thyroid cartilage.



Prevertebral region and root of the neck 9anterior view

KAPLAN) MEDICAL



89. Pr evertebr al region an d root of the n eck an terior view

a. Rectus capitis lateralis

muscle

b. Longus capitis muscle

c. Longus colli muscle

d. Levator scapulae muscle

e. Left rib

1 Second rib

g. Scapula

h. Sternum

i. Right rib

j. Posterior scalene muscle

k. Middle scalene muscle

1 Anterior scalene muscle

m . Carotid tubercle of sixth

cervical vertebra

n. Transverse process of atlas

o. Rectus capitis anterior muscle

The scalene muscles of the neck arise on the transverse processes

of the cervical vertebrae and insert on the first two ribs; they act to

rotate the neck and to assist in respiration. The anterior scalene

muscle originates on C3-6 and inserts on the first rib; the middle

scalene originates on C2-7 and also inserts on the first rib. The

posterior scalene muscle arises on C4-6 and inserts on the second

rib. The neck is flexed at the joint between the atlas and the occipital

bone by several muscles that arise on the vertebrae and insert

on the occipital bone. The longus capitus muscle arises from the

transverse processes of C3-6, and inserts on the occipital bone toflex the neck. The small rectus capitis anterior and lateralis muscles

both originate on the atlas Ci) and insert on the occipital bone to

flex the atlanto-occipital joint. The longus colli muscle originates

both on the transverse processes of C3-7 and the vertebral body

ofTi-3, inserts on C1-4, and acts to flex and rotate the neck. The

levator scapulae muscle arises on C1-4 and inserts on the scapula

to either raise the scapula or incline the neck toward that side.



Muscles of the neck, lateral view 90

KAPLAN)MEDICAL



90. Muscles of the neck, lateral view

a. Hyoid bone

b. Superior belly of omohyoidmuscle

c. Sternothyroid muscle

d. Sternocleidomastoid muscle

e. Inferior belly of om ohyoid

muscle

1 Clavicle

g. First rib

h. Sternum

I Occipital bone

j. Trapezius muscle

k. Levator scapulae muscle

I Middle scalene muscle

m . Anterior scalene muscle

n. Scapula

The trapezius is a broad, superficial muscle that originates along

the dorsal midline, from the occipital bone, ligaments along the

cervical vertebrae, or thoracic vertebrae. The muscle inserts on the

acromion process and spine of the scapula as well as part of the

clavicle. Its actions may include extension of the neck, elevation of

the clavicle, or a variety of movements of the scapula. The levator

scapulae extends between the cervical vertebrae and the scapula;

it also elevates the scapula. The stemocleidomastoid muscle

extends from the sternum and clavicle to the temporal bone and

acts to flex or rotate the neck. The omohyoid and stemothyroid

muscles arise on the scapula or sternum, respectively, and act

to depress both the hyoid bone and the larynx. The anterior andmiddle scalene muscles originate on the cervical vertebrae and

insert on the first rib; they rotate the neck and aid in respiration.



91eck, transverse section




91. Neck, transverse section

a. Sternocleidomastoid muscle . Body of C5 vertebrab. Anterior scalene muscle . Sternothyroid muscle

c. Middle scalene muscle . Sternohyoid muscle

d. Posterior scalene muscle . Thyroid cartilage

e. Levator scapulae muscle Pharynx

1 Trapezius muscle . Platysma

g. Spinal cord

A transverse section of the neck shows the central spinal cord lying

posterior to the body of the C5 vertebra, and the anterior pharynx

lying behind the larynx and its thyroid cartilage. The superficial

platysma is the most anterior of the muscles; lying between it and the

thyroid cartilage are the stemothyroid and stemohyoid muscles that

depress the larynx. Anteriolaterally, the stemocleidomastoid muscle

extends from the sternum and clavicle to the mastoid process. Deep

to this, the anterior, m iddle, and p osterior scalene m uscles extend

from the cervical vertebrae to the first or second rib and act to flex the

neck. Alongside the scalene m uscles, the levator scapu lae m uscle

acts to lift the scapu la or bend the neck . O n the posterior aspect

of the neck , the broad, flat trapezius m uscle is m ost superficial.



Lateral view

Superior view

i


Ocular muscles, lateral view and superior view 2



92 Ocular muscles, lateral view and superior view

a. Lateral rectus muscle . Inferior oblique muscle

b. Superior rectus muscle . Inferior rectus muscle

c. Levator palpebrae superioris . Optic nerve

muscle Medial rectus muscle

d. Superior oblique muscle . Optic chiasma

The extrinsic eye muscles work together to produce movements of

the eyeball. Four rectus muscles originate on the sphenoid bone

near the optic nerve, and insert on the surface of the eyeball. They

are the superior rectus muscle to move the eyeball to look up, the

inferior rectus muscle to move the eyeball to look down, the medial

rectus muscle to rotate the eyeball medially, and the lateral rectus

muscle to rotate the eyeball laterally. The superior oblique muscle

primarily rotates the eye medially, while the inferior oblique laterally

rotates it; in addition, actions of the oblique muscles include

depression and abduction, or elevation and abduction, respectively.

The levator palpabrae superioris muscle extends from the sphenoid

bone to the eyelid and acts to elevate and retract the eyelid.



Intrinsic muscles of the tongue, sagittal section 3

KAPLAMEDICAL--.



93. Intrinsic muscles of the tongue, sagittal section

a. Superior longitudinal muscle Hyoid bone

of tongue . M ylohyoid m uscleb. Transverse lingual muscle . Geniohyoid muscle

c. Lingual tonsil; root of tongue . Genioglossus muscle

d. Cartilage of epiglottis Mandible

e. Thyroid cartilage

The intrinsic muscles of the tongue are those that lie entirely withinthe tongue and act to alter the shape of the tongue for swallowing and

talking. The superior longitudinal muscle lies just under the mucous

membrane and runs from the root to the tip of the tongue and acts

to shorten the upper surface of the tongue. The transverse lingual

muscle arises along the lingual septum and inserts on the mucous

membranes at the lateral margins of the tongue. At the posterior end

of the tongue are lingual tonsils, masses of lymphatic tissue; the

epiglottis lies at the opening to the pharynx. The floor of the oral cavity

is formed by the mylohyoid muscle extending between the mandible

and the hyoid bone; the geniohyoid muscle arises at the center of the

mandible and inserts on the hyoid. The genioglossus muscle arises on

the mandible and acts to protrude the tongue and depress its center.



Extrinsic muscles of the tongue, pharynx and

larynx, lateral view



Pha rynx pos terior view 5

KAPLA) MEDICAL



Superficial shoulder muscles, anterior view



S Y S T E M

Muscles of the shoulder, scapula and arm, 7anterior view

CAPLAN) MEDICAL



Deep m uscles of the shou lder and arm anterior view 8



M uscles w ith scapu lar attachm ents posterior view

I APLA) MEDICAL....



Muscles with scapular attachments, posterior view 9

KAPLA) MEDICAL



Deep muscles of the back posterior view 1

KAPLAN MEDIC L



Anterior brachial muscles (flexors), lateral view



Posterior brachial muscles (extensors), lateral view 03

KAPLAii) MEDICAL..



104uperficial flexor muscles

f the forearm, anterior view

KAPLAN) MEDICAL



Superficial extensor muscles of the forearm, 05lateral view hand pronated)

ICAl...._1 1 MEDICAL



Deep flexor muscles of the forearm, anterior view 06

KAPLAJ) MEDICAL



Deep extensor muscles of the forearm, 07posterior view

I(APLAN MEDICAL



Muscles of the hand, posterior dorsal) view 9

I_ NMEDCL



uscles of the hand, anterior palmar) view 1

KAPLA MEDIC L



Intercostal muscles, anterior view 11

KAPLAN) MEDICAL. ...



Diaphragm anterior view 12

K PL MEDIC L



Superficial abdominal muscles, anterior view 14

KAPLAI I MEDICAL



Dee p abdo m inal m uscles anterior view 5

KAPLAN) MEDICAL....



Posterior abdominal wall muscles, anterior view 16

KAPLAN) MEDICAL



b

Pelvic diaphragm, superior view 17

KAPLAts) MEDICAL



Perineal muscles, inferior view 1 8

Male

h

KAPLAN) MEDICAL



Urogenital diaphragm, inferior view 19

CAPLAN) MEDICAL



ower limb muscles, anterior view 20

KAPLAMEDICAL



Muscles of the lower limb, posterior view



Superficial femoral muscles, anterior view



Deep femoral muscles, anterior view



Medial femoral muscles, medial view



g

Lateral femoral muscles, lateral view 25

KAPLAN) MEDICAL



k

Gluteal muscles, posterior view 26

KAPLAINI) MEDICAL



g

Posterior femo ral m uscles posterior view 27

KAPLAN) MEDICAL



Posterior thigh and gluteal muscles,

deep dissection, posterior view

128

KAPLAN) MEDICAL



M uscles of the anterior com partmen t 30of the leg anterior view

KAPLAN) MEDICAL.....



g

f

Muscles of the lateral compartment of the leg, 31lateral view

KAPLAls MEDICAL



c

g

e

Muscles of the superficial posterior 33compartment of the leg, posterior view

KAPLA) MEDICAL



Muscles of the deep posterior 34compartment of the leg, posterior view

KAPLA) MEDICAL



Plantar muscles of the foot, third layer



71. Hip joint, frontal section

a. C oxal bone . Z ona orbicularis of capsule

b. Articular cartilage . Articular capsule

c. Acetabular labrum Femur

T he hip joint is a sturdy syn ovial joint (ball and so cket joint) betw een

the globular head of the fem ur and the cu p•like acetabulum of the

coxal bone. A thin layer of articular cartilage covers both bone su rfaces

to reduc e friction. A fibrocartilage lip called the acetabular labrum

extends the edge of the acetabulum to increase its depth; it is locatedslightly beyond the widest diam eter of the femora l head to hold it

firm ly in place. The articular capsule is strong and dense; it com pletely

encloses the head and neck of the fem ur, and extends beyond the

edge of the acetabulum . The capsu le includes longitudinal bands of

fibers that stretch between the hip bone an d the fem ur to strengthen

the joint; the zona orbicularis of the capsule includes deep circular

fibers that form a collar to hold the head o f the femur tightly in the

socket. The joint perm its a range of m ovem ents: flexion an d extension,

addu ction and a bduction, circum duction and rotation.



72. Pelvic ligaments, posterior view

a. Iliac crest

b. Posterior superior iliac spine

c. Iliolumbar ligament

d. Fifth lumbar vertebra

e Supraspinous ligament

f. Short dorsal sacroiliac

ligaments

g Long dorsal sacroiliac

ligament

h.

I

Ik.

I.

Femur

Sacrospinous ligament

Superficial dorsal

sacrococcygeal ligament

Sacrotuberous ligament

Articular capsule of the

hip joint

Strong ligaments are necessary to stabilize the pelvis. The

supraspinous ligament that runs along the edges of the vertebral

dorsal spinous processes continues along the median sacral crest. In

addition, the iliolumbar ligament connects the fifth lumbar vertebra

both to the sacrum and the iliac crest. The sacroiliac joint is stabilized

by the horizontal short dorsal sacroiliac ligament between the sacrum

and the tuberosity of the ilium and by the oblique long dorsal sacroiliac

ligament connecting the sacrum to the posterior superior iliac spine.

The sacrotuberous ligament is connected at one end to the posterior

inferior iliac spine, the lower part of the sacrum, and the coccyx; the

other end attaches to the tuberosity and ramus of the ischium. Nearby,

the sacrospinous ligament extends from the sacrum and coccyx to the

spine of the ischium. The sacrococcygeal joint is stabilized by several

ligaments, including the superficial dorsal sacrococcygeal ligament.

At the hip joint, strong ligaments reinforce the articular capsule that

encloses the head and much of the neck of the femur.



74. Bent knee joint, anterior view with patella removed

a. Femur

b. Articular cartilage

c. Anterior cruciate ligament

d. Lateral meniscus

e. Lateral condyle of tibia

1 Fibula

g. Tibia

h. Tibial collateral ligament

I. Medial condyle of tibia

j. Medial meniscus

k. Posterior cruciate ligament

With the knee bent and the patella removed, the interior of the synovial

joint is revealed. The articular cartilage protecting the articular

surface of the femur extends superiorly behind the position of the

patella, as part of the femoropatellar joint. The two femoral condyles

are separated from the two tibial condyles by the medial and lateral

menisci. These pads of fibrocartilage fill in the space between the

convex surface of the femoral condyle and the flatter surface of the

tibial condyle; they act as durable shock absorbers and contributeto both stability and lubrication in the joint. Ligaments stabilize the

joint; the anterior cruciate ligament (ACL) extends between the lateral

condyle of the femur posteriorly and the intercondylar region of the

tibia anteriorly; the posterior cruciate ligament (PCL) connects the

posterior intercondylar region of the tibia with the medial condyle of

the femur anteriorly. The ACL resists forces pushing the tibia forward

while the PCL resists forces pushing the tibia posteriorly relative to the

femur. Excessive abduction or adduction motion at the knee joint is

limited by the fibular (lateral) and tibial (medial) collateral ligaments.



75. Knee joint, sagittal section

a. Femur . L ateral m eniscus, anterior

b. L ateral m enniscus, orn

posterior horn . Infrapatellar fat pad

c. Fibula . Patella

d. Tibia . Articular cartilage

e. Patellar ligament

A sagittal section through the lateral condyles of the fem ur an d tibia

reveals the anterior-posterior relationships of the fully-extendedknee joint. Articular cartilage covers the con vex articular surfac e

of the fem ur and the flatter articular sur face of the tibia. Between

the two articular cartilages lies the C -shaped lateral m eniscus, with

posterior and anterior horns positioned to fill the area between the

curving articular surfaces. Popliteal ligam ents strengthen the back

of the syn ovial articular capsu le. T he fibula articulates with the tibialepicondyle laterally a nd posteriorly; a collateral ligam ent extends

from the fibula to the lateral epicond yle of the femu r to strengthen the

joint. An teriorly, the patella m oves along the fem oral articular surface

when the qua driceps m uscle flexes the knee; the articular cartilage

of the pa tella is one o f the thickest du e to the intense stresses of this

m ovem ent. The q uadriceps mu scle tendon attaches on the superior

surface and is continuous w ith the inferior patellar ligam ent. The

infrapatellar fat pad absorbs shock s and fills in the space below and

behind the pa tella.



76. Ankle joint, posterior view

a. Fibula . Calcaneal (Achilles) tendon

b. Posterior tibiofibular Calcaneus

ligament . Medial talocalcaneal

c. Transverse tibiofibular igament

ligament . Talus

d. Posterior talofibular . Deltoid ligament,

ligament ibiocalcaneal part

e. Posterior talocalcaneal . Deltoid ligament, tibiotalar

ligament art

f. Calcaneofibular ligament . Tibia

The posterior view of the ankle joint shows several ligaments that

stabilize the articulations between the leg and ankle bones. The

largest tendon in the human body is the calcaneal tendon also known

as the Achilles tendon) that connects three lower leg muscles—thegastrocnemius, the soleus, and the plantaris—with their insertion on

the calcaneus, the largest of the tarsal bones. Above the ankle, the

distal articulation of the tibia and fibula are stabilized by the posterior

and transverse tibiofibular ligaments. Laterally, the ankle joint is

stabilized by connections between the lateral malleolus of the fibula

and the tarsal bones, including the talofibular and calcaneofibularligaments. On the medial side, the ankle is stabilized by ligaments

connecting the medial malleolus of the tibia with tarsal bones such as

the calcaneus and the talus, including the tibiocalcaneal and tibiotalar

parts of the deltoid ligament. Articulations between the tarsal bones

are also stabilized by ligaments, such as the medial and posterior

talocalcaneal ligaments connecting the talus and calcaneus.



104. Superficial flexor muscles of the forearm, anterior view

a

b.

c.

d.

e

1

Palmaris longus muscle

Humerus

Flexor carpi radialis muscle

Pronator teres muscle

Flexor carpi ulnaris muscle

Flexor digitorum superficialis

muscle

g.

h.

I.

J.

k.

l.

m .

Radius

Ulna

Second metacarpal bone

Pisiform bone

Hamate bone

Fifth metacarpal bone

Middle phalanx

The palmaris longus muscle arises on the medial epicondyle of the

humerus and flexes the wrist by inserting on the palm and a band

of connective tissue in the wrist called the flexor retinaculum. The

flexor carpi radialis muscle arises on the medial epicondyle of the

humerus, inserts at the base of the second and third metacarpal

bones, and both flexes and abducts the wrist. The flexor carpi

ulnaris muscle originates on the medial epicondyle of the humerusas well as adjacent parts of the ulna; it inserts on the pisiform and

hamate carpal bones, and on the fifth metacarpal bone. The flexor

carpi ulnaris both flexes and adducts the wrist. The flexor digitorum

superficialis muscle arises on the medial epicondyle of the humerus

as well as adjacent surfaces of the ulna and radius; it inserts on the

middle phalanges of fingers 2-5 by long tendons and acts to flex thefingers at the joints between the metacarpals and proximal phalanges

as well as the joint between the proximal and middle phalanges.

The pronator teres muscle arises on the medial epicondyle of the

humerus as well as the coronoid process of the ulna, inserts on the

lateral, distal surface of the radius, and pronates the forearm.



105 Su pe rficial exten sor m us cles of the forearm , lateralv iew hand pronated)

a. Lateral epicondyle of . Distal phalanx

humerus . Second metacarpal bone

b. Ulna . Radius

c. Extensor digitorum muscle . Extensor carpi radialis brevis

d. Extensor carpi ulnaris uscle

muscle. Extensor carpi radialis

e. Extensor digiti minimi ongus muscle

muscle . Brachioradialis muscle

f. Extensor expansion

The brachioradialis muscle arises on the ridge above the lateral

epicondyle of the humerus, inserts on the lateral, distal part of

the radius and flexes the forearm at the elbow. The extensor carpi

radialis brevis and extensor carpi radialis longus muscles flex the

wrist; the brevis originates on the ridge above the lateral epicondyle

of the humerus and inserts at the base of the second metacarpal

bone, the longus arises on the lateral epicondyle of the humerus,

inserts at the base of the third metacarpal, and abducts as well as

extends the wrist. The extensor carpi ulnaris muscle arises on boththe lateral epicondyle of the humerus and adjacent surfaces of the

ulna, inserts at the base of the fifth metacarpal, and both extends

and adducts the wrist. The extensor digitorum muscle arises on

the lateral epicondyle of the humerus and its tendons insert on the

phalanges of fingers 2-5; it extends those four fingers as well as

extending the wrist. The extensor digiti minimi muscle arises by

tendon from the lateral epicondyle of the humerus, inserts on the

extensor expansion of finger 5 and extends that finger at all joints.



107. Deep extensor muscles of th e forearm, posterior view

a. Ulna

b. Extensor pollicis longus

muscle

c. Extensor indicis muscle

d. Extensor expansion of index

finger

e. Distal phalanx

1 Radius

g. Extensor pollicis brevis

muscle

h. Abductor pollicis longus

muscle

I. Supinator muscle

The relative positions of the radius and ulna control hand position;in the supine position, the palm of the hand faces forward. The

supinator muscle arises on the lateral epicondyle of the humerus and

adjacent parts of the ulna, passes dorsal to the radius and inserts

on its lateral surface; it works in supination along with the biceps

brachii. The abductor pollicis longus muscle arises on the posterior

surfaces of the radius and ulna, inserts on the first metacarpal andtrapezium bones, and acts to abduct and extend the thumb. The

extensor pollicis longus muscle originates on the ulna, inserts

on the distal phalanx of the thumb, and extends the thumb. The

extensor pollicis brevis muscle arises on the radius, inserts on

the proximal phalanx of the thumb and extends the thumb. The

extensor indicis muscle arises on the ulna, inserts on the extensor

expansion of the second metacarpal and extends the index finger.



108. Trans verse sect ions of the arm

a. Biceps brachii muscle

b. Brachialis muscle

c. Humerus

d. Triceps muscle, lateral head

e. Triceps muscle, long headf. Triceps muscle, medial head

g. Tendons of flexor digitorum

superficialis muscle

h. Tendon of flexor carpi radialis

muscle

i. Tendon of flexor pollicis

longus muscle

j. Tendon of abductor pollicis

longus muscle

k. Tendon of extensor pollicis

brevis muscle

m. Tendon of extensor carpi

radialis longus muscle

n. Tendon of extensor carpi

radialis brevis muscle

o. Tendon of extensor pollicis

longus muscle

p. Tendons of extensor

digitorum muscle

q. Tendon of extensor digiti

minimi muscle

r. Tendon of extensor carpi

ulnaris muscle

s. Ulna

t. Pronator quadratus muscle

u. Tendon of flexor carpi ulnaris

muscle

v. Tendons of flexor digitorum



109. M usc les of the han d, po ster ior do rsal ) v iew

a. Insertion of lateral slips of

extensor digitorum muscleand interosseous and

lumbrical muscles

b. Third interosseous muscle

c. Tendons of extensor digiti

minimi muscle

d. Tendon of extensor carpiulnaris muscle

e. Extensor retinaculum

f. Tendon of extensor carpi

radialis brevis muscle

g. Tendon of extensor carpi

radialis longus muscleh. Tendon of extensor indicis

muscle

I. Tendons of extensor

digitorum muscle

j. First interosseous muscle

k. Extensor expansionL Insertion of central slip of

extensor digitorum muscle

The extensor retinaculum is a wide band of connective tissue along

the wrist; it holds tendons in place as they extend from muscles in

the forearm to their insertion points in the hand. Each of the four

tendons of the extensor digitorum muscle spreads out across the

joint at the base of the proximal phalanx to form a broad hood called

the extensor expansion, continues along the proximal phalanx, then

splits to form a central slip that inserts on the middle phalanx and

two lateral slips that pass along the side of the first interphalangealjoint. The two lateral slips rejoin and insert on the distal phalanx

along with tendons from the interosseous and lumbrical muscles.

The tendons of the extensor indicis and extensor digiti minimi

muscles parallel those of the extensor digitorum to insert on the

second and fifth finger, respectively. The tendons of the extensor

carpi radialis longus, extensor carpi radialis brevis, and extensor

carpi ulnaris insert on the base of the second, third, and fifth

metacarpals, respectively. Interosseous muscles are bipennate

muscles that originate along the sides of the metacarpals and

insert on the extensor expansions, acting to abduct the fingers.



110. Muscles of the hand, anterior (palmar) view

a. Tendons of flexor digitorum

profundus muscleb. Tendons of flexor digitorum

superficialis muscle

c. First and second lumbrical

muscles

d. Proximal phalanx

e. Adductor pollicis muscle1 Flexor pollicis brevis muscle

g. Abductor pollicis brevis

muscle

h . Flexor retinaculum

I. Pisiform boneI. Abductor digiti minimi muscle

k. Flexor digiti minimi brevis

muscle

1 Opponens digiti minimi

muscle

m. Fourth and fifth lumbricalmuscles

n. Proximal phalanx

The tendons of the flexor digitorum superficialis muscle are stabilized

at the wrist as they pass under the flexor retinaculum, and insert

on the middle phalanges. The tendons of the flexor digitorum

profundus muscle are deeper at the wrist and palm, but pass

through the superficial tendons to insert on the distal phalanx. On

the lateral (thumb) side of the hand, the adductor pollicis, flexor

pollicis brevis and abductor pollicis brevis muscles insert on the

proximal phalanx of the thumb to control its movements. On the

medial side of the hand, the abductor digiti minimi and flexor digiti

minimi muscles arise on the pisiform and hamate bones respectively,

insert on the proximal phalanx, and act to abduct or flex the little

finger. The opponens digit minimi muscle acts to bring the little

finger in opposition with the thumb. Four wormlike lumbrical muscles

extend between the tendons of the flexor digitorum profundus

and the extensor expansions (dorsal) to simultaneously flex themetacarpophalangeal joints and extend the interphalangeal joints.



111. Intercostal muscles, anterior view

a. External intercostal muscle . Costal cartilage

b. First rib . Internal intercostal muscle

c. First thoracic vertebra

Respiration involves changes in pressure within the thoracic cavity

due to movements of the ribs and diaphragm that change the

volume of the cavity. The intercostal muscles extend between the

ribs and function in the respiratory movements of the ribs. Eleven

external intercostal muscles on each side arise from the inferiorborder of ribs 1-11 and act to lift the rib during inspiration. The

external intercostals pass obliquely forward and down to insert

on the next lower rib, ranging from the tubercles posteriorly to the

end of the ribs anteriorly, except that the lower two extend to the

costal cartilage and th e upper two don t quite reach th e end of the

rib. Eleven internal intercostal muscles on each side originate at

th e costal groove on th e interior, inferior surface of ribs 1-11, pass

obliquely down and laterally to insert on the superior margin of th e

next lower rib. Th ey bring th e ribs closer together during exh alation.



112. D iaph ragm , an ter io r v iew

a. Xiphoid process . Medial arcuate ligament

b. Esophageal hiatus . Left crus of diaphragm

c. Diaphragm . Right crus of diaphragm

d. Aortic hiatus . Third lumbar vertebra

The diaphragm is a broad, thin dome-shaped muscle that separates

the thoracic cavity from the abdominal cavity. The muscle originates

laterally and anteriorly around the inferior margin of the rib cage

and costal cartilages, as well as the posterior aspect of the xiphoid

process of the sternum. Posteriorly, the diaphragm arises from the

medial arcuate ligament, allowing the psoas major muscle to pass

vertically along the body wall. Muscular fibers of the right crus of the

diaphragm arise on vertebrae I.1-3, while the left crus arises on 11-2;

the median arcuate ligament unites the two crura and passes over the

aortic hiatus. Openings in the diaphragm allow important structuresto be continuous between the two cavities; these openings include

the esophageal hiatus and the aortic hiatus. The diaphragm plays

an important role in respiration; contraction of the muscle causes

the "dome" to move inferiorly, expanding the thoracic cavity and

triggering inhalation by reducing intrathoracic pressure. Relaxation

of the diaphragm allows it to return to a convex shape that makes

the thoracic cavity smaller; elasticity of the lungs then expels air.



113. Diaphragm, inferior view

a Costal cartilage . Lateral arcuate ligament and

b. Esophageal hiatus welfth rib

c. Aortic h iatus . Medial arcuate ligament

d. Diaphragm . Vena caval foramen

e First lumbar vertebra . Central tendon of diaphragm

Muscle fibers of the diaphragm arise from the medial arcuate ligament

attached to the transverse process of vertebra Li, the lateral arcuate

ligament along the twelfth rib, the interior surface of the anterior and

lateral parts of the inferior ribs and costal cartilage, and the posterior

surface of the sternum at the xiphoid process. Anterior to the lumbar

vertebrae, muscle fibers of the right and left crura arise and pass

to either side of the aortic hiatus, an opening behind the fibers of

the diaphragm that allows passage of the abdominal aorta from thethoracic cavity to the abdomen. Other openings in the diaphragm

include the esophageal hiatus for passage of the esophagus toward

the stomach, and the vena caval foramen that allows the posterior

vena cava to return toward the heart. The muscle fibers of the

diaphragm converge on the central tendon, which has no skeletal

attachment, but is fused on its superior surface with the pericardium.



114. Superficial abdom inal muscles, anterior view

a Sternum

b. Cut edge of aponeurosis,external abdominal oblique

muscle

c. Aponeurosis, internal

abdominal oblique muscle

d. Internal abdominal oblique

musclee Inguinal ligament

f. Pubic tubercle

g Symphysis pubis

h . Spermatic cord

I. Umbilicus

I. External abdominal oblique

muscle

k. Aponeurosis, external

abdominal oblique muscle

L Fifth rib

The external abdominal oblique muscle is the most superficial of

the muscles in the torso wall. It is a broad, flat muscle that arises

on the anterior angles of the inferior eight ribs and inserts on the

pubic tubercle, the inguinal ligament, and the iliac crest. Thefibers of the broad, flat internal abdominal oblique muscle run

perpendicular and deep to the fibers of the external abdominal

oblique. The internal abdominal oblique arises on the fascia of the

lower back, the iliac crest and the inguinal ligament and inserts

on the inferior border of the lower three ribs and on the linea alba.

Both abdominal oblique muscles end in broad aponeuroses that

together form the anterior wall of the abdomen. Near the inguinal

ligament, a triangular hole in the aponeurosis provides for passage

of the spermatic cord (in males) or the round ligament of the uterus

(in females). Acting together, the two abdominal oblique muscles

on each side compress the abdomen, aiding in breathing and

defecation, or flex the trunk. Acting separately, they rotate the trunk.



115. Deep abdominal muscles, anterior view

a. Sternum

b. Fifth rib

c. Tendinous intersection

d. Rectus abdominis muscle

e. Arcuate line

1 Symphysis pubis

g. Aponeurosis of transversus

abdominis muscle

h. Iliac crest

i. Transversus abdominis

muscle

j. Umbilicus

k. Cut edges of rectus

abdominis muscle

The transversus abdominis muscle lies deep to the internal and

external abdominal oblique muscles and works with them to compress

the abdomen. The transversus abdominis originates on the iliac

crest, the inguinal ligament and the costal cartilage of ribs 7-12. The

aponeurosis of the transversus abdominis inserts on the linea alba.

The rectus abdominis muscle extends vertically along either side ofthe linea alba, and acts to depress the ribs, flex the spine and stabilize

the pelvis during walking. It originates along the symphysis pubis and

inserts on the costal cartilages of ribs 5 and the xiphoid process of

the sternum. Inferior to the arcuate line, the aponeurosis of the other

abdominal muscles is superior to the rectus abdominus; superficial to

the arcuate line, parts of the aponeurosis lie both superficial and deep

to the rectus abdominis, forming a sheath that encloses the muscle. At

several tendinous intersections, the rectus abdominis muscle is firmly

attached to the part of the sheath that stretches anterior to the muscle.



116. Posterior abdominal wall muscles, anterior view

a. Diaphragm . Iliacus muscle

b. Lateral arcuate ligament . Iliolumbar ligament

c. Quadratus lumborum muscle i. Umbilicus

d. Lumbar vertebrae . Psoas major muscle

e. Iliac crest . Medial arcuate ligament

1. Femur

The quadratus lumborum muscle arises from the iliac crest and the

iliolumbar ligament, which extends between the transverse processes

of the 5th lumbar vertebra and the iliac crest. The quadratus lumborum

passes under the edge of the diaphragm at the lateral arcuate

ligament and inserts on the lowest rib and the transverse processes

of lumbar vertebrae 1-4; together, the two quadratus lumborum

muscles act to depress the rib cage and individually each flexes thespine laterally. The psoas major muscle originates on the transverse

processes and bodies of the lumbar vertebrae, passes under the

edge of the diaphragm at the medial arcuate ligament, and inserts on

the lesser trochanter of the femur. The iliacus muscle arises on the

concave superior surface of the ala of the ilium, and its fibers join the

tendon of the psoas major to insert on the lesser trochanter of thefemur. The psoas major and the iliacus are part of a group of muscles

known as hip flexors—they flex the hip and laterally rotate the thigh.



117. Pelvic diaphragm, superior view

a. Coccyx . Symphysis pubis

b. C occygeus muscle . H iatus of urethra

c. Anal canal . Obturator internus m uscle,

d. Levator ani muscle, nd overlying obturator fascia

iliococcygeus . Tendinous arch for origin of

e. Levator ani muscle, evator ani muscle

pubococcygeus

f. Levator ani muscle,

puborectalis

L ooking down on th e pelvis from th e abdomen, one can see th e pelvic

diaph ragm th at separates th e pelvic cavity from th e perineal region

and supports the pelvic viscera including bladder and intestines.

T h e coccygeus muscle arises on th e spine of th e isch ium and th esacrospinous ligament, and widens to insert along th e coccyx. Th e

levator ani m uscle consists of th ree parts: th e iliococcygeus extends

from th e isch ial spine and adjacent tendinous arch of th e pelvic

fascia to the coccyx; th e pubococcygeus stretches from th e pubic

bone to the coccyx and surrounds th e urethra; and th e puborectalis

arises from th e symp h ysis pubis, surrounds th e anal canal andmeets with corresponding fibers from th e opposite side to support

th e rectum. Th e obturator intemus muscle is covered by an overlying

fascia; th e muscle originates on th e fascia as well as th e adjacent

margins of the pubis and isch ium. T h e obturator internus inserts on

th e greater troch anter of th e femur and rotates th e th igh laterally.



118. Perinea( muscles, inferior view

a. Coccyx

b. Anococcygeal ligamentc. Levator ani muscle

d. Ischia' tuberosity

e. Ischiocavernosus muscle

f. Bulbocavernosus

(bulbospongiosus) muscle

g. Central tendinous point ofperineum

h. Inferior fascia urogenital

diaphragm

i. Superficial transverse

perinea( muscle

I External anal sphincter

muscle

k. Urogenital hiatus

The levator an muscle extends from the surface of the lower pelvis to

the coccyx and the midline; those fibers anterior to the coccyx join with

the fibers from the opposite side to form the anococcygeal ligament.

The external anal sph incter m uscle is an elliptically-shaped group of

muscle fibers that surrounds the anus; external fibers arise on the

anococcygeal ligament and insert on the central tendinous point of the

perineum and deeper fibers form a complete sphincter. The superficial

transverse perinea( muscle also inserts on the central tendinous

point of the perineum. The ischiocavemosus muscle arises on the

ischial tuberosity and ramus and inserts on the pubic symphysis.

The ishiocavernosus compresses and stiffens the penis (in males) or

clitoris (in females). The bulbospongiosus (or bulbocavernosus) muscle

originates on the collagen sheath at the base of the penis (in males) or

the clitoris (in females); the fibers cross over the urethra (in males) or

the urethra and vagina (in females) and insert on the central tendinous

point of the perineum. The bulbospongiosus acts in males to stiffen

the penis and eject urine or semen; in females, the muscle stiffensthe clitoris and narrows the urogenital hiatus or vaginal opening.



119. Urogenital diaphragm, inferior view

a. Superficial transverse

perineal muscle

b. Deep transverse perineal

muscle

c. Sphincter urethrae muscle

d. Symphysis pubis

e. Arcuate pubic ligament

f. Transverse perineal ligament

g. Urethra

h . lschial tuberosity

i. Vagina

The urogenital diaphragm refers to the thin layer of muscle atthe outlet of the pelvis. Posterior and inferior to the symphysis

pubis, the arcuate pubic ligament is a thick, triangular ligament

connecting the two pubic bones. The transverse perineal ligament is

a region of thickened fascia between the urogenital diaphragm and

the arcuate pubic ligament. The deep transverse perineal muscle

arises on the ischial ramus, and inserts at the central tendinous

point of the perineum. The small superficial transverse perineal

muscle extends transversely between the ischial tuberosity and

the central tendinous point of the perineum. The sphincter urethrae

muscle arises from the inferior pubic ramus; fibers from both sides

meet to form a sphincter that constricts the urethra in the male

and compresses both the urethra and vagina in the female.



121. Muscles of the lower limb, posterior view

Posterior femoral muscles:

a Biceps femoris muscle

b. Semitendinosus muscle

c. Semimembranosus muscle

Superficial posterior

compartment of the leg:

d. Plantaris muscle

e Gastrocnemius muscle

Lateral femoral (glutea0 muscles:

1. Gluteal fascia over gluteus

medius muscle

g Gluteus maximus

Medial femoral muscles:

h . Adductor magnus muscle

i. Gracilis muscle

j. Calcaneal tendon

k. Iliotibial tract

The superficial gluteus maximus muscle extends and laterally rotates

the hip, while the deeper gluteus medius muscle abducts and medially

rotates the hip. Along with other muscles, the gluteus maximus inserts

on the iliotibial tract, a layer of fascia that lies posterior to the tensor

fasciae latae muscle, interconnecting the femur, patella and tibia, and

stabilizing the knee. On the medial side, the adductor magnus muscle

abducts the hip; portions of the muscle also flex and medially rotate

or extend and laterally rotate the hip. The gracilis muscle adducts and

medially rotates the hip as well as flexing the knee. Other femoral

muscles that flex the knee include the semitendinosus muscle, the

biceps lemon s muscle that also extends and laterally rotates the

hip, and the semimembranosus muscle that also flexes and medially

rotates the hip. The gastrocnemius muscle flexes the knee, plantar

flexes the ankle, and adducts the foot. The plantaris muscle inserts

on the calcaneal tendon to flex the knee and plantar flex the ankle.



122 Superficial femoral muscles, anterior view

Abdominal muscles related

to the leg:

a Psoas major muscle

b. lliacus muscle

Anterior femoral muscles:

c. Sartorius muscle

Quadriceps femoris muscle:

d. Rectus femorise. Vastus lateralis

f. Vastus medialis


g.Pectineus muscle

h. Gracilis muscle

I. Adductor longus muscle

j. Inguinal ligament

k. Tendon of rectus femoris

muscle

1 Patellam. Pubic tubercle

n. Pecten pubis

The psoas major muscle originates on the lumbar vertebrae while

the iliacus muscle arises on the broad, concave superficial surface of

the ilium; both muscles insert on the lesser trochanter of the femur

and flex the hip. The quadriceps femoris muscle is composed of

four muscles that attach at the patella and continue as the patellar

ligament to insert on the tibial tuberosity and act to extend the

knee. The rectus femoris arises on the ilium; it flexes the hip as well

as the knee. The vastus medialis, vastus lateralis and the vastus

intermedius all originate on the femur. Like the rectus femoris, the

sartorius muscle arises on the iliac spine; it inserts on the tibia

and flexes the knee as well as flexing and laterally rotating the hip.

Three medial femoral muscles adduct and rotate the hip medially.

The adductor longus muscle arises on the ramus of the pubis and

the pectineus muscle originates along the pectin pubis, a ridge

on the superior side of the ramus of the pubis bone; both insert

along the femur and also flex the hip. The gracilis arises on the

ramus of the pubis, inserts on the tibia and also flexes the knee.



123. Deep fem oral mu scles, anterior viewa Pecten pubis


b. Obturator externus muscle

c. Adductor brevis muscle

d. Adductor magnus muscle

e Gracilis muscle

Anterior femoral muscle:

f. Vastus intermedius muscle

g Adductor hiatus

h. Patella

I. Iliofemoral ligament

j. Greater trochanter of femur

The vastus intermedius muscle is deep to the rectus femoris; it

arises on the upper part of the femur, inserts on the patella along

with the other quadriceps tendons, continuing on as the patellar

ligament, and acts to flex the knee. The obturator extemus muscle

arises on the obturator foramen, inserts on the fossa medial tothe greater trochanter on the posterior side of the femur and

rotates the hip laterally. The adductor brevis and adductor magnus

muscles originate on the inferior ramus of the pubis and insert on

the femur; both adduct the hip. In addition, the adductor brevis

flexes the hip while different portions of the adductor magnus

may either flex or extend the hip. The adductor hiatus is a space

near the insertion of the adductor magnus where blood vessels

pass. The gracilis muscle also arises on the inferior ramus of

the pubis; it inserts on the medial surface of the tibia below the

medial condyle, and both flexes the knee and adducts the hip.



124. Medial femoral muscles, medial view

a Right h ip bone


b. Pectineus muscle

c. Obturator externus muscle

d. Adductor longus muscle

e. Gracilis muscle

1. Adductor magnus muscle

g Femur

h . Tibia

On the medial aspect of the thigh, the most superficial muscle is

the gracilis; it extends from the pubis part of the hip bone to the

tibia and flexes the knee as well as adducts the hip. The adductor

magnus is a large, powerful muscle that arises on the pubis and

ischium and inserts along the femur. The adductor magnus adducts

the hip; in addition, the superior portion flexes the thigh while

the inferior portion extends it. The adductor longus and pectineus

muscles extend between the pubis bone and the femur; they act to

flex and adduct the hip, and assist in medial rotation. The obturator

extemus muscle extends between the margin of the obturator

foramen and the posterior surface of the greater trochanter of the

femur; it rotates the thigh laterally as well as assists in adduction.



125. Latera l femoral muscles, lateral view

Lateral femoral (gluteal)

muscles:a. Gluteus medius muscle

b. Gluteus maximus muscle

c. Tensor fasciae latae muscle

d. Iliotibial tract

e. Femur

1. Tibia

g. Iliac crest

On the lateral aspect of the hip, the gluteus maximus muscle is the

most superficial of the gluteal muscles; it arises along the posterior

iliac crest, the sacrum and the coccyx. The fibers of the gluteusmaximus pass inferiorly and laterally to insert on the iliotibial tract—a

band of collagen tissue that passes down along the thigh to insert on

the tibia. The gluteus maximus is the major extensor of the hip joint

and also acts in lateral rotation. The deeper gluteus medius muscle

originates on the ilium, below the iliac crest, and inserts on the greater

trochanter of the femur. The gluteus medius is the major abductor of

the hip; portions of it may assist in rotating the hip either mediallyor laterally. The tensor fasciae latae muscle arises on the anterior

iliac crest and the fasciae lata, and inserts on the iliotibial tract. The

tensor fasciae latae abducts the thigh and rotates the hip medially.



126. Gluteal muscles, posterior view

a. Posterior superior iliac spine

b. Gluteus medius muscle

c. Piriformis muscle

d. Superior gemellus muscle

e. Obturator internus muscle

f. Greater trochanter of femur

g. Inferior gemellus muscle

h. Quadratus femoris muscle

i. Lesser trochanter of femur

j. Sacrotuberous ligament

k. Iliotibial tract

I Glluteus maximus muscle

m. Gluteal fascia

The superficial gluteus maximus muscle arises on the iliac crest, inserts

on the iliotibial tract, and is a major extensor of the hip. Deep to the

gluteus maximus, the gluteus minimus arises from the ilium, inserts on

the greater trochanter of the femur, and abducts the hip. The piriformis

muscle originates on the anterior part of the sacrum and inserts on

the greater trochanter of the femur; it rotates the hip laterally. The

superior gemellus muscle arises on the spine of the ischium, the

obturator internus muscle originates on the obturator foramen and

the inferior gemellus muscle arises on the ischial tuberosity. These

three muscles insert together on the greater trochanter of the femur

and rotate the hip laterally. The quadratus femoris muscle arises on

the ischium, inserts on the posterior surface of the femur between

the greater and lesser trochanters, and also rotates the hip laterally.



127. Pos terior fem ora l m us cles , po ster ior v iew

a. Femur

b. Biceps femoris muscle

c. Fibula

d. Tibia

e. Semimembranosus muscle

1 Semitendinosus muscle

g. Tuberosity of ischium

On the posterior aspect of the thigh, the long head of the biceps

femoris muscle arises on the posterior surface of the ischial tuberosity,

and the deeper short head arises midway down the femur, along the

linea aspera. The two heads unite and insert together on the apex onthe head of the fibula and on the lateral tibial condyle. It flexes the

knee as well as extending the thigh. The semimembranosus muscle

arises on the ischial tuberosity and inserts on the medial condyle of

the tibia; it extends the thigh, flexes the knee, and rotates the tibia

medially. The more superficial semitendinosus muscle originates

on the ischial tuberosity and inserts on the medial side of the tibia

shaft; it flexes and medially rotates the knee, and extends the thigh.



128. Posterior thigh and gluteal muscles, deep dissection,

posterior view

a. Gluteus minimus muscle . Tibia

b. Inferior gemellus muscle . Semimembranosus muscle

c. Quadratus femoris muscle . Adductor magnus muscle

d. Linea aspera of femur . Obturator internus muscle

e. Biceps femoris muscle, . Superior gemellus muscle

short head . Piriformis muscle

f. Fibula

The gluteus minimus lies deep to the gluteus medius; it arises on

the outer surface of the ilium, inserts on the greater trochanter ofthe femur, and abducts the hip. The piriformis, superior gemellus,

obturator internus, inferior gemellus and quadratus femoris muscles

arise along the pelvis, insert on or near the greater trochanter of the

femur, and rotate the thigh laterally. A deep view of the posterior

thigh muscles shows the short head of the biceps femoris, as it

arises along the linea aspera, a ridge of roughened surface that runs

longitudinally along the posterior surface of the femur. The short

head is joined by the long head of the biceps femoris that arises

on the ischium and both parts insert together on the fibula and the

lateral condyle of the tibia. The adductor magnus muscle arises on

the hip bone and inserts along the length of the linea aspera, and

both adducts and medially rotates the hip. The semimembranosus

muscle arises on the ischium, inserts on the medial tibial condyle, and

flexes the knee, extends the thigh, and rotates the tibia medially.



129 Thigh, transverse section

a Rectus femoris muscle . Semitendinosus muscle

b. Femur . Semimembranosus muscle

c. Vastus medialis muscle . Biceps femoris muscle, long

d. Femoral artery ead

e Fem oral vein . Biceps femoris muscle, short

f. Sartorius muscle ead

g. Gracilis muscle .Vastus lateralis muscle

h. Adductor magnus muscle . Vastus intermedius muscle

A transverse section of the thigh, shown a short distance above

the knee, illustrates the relative positions of the femoral muscles.

Anterior to the femur lies the vastus medialis, vastus intermedius,

and vastus lateralis muscles. Most superficial on the anterior aspect

is the rectus femoris. These anterior muscles all insert on the patellaand act to extend the knee. On the posterior-lateral side of the femur

are the short head and long head of the biceps femoris. Between

the biceps femoris and the large adductor magnus muscles are

the superficial semitendinosus and the deeper semimembranosus

muscles; they flex the knee. On the medial aspect are the gracilis and

sartorius muscles; they, too, flex the knee. Because of the unique

combination of origin and insertion for each, some of these muscles

also rotate the hip either medially or laterally, or adduct the hip. The

femoral artery and vein both lie deep within the thigh muscles.



130 Muscles of the anterior

anterior view

a. Lateral condyle of tibia

b. Head of fibula

c. Tibialis anterior muscle

d. Extensor digitorum longus

muscle

e. Extensor hallucis longus

muscle

1 Lateral malleolus

g. Tendon of fibularis

(peroneus) brevis muscle

compartment of the leg,

h. Tendons of extensor

digitorum longus muscle

i. Inferior extensor retinaculum

j. Medial malleolus

k. Tendon of tibialis anterior

muscle

1 Tendon of extensor hallucis

longus muscle

m. Distal phalanx

In anatomical terms, the lower limb is divided into two regions—the

thigh above the knee and the leg below the knee. The anterior

compartment of the leg has several muscles involved in dorsiflexion,

or movement of the foot to decrease the angle between the foot and

leg. The tibialis anterior muscle arises on the lateral condyle of the

tibia, and its tendon inserts on the medial cuneiform tarsal and first

metatarsal bones. The extensor digitorum longus muscle originates

on the lateral condyle of the tibia and the anterior surface of the fibula;

its tendons insert on the superior surface of the phalanges of toes2-5 and it extends the toes in addition to dorsiflexion of the foot. The

extensor hallucis longus muscle originates on the fibula and its tendon

inserts on the distal phalanx of the great toe; it extends the great toe

in addition to dorsiflexion of the foot. The inferior extensor retinaculum

is a band of collagen fibers that extends from the calcaneus laterally to

the medial malleolus of the tibia; it stabilizes the synovial sheaths for

the tendons of the fibularis brevis, tibialis anterior, extensor digitorum

longus, and extensor hallucis longus as they cross the ankle joint.



131. Muscles of the lateral

lateral view

a. Fibularis (peroneus) longus

muscle

b. Fibularis (peroneus) brevis

musclec. Lateral malleolus

d. Tendon of peroneus brevis

muscle

compartment of the leg,

e. Fifth metatarsal bone

1 Tendon of peroneus longus

muscle

g. Head of fibula

he fibularis longus (also known as the peroneus longus) muscle

arises at the head of the fibula; the muscle parallels the bone and

its tendon passes posterior to the lateral malleolus of the fibula and

under the sole of the foot before inserting at the base of the first

metatarsal bone. The fibularis longus acts in plantarflexion of the

foot (increases the angle between the foot and leg) and also everts

the foot (moves the sole away from the median plane). Because

it passes under the longitudinal arch of the foot, it also serves to

support the arch. The fibularis brevis (or peroneus brevis) muscle

lies deep to the fibularis longus; it originates along the middle part

of the fibula and its tendon runs posterior to the lateral malleolus

and inserts at the base of the fifth metatarsal bone. The fibularis

brevis is also involved in plantar flexion and eversion of the foot.



132. Deep muscles of the leg, anterior view

a. Tibia

b. Interosseous membrane

c. Inferior extensor retinaculum

d. Medial malleolus

e. Tendon of extensor hallucis

longus muscle

f. Tendon of fibularis

(peroneus) brevis muscle

g. Lateral malleolus

h. Extensor hallucis longus

muscle

i. Fibularis (peroneus) brevis

muscle

j. Fibula

The interosseous membrane consists of connective tissue fibers that

attach to both the tibia and fibula, stabilizing their positions relative

to each other, dividing the anterior from the posterior compartment

of the leg, and providing attachment sites for muscles. The extensor

hallucis longus muscle arises from the middle half of both the fibula

and interosseous membrane; its tendon passes through a channel

formed by fibers of the inferior extensor retinaculum passing on

either side, then inserts at the base and dorsal surface of the distal

phalanx of the great toe. It acts both to dorsiflex the ankle and to

extend the great toe. The fibularis brevis muscle arises along the

midsection of the fibula and its tendon inserts on the fifth metatarsal

bone. The fibularis brevis plantar flexes the ankle and everts the foot.



133. Muscles of the superficial posterior compartment

of the leg, posterior view

a. Plantaris muscle

b. Gastrocnemius muscle

c. Aponeurosis of

gastrocnemius muscle

d. Lateral malleolus

e. Calcaneal Achilles) tendon

1 Calcaneus

g. Medial malleolus

h. Soleus muscle

i. Femur

The gastrocnemius muscle has two heads; one arises on the

lateral condyle of the femur, the other on the femur above the

medial condyle. The deeper soleus muscle originates on the

head of the fibula and adjacent areas on the shafts of both the

tibia and fibula. The tendon of the gastrocnemius joins with the

tendon of the soleus to form the calcaneal tendon that inserts on

the large tarsus known as the calcaneus. The calcaneal tendonis commonly known as the Achilles tendon. Both muscles act

in plantar flexion of the ankle, and in adduction and inversion

of the foot. In addition, the gastrocnemius flexes the knee. The

plantaris muscle arises from the lateral supracondylar ridge

of the femur; its long tendon inserts on the calcaneal tendon,

and it weakly flexes the knee and plantar flexes the ankle.



134. Muscles of the deep

posterior view

a. Femur

b. Fibula

c. Flexor hallucis longus

d. Calcaneus

e. Tendon of flexor digitorum

longus muscle

f. Tendon of tibialis posterior

muscle

posterior compartment of the leg,

g. Medial malleolus

h. Flexor digitorum longus

muscle

i. Tibialis posterior muscle

j. Popliteus muscle

k. Tibia

Deep to the gracilis and soleus muscles, the flexor digitorum longus

muscle arises on the tibia, and its tendon passes behind the medial

malleolus and under the sole before it divides into four tendons

that insert on the inferior surfaces of the distal phalanges of toes

2-5. It flexes the joints of those toes. The flexor hallucis longus

arises on the fibula and the interosseous membrane; its tendon

passes behind the talus, under the sole of the foot, and inserts on

the distal phalanx of the great toe. It flexes the joints of the great

toe. The tibialis posterior arises on the interosseous membrane and

adjacent areas of the tibia and fibula; its tendon splits into slips

that insert on the navicular and second cuneiform tarsals as well

as the plantar surfaces of metatarsals 2-4. The tibialis posterioracts to adduct and invert the foot as well as to plantar flex the

ankle. The popliteus muscle originates on the lateral condyle of the

femur, inserts on the posterior surface of the shaft of the tibia, and

medially rotates the tibia at the knee (or laterally rotates the femur).



135. M usc les o f the do rsal foo t

a. Middle phalanx

b. Distal phalanx

c. Extensor expansion

d. Tendons of extensor

digitorum longus muscle

e. Extensor digitorum brevis

muscle

1 Calcaneus

g. Extensor hallucis brevis

muscle

h. Tendon of extensor hallucis

longus muscle

i. Dorsal interosseous muscles

The tendons of the extensor digitorum longus muscle are joinedby other extensor tendons to form the extensor expansions that

insert on the superior surfaces of the phalanges of toes 2-5

and extend the toes at the interphalangeal joints. The extensor

digitorum brevis muscles arise on the calcaneus and insert on the

dorsal surfaces of the toes to extend the metatarsophalangeal

joints of toes 2-4. The dorsal interosseous muscles arise along

the sides of the metatarsal bones, insert on the sides of toes 2-4

and abduct toes 3 and 4 at the metatarsophalangeal joints. The

tendon of the extensor hallucis longus muscle inserts on the

dorsal surface of the phalanges of the great toe to extend the

digit. The extensor hallucis brevis muscle arises on the calcaneus

bone, inserts on the proximal phalanx of the great toe, and

extends the toe.



136. Plantar muscles of the foot, first and second layers

a. Middle phalanx

b. Flexor digitorum brevis

muscle

c. Tendon of flexor hallucis

longus muscle

d. Lumbrical muscles

e. Tendon of flexor digitorum

longus muscle

1 Abductor hallucis muscle

g. Calcaneus

h. Quadratus plantae (flexor

accessorius) muscle

i. Abductor digiti minimi muscle

j. Proximal phalanx

k. Distal phalanx

The most superficial of the plantar muscles is the flexor digitorum

brevis muscle; it arises on the calcaneus, inserts on the sides of the

middle phalanges of toes 2-5 and flexes the toes at the proximal

interphalangeal joints. Deep to the flexor digitorum brevis, one can

see the tendons of the flexor digitorum longus muscle which insert

on the inferior surface of the distal phalanges to flex toes 2-5 at

the interphalangeal joints. The lumbrical muscles arise from the

tendons of the flexor digitorum longus and insert on the extensor

expansions of toes 2-5 to extend the interphalangeal joints but flex the

metatarsophalangeal joints. With an action similar to the lumbricals,

the quadratus plantae arises on the calcaneus and inserts on the

tendons of the extensor digitorum longus. On the lateral side of the

foot, the abductor digiti minimi muscle originates on the calcaneus,

inserts on the lateral side of the proximal phalanx of toe 5, and abducts

the toe. On the medial side, the tendon of the flexor hallucis longus

muscle inserts on the inferior surface of the distal phalanx of the

great toe, and flexes the joints of the great toe. The abductor hallucis

muscle originates on the calcaneus, inserts on the medial side of

the proximal phalanx of the great toe, and abducts the great toe.



S K E L E T A L S Y S T E M ( c o n td )

29 Lumbar vertebra, superior and lateral views

30 Sacrum and coccyx, anterior view

31 Sacrum and coccyx, posterior view

32 Intervertebral discs, lateral and midsagittal views

33 Sternum, anterior view

34 Rib and vertebra, articulated, superior view; rib, posterior view

35 Rib cage, anterior view

36 Pectoral girdle and upper limb, anterior view

37 Scapula, anterior and lateral views

38 Scapula, posterior view39 Clavicle and related bones, superior view; clavicle, inferior view

40 Humerus, anterior and posterior views

41 Ulna and radius, lateral and anterior views

42 Hand, posterior (dorsal) view

43 Hand, anterior (palmar) view

44 Hip bone, lateral view

45 Pelvis, anterior view46 Differences between male and female pelvis

47 Lower limb, anterior view

48 Femur and patella, anterior and posterior views

49 Tibia and fibula, anterior and posterior views

50 Bones of the foot, dorsal view

51 Bones of the foot, lateral view


52 Gomphosis (peg suture)

53 Suture

54 Syndesmosis, posterior view

55 Synchondrosis

56 Symphysis

57 Synovial joint, diagrammatic sagittal section

58 Tendon sheath

59 Bursa



A R T I C U L A T I O N S (c o n t d )

60 Gliding joint

61 Hinge joint

62 Rotating joint63 Ball and socket joint

64 Condyloid joint

65 Saddle joint

66 Temporomandibular joint, sagittal section

67 Shoulder joint, frontal section

68 Shoulder ligaments, anterior view

69 Elbow joint, sagittal section70 Elbow ligaments, anterior view

71 Hip joint, frontal section

72 Pelvic ligaments, posterior view

73 Knee joint, anterior view

74 Bent knee joint, anterior view with patella removed

75 Knee joint, sagittal section

76 Ankle joint, posterior view77 Ankle joint, frontal section

78 Superficial muscles of the body, anterior view

79 Superficial muscles of the body, posterior view

80 Muscle forms: fusiform and flat sheet

81 Muscle forms: pennate, circular, and multicaudal

82 Muscle forms: cylindrical, triangular, quadrilateral, biventral,

multiventral

83 Muscles of facial expression, anterior view

84 Muscles of facial expression, lateral view

85 Superficial muscles of mastication, lateral view

86 Deep muscles of mastication, lateral view

87 Muscles of the neck, anterior view

88 Suprahyoid and infrahyoid muscles of the neck, anterior view

89 Prevertebral region and root of the neck, anterior view

KAPLAN) MEDICAL



90 Muscles of the neck, lateral view

91 Neck, transverse section

92 Ocular muscles, lateral view and superior view

93 Intrinsic muscles of the tongue, sagittal section

94 Extrinsic muscles of the tongue, pharynx and larynx, lateral view

95 Pharynx, posterior view

96 Superficial shoulder muscles, anterior view

97 Muscles of the shoulder, scapula and arm, anterior view

98 Deep muscles of the shoulder and arm, anterior view

99 Muscles with scapular attachments, posterior view

100 Superficial and intermediate muscles of the back, posterior view

101 Deep muscles of the back, posterior view

102 Anterior brachial muscles (flexors), lateral view

103 Posterior brachial muscles (extensors), lateral view

104 Superficial flexor muscles of the forearm, anterior view105 Superficial extensor muscles of the forearm, lateral view

(hand pronated)

106 Deep flexor muscles of the forearm, anterior view

107 Deep extensor muscles of the forearm, posterior view

108 Transverse sections of the arm

109 Muscles of the hand, posterior (dorsal) view

110 Muscles of the hand, anterior (palmar) view111 Intercostal muscles, anterior view

112 Diaphragm, anterior view

113 Diaphragm, inferior view

114 Superficial abdominal muscles, anterior view

115 Deep abdominal muscles, anterior view

116 Posterior abdominal wall muscles, anterior view

117 Pelvic diaphragm, superior view118 Perineal muscles, inferior view

119 Urogenital diaphragm, inferior view

120 Lower limb muscles, anterior view

121 Muscles of the lower limb, posterior view



122 Superficial femoral muscles, anterior view

123 Deep femoral muscles, anterior view

124 Medial femoral muscles, medial view

125 Lateral femoral muscles, lateral view

126 Gluteal muscles, posterior view

127 Posterior femoral muscles, posterior view

128 Posterior thigh and gluteal muscles, deep dissection, posterior view

129 Thigh, transverse section

130 Muscles of the anterior compartment of the leg, anterior view

131 Muscles of the lateral compartment of the leg, lateral view

132 Deep muscles of the leg, anterior view

133 Muscles of the superficial posterior compartment of the leg,

posterior view

134 Muscles of the deep posterior compartment of the leg,

posterior view

135 Muscles of the dorsal foot

136 Plantar muscles of the foot, first and second layers

137 Plantar muscles of the foot, third layer

N E R V O U S S Y S T E M

138 Nervous system, anterior view

139 Neuron

140 Synapse, cutaway view

141 Central nervous system, sagittal section

142 Brain, lateral view

143 Brain, superior view

144 Brain, inferior view

145 Brain, midsagittal section

146 Brain, frontal section

147 Brain, transverse section

148 Brainstem, posterior view

149 Brainstem, lateral view

150 Limbic system

I(APLA N MEDICAL



NERVO US SY STEM (cont d)

151. Functional areas of the cerebrum

152. Ventricles of the brain

153. Cerebrospinal fluid pathway

154. Meninges of the brain, frontal section

155. Facial nerve and cutaneous branches of the cervical plexus

156. Spinal cord and spinal nerves

157. Branching of a typical spinal nerve, transverse section

158. Spinal membranes and nerve roots

159. Spinal cord, transverse sections

160. Cranial nerves, inferior view

161. Emerging spinal nerves, lateral view

162. Plexuses and thoracic nerves, posterior view

163. Cervical plexus, posterior view

164. Brachial plexus, anterior view

165. Lumbar plexus, anterior view

166. Sacral plexus, posterior view

167. Abdominal sympathetic nerves, anterior view

168. Nerves of the upper limb, anterior view

169. Nerves of the lower limb, posterior view

170. Nerves of the wrist and hand, anterior (palmar) and transverse views

171. Dermatomes, anterior and posterior views

172. Autonomic nervous system, sympathetic division

173. Autonomic nervous system, parasympathetic division

S E N S O R Y S Y S T E M S

174. Skin receptors (touch), microscopic view

175.Tongue (taste), superior view

176. Papillae and taste buds of the tongue

177. Nose (smell), midsagittal view

178. Olfactory epithelium

179. Eye and lacrimal apparatus (vision), anterior view

180. Eye (vision), sagittal view

181. Optic retina, ophthalmoscopic and microscopic views



S S O R Y S Y S T E M S f ro n t

182 Auditory system (hearing), anterior view

183 Middle ear, anterior view

184 Inner ear, anterior view

185 Membranous labyrinth of the inner ear, anterior view

186 Cochlea and Organ of Corti, microscopic view

E N D O C R I N E S Y S T E M

187. Male endocrine system, anterior view

188. Female endocrine system, anterior view

189. Pituitary gland (hypophysis) and pineal body, sagittal section190. Pituitary gland (hypophysis) hormones and target organs, male

191. Pituitary gland (hypophysis) hormones and target organs, female

192. Thyroid gland, anterior view

193. Parathyroid glands, posterior view

194. Pancreas, anterior view

195. Adrenal gland, anterior and sagittal section views

196. Testis, anterior view

197. Ovary, posterior view and transverse section

198. Placenta, fetal aspect, with diagrammatic transverse section

199. Cardiovascular overview, anterior view

200. Circulation (diagrammatic)

201. Blood cells, microscopic view

202. Anatomical relationships of the heart

203. Heart, anterior view

204 Heart, posterior view

205 Heart, frontal (coronal) section

206 Valves of the heart in ventricular systole, superior view

207 Valves of the heart in ventricular diastole, superior view

208 Conduction system of the heart, frontal (coronal) view

209 Artery and vein structure

KAPLAN) MEDICAL



MIIIIIIIMIIIIIMIMIIIIMIIIIM210 Arterial system, anterior view

211 Carotid and vertebral arteries, lateral view

212 Branches of the aortic arch, anterior view

213 Brain arteries

214 Middle cerebral artery, lateral view

215 Cerebral arteries, sagittal view

216 Ophthalmic artery, superior view

217 Upper limb arteries, anterior view218 Lower limb arteries, anterior view

219 Abdominal and thoracic branches of the aorta, anterior view

220 Middle thorax, transverse section viewed from below

221 Digestive system arteries, anterior view

222 Pelvic arteries, male, medial view

223 Pelvic arteries, female, medial view

224Venous system, anterior view

225 Veins of the head and neck, lateral view

226 Upper limb veins, anterior view

227 Lower limb veins, anterior and posterior view

228 Azygos veins, anterior view

229 Portal system of veins, anterior view

230 Abdominal and thoracic veins of the dorsal wall, anterior view

231 Fetal circulation

L Y M P H A T I C S Y S T E M

232 Overview, anterior view

233 Lymphatic drainage areas, anterior view

234 Lymphatic capillaries, microscopic view

235 Lymphatic drainage at the root of the neck, anterior view

236 Tonsils, sagittal view237 Waldeyer s ring, anterior view

238 Spleen, anterior view

239 Lymph node, microscopic view of transverse section

240 Intestinal lacteals, anterior and microscopic views



1

R E S P I R A T O R Y S Y S T E M

241. Respiratory overview, anterior view

242. Larynx, trachea and bronchi, anterior view

243 Nasal septum, medial view

244. Nasal cartilages, lateral view

245. Lateral wall of nasal cavity, medial view

246. Nasal conchae, larynx, and sinuses, coronal section

247. Larynx, anterior view

248. Larynx, sagittal section

249 Larynx, posterior view

250 Glottis, superior view

251. Trachea and bronchial tree, anterior and transverse section views

252. Lung lobes and pleura, anterior view

253. Lung hila, medial view

254. Air pathway and alveolus

255. Thorax, transverse section viewed from below

D I G E S T IV E S Y S T E M

256. Overview, anterior view

257. Overview, lateral view

258. Mouth and oral cavity, anterior view

259. Oral cavity, sagittal section

260. Oral salivary glands, anterior view

261. Salivary glands, lateral view

262 Tooth, sagittal section view

263. Upper teeth, inferior view

264. Esophagus, anterior view

265. Greater omentum, anterior view

266. Stomach, anterior view

267. Stomach, anterior cutaway view

268. Small intestine, anterior view

269. Large intestine, anterior view

270. Liver, anterior view

271. Liver, posterior view

KAPLAN) MEDICAL....



Illustrator: tephanie McCann, MA, is an independent medical

and scientific illustrator. She received her MA in

Medical and Biological Illustration from The Johns

Hopkins University, and BA in Fine Arts at the

University of California, Santa Cruz. She is currently

an instructor at Santa Barbara City College, teaching

Biological Illustration (Biology Department) and

Adobe Illustrator (Multimedia Arts and Technology

Department). Stephanie s studio is located in Santa

Barbara, California.

Text oanne Kivela Tillotson, PhD, has been teachingundergraduate biology laboratories for over 14 years,

the last io of which have been at Purchase College,

State University of New York, where she has received

the Pedagogy Award for innovative use of technology

in the teaching laboratory, and the SUNY Chancellor s

Award for Excellence in Teaching. Dr. Tillotson received

her BS degree in Biology from the University ofDubuque and PhD in Biochemistry from Michigan State

University.

Chief Medical Sonia E. Reichert, MD, previously served as Director

Consultant: f Curriculum for Kaplan Medical and is currently

an Internal Medicine Resident at SUNY Downstate

at Brooklyn. Dr. Reichert is a regular participant of

National Board conferences and has many yearsof experience in the creation and development of

Kaplan Medical s online, print, DVD, and other media

related educational tools in the medical and allied

health fields. She is the leading national expert in the

content, scoring, and structure of medical licensing

and allied health exams.

Medical ailesh Harwani, MD, PhD

Proofreader:

KAPLAN MEDICAL



B O D Y O R G A N I Z A T I O N

1 Anatomical position and terms of direction

2 Anatomical planes of the body

3 Anterior regions of the body4 Posterior regions of the body

5 Body cavities

6 Skeletal and visceral structures of the head and neck

7 Thoracic, abdominal and pelvic viscera, anterior view

8 Thoracic, abdominal and pelvic viscera, posterior view

9 Thoracic, abdominal and pelvic viscera, right lateral view

10 Thoracic, abdominal and pelvic viscera, left lateral view

I N T E G U M E N T A R Y S Y S T E M

11 Layers of the skin and associated structures

12 Epidermis

13 Hair

14 Fingernail

S KEL ETAL S YS TEM

15 Skeleton, anterior view

16 Skeleton, posterior view

17 Anterior view of the skull

18 Skull, lateral view

19 Skull, superior view

20 External surface of the base of the skull

21 Median sagittal section of the skull

22 Right temporal and sphenoid bones

23 Hyoid bone

24 Vertebral column, lateral view

25 Posterior view of the vertebrae

26 Atlas (Ci) and axis (C2), superior view

27 Cervical vertebra, superior and lateral views

28 Thoracic vertebra, superior and lateral views

KAPLA MEDICAL



n c l u d e s

1

INT E RACT IV EC O L O R I N G

CAR D S

a

KAPLAI• MEDICAL

Anatomy Flashcards

MiC L E A R L Y L A B E L E D A N D D E T A IL E D

FU LL-CO LO R CARDS

I L L U S T R A T I O N S : S T E PH A N I E M c C A N N , M A • T E X T : J O A N N E K I VE L A T I L L O T S O N , P hD

C H I E F M E D I C A L C O N S U L T A N T : DR . S O N I A R E I C H E R T , M D



Kaplan's A natomy Flashcards is designed to help students of human

anatomy learn and memorize the many structures and systems within

the human body. Learning human anatomy is a challenge that is best

met through a three-part process:

• having clear visualizations of the body s anatomical structures

• gaining a thorough understanding of the relationships

between anatomical structures and their functions

• working consistently to review the anatomy in order to

internalize anatomical information for future recall

The front of each card contains a vivid and precise full-color illustration.Clear lines and labels on each image indicate the structures to be

learned, with the identification key listed on the reverse side. In

addition, each card contains a descriptive text, which enhances

understanding of the functions and relationships of each structure.

The set is organized and color-coded according to 15 anatomical

systems for ease-of-use, and can easily be carried around for learning

and review on the go.

As a bonus, this set includes io coloring cards from Kaplan s top-

selling Anatom y Coloring Boo k. Students can color each image and test

their knowledge of various anatomical structures for the ultimate in

academic retention and recall.

Kaplan s Anatomy Flashcards is the ideal human anatomy study

resource for medical and nursing students, healthcare practitioners,and anyone interested in improving their knowledge of human

anatomy.

KAPLAN)MEDICAL,....



Illustrator: tephanie McCann, MA, is an independent medical

and scientific illustrator. She received her MA in

Medical and Biological Illustration from The Johns

Hopkins University, and BA in Fine Arts at the

University of California, Santa Cruz. She is currently

an instructor at Santa Barbara City College, teaching

Biological Illustration (Biology Department) and

Adobe Illustrator (Multimedia Arts and Technology

Department). Stephanie s studio is located in Santa

Barbara, California.

Text: oanne Kivela Tillotson, PhD, has been teachingundergraduate biology laboratories for over 14 years,

the last io of which have been at Purchase College,

State University of New York, where she has received

the Pedagogy Award for innovative use of technology

in the teaching laboratory, and the SUNY Chancellor s

Award for Excellence in Teaching. Dr. Tillotson received

her BS degree in Biology from the University ofDubuque and PhD in Biochemistry from Michigan State

University.

Chief Medical Sonia E. Reichert, MD, previously served as Director

Consultant: f Curriculum for Kaplan Medical and is currently

an Internal Medicine Resident at SUNY Downstate

at Brooklyn. Dr. Reichert is a regular participant of

National Board conferences and has many years

of experience in the creation and development of

Kaplan Medical s online, print, DVD, and other media

related educational tools in the medical and allied

health fields. She is the leading national expert in the

content, scoring, and structure of medical licensing

and allied health exams.

Medical ailesh Harwani, MD, PhD

Proofreader:

KAPLAN) MEDICAL



O ther Books by Kaplan M edica lAnatomy Coloring Bo ok

med Essentials: High-Yield U SM LETM Step i Review

USM LETM Step i Qb ook, Fourth Edition

USM LETM S tep 2 CK Qb ook, Fourth Edition

USM LETM Step 3 Qbook, Fourth EditionUSMLETM Medical Ethics:

The loo Cases You Are Most Likely to See on the Exam

USMLETM Step CS: Complex Cases

USMLETM Flashcards:

The 2 Diagnostic Tests You Need to Know for the Exam

USM LETM Physical Findings Flashcards:The 2 Questions You Are Most Likely to See on the Exam

USM LETM Pharmacology Treatment Flashcards:

The 2 Questions You Are Most Likely to See on the Exam



•

1 Anatomical position and terms of direction

2 Anatomical planes of the body

3 Anterior regions of the body

4 Posterior regions of the body

5 Body cavities

6 Skeletal and visceral structures of the head and neck

7 Thoracic, abdominal and pelvic viscera, anterior view

8 Thoracic, abdominal and pelvic viscera, posterior view

9 Thoracic, abdominal and pelvic viscera, right lateral view

10 Thoracic, abdominal and pelvic viscera, left lateral view

I N T E G U M E N T A R Y S Y S T E M

11 Layers of the skin and associated structures

12 Epidermis

13 Hair

14 Fingernail

S K E L E T A L S Y S T E M

15 Skeleton, anterior view

16 Skeleton, posterior view

17 Anterior view of the skull

18 Skull, lateral view

19 Skull, superior view

20 External surface of the base of the skull

21 Median sagittal section of the skull

22 Right temporal and sphenoid bones

23 Hyoid bone

24 Vertebral column, lateral view

25 Posterior view of the vertebrae

26 Atlas (Ci) and axis (C2), superior view

27 Cervical vertebra, superior and lateral views

28 Thoracic vertebra, superior and lateral views

KAPLA_t0 MEDICAL



S K E L E T A L S Y S T E M c o a t i )

29 Lumbar vertebra, superior and lateral views

30 Sacrum and coccyx, anterior view

31 Sacrum and coccyx, posterior view

32 Intervertebral discs, lateral and midsagittal views

33 Sternum, anterior view

34 Rib and vertebra, articulated, superior view; rib, posterior view

35 Rib cage, anterior view

36 Pectoral girdle and upper limb, anterior view

37 Scapula, anterior and lateral views

38 Scapula, posterior view

39 Clavicle and related bones, superior view; clavicle, inferior view

40 Humerus, anterior and posterior views

41 Ulna and radius, lateral and anterior views

42 Hand, posterior (dorsal) view

43 Hand, anterior (palmar) view

44 Hip bone, lateral view

45 Pelvis, anterior view

46 Differences between male and female pelvis

47 Lower limb, anterior view

48 Femur and patella, anterior and posterior views

49 Tibia and fibula, anterior and posterior views

50 Bones of the foot, dorsal view

51 Bones of the foot, lateral view


52 Gomphosis (peg suture)

53 Suture

54 Syndesmosis, posterior view

55 Synchondrosis

56 Symphysis

57 Synovial joint, diagrammatic sagittal section

58 Tendon sheath

59 Bursa



D I G E S T I V E S Y S T E M ( c o n t d )

272 Gall bladder, pancreas and duodenum, anterior view

273 Gall bladder, pancreas and duodenum, anterior cutaway view

274 Rectum, coronal section view

275 Abdomen, transverse section at T12, seen from below

276 Abdomen, transverse section at Li, seen from below

U R I N A R Y S Y S T E M

277 Overview, female urinary system, anterior view278 Anatomical relationships of the urinary system, anterior view

279 Overview, male urinary system, anterior view

280 Overview, male urinary system, viewed from the left

281 Kidney, anterior view

282 Kidney, frontal section view

283 Kidney and renal artery, frontal section view

284 Female urinary bladder, frontal section view285 Nephron of the kidney, microscopic view

R E P R O D U C T IV E S Y S T E M

286 Overview male reproductive system, anterior view

287 Male pelvis, anterolateral view

288 Male reproductive system, sagittal section view

289 Testes, anterior view

290 Seminal vesicles, prostate gland and seminiferous tubules,

posterior view

291 Penis, ventral and cross section views

292 Spermatogenesis, microscopic view

293 Overview female reproductive system, anterior view

294 Female pelvis, anterior view

295 Female reproductive system, sagittal section view

296 Ovary, frontal section view

297 Female reproductive system, menstrual cycle

298 Uterus, ovaries and vagina, frontal section, posterior view



R E P R O D U C T I V E S Y S T E M ( c o n t d )

299 Mammary gland and lymphatic drainage, anterior view

300Female external genitalia, inferior view

C O L O R I N G C A R D S

301. Regions of the abdomen, anterior view

302 Skeletal system, anterior view

303 Nervous system, posterier view

304 Lymphatic system

305 Muscular system

306 Digestive system

307 Cardiovascular system: arteries

308 Skeletal system: hand, posterior (dorsal) view

309 Nervous system: brain, midsagittal section

310 Respiratory system

l 1_)AtiMEDICAL



This publication is designed to provide accurate and authoritative

information in regard to the subject matter covered. It is sold with the

understanding that the publisher is not engaged in rendering legal,

accounting, or other professional service. If legal advice or other expert

assistance is required, the services of a competent professional should

be sought.

© 2009 Kaplan, Inc.

Published by Kaplan Publishing, a division of Kaplan, Inc.1 L iberty Plaza, 24th F loor

New York, NY l0006

All rights reserved. The text of this publication, or any part thereof,

may not be reproduced in any manner whatsoever without written

permission from the publisher.

Printed in China

January 2009

1 9 8 7 6 5

ISBN-13: 978-1-4277-9694-3

Kaplan Publishing books are available at special quantity discounts

to use for sales promotions, employee premiums, or educational

purposes. Please email our Special Sales Department to order or for

more information at [email protected] , or write to K aplan

Publishing, i L iberty Plaza, 24th F loor, New York, NY 101306.



Illustrator: tephanie M cCann, M A , is an indep enden t medical

and scientif ic i l lustrator. She received her M A in

M edical and Biological Illustration from Th e John s

H opkins University, and BA in F ine Arts at theUn iversity of C alifornia, Santa Cruz. She is currently

an instructo r at Santa Barbara City Co llege, teaching

Biological Illustration (Biology Departmen t) and

Ad obe Il lustrator (M ultimed ia Arts and Techno logy

D epartm ent). Step hanie's stud io is located in Santa

Barbara, Californ ia.

Text: oann e K ivela Tillotson, PhD , has been teaching

und ergraduate biology laboratories for over 14 years,

the last io of w hich h ave been at Pu rchase Co llege,

State University of New York, where she h as received

the Ped agogy A ward for innovative use of technology

in the teaching laboratory, and t he SU NY C hancellor's

A ward for E xcellence in Teaching. D r. Tillotson receivedher BS degree in Biology from the Un iversity of

Du buque and PhD in Biochemistry from M ichigan State

University.

Ch ief M edical Son ia E. R eichert, M D , previously served as Director

Consultant: f Curriculum for K aplan M edical and is currently

an Internal M edicine R esident at SUNY D ownstateat Broo klyn. Dr . Reichert is a regular participant o f

National Board con ference s and has many years

of experience in the creation and d evelopm ent of

K aplan M edical's online, print, DVD , and other m edia

related ed ucation al tools in th e me dical and all ied

health fields. Sh e is the leading n ational expert in th e

conten t, scoring, and structure of m edical licensingand allied health ex ams.

Medical ailesh H arwani, M D, PhD

Proofreader:



Kaplan's Anatom y f lashcards is designed to help students of human

anatomy learn and memorize the many structures and systems within

the human body. Learning human anatomy is a challenge that is best

met through a three-part process:

• having clear visualizations of the body's anatomical structures

• gaining a thorough understanding of the relationships

between anatomical structures and their functions

• working consistently to review the anatomy in order to

internalize anatomical information for future recall

The front of each card contains a vivid and precise full-color illustration.Clear lines and labels on each image indicate the structures to be

learned, with the identification key listed on the reverse side. In

addition, each card contains a descriptive text, which enhances

understanding of the functions and relationships of each structure.

The set is organized and color-coded according to 15 anatomical

systems for ease-of-use, and can easily be carried around for learning

and review on the go.

As a bonus, this set includes io coloring cards from Kaplan's top-

selling Anatom y Coloring Boo k. Students can color each image and test

their knowledge of various anatomical structures for the ultimate in

academic retention and recall.

Kaplan's Anatomy Flashcards is the ideal human anatomy study

resource for medical and nursing students, healthcare practitioners,

and anyone interested in improving their knowledge of human

anatomy.

CAPLAN) MEDICAL



B O D Y O R G N I Z T I O N

1. An atomical posit ion and term s of direction

2. A natomical planes of the body

3. An terior regions of the bod y4. Posterior regions of the body

5. Bod y cavities

6. Skeletal and visceral structures of the head and neck

7. Th oracic, abdom inal and p elvic viscera, anterior v iew

8. Th oracic, abdom inal and p elvic viscera, posterior view

9. Thoracic, abdom inal and p elvic viscera, right lateral view

10. Tho racic, abdom inal and pelvic viscera, left lateral view

I N T E G U M E N T R Y S Y S T E M

11. L ayers of the skin and associated structures

12. Epidermis

13. Hair

14. Fingernail

S K E L E T L S Y S T E M

15. Skeleton , anterior view

16. Skeleton , posterior view

17. An terior view o f the skull

18. Sku ll, lateral view

19. Skull, superior v iew20. E xternal surface of the base of the skull

21. M edian sagittal sect ion o f the skull

22. R ight tempo ral and sphenoid bones

23. H yoid bone

24. Ve rtebral column , lateral view

25. Posterior view of the vertebrae

26. At las (Ci) and axis (C2), super ior view27. Ce rvical vertebra, super ior and lateral views

28. Thoracic vertebra, superior and lateral views

CAPLAN)MEDICAL



r K E L E T A L S Y S T E M ( c o n t d )

29. Lumbar vertebra, superior and lateral views

30. Sacrum and coccyx, anterior view

31. Sacrum and coccyx, posterior view32. Intervertebral discs, lateral and midsagittal views

33. Sternum, anterior view

34. Rib and vertebra, articulated, superior view; rib, posterior view

35. Rib cage, anterior view

36. Pectoral girdle and upper limb, anterior view

37. Scapula, anterior and lateral views

38. Scapula, posterior view

39. Clavicle and related bones, superior view; clavicle, inferior view

40. Humerus, anterior and posterior views

41. Ulna and radius, lateral and anterior views

42. Hand, posterior (dorsal) view

43. Hand, anterior (palmar) view

44. Hip b one, lateral view

45. Pelvis, anterior view

46. Differences between male and female pelvis

47. Lower limb, anterior view

48. Femur and patella, anterior and posterior views

49. Tibia and Fibula, anterior and posterior views

50. Bones of the foot, dorsal view

51. Bones of the foot, lateral view


52. Gomphosis (peg suture)

53. Suture

54. Syndesmosis, posterior view

55. Synchondrosis

56. Symphysis

57. Synovial joint, diagrammatic sagittal section

58. Tendon sheath59. Bursa



52. Go m phosis peg suture)

a Tooth

b Alveolar socket

c Enamel

d Dentin

e Pulp

f Gingiva

g Alveolar ridge

h Periodontal ligaments

A gomphosis is a fibrous synarthrotic immovable) joint holding a tooth

in its alveolar socket in the maxilla or mandible. The bulk of the tooth is

composed of dentin, a mineralized matrix secreted by cells found in the

pulp cavity. The exposed portion of the tooth is covered by a crystalline

calcium phosphate layer called enamel—the hardest substance in thehuman body. The root of the tooth is bound in place by the periodontal

l igament; it is composed of collagen fibers extending from the dentin

of the tooth to the bone surrounding the root of the tooth. A bony

alveolar ridge forms the deep socket or alveolus where the peg-like

root of the tooth is inserted. Superficial to the bone is the gingiva,

mucosal tissue tightly bound to the bone surrounding the teeth; it

provides a smooth surface to reduce friction with food.

113264016 Anatomia Omului

Documents

Transcript of 113264016 Anatomia Omului